Can an Oral Polio Vaccine Help Stop the Coronavirus?

CHRISTIANE AMANPOUR: People around the world are desperate for a vaccine, a cure, treatment, testing you name it. Dr. Robert Gallo is a world-renowned virologist who in 1984 helped discover the HIV virus and how it causes AIDS. Now, he’s turning to the fight against coronavirus, leading an initiative to repurpose the oral polio vaccine for a short-term treatment. He believes that it could provide a couple of months of immunity, which would buy time for anyone infected to try to develop the antibodies to fight it.

Now, this is still awaiting FDA approval but Dr. Gallo believes that it can offer a little hope and he tell ours Walter Isaacson why that is in this exclusive interview.

WALTER ISAACSON: Dr. Robert Gallo, thank you for joining us.

DR. ROBERT GALLO, DIRECTOR, INSTITUTE OF HUMAN VIROLOGY, UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE: Thank you for having me.

ISAACSON: We have been hearing about the possibility of a vaccine being 18 months, maybe a year, two years away. You have an idea that you’ve been come out with about using and repurposing existing vaccines including the one, the oral vaccine that you and I got as a kid on a piece of sugar and just took it orally for polio. Tell me about that.

GALLO: Right. Well, first of all, the idea was engendered from discussions with Konstantin Chumakov. He is the associate director for vaccines development at the FDA. Chumakov’s parents were Russian virologists and made, I think, a startling observation long ago, in the 1970s. They observed that the oral polio vaccine not only was tremendously protective against polio but interestingly enough, it protected against other things like polio as an RNA virus. Its genetics in the form of RNA. Many are, HIV.

So yes, polio, yes, influenza. It protected against influenza even better than the developing vaccines that are specific for influenza that depend on time to develop the antibodies, et cetera, to be effective.

ISAACSON: So, does that mean if I took that polio vaccine as a kid, I shouldn’t be getting the flu?

GALLO: Well, yes. That’s what it meant. They didn’t see flu developing in the polio vaccinated people in Russia. There was a 3.85 or so fold reduction. And this has lost in the literature in our discussions of the global virus network. You know, I remember hearing it from Konstantin Chumakov who is himself a virologist, of course. And I remember hearing him say this before. And when he mentioned it again, there’s no reaction. Like people — you know, goes in one ear, out the other. I became rather excited about this and then we talked and I realized this is really, really interesting.

ISAACSON: So, how long does the immunity that you get from an oral polio vaccine? Does that last your whole life?

GALLO: Polio lasts a good period of time. If you pin me down and say, tell me exactly, I can’t say. But in this case, you are not working with what we call the adaptive immune system. It is not antibodies. So, this is shorter lived. So, if you use this to protect, let’s say, against flu, you would probably get five, 10 weeks, maybe longer.

There is some evidence now that this response of what we call the innate immune system actually can last longer than we would really expect. It is an emergency response until you get your antibodies made and your killer T- cells, it’s called the adaptive immune system from the lymphoid system.

ISAACSON: Well, let me get this straight. That means that if you take an oral polio vaccine as a kid, for a long time, it will protect you against polio. And maybe if you take it now, it will kick in a short-term immune response that might protect against flu or coronavirus? Is that what you’re saying?

GALLO: Exactly. Yes. Exactly. It’ll — we don’t know how long this would last, this innate immune system lasts, it’s variable in different things. But certainly, it would last — it certainly should last for a month, maybe two months and maybe significantly longer. You might wonder, how does this happen? In our cells we have what are called molecules that are sensors and they say, you know, you’re looking at a foreign RNA molecule, the genome of the coronavirus or the flu virus. And then say, wait a minute. This is an emergency. And you don’t wait — they don’t — the system doesn’t wait for the adaptive immune response for antibodies, for killer T-cells that are specific to these proteins of the new virus. Rather it sees the foreign RNA and says, react. And it kicks in your innate immune system and say now, give me the precise mechanism for that.

This is a very, very hot topic for basic immunology and such precise mechanisms are actually being worked out now. Chumakov, my friend Konstantin Chumakov’s father and mother working together called it simple, viral interference, but provided no mechanism and it was buried in the Russian literature. We want to unbury it and move quickly with this.

ISAACSON: Why was it buried in the Russian literature?

GALLO: I don’t know. I think it — well, one reason we can speculate, I guess, (INAUDIBLE) we are — we aren’t talking to each other. You know, this is in the 1970s or early. So, that’s number one. Number two, it was published in Russian. So, it wasn’t translated until late.

ISAACSON: Your friend, Konstantin Chumakov, is working at the FDA now?

GALLO: Right. Right. Exactly.

ISAACSON: You and he are doing a paper that’s going to come out and say from his parents’ studies it is possible that the polio vaccine, that you can just take on a sugar cube, will give you temporary immunity to other viruses because it will kick in your innate immune system?

GALLO: Well, you’ve said it simply and perfectly, and the answer is yes. People are interested, very interested. So, I am optimistic and we want to bring it to New York right away. So, we are having collaborators in New York City so that we want to move this as quickly as we can. There are people — I would say very advanced people, who are suggesting maybe we want to do trials where you deliberately give coronavirus to volunteers, young volunteers that should not have any problem with the virus and you do it under very controlled situations where they do experiments like that with influenza with volunteers at the University of Maryland in the vaccine center.

So, you know, I’m afraid of that. I don’t want to do that. But I sure like to get this out to people in the front lines. You didn’t ask me but somebody said, well, do you know this will work? No, I don’t know if it will work. I don’t know anything with certainty but I really think that the chances are good. And if I were betting, I’d bet pretty strongly that this is going to really help. So, I want to get moving fast on it.

ISAACSON: Do you already have FDA approval to do some trials?

GALLO: Well, the FDA is where Chumakov works and he’s already brought it to his boss and the boss’ boss and the boss’ boss and the boss’ boss’ boss. So, we’ve gone all the way through the FDA. It’s not formalized yet. They still have to get a committee to review. But very hopefully, because of the nature of the problem we’re facing and because the safety of this vaccine, proven safety. If you’re already vaccinated against polio, there’s no reports of any significant side effects, nothing.

ISAACSON: You know, a lot of our viewers may be kind of shocked that it could be just that simple, let’s repurpose some old vaccines and kick our immune system in. Do you think it’s safe? Are you sure it’s safe about people taking these vaccines again?

GALLO: Walter, what I can say is that, again, to be very clear, there’s nothing in biology or medicine that I’m absolutely sure of, 100 percent, you know, about 99 percent, 98 percent. What is the assurance of safety here? If you’re previously vaccinated with polio it’s just really — and even if you’re not, the risk is remote. It’s like, if you’re not vaccinated, there’s 1 in 800,000 chance that something could go wrong. 1 in 800,000 people who got something. But if you’re already vaccinated, what I see from talking with the Russian colleagues and looking at the literature, there is no side effect in — significant side effect so far ever that we know of. Think of this versus some of the off-license drugs that are going forward, remdesivir, hydroxychloroquine. So, their record of safety is nowhere near as good as this. OK. So, maybe that helps to put it in perspective.

ISAACSON: So, if we had this concept that would use safe older vaccine that is we know are safe, they have been used for decades, why wouldn’t we do it with the vaccine that was created for the first SARS virus in 2003?

GALLO: Because it’s never been demonstrated to do — be effective because it’s not available in quantity, because it would be very expensive. I hope those are enough reasons. We have no guarantee of safety with that one. We do with the oral polio — not guarantee, I would say 99 percent assurance that it’s going to be safe. So, we have safety, cheapness, ease of giving it, proven record. We haven in of those for SARS. And we don’t know if the SARS vaccine works, do we?

ISAACSON: Polio is an RNA virus.

GALLO: Right.

ISAACSON: Just like coronavirus that we’re facing now. Does that help make it effective? Would any vaccine that kicks the immune system up a notch be effective these days?

GALLO: I really don’t know the answer to that. I can’t say. The evidence is there with polio. There’s a suggestion for the same with measles. But it really documented with polio. So, you could argue that another RNA virus would be okay but the one you picked like SARS, I don’t even know if the SARS vaccine works. Where’s the proof that it works at all for anything, including SARS, you know? I believe we have candidate vaccines. There’s a big difference when people — I don’t like giving dates for vaccines that are newly developed, that is the specific ones. Making a specific vaccine against this coronavirus, whether it takes three months or 12 or 18 or two years or five years. You only know you have it when you have it. You have to prove efficacy. That’s when you have a vaccine. And safety, then you have a vaccine. Beforehand, you could say, I’ll have a candidate in that period of time. That is all.

ISAACSON: Would it be possible to create a double-blind study to look at the oral polio vaccine?

GALLO: That’s exactly what we’re planning to do, Walter. We are planning a double-blind study at — I hope it will be at two places at the same time, Mount Sinai in New York and our place in Baltimore. And then starting to accumulate data, get more polio vaccine, show things are working and then spread it out as wide as we can and try to hit populations that are really needing help.

ISAACSON: Tell me about the international community of scientists that you’ve created. I think you call it the Global Virus Network. Is that very collaborative or do we have competition? Are you working with Russia, China and others?

GALLO: No. It is not competition. There’s an enormous advantage of talking to people. And a few years ago, we were able to recruit Christian Brechot to be president. He’s made a significant difference. Christian was the former president of Pasteur Institute. And so, like for example, on the coronavirus, about every eight days, he has a phone call with, you know, anywhere from 15 to 25 people on it from all over the world. I think I learn more in the GVN than I do anywhere else about various things that happened in China, that are happening in Italy. I hear all the context that Italy was collaborating with China instead of the other. So, we go back and forth. This — you’re getting experts from everywhere. There’s no competition. We help everybody to try to get funded. We try to get in projects together. Our limitation, Walter, is clearly we want it to be free of government, and so we are. That allows us to get Russia and China in.

ISAACSON: Are you worried that you’re talking about it a lot but we have not tested it and it might start giving people false hope?

GALLO: Yes. Yes.

(LAUGHTER)

GALLO: That’s a tough question and an awkward one for me, of course, but I try my best to answer it. We have internally our own debates about when we should tell this one and that one and another one. But we were very worried about leaks. And colleagues have given me advice, you better get this out, before it’s misinterpreted. And we have talked to Dr. Redfield and — I mean, for me Bob and Tony. And we have told them everything. And then we have told everybody, you can imagine, in the FDA. So, now it’s not exactly — and we needed to spark the interest and get the approval, so it’s all over. Now I talked to yesterday the dean of our medical school, the president of the university. Do you think this would — is not out there by now?

I think people are discussing it already. So we felt we should be getting it out in an intelligent way, because we can’t just spring it out in a week or two, and then here it is, right? We need the support of people. We need the understanding of people. You draw on the experiences.

Let’s go back to HIV for a moment. In 1984, February, our lab really had the blood test fully developed. And the government — I didn’t know how long it should take. I thought it was slow. But the government took great pride in how fast it came out by December of `84 globally. It was only years later, I was sitting with the head of the Hemophiliac Society of Paris, France, and he invited me to his home for dinner. Everybody in his family was infected with HIV. He infected his wife. Babies the born. They’re all infected, two of them. And when we were talking, he was concerned that the test didn’t come out as fast as he would have liked, not ours, but where they were, in France. And I was thinking to myself. And I said, when did you get infected? And — because I was thinking maybe we could have helped. And he said, no, no, no, it was way too early. And he told me July of `84. And I said, I had the test in the lab in February of `84. Let’s say we had another half-dozen technicians sponsored by the government in my lab at the time. Couldn’t we test the hemophiliacs all over the place? And the answer is yes.

I didn’t speak up. I didn’t say anything. I went back did what I was kind of told. When I look back on what I did wrong, I think that’s what I did wrong. I would never go to just authority and do everything exactly as it’s supposed to be when it’s urgent and when it’s a matter of life and death.

So, this one was very, very difficult for us. And we fought back and forth. And not everybody agrees. I mean, some people raised the very question you did. But each way has its ethical dimensions here or political or whatever you want to call them, problems, no matter which way you go.

ISAACSON: So you’re putting forth this idea of repurposing the oral polio vaccine, and you’re doing it through a newspaper interview, and you’re doing it through this interview on TV.

Are you also going to publish in either a peer-reviewed journal or like a bio-archive online a scientific paper on this?

GALLO: Yes. Well, and, also, it’s written now. We’re just going over it, of course. When you don’t have data, it’s got to be a perspective or a commentary. So we like to send the commentary or perspective very quickly, I hope this week, to one of the major, visible journals. So the answer to that is, yes, of course.

But, remember, this is a proposal. And then we need to start collecting data and really start doing experiments that evaluate the innate immune response to infected people in this. I’m not going to do the experiment of deliberately infecting someone young, healthy, who is — presumably never get really sick, badly. And that would be — of course, you could do fantastic experiments, and get results in two weeks, three weeks. You would know a lot, and you would be doing a lot with studies on the native immune system.

Tempting as it is, I’m still too afraid to do that.

ISAACSON: So if this idea pans out, is there enough oral polio vaccine around, that people could get it?

GALLO: I don’t have that answer. I’m certainly hope so. I think so.

Remember, Bill Gates is responsible for vaccinating a great part of the world in Southeast Asia, India, that region. And it’s the same vaccine. And I know that two companies have quite a bit stocked away. I suspect CDC does, too. I have talked to Dr. Redfield about it. And he’s having his expert there to take — start looking. And it can be produced, and it’s not expensive.

So that’s another thing, that it’s helpful to have it visible, so people will think, we better start producing it. We’re involved in this, and we can really help, so that — I have to consider each of those angles. And I hope this helps. And I hope this is the pathway.

ISAACSON: Dr. Robert Gallo, thank you so much for joining us.

GALLO: Thank you, Mr. Isaacson. And very nice to see you again.