Onward Pharmaceutical Labs (OPL), one of the world’s largest pharma companies, is completing the development of a new vaccine, RSVIX, to protect children from a respiratory virus — the respiratory syncytial virus, or RSV — that endangers the lives of infants and young children. OPL expects RSVIX to be their next blockbuster and hopes to quickly capture most of the $7B U.S. market. The final clinical study before licensure is a head-to-head comparison with RESPIRWELL, the currently licensed vaccine produced by OPL’s rival, Beamer Labs. To succeed in the trial, OPL must prove equal protection with the four common serotypes their vaccine shares with Beamer’s licensed vaccine while adding coverage for five additional strains of the virus that RESPIRWELL does not have.

When Siddhartha Kumar, OPL’s lead medical monitor assigned to the trial, discovers that RSVIX is not performing as planned, he notifies his superiors, recommending they stop the trial and offer a dose of RESPIRWELL to all the study participants to ensure their protection. When the company refuses to inoculate the trial population with the licensed vaccine, Sid questions the ethics behind this decision while continuing to advocate for the safety of the children. Sid’s insistence leads to his dismissal, leaving like-minded others in the company scrambling to fill the void.