VGS    mRNA technologies. What is their future and scope, and what are the challenges that countries might face in rolling them out? Hello and welcome to Science in5. I'm Vismita Gupta-Smith. We are talking to Dr. Soumya Swaminathan today. Soumya, talk to us about mRNA technologies. What is the future?

SS    I think everybody around the world now has heard of mRNA. It stands for messenger RNA, and basically it's part of our cellular architecture. The RNA molecule is a sort of translator. You can think of it as a waiter who takes the order from the DNA - that is the customer, and takes it to the kitchen, that then prepares the food or the proteins in the cell. So this technology has actually been worked on for the last 30 years, but it's only during this pandemic that we realize a full potential of it. And billions of people around the world now have received an mRNA vaccine. So apart from COVID vaccines, the technology can be used to make vaccines for many other diseases, and many of them are already quite advanced. We've got vaccines for influenza, for other viruses, like the respiratory syncytial virus, for Lassa fever, for example, but also to try and develop better vaccines for malaria, for TB, for HIV, and then beyond infectious diseases this technology is now being used by some companies and centers to target cancers, because we know that for many cancers now, once you identify the genetic change in the cancer, you can actually try and target the treatment for that. So again, very exciting opportunities for treatment of human and probably animal diseases as well.

VGS    Soumya, talk to us about the challenges that countries might face when rolling out these technologies.

SS    The first one, of course, is the access to the vaccine. And we've seen that there have been global inequities. And even today, over 75% of Africans have not been fully vaccinated. So this is a challenge, and we're trying to meet that through expanding manufacturing around the world, through our mRNA technology transfer program, so that hopefully in the next couple of years, we will have much more diversified capacity, both for R&D and for manufacturing. The second challenge is really getting health systems up to speed and able to vaccinate, populations at a scale that hasn't been done before.

We've never vaccinated adults the way that we're doing now. And to cover the whole world's population means that you need the human resources, the financial resources, the technical know-how, but also the the supply chain. So all of these need investment, need planning and need support. And the third set of challenges is around vaccine acceptance or vaccine hesitancy. And there's been a lot of misinformation being spread around mRNA in particular, because it's a new technology and somehow it looks like there's some changes to the genetic structure of our bodies, which is certainly not the case.

As I said, it only takes the message, it takes the protein sequence and tells the cell, go ahead and make the spike protein, and then the mRNA itself gets disintegrated in our bodies very quickly.

VGS   Soumya, talk to us about the safety of mRNA vaccines.

SS    So the safety of vaccines is given a lot of importance by WHO and also by regulatory agencies, because vaccines are given to healthy people to prevent disease, to prevent infections. And therefore, there's been a lot of data collected. And as you know, billions of people have now received these vaccines around the world. And we've looked at the benefit-risk profile. In terms of mRNA vaccines, yes, you get the usual side effects initially of fever, headache, fatigue, some pain at the injection site. These usually subside within 24 hours or so. Very rarely you can get what is called myocarditis, which is inflammation of the heart muscles. This has been observed again, it's very rare, but it's been seen among young men, mostly 15 to 30 years of age, usually after the second dose of the mRNA. In almost all the cases, it's been mild and self-limiting with full recovery. And the fact is that the COVID infection itself causes myocarditi, 4 times more common than has been seen after vaccination. So it's actually much worse to get myocarditis from COVID disease, because that can give you prolonged cardiac problems. We have good systems of monitoring safety, and as time goes on, we've been able to collect more and more data. And at this point of time, we're very confident that all the vaccines that are authorized for use for COVID have very good safety profiles.

VGS    Thank you, Soumya. That was Science in 5 today. Until next time then. Stay safe, stay healthy and stick with science.