Lost Immunity by Daniel Kalla (free reads TXT) 📕

the speaker whistles. “One boy died of meningitis only a few days after receiving his immunization.”

“So antibiotics were your only real weapon?” Lisa asks.

“The truth is, we do not know how much of a difference any of our measures made. We are still unsure why the outbreak halted as abruptly as it began. Or if it has truly left us.” His voice lowers, as if letting them in on a secret. “Many people here are concerned that it might be lying dormant and will return again this winter.”

“Thank you, Dr. Haarde, that’s very enlightening,” Lisa says. “We’ll probably have more questions for you once we have a more complete picture of our situation. I hope it’s all right if we contact you again.”

“At a more reasonable time, of course,” Angela adds, as if she played no part in the late hour of the call.

“I would be pleased to share what I can from our experience,” he says. “I hope Seattle is not as… affected as we were.”

His grim tone, more than his description of the Icelandic outbreak and its frightening death toll, gnaws at Lisa. As she is just about to hang up, Haarde adds, “Incidentally, even though we have not seen a new case in over five months, we are still proceeding with our vaccination campaign.”

“Vaccination?” Lisa glances at Angela. “I thought you said none of the vaccines were effective against this strain of type B meningococcus.”

“That is true of the existing products on the market, yes. However, there is a new vaccine. Neissovax, produced by Delaware Pharmaceuticals.”

“Neissovax…” Lisa vaguely remembers reading a journal article a year or so earlier about the experimental vaccine.

“The early-phase-three trial results have only recently been published, but they are promising,” Haarde says, meaning that the drug has already undergone extensive testing and has been proven safe and effective among a trial group that must have included more than a thousand people to be classified as phase three. “Because of our history, we have volunteered to be the pilot site for a citywide immunization program.”

“When’s that supposed to begin?”

“Next month.”

As soon as Lisa disconnects, she looks over to Angela again. “So Delaware has already produced enough to vaccinate a whole city?”

CHAPTER 5

Happy memories from grad school flood back to Nathan Hull as he strolls past the columns of sleek stainless-steel machinery that sprout from the polished concrete floor and spiral to the ceiling forty feet above. Visually, the state-of-the-art development facility bears no resemblance to Nathan’s college lab, which was a tiny space crammed with racks of beakers, centrifuges, and other obsolete equipment. Missing, too, are the stenches of solvents, ammonia, and other chemicals. But the plant here in Littleton, Massachusetts, shares the same buzz of science, innovation, and promise that filled his lab at MIT.

Progress. Delaware Pharmaceutical’s forty-five-year-old vice president and chief development officer feels it all around him. Just as the mortar and pestle gave way a hundred years before to volume-controlled recipe processes that became the backbone of pharmaceutical manufacturing, robotics and automation are now supplanting that once-core technique. Delaware has invested hundreds of millions in this new facility, borrowing expertise from the aeronautical and automobile industries to create modular continuous processing in an end-to-end integrated and totally automated system. A plant that could be picked up, shipped, and reassembled anywhere in the world in weeks, if not days. A single site where R&D of new products could seamlessly morph overnight into 24/7 manufacturing and distribution.

Still admiring the machinery, Nathan ambles over to join Dr. Fiona Swanson where she stands inspecting a stack of bins. He can tell at a glance that his team’s director of product safety doesn’t share his sense of awe.

“So does this mean you’ll come to Reykjavík, too?” Fiona asks, in a mild Minnesotan accent that still occasionally reminds Nathan of a character in Fargo, one of his favorite movies among the Coen brothers’ oeuvre, even of all time.

“Wish I could,” Nathan says. “I can’t remember a bigger trial at this stage of development than this one.”

Fiona reaches into the nearest bin and extracts an individual yellow-capped vial. “Fifty thousand doses isn’t a trial, Nathan. It’s a full product launch.”

He holds up a palm. “Agreed, Fee. Not my idea.”

“But you’re going to do it, anyway?”

“We didn’t approach the Icelandic government. They came to us.”

When Nathan first met with the country’s minister of health, he told her it was premature to enroll an entire city in what effectively amounted to another phase-three trial of an unproven vaccine. And as it became clearer over the next few months of negotiations that the meningitis outbreak in Reykjavík had gone dormant or died out altogether, Nathan’s reticence to release Neissovax only intensified, as he saw no upside in vaccinating for a threat that was no longer active. He stalled as long as he could. But when the internal results from Delaware’s first large-scale clinical trial proved even more impressive than forecast, Nathan’s colleagues grew impatient. Eventually, Peter Moore, Delaware’s CEO, intervened. Nathan’s boss sat him down over herbal teas—Peter had forsaken caffeine, including his six-coffee-a-day habit, ever since suffering a mild stroke—and told him: “You know as well as I do that we could wait a thousand years and never stumble onto a better opportunity to market a new product.” So Nathan relented.

Fiona rolls the vial between a thumb and a finger. “And if something goes wrong in Reykjavík?”

“You saw the pooled data,” Nathan says, feeling compelled to defend a decision he still doesn’t fully support. “Over fourteen hundred subjects. No major reactions. And an effectiveness of well over ninety-eight percent. Better than we could have hoped for.”

“All under carefully controlled trial conditions. Could be very different in the real world.”

Nathan slips the vial from her hand. “You’ll be there to manage things.”

“Can’t manage what we can’t foresee.”

Nathan studies the vial. He finds the block-letter font that reads NEISSOVAX across the top of the label appealing, but the yellow cap still grates. He would’ve gone with the