Key takeaways:
Companies are studying the technology behind the Pfizer and Moderna COVID-19 vaccines for other uses. This includes HIV, the flu, and even cancer.
Many of these vaccines are just getting started in human clinical trials. That means researchers are still figuring out the best dose and if they’ll potentially work.
There are currently cytomegalovirus (CMV), influenza (flu), and respiratory syncytial virus (RSV) mRNA vaccines in phase 3 clinical trials.
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In December 2020, the Pfizer and Moderna COVID-19 vaccines became the first messenger RNA (mRNA) vaccines to be authorized by the FDA. The technology behind the vaccines had been studied for over 30 years. But this was the first time it became available to the public. Fast forward to today, and both vaccines are fully FDA approved.
Now, companies are starting to study mRNA vaccines for other potential uses. This includes infections like HIV and cytomegalovirus (CMV), for which vaccine development has been an ongoing feat.
Read on to learn more about how mRNA vaccine technology could be used beyond COVID.
What is mRNA vaccine technology and how does it work?
Messenger RNA (mRNA) vaccines work differently compared to other vaccines. For example, other vaccines may contain weakened or dead germs (or part of the germ). This trains your immune system to quickly recognize and fight the germ if you’re exposed to it in the future.
But mRNA vaccines don’t contain germs at all. Instead, they contain something called mRNA. Your body has its own mRNA inside of cells. Think of mRNA as a set of instructions. Your cells use these instructions to make proteins that your body needs. But the mRNA in vaccines can also be used to instruct your cells to make certain proteins, too.
For example, the vaccine mRNA might contain the code to make part of a germ (called an antigen). When delivered to your cells, it instructs your cells to make the antigen. This is what triggers your immune system to respond to an mRNA vaccine.
In the case of the COVID vaccines, your cells are instructed to make part of SARS-CoV-2 (the virus that causes COVID). This is what triggers your immune system and creates protection against the virus if you encounter it in the future.
Delivering instructions to make part of a germ is just one way that mRNA vaccines can work. Another example is how mRNA cancer vaccines work. They help your immune system recognize and target proteins or mutations found on certain cancer cells. In other words, there are many different ways to use this technology. More on that below.
What other mRNA vaccines are currently being researched?
With the success of the mRNA COVID vaccines, it makes sense that companies would explore mRNA technology for other uses. Below are six examples.
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1. Influenza (flu)
Flu vaccine effectiveness is estimated to be between 40% and 60%. But this is when flu virus strains in the vaccine are closely matched to those circulating in the population. An mRNA flu vaccine may have the potential to improve upon current flu vaccines. In fact, companies were working on them before COVID.
At least four mRNA flu vaccines have started clinical trials, including:
National Institute of Allergy and Infectious Disease (NIAID): In May 2023, NIAID started enrolling participants in a phase 1 trial studying a universal flu vaccine that uses mRNA technology. A universal vaccine would cover many different strains, ideally for a longer period of time. This could lessen the need for annual flu shots.
Sanofi: In 2021, Sanofi announced positive findings from a phase 1/2 clinical trial studying an mRNA flu vaccine that targets one strain of the flu virus. Since then, it has launched a phase 1/2 trial for a vaccine targeting four different strains.
Pfizer: In September 2022, Pfizer announced the launch of a phase 3 clinical trial for a single-dose mRNA flu vaccine for adults that targets four strains of the flu virus. The trial is expected to be completed in 2024.
Moderna: Moderna currently has five mRNA flu vaccines in clinical trials. One vaccine is in phase 3 trials and has been recently updated to work better against influenza B strains of the virus.
In addition to a seasonal flu vaccine, Moderna is also researching a combination mRNA COVID and flu vaccine, as well as one that also protects against respiratory syncytial virus (RSV). This could be a more convenient option if COVID booster shots are recommended every year, like flu shots. Moderna expects combination vaccines to be available by 2025.
2. Zika virus
A Zika virus infection can be especially risky for some people. This includes pregnant women, since it can cause stillbirth, miscarriage, and birth defects in an unborn baby. To date, there are no vaccines or treatments for a Zika virus infection.
There are several different Zika virus vaccines in development. But Moderna is studying the only one that uses mRNA. The company is currently studying the vaccine in a phase 2 clinical trial involving adults ages 18 to 65. The study is expected to be completed in 2024.
3. Respiratory syncytial virus (RSV)
Respiratory syncytial virus (RSV) is a respiratory virus. For many people, an RSV infection doesn’t result in serious illness. But it can be dangerous for certain people, like older adults and babies.
After unsuccessful prior attempts to develop a safe and effective RSV, there are now two FDA-approved RSV vaccines for older adults: Arexvy and Abrysvo. Both are considered protein subunit vaccines. This is similar to how the Novavax COVID vaccine works.
Moderna is currently studying an mRNA RSV vaccine for adults ages 60 and older in a phase 2/3 clinical trial. The company anticipates applying for approval during 2023. An mRNA RSV vaccine, as well as a combination vaccine targeting RSV and human metapneumovirus, is also being studied in a phase 1 trial that includes children under 24 months old.
4. HIV
HIV was first identified as the cause of AIDS in 1984. Since then, there have been many attempts to develop an effective HIV vaccine. But so far, none have been successful. There are several factors that make HIV vaccine development challenging. For example, the virus mutates frequently. Vaccines would need to keep up with these changes in order to work.
Moderna has mRNA HIV vaccines going through three phase 1 clinical trials. The company hopes to identify a viable vaccine candidate to move forward to phase 2 trials.
NIAID also has an mRNA HIV vaccine in a phase 1 clinical trial. The trial is expected to be complete in October 2023.
5. Cytomegalovirus (CMV)
Cytomegalovirus (CMV) is a common virus that can cause serious symptoms in people with weakened immune systems. Babies can also be born with a CMV infection, which can result in hearing loss. This is called a congenital CMV infection. Currently, there’s no CMV vaccine available.
Moderna is currently studying an mRNA CMV vaccine in a phase 3 clinical trial that includes women ages 16 to 40 years old. The trial is expected to be completed in 2026.
Moderna is studying the vaccine in this group because the virus can be transmitted from an infected mother to an unborn baby during pregnancy. This can result in a congenital CMV infection, which can cause vision problems, hearing loss, and other health issues.
6. Cancer
When you think of vaccines, preventing an infection likely comes to mind. You may be surprised to learn that there are cancer vaccines, too. But they’re used to treat cancer, not prevent it. Cancer vaccines work by helping your immune system find and destroy cancer cells.
Cancer mRNA vaccines are being studied alone and in combination with other cancer treatments, like chemotherapy and immunotherapy. Immunotherapy helps your immune system find and kill cancer cells.
There are several mRNA cancer vaccines in clinical trials. Some of them are personalized cancer vaccines. This means they’re made just for you based on your tumor sample. Others aren’t personalized. They work by helping your immune system target proteins found on cancer cells.
Moderna is studying at least three cancer vaccines in clinical trials. One is considered to be a personalized cancer vaccine. It’s currently in a phase 2 trial and treats melanoma. Another vaccine is in a phase 1 trial and treats solid tumors. The third vaccine is also in a phase 1 trial that was completed in August 2022. It targets a specific cancer cell protein in non-small cell lung cancer (NSCLC), colorectal cancer, and pancreatic cancer.
Memorial Sloan Kettering Cancer Center is studying an mRNA cancer vaccine for pancreatic cancer. Due to promising phase 1 trial results, researchers expect to start enrolling participants in a larger clinical trial in summer 2023.
The University Medical Center Groningen is collaborating with BioNTech on an mRNA cancer vaccine for ovarian cancer. The vaccine is currently in a phase 1 clinical trial, and it’s being studied in combination with chemotherapy.
BioNTech is also collaborating with Regeneron Pharmaceuticals on an mRNA cancer vaccine for advanced melanoma. It’s currently in phase 2 clinical trials. The study is expected to be completed in 2025.
The bottom line
The COVID-19 vaccines have shown that mRNA technology can be effective in vaccines. Because of this, companies are testing it for many other applications. In some cases, they may even offer hope where other vaccines have been unsuccessful, like with HIV.
Most of the mRNA vaccines being studied are in phase 1 clinical trials, with a few in phase 2 and 3 trials. So, there’s more research to be done until we know how well they’ll work in preventing infections or treating cancer. If they’re shown to be safe and effective, we may see more of them hit the market over the next several years.
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