Amongst the tragic news of war, dramatic food shortages, droughts, price rises and other disasters worldwide, a shining announcement got lost in the dimness of it all.
On March 14th, Moderna Inc. – that has now become a common name thanks to its COVID-19 vaccine Spikevax – announced that the first patient in a clinical trial for a HIV vaccine received their dose. At first, this might seem unsurprising news; after all, we have been used to getting vaccinated immediately after birth against a share of otherwise harrowing diseases. And yet here is the distinction: those diseases were not HIV-related, and the platform used to create them was not messenger RNA.
HIV, which stands for human immunodeficiency virus, was mostly unknown to man until the 1980s, when details of a silent epidemic started emerging (the outbreak continues to this day). This subtle virus acts differently from most others: it attacks a key protein of the immune system itself, leading to what is infamously known as acquired immune deficiency syndrome (AIDS); the syndrome caused the demise, among the many, of Queen’s lead singer Freddie Mercury. With AIDS, patients remain defenseless from other pathogens or diseases and are hence at risk of serious outcomes from otherwise frequently curable illnesses. Given this peculiarity, finding a vaccine has proven a challenge to modern medicine, to the point that, in the past decades, a truly effective one was not found. Certainly, treatments greatly improved prognosis, but an efficacious vaccine remains unavailable.
This difficulty faced with HIV intersects with the Moderna story, which, in turn, was not free of hardships. The biotech company was born in 2010 in Massachusetts, with the goal of using the evolving messenger RNA (mRNA) platform to cure diseases that had proven difficult to treat or lacked treatment whatsoever. The advantage of mRNA is in the way it harnesses the human body’s natural defenses: instead of injecting a weakened pathogen and prompting the immune system to fight it off, mRNA simply instructs cells to produce a given protein, without need for the live virus.
Messenger RNA sounds like a brilliant idea, but like all new discoveries, it carries the weight of uncertainty. In fact, before the pandemic, Moderna was losing hundreds of millions of dollars a year, and the survival of the company was not guaranteed. Meanwhile, though, they accumulated vital expertise. When the pandemic struck in 2020, Moderna was already in a fast track to produce the vaccine, which became the second to be approved in Europe and the US. This made the stock skyrocket over the course of the next year, reaching a peak of around 200 billion dollars in market capitalization in August 2021. More importantly, real-world studies seem to indicate that Spikevax may be the most effective of all available vaccines in preventing COVID-related deaths: in a report from Singapore, the adjusted COVID-19 fatality rate for receivers of Spikevax was 1 in 100,000, the lowest among the used vaccines. Quite a turnaround for a previously struggling nano-company.
With these triumphs, and an exponentially increasing cash flow, Moderna seemed unstoppable, and added many projects to their already large pipeline; among these projects is the elusive HIV vaccine. The clinical trial for this new product has just begun, and the actual efficacy is unknown, but the sole fact that recent technology seems capable of tackling a decades-old project is a reason for immense hope. Investors agreed, and the stock rose nearly 10 percent on the trading day of the announcement. In fact, a discovery of this kind could end an epidemic that has been spreading worldwide for decades, and could save countless lives, as well as avoid economically and socially costly treatments. Also, it would allow Moderna to consolidate itself as a leading pharmaceutical company well beyond its COVID-19 vaccine, allowing it to continue its vast and ambitious project pipeline. The cynic might point out that Moderna may not succeed in this attempt, since many others have failed: true, but it has managed the seemingly impossible once, and could well do so again in the coming years. And, perhaps, it will tackle medical challenges even greater than the ones it faces today.