On a cold Sunday night last November, Anthony Fauci, M.D., sat bundled up on his deck, having a (physically distanced) drink with a friend, when the call came. Albert Bourla, the CEO of Pfizer, was on the other end of the line. “Tony,” Bourla said, “are you sitting down?”
Bourla had the results from the phase 3 trials on an mRNA-based vaccine. He told Fauci it was “amazing.”
“Tony, it’s more than 90 percent effective at reducing the risk of developing severe COVID!” Bourla said. For a scientist like Fauci, it was a deeply emotional, cathartic moment.
A week later, Moderna divulged similar results. Perhaps the most stunning thing about these two vaccines, which rely on new mRNA technology, is how well they were shown to work across all age, racial and ethnic groups. It’s like having personal protective equipment, at a molecular level; it turns the human body into an internal vaccine factory.
And while you may fret that these new vaccines are just that — new — they are born from decades of study. They take vaccine technology from an analog to a digital space.
The new mRNA COVID vaccines represent a new class of vaccines because of their messenger RNA technology, but the concept is the same: Introduce instructions to the body for making a protein that the immune system will tag as a bad guy — so when the real bad guy shows up, the body is ready to fight it. These mRNA vaccines do not contain the live virus that causes COVID. They contain only the code for a small portion of the virus, the spike protein. They do not affect or interact with your DNA whatsoever.
These new mRNA-based vaccines for COVID have the power to inflict a double whammy against the virus — they stimulate the immune system to make antibodies and immune system killer cells. That’s like possessing two kinds of ammo just in case one is not as effective. And while we are still learning how variants of the virus, such as the delta variant, may impact the disease’s ability to spread, there’s no doubt these new vaccines are on track to save hundreds of thousands of lives. Most vaccines require some sort of booster; while booster shots may be recommended to everyone ultimately, their greatest impact will most likely be in those who are already at increased risk of disease, such as those of advanced age or with preexisting conditions.
I had the pleasure of speaking with two of the chief scientists behind the Pfizer/BioNTech mRNA vaccine. Soon after the Chinese released the virus’s genetic code in January, Uğur Şahin, M.D., and Özlem Türeci, M.D., got cracking thousands of miles away in their German laboratory. They’d been studying mRNA technology for cancer, but could pivot to tackle this new challenge. Previously, no new vaccine had been developed in less than four years. The race was on.
Şahin and Türeci are a married couple with Turkish roots who founded BioNTech in Germany in 2008. As doctors who specialize in cancer treatments, they described for me “the sense of urgency that cancer brings to people’s lives.” And when Şahin read an article in The Lancet in January 2020 about the quickly spreading coronavirus in China, his gut told him that a full-blown pandemic was upon us. Vacations were canceled and Project Lightspeed was born.
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Already, mRNA technology has been tested to treat sickle cell disease, and is also being studied for use against infectious agents such as Ebola and influenza. Şahin and Türeci expect the technology to revolutionize many areas of medicine, including cancer treatments.
Speed and versatility are important when it comes to chasing COVID with vaccines in the years ahead. Changes in the spike proteins drive the variant strains, but our vaccines can still meet the challenge. As more mutations accumulate, tweaks to the vaccines will probably be necessary. But we can be well prepared for COVID’s iterations with enough disease surveillance and routine sequencing to keep track of the virus’s evolving characteristics. In the meantime, preventing viral transmission through vaccination is essential to contain the virus and foil its natural tendency to refashion itself.
It may feel disheartening to know that we may have to live with COVID — a newly emerging plague — in our environment for the rest of our lives. But that may be the least of our worries going forward. Many pathogens, some much deadlier than COVID, lie in wait for a close encounter with our kind. Case in point: A few years ago, scientists in France awakened a gigantic, ancient virus from its 30,000-year-long slumber in Siberian permafrost that’s ready to infect again. Now this virus, dubbed Pithovirus sibericum, only infects single-celled amoebas (whew!). But the discovery has scientists wondering what other microbes are hidden in melting permafrost awaiting another chance to infect. If a 30,000-year-old virus can maintain its infectious abilities, other microbes are capable of revisiting humanity in catastrophic fashion. Which is to say: There may be no such thing as total eradication of a virus. Devastating diseases like smallpox could come back to haunt us if we’re not careful.
The good news is that we have modern science — and the lessons we’ve learned — on our side.
© 2021 by Sanjay Gupta. From the book World War C: Lessons from the Covid-19 Pandemic and How to Prepare for the Next One by Sanjay Gupta, M.D. Published by Simon & Schuster Inc. Printed by permission.