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The COVID Vaccine
Episode

Alex Greninger, Assistant Director of the UW Medicine Clinical Virology Lab

The COVID Vaccine

In this episode, we are privileged to host the outstanding Dr. Alex Greninger, Assistant Director of the UW Medicine Clinical Virology Lab. Dr. Greninger dives deep into the work he does in the lab and how their work helps improve healthcare, especially in discovering cures for human infectious diseases. He discusses viral diseases, innovations that helped produce the COVID vaccine, how the vaccines work, the difference between RNA and traditional vaccines in creating the immune response and more! We’ve really enjoyed the stimulating conversation with Alex and we learned so much about making sure to also tune in!

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The COVID Vaccine

About Dr. Greninger

Dr. Alex Greninger is the Assistant Director of the UW Medicine Clinical Virology Lab and the UW Assistant Professor of Laboratory Medicine. Dr. Greninger focuses on genomic and proteomic characterization of a variety of human viruses and bacteria with a focus on respiratory viruses and human herpes viruses. He has discovered a number of new human and animal viruses. His basic science lab at South Lake Union uses genomically informed approaches to understand human infectious diseases. Dr. Greninger got his M.D. and Ph.D. From UC San Francisco, his master’s in Scientist Immunology from Stanford and his master’s in Philosophy and Epidemiology from Cambridge in England.

The COVID Vaccine with Dr. Alex Greninger, Assistant Director of the UW Medicine Clinical Virology Lab: Audio automatically transcribed by Sonix

The COVID Vaccine with Dr. Alex Greninger, Assistant Director of the UW Medicine Clinical Virology Lab: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
Hey everybody, Saul Marquez here with the Outcomes Rocket. Thank you so much for tuning in. Today, I have the privilege of hosting Dr. Alex Greninger. He is the Assistant Director of the UW Medicine Clinical Virology Lab and the UW Assistant Professor of Laboratory Medicine. Dr. Greninger focuses on genomic and proteomic characterization of a variety of human viruses and bacteria with a focus on respiratory viruses and human herpes viruses. He has discovered a number of new human and animal viruses. His basic science lab at South Lake Union uses genomically informed approaches to understand human infectious diseases. Dr. Greninger got his M.D. and Ph.D. From UC San Francisco, his master’s in Scientist Immunology from Stanford and his master’s in Philosophy and Epidemiology from Cambridge in England. He has many clinical interests in facilitating clinical trial testing for respiratory viruses and human herpes viruses. And because of his expertise, I’m just thrilled and excited to have a conversation about the coronavirus, the vaccine, and a lot of questions that maybe you’re thinking about. Just going to be very interesting today. So thank you so much for joining me today, Alex.

Dr. Alex Greninger:
Thanks for having me. It’s great to be here.

Saul Marquez:
Yeah. And so before we get started and kind of diving deep into the work that you do in research, talk to us a little bit about what inspires your work and health. Yeah, I got interested in going to medical school early on. I had a pediatrician that I really liked and sort of I was doing my career day in high school with a pathologist, Which is not kind of a random way, but it was a great entry to realize that you could be a physician and deal with a lot of science. And then from there, just not able to make a ton of decisions. So doing the M.D. Ph.D. Route. And I think what I got really excited about, I think what’s really I was inspired, some of the work is initially was in viral discovery, this idea that there are lots of viruses out there to be found in people that could be the causes of diseases and then you would be able to cure. And that sort of morph. Hypothesis only almost not turn out not to be true. There are a ton of other viruses that we’ve known about for quite a long time where the same thing is true. We can cure or we can prevent them with vaccines. And it’s just about executing that vision over and over and over the effect size that you get with a viral disease, the ability to target its enzymes. It has enzymes that people, humans or other eukaryotes just don’t have.

Dr. Alex Greninger:
And so you have a broad therapeutic window. You can make great drugs, you can make great vaccines, and you can done and move on to the next one. That’s like what’s happened with sars-cov-2 in the last year is just freaking phenomenal. I mean, we’ve got small molecules that are authorized. We’ve got multiple monoclonal antibodies to the monoclonal level revolution coming. We’ve got multiple vaccines. I mean, when we put our effort scientifically and clinically on to a virus, I really don’t want to be overconfident here because they’re obviously like HIV and other ones have been very, very difficult. But we have the ability to really, really knock these things out. And there’s a lot still to be done in the respiratory viruses, other viruses. Just in my lifetime,

Dr. Alex Greninger:
You’ve seen hepatitis C, basically, we’ve got curative therapies. They’re human papilloma virus. We’ve got a fantastic vaccine there. And then right now, we’re really showed the promise of some new vaccine platforms and some new protein engineering principles with the viral glycoprotein that allowed us to get some Whiz-Bang vaccines. And we can do that again and again and again. And so that’s really what the underly inspiration is. And it’s just that This is a really sweet place to be in terms of treating and preventing viral diseases because you’re able to sort of see it work in your lifetime multiple times. And that’s an incredible opportunity.

Saul Marquez:
Yeah, it really is, Alex. And so what would you say is the or maybe a few things that have been critical-innovations that have allowed us to move at the pace that we were to, say, produce the COVID vaccine.

Dr. Alex Greninger:
Yeah. So there’s a lot of failure. It’s a lot of people who follow influenza vaccines. A major thing that happens from the RSV vaccine failures from the 70s and sort of trying to do postmortems on that for a long time basically has been covered while Barney Graham and Jason Collins working out how you can freeze type one fusion proteins and other glycoproteins in a pre Fusion confirmation. So these proteins, these viral glycoprotein are attachment proteins, sort of exist as a mousetrap where they’re sort of loaded. And then when they get close to a cellular membrane, they sort of by binding their receptor, they spring. And that’s what allows the use of the fusion machinery goes and basically allows the virus to enter the cell. So if you’re able to trap what you want to do is you want to block that sort of like pre-triggered mouse trap. And so they’ve basically made these proteins, mutations that can lock the protein down in that prefusion confirmation. And so we’ve got the right epitopes now being displayed for the immune system.

Dr. Alex Greninger:
I don’t know too many people who are… A lot of people are excited about DNA and RNA vaccines for a long time, but to have these new platforms, the ability to make RNA vaccines, which you can make basically like the day after you get a sequence and you can make these things relatively quickly. We didn’t have the manufacturing capacity to make billions of doses because it’s a new platform. But I think that’ll be a solved problem afteR COVID. And so that new platform that it was able to get out of the gate so quickly, be able to reprogram, tailor the doses as you need to. You know, that’s a really, really, really flexible platform. So those two things combined have really sort of ignited the field and sort of shown that this is a very tractable platform, providing the right epitopes immune system to see to make pretty strong antibodies. And there’s a lot more to go in there. And we’ve got to deal with all the viral evolution, the plasticity, the virus to sort of break into these attachment proteins. And that’s going to be a long we’ll be a long thread there. But with those two advances combined with each other, I don’t know anyone just a year ago sort of expected that we would be in such an advantageous position scientifically, technologically. We still got to implement it. And there’s a lot to go there.

Saul Marquez:
Yeah, it’s really exciting. And so the RNA type of vaccine is different than traditional vaccines. Can you explain to us like how like what the primary differences?

Dr. Alex Greninger:
Well, there’s a couple of differences. I mean, the first one is right out the gates. It’s a nucleic acid rather than a protein. Typical vaccine for a virus would be to either grow the virus and inactivate it or make a sub-unit, which means to basically take part of the virus and make that protein and then add some adjuvant, something to stimulate the immune system and inject that sort ofa protein vaccines, either the inactivated virus, an attenuated virus, or the subunit vaccines. And here what we’re doing is just injecting the sort of the blueprint, the messenger RNA that makes those Proteins. And so basically that RNA gets taken up by cells. This is, if you like, transduction cells in the lab. So adding RNA to the cells and the cells take up the RNA and they make the protein, which is kind of cool because you’re actually able to get it folded in a way sort of under native conditions. It’s just that’s just how the virus would do it, right? You give the RNA to the cells, they make my protein and the cell would make the protein. And here we’re doing. That just on that attachment protein, the spike protein for coronaviruses. And so that’s nice because you can get multiple, you can get actually decent amounts of protein made as RNA. It’s actually relatively quick and easy to make those Rna and then they get degraded over time. So they’re not there like long term. There’s really a very little risk, but really no risk for them sort of hanging around or some of the other issues we sometimes have with attenuated vaccines. And then not to just say it’s a nucleic acid, you’ve got to find a way to deliver that nucleic. If it was just a straight nucleic acid, it would get chewed up pretty quickly. And so you’ve got to sort of wrapped them in sort of this bubble of fat that are these sort of lipid nanoparticle. There’s a lot ofIP There’s a lot of work there. That’s the hardest part to make for manufacturing saide. That needs to be worked out a bit more about how we’re going to be able to scale these platforms. But that also is very important and also very bespoke.

Saul Marquez:
Yeah. And so I appreciate you highlighting the difference there, protein versus the nucleic acid, the blueprint that then kind of happens inside of us and then it’s having that wrapping and in fact, to make sure that it doesn’t get chewed up. I mean, just so interesting, Alex, like amazing that we’ve been able to do this. So we’ve got The JNJ vaccine. We’ve got the Pfizer, we’ve got the Moderna. Which one of those is this type of vaccine? Rna- based.

Dr. Alex Greninger:
Moderna and Pfizer are both the sort of Rna vaccine. The JNJ is an adenovirus vaccine. So basically they take the attachment protein and make it at high levels and put it on the outside of an adenovirus. Sort of chassy, as it were. The fact that the Pfizer and the Moderna vaccines are able to get made so quickly, go through phase one phase two, find the right dose, and get done basically before the trial is wrapped up in the same year that you discover the virus is just phenomenal. And again, those platforms are very, very extensible. I mean, that’s the thing that literally they had made the first candidate, Moderna vaccines, left three or four days after you get the genome sequence online, you order a construct, a synthesis, a gene synthesis comes in a little tube that can come in like three or four days.

Dr. Alex Greninger:
And then you basically could start making RNA. I mean, maybe a week after that genome sequence is online, you actually have a candidate vaccine that you’re putting into mice. And so they were able to go mice phase one face to face, three in under a year. And that’s just absolutely nuts when you look back at the sort of development. And I think what it is, I mean, I think there are a lot of people in the vaccinology field, in virology in general. I mean, you never know it’s going to work until you do it. And that’s why we do we have to do that. You can’t just say, OK, I got an idea, let’s put it to people immediately. But those are the technologies like insipient. They were they had existed. They had been shown notes a little bit of promise here. Usually, they were getting funded for biodefense efforts like that sort of things that weren’t super common. And we just needed to have, I will political will, but just everything that COVID just focused the mind. I mean, all of us. There was federal money on the table. A lot of it there. Everyone was galvanized. Everyone’s working together. And that’s just the sort of we just got to carry over that energy into our other respiratory virus and or other viruses that we are still up against.

Saul Marquez:
Fascinating Alex, thank you for explaining the differences there. I never really appreciated the basic science behind it all and the advances that you just highlighted. The other one that you mentioned was about, I guess, creating that immune response. And then you basically closed the cell and it doesn’t receive the virus. Right? I mean, that in itself is interesting.

Dr. Alex Greninger:
Yeah. And so, I mean, I think we talk about that. There’s also the monoclonal revolution that’s happening right now in infectious diseases, which is being able to clone out rapidly antibodies these cells out of people who’ve recovered from viral diseases and make monoclonals, ideally put several monoclonal antibodies together, get them nice and concentrated. That’s a problem, and then basically infuse them into people. And there you can take advantage that you’re already sort of know where those are going to target. And you can block viral entry sort of like a vaccine would. But in this case, you’re sort of giving people the business end of the vaccine. What you want the vaccine to make is these antibodies for the most part. And so you can give that. And we’ve got several authorized therapies now from Lily and Regeneron and a few others sort of on the shelf, too, that are exciting. We still have a lot of delivery problems to work out and we have to figure out the right pairs of antibodies given the future and how to structure this. So there’s really no move for the virus to evolve around them or to string mutations that can evolve.

Dr. Alex Greninger:
Sometimes these monoclonals are a little too specific, and that’s certainly another problem in the other viruses, the viral diseases that we spotted decades or hundreds of years of evolution and people. COVID, we can be on a first-name basis with sars-cov-2 variants because there are so few of them. Honestly. People talk about the various variants. We don’t even bother to talk about that with other viruses because it’s just so they’re so genetically diverse involving human immunity for so long. There’s a lot of work they’re going to have to be worked out, have to sort of pick them off one strain by strain. That’s what it is. But again, another one where we’ve been able this is crazy. Again, less than a year from the discovery of a virus to authorize therapies. We still have a few more kinks, mostly on the implementation side, to work out, how can we get these things concentrated that we don’t have to infuse them that we could inject them IM or how do we get infusion set up in a way to treat people on an outpatient basis? Because you’ve got to get those antibodies in early. That’s the key.

Saul Marquez:
Yeah, that’s so fascinating. And so the promise of these therapies is huge and we’re getting better. What would you say is kind of like focused on what you do, Alex? What would you say is how you guys aim at improving outcomes? What do you do and what do you fix them?

Dr. Alex Greninger:
Right. I’m a clinical pathologist. What we focus on in laboratory medicine, sort of two names for that specialty. And we focused mostly on testing. So before we had the vaccines, before we had any therapies, what we had was testing and sort of public health measures around pharmaceutical interventions, social distancing, masking. But testing was a big part, trying to isolate people and sort of get that information out there to people of what their risk is, screening people, all of that. And so that was a big part of February, March then the whole time. And basically, the US is doing on the order of two million tests a day for something that never tested for before, really in March. And it’s just been an incredible ramp-up. It’s sort of like bizarro world clinical pathology, because typically what we end up doing is telling you why you can’t have nice things, why we’re not going to test for something, because there’s no therapy. There’s no treatment, there’s nothing to be done. The biggest story in respiratory virus testing before this was a decreased reimbursement associated with testing for the many, many causes of respiratory disease that can be caused by different viruses.

Dr. Alex Greninger:
Because most of them, we didn’t have any therapies. We didn’t have anything we could do about them. And so in this world instead, we sort of bootstrapped our public health response onto honestly insurance and started testing hundreds of thousands to millions a day. And I think definitely in the Pacific Northwest and the western Washington area, testing has been a really key part of the public health response. We’ve had drive-thru’s open since June. We were one of the first, we provided like 20 to 50 percent of the nationwide testing, the first two weeks of March. We got off the blocks early. Even though the virus was there early, we were sort of able to meet some of that moment and get the information out to people of how many infections there are, where they are, and allow our physicians to protect our health care workers to protect themselves as well in the hospital in those early cases for coming through. And really that, combined with sort of some classical public health measures, just really helped us get beyond that first curve and honestly do pretty quite well if you’re comparing states in the United States and Washington State quite well. So that’s what we focus on mostly is just trying to get tests, trying to get out fast. So we’ve got to get turnaround time of under eight to nine hours. And that’s what we’ve been totally focused on. Is getting testing the logistics and all of the interface that has to be built. I mean, it’s all of the blocking and tackling a lot of the informatics, the pre-analytical, getting staffed appropriately so you can receive samples trying to get the entire workflow is as seamless as possible so that you can continue to scale and offer more testing. That’s really what we’ve done for the last year now.

Saul Marquez:
That’s amazing. And much kudos goes to you and the teams that you’ve got working on this. It’s just incredible that we’ve been able to respond to the virus the way that we have. It’s been challenging. And now a lot of people talk about different strains and things like that. How are you looking at the future here, Alex? A lot of people don’t know what to expect. What do you think? Knowing what you know about how these things evolve and give us your thoughts there.

Dr. Alex Greninger:
So, I mean, there’s definitely there’s near-term sort of short term, medium term, long term, right? So the major things like right now in the next few weeks is we’ve got to chill out still a little bit as a country about sort of reopening because we are really clearly, in many states in the middle of a fourth wave. Up in your area that was like Michigan then doubling now for a couple of weeks. They’re higher than they were double or triple what they were three or four weeks ago. Washington State, we’re ticking up and our percent positivity and it takes a month to get once you’ve gotten the vaccines, vaccines in there, like sort of two weeks after the second vaccines when we sort of were measuring the effectiveness in those studies, that takes time to get the immunity in. And it just takes time. We’ve only got really about is it a third of adults have been vaccinated. So the good news is we’ve got like seventy-five, eighty percent of people over sixty-five, seventy around the state vaccinated.

Dr. Alex Greninger:
So our mortality and morbidity statistics are just going to look better and better and better. But we can still have a good number of cases. And with the long COVID and all the other –, it’s really worth it to just if we can get three million people vaccinated a day over the next month. I mean, that’s almost one hundred million vaccines in arms just for waiting like four weeks. And so we’re really at a highly poised moment where we need to get the population effects of vaccination on board, which we haven’t gotten yet. We’ve got in our long-term care facilities and our health care areas. But again, we don’t ask the measles, the mumps vaccine to handle 50 to 60 thousand cases a day in the United States. Like that’s a lot of virus that’s getting amplified in people. That’s going to come challenge the people who are vaccinated. Right?

Dr. Alex Greninger:
So vaccines are great, but they really work amazingly well and sort of the nonlinear ways they basically about herd immunity, but basically to continue to make the risk low for everyone. And that’s going to be several months down the road before we get the population effects of vaccination. And then after that, we’ve got to get the world vaccinated. Because you’ve seen, as people have talked about, I mean, we’re not supposed to name viruses or variants based on locations, but people still talk about the UK variant, South Africa, California Variant, New York, Brazilian. That’s the whole world. That’s are actually a lot of the places, countries that have had a lot of cases because viral evolution, you prime the pump of viral evolution by giving it a large population size.

Dr. Alex Greninger:
So the UK, US, Brazil, we did our part in that. Lord knows in terms of giving a lot of infections, a lot of amplification, a lot of replication for the virus, and then you put a little bit of selection on it and it’s going to move. And these are very plastic proteins, especially the attachment proteins. And they can they can accrue different mutations to sort of chip away at the immunity. And we know from other coronaviruses, we’ve never solved another coronavirus. We’ve got four of them that come around every winter, usually in bi-annual peak. So every two years and they’re able to establish reinfection. They’re able to evolve around prior immunity. I can’t say, because they’re not really able to evolve around prior vaccinations at all the vaccine form. But we know the long term is going to take sort of almost like a poliovirus type sort of response where we’ve got to basically get worldwide coverage and try to stamp these things down as best we can. And then we have to be really dower, I mean, the number of animal reservoirs that this virus can hang out. And you’ve heard about the mink, you’ve heard about the tigers and the zoo. It’s just been a nonstop litany of different animals this virus can go into, evolve into, hang out in.

Dr. Alex Greninger:
It is over the long run. It just seems like it’s going to always be there and it’s going to force us to respect COVID-19, respect sars-cov-2 and also respect the entire enterprise of respiratory viruses because its symptoms are so nonspecific right out of the gate. So come two years from now, a respiratory disease, people are going to want to know one, is it COVID? And two, what is it and what can we do about it? So getting all of that together is actually really going to be important. But right now we’re focused on COVID. That’s the rub. We’ve got to get the population side, population effects of vaccination. And then we know that this virus is going to continue to evolve. It’s going to put a mutation on mutation and chip away at immunity, just like it has. And we’ll probably have to update the vaccines and just continue to implement, implement, implement and educate.

Dr. Alex Greninger:
And in a way, I think especially in the winters, I mean, mask is actually probably a pretty limited intervention in terms of like a low-key intervention, like it’s not really impinging on your freedoms too much.

Saul Marquez:
Yeah.

Dr. Alex Greninger:
And we were able to crush the other respiratory viruses, influenza or asteroid syncytial virus or influenza virus. None of them had their season that same time.

Saul Marquez:
That’s insane. You know Alex, I was talking to physicians and a couple of meetings that I was and that’s the same thing that they told me. They said, man, like what happened? The flu season gone. Mask wearing works.

Dr. Alex Greninger:
Social distancing. The whole nine yards. But people got vaccinated hopefully, too. We had a big push for that. But yeah, we’ve done over I think it’s 50 thousand tests on our drive-thru sort of screening, not really medical test screening for influenza. And I think we’ve had three positives in Seattle. I mean, nothing, nothing. But then but then you’ve got to look at Australia. There was nice some studies showing they did a great job with COVID. Even when COVID came back, they were able to sort of clamp it down. And you saw in the Australian Open, there’s people in the stands there. They’re they’re doing normal things and they’re respiratory syncytial virus is having twice as many cases as normally does in a normal season because it didn’t get to book its last season. And so immunity levels are a little bit lower. It’s a little more time to evolve.

Dr. Alex Greninger:
And so we do sort of expect if you go back to business as usual, we’re going to see all of the respiratory viruses that we didn’t get over the last year are going to come back and have sort of two seasons worth, as it were. So they’re going to sort of binge-watch humans, as it were, two seasons. And that’s in the background of COVID. Right. It’s got to be in the background of worries over COVID. It’s going to be… I think the masking is worthwhile to sort of keep around indoors, sort of some those areas, airplanes, all the all the areas where you expect it to be somewhat higher risk or travel or whatnot. It’s not too bad.

Saul Marquez:
Listen, I’m OK with it. I mean, I don’t mind wearing a mask, especially since I know we’re all washing my family. We’re all washing our hands like crazy now. We did before. But I mean, you should see us now.

Dr. Alex Greninger:
Well, it’s probably the mask that’s doing the most of the heavy lifting in terms of. Washing hands is important, don’t get me wrong. But it’s going to do… For respiratory diseases certainly it seems like the mask. I mean, I haven’t had a respiratory virus the entire year.

Saul Marquez:
I haven’t either.

Dr. Alex Greninger:
So, yeah, usually you get like one or two.

Saul Marquez:
Yeah.

Dr. Alex Greninger:
And you amplify those. And the damnedest thing is that it’s just like COVID was unique. Not super unique but relatively unique, certainly the number of the degree of mortality and morbidity, but certainly that sort of power, a lot of mortality by age. Older people were more at risk. They’re exceptionally more at risk for bad outcomes. That aspect is sort of common to other respiratory viruses. So whatever you got, it was just a bad cold or whatever. You never know if that thing gets into immunocompromised populations. As physicians, we have to be super careful about not having any presentism at work. They’re sort of working while sick because we interact with so many vulnerable populations. But it’s all related when it comes to infectious diseases. So being able to clamp down all those amplifications and people across the world, it’s a net benefit.

Saul Marquez:
It is. Well, folks, you’re listening to this today. There is a benefit to getting mass vaccination. So do what you can to lead your employees, to lead your organisations, to lead your providers for your health system leader to get this done. I mean, we’re doing a good job, but we need that. What did you call it, Alex? Herd vaccination?

Dr. Alex Greninger:
For so long, four months now, it’s been about when can I get vaccinated, when are we going to get enough vaccine? And I think this next month is the month where we bring on so much more vaccine that is really comes down to now the volitional side, like going out and getting vaccinated. We’re going to open it up. You’ve got states already opening up to basically all adults in the state. We don’t have a super organized system for that. That is, I don’t know if you’ve gotten the vaccine, but I mean.

Saul Marquez:
I haven’t yet.

Dr. Alex Greninger:
All right. Good deal. All right. So as soon as you can go get vaccinated.

Saul Marquez:
Are you?

Dr. Alex Greninger:
Oh, yeah. Yeah. We got vaccinated early. It’s the health care worker world. So we’re right there at the beginning. But, you know, you get two stickers placed on a card, right? I mean, it’s not like there’s the I want to say there should be this is a contentious issue about central database for this sort of stuff. But like I mean, I want to say that if someone checking keeping track. But it’s really hard. Like, there isn’t. It’s all on an individual level, right. And I mean, that’s I guess you could say it’s a good one was going to hunt you down. But I mean, at the same time we know they’re going to be gaps and we don’t have. And then the other thing is, we don’t know. One of the weirdest things, at least the weirdest. But like it was odd. I struck me as odd. It still strikes me that a little bit is we’ve got some really great tests for the degree to which you react to the vaccine reacts, you respond to these vaccines and is there a serological testing. And in the Pacific Northwest, we have not seen much serological testing to look at whether you were previously infected. Health insurers have not been super excited about reimbursing. There’ve been some serious surveys to get it done. But I mean, there’s just not a lot of use of serology. We classically don’t use serology when it comes to influenza vaccine or other story, but we just don’t use it. We use it to find chronic viruses, HIV, Hep C, B, we use serology as a low-cost, highly sensitive way to screen for the virus. But we do have what it comes to this variance when it comes to people, there can be a thousandfold difference in people’s responses to vaccines or to infection across different populations. You’ve got the variants in multiple variants at play.

Dr. Alex Greninger:
There is a little more opportunity for, unfortunately, to say of the lab medicine versus clinical, because there is a little more opportunity to understand what’s going on there. We still need to work out some of these assays and especially we’re just now seeing vaccines. We’re seeing we’re seeing some vaccine failures as well. And we need to work out these correlative protection. But I do think there’s a way for a more scientific and informed response that we’re not necessarily seeing translated just yet into the clinic. You see it happening, these vaccine studies, you see it happen in sort of natural history studies. And people are interested in clinical research, but we haven’t really seen it translate into the clinical and widespread population.

Saul Marquez:
Sounds like an opportunity for us. But man, with leaders like you, Alex, Doing the work, I feel confident. And listeners, I hope you feel encouraged as well to know that we have thinkers like Alex and doers like Alex doing the work that we need to keep our communities safer and keep ourselves safer. What would you say you’re most excited about today, Alex?

Dr. Alex Greninger:
I mean, I think I sort of covered a little bit. The field of clinical virology is so poised, we just expanded our sort of analytical capacity around the country to test for viral diseases, to test for infectious diseases out the wazoo. We’ve got actually a lot of clinical pathology, sort of like private companies have taken on this public health mandate. We’ve got to enhanced sequencing capacity that’s been covered a lot now. And people talk about how little the US is sequencing. But really, honestly, that’s changed a lot in the last two or three months. And we’re bringing on incredible amounts of capacity from a laboratory standpoint. We’ve brought it on and we really need to use it. Actually, be a little sad to see some of it’s going to have to go away and can’t maintain that level of testing all the time. But I do think that we have an opportunity. Take hepatitis C. There’s a virus that we’ve got great drugs for, basically getting to the point where we have sort of pan genotypic almost no testing needed. We just need to find Hep C cases, get drug eight to 12 weeks of drug into people, and then boom, it’s done. Right. And so it’s really about case finding and we’re at a very poised position for that virus. And so using this analytical capacity, thinking about innovative ways to screen or screen populations for it to just basically eliminate hepatitis C in the United States is an achievable goal. I think that’s actually the goal in Washington state. But I think 2030 or something like that. There’s the old stuff like hepatitis C and then there’s the new clinical research where we make vaccines against Rsv for Influenza and a new virus. The antibodies just keep knocking down the virus that we commonly get every year across the population. And it’ll protect our immunocompromised individuals. It’ll protect our elderly. And also the best thing is you won’t get colds every year, too. So it’s a win-win-win across the board and we have the ability to do that now. So it’s just maintaining this excellence in the scientific side and then also continuing to educate and get, like you talked about, whatever thinkers and doers.

Dr. Alex Greninger:
I mean, really what it comes down to is people going out there supporting the scientific approach and then also right now getting vaccinated and acting smart, being aware of what they how they what they do contributes to population health at large. And so I really appreciate what you do. But also, it’s not just about the podcast. It’s about what people do after after they hear that or what they do. Everyone’s related here.

Saul Marquez:
Yeah. So speaking of which, Alex, what’s the call to action here? What do we need to be doing and let us know what that looks like. And also if anybody listening wants to connect with you or learn more, where can they reach out or where can they find your work.

Dr. Alex Greninger:
Sure. Well the first things first, as soon as you can get vaccinated for COVID-19, right., that’s the first thing right out of the gate. The same thing goes for influenza every September. When that comes around, you get vaccinated for that. If you can see their vaccine efficacy units around the country that are these sort of groups that basically look at some of these phase one, phase two vaccine candidate for other viruses, some other approaches are convinced you can get involved in clinical research.

Saul Marquez:
That’s super, super helpful. The faster we enroll people, the sooner we get information back about what’s working and sort of what’s the best approach. So that’s another way to get involved is also the therapeutic arm for covid. There are these active trials to being involved in clinical research I think is really helpful for to sort of move things forward. Like I said, we’ve got a lot of incipient technologies and great approaches, and it really is just about getting the data and people to show that we can go we can get these things through the FDA and get them implemented on a population wide basis like. It actually comes at the federal and state level, so supporting people who are agree with this approach, this is something that’s worth funding and worth acting on. So that’s been very helpful to have a covid focus. The mind, I mean, was totally bipartisan. This is whether it’s Trump or Biden. They were in on vaccine development. There’s a lot of talk about the US response to COVID-19. But when it comes to finding magic, sort of silver Bullets or magic bullets to knock This virus out, that’s where we put our nickel down. And we really can do that. So we can continue To do that. And those are the things I think people can do. Right, of the gates. And of course, mask. And if you feel a little ill, just stay at home. That’s true for all the viruses, not just for COVID.

Saul Marquez:
Now, this is great. Very clear call to action. Alex, I want to say thanks for joining us. This has been such a stimulating conversation. I know that the listeners are enjoying just as much as I am. If anybody wants to reach out or find more of your work, where can they do that?

Dr. Alex Greninger:
Basically, I have a Lab website, so Greninger Lab at the University of Washington. So they can call the contact. Details are all there, but that’s probably the best way to sort of reach out personally to me. I’m happy to connect people to other resources, depending on where they’re at in the country or around the world and what’s going on. Definitely happy to help connect people with what’s available, answer the questions, that kind of thing. You know, it takes all of us to get it done.

Saul Marquez:
It does. Well, Alex, thank you. And certainly looking forward to staying in touch. This has been really great.

Dr. Alex Greninger:
Well, thanks so much for having me. Really appreciate this great conversation.

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Things You’ll Learn

  • Learn more about virus and viral diseases
  • We still have a lot to learn about respiratory viruses
  • Learn the different ways vaccines are created
  • Find out the difference between RNA type of vaccine vs traditional vaccine
  • Respiratory diseases can be caused by different viruses.

 

Resources

Website: https://depts.washington.edu/uwvirus/

https://www.uwmedicine.org/bios/alexander-greninger