Mar 16, 2024 - Health

COVID paved the way for a new vaccine era

Illustration of a scientist holding up a vaccine vile surrounded by various abstract shapes

Illustration: Sarah Grillo/Axios

The unprecedented success of the COVID-19 vaccines has elevated the mRNA platform and raised expectations the technology could soon be wielded against other infectious diseases.

The big picture: COVID is still the only disease for which any mRNA vaccines are approved, but dozens more are being developed and tested against the flu, RSV, HIV and even cancer.

Between the lines: Scientists had been working on mRNA vaccines for decades, but the technology, which essentially provides instructions to the immune system, got a significant boost when Pfizer's and Moderna's COVID vaccines were developed and brought to market at a record pace.

  • The effectiveness and safety of the vaccines sent clear signals about the promise of the technology, spurring new investment and interest.
  • "The obvious impact has been the acceptance in the scientific community of the benefits of mRNA vaccine technology, which existed before the pandemic but hadn't proved itself on the scale of Phase 3 [clinical trials] and beyond," said Cornell virologist John Moore.

State of play: By next year, it's possible Pfizer and Moderna will both have approved combination flu-COVID vaccines that would make it easier to provide protection against the respiratory threats.

  • Just this week, Moderna and Merck launched a late-stage study of an experimental skin cancer vaccine after the companies reported in an earlier trial it cut the risk of melanoma death in half.

Friction point: Remarkable advances are also coming at a time of heightened vaccine skepticism, potentially tempering the impact of any future breakthroughs.

  • "From a scientific point of view, we are entering the golden age of vaccines … that is phenomenal and something we should be very excited about," said former Biden administration COVID response coordinator Ashish Jha.
  • "And yet, we're also entering a time where people are more skeptical about vaccines than any time in the last 50 years. That contrast — that contradiction, almost — is very odd and we have a lot of work to do."

What we're watching: The technology is still tricky and will be deployed differently depending on the disease.

  • As with any treatment or vaccine under development, unanticipated issues can arise.
  • Development of a closely watched HIV mRNA vaccine candidate, for example, recently hit a speed bump when skin problems arose in small, early-stage studies, Science reports.

While extraordinary effort went into speeding the COVID vaccines to market, other mRNA products will face a more conventional — and slower — development timeline.

  • "I worry a little bit that the perceived speed with which we were able to develop safe and effective vaccines has given people unrealistic expectations," said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
  • "Nevertheless, we did something remarkable, and we proved to ourselves that we can do hard things," she added.

The bottom line: "When you have a new tool that is potentially valuable for multiple pathogen vaccines, you're going to look at it, and some of those might turn out to work very well," Moore said.

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