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Dear Pascal Soriot,

I’d like to talk to you about your priorities.

Your company, AstraZeneca, is investing heavily in the development of a Covid-19 vaccine — and you have said you have no intention of turning a profit on any vaccine in the midst of a pandemic.

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But I have concerns about your commitment to transparency. When the news broke late Tuesday that a participant in your late-stage Covid-19 vaccine trial experienced a serious reaction, the company would only confirm the trial was put on hold in order to review safety data due to a “potentially unexplained illness.”

On Wednesday morning, another statement was issued with essentially the same information, and very little specifics.

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That same morning, though, you held a conference call with JP Morgan clients, who learned more details than had been disclosed to the public. The participant developed symptoms consistent with a rare but serious spinal inflammatory disorder called transverse myelitis. While that diagnosis hadn’t been confirmed, you shared that she was now recovering.

I’m glad to hear she is doing better, but why was that information not disclosed more widely?

Whatever your reasons, I think you did the wrong thing.

In the middle of a pandemic — when the whole world, literally, is hoping a useful vaccine is on the horizon — everyone was left to guess what went wrong and what it might mean.

I understand this was a single instance in a large trial, but there is already so much distrust surrounding Covid-19 vaccines. The issue, as you know better than most, is highly politicized thanks to President Trump’s transparent push for a vaccine prior to the Nov. 3 election. Polls indicate that Americans are worried politics is overtaking science.

As a result, Trump’s attempts to bully the Food and Drug Administration prompted you and the chief executives from eight other vaccine makers to issue a public pledge earlier this week to only seek approval if the safety and effectiveness data is sound.

Clearly, you understand the public is concerned about the impact this serious reaction can have on the trial and the extent to which a vaccine will actually be safe. No one wants to be a guinea pig so someone else can get re-elected to office.

“Skepticism is rampant,” said Art Caplan, a bioethics professor at the New York University School of Medicine, “and a high standard of transparency is needed.”

But whatever his faults at least Trump is transparent. You, on the other hand, well, not so much.

The failure to be more forthcoming right away only raises further questions about vaccine safety – at least for those who are unfamiliar with vaccine development. Vague reassurances about a “routine action” are meaningless when the whole world is scrutinizing your every move.

“The entire public has an interest in, and is deeply affected by, how quickly these vaccine trials are moving and whether they’re ultimately safe and effective,” Holly Fernandez Lynch, an assistant professor of medical ethics at the Perelman School of Medicine at the University of Pennsylvania, told me.

“And it’s intensified with the White House pressure to move things quickly and Trump’s comments. We’re in a precarious state of public trust and withholding information about a bad thing — or what might be a bad thing — in a trial further erodes that trust,” she added.

Now, I understand that you have a fiduciary responsibility to tell shareholders about material information. But to what extent the added details that were provided on the investor call are, in fact, material is unclear to me. If it is material, though, then your company should have released the information to all investors in a press release.

It is, however, clear that the information wasn’t simultaneously shared with the public.

“They may argue that what was said was not material and, therefore, it did not have to be publicly disseminated,” Charles Elson, a professor of corporate governance at the University of Delaware, explained to me. “Material information shouldn’t be disclosed selectively to particular investors. If you disclose, it has to be fair disclosure.”

In this case, Pascal, I do think the optics appear questionable.

“I’m not sure there was anything material that came out” on the call, says John Coffee, a professor of securities law and corporate governance at Columbia University. “They were filling in listeners on what was already known to be a serious adverse event.”

“But it may not have been the ideal way to deal with investors. It has a scent of selective disclosure. So at the same time, I suspect it’s a gray enough area for some to say he was conveying material information to institutional investors.”

In short, I believe there was a lack of fairness.

As a result, you missed an opportunity to bolster confidence in vaccine makers and the pharmaceutical industry as a whole.

And this should have been your priority.

  • Thanks for writing this open letter to the CEO of AstraZeneca. We needed real information about the vaccine development

  • Come on Ed, it must have been a slow news day. Soriot provided no more “meaningful” information in the investor meeting than what had been previously reported. The facts remain the same: the trial was put on hold due to a serious adverse reaction which needs to be thoroughly investigated. The possible name of the serious reaction (still not confirmed) and the fact that the patient is recovering tells us nothing more about the potential viability of the vaccine. The President is often criticized for speaking too quickly (before all the facts are known)… Soriot should not do the same. This matter needs to be thoroughly researched before additional information is communicated. In the meantime, AZ has acted in an appropriate manner in both the suspension of the trial and in its communication.
    The FDA and the Vaccine companies need to ensure that all appropriate steps are taken to ensure the effectiveness and safety of the vaccine. The Companies’ pledge is not an attempt to take on the FDAs responsibility but rather to reassure a public made jittery by a press driven by political considerations. The President pushing (and assisting) all parties to develop a SAFE and EFFECTIVE vaccine as quickly as possible is not “bullying.” It is what leadership should be doing. That being said, the FDA, not the President, will be the final judge of whether we have a safe and effective vaccine.

  • What a worthless letter. First comparing Trumps “transparency” when we all now know he lied completely about the virus which cost millions of people hardship, to AZs 1 person in a trial of 30,000 and who disclosed it as even being worthy of an argument lacks merit. Everyone wants relief, but it does no good to raise a red flag until it’s warranted. The person nay have contracted their illness otherwise. Why spook the crowd of millions, until you know its actually worthy of giving all notice of if it truly could be just 1 affected person? This was just a worthless article.

  • It’s a good letter as far as it goes, but like the (lack of) disclosure by AstraZeneca, it doesn’t go far enough. Big Pharma already has a big public image problem, and the lack of disclosure makes it worse. It suggests AstraZeneca is hiding something, and makes it less likely that the public (including me) will be willing to trust any vaccine that it might produce. The CEO of AstraZeneca is in the wrong line of work.

  • The optics smelled from the outset. The CEO is not a clinical scientist. The information should have been transmitted by the senior-most clinical scientist (Chief Medical Officer) after thorough internal discussions.

  • Well I wonder what happened to the Russian vaccine you all despised May be sharing knowledge in a case like this is not that bad instead of critizing

  • You’re in such rush to know what happened only if you’re an investor. No, the rest of the world does not need to know the next day what the illness was. There are other vaccines anyway. A very unnecessary letter.

  • What gets me is that everyone is stating that: 1 we don’t want to wear mask and social distance. 2 we need a vaccine quickly and safely. 3. we don’t want a vaccine as we don’t trust them.

    A vaccine normally will take a couple of years (in that case we would have to wear mask and social distance for 2 -10 years).

    Medical science has advanced in recent years and we are capable to conduct expedite research on vaccines. (If no one will take the vaccine we will be waiting years for trust of the vaccine and heard immunity to take effect 2 – 5 years).

    As for me I trust vaccines that are and have been investigated to be safe and effective. Many people have had plenty of vaccines with in their lifetime. (E.g. Mumps, Polio and the Flu). Another fact is that some people will die of a vaccine, people die of Advil and many types of medications (if you ever watch drug commercials on TV you would see this).

    Do I think pharmaceutical companies are rushing research for a vaccine I would say yes. Do I think they are doing it just for money and political game I would say no. I believe these companies have scientist who are working around the clock to identify a safe vaccine to save lives.

    What gets me is that everyone is stating that: 1 we don’t want to wear mask and social distance. 2 we need a vaccine quickly and safely. 3. we don’t want a vaccine as we don’t trust them.

    • I don’t actually think it’s the same people saying those three things. One large swath of the country doesn’t want to wear masks or keep social distance. Another large group is quite content to wear a mask proudly, even when they’re driving alone in a car somewhere. I think most people realize that an effective vaccine would end this pretty quickly, but the first group would really only be enthusiastic about it if it can be used to rally behind the president and get him reelected. The second group does not want and will not trust a vaccine that comes out before the election, and seem to believe that it has to take years of development time in order to be trusted. Though I think if their candidate of choice wins in November, they will quickly come around to rally behind the vaccine…

  • And why did we only find out the trial had been suspended for the second time now? This reeks of impropriety and an effort to push through the vaccine at any cost. It is truly too big to fail. Also the first was diagnosed as transverse myelitis and was later reclassified as MS. MS can be vaccine induced. And TM and MS are not distinct clinicopathological entities but rather TM be a manifestation of MS. This vaccine should be withdrawn from further testing.

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