The future of vaccines

Sustained investment and effective introduction of new technologies are essential to enable vaccine-preventable diseases to be controlled, eliminated and potentially eradicated ^[1]

Video transcript

The way we look for new cures and treatments is evolving and medicines are more personalised now than ever before.

Treatments are becoming more sophisticated, so once deadly conditions like HIV, heart disease, and some cancers, and now turning into long-term manageable conditions.

New exciting treatments like CAR-T therapy, which has recently been adopted by the NHS for use in children who have leukaemia, is able to modify the patient's own immune cells to target the disease, or gene therapies which are able to change the patient's DNA to actually tackle the root cause of the disease.

Treatments like this are breaking the boundaries of medical science, and helping scientists make advances in rare diseases, which often affect the youngest of patients.

Companies are working on hundreds of advanced therapies, and the UK is at the heart of it.

There'll be challenges along the way, but with 7,500 new medicines in the global pipeline, we have the potential to transform the way we treat patients here and around the world.

The way we look for new treatments and cures is evolving, and medicines are more personalised now than ever before. Treatments are becoming more sophisticated as we gain a better understanding of science and disease.

Dr Ali Hansford looks at what the future hold for medicines research and the treatments on the horizon.

1. Pharmaceutical companies are innovating for the next generation of vaccines

Over 260 vaccines² are in development for the prevention or treatment of disease, and new technologies are helping us find potential new vaccines.

2. Innovation could improve the simplicity and efficiency of vaccine delivery

In their research and development, pharmaceutical companies aren’t just looking at new vaccines for diseases, but also looking at ways to make vaccines more effective and easier to use. That’s especially important for infectious diseases impacting parts of the world without developed health care systems.

That research includes:

Reducing the need for multiple doses of a vaccine by boosting the body’s immune response³
Improving manufacturing processes to deliver vaccine doses more quickly¹
Making transportation and storage of vaccines easier to reduce wastage and improve access for hard to reach communities¹

3. New technologies are helping us develop future vaccines

Advances in our understanding of disease and leaps forward in science and technology are helping us design more effective vaccines, ones with a better immune response or vaccines that can be easier or quicker to manufacture.

On the cutting-edge of vaccines development, researchers are looking at

Live-Attenuated Viruses (LAVs)

LAVs are vaccines which still contain a weakened ‘live’ virus and can cause a strong response from the immune system – nearly as good as if the person has been infected with the real virus.

Since LAVs are still live, there is a degree of unpredictability which can cause some safety and stability concerns e.g. the potential to cause disease in immune-compromised individuals (HIV) or the potential to become virulent (wake up), infect the person and able to pass on.

Nucleic acid-based vaccines

Nucleic acid-based vaccines are a new development. Cells are injected with a genetically engineered ‘plasmid’ – a bit of DNA that is separate to the cells’ own chromosomes which can replicate independently – which contains an antigen to cause an immune response.

That means the cell produces the antibody for an effective immune response. DNA vaccines have potential advantages over conventional vaccines, including the ability to induce a wider range of immune response types.

Currently no DNA vaccines have been approved for human use. Research is investigating the approach for viral, bacterial and parasitic diseases in humans, as well as for several cancers.

mRNA vaccines

RNA vaccines work by introducing an mRNA sequence (the molecule which tells cells what proteins to build) which is coded for a disease specific antigen; once produced within the body, the antigen is recognised by the immune system, preparing it to fight the real thing.

RNA vaccines are faster and cheaper to produce than traditional vaccines, and an RNA-based vaccine is also safer for the patient, as they are not produced using infectious elements. Two forms of mRNA vaccines have been developed:

conventional mRNA vaccines – The simplest type of RNA vaccine, an mRNA strand is packaged and delivered to the body, where it is taken up by the body’s cells to make the antigen.

self-amplifying mRNA vaccines – The pathogen-mRNA strand is packaged with additional RNA strands that ensure it will be copied once the vaccine is inside a cell. This means that greater quantities of the antigen are made from a smaller amount of vaccine, helping to ensure a more robust immune response.

Recombinant DNA platforms

Recombinant DNA platforms produce an exact genetic match to proteins of a virus. The protein’s DNA will be combined with DNA from a virus harmless to humans, and once injected, will rapidly produce large quantities of antigen which stimulate the immune system to protect against the virus

Virus-Like Particle (VLP) based vaccines

Virus-like particles (VLPs) are molecules that closely resemble viruses but are non-infectious because they contain no viral genetic material. VLPs contain repetitive, high density displays of viral surface proteins that present ‘conformational viral epitopes’ – the part that causes an immune response.

Non-replicating Viral Vectors

Viral vectors are tools commonly used to deliver genetic material into cells. A viral vector vaccine induces expression of pathogen proteins within host cells similarly to other attenuated vaccines. However, since viral vector vaccines contain only a small fraction of pathogen genes, they are much safer and infection by the pathogen is impossible.

Recombinant Nanoparticles

Recombinant DNA is artificially created DNA. These types of vaccines use genetically engineered three-dimensional nanostructures that incorporate recombinant proteins critical to disease pathogenesis (the biological process that allows it to happen). In short, they support production of the antigens that cause an immune response.

Peptide vaccines

Synthetic proteins that mimic naturally occurring proteins from viruses, causing an immune response.

Adjuvant technology – this boosts the immune system’s response to a vaccine, improving its efficacy and giving the potential for vaccines to be developed that are longer lasting and more effective in older populations
Bioconjugation technology – developments in the process of joining a protein to an antigen could increase vaccines effectiveness

References and further links

¹ Innovation for a healthier world 2015 (IFPMA 2015)

² Medicines in Development, 2017 Update Vaccines (PhRMA, 2017)

³ What does the future of vaccination hold? (Australian Academy of Science, Apr 2020)