YouSaid · the spoken record

Tal Zaks

lines on the record: 85
first: 2025-01-14
most recent: 2025-01-14
sittings or episodes: 1
sources: podcast

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“A true mentorship that has really lasted, I feel, a lifetime that's certainly the kindest that I think anybody has ever been to me. And in a small way, when people call me up, whenever somebody has ever worked with me, I always have that in the back of my mind. I feel a debt of paying it forward, if you want.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Personalized cancer vaccine. I called him up and I said, Hey, Steve, he's the best example of a public servant scientist that one can ever hope to meet. And he's one of these people who've actually not just moved the whole field. I mean, the whole field of immune oncology owes a great debt of gratitude because not only has he uncovered himself some of the key themes, but he's actually trained an entire generation of Asun, I'm proud to be one of his fellows. But I call him up and said, Hey, we've got this personalized cancer vaccine. I think it's got a shot of working. Would you be interested in maybe collaborating from the National Cancer Institute? Now, of course, I'm at this mRNA company back in 2016. Nobody thought this would work. My wife included. And yet, he invited me to come down to Bethesda and give a seminar and talk to his team. And they partnered with us and they ran a small clinical trial. And he actually listened and he continued to support he bought into it. And I have to say that that belief in me that”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Tell you the kindest thing anybody's ever done for me was probably Steve Rosenberg when he took me into his lab back in the NCI in the late 90s. And the kindest thing he did was that as I probably wasn't one of his best postdocs, I kept proving why things didn't work as opposed to showing things that did work. And as I was leaving, he said, look, Tal, if there's anything I can do to support you in your future, don't hesitate. You know, I didn't feel like I was that good. I wasn't sure that he really mean it, but it took me almost a quarter of a century to realize how deeply he meant it. Because not only did he come and support me over time, but I tried in his lab to make an mRNA vaccine for cancer. We did it in mice. We published it back in 1998 or so. And when I was at Moderna, and now this is 2016, 2017, so 20 years later, and we've come up with this.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Up and running in a place where patients had no autonomy if you measured outcomes in a certain way. But of course that's not a way that's acceptable to us to measure outcomes. So I think the world's going to stay messy, purposefully so. I hope so. I think it's what makes us human beings human. And so in that regard, I think I'm a little bit more circumspect for how rapid some of these technologies will actually be able to be deployed. And we're going to have to be careful to balance. And that's true of AI. in general in every application sphere, no less healthcare.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“That for me is still a little bit the realm of science fiction. You can get digital twins up to a point. They're going to be valuable, again, up to a point. The place where you need to be careful is we have to be able to balance this with the ethical obligations to patient autonomy and the other things that we hold dear and near to our heart. It can't be utilitarian because the utilitarian approach will be dictatorial and that's not going to work. And I think we're already seeing a public backlash against science trying to assert itself in the name of good. Science is only in the name of good and how we use it and deploy it. So you could probably get your best healthcare system”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Actually, find ways to put in systems that will improve productivity of the healthcare system. That's where I think the bull case is. And once we figure out how to do that and align that with an economic return on that investment, then I think you'll see an acceleration of change and the pace of change can actually be very rapid.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“That's going to be super challenging to get integrated. The bullish case is that there's somehow an integration of these systems and a realignment of incentives that allows people to leverage productivity. I mean, I think it was one of your prior guests who made the point when they were looking at the early days of EMRs, electronic medical records, now we call them EHRs electronic health records, and realize that the implementation of those systems into hospital systems actually hurt productivity, which is an abomination. I mean, the whole point of technology is to improve productivity. And I remember this as an intern. I mean, people started put PCs on nurses' desks and have the nurses start to spend time typing in. Okay, that just took time away from what they were doing. That didn't help anybody. If we figure out how to turn this on its head and”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, it means that I've got a company that's figured out how to do better transcription for nurses, but not physicians. So they're going around and they're making a new AI tool just for nurses and nursing homes. Okay. And then I got somebody else who said, hey, I've got a great system that can read the charts and figure out who's a good patient for a clinical trial. I'm going to go and deploy that in more institutions. Okay. That's all such thin piecemeal applications.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“The bear case is that they make slow roads one thin vertical domain at a time. That's already starting to happen, but it's slow. It gets encumbered by finding return on investment for each one of those thin verticals.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Dumb it down for me. Why is it? And my PhD mentor taught me early on that if you can't explain what you're doing to a kindergarten student, then you don't understand it”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“The five whys. Why is this? Why is this? Why is this? And the second thing that made him so effective is that when you gave him the answer, it had to be in plain English that he understood. If he didn't understand, he said, I'm sorry, I don't understand what you're telling me. Can you please?”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Earned great returns without the deep domain expertise have done so because they know how to find the right expertise, how to understand the question. And again, given it's such a multidisciplinary challenge, look, even I don't have the expertise. I've got a narrow band of it. All I've learned, if anything, is to ask the questions of the areas that I don't understand. And so if that's true, then of course somebody doesn't even need my expertise to go ask those questions. They can come from wherever. And you've seen people do that. It's that ability to ask the right questions and find the people whose answers you trust and the understanding of why you trust their answers that I think makes a great investor. It's also the traits that make a great general manager. I mean, again, I was fortunate to work with Stefan Buncel and his executive teams, his brilliance is being able to go function by function and just ask.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I think it is possible. I think it's been proven possible. I think those people who are successful in it are successful because they're smart in recognizing the multidisciplinary nature and knowing how to ask the questions. I've seen this up front. In fact, some of my colleagues even at Orbimed are not people with operational experience at all. And one of my realizations early on was, huh, I thought I needed all this experience to be good at it. Well, in fact, no, it turns out that people can be much smarter than me and can get there without the experience, just by virtue of their wisdom. Now, that being said, I do believe that you can replace experience with wisdom up to a point. Beyond that, you better go and ask somebody. And so I think those investors who can and have”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“At the end of the day, that is the driver. Yes, the science and the technology and the medicine, they all have to work, but it's the people who make it work. And it's the people who believe, who are putting their time on earth and their talents to drive it that are going to make the difference and are going to make the returns.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Can afford to take the risk where we are in life. And if this were to work, this would be big. So she said, okay, fine, go have fun. Do whatever. And we agreed that I do this for three to four years. And then it will flame out I'd have an interesting experience and I would still be employable probably and it'd be okay. When investors came to me at some point, and I remember when we turned public, and so investors started asking me, well, Tom, what do you think about the stock price? And the only answer I could come up with, I'm investing in this company something far more valuable to me than capital. It is my time on earth. So you do with your money what you see fit, but I'm telling you, I'm putting my time on earth into this. That's how I believe in this company. And so it taught me the primacy of sweat equity, if you will. And so I want to make sure that my capital equity follows the sweat equity of people I believe in.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“As long as we're clear-eyed about what it is and you got the right people around the table and you're in a position where you can take the portfolio approach of those. Now, it is interesting to me coming over to this side, the difference between being an investor and being an executive in one of these companies. So I can take a very hard-nosed look at the risk and I know I owe my LPs a certain return over time and it's going to be met by this portfolio. An executive in the company? Oh, no, they are going to live and die by that being successful. And I remember when I joined Moderna, my wife, who's a smart one in the family and has a PhD in biochemistry, looked at me and said, Tal, come on, this thing, I mean, mRNA is never going to work. Really? And I looked at her and I said, honey, not only is it unlikely to work, we're also never going to make any money because the book value was yay high when I joined and who thought. But I said I'd rather fail on something big than succeed in something small.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Who was an economist in the prior century? His whole economic thesis was that what drives economic progress is the naivete of thinking how easy it's going to be. You get excited about an idea. And the example he gives is back when they had to dig a tunnel through the Husak Mountains to connect the Boston area with the Hudson Valley. And they said, this is critical for economic development. So what's it going to take? So they brought in a bunch of geologists and they started picking at the stone. And they came to the conclusion that, look, it's a big mountain. We got to tunnel through it. But here's the thing. The shell of the mountain is really hard. But the core is soft. And so we'll get through the hard part, and then it'll be soft. It'll be easy digging. Then we get to the other side, a little bit of hard, and we're done. So give us a couple million dollars in those terms and two years, and we'll be through it. And five years in, and it's still hard. There was never any soft part in the middle of that mountain.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“I think the one that we get probably the most wrong is the one that is still the hardest to predict, which is what is the magnitude of clinical benefit that this will bring? Because clinical benefit is not a black and white. We typically invest in things where we understand the biology and we think we can de-risk it along the way. Okay, that's going to work. And then we have a belief in the drug because we understand the preclinical pharmacology and that's all good. And so it should work to some extent in the clinic. But how good is it going to be in a world which is so competitive? It can't just be something that somebody's already done before or even slightly worse. That's going to be dead. So it's got to somehow differentiate, it's got to somehow be better. It's got to offer something. And that's probably the part that's the most challenging to predict. There's a wonderful obituary that Malcolm Gladwell wrote years ago of Albert Hirschberg.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Because the upside is just not as much. It means that when you look at your investment portfolio, you have to take a very careful view of the balance of risk. Now each individual company, you got to, as Carl Gordon-Boss said, somebody's got to come and pound the table and be believing that this thing's going to work. There's nobody around upon the table. We're not making the investment. So there's got to be that sense of belief in the content and the people and the potential. We tried to take a very hard nosed look at what the probability of success is across the myriad of dimensions. And there are, as I said, many. Now, what do we get wrong? We probably get wrong each and every one of the dimensions. Sometimes we get the team wrong. Sometimes we get the science wrong. Sometimes we get the clinical application wrong. And sometimes we get the commercial opportunity wrong. I don't know that there's anyone that stands out because we try to look at the portfolio.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“As I joined this field, as I became an investor, one of the more interesting books I read is Scott Kapoor's The Secret of Sandhill Road, where Andreessen Hurwitz talks about what it takes to be a VC investor in tech. And they have a mindset where their returns can be 1,000 to one. And so they're okay to win only one in 100. The math still works. In our space, that actually doesn't work like that. Our returns are not gigantic. To get a 10x return for us is wonderful, not something you see commonly. And to get a larger than 10x return is rare. So we shoot for three to four x returns, five x return is a great outcome for us, which means that we can't afford to get as much wrong. As the tech folks can't.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Today, this is a growing problem. The likelihood of dying from significant infections continues to go up. And it's not a lack of scientific tools to understand bacteria and how to make better drugs. They're just a complete lack of commercial incentive to do so. I've got colleagues I'm working on some rare diseases and I've got colleagues who ask me, oh, you know, what do you think because pharmaceuticals pull back a little bit from rare diseases? Is that going to be a challenge? And I use this example to say that it's not a given that the economic incentives will always be there and we need to be super careful and super mindful of the policy implications that we have at the society level of what we think is important and how we reimburse these efforts because it is the return on investment engine that ultimately drives the innovation that benefits not just us today but our kids and our grandkids in the future.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Slide and give you a more accurate reading than a pathologist. Hands down, their FDA approved. But the problem is that less than one slide of any tissue microsection ever gets read by a computer. We still have microscopes and people looking down the microscope. Who's going to pay for changing all those microscopes to be digital and who's going to get a return on that investment? So you can see everywhere you look bottlenecks in the ecosystem of applying a technology that's already here today and continues to improve. And it's also true of drug development. And one of the examples I gave at that National Academy meeting, and I think is true, and as a warning sign for me, is the failure to develop antibiotics. So back in my dad's era, he benefited from drugs that are today generics. But when he went into the hospital with an infection, doctors had an antibiotic off-the-shelf that worked against the bugs in the hospital. We don't have those.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“I think in the 20 to 30 year horizon, they will experience healthcare very different than we are experiencing healthcare. I think what it means to go into the hospital, what it means to sit with a physician, what it means to get diagnosed and treated will be different. I think it will have more interventions far earlier. I hope that there will be an emphasis on maintaining health and promoting health as opposed to treating illness. Illness is always going to be with us and we will need to evolve our tools of treating with it. But yes, I do believe it's going to be different. Now that being said, we are also living in a time where, and this is what makes my unique job so fascinating, technology today can do more than our ecosystem has figured out how to integrate. And I say this both as an investor and a consumer. There are programs that can scan a pathology.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Evolve and the role of the physician will change into being the translator for people of some of this wisdom as opposed to the person who is entrusted with having all that wisdom in their head.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Time because it will bring a profound change in what it is to be a physician. I think that change is already occurring. If you look in the last 10 or 20 years in the US, we talk about physician burnout. Well, physicians have gone from having agency making decisions, spending time with the patient and earning a return on their time to now being employees of large health care systems whereby the treatment they meet out is a function of algorithms, the quality control is a function of algorithms, and the reimbursement, you know, what they can actually prescribe is a function of what the healthcare system will tell them. And by the way, they're all employees of the healthcare system to begin with. So all of the agency has been taken out. The time that they're able to spend with people has been trimmed and trimmed and trimmed. And so the role of what it is to be an internal medicine doctor has changed. I think that with the system of knowledge that AI is gearing up to be, it will continue to”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Of that. The best I can envision for somebody is to be as healthy as they were before they had cancer. Now, think of a vaccine. What does a vaccine do? It actually takes a healthy person and makes them healthier in the future. A serious medical doctor like myself in the previous era, if you told me that I would be interested in spending time making healthy people healthier, I would have looked at you strange and said, yeah, no, the people who do that are the yoga instructors, the quacks, and the nutritionists. I mean, I'm a serious doctor. I don't make healthy people healthier. If you're healthy, get out of my office. I got sick people lining up. I don't do that. But actually, that's what vaccines do. And that's what this new age of technology is going to enable us to do. Now, how do we deploy that information? I think in the 10-year horizon, you're going to see some of those insights now becoming institutionalized. I think it's going to take a long.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Where a whole world of drug development has to come in. But that's where I agree with the folks that have been saying that we've got a sick care system as opposed to a health care system. And look, my greatest learning as a physician from the COVID vaccine, I started this journey as a medical oncologist. Now, what's a medical oncologist? Somebody who deals with somebody who's got cancer. What's my vision for a patient that comes into my office? We started talking about vision. Well, my vision for that patient is their past.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“And he asked himself, Well, if I correct somebody's blood work for other parameters that the machine measures, but I don't even know what they are, can I reduce the variability? How much of the variability in the normal is actually true variance versus things we could correct for that are based on you? And it turns out that about half the variance of the distribution of what normal is actually false distribution if we could correct it relative to your factors, it would make that distribution much narrower, which means that we could now pick up things that otherwise look normal. But based on all those other things that the machine can figure out, this is a perfect application of AI because I can start to pick up abnormalities much sooner. Now, the question is, does that lead to interventions that we know will be of benefit sooner? Well, that's”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“An emergency room, and you get blood work, you're going to get the same panel that you did when I was a medical student 40 years ago, maybe with two additional analytes that have been added in the last 40 years. I find that so depressing. With all the progress we've had, and it's the same blood work. Now, here's an interesting fact. There's a brilliant AI scientist at the Weitzman Institute called Amos Tanai, and he spent most of his career designing better proteins to make drugs and things of that nature that you would associate with AI. But he was curious to understand how much of that regular blood work variability can be trimmed if we understand you as a person better. And so what he did is he teamed up with one of the Israeli healthcare networks to collect information on, I don't know, quarter million people over a decade. And he took that same blow.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“There's a lot of differences between people in terms of what is the right intervention for them. And I think my generation of medicine is guilty with peanut buttering the effect across a population without really understanding the chunkiness of it. I actually told my wife the other day that this is the year for me, for us, to actually start collecting data in a more thoughtful manner and a much deeper level than we've done in the past. Because like most people, I go once every year or two and get the usual blood work and take my statin for a pet of high cholesterol and think I'm done. But I think there's a whole lot more that we're going to learn that we can do. It is amazing to me and one of the triggers is the recognition you go and get the blood work in a hospital. And the thing that I find very depressing is the fact that if you go today”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“There's an old saying in the Talmud, which is my ethical framework given my religion, that since the time of the destruction of the temple, prophecy has been given to fools. So to the degree that I'm going to give you any prophecy that makes me a fool, but to the degree you listen, well, that's on you. So five years is probably the easiest. I'm of a certain age and generation and fairly conservative in my view. So up until now, I looked at all these data collections and thought to myself, well, you know, everybody knows what it means to eat healthy and exercise more. So getting more data to tell you what you already know is actually not going to change much. But I'm actually coming around because I do agree that I think”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“And so now we're very intentionally changing somebody's DNA to have an effect that will last for the lifetime. Well, there are some people who are going to find that challenging based on their ethical and moral framework. That's legitimate. There's a concern for what this means for future generations and making sure that we're doing it for the individual and not with unintended consequences for their offsprings. Or maybe sometimes with an That will raise a whole slew of new moral questions and ethical debates that we will have to resolve before this is widely acceptable. But at the end of that, if you can have a medicine that you take once, twice or three times and then you're cured for the rest of your life as opposed to having to take an injection every two weeks, I think that's huge progress for those patients.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Having to redose for the entire lifetime. And the company I've been spending the last year as the acting CEO, Exilio, is doing exactly that. It's taking this mRNA and a lipid nanoparticle, which is the same as Moderna vaccine, if you will, conceptually. It's not the same chemistry. But then the information that's encoded in that is actually allowing that mRNA to insert itself into the nucleus and make a change forever. Now, that is going to bring a whole slew of new challenges. One of the criticisms and the public backlash against mRNA was the mistaken conception that it will somehow change the DNA. And the truth is mRNA does not. It can't, based on first principle, and there's no empirical evidence that anybody's ever been able to show because it can. So mRNA doesn't do that. But there are ways to encode different information when mRNA where it will do that.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“It looks exactly the same. In fact, it's the same components. It's the information they encode that makes the drug. So these drugs as information, that's a new concept. And then there's a whole world of opportunity in what's called gene therapy, which is the ability, I started by mentioning rare genetic diseases where somebody is born missing an enzyme or protein. And if you can actually just put in the information that encodes for that protein, you fix the problem. And so now physiology should reassert itself as normal physiology of any other person. You can do that in mRNA with the traditional approach moderna is doing that for rare diseases, but then that mRNA is transient and you need to redoze every time. But if you could actually use that mRNA as an intermediary to get in and fix the genome once and for all, then you would potentially have a long-term beneficial effect without having.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Will broaden it out to sort of nucleic acid medicines, if you will. Which mRNA is an important part of? There's other types of RNA, most notably SIRNA. And I think these medicines are enabling new types of pharmacology that we haven't had before. They need a lot of investment in technology and delivery and getting them to the right tissue, but we all benefit from the same thing we benefited from in the vaccines as a platform, which is once you get the first one right, the marginal cost for the next one is a fraction. Nucleic acids have that unique property of almost software like we used to call it in the early days of Moderna, a software-like platform, because basically it's the same physical construct of a drug, but the information in the nucleic acid, you change the information, you get out a different drug, you get out a different vaccine. But actually under microscope,”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Things that have ethical and moral frameworks and forcing people to take vaccines is an ethical and moral consideration that the public has to buy into. And it's legitimate that they don't And that's a hard and messy thing in a democracy. In a dictatorship, it's easy. And yes, on average, in a dictatorship, everybody gets a vaccine. No question, they'll be healthier. That being said, you now have a balance of two opposing moral forces. And that's a reckoning that has to happen in the public square. It is not the scientists or the physicians purview. Dictate that. And I think that's where we probably overstepped. And I think my biggest learning has been the importance of the open and honest dialogue with the public on what it is that we do.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“It is science, it is good. Science per se is not an ethical framework of a force for good. People who deploy it for good have the obligation to explain why their moral framework is what it is, and that abuts in other ethical and moral considerations having to do with people's autonomy, freedom, and other aspects that have also ethical and moral perspectives to them. And our society is a balance of these different forces. And as a democracy, and I'm very proud of our democracy and I'm a proud immigrant into this country for both the opportunity and the democratic processes we have, I also have to recognize that that means that the public gets to say and vote on the thing.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“And as I stand back and look at that success, and again, both on the efficacy side, I mean, people have done the math. These vaccines have saved millions of lives. Full stop. Anybody who believes in reason and science will agree that that's incontroversial. But where did we fail? Because obviously the sentiments I'm expressing here are not uniformly shared by the public. I even have people in my own family who refuse to take the vaccine. I think it's a question of trust in institutions, and I think it's also a question of probably scientists, myself included, overstepping our boundary in a sense. And it goes back to the point I started with of the misguided philosophical framework that we operate under, which assumes that because”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Mission to get it right, but B, if you don't, you go to jail. I mean, this is as important as it gets in terms of getting it right. And believe me, all of us sitting on that side of the table, we're super conscious of the responsibility in making sure we got that safety profile right now. Where did we miss a beat? It was probably in terms of the public backlash.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Pulled and people don't use them anymore. The adenovector vaccines, whether it was JNJ vaccine or the AstraZeneca one, we discovered event rates that happened at one in 150,000 cases. And they were discovered within weeks to months. They were assessed as true and relevant, and they were quickly added to the label. Even we discovered this rare myocarditis finding in young adults. It was reported and appropriately put on the label. Still, by the way, the risk of getting the virus is much higher even just for that side effect of myocarditis, but it appeared to be related to vaccine and it went on the label. So I've never been as sure of anything in my life as I am of the safety profile of these vaccines because the data and the way it's been collected and analyzed. And look, when the executive on the other side of it, A, this is your lifestyle.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Vaccine to probably at the time it was millions and counting as we were rolling it out. It ended up being billions. We collected the safety data with the rigor and breadth that has never been done before in human history using tools that have never been available before in human history. The event rates in terms of side effects that people were reporting was about 10 to 20 fold higher than had ever been reported before with even prior vaccines. And the reason was A, the public was fearful. It was a pandemic. B, this was all quick. Nobody had heard of mRNA. And C, all the government entities were pushing out tools to report safety. So this was a real concern and we had to stand up systems to capture all of that. Now, the proof is in the pudding. If you remember some of the other vaccines that ended up getting on the market and then...”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“And if you look at the original design of the trial, the event rates that was expected to take up to a year actually occurred within three months. So because we were able to target the trial to where the events were happening, we could get the answer quicker and be ready with a vaccine. So all those elements, I think, are what enabled that unusual success. I do have to mention one word about safety here, and we'll come back to the public perception question. These mRNA vaccines have been the most well-studied medical intervention in the history of mankind. Full stop. I can tell you as the one responsible for setting up the collection and analysis of the adverse events data, that we had thousands of people pouring over tens of thousands of adverse event reports. We had given this”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Don't, and then you see well, what are the event rates? And this is where modern technology actually helped us. So we were looking at the spread of the pandemic as we were rolling out the phase three trial. And we could predict weeks ahead where hotspots would be. And we use those predictions to go and open clinical trial sites in places where we knew that event rates would be.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“All done very expediently. In fact, at a pace that it takes a global pandemic to get done. And that also enabled the investment in manufacturing and the scale up in manufacturing that usually is done later and in a much more circumspect environment. By the time we had to scale up the investment in manufacturing, there was a period of several months that it was challenging and the company had to actually foot the bill, go raise money in the capital market. People think the government funded it. No, it was private capital if you go back and look at the history that actually funded the commercial expansion. What the government did at a certain time point was backstop the investment and said, okay, we'll pay for these doses. But the capital actually came from the private sector. And then the final factor was actually, well, to test a vaccine or any medical intervention in a phase three trial, you need a certain amount of events to happen. So you give half a population your vaccine and half”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“And so we had set out years before to build a manufacturing process that would allow us to churn out a small batch in a rapid turnaround time. Guess what? That same size batch is exactly what you need to run a phase one trial with just two doses because the cancer patient is going to get doses for six months every three weeks. And so that served us well to be prepared to move so quickly. So that's what enabled us to start quickly. But how did we get to the end point quickly? Well, that was two factors, really. The first was the private partnership and this had to do with the NIH and the CDC and the FDA under Operation Warp Speed actually getting the government's act together and giving us guidance and working with us to be able to move quickly. So what usually take weeks and months of back and forth with the agency was literally a week agreeing on a protocol, agreeing on endpoints, agreeing on trial design, et cetera.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“The second thing was that we had agreed with the NIH we would run a demonstration project where the NIH team would pick a virus, something nobody ever heard of we haven't sequenced before. They'd send us the sequence, we'd make a quick batch, they'd test it in a phase one, and we'll start the clock and we'll see how fast we can go. That was the outcome of that meeting. And then suddenly someone started coughing in Wuhan in December. Two months later, the rest is history. So we were well prepared as a company with a platform. And it's interesting there was a recent economist piece on personalized cancer vaccine and how it all benefited from COVID and mRNA vaccine. What people don't realize is actually the opposite is true. When we set out to do the personalized cancer vaccine in order to treat somebody with cancer at a personalized dose, you have to make a small batch and you have to have a very quick turnaround time because people with cancer, they can't wait.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“Forget that, but in 2017, Zika was all the scare. So we partnered with the government, we started to develop a Zika vaccine. By the time we got there, it was of no interest. Okay. But at least the NIH took notice of the rapidity and potential of this platform. And in fact, I've told this story before, but in September of 2019, Stefan and I went down to see Tony Fauci in the NIH, and we were talking about the latest vaccine. It was something against cytomegalopirus and Dr. Fauci looked at me and says, So if what you're telling me, Tal is you've got the best vaccine platform I've ever seen. And with a bit of hotzpa, I said, yes, sir, and let me tell you why. And so the outcome of that meeting was twofold. Number one, the NIH wrote a paper. They published it in 2019. You can find it online with Dr. Fauci and his team citing mRNA technology as a leading platform in our readiness for pandemic. This is November of 2019.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“So, first of all, we were very well positioned in the beginning of 2020 to get there. What most people don't realize is that by the beginning of 2020, Moderna had already tested the ability of mRNA to generate neutralizing antibodies in humans against eight different viruses. COVID was to be our ninth. And our success rate was eight out of eight. That is unprecedented in drug development. It's a function of the platform nature of this. And so if you get the antigen right, that thing you're trying to immunize against, you're going to hit. And so we were very well prepared. And the other thing that helped us along was that we had already been collaborating with the NAH before then. So the government got to know us, BARTA and the NIH during Zika.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“In December of 2019, when somebody started coughing in Wuhan in that first Wall Street Journal article came, the person who in the company first picked it up was the head of the vaccines. The next person who actually took it and ran with it was Stefan himself. And he saw right from the start the importance of chasing this. It wasn't clear to the rest of us, frankly, whether this would peter out like prior vaccines. If you remember, January, February, even beginning of March of 2020, common wisdom would have had that, yeah, this is going to peter out. There's not going to be a big thing. Stefan was absolutely operating in a very different mindset. He saw the opportunity with his own will and management team took the company there and the rest, as they say, is history.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source
“We didn't drop the other elements, but we made sure to have the right capital allocation strategy. Now, remember in the early days, the loudest conversations we had at the executive team around the executive table was around the relative capital deployment of these various different applications. I was fortunate to work with, I think, some of the smartest people I've ever met. I've already mentioned Stefan, but we were at the time, three physicians on the executive team, Lawrence Kim, who trained as a physician but then became a finance executive at Goldman Sachs and joined us as our CFO. Today he's a very successful investor in his own right. Stephen Hoag, who's the president of the company to this day, a physician who then spent years consulting with pharma and then joined as the president of the company. And Stefan, it was a very robust dialogue of where do we invest the marginal dollar? Where do we see this technology panning out? And to take agility to the extreme.”
2025-01-14 · Invest Like the Best · Tal Zaks - Bridging Science, Medicine, and Returns - [Invest Like the Best, EP.406] · IDENTIFIED FROM THE TRANSCRIPT · source