Autumn: Immunizations and the Nobel Prize

Debra L. Glasser, M.D.

PHOTO BY GLORIA TOWNE

We are well into autumn in the PNW! The trees’ beautiful fall colors are at their peak and it is that time again for immunizations against winter viruses (influenza, COVID- and now maybe RSV).  It is also the time when Nobel prizes are awarded. This year the Nobel Prize in Physiology or Medicine went to 2 imminent scientists whose seminal work was used to develop the COVID-19 vaccine.

The Washington Federation of State Employees began bargaining with the state on the terms of the vaccine mandate on Aug. 16.

It is time to get your autumn vaccines!

Yesterday’s article in the Jolt offered an excellent comprehensive review of the upcoming winter respiratory viruses and their vaccines.

Here is my simple guidance: everyone over the age of 6 months should have a flu shot AND the new COVID-19 vaccine, the latter when available at your pharmacy. The decision re. the RSV vaccine should be made between you and your or your child’s doctor.

See the CDC (Center for Disease Control) article cited below and this colorful chart to help:

Immunizations to protect against flu, COVID-19 and RSV graphic by the CDC, public domain.

Now a drumroll for The Nobel Prize Winners in Medicine!

On October 2, two collaborating scientists from the University of Pennsylvania won this year’s Nobel Prize in Medicine “for their discoveries concerning nucleoside base modifications that enabled the development of the effective mRNA vaccines against COVID-19.” Their work together, over decades, is a testament to science, rigor, persistence, and vision.

Click here for the press release.

The winners are Katalin Kariko, Ph., who for years remained single-minded in her effort to find a path to using mRNA clinically because of its huge potential, and Drew Weissman, M.D. Ph.D., an immunologist whose expertise is dendritic cells’ role in immunity and immune reactions.  Together, they discovered the roadblocks that had been standing in the way of using mRNA for therapy and vaccines.  Subsequently, they discovered the path around those roadblocks.

They published their breakthrough studies between 2005 and 2010. Soon after two companies (BioNT/Pfizer and Moderna, now almost household words) began to work on clinical applications of mRNA.  Because of their head start, these two companies were at the forefront of developing the COVID-19 vaccine at breakneck speed when the pandemic hit. In less than a year after the virus’ worldwide spread, millions of doses of vaccine had been manufactured, researched, and determined safe and ready to go!

That time frame for vaccines was unprecedented. Before this, vaccines were made from viruses (active or inactive), which had to be grown in tissue culture, a long and laborious process. That process would have taken too long to impact the rapid-fire spread of COVID-19.

Read more on the discoveries that enabled the development of the vaccines.

Now for a few definitions:

• DNA = the genetic material in our chromosomes, i.e., our genes; they hang out in the nucleus (a separate place in the center of our cells – like the yoke in a fried egg with the white being the cytoplasm). Remember elementary school basic biology? No worry, this is enough for now.
• mRNA = a special mirror image copy of a piece of DNA that is specially made to code for (that is, direct the manufacture of) a specific protein by the cell. We have amazing protein factories in every one of our cells. These factories are called mitochondria. Ahh…those vague memories…

The work of Drs. Kariko and Weissman determined how to safely introduce mRNA, designed to manufacture a specific protein, into people without major side effects.  Their research paved the way for the mRNA COVID-19 vaccine, mRNA that was made to manufacture the spike protein of COVID-19. Sound familiar?

A hand holding a Nobel prize

Image of a hand holding noble prize, photo by Marco Verch

Here are the scientific steps it took, all backed by extensive research (think in years) to reach each step:  

• Scientists rapidly determined the genetic code of the SarsCov2 RNA, the name of the virus that causes the disease COVID-19 and shared it openly and worldwide.
• It was the human genome project that first mapped the human genetic code in 2003 after 13 years of intensive research. That laid the foundation for virus mapping, now finding applications never imagined before this time.  Think on the level of discovering that the Earth is round and not flat.
• It was determined that the spike protein on the outer membrane of the SarsCov2 virus is the lock that opens the door for the virus to get in and infect cells.
• The RNA piece that coded the spike protein was unraveled.
• Using the Nobel winners’ key research findings, mRNA was manufactured from the spike protein’s coding RNA.
• This spike protein mRNA was used to manufacture the COVID-19 vaccine by BioNTech RNA (collaborating with Pfizer) and Moderna, who were at the forefront of this technology.
• People receiving that mRNA could then make their own spike protein and stimulate their immune systems to recognize and wipe out SARS-CoV-2 before they are severely infected.
• Once the mRNA vaccines were manufactured, simultaneous large-scale studies in humans regarding safety and effectiveness were completed. Doing this simultaneous study of a product being developed was cutting-edge science itself, a critical advance due to the urgency of the pandemic.
• VOILA: COVID-19 vaccines were made, leading to the manufacture of billions of doses made by Pfizer and Moderna, with other companies later developing vaccines using different technologies.

The manufacture of the COVID-19 vaccine in record time was an unprecedented worldwide collaborative effort. This remarkable feat involved scientists in academia and industry launching projects with immediacy with strong financial and logistical backing of governments, private industry, and non-profit organizations. 

Breakthroughs in science like this one take years but eventually, like the work of these scientists, the end goal is reached and pays off in huge benefits to humanity the likes of which we are only beginning to see.

All told, over 13 BILLION doses of COVID-19 vaccine were given worldwide, saving millions of lives and allowing societies to re-open and return to normal conditions.   

Time will tell how far and wide this technology will be used for the benefit of humanity, both to treat and prevent disease. Already studies are being conducted on an anti-cancer agent for multiple myeloma (a rare bone marrow cancer) using mRNA technology. Stay tuned for a lot more.

Let us celebrate and honor the great gifts of science and the scientists who dedicate their lives to this work as this year’s Nobel prize winners did on mRNA. This is science for the health and benefit of humanity.

Let us also celebrate living in a place where the result of their work, the winter vaccines are available:   go and get them! Rain or shine… well now, mostly rain…

Post Note

I have been writing this column for the Jolt for one year this week! Thank you to all my readers as well as those who have commented and emailed me. Keep those coming!  I appreciate the ongoing support of the Jolt staff (Danny and Sage) and fellow columnists' inspiration. It has been a rich experience writing this column, something I had dreamed of doing for years!

Debra L. Glasser, M.D., is a retired internal medicine physician in Olympia. Got a question for her? Write drdebra@theJOLTnews.com