One of the biggest concerns on the mind of Dr. Noubar Afeyan, co-founder and chairman of Moderna, is variants.
As Afeyan rushes to create more doses of the Moderna vaccine to deliver all over the world, he knows that variants are lurking that could require even those vaccinated to get regular boosters.
“The biology of the variants and how they can overcome the biology of how your immune system changes over time, that’s the big unknown,” he said during a visit to South Florida, where he will deliver a commencement speech at Miami Dade College.
Afeyan says it is more likely than not that even those who are vaccinated will need some form of a booster to make antibodies against variants.
“People are projecting this could look like a seasonal flu — and it may — which means annual booster shots of different strains that are being protected against,” he said. “But we don’t know enough to say that for sure.
In the future, Afeyan foresees a booster that would be a combination of half a dose of the existing vaccine and half a dose of a new variant vaccine.
“What that does is it bolsters your immunity for what you already have and then starts making antibodies for the variants.”
Florida is a hot spot for variants, with five strains identified in the state. So far, the COVID-19 vaccine is thought to be effective against them.
Afeyan, an Armenian-American entrepreneur, inventor and philanthropist, spends his days talking to researchers and global leaders and is on the cutting edge of efforts to end the pandemic. He shared his insight with the Sun Sentinel.
Vaccines of the future
Moderna anticipates cranking out as many as a billion COVID-19 vaccine doses this year. But next year, Moderna could ramp that up to as many as 3 billion doses, Afeyan said. While a double dose has become the norm, that could change.
“We are also testing whether half the amount will still give the same protection,” he said. “In the beginning, we didn’t test that because we wanted to give people the maximum we could, but now we need to reach more people.”
Afeyan said getting the vaccine down to one dose would help parts of the world where the disease is spreading fast.
“By making more vaccine and making it more potent, suddenly we are doing our part for the rest of the world if we could get it out and let the other governments do their job,” he said.
Length of immunity from vaccines
Afeyan says how long vaccine immunity will last is hard to know. “I think we’re going to have to watch carefully. We know for up to nine months we can feel confident because that’s when we first did our trials,” he said. “Beyond that, especially with variants, that is a bit of an unknown.”
Moderna is looking into technology that can measure antibody levels and gauge how long immunity lasts. “We have to be vigilant to see when immunity is waning. … We will see it in new cases. If you see a spike in vaccinated people getting infected, we will have to react very quickly. We know what to do about it. We can just vaccinate again.”
On vaccine hesitancy
“At the end of the day, if one wants to work and be in the community, you have to think through the risk you are under and the risk you are putting other people under,” he said. “It’s clear without this protection, the risk is very high. And as these mutants come about, it’s going to be even higher.
“It’s also clear, based on testing on hundreds of millions of people who have received the vaccine, that it’s effective and reduces the risk dramatically,” he said.
“A vaccine is basically a mask inside your body,” he said. “It’s doing the same thing. It’s preventing the virus, once it gets in, from actually infecting your cells.”
On herd immunity
Afeyan said Americans may never know the percentage of people who need to be vaccinated or immune to completely shut the virus down. But he feels hopeful the country will recognize when it happens as case numbers dwindle.
Refrigeration of vaccines
Refrigeration requirements initially made vaccine rollout complicated.
“We have improved on that front,” Afeyan said. “Our product was slated to be kept in the refrigerator for 30 days and on the tabletop at room temperature for a whole day. We keep testing to see whether that’s what we should do or if we could go longer. My expectation is that the refrigeration time will be elongated to many months, which means you can ship it to any number of places and it will still be good.”
Afeyan said now that messenger RNA, the technology used for COVID-19 vaccines, has proven effective, Moderna is looking at how it can be used in other ways. In the future, messenger RNA could be used to combine a flu shot and a COVID-19 vaccine.
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