Look beyond mRNA vaccines to maximize global coverage

It didn’t work, partly because the Indian government restricted the export of the vaccine after the delta version arrived – but also because of the unexpected and early success of mRNA-based shots from Moderna and Pfizer. These quickly hit the market and set high standards for efficacy against the original version of the virus. But they were remarkably unsuitable for production and distribution in the emerging world. They need to be stored at unusually low temperatures, and their novel and unfamiliar production process is not easy to replicate.

Given their effectiveness as a mainstay of rich-world vaccination programmes, it is not surprising that, on the rare occasions when the West thinks of vaccines for developing countries, the focus is on whether mRNA How to increase the footprint of The rise of Delta and then the Omicron variant—against which booster mRNA shots seem to work better than many alternatives—has led some to conclude that, unless the whole world switches to mRNA, effective global vaccination is impossible. Is. It seems that both activists and rich-country policymakers think so.

But we shouldn’t be too convinced. Indian regulators have approved just two shots—both, as it happens, largely developed in the US—that could prove to be a safer bet than mRNA for much of the world.

The first is developed by Novavax Inc., based in Maryland. It encodes the genetic sequences from the spike protein into a virus that targets insects, then loads that virus into cultured insect cells. Novavax—which received $1.6 billion in 2020 from the Trump administration’s Operation Warp Pace, the largest such payment at the time—took some time before this hypothetical process escalated. Its Indian partner, the Serum Institute of India, complained last year that the Biden administration was withholding the raw materials India needed to produce the shot, delaying its roll-out by six months or more.

The vaccine has now been approved by India, the European Union and the World Health Organization – and is already being administered in Indonesia and the Philippines. Like the mRNA vaccines, the Novavax shot retains efficacy against the Omicron variant. A booster shot ups protection by 73 times, which is a higher multiplier than an mRNA booster. In addition, protein sub-unit shots such as Novavax can be stored in a regular-temperature refrigerator. And the technical process behind such vaccines has been described as “old-school”, far better understood than mRNA vaccines. This has allowed Novavax to nominate manufacturing partners in countries around the world, although Serum Institute will be its workhorse producing 150. Million shots a month.

The second new vaccine is called Corbevax. Although its Phase III trial data is not yet public, its potential is exciting. It is also a protein sub-unit vaccine, but, instead of baculovirus and moth cells, the manufacturing process uses yeast, similar to methods used for hepatitis B vaccines for decades. It was originally developed by researchers at Texas Children’s Hospital and Baylor University, and later co-developed by India-based Biological E Ltd, a major producer of hepatitis B vaccines. Perhaps most importantly, the technique for making Corbewax is not easy to understand and replicate, there are no complicated intellectual property questions involved. This means that production can be scaled up rapidly in many different parts of the world. The developers of the vaccine have already transferred technology to manufacturers in developing countries such as Indonesia, Bangladesh and Botswana.

Here’s what’s weird: Corbevax wasn’t on policymakers’ radar. The vaccine only took $7 million to develop, mostly from Texas philanthropists. You can’t help wondering if ‘old-school’ vaccines were just a fraction of the billions handed out by G-7 countries to ‘innovative’ vaccines, would we be farther than ever in ending the pandemic . One of the vaccine’s developers said government officials weren’t interested in his shot: “People were so fixated on innovation that no one thought, ‘Hey, maybe we’re going to have a low-cost, sustainable, easy-to-use vaccine. which can vaccinate. The whole world.'”

We shouldn’t make that mistake twice. The only way to make sure we don’t ruin 2022 or 2023 with worse forms is to accelerate global vaccination. To increase production globally, we need to focus on processes that are easy to replicate and where technology can be transferred rapidly; mRNA isn’t the only game in town.

Mihir Sharma is a Bloomberg Opinion columnist