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Mythbusters: what mRNA vaccines actually are

“The vaccine will alter my DNA!”

“The vaccine will kill millions like others have done!”

“Bill Gates is planting a microchip in the coronavirus vaccine!”

The MHRA has granted temporary authorisation for Pfizer and BioNTech COVID-19 mRNA vaccine in the UK. Simultaneously, worrying reports have emerged that many people may refuse to get the vaccine once it is available. A key factor in this has been the circulation of misinformation among anti-vaxxer groups. In this blog, we will explore the detrimental impact of misinformation and will also explain everything you need to know about mRNA vaccines.

One step forward, two steps back

The World Health Organisation (WHO) certified the global eradication of smallpox in 1980.

Smallpox was an infectious disease caused by the variola virus. It caused millions of deaths globally. In 1796, Edward Jenner created the first successful smallpox vaccine when he observed that milkmaids who previously caught cowpox did not catch smallpox. He showed that a similar inoculation could be used to prevent smallpox in other people. Then in 1967, WHO launched an intensified plan to eradicate smallpox. Widespread immunisation and surveillance across the world, led to the last known natural case in Somalia in 1977. This is the only infectious disease to achieve this distinction. It remains among the most notable and profound public health success story in history.

Cases of measles are rising. More importantly, measles-related deaths are rising.

What’s most shocking about this, is that this rise in cases and deaths is seen in countries where access to healthcare and vaccinations is not a second thought. Unfortunately, there have been multiple measles outbreaks in Western countries where the measles virus was previously considered eliminated.

There are currently 64,390,544 coronavirus cases and 1,490,724 deaths – with no signs of flattening. How can we begin to consider returning to normal, when other preventable infectious diseases are so easily ignored?

The damage has been done

Vaccination hesitancy and compliancy are multifactorial problems. While access for some is a major barrier; in recent years, there has been a surge in the opposition to vaccines in general. This is particularly seen against the MMR (measles, mumps, and rubella) vaccine. Most notably, in 1998, former British doctor and researcher, Andrew Wakefield, released a paper in The Lancet suggesting a connection between the MMR vaccine and the development of autism in young children. Several studies later disproved this association, and many criticised Wakefield for his flawed and unethical research methods. The Lancet retracted Wakefield’s study and its editor declared it ‘utterly false’. Nevertheless, the damage was already done.

This myth spread and has continued to linger in people’s minds. It shows the detrimental and frightening impact misinformation can have. The ongoing coronavirus pandemic has been no exception to this. The increase in public interest in their personal health and wellbeing (a positive) alongside the widespread use of social media has enabled conspiracy theorists to thrive and spread false information.

If I was a social influencer with a large social media following, which I am not, I could go online and say something completely absurd about medicine or the government with no absolutely no evidence to back up my claim. While many would rightly discredit what I said, there would be some people who would believe me. Then these whispers would spread. And then what I said could manifest in society as some sort of valid statement.  

Proving that our voices have never been more powerful.

Now, there are many cases where this is a positive – to spread positivity and speak out against racial and social injustices. Yet, as seen with the ongoing COVID-19 pandemic, this spread of false information and fearmongering can have both immediate and long-term negative effects.

A new type of vaccine

Pfizer and BioNTech recently announced that their vaccine candidate was found to be more than 90% effective in preventing COVID-19 in participants. While this has sparked some hope during a very bleak time, anti-vaxxer groups have begun to circulate false and damaging information that could prevent an effective roll-out of this vaccine. But what is exactly different about this vaccine?

Unlike conventional vaccines, which are produced using weakened forms of the virus, Pfizer and BioNTech are focussed on an mRNA vaccine. RNA vaccines can be constructed quickly using only the pathogen’s genetic code.

History

The first report of the successful use of in vitro transcribed mRNA in animals was published in 1990. However, early promising results did not lead to substantial investment in developing mRNA therapeutics, largely due to concerns associated with mRNA instability, high innate immunogenicity and inefficient in vivo delivery.

Over the past decade, major technological advancements have enabled mRNA to become a promising therapeutic tool. The use of mRNA has several beneficial features over conventional methods. Firstly, mRNA is a non-infectious, non-integrating platform. Therefore, there is no potential risk of infection or insertional mutagenesis. Secondly, various modifications can make mRNA more stable and highly translatable, making it is more efficacious. Thirdly, mRNA vaccines are highly scalable as they can be rapidly manufactured with relatively little costs.

Basic principles of mRNA vaccines

mRNA is the intermediate step between the translation of protein-encoding DNA and the production of proteins. There are two major types of RNA that are currently studied as vaccines: non-replicating mRNA and viral derived, self-amplifying RNA. Conventional mRNA-based vaccines encode the antigen of interest and contain 5′ and 3′ untranslated regions. Whereas self-amplifying RNAs encode both the antigen and the viral replication machinery that enables intracellular RNA amplification and abundant protein expression.

Pfizer and BioNTech’s vaccine candidate – also known as BNT162b2 – is a non-replicating, modified mRNA lipid nanoparticle vaccine. It is composed of nucleoside-modified mRNA encoding a mutated form of the spike protein for SARS-CoV-2. The mutated version contains two proline substitutions that enable it to adopt a shape that stimulates neutralising antibodies. The mRNA is encapsulated within lipid nanoparticles, which prevent mRNA degradation and mediate intracellular delivery. The mRNA vaccine is given via intramuscular injection and enters cells, where it provides instructions to produce the spike protein (antigen). Synthetic production methods of mRNA means that no virus is needed and it also offers a more flexible approach to tackling pathogens which are rapidly evolving. Two doses of the vaccine need to be given and it must be stored and transported at -70 °C.

Misconceptions resolved

One of the main concerns about the vaccine is the fact that there are currently no approved mRNA- based vaccines. Therefore, some experts worry about injecting the first vaccine of this kind into hundreds of millions of people so quickly. As a result, it is imperative that keys questions are asked, including how much protection the vaccine offers, to whom and for how long. This will require trials involving a large number of people with monitoring over weeks or months. For many, including the research community, a close analysis of the data at the end will be important, but does not dampen current enthusiasm!

Another concern is the assumption that the genetic material will alter people’s DNA. While this synthetic mRNA is genetic material, it cannot be transmitted to the next generation. mRNA vaccines do not affect the DNA inside the cell. The mRNA fragment is a specific piece of the virus and is degraded by normal cellular processes after protein production.

A rather unusual concern that has surfaced is that Bill Gates is planning to use the vaccine to control the world. Individual’s claim that Bill Gates owns the patent and vaccine for coronavirus and that he’s a partner in the lab in Wuhan, China. There is no evidence whatsoever to support these claims.

Final thoughts

Vaccines are one of the greatest developments of modern medicine. They have helped wipe out many infectious diseases. Developing a vaccine is a long and complex process that combines both art and science. Given the urgency of the pandemic, strong partnerships across research and healthcare have been vital.

mRNA vaccines represent a promising alternative to existing conventional approaches. Initial preliminary results of the Pfizer and BioNTech vaccine are promising. While further analysis of the data is warranted, many researchers are still prepared to accept caveats. In these uncertain times, a vaccine that works is the main priority. Even if it works for only a few months, it is what is essential to regain some normality.

Smallpox existed, it took the lives of millions and it was eradicated with the help of a vaccine. Coronavirus exists and the only way it can be eradicated is with the help of a vaccine.

It is our job to promote the spread of evidence-based information and ensure that we conduct research in a manner that puts all human life at the forefront. 

Image credit: By freepik – www.freepik.com


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Coronavirus / covid-19 / mRNA / Vaccine