Fauci calls for development of pan-coronavirus and intranasal vaccines in fight against Covid variants
Even as vaccine manufacturers plow a path to market for Omicron-specific booster shots this fall, NIAID director Anthony Fauci’s message is clear: “Our job is not done.”
Fauci, who also serves as chief medical advisor to President Joe Biden, took the White House podium on Tuesday to offer a glimpse at where next-generation vaccines are headed — specifically highlighting the need for pan-coronavirus candidates and mucosal options that can be administered intranasally.
“Innovative approaches are clearly needed to induce broad and durable protection against coronaviruses known and unknown,” he said.
At the end of last month, the FDA recommended that vaccine manufacturers like Pfizer and Moderna move forward with Omicron-specific formulations, which may be available in early- to mid-fall.
Thanks to current vaccines, we’ve averted well over two million deaths and about a trillion dollars in healthcare costs, Fauci said. However, vaccine development is becoming increasingly complicated, as we’re now seeing “sublineages of sublineages” of Covid variants.
“These injectable vaccines do a great job at preventing severe disease, but they do little to prevent infection and transmission, and transmission is the engine of variant evolution,” said Martin Moore, CSO and cofounder of Meissa Vaccines.
Down the road, Fauci advocated for pan-coronavirus vaccines, or mucosal options that could potentially stop transmission in its tracks.
“When you have a mucosal, and in this case, intranasal, what you do is you stimulate at the local level,” Fauci said during the summit, which was broadcast live on Zoom. “The goal of that is not only to protect against disease, but to protect against acquisition and by acquisition, transmission. And that’s really the holy grail.”
Current vaccines induce robust systemic immune responses, but do not induce a mucosal response, according to Akiko Iwasaki, an immunology professor at Yale University. She’s also the co-founder of Xanadu Bio, a Yale spinout looking to bring an intranasal Covid candidate into the clinic. Mucosal vaccines are designed to prevent a virus from ever getting to a host cell, like putting a guard outside your house to protect from invaders, Iwasaki said.
Iwasaki recently co-authored a paper in Science Immunology alongside Scripps Research Translational Institute founder Eric Topol that advocates for an accelerated initiative for intranasal Covid-19 vaccines, similar to Operation Warp Speed.
“We know from 200 years of vaccinology … that vaccines that mimic natural infection tend to work best,” Moore said. “No one here today can tell you that mucosal COVID vaccines work, we’re not there yet. We need clinical efficacy data to answer that question, and that’s why we’re here.”
Manufacturing is also “a key part of the future,” Moderna’s CMO Paul Burton said at the summit, adding that the company has recently struck deals to build new plants and R&D sites in Australia, the United Kingdom, Canada and Kenya.
“We have to continue these discussions, continue these collaborations to instill confidence,” Burton said. “Getting that confidence and then the ability to get these shots made in countries and into people’s arms I think is how we’re going to continue to get out of the pandemic.”
Pfizer biopharma group president Angela Hwang added that the developers continue to implement lessons learned from the pandemic to make the process more efficient.
“Probably two and a half billion people have received the Pfizer vaccine,” she said. “That’s an incredible wealth of real world evidence that we’re sitting on. And so I think that we have a great opportunity, having that strong depth and breadth of data, to use that to also help us to understand, how can we design new therapies?”
*A correction has been made to the attribution of two quotes by Martin Moore.