Albert Bourla: Pfizer CEO
技术与编程商业与创业政治与社会音乐与艺术哲学与宗教
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AI 智能总结
辉瑞CEO谈新冠疫苗研发、科学与信任危机
本期访谈嘉宾是辉瑞公司CEO阿尔伯特·布尔拉，他详细讲述了新冠疫苗从研发到上市的全过程，包括2020年11月8日等待三期临床试验结果的历史性时刻。对话深入探讨了科学、信任、制药行业的道德责任，以及疫苗在全球公共卫生中的角色。
新冠疫苗制药行业科学与信任公共卫生商业伦理
阿尔伯特·布尔拉（Albert Bourla）是辉瑞公司（Pfizer）CEO，兽医出身，在辉瑞工作超过25年，2019年出任CEO。他领导辉瑞与BioNTech合作，在不到一年时间内研发出全球首批获批的mRNA新冠疫苗。
📌 核心观点
- 2020年11月8日，布尔拉在康涅狄格州的小办公室等待三期临床试验结果，当得知疫苗有效率超过90%时，他当场落泪——这是他职业生涯中最重要的时刻之一。
- 辉瑞选择不接受美国政府的Operation Warp Speed资金，以保持研发独立性，避免政治干预影响科学决策，这一决定在当时颇具争议。
- 布尔拉认为，科学与信任的危机是当代最大的挑战之一：既不能盲目相信权威机构，也不能全盘否定科学成就，需要用独立思考来判断真相。
- 疫苗定价和专利问题上，布尔拉为辉瑞的商业模式辩护，认为利润驱动的创新体系是推动医学进步的核心动力，但也承认需要更好的全球公平分配机制。
- 他分享了作为希腊犹太人在二战期间家族的遭遇，这段历史深刻影响了他对生命价值、道德责任和科学使命的理解。
- 对于疫苗副作用和安全性争议，布尔拉坚持认为数据是透明的，但承认沟通方式可以做得更好，公众的疑虑需要被认真对待而非简单驳斥。
✨ 金句摘录
布尔拉：疫苗在过去一个世纪拯救了数亿人的生命，如果你忽视科学的力量，你就没有诚实地面对历史的教训。
布尔拉：这一生很短暂，对我来说，没有诚信的生命不值得活。
布尔拉：两个群体都声称自己掌握真相——一个说机构会拯救你，另一个说机构会伤害你。真相是，没有人能告诉你哪个是哪个，你必须用自己的头脑去判断。
📋 章节目录
暂无章节信息
🔑 关键词
donvaccinepfizermoneygoingsaidsurefdasciencehumandidnkidscoviddatastudydoingvaccinesworryconversationfear
💬 精彩语录
"And I think the hard truth is that no one in this world can tell you with absolute certainty which is which."
我认为残酷的事实是，这个世界上没有人能够绝对确定地告诉你哪个是哪个。
— Albert Bourla （00:50.680）
"When my words fall short, as they often do, it is only because of the limitations of my mind and of my speaking ability."
当我的言语不够时，就像经常发生的那样，那只是因为我的思想和说话能力的限制。
— Albert Bourla （02:52.520）
"and that the government will save you, the company will save you, the science, the authorities, the experts, the institutions will save you."
政府会拯救你，公司会拯救你，科学、权威、专家、机构会拯救你。
— Albert Bourla （00:25.760）
"and that the government will hurt you, the company will hurt you, the science, the authorities, the experts, the institutions will hurt you."
政府会伤害你，公司会伤害你，科学、当局、专家、机构也会伤害你。
— Albert Bourla （00:37.360）
"Don't blindly follow any leader, neither the emperor nor the martyr who points out that the emperor has no clothes."
不要盲目追随任何领导者，无论是皇帝还是指出皇帝没有穿衣服的烈士。
— Albert Bourla （01:03.800）
🎙️ 完整对话（1343 条）
Lex Fridman (00:00.000)
The following is a conversation with Albert Berla, CEO of Pfizer.
以下是与辉瑞公司首席执行官阿尔伯特·贝尔拉（Albert Berla）的对话。
Lex Fridman (00:04.600)
If you'd like to skip ahead to our conversation, the timestamps as always are below.
如果您想跳到我们的对话，时间戳一如既往地位于下面。
Lex Fridman (00:09.840)
But if not, please allow me to say a few words about truth and human nature.
但如果没有的话，请允许我谈谈真理和人性。
Lex Fridman (00:15.560)
Specifically, about two groups of people throughout history that seek to lay claim to the truth.
具体来说，是关于历史上两群寻求真理的人。
Lex Fridman (00:21.880)
The first group will tell you that only they possess the truth,
第一组会告诉你只有他们拥有真理，
Lex Fridman (00:25.760)
and that the government will save you, the company will save you, the science, the authorities, the experts, the institutions will save you.
政府会拯救你，公司会拯救你，科学、权威、专家、机构会拯救你。
Lex Fridman (00:32.840)
The second group, too, will tell you that only they possess the truth,
第二组也会告诉你，只有他们拥有真理，
Lex Fridman (00:37.360)
and that the government will hurt you, the company will hurt you, the science, the authorities, the experts, the institutions will hurt you.
政府会伤害你，公司会伤害你，科学、当局、专家、机构也会伤害你。
Albert Bourla (00:44.520)
Both groups have the benevolent and the malevolent, their heroes and their charlatans.
这两个群体都有仁慈的和恶毒的，他们的英雄和江湖骗子。
Lex Fridman (00:50.680)
And I think the hard truth is that no one in this world can tell you with absolute certainty which is which.
我认为残酷的事实是，这个世界上没有人能够绝对确定地告诉你哪个是哪个。
Lex Fridman (00:57.720)
You have to use your mind.
你必须用你的头脑。
Albert Bourla (00:59.640)
This is the burden of being human, of being free.
这是生而为人、自由的负担。
Albert Bourla (01:03.800)
Don't blindly follow any leader, neither the emperor nor the martyr who points out that the emperor has no clothes.
不要盲目追随任何领导者，无论是皇帝还是指出皇帝没有穿衣服的烈士。
Lex Fridman (01:11.440)
And then there's the lessons of history.
然后是历史的教训。
Lex Fridman (01:14.720)
Vaccines have saved hundreds of millions of lives in the past century,
在过去的一个世纪里，疫苗拯救了数亿人的生命，
Lex Fridman (01:19.400)
and in general, the advance of medicine has saved billions of lives.
总的来说，医学的进步拯救了数十亿人的生命。
Albert Bourla (01:23.320)
If you ignore the power of science, you're not being honest with the lessons of history.
如果你忽视科学的力量，你就没有诚实地面对历史的教训。
Lex Fridman (01:28.320)
And if you ignore the corrupting nature of power and money within institutions,
如果你忽视机构内部权力和金钱的腐败本质
Albert Bourla (01:33.040)
including governments and companies that led to the suffering and death of hundreds of millions in the past century,
包括在上个世纪导致数亿人受苦和死亡的政府和公司，
Albert Bourla (01:39.840)
you are once again not being honest with the lessons of history.
你再一次不诚实地对待历史的教训。
Albert Bourla (01:45.040)
I announced that I will be having this conversation with Albert Burla, Pfizer CEO, and a lot of people wrote to me.
Albert Bourla (01:52.080)
I would like to say that I was and am and always will be listening and learning with an open mind from everyone.
Albert Bourla (01:59.920)
My own opinion, worth little as it is, is that the development of the COVID vaccines is one of the greatest accomplishments of science in recent history.
Albert Bourla (02:08.720)
For the rest, from safety and efficacy to policy and economics,
Lex Fridman (02:13.080)
I stand humbled before a complicated world full of fear and anger.
Albert Bourla (02:18.240)
A small number of malicious people from all walks of life will use that fear and anger to divide us,
Lex Fridman (02:24.800)
because the division makes them money and gives them power.
Albert Bourla (02:29.120)
I took two shots of the Pfizer vaccine.
Lex Fridman (02:31.280)
This was my decision.
Albert Bourla (02:32.840)
I don't ever want to force this on anyone, and I certainly don't want to dismiss your concerns or worse,
Lex Fridman (02:39.200)
you as a person if you choose not to get vaccinated.
Albert Bourla (02:43.120)
I can assure you one thing, in this conversation, and in any conversation,
Lex Fridman (02:47.920)
the choice of questions I ask and words I say is mine and mine alone.
Albert Bourla (02:52.520)
When my words fall short, as they often do, it is only because of the limitations of my mind and of my speaking ability.
Lex Fridman (03:00.320)
It is not due to pressure or fear.
Albert Bourla (03:03.200)
I'm not afraid of anyone.
Lex Fridman (03:05.200)
I cannot be bought by anyone with money, power, or fame.
Albert Bourla (03:09.000)
I hope to prove this to you and to myself in the coming years.
Lex Fridman (03:13.520)
This life is short, and to me, without integrity, it is not worth living.
Albert Bourla (03:19.160)
People sometimes talk down to me, call me naive.
Lex Fridman (03:22.720)
Perhaps they are right, but it is who I am.
Albert Bourla (03:26.760)
I think this life, this world, this, our human civilization is beautiful.
Lex Fridman (03:32.480)
And as Dostoevsky said, beauty will save the world.
Albert Bourla (03:37.560)
This is the Lex Friedman Podcast, and here's my conversation with Albert Borla.
Albert Bourla (03:43.800)
The development of the COVID 19 vaccine was one of the greatest accomplishments of science in recent history.
Albert Bourla (03:50.880)
No matter what, this should give people hope for the future.
Lex Fridman (03:54.360)
And yet, it is more of a source of division.
Albert Bourla (03:57.640)
I hope we can discuss both the inspiring and the difficult ideas in this conversation
Lex Fridman (04:02.560)
so that we can do our small part in healing this division.
Albert Bourla (04:06.440)
I hope so.
Lex Fridman (04:07.720)
Take me through the day of November 8th, 2020,
Albert Bourla (04:10.080)
when the Pfizer team were waiting for the results of the phase three clinical trials.
Albert Bourla (04:14.880)
We had assembled in a very small office that we are having in Connecticut, very few people.
Albert Bourla (04:20.440)
There were five, I think.
Lex Fridman (04:22.320)
And in another place, what we call the Data Monitoring Committee,
Albert Bourla (04:28.640)
which is a group of experts, independent experts, they're on Pfizer,
Lex Fridman (04:32.240)
we're going to have the opportunity to unblind the data
Lex Fridman (04:36.920)
and then tell us if the study needs to continue or if it is successful or if it fails.
Lex Fridman (04:44.160)
And we were waiting for their call.
Lex Fridman (04:45.920)
So the call came a little bit later than what we expected,
Albert Bourla (04:49.600)
which created a lot of anxiety to all of us, but came around, I think, two o clock.
Lex Fridman (04:55.160)
You're just sitting there waiting? What were you feeling?
Lex Fridman (04:57.600)
Sitting there waiting and teasing one another, drinking coffee, making jokes.
Lex Fridman (05:04.480)
So how did you feel like when you heard the results, the successful results?
Lex Fridman (05:11.360)
Free, liberated, happy.
Albert Bourla (05:16.080)
Like if a huge weight that was on my shoulders was lifted.
Lex Fridman (05:23.280)
I heard you said, I love you to the team.
Albert Bourla (05:27.840)
I did. This is how we speak in Mediterranean.
Lex Fridman (05:33.000)
Listen, maybe it's the Russian thing too.
Albert Bourla (05:35.400)
I love love, so I appreciate that kind of celebration.
Lex Fridman (05:41.200)
So looking back from that moment to before,
Lex Fridman (05:43.560)
how much did it cost to develop the Pfizer BioNTech vaccine?
Lex Fridman (05:48.040)
What was it like making the decision to make that investment
Lex Fridman (05:51.680)
when the risk is very high and you don't know if it's going to be successful?
Lex Fridman (05:56.200)
You know, we do a lot of that anyway.
Albert Bourla (05:58.120)
This is what we do in our daily work.
Lex Fridman (06:00.800)
We are putting money.
Albert Bourla (06:02.880)
We are investing in research, which is highly risky.
Lex Fridman (06:05.840)
The difference in that case was that we didn't risk at all.
Albert Bourla (06:09.240)
We put it all in.
Lex Fridman (06:10.880)
We put everything in one go so that we don't lose time.
Albert Bourla (06:15.640)
Usually, we will spend 50 millions.
Lex Fridman (06:17.600)
And then if that goes well, then we will spend another 50.
Lex Fridman (06:20.400)
And then if it goes well, then 100.
Lex Fridman (06:22.240)
Here, we put all together a little bit more than $2 billion, $2.3 billion.
Lex Fridman (06:28.720)
And it was a significant decision.
Lex Fridman (06:33.680)
But it was a very easy decision to make in the context of what
Albert Bourla (06:38.120)
we were living at that time.
Lex Fridman (06:39.680)
It was a pandemic.
Albert Bourla (06:41.080)
People were scared.
Lex Fridman (06:42.080)
We were scared.
Albert Bourla (06:42.960)
We didn't know how tomorrow would look like.
Lex Fridman (06:46.440)
We were living unprecedented situations.
Lex Fridman (06:49.120)
And we knew that we have capabilities that may help.
Lex Fridman (06:54.280)
So there was not a second question or choice.
Albert Bourla (06:57.600)
We go all in.
Lex Fridman (06:59.120)
When you make decisions like that, you're
Albert Bourla (07:02.160)
the CEO of a company that needs to make money
Lex Fridman (07:08.000)
and that hopes to do a lot of good in the world.
Lex Fridman (07:12.680)
How much of both of those things are part of the calculation?
Lex Fridman (07:17.360)
So when you said it was an obvious choice,
Albert Bourla (07:21.560)
I think you've said a bunch of things of the kind of saying
Lex Fridman (07:25.840)
we need to go all in, sort of very boldly diving in.
Lex Fridman (07:31.320)
How much was that the world is facing uncertainty and fear
Lex Fridman (07:37.240)
and potentially destructive pandemic in the early days,
Albert Bourla (07:40.960)
just when you're seeing the full uncertainty before us,
Lex Fridman (07:43.440)
don't know how it's going to unroll?
Lex Fridman (07:45.240)
And how much of it is this may also
Lex Fridman (07:48.320)
be a good financial decision to take this risk?
Albert Bourla (07:51.000)
Yeah, I think about it all the time.
Lex Fridman (07:53.240)
And I know very well that if you focus too much on making money,
Albert Bourla (07:56.880)
you will never make.
Lex Fridman (07:58.440)
You should focus in what is the real value driver.
Lex Fridman (08:02.760)
And the real value driver, it is to make breakthroughs
Lex Fridman (08:07.080)
that change patients lives.
Albert Bourla (08:08.880)
If you don't do that, you will never make money.
Lex Fridman (08:11.360)
If you do that, don't worry.
Albert Bourla (08:13.320)
Things will fall into place, and also money will follow.
Lex Fridman (08:16.440)
But the mentality of the company is
Albert Bourla (08:18.600)
to be how to help the patient.
Lex Fridman (08:19.920)
And that's what the management was that the shareholders want,
Albert Bourla (08:23.160)
because that's the only way that we can create value.
Lex Fridman (08:26.360)
In this particular case, we're not
Albert Bourla (08:28.240)
thinking at all about what are we
Lex Fridman (08:31.120)
going to make when we sell it or if we don't sell it.
Albert Bourla (08:34.760)
Because what we were focusing 100%
Lex Fridman (08:37.680)
was how to bring a solution to the world that
Albert Bourla (08:40.520)
will help all of us change the fear that
Lex Fridman (08:44.400)
was bringing hope to the world.
Lex Fridman (08:46.440)
And as always, when you do that, you
Lex Fridman (08:49.760)
will have good returns as well.
Albert Bourla (08:53.400)
On a philosophical level, on a human level,
Lex Fridman (08:55.840)
do you ever worry that the pressure
Albert Bourla (08:58.520)
to cover the costs that were invested,
Lex Fridman (09:01.400)
to develop a new drug, to develop this vaccine,
Lex Fridman (09:05.080)
harms your ability to conduct unbiased studies?
Lex Fridman (09:08.560)
Not at all, because the studies are highly regulated.
Albert Bourla (09:12.840)
Everybody knows what regulators, and when
Lex Fridman (09:15.720)
I say regulators, FDA, European authorities, UK authorities,
Albert Bourla (09:20.560)
Israeli authorities, Japanese authorities, Canadian
Lex Fridman (09:22.800)
authorities, want to see how the study needs to be conducted
Lex Fridman (09:27.360)
and what exactly they need to see to approve it or not.
Lex Fridman (09:30.200)
So clearly, everybody takes into consideration
Lex Fridman (09:34.400)
how much money I'm going to invest
Lex Fridman (09:35.840)
and what is the chances that I'm going to lose them.
Lex Fridman (09:38.960)
But what you can do is to change the rules of the game
Lex Fridman (09:42.680)
so that you won't lose the money.
Albert Bourla (09:44.680)
There are very well established methodologies
Lex Fridman (09:47.960)
that would say with very high precision
Albert Bourla (09:50.960)
if your medicine is effective, if your medicine is safe.
Lex Fridman (09:54.800)
And those are there for all and are
Albert Bourla (09:57.320)
playing with the same rules.
Lex Fridman (09:59.720)
Do you have an intuition about why
Albert Bourla (10:02.000)
is the FDA trying to get 75 years to release the Pfizer
Lex Fridman (10:07.480)
data?
Albert Bourla (10:08.040)
They're trying to request that it will not
Lex Fridman (10:10.160)
be released for 75 years.
Lex Fridman (10:12.400)
And then maybe the broader version of that question
Lex Fridman (10:16.120)
is do you think people should have
Albert Bourla (10:18.720)
sort of full transparency and immediate access to the data,
Lex Fridman (10:22.760)
immediate on the scale of weeks, not years?
Albert Bourla (10:27.240)
I think the relations with regulators,
Lex Fridman (10:30.240)
they have been always very transparent.
Lex Fridman (10:32.120)
And there are a lot of laws that they
Lex Fridman (10:35.320)
are forcing regulators and companies
Albert Bourla (10:40.320)
to put out their interactions and what exactly was discussed.
Lex Fridman (10:44.720)
Now, to go into specific details of some discussions,
Albert Bourla (10:50.000)
I don't know what is the reason that FDA
Lex Fridman (10:52.120)
wants to take the time.
Lex Fridman (10:53.680)
And I'm sure they have very good reasons.
Lex Fridman (10:56.760)
Well, let me just say my side of it.
Albert Bourla (10:59.760)
It doesn't look like a good reason.
Lex Fridman (11:01.720)
It looks like maybe it's because I come from the Soviet Union.
Albert Bourla (11:04.920)
Now, this is not you saying this.
Lex Fridman (11:06.880)
This is me saying this.
Albert Bourla (11:10.200)
There seems to be a bureaucracy that
Lex Fridman (11:11.880)
gets in the way of transparency.
Albert Bourla (11:13.400)
That's always the challenge with government.
Lex Fridman (11:15.280)
So government is very good at setting rules and making
Albert Bourla (11:17.960)
sure there's oversight of companies and people and so on.
Lex Fridman (11:21.360)
But they create, they slow things down,
Albert Bourla (11:24.120)
which is a feature and a bug.
Lex Fridman (11:26.240)
And in this case, they slow down so much.
Albert Bourla (11:29.120)
I think the reason they set it at 75 years
Lex Fridman (11:31.680)
is because they set a rate of being
Albert Bourla (11:34.440)
able to only review 500 pages of data a day
Lex Fridman (11:37.360)
or something like that.
Lex Fridman (11:38.640)
And that's a very kind of bureaucratic thing,
Lex Fridman (11:41.360)
where in reality, you could just show the data.
Lex Fridman (11:44.840)
And it's not like something is being hidden.
Lex Fridman (11:47.480)
But in the battle to win people's trust,
Albert Bourla (11:50.200)
to inspire them with science, it feels
Lex Fridman (11:52.240)
like transparency is one of the most beautiful things, one
Albert Bourla (11:55.080)
of the most powerful things that the FDA has.
Lex Fridman (11:57.640)
FDA has the potential to be one of the great institutions
Albert Bourla (12:01.320)
of our country.
Lex Fridman (12:02.400)
And this is one example that it feels, to me, like a failure.
Lex Fridman (12:06.600)
So in your perspective, you're saying,
Lex Fridman (12:08.440)
I'm sure they have a good reason.
Lex Fridman (12:10.200)
So to you, the FDA is this black box
Lex Fridman (12:13.360)
that you submit things to once they approve.
Albert Bourla (12:17.400)
You know that those are the rules.
Lex Fridman (12:20.080)
It's approved.
Albert Bourla (12:21.120)
That's it.
Lex Fridman (12:21.880)
But this is not a black box.
Albert Bourla (12:24.360)
We know very well what is the process.
Lex Fridman (12:28.080)
Everybody knows very well what are the processes.
Albert Bourla (12:30.920)
The review process also, it is very detailed.
Lex Fridman (12:35.720)
They have scientists of very, very high caliber.
Albert Bourla (12:38.320)
Not every regulator in the world,
Lex Fridman (12:40.360)
but the Europeans, the BRIDs, the FDA clearly,
Albert Bourla (12:45.000)
they have very, very high caliber of scientists
Lex Fridman (12:47.080)
that they are going into a lot of details.
Lex Fridman (12:50.040)
And also, basically everything for a study
Lex Fridman (12:55.520)
is really released by law in the specifications
Albert Bourla (13:00.040)
of the product, but it's a very detailed document
Lex Fridman (13:02.560)
that it is issued and has basically the essence
Albert Bourla (13:05.280)
of everything that was discussed.
Lex Fridman (13:06.840)
I don't know about specific documents
Albert Bourla (13:10.520)
if take them time to release,
Lex Fridman (13:12.440)
but clearly this is not a black box type of process.
Albert Bourla (13:15.960)
A lot of this stuff is how do you effectively communicate
Lex Fridman (13:19.120)
to the world about the incredible science that's been done,
Albert Bourla (13:22.520)
about the processes that were followed.
Lex Fridman (13:24.640)
I agree with you.
Lex Fridman (13:25.640)
And then sometimes it's just in eloquence in communication.
Lex Fridman (13:29.520)
It's not that there's a failure process.
Albert Bourla (13:31.360)
It's in eloquence of communication and silence.
Lex Fridman (13:34.400)
Silence in the moment when clearly a lot of people
Albert Bourla (13:37.120)
are bothered and have questions.
Lex Fridman (13:40.120)
This is when you speak out and you explain exactly why
Albert Bourla (13:44.720)
as opposed to letting the sort of distrust build up
Lex Fridman (13:48.960)
and linger because the result is there's a very large
Albert Bourla (13:51.800)
percentage of the population that just,
Lex Fridman (13:56.340)
I mean, it divides people and science suffers, I think.
Lex Fridman (14:01.260)
And also the effectiveness of solutions suffers
Lex Fridman (14:04.700)
like the vaccine and so on.
Albert Bourla (14:08.560)
I asked a few folks I know
Lex Fridman (14:10.480)
if they had challenging questions for you.
Albert Bourla (14:12.680)
I'm sure many of them answered your call.
Lex Fridman (14:17.120)
Yeah, many friendly folks out there.
Albert Bourla (14:21.160)
By the way, I'm sweating not because this is a difficult
Lex Fridman (14:24.800)
conversation, it is, but it's also hot in here
Albert Bourla (14:27.020)
for the record.
Lex Fridman (14:29.600)
So one of the folks is Mr. Jordan Peterson.
Albert Bourla (14:33.160)
I don't know if you know who that is.
Lex Fridman (14:35.400)
He's a psychologist and intellectual and author.
Albert Bourla (14:38.280)
He suggested to me that I raised the concern
Lex Fridman (14:40.760)
that there's a close working relationship
Albert Bourla (14:42.740)
between Pfizer, FDA, and CDC.
Lex Fridman (14:45.720)
So we talked about FDA.
Lex Fridman (14:48.840)
Do you worry that this affects both positive and negative
Lex Fridman (14:53.560)
Pfizer's chances of getting drugs approved?
Albert Bourla (14:56.560)
The fact that there's people that worked at the FDA
Lex Fridman (14:59.480)
that now work at Pfizer, Pfizer, FDA,
Albert Bourla (15:01.780)
that there's a kind of pipeline.
Lex Fridman (15:04.080)
Does this worry you that it affects your ability
Lex Fridman (15:08.560)
to do great, unbiased work?
Lex Fridman (15:11.760)
I have zero doubts that this is not affecting at all
Albert Bourla (15:16.600)
their ability to be unbiased and regulate.
Lex Fridman (15:21.100)
And in order to, for the system also reinforces that
Albert Bourla (15:24.200)
by creating significant time barriers.
Lex Fridman (15:27.840)
If someone moves from an industry to FDA,
Albert Bourla (15:30.760)
she won't be able to deal with topics for a period of time.
Lex Fridman (15:34.600)
And then for even an enhanced period of time
Albert Bourla (15:36.480)
with topics that are related with a company
Lex Fridman (15:38.480)
he or she may come from.
Albert Bourla (15:40.840)
I think these regulators, they are really very strict.
Lex Fridman (15:46.960)
Rightly so.
Albert Bourla (15:48.360)
If anything, I feel sometimes that maybe they should
Lex Fridman (15:52.160)
be a little bit more open minded,
Albert Bourla (15:55.000)
particularly when it comes to new technologies,
Lex Fridman (15:57.400)
rather than trying to judge and implement the same
Albert Bourla (16:00.880)
framework of variation of new technologies to all.
Lex Fridman (16:03.520)
They are always as regulators in the conservative side.
Lex Fridman (16:07.280)
But always, always, they are unbiased
Lex Fridman (16:11.640)
and they are trying the best.
Lex Fridman (16:13.680)
And it's not only one or two people.
Lex Fridman (16:15.960)
They have processes to make sure that there are self checks
Lex Fridman (16:19.080)
and balances within the agencies,
Lex Fridman (16:21.320)
both in CDC and in the FDA.
Albert Bourla (16:23.840)
Difficult decisions, they bring external experts
Lex Fridman (16:26.520)
that they should express.
Albert Bourla (16:27.900)
Easy decisions, they are internal experts
Lex Fridman (16:30.080)
that they are debating a lot.
Lex Fridman (16:31.300)
And if there are disagreements, they elevate them.
Lex Fridman (16:33.520)
So I think we are lucky to have good regulators.
Albert Bourla (16:39.100)
I think I agree with what you said before,
Lex Fridman (16:42.560)
as with all governmental agencies, there is bureaucracy.
Lex Fridman (16:46.540)
And the bureaucracy needs to be addressed.
Lex Fridman (16:49.760)
And by saying bureaucracy is not relaxing the bar.
Albert Bourla (16:54.640)
The bar needs to remain high.
Lex Fridman (16:56.640)
But focusing on what matters rather than on the detail.
Lex Fridman (17:04.440)
So you don't, I've been reading quite a bit about history.
Lex Fridman (17:08.960)
You don't worry about human nature and corruption
Albert Bourla (17:12.240)
that can seep in.
Lex Fridman (17:13.480)
You're saying institutionally,
Albert Bourla (17:15.120)
there's protections against this.
Lex Fridman (17:16.840)
I think there is always the fear of corruption,
Albert Bourla (17:21.240)
particularly when you speak about public servants.
Lex Fridman (17:24.060)
But clearly the risk is very different country by country.
Lex Fridman (17:28.680)
And speaking about agencies by agencies,
Lex Fridman (17:31.960)
I think the regulatory agencies
Albert Bourla (17:34.400)
have a very good track record in history
Lex Fridman (17:37.020)
of the US, of Europe, of England,
Albert Bourla (17:40.040)
of very, very good track record of integrity.
Lex Fridman (17:44.720)
It's something I think about.
Lex Fridman (17:46.240)
So I grew up in the Soviet Union
Lex Fridman (17:47.900)
and I need to perhaps introspect this a little bit.
Lex Fridman (17:52.900)
But when I was growing up, ethically,
Lex Fridman (17:56.900)
there was a sense that bribery
Albert Bourla (17:59.500)
is the only way you can get stuff done.
Lex Fridman (18:01.640)
That was the system of the time.
Albert Bourla (18:04.020)
Like you get pulled over by a police officer.
Lex Fridman (18:06.740)
Like obviously you need to bribe them.
Albert Bourla (18:09.140)
I mean, it was like the way of life.
Lex Fridman (18:11.460)
And then so coming to this country was beautiful
Albert Bourla (18:14.460)
to see that the rule of law has so much power.
Lex Fridman (18:16.980)
And ultimately the rule of law when enacted,
Albert Bourla (18:21.820)
when it holds up, it gives people freedom
Lex Fridman (18:26.660)
to do the best work of their lives.
Lex Fridman (18:28.540)
But there's still human nature.
Lex Fridman (18:30.660)
And that worries me a lot here.
Lex Fridman (18:32.300)
And again, it goes back to the perception,
Lex Fridman (18:34.480)
the communication, when there's people
Albert Bourla (18:36.780)
that have worked at Pfizer and an FDA, at the CDC,
Lex Fridman (18:41.860)
you look at their resume,
Albert Bourla (18:42.940)
they have those things on their resume, it worries people.
Lex Fridman (18:46.700)
Are these great leaders that we are supposed
Lex Fridman (18:50.100)
to see as authorities, are they playing a game on us?
Lex Fridman (18:54.620)
I would say that I recognize what you said
Albert Bourla (18:58.260)
about what happened in, or what,
Lex Fridman (19:00.540)
I'm sure that what you described
Albert Bourla (19:02.700)
in the country that you're coming from,
Lex Fridman (19:05.300)
it was how you experienced it.
Lex Fridman (19:07.620)
And I know that there are other countries
Lex Fridman (19:09.300)
that you need to do these things to do your job.
Albert Bourla (19:13.300)
I don't think it's the case in this country,
Lex Fridman (19:17.800)
particularly when it comes to those agencies
Albert Bourla (19:19.620)
that you mentioned.
Lex Fridman (19:20.860)
I think they have a very high track record.
Lex Fridman (19:23.780)
And also, I don't think that there are a lot of people
Lex Fridman (19:26.700)
that they are worried about it or doubt it.
Albert Bourla (19:29.020)
I'm sure, like everywhere, there will be a minority,
Lex Fridman (19:31.900)
but the vast majority of the Americans,
Albert Bourla (19:34.180)
the vast majority of the Europeans,
Lex Fridman (19:35.620)
the vast majority of the Brits,
Albert Bourla (19:37.300)
the vast majority of the Israelis,
Lex Fridman (19:39.380)
they trust what FDA or EMA or CDC or MHRA will say.
Albert Bourla (19:44.380)
MHRA will say.
Lex Fridman (19:48.100)
Still, there's currently a distrust
Albert Bourla (19:50.060)
of big pharma in the public.
Lex Fridman (19:51.620)
Maybe this is something I'd love to hear your comment on.
Albert Bourla (19:55.700)
There's distrust of science when it's tangled up
Lex Fridman (19:57.980)
with corporations and government institutions,
Albert Bourla (1:00:02.440)
This is an end with all the caveats
Lex Fridman (1:00:06.080)
that the numbers are small, no one died.
Albert Bourla (1:00:08.440)
It was 100% efficacy on deaths.
Lex Fridman (1:00:11.280)
Of course, I'm sure that in real world,
Albert Bourla (1:00:14.760)
when the numbers are getting very high,
Lex Fridman (1:00:16.080)
we may have 99 instead of 100.
Lex Fridman (1:00:18.760)
But these are spectacular results
Lex Fridman (1:00:23.240)
for something that you can take home and stay home.
Albert Bourla (1:00:25.880)
The biggest problem right now in Europe, in the US,
Lex Fridman (1:00:29.120)
when we have surges,
Albert Bourla (1:00:30.320)
every time that we have a surge of COVID,
Lex Fridman (1:00:34.200)
it is that the ICUs are full,
Albert Bourla (1:00:36.880)
the hospitals are paralyzed,
Lex Fridman (1:00:39.240)
they have to postpone elective surgeries,
Albert Bourla (1:00:41.920)
they have to postpone other operations
Lex Fridman (1:00:43.440)
because they don't have the capacity because of that.
Albert Bourla (1:00:46.960)
Keeping people out of the hospitals, home,
Lex Fridman (1:00:50.520)
keeping people without dying,
Albert Bourla (1:00:55.800)
it is something that I didn't have before.
Lex Fridman (1:00:59.200)
And this is a significant, significant game changer.
Albert Bourla (1:01:03.880)
I have to ask a controversial, difficult question.
Lex Fridman (1:01:08.120)
What are your thoughts about ivermectin?
Lex Fridman (1:01:11.720)
Has it sufficiently been studied?
Lex Fridman (1:01:14.160)
Has Pfizer considered it in its, like I said,
Albert Bourla (1:01:17.200)
incredible development of the antiviral
Lex Fridman (1:01:20.400)
as a comparator or that kind of thing?
Albert Bourla (1:01:22.920)
Just investigate it in general.
Lex Fridman (1:01:25.000)
The reason I bring it up,
Albert Bourla (1:01:26.840)
because I've read quite a few criticisms of people.
Lex Fridman (1:01:30.400)
There's been some comparisons
Albert Bourla (1:01:31.560)
of paxilovir to the ivermectin,
Lex Fridman (1:01:33.400)
and I think people should look up.
Albert Bourla (1:01:36.200)
There is Dr. John Campbell that describes that comparison
Lex Fridman (1:01:39.480)
and makes that claim,
Lex Fridman (1:01:40.440)
and there's quite a lot of people that debunk
Lex Fridman (1:01:42.800)
or argue against that.
Albert Bourla (1:01:44.520)
You can do your own research,
Lex Fridman (1:01:46.240)
but there is a lot of people that kind of see
Albert Bourla (1:01:48.920)
this free drug without patents on it
Lex Fridman (1:01:52.400)
and say this could be the savior.
Lex Fridman (1:01:54.280)
So can you just speak to that comparison?
Lex Fridman (1:01:57.160)
It's not the first time.
Albert Bourla (1:01:58.160)
If you remember, there were other compounds
Lex Fridman (1:02:00.600)
that were claimed that they are the solution to COVID,
Lex Fridman (1:02:08.320)
and clearly they were proving that they're not.
Lex Fridman (1:02:12.560)
There are compounds that are solutions
Lex Fridman (1:02:13.960)
and compounds that are not.
Lex Fridman (1:02:15.400)
I, as a scientist, and I discuss with our scientists,
Albert Bourla (1:02:19.080)
they don't see any reason why a medicine like ivermectin,
Lex Fridman (1:02:24.520)
which is a parasitic site,
Albert Bourla (1:02:25.800)
to be able to act on COVID,
Lex Fridman (1:02:28.640)
and so they don't see that there's any connection,
Lex Fridman (1:02:31.680)
and they haven't seen any paper
Lex Fridman (1:02:34.840)
that describes someone that used it that had any results.
Albert Bourla (1:02:37.920)
I'm sure that there will be some people that will claim,
Lex Fridman (1:02:40.840)
because people are claiming anything,
Lex Fridman (1:02:43.000)
but I don't think that there was any paper
Lex Fridman (1:02:46.760)
in any peer review magazine,
Albert Bourla (1:02:49.240)
any reliable scientific magazine, to support this claim.
Lex Fridman (1:02:52.920)
So we are focusing on saving people's lives.
Albert Bourla (1:02:56.680)
We are not focusing on craziness.
Lex Fridman (1:03:02.080)
Well, to push back, there is quite a lot of papers,
Lex Fridman (1:03:06.560)
but the studies are small,
Lex Fridman (1:03:08.000)
so there's no conclusive evidence, and that's the point.
Albert Bourla (1:03:10.320)
I haven't seen any that it is reliable.
Lex Fridman (1:03:12.920)
I don't know where are these, small or big, reliable.
Albert Bourla (1:03:16.840)
I haven't seen any.
Lex Fridman (1:03:18.300)
Well, some of the big ones have been retracted,
Albert Bourla (1:03:21.400)
which means they weren't legitimate.
Lex Fridman (1:03:24.040)
Yes.
Lex Fridman (1:03:24.860)
Yeah, so?
Lex Fridman (1:03:27.000)
This is definitely something that people need to look into,
Albert Bourla (1:03:29.160)
the people that kind of question
Lex Fridman (1:03:31.880)
are the effectiveness of ivermectin,
Albert Bourla (1:03:33.280)
definitely something to think about,
Lex Fridman (1:03:35.600)
and I think it's the reason that past public.
Albert Bourla (1:03:37.600)
It was chloroquine alone before.
Lex Fridman (1:03:39.200)
Yes.
Albert Bourla (1:03:40.320)
For God's sake.
Lex Fridman (1:03:41.440)
That's why PaxLovid.
Lex Fridman (1:03:42.280)
How many people died because of that?
Lex Fridman (1:03:45.640)
Yeah, this is the dangerous thing.
Albert Bourla (1:03:48.580)
This is the sad thing.
Lex Fridman (1:03:51.720)
PaxLovid has been studying thousands of people
Lex Fridman (1:03:53.760)
and will be under the scrutiny, not only of regulators,
Lex Fridman (1:03:58.200)
but as we will go into the implementation,
Albert Bourla (1:04:00.960)
as it happened in many countries,
Lex Fridman (1:04:02.600)
they will monitor to see what's happened.
Albert Bourla (1:04:04.880)
Let's say that whatever we do, once it is out there,
Lex Fridman (1:04:07.800)
within a few weeks, they will know all hospitals,
Albert Bourla (1:04:10.640)
if it works or not, because they will see the statistics.
Lex Fridman (1:04:13.840)
We've gone through one of the more difficult periods
Albert Bourla (1:04:19.320)
in recent human history over the past two years,
Lex Fridman (1:04:21.760)
like as a society.
Lex Fridman (1:04:23.240)
What gives you hope about the future
Lex Fridman (1:04:26.340)
for our human civilization?
Albert Bourla (1:04:29.480)
You look into the next few years.
Lex Fridman (1:04:31.720)
I think the human ingenuity.
Albert Bourla (1:04:34.080)
I think although there is,
Lex Fridman (1:04:36.920)
the world always is progressing,
Albert Bourla (1:04:39.160)
although there are a lot of things
Lex Fridman (1:04:40.400)
that need to be fixed in the society of 2020.
Albert Bourla (1:04:45.960)
The society of 2020 is better at large
Lex Fridman (1:04:49.800)
than things 50 years back, 100 years back,
Albert Bourla (1:04:53.160)
in all different aspects, from poverty,
Lex Fridman (1:04:56.360)
for human rights, from science,
Albert Bourla (1:05:00.880)
from quality of life, from any aspect.
Lex Fridman (1:05:03.440)
I am positive that humans can create
Lex Fridman (1:05:09.240)
and always create a better future
Lex Fridman (1:05:11.240)
and will continue doing so.
Albert Bourla (1:05:14.560)
You have helped save the lives of millions of people,
Lex Fridman (1:05:17.800)
helped improve the quality of their lives,
Lex Fridman (1:05:20.080)
but you yourself are just one biological organism
Lex Fridman (1:05:24.240)
with an expiration date.
Lex Fridman (1:05:26.120)
Do you ponder your mortality?
Lex Fridman (1:05:28.200)
Do you think about your death?
Lex Fridman (1:05:30.440)
Are you afraid of death?
Lex Fridman (1:05:32.400)
That's a very interesting question.
Albert Bourla (1:05:34.240)
I was discussing with a lot of people
Lex Fridman (1:05:37.160)
that I was fearless of death, I couldn't care less,
Albert Bourla (1:05:40.080)
when I was young.
Lex Fridman (1:05:41.940)
The first time that I start feeling
Albert Bourla (1:05:46.320)
that I want to be around was when I had kids.
Lex Fridman (1:05:49.960)
And then I started feeling that,
Albert Bourla (1:05:52.120)
oh gosh, I hope I will be around to see their wedding.
Lex Fridman (1:05:56.400)
I hope they will be around to see their children.
Lex Fridman (1:05:59.720)
So if there is something that scares me,
Lex Fridman (1:06:02.640)
the possibility I will not be part of their lives anymore
Lex Fridman (1:06:05.560)
and I will not be watching.
Lex Fridman (1:06:06.760)
I hope there is life upstairs,
Lex Fridman (1:06:09.000)
so I will be able to watch them from there.
Lex Fridman (1:06:11.720)
From upstairs, get a nice overview.
Albert Bourla (1:06:15.720)
Let me ask the big ridiculous question.
Lex Fridman (1:06:19.320)
And you only have two minutes or less to answer it.
Lex Fridman (1:06:22.960)
What is the meaning of life?
Lex Fridman (1:06:24.320)
What's the meaning of this whole thing?
Albert Bourla (1:06:26.020)
You said ingenuity is the thing that gives you hope.
Lex Fridman (1:06:29.000)
We seem to be all busy trying to help each other,
Albert Bourla (1:06:31.320)
trying to build a better world.
Lex Fridman (1:06:33.040)
Why are we doing that?
Albert Bourla (1:06:34.160)
I would repeat something that Steve Jobs has said.
Lex Fridman (1:06:38.680)
Death is life's biggest invention.
Albert Bourla (1:06:42.720)
It eliminates the old and gives place to the new.
Lex Fridman (1:06:47.480)
Life is all about moving forward.
Albert Bourla (1:06:51.520)
Life is all about creating new things.
Lex Fridman (1:06:56.520)
And maybe everyone is a contributor,
Lex Fridman (1:07:00.120)
but no one is the owner.
Lex Fridman (1:07:03.000)
And always creating something new.
Albert Bourla (1:07:05.200)
Always.
Lex Fridman (1:07:06.320)
Adding something beautiful into the world,
Albert Bourla (1:07:08.080)
maybe a little bit of love.
Lex Fridman (1:07:10.480)
Hopefully.
Albert Bourla (1:07:11.700)
Albert, thank you so much.
Lex Fridman (1:07:12.840)
It's a huge honor that you go through
Albert Bourla (1:07:15.680)
some of these difficult questions with me today
Lex Fridman (1:07:18.200)
and that you give your extremely valuable time
Albert Bourla (1:07:20.840)
for this conversation.
Lex Fridman (1:07:21.840)
Thank you so much for talking today.
Albert Bourla (1:07:23.000)
Thank you for your interest and I'm happy,
Lex Fridman (1:07:25.520)
as I was telling you before,
Lex Fridman (1:07:26.640)
but I can brag with my kids that I was in your podcast
Lex Fridman (1:07:31.680)
because you are their hero.
Albert Bourla (1:07:33.320)
You made it.
Lex Fridman (1:07:34.160)
I made it.
Albert Bourla (1:07:35.680)
Thank you.
Lex Fridman (1:07:36.520)
Thank you.
Albert Bourla (1:07:37.680)
Thanks for listening to this conversation with Albert Burla.
Lex Fridman (1:07:40.600)
To support this podcast,
Albert Bourla (1:07:41.880)
please check out our sponsors in the description.
Lex Fridman (1:07:44.440)
And now, let me leave you with some words from Oscar Wilde.
Albert Bourla (1:07:48.400)
The truth is rarely pure and never simple.
Lex Fridman (1:07:52.320)
Thank you for listening and hope to see you next time.
Albert Bourla (20:00.240)
like we've talked about.
Lex Fridman (20:02.580)
But they have to be entangled to achieve scale,
Albert Bourla (20:07.220)
oversight, and to achieve the kind of scale
Lex Fridman (20:09.340)
that Pfizer's been able to accomplish.
Lex Fridman (20:11.340)
So, how can Pfizer regain the public trust?
Lex Fridman (20:16.660)
How can you regain the public trust, do you think?
Albert Bourla (20:19.060)
Not regain, but sort of take steps
Lex Fridman (20:21.820)
to increase the public trust.
Albert Bourla (20:24.340)
Reputation is something that you can lose in buckets,
Lex Fridman (20:29.860)
but you can earn it back in drops.
Lex Fridman (20:32.660)
And once you've lost it,
Lex Fridman (20:36.100)
you are going to take a lot of effort to bring it back.
Lex Fridman (20:40.380)
And the pharmaceutical industry lost it.
Lex Fridman (20:42.500)
It's clear that the reputation of the industry
Albert Bourla (20:45.380)
in the last decade was on the lowest
Lex Fridman (20:50.060)
that we have seen ever.
Lex Fridman (20:52.500)
And there are many reasons for that,
Lex Fridman (20:56.740)
but clearly there are reasons that are related also
Albert Bourla (20:59.540)
with the behavior of the industry.
Lex Fridman (21:01.980)
That needed to change, and I'm hopeful
Albert Bourla (21:04.740)
that very few will disagree
Lex Fridman (21:08.340)
that the industry is a very different industry right now.
Albert Bourla (21:12.340)
That being said, I truly believe
Lex Fridman (21:16.260)
that if there is one lesson that stands out
Albert Bourla (21:20.860)
from the many lessons that we learned during COVID,
Lex Fridman (21:23.940)
is the power of science in the hands of the private sector.
Albert Bourla (21:29.060)
I think it was the private sector
Lex Fridman (21:32.420)
that came with solutions with diagnostic tests
Albert Bourla (21:36.420)
when we didn't have, solutions with respirators
Lex Fridman (21:39.900)
when we didn't have, solutions with treatments,
Albert Bourla (21:43.340)
solutions with vaccines.
Lex Fridman (21:45.500)
And I think that demonstrated very clearly to the world
Albert Bourla (21:50.740)
the value of thriving life sciences sector,
Lex Fridman (21:56.860)
private life sciences sector to society.
Albert Bourla (22:00.420)
That also affected very positively the reputation,
Lex Fridman (22:04.540)
both of the sector and of Pfizer.
Albert Bourla (22:08.140)
I'm not going to make the mistake to consider given.
Lex Fridman (22:11.500)
I'm not going to make the mistake
Albert Bourla (22:13.380)
that because our reputation is high, that will remain so.
Lex Fridman (22:17.660)
We need to earn it every day.
Albert Bourla (22:19.940)
Every day with everything we do,
Lex Fridman (22:22.140)
with everything we say, with the way we behave.
Lex Fridman (22:25.060)
And I hope that we'll rise to this occasion
Lex Fridman (22:28.100)
and we will do that.
Albert Bourla (22:30.060)
You've been at Pfizer for 28 years.
Lex Fridman (22:32.380)
Time flies when you're having fun.
Lex Fridman (22:33.780)
And you've become CEO in 2019.
Lex Fridman (22:37.700)
It is a company you love, a company you believe in.
Albert Bourla (22:41.940)
It's a company that has developed drugs
Lex Fridman (22:43.620)
that has helped millions of people.
Lex Fridman (22:46.220)
So let me ask yet another hard question
Lex Fridman (22:50.060)
on this topic of reputation.
Albert Bourla (22:51.740)
In 2009, Pfizer pleaded guilty
Lex Fridman (22:54.180)
to the illegal marketing of arthritis drug Bextra
Lex Fridman (22:57.620)
and agreed to a $2.3 billion settlement.
Lex Fridman (23:01.420)
How do you make sense of the fact that this happened
Lex Fridman (23:04.860)
to a company you love and that you believe in?
Lex Fridman (23:07.900)
Yes, the Bextra case in 2009
Albert Bourla (23:12.300)
was related to things that happened in 2003.
Lex Fridman (23:16.340)
And the things that happened in 2003
Albert Bourla (23:17.980)
were things that basically several of our reps
Lex Fridman (23:21.620)
did off label promotion.
Lex Fridman (23:24.180)
So they spoke with the physicians
Lex Fridman (23:27.300)
about off label use of the product, and they shouldn't.
Lex Fridman (23:31.300)
Can you clarify it?
Lex Fridman (23:32.660)
So off label are things that the FDA didn't approve,
Albert Bourla (23:35.700)
extra stuff.
Lex Fridman (23:37.060)
You basically say this drug does extra stuff
Albert Bourla (23:39.380)
that the FDA never approved.
Lex Fridman (23:40.820)
Correct, and this is something that it is allowed
Albert Bourla (23:43.420)
when physicians are speaking to physicians,
Lex Fridman (23:45.420)
but it is not allowed for the pharmaceutical companies
Albert Bourla (23:48.140)
to refer to these studies,
Lex Fridman (23:50.300)
because usually our studies that are happening off label.
Lex Fridman (23:53.100)
And apparently several of our reps in 2003, they did it.
Lex Fridman (23:57.460)
And we had to settle in 2009,
Lex Fridman (24:02.580)
and we paid a very big fine, as you said.
Lex Fridman (24:05.220)
The fine was related not to the severity of the conduct,
Lex Fridman (24:08.580)
but the size of the revenues.
Lex Fridman (24:10.300)
So the fines are, if Bextra was a small product,
Albert Bourla (24:13.420)
we would get a small fine.
Lex Fridman (24:14.500)
Bextra was a very big product,
Lex Fridman (24:15.980)
and we got a very large fine.
Lex Fridman (24:17.740)
Very bad, what happened in 2003.
Albert Bourla (24:21.580)
I don't think that these things happened since then.
Lex Fridman (24:26.580)
We have a stellar record from 2009 until now
Albert Bourla (24:29.980)
of complying with every single regulation and rule.
Lex Fridman (24:34.980)
We have internal processes to make sure
Albert Bourla (24:37.420)
that these are not happening by individuals
Lex Fridman (24:39.660)
that may have an interest.
Albert Bourla (24:41.900)
For example, to get a promotion,
Lex Fridman (24:43.660)
they may try and do things
Albert Bourla (24:45.300)
that are not the right things.
Lex Fridman (24:47.140)
And we have, more importantly, a culture in this company
Albert Bourla (24:52.540)
that really sets aside people that they think differently.
Lex Fridman (24:56.460)
So I didn't like what happened in 2003,
Lex Fridman (25:01.700)
but I believe a lot has changed
Lex Fridman (25:03.660)
in the 20 years that followed, or almost 20 years.
Lex Fridman (25:07.620)
So you're developing drugs,
Lex Fridman (25:09.500)
you're developing solutions to help millions of people,
Lex Fridman (25:12.460)
but there's risk involved.
Lex Fridman (25:14.740)
And so there will be lawsuits heading back your way
Albert Bourla (25:18.940)
because there's a lot of lawyers in the world, partially.
Lex Fridman (25:27.540)
How do you put that into the calculation
Lex Fridman (25:29.900)
of how you try to do good in the world?
Lex Fridman (25:35.740)
That some of the cost is the lawsuits.
Lex Fridman (25:38.180)
How do you not fall victim to thinking
Lex Fridman (25:41.980)
that it's just the cost of doing business,
Lex Fridman (25:44.660)
and that some of the lawsuits might actually represent
Lex Fridman (25:46.980)
real pain that people are going through?
Albert Bourla (25:49.780)
No, I think that we try always to do the right thing.
Lex Fridman (25:52.500)
And that's, as I said, very well embedded into our culture.
Albert Bourla (25:56.860)
If you don't do the right thing,
Lex Fridman (25:59.100)
sooner or later, you will pay for it, one way or another.
Lex Fridman (26:03.140)
And right now, for us doing the right thing,
Lex Fridman (26:05.380)
it is being able to find innovations to issues
Albert Bourla (26:09.980)
that are real, diseases that they do not have
Lex Fridman (26:14.740)
good coverage, good treatments right now.
Albert Bourla (26:17.860)
We try to find treatments that significantly
Lex Fridman (26:21.420)
surpass the current standards of care.
Lex Fridman (26:26.020)
And we try not only to comply with what regulators
Lex Fridman (26:29.460)
are asking us to do, this is what you need to do
Albert Bourla (26:31.420)
to prove the safety or the efficacy, but exceed them.
Lex Fridman (26:34.900)
No matter what we do on that,
Albert Bourla (26:37.380)
I'm sure that people will find opportunity
Lex Fridman (26:39.540)
because, as you said, there are a lot of lawyers to sue us.
Lex Fridman (26:42.740)
But we believe in the justice system
Lex Fridman (26:44.460)
and we believe that eventually,
Albert Bourla (26:47.540)
if you are doing the right thing,
Lex Fridman (26:49.820)
you will be on the right side of the history.
Albert Bourla (26:53.140)
I'm really glad you say that because
Lex Fridman (26:57.900)
focusing on doing the right thing, no matter the money,
Albert Bourla (27:01.020)
I believe is the best way to make money.
Lex Fridman (27:03.820)
That's exactly what I said.
Lex Fridman (27:04.900)
And also, in another way, in other realms,
Lex Fridman (27:08.620)
creating a product that people love
Albert Bourla (27:10.180)
is the best way to make money.
Lex Fridman (27:11.780)
So focusing on the core of the thing
Albert Bourla (27:15.180)
that makes people feel good,
Lex Fridman (27:16.700)
that brings value to people's lives.
Lex Fridman (27:19.700)
So I'm now in Austin, Texas.
Lex Fridman (27:23.340)
My good friend, Joe Rogan, he's been highlighting to me
Albert Bourla (27:27.220)
this aggressive marketing on mainstream media channels
Lex Fridman (27:31.100)
by Pfizer.
Lex Fridman (27:32.340)
So let me ask a general marketing question.
Lex Fridman (27:35.340)
Do you see this as a conflict of interest?
Lex Fridman (27:37.420)
Is it my bias, the reporting of news?
Lex Fridman (27:40.580)
That a lot of us, a lot of people, me included,
Albert Bourla (27:44.340)
look to these mainstream channels of news
Lex Fridman (27:47.900)
for kind of authority of like,
Lex Fridman (27:49.300)
what the heck's going on in the world?
Lex Fridman (27:51.580)
And if Pfizer is sponsoring
Albert Bourla (27:56.940)
many of these shows,
Lex Fridman (28:00.260)
there's a worry, it may be a perception thing,
Lex Fridman (28:03.420)
but there's also a natural worry
Lex Fridman (28:05.060)
that it would influence what they're talking about
Albert Bourla (28:07.180)
because they're afraid of losing the sponsorship.
Lex Fridman (28:09.020)
It's subtle, but at scale, it might have a serious impact.
Lex Fridman (28:12.940)
Do you worry about this?
Lex Fridman (28:14.980)
I think people could go one way or another
Albert Bourla (28:17.980)
because of multiple reasons.
Lex Fridman (28:21.380)
From our perspective,
Albert Bourla (28:24.620)
I don't think we have aggressive marketing.
Lex Fridman (28:28.820)
What we do, we go on TV
Lex Fridman (28:31.180)
and we are having ads about our products
Lex Fridman (28:35.140)
and they're highly regulated.
Albert Bourla (28:38.300)
I think it is the right of people to know,
Lex Fridman (28:40.900)
to learn that if there is a product like that.
Albert Bourla (28:43.740)
It's very clearly that we cannot say things
Lex Fridman (28:47.260)
that they are off label, that have not been approved.
Albert Bourla (28:49.620)
We need to have, every time we go on TV, as you know,
Lex Fridman (28:52.580)
FDA is forcing us to say also the bad things
Albert Bourla (28:55.740)
that can happen for a medicine.
Lex Fridman (28:57.380)
Sometimes that takes more time than the good things.
Lex Fridman (29:01.340)
And I don't think that we are doing aggressive marketing.
Lex Fridman (29:04.660)
Now, people could be influenced
Lex Fridman (29:08.420)
and can be biased in the podcasts
Lex Fridman (29:10.700)
or the other type of media activities that they have
Albert Bourla (29:14.340)
for multiple different reasons.
Lex Fridman (29:17.460)
Yeah, I know, but it's still, it's pressure.
Albert Bourla (29:19.980)
It's human nature.
Lex Fridman (29:20.820)
I mean, one of it is perception, but I worry about too.
Albert Bourla (29:24.460)
I think I have a ton of sponsors for this podcast,
Lex Fridman (29:26.540)
for example, and none of them ever asked me to anything.
Albert Bourla (29:30.340)
They're just, you know,
Lex Fridman (29:31.820)
I think likely that kind of pressure's not happening
Albert Bourla (29:34.900)
for Pfizer, but there's implied pressure sometimes.
Lex Fridman (29:39.460)
And I worry about that a lot because, you know,
Albert Bourla (29:43.140)
I look at academia, like I look for the good in people.
Lex Fridman (29:48.380)
I tend to believe most people are good
Albert Bourla (29:50.180)
or have the capacity to be good and desire to be good.
Lex Fridman (29:54.780)
When I came to MIT, I was a little bit disappointed,
Albert Bourla (30:01.860)
maybe heartbroken.
Lex Fridman (30:05.860)
How much pressure?
Albert Bourla (30:09.820)
I think unjustified pressure people felt
Lex Fridman (30:12.700)
from financial constraints, especially at MIT
Albert Bourla (30:16.060)
when there's, I think, a lot of money.
Lex Fridman (30:19.260)
People still felt constraints and they weren't,
Albert Bourla (30:22.700)
it wasn't bringing out the best in them.
Lex Fridman (30:24.500)
They weren't supporting each other.
Albert Bourla (30:25.660)
They weren't loving each other,
Lex Fridman (30:26.940)
like celebrating each other's successes.
Albert Bourla (30:30.060)
I don't want to blame money on everything,
Lex Fridman (30:32.020)
money constraints, but when you have sponsors,
Albert Bourla (30:35.460)
it just, I personally worry
Lex Fridman (30:38.180)
that it doesn't bring the best out of people.
Lex Fridman (30:41.380)
And so I feel like I want to put some responsibility
Lex Fridman (30:44.820)
on sponsors and great big companies like Pfizer
Albert Bourla (30:49.460)
to kind of not get in the way of the best of human nature,
Lex Fridman (30:56.700)
whether it's sponsoring podcasts, mainstream media,
Albert Bourla (31:02.020)
like, I don't know, athletes, whatever.
Lex Fridman (31:05.140)
You need to know that we are so, so careful
Albert Bourla (31:08.020)
with sponsorships.
Lex Fridman (31:09.220)
First of all, we have very few, very, very few.
Albert Bourla (31:12.100)
We have a team that for every single one,
Lex Fridman (31:14.660)
could be $2,000.
Albert Bourla (31:16.820)
They will try to see if there is a conflict of interest
Lex Fridman (31:19.260)
in the way we do it.
Lex Fridman (31:20.420)
And also what is the reputation of the persons
Lex Fridman (31:25.420)
or the programs that we are sponsoring?
Lex Fridman (31:27.860)
So I don't think, our friend, I think was from Texas.
Lex Fridman (31:32.540)
Yes. Yeah.
Albert Bourla (31:33.460)
I don't. Joe Rogan, yes.
Lex Fridman (31:34.900)
Yes.
Albert Bourla (31:35.740)
I don't think he got it right
Lex Fridman (31:37.780)
that we do those type of things.
Albert Bourla (31:41.340)
We don't.
Lex Fridman (31:42.180)
Oh, in terms of like having a negative effect on.
Albert Bourla (31:44.620)
Not even having aggressive sponsorships.
Lex Fridman (31:46.580)
We have very few.
Albert Bourla (31:48.060)
Yeah, when you clip them all together.
Lex Fridman (31:49.900)
And most of the sponsorships that we have,
Albert Bourla (31:51.460)
it is more on patient related organizations
Lex Fridman (31:55.340)
rather than we are very careful not to sponsor other things
Albert Bourla (31:58.860)
that can be perceived, not even influenced,
Lex Fridman (32:02.300)
but perceived that we may influence.
Lex Fridman (32:03.740)
So we are very, very careful on that.
Lex Fridman (32:05.340)
This is not the case with us.
Lex Fridman (32:07.460)
So with the incredibly fast development of the vaccine,
Lex Fridman (32:13.340)
could you tell me the story from the engineering
Albert Bourla (32:16.820)
to the science, to the human story
Lex Fridman (32:19.300)
of how you could do it so fast?
Albert Bourla (32:22.680)
By November, you even had the ambition to do it by October.
Lex Fridman (32:26.380)
It was in the initial days.
Lex Fridman (32:28.540)
How do you. Eight days later.
Lex Fridman (32:31.140)
In that time, how do you show
Albert Bourla (32:33.500)
that the vaccine is safe and effective
Lex Fridman (32:36.860)
given that I think previous vaccines
Lex Fridman (32:38.820)
have taken years to do that?
Lex Fridman (32:40.260)
Yeah, the vaccines take years to do that.
Lex Fridman (32:43.220)
And the time that it takes, it is basically
Lex Fridman (32:48.900)
the vast majority of the time to conduct
Albert Bourla (32:50.980)
the final phase three study,
Lex Fridman (32:53.180)
that is the confirmatory study.
Lex Fridman (32:55.460)
And you do that because the phase three study
Lex Fridman (32:57.140)
costs a lot of money, in our case, cost almost a billion.
Lex Fridman (33:00.660)
So you don't want to go and risk a billion
Lex Fridman (33:03.780)
in blinded data normally before you do a lot of experiments
Albert Bourla (33:08.700)
to make sure that the product that you're putting
Lex Fridman (33:10.900)
in the phase three is the right one.
Albert Bourla (33:13.540)
We didn't have that time.
Lex Fridman (33:15.060)
So we risked all the money.
Lex Fridman (33:17.500)
So we went into, we condensed all the time
Lex Fridman (33:21.740)
towards this phase three.
Lex Fridman (33:23.100)
But the phase three study had to follow all the rules
Lex Fridman (33:27.140)
that any study follows when we do this trial.
Albert Bourla (33:31.580)
Could you just briefly describe the basics
Lex Fridman (33:34.820)
of what is phase one, what is phase two, what is phase three?
Albert Bourla (33:37.860)
Let's say that there are so many phases
Lex Fridman (33:39.940)
when you try first of all to find
Lex Fridman (33:42.500)
what is the right vaccine.
Lex Fridman (33:43.620)
We tried from 20 different vaccines,
Albert Bourla (33:45.980)
we nailed down to four.
Lex Fridman (33:47.740)
And for those four, we selected eventually two
Lex Fridman (33:50.380)
and then eventually one.
Lex Fridman (33:52.340)
Once you have those selections,
Lex Fridman (33:55.380)
what is the dose you're going to use?
Lex Fridman (33:57.140)
And then we tried multiple different doses
Albert Bourla (33:59.980)
to see which one we think is the best.
Lex Fridman (34:02.460)
What does trying entail in those early days?
Albert Bourla (34:05.180)
You go first of all with smaller doses in humans.
Lex Fridman (34:11.380)
And then after you have done a lot of experiments
Albert Bourla (34:13.980)
in animals so that you can feel that it is safe enough
Lex Fridman (34:17.340)
to go to humans and then go with very low dose.
Lex Fridman (34:20.500)
And then you gradually increase the dose
Lex Fridman (34:22.180)
and then you monitor those humans to make sure
Albert Bourla (34:24.820)
that there are not any, let's say reactogenicity
Lex Fridman (34:28.340)
to what you are giving them.
Albert Bourla (34:29.740)
At the same time, you start to measure what it's doing
Lex Fridman (34:32.060)
in terms of immune responses.
Lex Fridman (34:34.500)
So you do that with multiple vaccines
Lex Fridman (34:36.140)
and you do that with multiple doses
Lex Fridman (34:37.780)
and you do that with multiple ages of people,
Lex Fridman (34:40.540)
young people, old people.
Lex Fridman (34:42.500)
And eventually from the 20 vaccines to multiple doses,
Lex Fridman (34:47.060)
to multiple schedules, is it after three weeks
Albert Bourla (34:49.980)
the second dose or is it after four weeks
Lex Fridman (34:51.980)
or after six months?
Albert Bourla (34:53.820)
All of that will inform you that I think this is the vaccine,
Lex Fridman (34:59.620)
this is the dose, this is the scheme
Albert Bourla (35:02.420)
that I believe will give me the best results.
Lex Fridman (35:05.540)
And when you have that,
Albert Bourla (35:06.540)
then you go to do what we call the phase three.
Lex Fridman (35:09.900)
This is a very big study with thousands of people
Albert Bourla (35:14.180)
where you use the vaccine that you think is the right one
Lex Fridman (35:17.420)
and a placebo.
Albert Bourla (35:19.660)
The placebo and the vaccine, they look identical.
Lex Fridman (35:22.540)
Nobody knows if is injected a placebo or a vaccine.
Albert Bourla (35:26.620)
The physician that makes the injection,
Lex Fridman (35:29.220)
the doctor doesn't know if he's injecting placebo
Albert Bourla (35:32.300)
or vaccine, he knows a barcode.
Lex Fridman (35:35.380)
Only the computer knows.
Albert Bourla (35:37.420)
In order to go into this computer, there are keys
Lex Fridman (35:39.900)
and there are at least two people
Albert Bourla (35:41.420)
that needs to put their keys
Lex Fridman (35:42.860)
so that someone can see the data.
Lex Fridman (35:44.980)
And those people, they have legal obligations
Lex Fridman (35:48.380)
never to do that, right?
Lex Fridman (35:49.900)
So before a certain point.
Lex Fridman (35:52.260)
So all of that is blind.
Albert Bourla (35:53.980)
The idea is that when you go into this study,
Lex Fridman (35:58.260)
you need to make sure that you are going with the right one.
Albert Bourla (36:00.700)
That's why it takes so much time.
Lex Fridman (36:02.820)
But the study is the study.
Albert Bourla (36:04.460)
You need to have a significant number of people
Lex Fridman (36:07.380)
that will give the two
Lex Fridman (36:09.140)
and then you let them live their lives.
Lex Fridman (36:10.980)
And then you see how many of them will get the disease.
Lex Fridman (36:13.460)
And then you see if there are differences
Lex Fridman (36:16.140)
in percentage of infections for the vaccinated
Albert Bourla (36:19.100)
compared to the non vaccinated.
Lex Fridman (36:20.540)
At the same time, you're monitoring all of them
Albert Bourla (36:22.500)
to see if there are differences in the safety profile.
Lex Fridman (36:25.260)
If those that go to placebo have the same,
Albert Bourla (36:27.220)
let's say, heart attacks with those that they didn't.
Lex Fridman (36:31.020)
They got the vaccine because heart attacks will happen
Albert Bourla (36:33.340)
if you have 50,000 people because it's part of life.
Lex Fridman (36:37.700)
These are the, all these processes are very, very,
Albert Bourla (36:40.580)
very well established and since years.
Lex Fridman (36:43.820)
What we did the last one was exactly the same
Albert Bourla (36:46.020)
as we did always.
Lex Fridman (36:47.140)
We just didn't lose time.
Albert Bourla (36:49.300)
We didn't, we're not careful with money.
Lex Fridman (36:51.780)
Instead of recruiting 50,000 people over a year,
Albert Bourla (36:57.260)
because we had let's say 30 hospitals doing the recruitment,
Lex Fridman (37:01.860)
we went with 150 hospitals doing the recruitment.
Albert Bourla (37:04.380)
That cost a lot of money.
Lex Fridman (37:05.820)
But instead of recruiting them in a year,
Albert Bourla (37:07.980)
we recruited them in three, four months.
Lex Fridman (37:10.100)
So I did this type of things by taking return on investment,
Albert Bourla (37:15.220)
taking costs out of the equation
Lex Fridman (37:17.300)
and we were able to achieve this result.
Lex Fridman (37:19.220)
But it's not the process, believe me.
Lex Fridman (37:22.500)
It is the heart of the people.
Albert Bourla (37:25.220)
People don't know what they can and what they cannot do.
Lex Fridman (37:29.460)
And if anything, they have a serious tendency
Albert Bourla (37:32.500)
to underestimate what they can do.
Lex Fridman (37:35.300)
And always, when you ask them something
Albert Bourla (37:38.340)
that is seemingly impossible,
Lex Fridman (37:40.660)
they will think out of the box to be able to deliver.
Albert Bourla (37:44.540)
We discussed about the timing.
Lex Fridman (37:45.900)
Instead of eight years, we then asked them to do it
Albert Bourla (37:48.940)
in six, we asked them to do it in eight months.
Lex Fridman (37:52.740)
Our normal manufacturing yearly production of Pfizer
Albert Bourla (37:57.660)
was 200 million doses of vaccines every year.
Lex Fridman (38:00.220)
That's what we are doing in the last 10 years.
Albert Bourla (38:03.020)
We didn't ask them to make 300 million doses for a new vaccine.
Lex Fridman (38:06.380)
We asked them to make 3 billion doses for a new vaccine.
Albert Bourla (38:11.060)
The discovery phase of a new molecule,
Lex Fridman (38:13.740)
like the treatment that we have now, the pill against COVID,
Albert Bourla (38:16.740)
takes four years.
Lex Fridman (38:18.300)
We didn't ask them to do it in three.
Albert Bourla (38:19.660)
We asked them to do it in four months,
Lex Fridman (38:20.980)
which is what they did.
Albert Bourla (38:22.580)
When you are setting this type of goals,
Lex Fridman (38:25.860)
they know immediately, they cannot just think
Albert Bourla (38:29.140)
within the box.
Lex Fridman (38:30.340)
And immediately, this is where the human ingenuity
Lex Fridman (38:32.660)
and the heart comes.
Lex Fridman (38:34.380)
And this is how they surprised all of us.
Lex Fridman (38:37.500)
So there's incredible science and engineering
Lex Fridman (38:40.020)
going on here.
Albert Bourla (38:40.860)
This is an incredible thing. Absolutely.
Lex Fridman (38:43.260)
This is what's bothering me,
Albert Bourla (38:45.180)
that the conversation in public is often not about that.
Lex Fridman (38:52.180)
It's about politics, unfortunately.
Albert Bourla (38:53.500)
Politics.
Lex Fridman (38:54.340)
So I spent the day with Elon Musk yesterday.
Albert Bourla (38:57.700)
He works with rockets.
Lex Fridman (39:00.500)
Similar situation as with Pfizer,
Albert Bourla (39:02.460)
in the sense that there's NASA
Lex Fridman (39:04.580)
and then there's this private company.
Lex Fridman (39:07.060)
And that's a source of incredible inspiration to people.
Lex Fridman (39:11.460)
No politics, very little politics.
Lex Fridman (39:15.820)
So this is part of the thing I'm trying to,
Lex Fridman (39:18.780)
I'm hoping to do our little part in this conversation
Albert Bourla (39:22.380)
to help untangle a little bit,
Lex Fridman (39:25.700)
just reveal the beauty and the power of the thing
Albert Bourla (39:30.420)
that was done here, especially with the vaccine,
Lex Fridman (39:32.260)
but other things that are being done
Albert Bourla (39:33.500)
with the antiviral drug.
Lex Fridman (39:37.860)
Let me just kind of linger on the safety.
Lex Fridman (39:39.940)
What can you say?
Lex Fridman (39:42.580)
There's a lot of people that are concerned
Albert Bourla (39:45.900)
that the Pfizer vaccine, by the way,
Lex Fridman (39:49.100)
of which I took two shots, no booster yet,
Albert Bourla (39:54.660)
is unsafe.
Lex Fridman (39:56.740)
What do you say to people that say that?
Albert Bourla (39:59.980)
No, they should not fear something like that.
Lex Fridman (40:03.300)
It's completely wrong.
Albert Bourla (40:04.620)
There is no medical product in the history of humanity
Lex Fridman (40:09.500)
that have been tested as much as this vaccine.
Albert Bourla (40:12.700)
Has been administered to hundreds of millions of people.
Lex Fridman (40:16.940)
And because of the importance of COVID,
Albert Bourla (40:19.980)
they have been scrutinized, those people, constantly.
Lex Fridman (40:24.260)
Right now, healthcare authorities are looking
Albert Bourla (40:27.140)
for every single signal around the world
Lex Fridman (40:30.380)
of people that they got the vaccine
Lex Fridman (40:31.500)
and try to see if it is vaccine related or not.
Lex Fridman (40:34.460)
There are electronic medical records
Albert Bourla (40:36.980)
that will tell us when and what happened
Lex Fridman (40:40.620)
to a person when he did got the vaccine.
Lex Fridman (40:43.540)
And we know now, we have so high certainty
Lex Fridman (40:49.100)
that it is so safe, exactly as the data sheet says
Albert Bourla (40:56.340)
about this vaccine, more than any other product.
Lex Fridman (40:59.180)
They should not be afraid of something like that.
Lex Fridman (41:01.500)
And they should not listen to information
Lex Fridman (41:06.380)
that it is misinformation, that it is spread on purpose.
Albert Bourla (41:10.460)
Well, I don't like the word misinformation
Lex Fridman (41:13.900)
because, you know, again, back to the Soviet Union,
Albert Bourla (41:21.220)
anyone who opposes the state is spreading misinformation.
Lex Fridman (41:24.820)
So you can basically call anything misinformation.
Albert Bourla (41:27.460)
That's the unfortunate times we live in,
Lex Fridman (41:29.900)
is you can call anyone, you can basically call anybody
Albert Bourla (41:34.060)
a liar and say, I'm the sole possessor of the truth.
Lex Fridman (41:37.260)
And just no offense to me, just because you wear a tie,
Albert Bourla (41:40.100)
it doesn't mean you're any more likely to be
Lex Fridman (41:43.100)
in the possession of the truth than anyone else.
Albert Bourla (41:45.660)
So.
Lex Fridman (41:46.500)
I wouldn't disagree with that at all.
Albert Bourla (41:48.220)
I don't think that.
Lex Fridman (41:49.060)
That's somebody who's not wearing a tie.
Lex Fridman (41:50.500)
And as you can, people can see
Lex Fridman (41:52.300)
that I'm not wearing a tie and you are.
Lex Fridman (41:54.500)
But it's not about being able,
Lex Fridman (41:58.820)
those that they have the power to impose on the others,
Albert Bourla (42:04.380)
the stigma that what you're saying is misinformation.
Lex Fridman (42:09.700)
But there are a few things that as society
Albert Bourla (42:12.220)
we have accomplished and science is one of them.
Lex Fridman (42:15.500)
And data is, and analytics of data is another one.
Lex Fridman (42:21.380)
And to say that something which is highly scientific
Lex Fridman (42:26.380)
by people that they are not scientists.
Albert Bourla (42:31.300)
I think that it is not what you're describing,
Lex Fridman (42:35.520)
what used to happen in Soviet Union
Albert Bourla (42:37.500)
or in any other autocratic regime in the world right now.
Lex Fridman (42:42.300)
But I definitely do think that the scientists,
Albert Bourla (42:47.540)
the public science communicators I've listened to
Lex Fridman (42:49.900)
over COVID have really disappointed me
Albert Bourla (42:52.380)
because they have not spoken with empathy.
Lex Fridman (42:56.780)
They haven't sufficiently in my view
Albert Bourla (42:58.760)
have put their ego aside and really listened to people.
Lex Fridman (43:02.140)
Yes, people that don't have a PhD,
Albert Bourla (43:03.980)
people who have not really,
Lex Fridman (43:07.860)
maybe not even taken like a biology course in college
Albert Bourla (43:10.460)
or something like that.
Lex Fridman (43:11.340)
But still they have children, they worry, they fear.
Albert Bourla (43:17.340)
They don't know who to trust.
Lex Fridman (43:19.000)
They don't know if they should listen to the CEO of Pfizer
Albert Bourla (43:23.740)
who might have other incentives in mind,
Lex Fridman (43:26.060)
who might just care about money and nothing else.
Lex Fridman (43:29.060)
And so they just use common sense and they ask questions.
Lex Fridman (43:32.580)
And I think to them talking down to them
Albert Bourla (43:35.180)
as if they're not intelligent and so on
Lex Fridman (43:36.780)
is something scientists have done
Albert Bourla (43:39.520)
almost like rolled their eyes.
Lex Fridman (43:40.660)
And that disappoints me because I think
Albert Bourla (43:42.900)
that's kind of what is the source of division.
Lex Fridman (43:46.180)
Humility is a virtue.
Albert Bourla (43:47.500)
Yes.
Lex Fridman (43:48.340)
And the fact that you are educated
Albert Bourla (43:51.580)
doesn't mean that you are having either humility or empathy
Lex Fridman (43:56.060)
or you have good human qualities.
Albert Bourla (43:58.680)
This was never and will never be a metric
Lex Fridman (44:03.340)
of judging this type of virtues.
Albert Bourla (44:06.420)
Those that they do this, they're wrong.
Lex Fridman (44:09.500)
And actually they are not doing good service
Albert Bourla (44:13.900)
to the public health because they're undermining.
Lex Fridman (44:15.900)
People are not stupid.
Albert Bourla (44:17.100)
They see if you're not be respecting them
Lex Fridman (44:21.300)
and if you're not respecting their need to learn
Albert Bourla (44:23.980)
because that affects their health,
Lex Fridman (44:25.220)
the health of the mother, of the kids.
Lex Fridman (44:27.100)
So I fully agree with you that we should be very patient
Lex Fridman (44:31.540)
to explain again and again and again what is happening.
Lex Fridman (44:36.080)
And the vast majority of the people
Lex Fridman (44:37.900)
that they don't get vaccinations right now
Albert Bourla (44:39.740)
is because they're afraid.
Lex Fridman (44:41.140)
It's not for any other reason.
Albert Bourla (44:42.540)
It's not that they have an agenda.
Lex Fridman (44:44.920)
What I'm saying it is there is a small number of people
Albert Bourla (44:48.820)
that they have made business for them
Lex Fridman (44:52.780)
to profit from this anxiety.
Albert Bourla (44:56.820)
I'll give you an example.
Lex Fridman (44:59.340)
I have been arrested by FBI.
Albert Bourla (45:00.900)
This is what someone wrote.
Lex Fridman (45:03.620)
I read it, I laughed.
Albert Bourla (45:05.460)
I mean, okay, this is where they take it.
Lex Fridman (45:08.900)
There was a reason why they wrote it that.
Albert Bourla (45:11.200)
The Pfizer CEO was arrested by the FBI
Lex Fridman (45:13.060)
because they want to create doubts
Albert Bourla (45:15.200)
in the minds of the people that they're afraid
Lex Fridman (45:18.020)
and say, look, if the FBI arrested him,
Albert Bourla (45:19.680)
likely I will not do the vaccine.
Lex Fridman (45:21.460)
But I laughed.
Albert Bourla (45:22.900)
A week later, the wife of the Pfizer CEO died.
Lex Fridman (45:29.700)
There is a picture in this website of my wife.
Albert Bourla (45:34.060)
Someone sends to me, now I'm pissed.
Lex Fridman (45:36.900)
I'm not laughing.
Albert Bourla (45:38.540)
I tried to find my kids to tell them,
Lex Fridman (45:41.020)
if you read something, mom is fine.
Albert Bourla (45:42.820)
Don't worry.
Lex Fridman (45:44.140)
Then I remember that she has very old parents back in Greece.
Albert Bourla (45:49.380)
We start calling them to making sure
Lex Fridman (45:51.340)
because so you know that that will be picked up
Lex Fridman (45:53.080)
by Greek newspapers and they will publish it, okay?
Lex Fridman (45:56.100)
They are those people that wrote these things.
Albert Bourla (45:58.380)
They know very well that my wife didn't die
Lex Fridman (46:01.060)
and died because she was vaccinated, right?
Lex Fridman (46:04.860)
So this is the narratives that they are on purpose forming
Lex Fridman (46:09.860)
to profit from the stress and the anxiety of good people.
Lex Fridman (46:18.540)
And that's something I have to kind of,
Lex Fridman (46:20.500)
people that listen to this, that kind of doubt institutions,
Albert Bourla (46:24.720)
I do also want to say that there's quite a few folks
Lex Fridman (46:29.220)
who realize they can make money from saying,
Albert Bourla (46:35.460)
the man is lying to you.
Lex Fridman (46:37.860)
The government is lying to you.
Albert Bourla (46:40.300)
It's all corrupt.
Lex Fridman (46:42.460)
It's all a scam.
Albert Bourla (46:44.740)
Big pharma is lying to you.
Lex Fridman (46:46.280)
They're manipulating you.
Albert Bourla (46:48.360)
I'm surprised at how much money can be made with that.
Lex Fridman (46:51.700)
And it's sad.
Lex Fridman (46:52.700)
So you have to, just as people use their common sense
Lex Fridman (46:56.580)
to be skeptical when listening to politicians
Lex Fridman (47:00.420)
and powerful figures, they should be skeptical
Lex Fridman (47:03.340)
to also when listening to sort of the conspiracy theorists
Albert Bourla (47:06.980)
or not even the conspiracy theorists,
Lex Fridman (47:08.740)
but people who raise questions about institutions.
Albert Bourla (47:11.780)
Think on your own, think critically with an open mind
Lex Fridman (47:16.460)
that everyone can be manipulating you,
Lex Fridman (47:19.660)
but also everybody has the capacity to do good.
Lex Fridman (47:22.780)
And I think science in its pure form,
Albert Bourla (47:26.220)
not when entangled with institutions is a beautiful thing.
Lex Fridman (47:31.220)
And in the hands of many companies,
Albert Bourla (47:33.180)
it is a beautiful thing at scale.
Lex Fridman (47:35.320)
Still, you have a lot of incentive
Albert Bourla (47:39.520)
as having created the vaccine at Pfizer,
Lex Fridman (47:42.720)
this incredible technology to sing it praises.
Lex Fridman (47:49.680)
So there's a kind of, you know, people are skeptical,
Lex Fridman (47:53.700)
like how much do we trust,
Lex Fridman (47:55.840)
how excited Albert is about this vaccine.
Lex Fridman (48:00.760)
So for example, I mean, not to do a Shakespearean analysis
Albert Bourla (48:04.640)
of your Twitter, but I think he tweeted something
Lex Fridman (48:07.200)
about a study with a 100% efficacy of the vaccine
Albert Bourla (48:11.760)
or in stopping and transmission or something like that.
Lex Fridman (48:15.840)
Do you regret sort of being like over representing
Albert Bourla (48:23.520)
the effectiveness of the vaccine,
Lex Fridman (48:24.880)
technically saying correct things,
Lex Fridman (48:27.600)
but just kind of like highlighting the super positive things
Lex Fridman (48:32.600)
that may be misinterpreted, you know, saying 100%?
Albert Bourla (48:36.320)
No, I never said something 100%.
Lex Fridman (48:38.320)
Every time I speak, if a number is 100%,
Albert Bourla (48:41.440)
I rush to say that in biology, there is nothing 100%
Lex Fridman (48:44.520)
because always there will be
Lex Fridman (48:45.680)
when you go to the millions, okay?
Lex Fridman (48:47.520)
There were in the study things that were 100%,
Albert Bourla (48:50.120)
for example, deaths or in South Africa.
Lex Fridman (48:52.720)
When we tried, there was 100% efficacy.
Albert Bourla (48:56.480)
Clearly, it's more numbers.
Lex Fridman (48:58.140)
When the numbers will become much bigger,
Albert Bourla (49:00.880)
the 100% will not hold, but will be 95, 96.
Lex Fridman (49:04.840)
So still the direction of this is the point.
Lex Fridman (49:07.280)
So I'm very, very careful what I tweet.
Lex Fridman (49:11.440)
And in addition to how careful I am,
Albert Bourla (49:15.640)
I have people that they are looking at
Lex Fridman (49:18.160)
and they're having second or third opinions
Lex Fridman (49:20.440)
to make sure that we don't put, why?
Lex Fridman (49:22.480)
Because I know that people are listening to me right now,
Albert Bourla (49:24.880)
everything I say, and I want to make sure
Lex Fridman (49:27.760)
that they continue not only being clear
Albert Bourla (49:32.680)
as to what I want to say, so there are no misunderstandings,
Lex Fridman (49:36.000)
but also I maintain the trust of the people.
Albert Bourla (49:38.600)
I don't think that someone who only cherry picks information
Lex Fridman (49:43.140)
and only emphasizes positive things,
Albert Bourla (49:45.920)
it's someone that is the one to be trusted.
Lex Fridman (49:48.400)
And I want me and Pfizer to be trusted.
Lex Fridman (49:52.080)
So many felt the vaccine was presented as a cure
Lex Fridman (49:55.680)
that wouldn't require regular booster shots.
Lex Fridman (49:58.800)
Was that something you believed early on?
Lex Fridman (50:00.980)
Did you always believe that many regular shots
Lex Fridman (50:02.940)
would be required?
Lex Fridman (50:04.280)
And maybe in a bigger picture,
Lex Fridman (50:05.840)
how many do you think this will, for the Pfizer vaccine,
Lex Fridman (50:10.200)
is it something you see that's taking a booster shot
Lex Fridman (50:13.160)
regularly, like annually?
Lex Fridman (50:15.160)
Yes, in the beginning when we had the first months
Albert Bourla (50:17.960)
with the vaccine, people would ask me,
Lex Fridman (50:20.000)
do we need another one?
Lex Fridman (50:20.940)
And I said, we don't know.
Lex Fridman (50:22.520)
I was very clear about it.
Albert Bourla (50:24.280)
Then around April, May, I start seeing the first data
Lex Fridman (50:27.080)
and I made statements that I think we will need a booster
Albert Bourla (50:31.760)
around eight to 12 months after the second dose.
Lex Fridman (50:34.880)
And then after that, annually vaccinations,
Albert Bourla (50:37.440)
this is what I said,
Lex Fridman (50:39.000)
believe is one of the most likely scenarios.
Lex Fridman (50:42.520)
And it was based on the data that I had,
Lex Fridman (50:44.400)
but then Delta came.
Lex Fridman (50:46.200)
And because I always making the caveat
Lex Fridman (50:48.960)
that with absent a new variant with everything we know.
Albert Bourla (50:52.880)
With Delta, it was proven that we need the booster
Lex Fridman (50:55.520)
to move to the three, to the six months.
Lex Fridman (50:58.120)
And this is what happened.
Lex Fridman (51:00.680)
And I still said, I think the booster is a six months.
Lex Fridman (51:05.440)
And then I think it will be an annual revaccination likely.
Lex Fridman (51:08.900)
We have to monitor to see the data,
Lex Fridman (51:10.840)
but this is the likely scenario.
Lex Fridman (51:12.880)
Now we have Omicron.
Lex Fridman (51:15.060)
And Omicron says that two doses might be challenging.
Lex Fridman (51:19.040)
We don't know exactly yet, but three doses work.
Lex Fridman (51:22.760)
So clearly a lot of countries already started moving now
Lex Fridman (51:26.200)
the third dose, not from six months to three.
Lex Fridman (51:29.760)
So that they will reduce the period
Lex Fridman (51:33.160)
that people will not be protected with the third dose.
Albert Bourla (51:39.840)
I don't know with Omicron if how long this will last.
Lex Fridman (51:44.680)
And frankly, I don't know if we will need a new vaccine
Albert Bourla (51:47.080)
tailor made to Omicron based on everything we know so far.
Lex Fridman (51:51.120)
We are monitoring and we will know way more
Albert Bourla (51:53.240)
in the weeks to come.
Lex Fridman (51:54.720)
If there is a need for a new vaccine, we will have it.
Lex Fridman (51:58.200)
And if there is a need for mass production
Lex Fridman (52:00.640)
of this new vaccine, I can also feel very comfortable
Albert Bourla (52:04.160)
that we will not lose any of our capacity
Lex Fridman (52:06.680)
that we have developed.
Albert Bourla (52:08.080)
Right now we are running at 1 billion almost approximately
Lex Fridman (52:12.560)
doses per quarter, four per year.
Lex Fridman (52:15.800)
And if we have to switch and have half of that
Lex Fridman (52:18.860)
in the new, half of that in the old,
Albert Bourla (52:20.120)
we will do still 4 billion doses.
Lex Fridman (52:22.040)
So I think the world should feel very, very comfortable
Albert Bourla (52:26.280)
that if there is a need, we will be ahead of the virus.
Lex Fridman (52:30.000)
Yeah, you did, you delivered or produced 3 billion
Albert Bourla (52:33.200)
this year vaccines and you're on track
Lex Fridman (52:35.480)
to do 4 billion next year.
Albert Bourla (52:37.560)
I mean, if we had a lot more time,
Lex Fridman (52:41.680)
we would talk about how the heck you achieve
Albert Bourla (52:43.360)
that kind of scale, it's truly incredible.
Lex Fridman (52:46.120)
Let me ask the policy question.
Lex Fridman (52:48.320)
What are your feelings about vaccine mandates
Lex Fridman (52:52.040)
in terms of, do you think the most effective way
Lex Fridman (52:56.480)
to vaccinate the population is to acquire it?
Lex Fridman (53:00.320)
Or do you go with the American way
Lex Fridman (53:04.840)
and give people the freedom to choose?
Lex Fridman (53:07.480)
I think it is a very difficult topic
Lex Fridman (53:12.080)
and a very difficult decision for whoever needs to make it.
Lex Fridman (53:15.120)
And clearly it's not me.
Albert Bourla (53:16.680)
It is the public health officials of every country
Lex Fridman (53:19.040)
that they have to make this decision.
Albert Bourla (53:21.280)
I have to make the decision for Pfizer employees.
Lex Fridman (53:24.720)
And I had to balance the fear of those that they work,
Albert Bourla (53:31.920)
that they want to feel that the others are vaccinated
Lex Fridman (53:35.040)
and the fear of those that they don't want
Albert Bourla (53:36.720)
to get the vaccine.
Lex Fridman (53:38.040)
And eventually I came to the decision
Albert Bourla (53:40.640)
that we will mandate it at Pfizer.
Lex Fridman (53:42.920)
We are flexible, we are giving exceptions,
Albert Bourla (53:44.960)
of course for health, maybe some religions,
Lex Fridman (53:47.960)
but we decided to mandate it.
Albert Bourla (53:51.160)
Now, at Pfizer, when we did this decision,
Lex Fridman (53:54.960)
we were at 90% vaccination rates
Albert Bourla (53:57.280)
when we said we are going to mandate it.
Lex Fridman (53:59.640)
And that took it up to 96.
Lex Fridman (54:03.800)
It works, right?
Lex Fridman (54:06.440)
This 10% was never going to move, I felt.
Albert Bourla (54:10.200)
Because no matter what, you have a small number of people
Lex Fridman (54:12.680)
that really are scared.
Lex Fridman (54:14.600)
And they don't feel comfortable to do it, okay?
Lex Fridman (54:17.320)
It worked in our case, we took it to 96%.
Albert Bourla (54:20.440)
I'm happy for those people.
Lex Fridman (54:22.240)
A lot will not disease and some will not die
Albert Bourla (54:25.480)
of those people.
Lex Fridman (54:26.600)
But it's not me to say, because the debate,
Albert Bourla (54:31.000)
it's serious debate.
Lex Fridman (54:32.680)
And there are a lot of pros and cons
Albert Bourla (54:34.520)
if you need to push people,
Lex Fridman (54:35.760)
if you need to give them the freedom.
Lex Fridman (54:38.440)
And it comes with the territory.
Lex Fridman (54:42.600)
If you are elected to run a country,
Albert Bourla (54:45.440)
you should be ready to make difficult decisions.
Lex Fridman (54:47.680)
And no matter what decision you make,
Albert Bourla (54:49.120)
there will be fake stories written about you
Lex Fridman (54:50.720)
as we talked about.
Albert Bourla (54:51.760)
You will not be able to please everyone.
Lex Fridman (54:53.840)
Yes.
Albert Bourla (54:55.920)
Well, let me just say that I think,
Lex Fridman (54:57.920)
again, coming from the Soviet Union,
Albert Bourla (54:59.640)
I think at the public level, at the federal level,
Lex Fridman (55:01.960)
mandates is a really bad idea.
Albert Bourla (55:06.760)
Even if it's good for the health of the populace,
Lex Fridman (55:10.760)
there's something about preserving the freedom
Albert Bourla (55:12.280)
is really powerful about this country.
Lex Fridman (55:14.560)
Like doing the hard work of convincing people
Albert Bourla (55:17.000)
to get vaccinated, to choose to get vaccinated
Lex Fridman (55:20.440)
if they want, but still have the freedom not to.
Albert Bourla (55:23.520)
That's a really powerful freedom.
Lex Fridman (55:25.720)
To me, it's super lazy to mandate.
Albert Bourla (55:28.400)
People should understand the science
Lex Fridman (55:31.080)
and want to get vaccinated.
Lex Fridman (55:38.480)
Do you think children need to get vaccinated?
Lex Fridman (55:41.520)
I do.
Albert Bourla (55:42.360)
I do think that they need to get vaccinated.
Lex Fridman (55:44.560)
So age ranges five to 16.
Albert Bourla (55:48.840)
There's a lot of parents
Lex Fridman (55:53.400)
that fear for the wellbeing of their children.
Lex Fridman (55:56.160)
Can you empathize with those parents?
Lex Fridman (55:57.920)
Can you steel man their arguments
Lex Fridman (56:01.080)
against the vaccine for their children?
Lex Fridman (56:04.120)
You know, because people know who I am.
Albert Bourla (56:06.120)
I had the opportunity to interact with parents
Lex Fridman (56:12.560)
before that was, let's say, approved.
Lex Fridman (56:15.280)
And there were so many, way more,
Lex Fridman (56:18.800)
that I had a lot of empathy
Albert Bourla (56:21.720)
because they were afraid for their kids
Lex Fridman (56:24.080)
because they didn't have a vaccine.
Lex Fridman (56:26.720)
And they were the ones that were speaking at that time.
Lex Fridman (56:30.240)
Bring me vaccine.
Lex Fridman (56:31.120)
When are you going to bring me a vaccine?
Lex Fridman (56:32.720)
I really fear.
Albert Bourla (56:33.800)
I feel that this is unfair,
Lex Fridman (56:35.400)
but I am protected.
Albert Bourla (56:36.640)
My husband is protected.
Lex Fridman (56:38.440)
My old son is protected.
Lex Fridman (56:39.720)
And my little sweetheart,
Lex Fridman (56:41.760)
because she's below the age, is not protected.
Albert Bourla (56:45.600)
Now that we have the vaccines,
Lex Fridman (56:47.440)
I'm sure that those that they are afraid of the vaccine,
Albert Bourla (56:50.600)
not of the disease,
Lex Fridman (56:51.680)
which are smaller number, admittedly.
Albert Bourla (56:54.440)
Also, they will have, if they're afraid of them,
Lex Fridman (56:57.480)
I'm sure that they will afraid even more about their kids
Albert Bourla (57:00.080)
because they love, I would say,
Lex Fridman (57:02.240)
more than they love themselves.
Lex Fridman (57:04.040)
So it's going to be this situation.
Lex Fridman (57:06.400)
And again, the same.
Lex Fridman (57:08.800)
How can you do to demonstrate, to convince people,
Lex Fridman (57:12.200)
to win the minds and the hearts of the people
Lex Fridman (57:14.000)
that this is the right thing to do?
Lex Fridman (57:15.240)
What do you think about that calculation?
Albert Bourla (57:16.720)
Because the risk for kids is very low.
Lex Fridman (57:19.480)
Kids do die.
Albert Bourla (57:20.840)
Kids do go to the hospital from COVID.
Lex Fridman (57:22.880)
Yes.
Lex Fridman (57:23.840)
But the rate is very low.
Lex Fridman (57:25.600)
The rate is lower, but kids, they do die.
Lex Fridman (57:30.000)
And how can you say that I'm not going to,
Lex Fridman (57:32.600)
I'm not going to protect a kid
Lex Fridman (57:34.520)
for something that it is likely to happen?
Lex Fridman (57:36.960)
And it is not only that.
Lex Fridman (57:38.400)
What happens in the school
Lex Fridman (57:39.800)
when they stop the education process
Albert Bourla (57:42.600)
because a kid got the disease
Lex Fridman (57:44.840)
and they don't have vaccines so that they can control.
Albert Bourla (57:48.320)
It is such a big disruption
Lex Fridman (57:50.720)
and such a big risk for the health of the kids
Albert Bourla (57:58.160)
that it shouldn't be a debate.
Lex Fridman (57:59.720)
Look, how many kids are having polio right now?
Albert Bourla (58:06.000)
Way fewer number than those
Lex Fridman (58:08.480)
that they're having COVID in the hospital.
Lex Fridman (58:11.480)
But everybody's getting the vaccine.
Lex Fridman (58:14.920)
Well, polio was deadlier for kids.
Lex Fridman (58:17.160)
But it's not now.
Lex Fridman (58:18.280)
So why a kid to do it now?
Albert Bourla (58:21.960)
Because it needs to be protected.
Lex Fridman (58:23.600)
Well, the unique thing about the COVID vaccine
Albert Bourla (58:26.040)
is a new type of technology too.
Lex Fridman (58:28.240)
So there's an extra concern.
Albert Bourla (58:30.800)
Choosing to vaccinate a child,
Lex Fridman (58:33.440)
you're making a choice that can potentially hurt them.
Albert Bourla (58:37.760)
That's the way parents that are hesitant
Lex Fridman (58:39.480)
about the vaccine think.
Albert Bourla (58:41.680)
I think choosing to vaccinate children makes a choice
Lex Fridman (58:47.040)
so that something could not potentially hurt them,
Albert Bourla (58:49.320)
which is the disease.
Lex Fridman (58:50.280)
That's why we are doing vaccinations since ever.
Albert Bourla (58:54.000)
I know that there are people
Lex Fridman (58:57.360)
that they're concerned for themselves and for their kids.
Lex Fridman (59:00.360)
What I know it is that I'm a scientist and I'm a parent.
Lex Fridman (59:05.720)
And I am telling you that vaccines
Albert Bourla (59:09.160)
is a very good thing for kids.
Lex Fridman (59:10.440)
And thank God we were able to develop.
Lex Fridman (59:14.720)
So we've talked quite a bit about the vaccine,
Lex Fridman (59:16.960)
but there's an incredible new technology
Albert Bourla (59:18.480)
that Pfizer is developing
Lex Fridman (59:20.120)
with the PaxLovid antiviral for COVID.
Lex Fridman (59:24.000)
Where does that stand?
Lex Fridman (59:26.320)
How does that work?
Lex Fridman (59:28.640)
And how are you able to develop it in four months?
Lex Fridman (59:33.440)
Like you said, and all of that in just a few minutes.
Albert Bourla (59:37.440)
First of all, what this is about,
Lex Fridman (59:39.320)
this is a real game changer.
Albert Bourla (59:41.920)
This is a course of treatment
Lex Fridman (59:44.120)
that you get only if you get the disease, you get COVID.
Albert Bourla (59:48.280)
Then what happens is that you will take for five days,
Lex Fridman (59:51.960)
pills day and night, and twice a day for five days.
Lex Fridman (59:56.600)
And instead of 10 people from those that disease
Lex Fridman (59:59.040)
to go to hospital, only one will go.
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