For what, for whom?
There are now vaccines for more than 20 life-threatening diseases and vaccination prevents two to three million deaths a year, according to the World Health Organization.
Until covid-19, vaccination most often affected specific categories: children (poliomyelitis, etc.), but also the elderly or immunocompromised, with, for example, the flu vaccine. The annual production, before the epidemic, was 5 billion doses … To which were added at least 11 billion doses of covid vaccine produced in 2021.
If a serum was quickly found for coronavirus, it is not yet the case for various infectious diseases, such as HIV. In addition, the inequality of vaccines, highlighted by the pandemic, affects other viruses or pathogenic bacteria. According to Inserm, in 2018 there were 140,000 measles-related deaths worldwide, especially among children in low-income countries.
Since the discovery of the first smallpox vaccine by British physician Edward Jenner in the 18th century, the range has expanded considerably.
The most traditional are vaccines that use inactivated virus technology: the virus is killed, but retains its ability to induce the creation of antibodies (flu). The technology of the so-called attenuated virus is close: the infectious agent is weakened through various chemical processes (measles, mumps, rubella, etc.).
More recently, other technologies have been added, such as subunit vaccines, or viral vector vaccines: the latter use an adenovirus as a “vector” to present to the immune system a fragment of the virus against which we want the body. produce antibodies (Ebola).
Latest arrivals, messenger RNA vaccines, never marketed before 2020. With this serum, the cells of the human body will be made to manufacture, from injected messenger RNA fragments, a piece of the Sars-CoV-2 virus against which they will train thus. to defend himself.
Traditionally, the world of vaccines was restricted to a few large laboratories because the investments required to develop a new serum are very important. “It was a reserve for a few happy people. Messenger RNA redistributes the cards,” said Judge Loïc Plantevin, a health expert at Bain & Company.
Before the pandemic, four giants accounted for 90% of the market in value: the Americans Pfizer and Merck, the British GSK and the French Sanofi. But none, except Pfizer, only through an association with the German biotechnology BioNTech, has managed to prevail in the race against covid.
Traditional technologies are still difficult to deploy and relocate
The pandemic has revolutionized this closed sector with the emergence of biotechnologies such as BioNTech and the American Modern, the origin of the first RNA vaccines. Not to mention the new producing regions. In the face of unequal access to doses, the WHO has, in fact, launched a program to establish RNA vaccination sites in six African countries from 2024.
There are other initiatives, for example, a collaboration between Drew Weissman, one of the developers of messenger RNA technology, and Thailand, to provide access to vaccines to populations in low-income countries.
Important actions for health sovereignty, but only possible for the messenger RNA technique, believes Loïc Plantevin, for whom “traditional technologies remain difficult to deploy and relocate.”
What are the ways forward?
With Covid, billions of dollars have flowed into the infectious disease sector, which is often less dynamic for large laboratories than therapeutic areas such as oncology.
Since then, initiatives have multiplied. Modern wants, in particular, to advance the development of vaccines against dengue, Ebola or malaria. Sanofi, which has suffered a setback against covid, has also launched massive investments in RNA vaccines.
The pandemic has accelerated and reminded us of the need to continue innovating in vaccines
However, will messenger RNA be the answer to all infectious diseases? Will we see an HIV vaccine soon? “This technology still needs time, with improvements to be made,” warns Loïc Plantevin. Especially for conservation, its weak point. However, “the pandemic has accelerated and reminded us of the need to continue innovating in vaccines,” he added.
At the end of 2020, Nobel laureate in medicine and virologist Charles Rice said: “In any case, the covid-19 crisis has really changed the way we do science, to make it a joint effort instead of working. in different laboratories, isolated. , as we did years ago ”.