Innovation in American Healthcare in the Search for a Vaccine

 Tawny Hammett, M.S. Individualized Genomics & Health  Johns Hopkins University Alumna

The COVID-19 pandemic is slowly starting to makes its way to a period of tenuous recovery, bringing a welcomed sigh of relief to those feeling pandemic fatigue. Though many uncertainties still lie ahead, states are cautiously opening back up, providing a small sense of normalcy that many were used to before the public health crisis disrupted the world. While many of us still mourn the loss of family, friends, and complete strangers afflicted by SARS-CoV-2, the virus that causes COVID-19, we’re left gazing into the nebulous future of what the post-pandemic world will look like. Will social distancing always be a thing? Will we ever be able to attend a football game or state fair again? Is pajama professional the new acceptable business attire? Though no one at this time can tell for sure, we do know that the ‘normal’ we left behind is long gone, and the innovation that was spurred during dark times is here to stay.

We’ve already seen this occur in economic sectors such as travel, retail, and the food and beverage industry. Even the way Americans work has significantly changed, with many companies embracing the newfound freedoms (and at times, frustrations) of working from home. While we try to make sense of the thick fog still before us, we know one thing is certain – the future of healthcare will be drastically different. Telemedicine, once a term previously known by only health IT professionals, has now become a household concept. Many healthcare systems have removed physical payment systems for sanitation purposes and instead have opted for online bill review and pay, thus facilitating a more modern form of healthcare payments and revenue cycle management1. Though it may not be as obvious, we’re also beginning to see public health merge with precision medicine fueled by genomic science, specifically in the expeditious race for a vaccine.

There are more than 90 SARS-CoV-2 vaccines currently in development2. More traditional vaccines we’re familiar with today include active, inactivated, toxoid, and biosynthetic vaccines. Active vaccines, such as those used against polio, use live but weakened (attenuated) virus with induced mutations that render it harmless. Inactivated vaccines use a denatured form of the virus, such as those used against pertussis (whooping cough). Toxoid vaccines, such as those used against diphtheria and tetanus, do not use the virus or bacterium itself, but instead contain the toxins made by them, which elicits an immune response against infection. Biosynthetic vaccines, such as those used against hepatitis B, are recombinant DNA vaccines produced when DNA encoding a bacterial protein is inserted into cells, which later stimulates an immune response3.

The knowledge gained from approved vaccines coupled with more recent genomic discoveries has undoubtedly been applied to emerging viral-vector, protein-based, and nucleic acid vaccine candidates being studied to fight COVID-192. Companies exploring viral-vector vaccines use replicating viral-vectors or adeno-associated viruses (AAVs)4. An AAV vaccine for SARS-CoV-2 does not yet exist, but AAVs have already proven to be safe and effective in gene therapies that treat hereditary blindness and spinal muscular atrophy5. Protein-based vaccines being researched also use a biosynthetic approach via manufacturing protein fragments and in this case, would mimic SARS-CoV-2’s protein shell2. Nucleic-acid vaccines using DNA or mRNA have already shown promise in safety, with companies such as Moderna’s headline-making news with their Phase 1 clinical trial data6. Many of these newer viral approaches against SARS-CoV-2 are novel and if successful, could be the first licensed vaccine of their kind in history.

Vaccinology and therapeutics using genomic data and biotechnology will pave the way into a new era of American healthcare. Though not a guarantee, the hope is that we’ll be able to understand more accurately the health mysteries underlying diseases like cancer and developmental disorders that have baffled healthcare professionals for decades by evaluating their environmental, genetic, and epidemiological links. Combined with the enormous potential in quantum computing processing power, our annual checkups may one day come from an a doctor on our screens rather than in their offices. These are futuristic scenarios to dream about, but they are not outside the realm of possibility, and are already being explored in some respects by researchers all over the world. Given how the pandemic has forced us to innovate and push healthcare towards more technological advancements, these possibilities may come sooner than we think.

Contact Tawny Hammett at tawnyhammet@gmail.com for any comments, corrections, or to chat about the future of healthcare.

References:

1.) InstaMed, a J.P. Morgan Company. Trends in Healthcare Payments Tenth Annual Report: 2019.

2.) Callaway, E. (April 28, 2020).  The race for coronavirus vaccines: a graphical guide. Nature.

3.) NIH U.S. Library for Medicine. Medline Plus. Vaccines (immunizations).

4.) Wikipedia. Adeno-associated Viruses.

4.) Spark Therapeutics. Luxturna Gene Therapy Education and Resources. Inherited Retinal Diseases.

5.) Moderna. (May 18, 2020). Moderna Announces Positive Interim Phase 1 Data for its mRNA Vaccine (mRNA-1273) Against Novel Coronavirus.

 

Leave a Reply