His vaccine astonished the world

Mikael Dolsten is a Swedish physician and researcher who has made an international career in the pharmaceutical industry. Since 2010 he has served as President of Worldwide Research and Development at the American pharmaceutical giant Pfizer. During his career he has helped to develop around 30 drugs and topped this with a Covid-19 vaccine that was produced in an incredibly short space of time.

Over the past year he has had many contacts with Sweden. He has been a guest professor at Lund University since the beginning of the year. In July he was one of the summer guests on the long-running and popular Swedish radio programme “Sommar i P1” when a broader audience learned that a Swede was behind Pfizer’s vaccine. At that point the vaccine had already been injected into millions of Swedish arms.

His Sommar episode was the fourth most listened to of the year. Dolsten received a lot of responses.

“Old childhood friends, schoolmates, university colleagues and family friends who I haven’t heard from for many years got in touch. It was personally very gratifying and as a physician conducting research it’s an honour to share how a pharmaceutical company was able to work with hospitals, doctors, nurses throughout the world to produce a vaccine,” he says.

The radio programme began with a scene that took place at Pfizer’s offices in Greenwich outside New York in November 2020 where Pfizer’s research team was assembled. The company had worked in cooperation with German research company Biontech on producing a vaccine in record time – just eight months. Now it had been tested in a large study involving 40,000 individuals. Those present in the room were eagerly awaiting the results. Then the announcement comes: The vaccine is 95-percent effective with high safety and tolerance.

“Incredible” declared Dolsten. He goes on to give an account of events.

“We started in March 2020. At that time people were still sceptical about whether it was a pandemic, which is something we’ve only read about in history books. But when three continents were involved, it was time for us to get going.”

Pfizer had been working with Germany Biontech for two years on developing a flu vaccine based on mRNA technology. Now when they contacted the German company it turned out that they had already started work on developing a vaccine against the coronavirus.

“We saw a possibility to take it all the way to a vaccine through the solid partnership we already had, and we started drawing up a contract. That normally takes up to six months, but had a letter of intent within one week and a signed contract within 10 days.”

The technology was based on mRNA – which both Pfizer and the US biotech company Moderna had selected for their coronavirus vaccines. The technology was fairly untested. There were no mRNA vaccines on the market at the time.

But basic research around mRNA has been under way for many years.

“We had a lot of experience of mRNA technology through our collaboration with Biontech. This strengthened our conviction that it was ready to be used and had enormous potential in a pandemic. At this stage it doesn’t take long to produce a vaccine and to adapt it to mutated variants if the virus changes its characteristics,” says Dolsten.

The first people were already being vaccinated in May. In July the first immunological analysis was ready and it showed that the immune response was very good. Then followed the major task of putting the puzzle together to find the variant and dose that would be the best combination for a vaccine that was effective, well-tolerated and safe.

“During the last few days of July we decided to start planning large clinical studies and also to build up vaccine production. The risk was much higher than in a normal project and I’m grateful every day that Pfizer invested USD 2 billion, even before we had all of the puzzle pieces in place.”

The vaccine against Covid-19 consists of mRNA that contains genetic information about the so-called spike protein on the surface of the coronavirus. When the vaccine is injected into a person’s arm and enters the cells the ribosomes read off the code and produce the spike protein that triggers the body’s immune response to recognise the virus and build immunity.

The new vaccines are a breakthrough for mRNA technology. Now it is being used to develop vaccines against several other viral diseases and even for cancer where the immune response can be made to attack tumour cells.

“We’ve recently obtained our first influenza vaccine candidate in clinical studies. We have a cancer drug on the way into clinical trials. More will come in a relative short time,” says Dolsten.

“This will be the most important technology in biomedical research to prevent and treat diseases in this century. The technology is being used for infectious diseases here and now, and will be used for cancer in the years ahead. Further into the future mRNA technology will have the potential to be used to cure genetic diseases as well.

How is the Swedish pharmaceutical industry doing in an international perspective?

“Sweden is strong in biomedical research at universities, it has well-organised medical care, and a biotech industry and an innovation system with venture capital and strategic support from the authorities and the government,” he says.

He also points out that there is an entrepreneurial spirit here and a talent base that is suitable for highly specialised research and industries.

“Sweden also has a knowledge bank of registers filled with medical data collected from patients over many years. With the help of powerful AI, this could be used to better understand diseases and develop new treatments in the future,” he says.

MIKAEL DOLSTEN

Age: 63

Education: Degree in Medicine from Lund University 1985. PhD in cancer immunology from Lund University 1988.

Career: Associate Professor Lund University 1990. Adjunct Professor 1996. Research Director Astra Draco, Lund 1997–2003. Research Director Boehringer Ingelheim, Germany 2003–2008. Research Director Wyeth, USA 2008–2010. Chief Scientific Officer and President Worldwide R&D, Pfizer, USA 2010–

Other information: Guest professor at Lund University from 2021. Scientific advisor to President Obama’s government, Joe Biden’s “Cancer Moonshot” initiative and recently to the United Kingdom’s pandemic G7 programme.

Doctor Mikael Dolsten is awarded the Academy’s Gold Medal for his outstanding contributions as a researcher and leader in the pharmaceutical industry. As head of research, development and medical operations at Pfizer – one of the world’s largest pharmaceutical companies – he has led the development of multiple new medicines and vaccines, most recently the successful development of a Covid-19 vaccine.