The Plague Year: America in the Time of Covid

by Lawrence Wright

Graham and McLellan designed the modified proteins within a day after downloading the sequence for SARS-CoV-2. The key accelerating factor was that they already knew how to alter the spike proteins of other coronaviruses. On January 13, they turned their modified spike protein over to Moderna, for manufacturing. Six weeks later, Moderna began shipping vials of vaccine for clinical trials. Typically it takes months to years, if not decades, to go from formulating the vaccine to making a product ready to be tested, a process that privileges safety and cost over speed. The FDA required another twenty-four days to approve the product for trials, for a total of sixty-five days from inception to trials, “an all-time record,” said Graham. Graham had to make several crucial decisions while designing the vaccine, including where to start encoding the spike-protein sequence on the mRNA. Making bad choices could render the vaccine less effective—or worthless. He solicited the advice of his colleagues. They all said the final decisions were up to him—nobody had more experience in designing vaccines. Graham made his choices. Then, after Moderna had already begun the manufacturing process, the company sent back some preliminary data that made him fear he had botched the job. Graham had a panic attack. Cynthia was alarmed by his mood. “It was a crisis of conscience that I just never see in him,” she said. “He was beside himself.” His expertise and judgment had been called into question. ...