In recent years, there has been a dramatic shift in the amount of space vaccines occupied in the public consciousness. During the development and testing of the current Covid-19 vaccines, humans followed the different phases of the clinical trials such as an early season of American Idol. In fact, many referred to it as the “Chase after a vaccine.” This, of course, makes sense as health officials from the outset of the pandemic have made it clear that a safe, effective vaccination our ticket back to a kind of normality.
A few months after the rollout, there are still a lot of vaccines on our radar. Although it is a victory for public health, there was great confusion last week findings of clinical trials first announced in February. According to several dramatic headlines and exuberant, widespread social media posts, thanks to technology developed by Moderna for their Covid-19 vaccine, a very effective HIV vaccine is well within reach – like a contemporary public health fairy tale.
Unfortunately, that did not happen. But some combination of misinterpretation the findings of the study, and our constant thirst for vaccine news, led to the feel-good story going viral. (Sorry.)
Meanwhile, the actual results of the study represent a significant breakthrough, which brings researchers one step closer to the development of vaccines, not only for HIV, but also viral infections. Here’s what you need to know about these legally exciting findings.
Confusion and vaccine enthusiasm aside, why are we talking about this research?
The short version is that it was the first clinical trial on humans that successfully used an approach that complements the immune system to develop a specific type of antibody – an important component of a future HIV vaccine.
Specifically, they found that 97 percent of the participants who received the vaccine had the immune response that researchers had hoped for. (And yes, this approach was tested using two doses of a vaccine, which may have contributed to the confusion over the findings.)
Known as IAVI G001, the clinical trial was evidence of concept study, meaning that its purpose was to determine whether this particular method showed enough promise to justify further research. (It did.) The study was a collaboration between the International AIDS Vaccine Initiative (IAVI) – which also the official sponsor of the trial – and Scripps Research, and is funded through, among others, the Bill & Melinda Gates Foundation and the National Institute of Allergy and Infectious Diseases (NIAID).
How does this vaccine approach work?
Before examining the details of this clinical trial, it is important to have some context, says Dr Mark Feinberg, the President and CEO of IAVI. Although he was not part of the research team that conducted this clinical trial, Feinberg has more than 20 years of experience in investigating HIV / Aids and the biology of other emerging diseases.
‘It’s easier for the immune system to neutralize a potent antibody response to SARS-CoV-2 [than HIV], ”He says Rolling clip. “It’s incredibly difficult to deal with HIV, and it’s just because of fundamental differences in the viruses and the types of infections it causes.”
It helps – at least from a scientific perspective – why researchers were able to develop multiple effective Covid-19 vaccines in less than a year, while research on an HIV vaccine has been going on for decades. To date, no HIV vaccine study has been able to broadly neutralize antibodies through vaccination – something that Feinberg and his colleagues believe is an integral part of the development of an effective HIV vaccine. Broad-neutralizing antibodies (bnAbs) are rare but powerful, specialized blood proteins that can counteract many different strains of a virus – something that is especially important with HIV, which mutates very frequently than other viruses.
‘We are concerned about Covid [variants], but what Covid does in two months’s, HIV does in one day, “says Dr. Larry Corey, a virologist at Fred Hutchinson Cancer Research Center and co-founder of the HIV Vaccine Trials Network (HVTN). In addition to his contributions to HIV research – including the development of antiretroviral drugs – Corey was one of the two scientists who led Dr. Anthony Fauci used it to oversees more than 80 clinical trial sites development of candidates for Covid-19 vaccines during Operation Warp Speed.
As someone who is familiar with both viruses but not involved in IAVI G001, Corey explains that while developing an effective HIV vaccine is ‘a much more formidable challenge’ than creating one for Covid-19 “This breakthrough was a good one.”
What was that breakthrough exactly?
The vaccine tested in the IAVI G001 clinical trial is specifically designed to activate certain cells that have the potential to produce bnAbs. “We need to walk the immune system this way to neutralize antibodies in general,” Feinberg explains, noting that in 97 percent of the participants who received the vaccine, this approach worked exactly as we wanted it to work.
Feinberg now says researchers can shift their efforts to take the next steps needed to create an HIV vaccine.
In addition, researchers believe that this method of replenishing the immune system to produce bnAbs can also be applied to the formation of vaccines for other challenging pathogens such as malaria, and the Zika and hepatitis C viruses. Feinberg also says that this approach also has the potential to play a role in the development of a universal flu vaccine – as in most strains that will make our annual flu shot significantly more effective.
How do Moderna and the Covid-19 vaccine fit into the picture?
The reports that this breakthrough with HIV vaccine was only possible thanks to the mRNA technology that Moderna invented when they developed their Covid-19 vaccine are inaccurate for several reasons. First, the research in of RNA-based vaccines can work for HIV started long before anyone heard of SARS-CoV-2. ‘HIV [vaccine research] the backbone and the creation that enabled us to do such an incredible awesome lift on Covid, ”Corey explains. While Moderna is also working with the research team to develop and test a vaccine based on mRNA that uses this approach to produce bnAbs, it is the next step in the process – in other words, research that has not yet happened.
That being said, the lessons learned and the techniques perfected during the development of a Covid-19 vaccine will certainly be an asset, to the next stages of the investigation into an effective HIV vaccine. “Hopefully Covid will teach us how to do things, will help us with HIV vaccines,” Corey says.
For one, use RNA technology – which uses a messenger (mRNA) that serves as a piece of genetic code, which encourages the body to make a lure that looks like the virus, in the hope that the immune system is tricked into attacking it, which eventually will end up developing antibodies to ward off the virus – is expected to accelerate the pace of discovery and development towards an HIV vaccine. “RNA technology alone is not going to overcome the fundamental challenges of making an HIV vaccine – it’s going to be the same,” Feinberg explains. “It’s just the tool provided by RNA technology that will enable us to move faster and incorporate our best ideas faster into human studies than we could have done before.”
How much faster are we talking? According to Feinberg, it is still too early to have any timeline for the development of an effective HIV vaccine, but he notes that this process, unlike the Covid-19 vaccines, will take more than a year.
What else could it mean for research on HIV vaccine?
Although some of the recent reporting on this clinical trial includes what Feinberg calls ‘irrational exuberance around the interpretation of some data’, it is promising to see that one year into our careers as armchair virologists we are very excited about vaccines. “I think here’s optimism,” Corey says. “In the first place, the understanding of vaccines in the country has increased significantly, so the interest in the development of vaccines is there.”
During the pandemic, Corey said he was concerned that – like so many other things – research on HIV vaccines would be “buried under Covid”. But now he is hopeful that the growing public awareness about vaccines and their development, thanks to Covid, will ultimately be a boon for HIV vaccine research.
“As we emerge from the Covid epidemic, I hope there will be momentum,” he says. ‘And that citizens will participate in HIV vaccines as in Covid. I mean, how wonderfully they helped them in Covid – all these people got up, rolled up their sleeves and got the critical shots. ”
Editor’s note: This story has been updated to explain that no HIV vaccine has yet been produced bnAbs.