Yale Medicine Infectious Disease Specialist, Dr. Onyema Ogbuagu, MD talks about a possible new flu shot on the way.
Interview conducted by Ivanhoe Broadcast News in 2022.
What is mRNA and what does it stand for?
OGBUAGU: mRNA means messenger RNA, but in the context of vaccines, it means modified messenger RNA. It’s a nucleotide sequence, or consider it a generic code that encodes for various proteins. One way to get the body to make a protein is to make an mRNA sequence. That’s the technology that has been harnessed for medical applications such as vaccines.
How was this important during COVID-19 discovery?
OGBUAGU: mRNA technology has been percolating in background for way over two decades up to now. I think that when the world had an urgent need for vaccines, when SARS-CoV-2 virus hit, that causes COVID, then it became an opportunity to test this new approach to vaccine development. The reason why mRNA technology was actually selected was that it’s a technology that can be deployed pretty rapidly. It’s relatively easier technology than other prior approaches to vaccine development. It was quickly deployed for COVID-19 and we’ve seen how they’ve really resulted in the emergence of safe and really highly effective vaccines for COVID-19.
Can a person feel a difference between an mRNA vaccine and what we have now?
OGBUAGU: That’s a great question. Probably not. Different vaccines have different frequencies of local side effects, which are things like arm pain, that people feel a swelling or redness and, of course, systemic symptoms like fever, etc. The thing people uses attribute to getting a flu vaccine for example, saying, I took the flu shot and I got the flu. What that really represents, it’s your body responding to a vaccine, which means that your immune system has detected the vaccine antigen and it’s really revving up to produce both antibodies, which are proteins that can neutralize infected cells, or what we call cell-mediated immunity. What it really means is that most of these vaccines are expected to cause some form of a reaction from the immune system, which manifests as the symptoms people feel. There’s really no way to distinguish between symptoms from one vaccine to another.
If you’re not feeling great, that’s a sign it’s working?
OGBUAGU: That’s exactly correct. In the most part, majority of individuals who have symptoms after vaccines, those tend to be individuals who are responding quite well to the vaccines. They denote, those reactions are typically mild and they’re short-lived.
What are the next steps in this technology?
OGBUAGU: I think we’ve been really amazed at how well and really blown out of the water with how well the mRNA vaccines have performed a regards to safety and efficacy. We have not rested at that and we’re moving straight into other infectious diseases. Currently, we just started mRNA vaccine for influenza, later on in the fall or winter, we’ll be starting an mRNA vaccine for the shingles. I do know my other colleagues and many other groups around the country and the world are working on other infections such as Lyme disease, for example. The wonderful thing about mRNA technology is that also it does have some applications in oncology, and that’s for certain cancers. We all know that cancers are normal cells that divide a little more rapidly than the body cells, but some of them actually make interesting antigens, which are proteins that distinguish them from cells in the body. mRNA technology can actually provide an approach where we can simulate producing those proteins through mRNA and harness the immune system to target and destroy cancer cells. That’s a new frontier in mRNA technology that we’re all very excited about.
How can the body fight the cancer itself?
OGBUAGU: Harnessing the immune system. Think of it as a target and kill approach where you can target the specific antigen or protein that tumor cells produce and then you get the immune system to recognize and fight those tumor cells. That’s certainly an approach that we’re really excited about and there are actually clinical trials ongoing to start to test that hypothesis.
How far away are you from the clean shot? Could we see this in the next flu season or is it going to be a couple of years? What would the timeframe?
OGBUAGU: We are talking in months, and not years. We do have preliminary DANA in what we call the safety and immunogenicity. Safety means just how well people tolerated the vaccine, but also how well they developed antibodies to these vaccines. We’re comparing those to the already approved vaccine versions. Some of our early data’s promising and we want to evaluate that a little more with a Phase 3 trial, where we enroll tens of thousands of individuals and see how well it performs in the real world.
When will the Phase 3 trial wrap up then?
OGBUAGU: We can’t state exactly when it will wrap up, it’s an event-driven studies. We’re going to be looking at flu events in the different arms of the study. Again, still looking at immune responses among the individuals. I would think that given that we’re heading into a flu season, it might just be a few months down the road.
Could you see this by the end of this flu season or are you’re looking more towards next, next flu season?
OGBUAGU: I would expect that by the end of flu season of 2023. Before March 2023, we should be able to have at least preliminary results.
Is it correct to describe it as building a better flu shot?
OGBUAGU: I would say building alternatives for the flu shot. Remember that some individuals do not tolerate the already approved influenza vaccine, so this gives them another option. Again, building on the safety that we’ve observed to the COVID-19 vaccines, we think that, especially for those who can tolerate some of the other forms, that this might be a viable alternative. Of course, we hope that we perform as well and there’s always the chance that we could perform even better, but that’s yet to be determined.
Is there anything I didn’t ask you that you would want people to know about this technology?
OGBUAGU: No, I think people have fears about new technology and we’re now two years in, into what is really has been a global uptake of mRNA vaccines. Again, this is really just to reassure the public because we’ve learned that sometimes the science is not enough, but the way we communicate that science to the public matters. We again, need to communicate to the public that these trials have been conducted on are being conducted with the highest level of scientific rigor and so that people can be confident that if they authorize and approved for any indications or preventing any viral infections, that they’re safe, they’re effective, and really should be used to optimize the benefits. Taking vaccines is a team sport. If we’re ever able to eradicate viral transmission in the community, it has to start with all of us rolling up our sleeves, getting vaccines, being protected against the viruses, and not just protecting ourselves, we’re protecting the vulnerable among us. That’s the message I would like to send.
END OF INTERVIEW
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