The trouble with a Nobel for mRNA COVID vaccines

General Studies Paper 3

Context

• The 2023 Nobel Prize for Physiology or Medicine has been awarded to Katalin Karikó and Drew Weissman for developing the mRNA vaccine technology that became the foundation for history’s fastest vaccine development programme during the COVID19 pandemic.

mRNA vaccine

• An mRNA vaccine is a type of vaccine that uses a copy of a molecule called messenger RNA (mRNA) to produce an immune response. The vaccine delivers molecules of antigen-encoding mRNA into immune cells, which use the designed mRNA as a blueprint to build foreign protein that would normally be produced by a pathogen (such as a virus) or by a cancer cell. These protein molecules stimulate an adaptive immune response that teaches the body to identify and destroy the corresponding pathogen or cancer cells.
• The mRNA is delivered by a co-formulation of the RNA encapsulated in lipid nanoparticles that protect the RNA strands and help their absorption into the cells.

The Nobel prize in Medicine, 2023

• It acknowledges the work that has created benefits “for all mankind”, but if we had to be stricter about holding scientific accomplishments up to this standard, the subset of mRNA vaccines used during the COVID19 pandemic may not meet it. Yet, Dr. Karikó and Dr. Weissman, and others, deserved to win the prize for their scientific accomplishments. Instead, their triumph tells us something important about the world in which science happens and what “for all mankind” should really mean.

At the expense of public funds

• Much of the knowledge that underpins most new drugs and vaccines is unearthed at the expense of governments and public funds. The cost and time estimates of this phase are $1 billion and $2.5 billion and several decades, respectively. Companies subsequently commoditise and commercialise these entities, raking in millions in profits, typically at the expense of the same people whose taxes funded the fundamental research.
• There is something to be said for this model of drug and vaccine development, particularly for the innovation it fosters and the eventual competition that lowers prices, but we cannot deny the ‘double-spend’ it imposes on consumers — including governments — and the profit seeking attitude it engenders among the companies developing and manufacturing the product.
• Once Moderna and Pfizer began producing their mRNA COVID19 vaccines, they were also mired in North American and European countries’ zeal to make sure they had more than enough for themselves before allowing manufacturers to export them to the rest of the world; their use in other countries (including India) was also complicated by protracted negotiations over pricing and liability.

On COVAX

• COVAX is the vaccines pillar of the Access to Covid-19 Tools (ACT) Accelerator. The ACT Accelerator is a global collaboration to accelerate the development, production, and equitable access to Covid-19 tests, treatments, and vaccines.
• It is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), the Global Alliance for Vaccines and Immunisation (GAVI) and the World Health Organisation (WHO).
• COVAX, the programme to ensure poorer countries did not become the victims of their subpar purchasing power and had sufficient stocks of mRNA vaccines, fell far short of its targets. India, Russia, and China exported billions of doses of their vaccines, but their efforts were also beset by concerns that manufacturing capacity had been overestimated — in India’s case —and over quality in Russia’s and China’s.

Corbevax

• A counterexample to the path that Dr. Karikó followed is Corbevax: Baylor College of Medicine, Houston, and the Texas Children’s Hospital Centre for Vaccine Development developed this protein subunit vaccine and licensed it to India’s Biological E for manufacturing. They did not patent it. It helped in the development and access of a low cost COVID19 vaccine to people of the world without patent limitation.

Conclusion:

• We cannot blame our scientists for trying to profit from their work; the mRNA vaccine could have benefited everyone during the pandemic, but it did not. So, history should remember what actually happened during the pandemic and what the 2023 Medicine Nobel claims happened differently.