mRNA vaccines: The next wave of innovation in medicine

By Nicole Witowski

The first mRNA vaccines were tested in the 1990s, but it wasn’t until COVID-19 hit that mRNA technology truly took off. In a matter of months, scientists around the world raced to develop a vaccine that could protect against the deadly virus. mRNA vaccines – including those from Pfizer-BioNTech and Moderna – were the first to be approved and the most effective.

Unlike traditional vaccines that use a weakened or inactive virus, mRNA vaccines work by teaching cells how to make a protein that triggers an immune response. In the case of COVID-19, mRNA vaccines teach cells to produce the spike protein found on the surface of the virus that causes COVID-19. This prompts the immune system to make antibodies that can fight future infections.

The success of these vaccines not only saved countless lives but also brought massive funding and attention to mRNA-focused research and development. Now, scientists are exploring the potential of mRNA to revolutionize treatment for other diseases.

Read on to see how researchers are pushing to develop mRNA vaccines for respiratory syncytial virus, HIV, and even cancer.

mRNA for infectious disease prevention goes viral

COVID-19 was just the tip of the iceberg for infectious diseases. Researchers today are exploring how mRNA technology can be used to develop vaccines for other infectious diseases like the flu and respiratory syncytial virus (RSV).

Because mRNA vaccines can be developed and manufactured quickly, they could be used to respond rapidly to emerging infectious diseases. This was demonstrated with the COVID-19 pandemic when companies developed and supplied mRNA vaccines in record time.

Giants like GlaxoSmithKline, Pfizer, and Moderna are sprinting to launch the world’s first vaccine for RSV, a seasonal respiratory virus that kills 6,000 to 10,000 U.S. seniors each year. RSV is also the leading cause of hospitalization in infants.

GlaxoSmithKline and Pfizer have both applied for FDA approval for their respective RSV vaccines, which could see approvals in 2023. Moderna isn’t too far behind with a product in clinical trials that could wrap up late this year or early 2024.

A glimmer of hope for HIV vaccinology 

HIV is a harder nut to crack.

In 2021, about 38 million people globally were living with HIV. What’s more, 650,000 people died from AIDS-related illnesses worldwide in the same year.

Medical advances in AIDS include antiretroviral drugs (ART) to suppress the virus and daily HIV-prevention pills or frequent injections, known as PrEP, that can reduce the risk of transmission if taken correctly. These drugs need to be taken for life.

The benefit of a vaccine to fight HIV would be immense, but dozens of traditional approaches to HIV vaccine development have failed over the past few decades. As one of the fastest-mutating viruses, HIV has millions of variants. This makes it tricky to develop a vaccine for the virus. By comparison, the number of SARS-CoV-2 variants causing the COVID-19 pandemic is about a dozen.

But mRNA technology is giving scientists new hope.

Researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, are testing three experimental mRNA HIV vaccines in clinical trials this year. The International AIDS Vaccine Initiative (IAVI) and Moderna have also launched a trial of an mRNA HIV vaccine.

While this new approach could change the tide, mRNA vaccines for HIV are still in the early stages of development.

The next big breakthrough in cancer treatment

Researchers have long hoped to use mRNA to treat cancer. Like vaccines, mRNA can be used to encode cancer-specific proteins that train the immune system to recognize and target a tumor. But unlike vaccines against infectious diseases, cancer vaccines focus on treating rather than preventing the disease.

Life science companies large and small are getting in on the action. Among drugmakers leading the charge are Moderna and Merck with a treatment for melanoma that combines a personalized vaccine – called a neoantigen cancer vaccine – with an immunotherapy drug.

Melanoma is one of the most aggressive forms of cancer. It only accounts for about 1% of all skin cancers, yet it’s the leading cause of death from skin tumors. About 7,990 people are expected to die from melanoma in the United States in 2023. And nearly 100,000 new melanomas will be diagnosed.

Moderna’s cancer vaccine, mRNA-4157/V940, is custom-built for each patient using tumor cells removed from the patient during surgery. The vaccine is designed to prime the immune system to recognize and attack specific mutations in cancer cells.

In the past, similar experimental cancer vaccines targeted a single tumor mutation, or neoantigen. Moderna’s mRNA technology teaches the body to recognize and respond to as many as 34 neoantigens.

And Merck’s Keytruda, which is already used to treat melanoma, disables a protein that helps cancer evade the immune system.

The combination treatment can lower the odds of melanoma recurring in high-risk patients, according to early results from phase 2 testing. Because the treatment needs tumor cells to function, it isn’t meant to prevent melanoma. Instead, it aims to limit the risk of death or recurrence after a diagnosis.

Researchers plan to enter phase 3 testing for the vaccine later this year. If it shows similar results, the treatment could hit the market within a couple of years.

Learn more

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