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NewslettersThe Capsule

Buy a COVID vaccine, get an HIV vaccine for free?

By
David Z. Morris
David Z. Morris
and
Sy Mukherjee
Sy Mukherjee
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By
David Z. Morris
David Z. Morris
and
Sy Mukherjee
Sy Mukherjee
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April 6, 2021, 5:31 PM ET
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Okay, not quite. But there is thrilling and fascinating news about promising early trials that could lead to an HIV vaccine – and the project hinges on the same long-gestating mRNA technology that has already produced one medical miracle.

The preliminary results for an experimental HIV vaccine centered on a protein called eOD-GT8 were released back in February by IAVI, a nonprofit drug developer. They appear to have gone little-noticed by the public before a wildly viral tweet from health advocate Dr. Ayoade Alakija this week.

WOW 😳 New HIV vaccine with a 97% antibody response rate in phase I human trials. This is the most effective trial HIV vaccine to date. It is based on the Moderna's COVID vaccine. COVID tech acceleration could change Rx for cancer & HIV in future. https://t.co/3Nl0UJj6xW

— Dr. Ayoade Alakija (@yodifiji) April 4, 2021

Bear in mind that this is a Phase I trial involving only 48 subjects, and only covers a small part of what researchers say would likely be a complex HIV vaccination regimen. But the results sure sound good: the experimental vaccine produced antibody precursor B cells in 97% of participants. As with COVID and other viruses, the right antibodies theoretically bind to HIV’s spike proteins, preventing it from penetrating cells and infecting patients.

“This study demonstrates proof of principle for a new vaccine concept for HIV, a concept that could be applied to other pathogens, as well,” said William Schief, head of the IAVI Neutralizing Antibody Center, which developed the vaccine.

The vaccine tested in the recent study wasn’t itself developed using mRNA technology, but IAVI has said its next step will be partnering with Moderna to develop an mRNA-based version of the treatment. IAVI says using mRNA could “significantly accelerate the pace of HIV vaccine development,” because of the same features that made it essential for rapid development of a COVID-19 vaccine.

All this is exciting. But there’s a much larger point. For anyone over 40, even the faintest promise of an HIV vaccine probably sounds like a miracle. There could be more miracles around the corner: there’s accelerating research into the use of mRNA vaccination to treat the emperor of all maladies: cancer.

And this bounty of real and pending miracles are thanks substantially to government funding of basic scientific research.

Most obviously, mRNA pioneer Katalin Karikó’s work was supported after 1985 by state-backed U.S. universities including Temple and the University of Pennsylvania, though she had a hard time getting big federal agency grants.

One way to view Karikó’s challenges is to imagine just how much harder it would have been to pursue her work in the private sector, where quarterly profits rule and waiting four decades for a return on your investment is unthinkable. Moderna, for instance, only began doing mRNA vaccine research ten years ago, by which time Karikó had already been working on the problem (for little financial reward) for thirty years. Other elements of COVID vaccine technology emerged from the National Institutes of Health and the Defense Department.

(IAVI, the HIV vaccine developer, is itself 58% funded by governments and supranational organizations.)

Some have used this reality as a political weapon to ding drug developers for their profits, but that’s missing the deeper point: basic research and commercialization are two sides of the same coin, each crippled without the other. But the coin is becoming unbalanced, with U.S. federal investment in basic research declining by 50% as a share of GDP since 1977.

Now there’s a chance to slow that trend. The Biden administration’s proposed infrastructure bill includes tens of billions of dollars for the National Science Foundation and other scientific and technical research efforts. That could lay the foundation for any number of life-saving (and profitable) future miracles.

David Z. Morris
david.morris@fortune.com
@davidzmorris

Correction 4.7.21 This piece previously described IAVI’s experimental vaccine as producing counter-HIV antibodies in 97% of subjects. The experiment actually triggered production of VRC01-class immunoglobulin G (IgG) B cells, a precursor to the antibodies themselves. We regret the error.

DIGITAL HEALTH

States ban ‘vaccine passports’ Texas today joined Florida in banning state agencies from requiring ‘vaccine passports,’ or proof of COVID-19 vaccination, three days after Florida Governor Ron De Santis did much the same. The Texas order would impact schools, hospitals, and government buildings. In substance, these bans might not be entirely retrograde, since there are legitimate reasons for nonvaccination (especially with access still so limited), and skepticism of government mandates has plenty of rational basis. But the orders, and others like them, come amidst a wave of ludicrous conspiracy theories about vaccines and, increasingly, health records – despite the fact that vaccinations have been generally required to attend U.S. public schools for decades. (CBS DFW)

INDICATIONS

Moderna increasing COVID-19 vaccine production capacity Catalent, a manufacturer producing vaccine for Moderna, will increase vaccine vial output at its facility in Bloomington, Indiana. Though the precise scale of the increase is unclear, the expansion will help Moderna reach its goal of delivering 200 million doses to the U.S. by the end of July. (Wall Street Journal)

Army-developed COVID vaccine begins testing It turns out U.S. Army researchers have been working on their own COVID vaccine, and a small trial of a few dozen adults was expected to begin today at the Walter Reed Army Institute of Research. Results are expected by midsummer, with potential further development to follow. Though behind the curve set by the likes of Pfizer, the next wave of COVID vaccines could prove useful based on variations in their technology or delivery method. (Wall Street Journal)

THE BIG PICTURE

JAMA faces searing backlash over its track record on race A deeply troubling new investigation of the Journal of the American Medical Association by STAT News shows a stark pattern of editorial decisions downplaying and ignoring the health implications of racism. The report follows a February controversy in which a white JAMA deputy editor questioned the existence of racism in medicine, despite reams of statistical analysis demonstrating racism’s impact on Black patient outcomes in particular. That led to resignations and an investigation – but STAT found much more, including a long list of deeply troubling JAMA publications that appeared to ignore social and economic factors in disparate health outcomes along racial lines – and researchers claiming they had been asked to remove the word “racism” from their submissions. (STAT News)

REQUIRED READING

Africa needs billions to contain COVID-19 - Marco Quiroz-Gutierrez

Norwegian asks CDC to relax cruise restrictions - Associated Press

Don't book summer travel yet, Boris Johnson warns - Bloomberg

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