Could the silver lining of the pandemic be pan-vaccines?

The White House has announced it will end the public health emergency for COVID on May 11, officially accepting that COVID is endemic, where the virus will have a constant but manageable presence in our country. Along with coronavirus strains with the potential to mutate, 20 different influenza A and B virus subtypes are also circulating in animal and human reservoirs. It is only a question of time before the next pandemic can emerge.

Many experts are recommending a strategy of annual COVID vaccinations like the flu shot, where the vaccine is designed on an annual basis to target the likely dominant strains of the season. The challenge of that is two-fold: 1) It is difficult to predict which influenza virus subtype will cause the next pandemic, and 2) seasonal flu vaccines offer little protection against a pandemic influenza virus.

Building on the science of the past few years, University of Pennsylvania scientists have developed a vaccine that could give people a baseline level of protection against all 20 known flu strains, reducing disease and death when the next flu pandemic occurs.   

Most universal influenza vaccine strategies are designed to elicit a response to sections of virus that are shared in multiple influenza strains. The UPenn team has taken an alternative approach by designing multivalent vaccines that elicit responses to uniquely identifying sections of each of the 20 known flu virus strains. The vaccine presents 20 unique antigens for each of the virus subtypes. More than 30 years of research in chemistry, biology, nanomedicine, and the new nucleic acid–based vaccine platforms are what have enabled this second approach feasible today.

We are living in remarkably innovative times.  

The team at UPenn is not the only group developing multivalent mRNA vaccines: Moderna, Pfizer, BioNTech, Sanofi, Translate Bio, GlaxoSmithKline, and CureVac are all working on mRNA influenza vaccines. These new mRNA pan-influenza vaccines will likely not prevent disease but rather limit severe disease and protect against death.   

There are some key advantages to mRNA vaccine platforms over previous vaccine technologies. From the medical innovation perspective, immunity and protection is better because mRNA makes it easier to incorporate a larger number of antigens and also because viral proteins are expressed at high fidelity by human cells, likely preserving the natural structure. Secondly — and critically — from the public health perspective, mRNA vaccines are less burdensome to produce than recombinant technology, as there is no need to grow the virus in eggs. This, in turn, will facilitate vaccine approval and distribution. As we have seen, biomanufacturing challenges often limit the best medical technologies from being effectively utilized. 

The Bipartisan Commission on Biodefense, co-chaired by former Sen. Joe Lieberman and former Homeland Security Secretary, Gov. Tom Ridge, and led by Executive Director Dr. Asha George, issued a report in January 2021 describing a visionary Apollo Program for Biodefense. Inspired by President Kennedy’s seemingly impossible moonshot of the 1960s, the Apollo Program could eliminate future pandemics within 10 years by investing $100 billion into 15 technology priorities. The first priority listed — and one of the most key technologies for prevention — is vaccines. 

The risk of naturally occurring pandemics grows as biodiversity is reducing; due to deforestation, opportunities for animal–human interactions and zoonotic disease transmission are increasing, and genetic technologies are developing more rapidly and cheaply than ever before.

The increased biothreat landscape only substantiates the urgency for rapid advances in vaccine development.   

In particular, Congress has a number of opportunities this year to authorize and make sustained investments in forward-looking technology programs like the Apollo Program for Biodefense and in preparedness policy issues to ready our country to defend against the next pandemic-potential virus. Such vehicles include the reauthorization of the National Defense Authorization Act, the Farm Bill and the Pandemic and All-Hazards Preparedness Act (PAHPA), which is up for renewal for the first time since the world locked down due to COVID. Congress and the Biden administration have an opportunity to work in bipartisan fashion to make this a priority. 

If there is a silver lining from the emergence of COVID, it is that medical innovation, and specifically vaccine innovation, advanced at a historic pace. We must not lose that momentum as we approach the third anniversary of the pandemic.  

Ambika Bumb, PhD, served as President Biden’s Deputy Executive Director of the President’s Council of Advisors on Science and Technology. Today she is Deputy Executive Director at the Bipartisan Commission on Biodefense.