RFK Jr’s ‘ill-informed nonsense’ forfeits America’s mRNA vaccine leadership

It took only 11 months from the identification of the Sars-Cov-2 virus sequence in January 2020 to the approval for the Pfizer mRNA vaccine on December 11, 2020. Arriving during the height of the pandemic, the vaccines ultimately saved an estimated 14.4 million lives worldwide. The development of a vaccine in less than a year was only possible because of mRNA technology.

This was one of the greatest coordinated scientific, medical and public health achievements of the past 50 years – certainly equivalent to the development of the polio vaccine by Jonas Salk announced in 1955 and drawing parallels to the moon landings in the late 1960s.

The speed at which the mRNA Covid vaccines were developed, mostly from US discoveries, is now part of scientific legend, and was in part attributed to the Trump administration’s audacious US$18 billion plan Operation Warp Speed.

Believing that mRNA technology holds great promise for better vaccines and other therapeutics, the US government has since invested a further US$500 million to support the development of new or improved mRNA vaccines for other important diseases such as bird flu, which could potentially be the next global pandemic along with many other important infectious diseases such as those caused by HIV.

The US federal funding also supports basic research aimed at further improving the efficiency of mRNA technology so it can be used to deliver a vaccine as a sniff through the nose rather than an injection, developing promising cancer vaccines, and perhaps most importantly of all, simplifying the delivery of powerful new monoclonal antibody drugs that are the new frontier of medicine.

These antibody drugs remain hugely expensive because of the high cost of manufacture. The mRNA technology offers the potential to instead have the body make the antibody – at a mere fraction of the cost. So-called mRNA therapeutics will revolutionise the wider availability of these new drugs, most of which remain unaffordable in countries like New Zealand. Two examples of antibody drugs now available in NZ are Pembrolizumab (Keytruda) – used for the treatment of metastatic melanoma, lung cancer and Hodgkin lymphoma – and infliximab (Remicade) for the treatment of arthritis and other immune inflammatory diseases. There are dozens more that are not licensed in New Zealand.

US Secretary of Health and Human Services Robert F Kennedy Jr is clearly no fan of vaccines, and especially mRNA technology, making outlandish claims that “mRNA technology poses more risks than benefits for these respiratory viruses” and “mRNA vaccines cause a virus to mutate”. In a draconian move that has stunned the science and medical world, he has cancelled US$500m federal funding for mRNA vaccine research, leaving 22 vital research projects without support.

Kennedy’s claims are ill-informed nonsense. Vaccines do not cause a virus to mutate. Viruses, especially RNA viruses such as flu and Covid, mutate naturally. On rare occasions, a mutation may change a viral antigen that your immune system recognises, which can result in an escape mutant that is typically the forerunner of a new pandemic variant, but this usually requires clusters of mutations.

It makes no difference if your existing immunity is the result of a natural infection or vaccination. Influenza is a great example of a virus that constantly changes its dominant antigen, hemagglutinin. This is why we need an updated vaccine every flu season.

Viral antigenic drift and shift is a major problem, and mRNA vaccine technology offers the best solution to overcome it. Including different hemagglutinin sequences in an mRNA vaccine will provide protection against a wider group of strains and could potentially achieve the holy grail of vaccine science – a single universal influenza vaccine.

This was just some of the funded mRNA research cancelled in the US. Although this is a tragic mistake for science in the US and essentially forfeits their clear leadership in the field, many other countries, including New Zealand, are actively embracing the science of mRNA technology with significant levels of funding that eclipse what the US is now investing. Only time will tell if the US administration changes its mind about mRNA vaccine research, but I’m not holding my breath.

The ability to rapidly swap one vaccine target sequence for another is a great advantage of mRNA technology. Another is size, scale and cost. It is so much cheaper and quicker to make millions or even billions of doses of mRNA. A five-litre benchtop vessel the size of a pressure cooker, with all the ingredients for making mRNA, can produce up to a million doses of vaccine a day. Compare this with the vast efforts required for making the influenza vaccine which is grown in millions of eggs that must be procured each year, or in cell culture where a one litre reactor produces a mere 50-100 doses of vaccine.

We can do this now in New Zealand. We have invested in mRNA science and technology with the establishment of a seven-year, $70m mRNA platform to support a national consortium of mRNA investigators working in both human and animal diseases unique to New Zealand. The platform supports the research and development of improved mRNA technology and offers the possibility of a national manufacturing pipeline to respond to the next pandemic, when it arrives. When that day comes, expect the turnaround time for a lifesaving mRNA vaccine to be even faster than in 2020.