When Tom Pooley, 21, became the first person to receive an experimental vaccine against plague as part of a medical trial last summer after tests on mice, he was inspired by the thought that his involvement could help to rid the world of one of the most brutal killers in human history.
“They made it quite clear I was the first human to receive it,” says Pooley, a radiotherapy engineering student. “They didn’t dress it up, but they made it clear it was as safe as possible. There are risks, but they are talented people: it’s a big honour to be the first.” The single-shot, based on the Chadox technology developed by the Oxford Vaccine Group and AstraZeneca, took less than five seconds to painlessly administer, he says. That night, he felt a little unwell, but he was fine within three hours; and the small trial continued apace to combat the centuries-old bacteria threat, which killed 171 in Madagascar as recently as 2017. It uses a weakened, genetically altered version of a common-cold virus from chimpanzees.
It is just one example of how scientists are increasingly looking at how Covid treatments can help to treat other diseases. Trials are expected to be developed for other similar jabs against dengue, Zika and a whole host of pathogens. Another vaccine study against Ebola is already going to human trials. As Professor Sarah Gilbert, architect of the Oxford Vaccine, has said: “We’ve got the cake and we can put a cherry on top, or we can put some pistachios on top if we want a different vaccine, we just add the last bit and then we’re ready to go.”
The Covid pandemic sparked an unprecedented drive to control a lethal disease whose outbreak led to a near global shutdown to contain its spread. Billions in public and private money were pumped into research like never before in such a short space of time. It’s not something the medical world would have chosen, but the developments of the past two years could not have happened without Covid-19 – the pathogen has served as a giant catalyst ushering in different technologies, data and research that offer insights into other diseases.
The lessons that have been learned – and the new norms that have solidified – will change medical science forever. The world now sits on the verge of a number of potentially significant breakthroughs, mostly thanks to the growing research into hi-tech vaccines, which could benefit patients with cancer and a whole raft of infectious diseases.
“Covid has stimulated the rapid translation of previous knowledge into practice,” says Independent Sage member and UCL professor of virology, Deenan Pillay. “Developing science takes many years and needs an opportunity to be implemented. Covid has provided an easier regulatory environment, with fast-tracked trials, so vaccine developments, for example, have been really quick.” Until Covid it could take a decade or more for a new vaccine or drug to go through all the development and regulatory stages, he adds, but now they have been rolled out within 12 months of first description of the disease.
Already they have their sights set on another killer disease, malaria, which is estimated to have killed almost half of all people since the Stone Age. It remained a leading cause of global infectious disease death last year: more than 600,000 people, usually young children, died from it.
Bucala’s team, in partnership with pharmaceutical company Novartis, succeeded in developing a “self-amplifying” RNA (also known as saRNA) jab for it. The technology stems from a successful RNA malaria vaccine for mice developed at Yale and is in advanced preclinical testing. It could be tested for the first time in humans within two years.
“You can potentially protect against a range of tropical diseases using self-amplifying RNA, which targets a parasite-encoded MIF protein that kills memory cells,” he says. “The self-amplification advancement will create the next generation in RNA vaccines, permitting much lower dosing and the generation of critically needed memory T-cell responses. All of this will unfold in the next five to 10 years.”
Or even earlier: at the start of February, Moderna began their trial for an HIV vaccine that relies on the same mRNA technology as the Covid jab. If they’re successful, a one-off jab will offer lifetime protection. Now this technology is being studied to see if it could help control largely treatment-resistant conditions, such as rabies, Zika, and cancer of the colon, skin, breast and other parts of the body.
If there’s one area of optimism, it is this move towards scientific collaboration and the impressive advances that have emerged in such a relatively short space of time. “It’s been such a horrific time for so many people”, agrees David Braun, an oncologist and scientist focusing on cancer immunotherapies at the Yale Cancer Centre in New Haven, whose team is working to transfer the RNA technology to a cancer jab. “I hope that some of the scientific advances made during this period might help us to treat other diseases, so that at least there can be one glimmer of hope that comes out of this tremendously difficult situation.”
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