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Mount Sinai Awarded $42 Million to Prepare for Future Pandemics and Advance Influenza Research

May 25, 2021 | COVID-19, Featured, Research

Adolfo García-Sastre, PhD, left, and Shashank Tripathi, PhD, Assistant Professor of Microbiology. File photo

The National Institute of Allergy and Infectious Diseases (NIAID) has awarded the Icahn School of Medicine at Mount Sinai a seven-year contract valued at more than $42 million to advance basic research into influenza and COVID-19, and prepare for future pandemics.

This marks the third time Mount Sinai has received a seven-year NIAID contract under the leadership of Adolfo García-Sastre, PhD, Director of the Global Health and Emerging Pathogens Institute and Irene and Dr. Arthur M. Fishberg Professor of Medicine, who serves as Principal Investigator. Florian Krammer, PhD, Mount Sinai Professor in Vaccinology; and Viviana Simon, MD, PhD, Professor of Microbiology, Pathology, and Medicine (Infectious Diseases), will serve as the contract’s co-investigators.

“This contract represents 21 years of continuity in conducting research that leads to better treatments, better vaccines, better disease management, and better prevention of pandemics,” says Dr. García-Sastre.

The team’s work will lay the foundation for diagnostics, therapeutics, and clinical trials, but will not include the actual implementation of the clinical trials. The contract also calls for the surveillance of emerging pathogens, risk assessment studies on as many as 15 respiratory viruses each year, and training of postdoctoral fellows and graduate students. “Training is part of the fight against infectious diseases. You need the people and the weapons,” says Dr. García-Sastre.

Mount Sinai’s previous NIAID contracts have led to many advances. In response to the 2009 H1N1 flu pandemic, Dr. García-Sastre; Peter Palese, PhD, Chair of the Department of Microbiology; and Dr. Krammer launched their seminal work in developing a universal influenza vaccine. The vaccine— administered only once or twice in an individual’s life, rather than each year—has now undergone two phase 1 clinical trials and is expected to move toward a human challenge trial.

Since COVID-19, like influenza, will probably remain within the human population, Dr. García-Sastre says there may be a need to develop a universal COVID vaccine as well.

The new NIAID contract calls for funding of $6 million per year over seven years, but Dr. García-Sastre expects there will be room for additional funding. “The last contract did not have a specific amount of money for COVID-19 because there was no COVID-19 at the time,” he says, so when the pandemic started the government provided extra funding to study and find treatments for the new disease.

In fact, Mount Sinai’s research in influenza allowed the team to respond quickly to COVID-19. “Through this initiative we were able to develop and respond with diagnostics, treatments, and a vaccine,” Dr. García-Sastre says. “We were able to screen compounds that had potential for treatments and by testing COVID-19 proteins we identified targets and inhibitors of these targets.”

Work led by Dr. Palese, in collaboration with the University of Texas at Austin, produced a low-cost COVID-19 vaccine that is currently being tested in humans in Vietnam and Thailand, with clinical trials expected to begin in Brazil.

The team has also identified a promising small-molecule drug, plitidepsin, which appears to be particularly effective in stopping the replication of SARS-CoV-2, the virus that causes COVID-19. Clinical trials of plitidepsin are about to start in the United Kingdom, and the Spanish drug maker, PharmaMar, is negotiating with the U.S. Food and Drug Administration to begin clinical trials in this country as well.

While the new NIAID contract calls for Mount Sinai’s team to take a proactive response to future pandemics, they will also continue to focus on influenza, which remains a major international health concern. Influenza pandemics arise periodically, and according to the World Health Organization, the seasonal viruses infect as many as one billion individuals a year and lead to 650,000 deaths. There is much more to discover about how the human body responds to influenza, says Dr. García-Sastre, and the NIAID contract will support that important work.

Mount Sinai Honors Front-Line Heath Care Workers in a Unique Crystal Virtual Tribute

May 18, 2021 | Featured

Rodrigo Saval, the Mount Sinai Health System’s first inpatient, center, became Mount Sinai West’s 500th COVID-19 discharge patient.

The Mount Sinai Health System’s annual Crystal Party—a festive fundraiser held each year under a tent large enough to accommodate more than 1,000 attendees in the Central Park Conservatory Garden—was replaced this year by a moving 50-minute video called the Crystal Virtual Tribute. Streamed to hundreds of viewers at 7 pm on Thursday, May 6, the video honored Mount Sinai’s front-line health care workers, scientists, and students who helped save thousands of lives during the COVID-19 pandemic. Many of the participants provided first-hand accounts of the fear and bravery they encountered during the dark, early days of the pandemic last spring and showed how the Mount Sinai Health System came together to beat back an unknown pathogen.

Kenneth L. Davis, MD

“It has been more than 400 days since the world as we knew it changed completely,” said Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System, in the Crystal Tribute’s opening remarks. “Nurses went beyond the call of duty, taking on extra shifts and overtime. Doctors overcame unprecedented challenges, doubling up patients in rooms and fighting to secure enough ventilators to keep the severely ill alive. Scientists and physicians worked tirelessly to discover the very best treatments. And many of you made generous donations to make sure our staff had the PPE (personal protective equipment) and housing we needed to save lives and to facilitate our science,” Dr. Davis said.

“Day in and day out through the terrifying early weeks and the heartbreaking months that followed, through the depths of the pandemic and still to this day, our staff dealt with unspeakable tragedy. Our clinicians made some of the biggest breakthroughs in how to improve patient outcomes and treat the virus. And it was Mount Sinai virologists who developed the nation’s first antibody test. These men and women on the front lines not only saved lives; they saved the city of New York.”

Nurse Manager Jamie Ruhmshottel, BSN, RN-BC, at The Mount Sinai Hospital (MSH), recalled, “There was an angel looking out for me making sure I didn’t get sick and I didn’t run out of fuel and kept going to serve my purpose.”

Jamie Ruhmshottel, BSN, RN-BC, left, with a colleague at The Mount Sinai Hospital

With so many patients on ventilators and families unable to accompany them into the hospital, communication was challenging. Valerie Burgos-Kneeland, DNP, RN, Intensive Care Unit, MSH, said she was determined to give patients the individual respect they deserved. She asked the hospital’s social workers to find out from the patients’ families what the patients liked to do so the staff caring for them would know, “They have lives and families out there who they’re looking to give back to. And they have things they want to do in their life. They’re not done yet.”

The Critical Care Unit at Mount Sinai Queens was filled with so many COVID-19 patients requiring oxygen that it ran out of space and began treating patients in hallways and closed rooms, which would have been unthinkable under different circumstances. Among those requiring intubation was one of their own, Chief Physician Assistant Jimmy Lee, PA, who had been an indispensable member of the hospital’s Critical Care team.

Ugo Ezenkwele, MD, MPH, Chief of Emergency Medicine, Mount Sinai Queens, said the staff understood they could become as sick as their colleague Mr. Lee, but they also knew they had to keep going. “We sort of felt like this was a defining moment. You saw that grief. You saw that angst. You saw that uncertainty.”

Ugo Ezenkwele, MD, left, and Jimmy Lee, PA

But Mr. Lee rallied, and was able to return to the work he loves. “When we talk about Mount Sinai Queens, it is a story of people who potentially could be forgotten,” Dr. Ezenkwele added. “We are immigrants. We are first-generation. We are second-generation. We are essential workers, children of essential workers, and we are children of people who work hard. And so that’s the heart. We are the community we serve.”

Scott Lorin, MD, MBA, President and Chief Operating Officer, Mount Sinai Brooklyn, said his hospital served some of the hardest-hit communities in the city. The hospital’s first COVID-19 patient arrived on March 9, 2020. “By March 16, we were doubling our cases of COVID-19 every two to three days,” he said. Two weeks later, 220 of the hospital’s 260 patients had COVID-19. “Almost 50 percent of our patients in the hospital required oxygen. It was a proverbial war zone and no one had ever trained for that.”

Scott Lorin, MD, MBA

Making matters more challenging was the fact that Dr. Lorin and the hospital’s management team developed COVID-19 during the week of March 23. That is when the Health System stepped in to help Mount Sinai Brooklyn and deployed 200 nurses, physicians, and additional staff from its seven other hospitals.

David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens, said, “We came of age as a Health System during COVID-19. Our ability to move patients from hospital to hospital, to move supplies and to consider everything related to COVID care as a continuous whole, rather than as discrete, individual campuses—that made a huge difference. The coordination that was done at the system level was one of the keys to our success.”

Richard A. Friedman and James S. Tisch, Co-Chairmen of the Mount Sinai Health System’s Boards of Trustees, led an effort that raised $100 million for COVID-19 response and research.

“One of the top priorities was supporting the front-line workers,” Mr. Tisch said. “Everybody had enormous empathy and respect for them. Trustees just wanted to know what they could do to help out.”

Mr. Friedman said, “This wasn’t even a case of, ‘Well, do I give? Do I not give?’ This was, ‘How much can I give?’”

Nurses at Mount Sinai Queens created a rock garden of hope during the height of the pandemic.

The funding helped support Mount Sinai’s scientific work. “I immediately resourced the money to our scientists who were doing groundbreaking research that ultimately saved lives,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System.

One of the beneficiaries of the funding was the laboratory of Florian Krammer, PhD, Mount Sinai Professor in Vaccinology, which was the first in the United States to create a test to determine whether an individual had antibodies to SARS-CoV-2, the virus that causes COVID-19.

Miriam Merad, MD, PhD, Director of the Precision Immunology Institute at Icahn Mount Sinai, was among the physician-scientists on the front lines. Dr. Merad organized teams of students and researchers to collect and analyze patients’ blood samples in order to find treatments for COVID-19.

The steps that faculty, staff, and students took to serve patients and find cures during such a dark time marked a pivotal moment in the history of Mount Sinai.

“The miracles that happened at Mount Sinai were made possible by the culture of this special place,” said Dr. Davis. “From our faculty to our administration, from our labs to our exam rooms, everything is centered on collaborating to provide the best possible care. And that commitment put Mount Sinai at the forefront of the pandemic response.”

The experience, he said, made the Mount Sinai community stronger than ever. “While we may not be together in Central Park tonight,” Dr. Davis added, “I know we’ll gather again soon under the same tent. We’ll overcome this pandemic and we’ll do it together. And I can’t wait to see you all next year in person.”

Watch the Crystal Virtual Tribute

Meet some of those at Mount Sinai who confronted the COVID-19 pandemic

More Voices From the Pandemic: Reflections on Darkness, Healing, Gratitude, and Hope in Virtual Crystal Tribute

May 17, 2021 | Featured

The Mount Sinai Health System’s annual Crystal Party fundraiser saluted the outstanding work of its clinicians and scientists, and staff and students, who heroically confronted the COVID-19 pandemic. A tribute video captured many poignant first-person accounts from several different perspectives, including those of grateful patients who received care at Mount Sinai. Here are some of their reflections. See the entire video here.

Jeremy Boal, MD, Executive Vice President, Chief Clinical Officer, Mount Sinai Health System; and President of Mount Sinai Beth Israel and Downtown

“We couldn’t be in denial. We couldn’t say, ‘Ah, it’s not going to be that bad. We’ll just get through it doing what we normally do.’ We actually had to grapple with this idea that in order for us to get through this, to help our city through this, we were going to have to behave in ways we had never behaved before.”

Vicki LoPachin, MD, MBA, Senior Vice President, Chief Medical Officer, Mount Sinai Health System

“What is the right equipment that our staff need? What is the right protective equipment? How do you wear it? How long can you wear it? What are the right treatment protocols? We had to pull together the great experts across our Health System and great clinical minds, and then marry that with what we were seeing clinically with the patients in New York.”

Judith A. Aberg, MD, the Dr. George Baehr Professor of Clinical Medicine and Chief of the Division of Infectious Diseases

“Within a period of even a week, we were opening up clinical trials, looking at potent anti-inflammatories and antivirals, and by the Fall, we had transfused convalescent plasma to more than 1,400 individuals.”

James C. Tsai, MD, President, New York Eye and Ear Infirmary of Mount Sinai

“New York Eye and Ear played a pivotal role because we were able to be a resource to the other hospitals. Hundreds of our dedicated physicians, nurses, and other staff were redeployed to other hospitals in the Mount Sinai Health System.”

Rohini Bahethi, MD, who was a third-year medical student in 2020 when she served as a leader of a vast COVID-19 volunteer workforce of medical and graduate students

“We had over 530 people. And then, at the end of a three-month period, we had over 30,000 hours logged by students, which is so incredible.”

Rev. Amy Strano, MDiv, Director of Spiritual Care and Education

“The pandemic has been a struggle for all of humanity and for every single human being. And how do we make sense of that? How do we keep going day to day?

Lynne D. Richardson, MD, Co-Director, Institute for Health Equity Research

“COVID has ripped off the band-aid and shown all of us who gets sick and who dies in America when the pandemic hit.”

Carol R. Horowitz, MD, MPH, Dean for Gender Equity, and Director, Institute for Health Equity Research

“People aren’t sick because they didn’t try hard enough, or they didn’t behave well enough. People are sicker because they live in a place or are treated in a way that it’s much harder to stay healthy.”

Nitza Rochez, avid marathon runner who, a month after being diagnosed with COVID-19, started to experience severe headaches, dizziness, and heaviness of her limbs, severely impairing her mobility

“Before COVID, I was actually in one of the best spots of my adult life. I ran marathons. I was at my physically fittest and strongest. “[After COVID], my family had to take care of me because I was so ill. And, initially, the connection was not made that it was post-COVID. I just kept getting told that it was in my head as I was getting sicker and sicker. Getting dismissed, it’s crushing. It really is, because you really do feel hopeless. “Once I started at Mount Sinai [Center for Post-COVID Care], I was given steroids, I felt a difference. Physical therapy. I was advised to go on an anti-inflammatory diet. I was given care and guidance.”

Rodrigo Saval, the Mount Sinai Health System’s first inpatient, who spent 54 days at Mount Sinai West; when he was released he was the hospital’s 500th COVID-19 discharge

“I think that what I would tell people is to never lose hope. No matter how bad it is, it’s going to get better. There’s light after the tunnel. And it was quite a tunnel. “2021 is a new beginning for me. I’m so thankful to be alive, to be able to be home. And so thankful to all the staff, doctors, and nurses at Mount Sinai West.”

Watch the Crystal Virtual Tribute

After Her New Daughter Spends Two Months in the ICU, Mom Thanks the Compassionate and Caring Team at Mount Sinai West

May 14, 2021 | Featured, Patient Stories, Stories of Excellence

Allyson Bragg with her daughter, Aayla, who was in the Neonatal Intensive Care Unit at Mount Sinai West for more than two months.

Allyson Bragg lives in Edison, New Jersey, a 45-minute drive from Mount Sinai West under the best of conditions. But after meeting Robin Brown, MD, an obstetrician and gynecologist at Mount Sinai West, she had no hesitation in driving to New York City so that Dr. Brown could oversee her pregnancy.

Allyson needed someone special. She had suffered numerous miscarriages, and was referred to Dr. Brown by Martin Keltz, MD, a reproductive endocrinologist, who said Dr. Brown was an expert in high-risk pregnancies. “He was so right. She is incredible; I love her.”

Although Allyson’s pregnancy was uneventful, her daughter Aayla was born prematurely at 28 weeks. Weighing 1 pound and 4 ounces, Aayla was in the Neonatal Intensive Care Unit at Mount Sinai West for more than two months.

Allyson was determined to be with her daughter every day, but she found the commute and expenses of gas and tolls challenging. That all changed when Allie Rubin, LCSW, secured a room for Allyson at the Ronald Mc Donald House located in Manhattan’s Upper East Side. Allyson stayed there for 55 days, allowing her to have unlimited time with Aayla, worry free. “I am so grateful to Allie. Despite the circumstances, it was a wonderful experience,” she says.

Allyson is also appreciative of the entire nursing staff for their care. She has special praise for Glen Marie Bona Greszta, RN. “Glenn was amazing.” She was the first one on Aayla’s care in the NICU after she was born. Glen shared knowledge about premature babies and, by going above and beyond, assured Allyson that Aayla was in good hands.

“I was thrilled that Glen was the nurse who put Aayla in her car seat when she was able to leave the NICU, so she was the first and last person to care for my rainbow baby,” she says. “Nurse Glen sets the standard for nursing care! I’m also grateful for nurses Rose Husbands, RN, and Yolanda Dela Cruz, RN; they treated my daughter like she was their own.”

What You Need to Know About COVID-19 Vaccination in 12- to 15-Year-Olds

May 13, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

Schools, playgrounds, and, most of all, our children will soon be better protected against COVID-19, thanks to the latest news from the U.S. Food and Drug Administration (FDA). The agency has announced that the Pfizer-BioNTech COVID-19 vaccine is safe and effective for children between the ages of 12 to 15 and authorized emergency use of the vaccine; the CDC also recommends the vaccine in this age group. You may have questions about this new development. Kristin Oliver, MD, MHS, Assistant Professor of Pediatrics, and Environmental Medicine and Public Health, at the Icahn School of Medicine at Mount Sinai, has answers.

How effective is the Pfizer-BioNTech COVID-19 vaccine in children aged 12 to 15?

All indications are that COVID-19 vaccination is highly effective in children ages 12 to 15. In the trial, the vaccine prevented 100 percent of COVID-19 cases among participants who got the vaccine. It’s important to remember that the results we see in clinical trials—called efficacy—may be slightly better than what we see when the vaccine is out in the world—effectiveness. People in the clinical trials always get the vaccine exactly as indicated, but this isn’t always the case in the real world. Once we start immunizing more and more people over time, we’ll have a better sense of the vaccine’s effectiveness for ages 12 to 15, but I expect this will also be really high.

Is it safe?

The COVID-19 vaccine is safe for children ages 12 to 15, just as it is for people 16 and older. In addition, the FDA will continue to monitor safety for another two years.

Researchers at the CDC are investigating a link between COVID-19 vaccines from Pfizer-BioNTech and Moderna and heart inflammation in young men and boys. Myocarditis and pericarditis can be serious but, fortunately, these side effects to vaccination are very rare and the cases connected to receiving the COVID-19 vaccine have been mild. So, the benefits of COVID-19 vaccination in this group still outweigh the risks of getting myocarditis from the vaccine.

Will our children experience any side effects from the vaccine?

We can expect children to have side effects similar to what we’ve seen in adults. The most common are pain and swelling at the injection site, tiredness, and headaches. In the study fewer than one in five 12- 15 year olds who get the shot, had a fever. The good news is that these side effects usually only last for a couple of days and can be treated with over-the-counter medication.

Remember: these types of side effects are a sign that the body’s immune system is responding to the vaccine, which is a good thing. We have seen more of these side effects to the COVID-19 vaccination than, say, the tetanus booster or HPV vaccine. For that reason, you might want to have your child take the vaccine on day when you know they can take is easy the next couple days.

Are there some 12- to 15-year-olds who should not take the vaccine?

Anyone who has had an allergic reaction to any component of the vaccine, or who had an allergic reaction to the first dose of the vaccine, shouldn’t take it.

But peanut, egg, and other food allergies are not a contraindication. If your child has any of these allergies, they can take the vaccine. If you have any questions about your child’s allergies and COVID-19 vaccine, check with your pediatrician.

If my child had COVID-19, do they still need to get a vaccine?

The U.S. Centers for Disease Control and Prevention has said that everyone who can get a COVID-19 vaccine should do so, even if they’ve already had COVID-19. In general, we don’t know how long protection against the virus lasts after an infection, or how well previous infection prevents infection with some of the new variants. In our efforts to keep everyone healthy, the recommendation is to get vaccinated.

What are the benefits of vaccinating children ages 12 to 15 against COVID-19?

Vaccines are an important tool in protecting us from developing COVID-19. It is exciting that children ages 12 to 15 can now get vaccinated—and it is important that they do so. While it is true that younger people are less likely than their elders to get seriously ill and die from COVID-19, they are not immune to the virus. Children can, and have, contracted the virus, gotten seriously ill, and even died. So the first benefit of vaccination is to protect them from the virus and its complications. Additionally, we know that children can transmit the virus to others who are more at risk for serious complications. By vaccinating young teens, we can help prevent that transmission as well as protect grandparents, babysitters, and other more vulnerable people who are in their orbit.

Get more COVID-19 vaccine information from Mount Sinai

Scientists Celebrate International Day of Immunology and Their Role in Advancing Breakthroughs for COVID-19

May 6, 2021 | COVID-19, Featured, Research

Renowned immunologist Miriam Merad, MD, PhD, center, and members of Mount Sinai’s Precision Immunology Institute created T-shirts that support COVID-19 vaccinations in honor of International Day of Immunology.

The significant role the human immune system has played in the spread and containment of the SARS-CoV-2 virus, which causes COVID-19, was the subject of an International Day of Immunology summit, held virtually on Thursday, April 29, 2021, and co-organized by pioneering immunologist Miriam Merad, MD, PhD, Director of the Precision Immunology Institute at the Icahn School of Medicine at Mount Sinai. Dr. Merad, who, in 2020, was elected to the National Academy of Sciences, also serves as Director of Mount Sinai’s Human Immune Monitoring Center.

Scores of prominent researchers from throughout the world gathered at the summit to celebrate the international collaboration that took place during the pandemic and the speed at which their work was translated into desperately needed treatments. Their deep understanding of the different ways in which the human immune system reacts to SARS-CoV-2 has helped guide the worldwide medical response.

Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases, gave opening remarks. “As an immunologist, physician, and U.S. government official, who, for decades, has helped lead the public health response to emerging diseases, it has become clear to me the important role that immunology plays in medicine and in infectious diseases,” he told the audience.

“People with healthy, intact immune systems—such as most young people—can control SARS-CoV-2 infection by limiting its effects to the upper airways in mild symptoms,” Dr. Fauci said. “In contrast, older people or individuals whose immunity is compromised by immunosuppressive agents, or an immune-compromising illness such as cancer, are unlikely to produce a robust immune response that can keep SARS-CoV-2 in check. When the history of this COVID-19 pandemic is written, the discipline of immunology will stand out for its important role in explaining the remarkable protean manifestations of SARS-CoV-2 infection and in enabling us to identify and exploit vulnerabilities in the virus to develop safe and effective vaccines to thwart its pandemic spread.”

Florian Krammer, PhD

The summit’s participants also included Özlem Türecki, MD, Co-founder and Chief Medical Officer of BioNTech, the company that partnered with Pfizer to produce the first authorized mRNA vaccine and the first vaccine to fight COVID-19; and Florian Krammer, PhD, Mount Sinai Professor in Vaccinology at the Icahn School of Medicine at Mount Sinai, who created one of the world’s first antibody tests for SARS-CoV-2.

Dr. Türecki described the development of BioNTech’s mRNA vaccine for COVID-19, which the company dubbed “project light speed,” beginning in January 2020 as soon as virus’ genetic sequence became known. She said BioNTech’s early investment in mRNA technology allowed the company to move quickly, particularly when their scientists expected the pandemic to spread “even faster” than it ultimately did.

BioNTech created 20 vaccine candidates at first, and then pared them down to four. By July, the company selected its “pivotal candidate” for phase 3 efficacy testing. In November, the vaccine was found to be 95 percent effective, and in December, the United States began administering the vaccine under the Food and Drug Administration’s Emergency Use Authorization.

According to Dr. Türecki, BioNTech was able to reach the market quickly by perfecting its manufacturing process at the same time it developed the vaccine. The Pfizer-BioNTech vaccine has now been authorized in more than 65 countries and administered to more than 260 million people.

Dr. Krammer said that eventually, scientists will “disentangle” the many questions that still remain about SARS-CoV-2 and the adaptive human immune system. For example, will people have long lasting immunity? He also questioned whether it would be advantageous to receive two different COVID-19 vaccines rather than the same one twice.

“But there’s a more pragmatic question here,” he said. “We are in a situation right now where we don’t have enough vaccines, and the production rate of the vaccines that are currently produced and licensed is not high enough to cover the globe and a lot of countries are struggling to get access to vaccines.” Improving the situation is critical.

Indeed, Ester C. Sabino, PhD, Professor, Institute of Tropical Medicine, at the University of São Paulo, Brazil, said, “If we don’t have access to vaccines, then probably herd immunity will never be reached.”

Panelist Adrian Hill, DPhil, Director of the Jenner Institute at Oxford University in England, and a co-developer of the AstraZeneca vaccine for COVID-19, concurred. “The biggest failing in responding to COVID-19 has not been in vaccine technology—they perform really well. And it hasn’t been in the speed of response—that’s been extraordinary,” he said. “It’s been in the lack of physical locations that manufacture vaccines widely around the world. We need to have facilities that can flip overnight to make outbreak pathogen vaccines.”

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