When drug companies like Pfizer and Moderna learned to successfully incorporate messenger RNA technology into a COVID-19 vaccine, experts say they likely opened the door to a significant shift in the future of immunization.
The milestone in vaccine development was met with enthusiasm from most, but the seemingly swift pace and novel approach is causing hesitancy in others.
Experts say the new technique shouldn’t dissuade people from getting the vaccine. While the mRNA method is new to inoculations, the actual technology has been around for decades.
The difference now, they say, is scientists have ironed out the kinks to make a useful product.
“It sounds fancy, mRNA, but there’s nothing outlandish about it,” said Dr. Earl Brown, a virology and microbiology specialist with the University of Ottawa. “This is the way our cells operate — we live by mRNA.”
Vaccines from Pfizer-BioNTech and Moderna were the first inoculations approved for humans to use mRNA, which provides our cells with instructions to make proteins. In the case of COVID vaccines, the injected material shows cells how to make a harmless piece of the coronavirus spike protein, which then teaches our immune system to recognize the virus and fight off a future infection.
Scientists made the vaccine by programming genetic material from the spike protein into mRNA, a process that theoretically could work for other viruses.
“As long as you know how to create those instructions — that genetic code you need to convince your body to create that target — you can design an mRNA vaccine against any antigen,” said Nicole Basta, an associate professor of epidemiology at McGill.
“But the question is whether it will be effective, and whether it will be safe.”
The development of future mRNA vaccines might be quick, Basta says, but they would need to go through the usual evaluation process and clinical trials to ensure safety and efficacy. So vaccines for other viruses won’t be popping up overnight.
Still, Basta adds, there’s potential for using mRNA to either improve upon existing vaccines or to develop new ones against other pathogens.
Dr. Scott Halperin, a professor at Dalhousie University and the director of the Canadian Centre for Vaccinology, sees mRNA vaccines as “evolutionary rather than revolutionary.”
Part of the reason COVID vaccines came together so quickly was the technology had been developing for years, Halperin said. The global pandemic offered scientists a pressing opportunity — and unprecedented funding and collaboration — to try again for a viable injection.
Previous research had been done on creating mRNA vaccines against Zika and other viruses, Halperin added, and there were earlier efforts focused on cancer treatments. Coronavirus-specific research was further sped up by spike protein analysis from SARS and MERS.
While the mRNA technology itself is impressive, Halperin says improvements need to be made to create a more temperature-stable product before these types of vaccines and treatments “truly take over.”
“The logistics of delivering mRNA vaccines right now, we wouldn’t want to have to do that for every vaccine we produce,” he said, referencing the ultra-cold storage temperature that’s currently needed. “But I do think it’s an important milestone.”
Scientists are expected to continue advancing the technology, just as they did recently in solving two confounding problems with mRNA — its fragility and instability.
Brown says fragility was resolved by packaging the mRNA in a fat coating, giving it something to help bind onto cells so it wouldn’t disintegrate upon injection. The instability was conquered by modifying the uracil component of RNA, one of the four units of its genetic code.
“The technology application is new, but the science is mature,” Brown said. “We’ve just reached the point at which we can apply it.”
Traditional vaccines typically contain a killed or weakened virus, Brown said. Those methods are still being used in COVID vaccine development, including by AstraZeneca-Oxford, whose product has not yet been approved in Canada.
A benefit to using mRNA is the speed at which a vaccine can be developed or updated once scientists know what to target, Brown says.
While experts believe current vaccines will work against recent variants of the COVID virus — including one originating in the U.K. that’s more transmissible — Brown says mRNA’s adaptability could theoretically come in handy if new strains emerged that necessitated an update.
“In six weeks they could produce something,” he said. “It would still have to go through Phase 3 trials, but it does give you more flexibility and a big leg up.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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