In the spring of 2020, the US government formed and funded Operation Warp Speed with various private partners to accelerate the development of COVID-19 vaccines and treatments. In less than a year, the effort produced multiple COVID-19 vaccines that received regulatory approval, a feat The Wall Street Journal called “the most remarkable achievement in modern medicine.”
The achievement was a testament to the scientific and collaborative skills of many, but perhaps especially Matthew Hepburn, who had served as Operation Warp Speed’s lead for Vaccine Development. That success led to his current role in the Biden White House as Senior Advisor for pandemic preparedness at the Office of Science and Technology Policy.
As a medical student at Duke University contemplating which specialty to choose, Hepburn recalls thinking, “I really wanted to have an impact.” The face of impact in medicine arguably belonging to Jonas Salk, developer of the polio vaccine, Hepburn became an infectious disease specialist, and impact is what Operation Warp Speed delivered. COVID-19 vaccines have saved millions of lives across the globe.
Not that Hepburn is celebrating. He knows that more work is needed.
But he also remains an optimist. Among other successes during the pandemic, the world tripled its capacity for manufacturing vaccines overnight. His hope is that world health authorities and government leaders will support further international cooperation toward injecting arms around the world with new and existing vaccines.
An Ann Arbor, Michigan, native, Hepburn served 23 years as an Army physician, six of those years running pandemic research and preparedness for DARPA, the Defense Advanced Research Project Agency. His expertise in infectious diseases prompted TEDMED to recruit him to deliver a talk on Ebola and other infectious diseases. But by the time the date of that talk rolled around—March 3, 2020—nobody wanted to hear about Ebola. They wanted to hear about this new threat just then arriving in America: COVID-19. Pivoting, Dr. Hepburn predicted to the TEDMED audience that COVID vaccines would be produced in record time. At that time, he didn’t know he would play a leadership role in fulfilling that prediction. Brunswick Partners Tanisha Carino and James Dray interviewed Dr. Hepburn.
Matt Hepburn at his TEDMED 2020 Talk titled "3 building blocks for pandemic prevention that inspire optimism.”
Your job is to worry about COVID. Should the rest of us still worry about it?
There’s no question we’ve made tremendous progress as a country in the fight against COVID. We have gotten Americans vaccinated. COVID deaths are down dramatically from the peaks we have seen. At the same time, we must stay vigilant.
The reality is that COVID continues to mutate, to be an extremely transmissible virus, and to be a real threat to the most vulnerable, the elderly, the ill and the immunocompromised. And we’re still seeing hundreds of people die each day. That’s why it’s so important that people are up to date on their vaccines. Scientists have updated the COVID vaccines so they target both the original strain of the virus and subvariants of Omicron—the version of the virus that is most prevalent today. There’s also an effective antiviral, Paxlovid, that works to keep the highest-risk individuals out of the hospital. If people take steps to protect themselves, we now have ways to minimize risk. That’s so important.
Do low vaccination rates in some parts of the world keep you awake at night?
Under President Biden’s leadership, the United States has led the global vaccination effort. We have donated more vaccine doses than any other country. We’ve made a lot of progress, but there’s more work to do.
Low COVID vaccination rates worldwide are tragic, and also create a risk of further transmission, which can result in new generations of mutations.
One of the silver linings of the pandemic was our ability to develop safe and effective vaccines as a global community and to produce billions of doses which we’ve never done before. It’s estimated that worldwide vaccine production capacity tripled in a year. That’s the power of the global community organizing and taking action, and it offers lessons for other vaccine-preventable diseases.
The most important thing we could do for global pandemic preparedness is get really good at making and delivering shots in the arms of everybody globally in record time. There would be a massive impact on human health, and then an established protocol for moving fast against the next pandemic threat.
In my view, no tax dollars are better spent than for community health workers, those who go to that church, who live in that neighborhood. They’re the ones who can communicate best on vaccines.
In your early 2020 TEDMED Talk, you accurately forecast the fast development of a COVID vaccine. Looking back, what did you fail to foresee?
Richard Danzig, who was the former secretary of the Navy and a mentor to a whole generation of biodefense experts, always said, “We have to be prepared to be surprised.” COVID was full of terrible surprises. We were surprised at how transmissible it was. At how fast it mutated.
We were surprised by issues related to building confidence in the public about the safety of the vaccines, the efficacy of the vaccines, and the importance of getting vaccinated. I’ve been doing pandemic preparedness planning for decades. As a scientist, as a researcher, as a clinician, I immediately gravitate to the problem I believe we can solve. I’m going to figure out a way to make vaccines better, or faster. Or, hey, we could make it thermal stable, so then it would be easier to distribute. That’s how the scientific community at large operates. I always just assumed that if we had a safe and effective vaccine, of course people would take it.
Being better prepared for future pandemics will require a deeper understanding of people. We need to understand people better in order to better communicate.
In my view, no tax dollars are better spent than for community health workers, those who go to that church, who live in that neighborhood. They’re the ones who can communicate best on vaccines.
To what extent did the pandemic illustrate the potential for private-sector/public-health partnerships?
Pre-pandemic, there was not a lot of interest, private or public, in pandemics. Then came COVID and all of a sudden there was so much interest. We hadn’t thought about how to harness it. Some of the really good state health departments harnessed the innovation of their communities, private-sector philanthropy, common citizens. There were some amazing examples of state health departments utilizing the private sector to achieve a much better pandemic response. I had a great visit with the state health department in Washington and how they worked with some of the really strong private-sector elements to help with vaccine rollout and vaccine messaging and vaccine availability.
Are there lessons that public health could take from the private sector?
My personal obsession is on advancing purposes that only the government can do.
We actually have a venture capital fund now in the Department of Health and Human Services that’s called BARDA Ventures. What they do is they participate in capital raises of promising biotechnology that we really need for future pandemic response. But the government is only a small amount of a total capital raise. So we sort of get this best of both worlds of small government investment but then the innovation so we’re ready for future pandemics. It doesn’t work in all cases, but we’ve never had that tool before.
What role did the military play in your success as a public health leader?
One of the gifts that I’ve had in terms of my professional career is military leadership training and opportunities. I received an ROTC scholarship as an undergrad.
Every semester in undergrad, I was taking classes on leadership. I spent an entire summer in leadership training because that’s what the military does.
In a sense I had been training my whole career to be one of the leaders of Operation Warp Speed. I had been working in pandemic preparedness and biodefense and vaccines and such for my career. A large majority of the Operation Warp Speed leadership came from the Department of Defense where there were logisticians and operational planners who were led by a four-star general, General Gus Perna, who was in charge of US Army Materiel Command.
For Operation Warp Speed, he handpicked some of the best operational planners and logisticians in the Army, in my opinion. What I’ll always remember and what was astounding to me was their ability to pivot so quickly from their typical operational planning to vaccine development and vaccine distribution. They were intense learners. They came in with their notebooks and their lists of questions and it was crazy how quickly they were able to apply operational planning and leadership to vaccine development and distribution. I think the military contribution to Operation Warp Speed was really a testament to military leadership training.
Also, the military creates a culture of service and teamwork. It’s not about you. It’s about your service to the American people. There is a focus on mission, on service, that governs everything we do. I should add that there are tons of public health professionals who are dedicated to that service goal, especially in local health departments.
What excites you about the future of medicine?
Our ability to organize and process health data has been slow and has lagged, but we’re catching up. We’re going to figure out what works best for what people over what times. I think just about any health problem is going to be solvable. We’re going to have all kinds of life-saving treatments that are readily available.
Home diagnostic testing is a case in point. As a society now, we are testing at home for COVID and flu and RSV. Increasingly, we’re tracking our blood pressure at home. Bringing more testing technology into the home could be great for the health of the individual.