Vaccines have been one of the world’s greatest weapons against infectious diseases. Through widespread immunisation campaigns, we have successfully eradicated smallpox, made significant strides towards defeating polio, and significantly increased the survival and well-being of children worldwide. The field of immunisation research is undergoing a revolution, with exciting advancements promising an even healthier future. As the World Health Organization’s World Immunisation Week gets underway from the 24th to 30th April, urging countries to increase their investments in immunisation programmes to safeguard future generations, lets have a look at some of the promising developments that are going on in the world of immunisation research.
Lessons learnt from the COVID-19 pandemic
In the wake of the COVID-19 pandemic, vaccine development has seen remarkable advancements in recent years. Collaboration among scientists, researchers and pharmaceutical companies, lead to the rapid development and distribution of several highly effective COVID-19 vaccines. These breakthroughs in mRNA vaccine technology have helped to revolutionise the field, offering newfound hope for combating other infectious diseases. Lessons learned from the rapid development process, streamlined clinical trials, and accelerated regulatory pathways have provided invaluable insights and a blueprint for expediting future vaccine development and tackling other challenging diseases, such as HIV, influenza and malaria with new innovative approaches.
UKHSA: Vaccine Development and Evaluation Centre (VDEC)
In August 2023, the UK Health Security Agency (UKHSA) launched the Vaccine Development and Evaluation Centre (VDEC)ā a āstep changeā for UKās growing vaccine capabilities; facilitating the development of new vaccines and therapeutics and monitoring the effectiveness of existing vaccines.
The VDEC plays a crucial role in supporting the development of new vaccines, from initial design to assessing effectiveness against emerging variants, VDEC is prioritising pathogens without existing vaccines or in need of improvement, such as avian influenza, monkeypox, and hantavirus. For instance, VDEC is currently conducting clinical trials for a potential vaccine against Crimean-Congo haemorrhagic fever, a disease which can be fatal in up to 40% of those hospitalised. Additionally, VDEC aims to address vaccinations against common infections including tuberculosis (TB) and Clostridium difficile and is looking at developing vaccines against Lassa Fever and Nipah Virus, both listed by the WHO as potential pandemic pathogens lacking pharmaceutical countermeasures.
Beating bladder blues: a game changer vaccine against UTI’s
Urinary tract infections (UTIs) pose a prevalent challenge, particularly for women. While not life-threatening, they can be painful and disruptive. Traditionally, antibiotics have been the go-to treatment. However, antibiotic overuse contributes to antibiotic resistance, a growing global concern. Enter the potential of UTI vaccines!
According the Medscape, the first long-term follow-up study of an oral vaccine for recurrent UTIs suggests its potential as a game-changer for UTI prevention, with participants experiencing dramatic reductions in infections after receiving the vaccine, called Uromune. The study, followed 89 patients for nine years, demonstrating both safety and efficacy. Forty-eight participants remained UTI-free during the follow-up period, with an average UTI-free period of 4.5 years, and no adverse effects were reported. While further studies are needed to confirm the vaccine’s effectiveness in more complex UTI cases, its potential as a preventive strategy against antibiotic-resistant UTIs is promising.
Universal RNA-Based Vaccines: the future of vaccinations?
Researchers at University of California Riverside have developed a ground-breaking RNA-based vaccine strategy demonstrated to be effective against any strain of a virus, potentially revolutionising vaccination practices. Traditional vaccines target specific viral proteins, necessitating yearly updates to combat evolving strains. In contrast, this innovative approach targets a universal part of the viral genome shared by all strains, eliminating the need for adapting the vaccine.
The vaccine utilises small interfering RNA molecules to activate the body’s immune response, bypassing the need for traditional immune activation proteins. Notably, it can be safely administered to infants and the immunocompromised. This breakthrough, holds promise for developing vaccines against various viruses, including influenza, with potential for easy adaptation to other pathogens. Its broad applicability and effectiveness make it a promising candidate for a universal vaccine, addressing the longstanding challenge of viral evolution and vaccine effectiveness.
UK launches global trial for innovative cancer immunotherapy: mRNA-4359
Cancer patients in the UK are participating in a global trial for a new mRNA therapy, mRNA-4359, which aims to help the body recognise and fight cancer cells. Administered at Imperial College Healthcare NHS Trust, the trial evaluates the therapy’s safety and effectiveness against melanoma, lung cancer, and other solid tumours by training the immune system to target tumour markers. The trial, named Mobilize, is it its early stages. Whilst researchers hope this therapy, if proven safe and effective could offer a new treatment option for resistant cancers.
Ebola vaccines: revolutionising outbreak response
The battle against Ebola, a deadly infectious disease with devastating symptoms, has seen significant progress with the development of a promising vaccine named rVSVĪG-ZEBOV-GP. This vaccine, administered through a single dose, has shown remarkable effectiveness in reducing both infections and fatalities caused by the Ebola virus.
Through research, published in the The Lancet, conducted during the second-largest Ebola outbreak in the Democratic Republic of Congo, epidemiologists have demonstrated that the vaccine can cut the mortality rate in half, regardless of when it’s administered relative to the onset of symptoms. This breakthrough not only highlights the importance of vaccination campaigns during outbreaks but also offers hope for controlling and preventing the spread of Ebola, marking a significant advancement from the limited treatment options available in the past.
Malaria vaccines: a significant milestone
In December 2023, the WHO officially prequalified the R21/Matrix-M malaria vaccine, facilitating broader access to the vaccine. Developed by Oxford University and manufactured by the Serum Institute of India, the R21 vaccine is the second malaria vaccine to receive WHO prequalification after the RTS,S/AS01 vaccine.
Both vaccines have demonstrated safety and efficacy in clinical trials, offering promising tools for malaria prevention. This milestone is particularly significant in regions like Africa, where malaria imposes a heavy burden, causing nearly half a million children’s deaths annually. The prequalification process ensures that vaccines meet international standards of safety, efficacy, and quality, furthering the global effort to combat malaria and promote public health.
Vaccines for other mosquito borne diseases
The development of vaccines for dengue, chikungunya, and zika virus represents a significant stride in combating mosquito-borne diseases.
Dengue, a disease which has seen vaccine development efforts for decades, resulting in the first licensed vaccine in the UK in 2023; Qdenga vaccine. Qdenga is currently only recommended for use in the UK by the Joint Committee on Vaccination and Immunisation (JCVI) for those who have had a confirmed dengue infection in the past. It is however being used extensively across Brazil as part of their public health programme to combat the current outbreak of the disease.
Valneva’s VLA1553, or Ixchiq, became the first FDA-approved chikungunya vaccine in the USA in November 2023, marking a milestone in fighting the disease globally. Additionally, a Zika vaccine trial commenced in Liverpool in April 2023, and in March 2024, Valneva also initiated phase 1 trials of a second generation Zika vaccine. While challenges and hurdles may persist, including vaccine efficacy, safety, and distribution, these developments highlight collaborative efforts to mitigate the impact of these diseases on global public health.
Broader Spectrum Vaccines
Combination vaccines targeting multiple diseases are being explored, offering wider protection with fewer injections. This would mean fewer visits so would likely improve compliance and overall vaccination rates. Currently clinical trials are ongoing for a combined Covid and Flu vaccines with the hope in the future to produce a triple vaccine combining Covid, Flu and Respiratory Syncytial Virus.
Next-Gen Delivery Systems
The fear of needles can be a real barrier to vaccination. But what if getting vaccinated didn’t involve a needle at all? Enter next-generation delivery systems. Researchers are exploring innovative ways to deliver vaccines painlessly and conveniently through painless patches, sprays, ultrasound and even pills for vaccine delivery.
- Vaccination by Ultrasound: Researchers at the University of Oxford, have developed a needle-free vaccine delivery method using ultrasound technology. This innovative approach involves using ultrasound to push the vaccine mixture under the surface of the skin.
- Microneedle Patches: Imagine a small, adhesive patch with tiny needles that painlessly deliver the vaccine through the skin. These microneedle patches could be self-administered or applied by healthcare professionals, offering greater flexibility and potentially even at-home vaccination options.
- Oral and Nasal Vaccines: Oral vaccines currently exist for diseases such as rotavirus, polio, cholera and typhoid. For respiratory illnesses like influenza, we already have a nasal sprays that deliver the vaccine directly to the mucous membranes lining the nose, avoiding the use of a needle and providing effective immunity. Currently research is ongoing into developing oral and nasal covid-19 vaccines, alongside further development for newer oral polio vaccines. This method of delivery would be particularly beneficial in regions with limited access to medical facilities.
Personalised Immunisation
Consider a vaccine designed to match your unique immune response and risk factors, promising more potent and enduring protection. Indeed, personalised vaccines are currently in progress for customised cancer treatment. Supported by NHS England’s Cancer Vaccine Launch Pad, immunotherapies are developed by analysing a patient’s tumour to identify distinct mutations exclusive to their cancer, enabling personalised treatment precisely tailored to their individual condition. These personalised vaccines offer a targeted approach compared to traditional cancer therapies, potentially minimising complications and side effects from aggressive treatments.
A brighter, healthier future
The field of immunisation isn’t resting on its laurels. New vaccines are constantly being developed to target emerging threats and improve upon existing ones. From faster development times to exploring alternative delivery methods, the future of vaccines and preventable diseases is even brighter and healthier. The advancements in immunisation research offer a glimpse into a future where we can prevent a wider range of diseases, reduce reliance on antibiotics, and ultimately create a healthier, safer world for everyone living in it. Whilst challenges remain in terms of accessibility and affordability, and developing and testing new vaccines also takes time and resources, the future of vaccines still remains undeniably promising. With continued research and development, vaccines have the potential to become even more effective, convenient, and accessible to all.
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