It’s been a whirlwind year for Stéphane Bancel. Just over a year ago in March 2020, the World Health Organization declared the Covid-19 outbreak a pandemic. That same month Moderna, the biotech company that Bancel has helmed for the past nine years, sent its first batch of a new Covid-19 vaccine to the National Institutes of Health for testing.
Today, millions of people have been vaccinated with Moderna’s vaccine — the first product that the company ever brought to market — thanks to mRNA technology that enabled vaccines to be prepared, tested and manufactured in just a few months. Until the year 2020, the fastest anyone had ever developed a new vaccine was four years. “I’ve had no life for the past 12 months,” Bancel says with a small laugh. “I dream of a day when I can take a vacation.”
That frenetic pace has been extremely profitable, both for the company and its CEO. As of year-end 2020, Moderna booked $2.8 billion in unearned revenue for its mRNA vaccine, and reported $18.4 billion in advanced purchase orders for 2021. Bancel, who became a billionaire for the first time in April 2020 according to Forbes, now has a net worth of $4.6 billion.
Bancel says that Moderna is continuing to charge forward with creating new mRNA vaccines and therapies. “In 2021 and 2022 Moderna is going to scale at a pace that has never happened before in biotech,” Bancel says. From new vaccines for infectious disease to new cancer treatments and cures for genetic disorders like cystic fibrosis, here’s what Bancel says is on deck:
First up: New vaccines for new variants
The rise of new variants, some of which are less susceptible to vaccines, means that new variations of Covid-19 vaccines will continue to be produced for years to come. Many experts believe that Covid-19 will never truly go away, but instead become a seasonal illness. “You might end up with a thing like the flu where every year, every two years, you need a boost,” Bancel says.
Moderna has already shipped a new batch of Covid-19 vaccines to the National Institutes of Health for testing that is targeted specifically against the B.1.351 variant that was first discovered in South Africa. In March, it also started clinical trials of a new version of its vaccine that is stable at refrigerator temperatures, unlike the current version that must be stored in ultra-cold freezers.
A Better Flu Vaccine
Current flu vaccines take about 6 months to make since a version of the virus must be grown in eggs. They’re also only about 30-60% effective at preventing the seasonal illness. Using the same tech it did for Covid, Moderna is working on a new vaccine that Bancel believes will be 90% effective or more against the flu. More importantly, he says, the vaccines can be altered quickly to adapt to yearly changes in the virus. “I think we’re going to create a flu vaccine that the world has been waiting on for a long time,” he says. “It’s going to be in the clinic very soon.” Industry researchers have estimated the global market for influenza vaccines is more than $4 billion, and there’s room to grow here, too—on average, fewer than 50% of U.S. adults bother to get a flu vaccine, and one reason why is the relatively low efficacy. A more effective flu shot could lead to more jabs in arms.
Treating Cancer With A Shot
Moderna currently has five therapeutic cancer vaccines, injections that train the immune system to attack cancerous cells in the body, in clinical trials. There are two current vaccines on the market that treat existing cancers (as opposed to preventing them, like the HPV vaccine), but both are only used for advanced cancers and are expensive to produce. mRNA cancer vaccines could have the advantage of being safe, easy to develop and relatively cheap — though there are some hurdles to overcome including limited clinical data and the inherently fragile nature of mRNA. Bancel is enthusiastic about the applications here, “In the future, I think a lot of vaccines and therapeutics will be based on mRNA technology,” he says. One big advantage over existing drugs, he says, is safety. “It’s very very low biology risk. It’s a human protein made in a human cell in your body.”
Preventing Birth Defects
Before flu or cancer, Moderna’s next, non-Covid-19 vaccine to reach the public will likely be its vaccine for cytomegalovirus, or CMV. A harmless virus for most healthy adults, CMV can be passed from parent to baby in the womb. It is the number one cause of birth defects in the U.S., where 1 in 200 babies are born with the virus. In infants, the virus can cause hearing loss, vision loss, learning disabilities and other developmental disabilities. Bancel says that scientists have tried to create a vaccine to prevent CMV for more than 20 years, and Moderna’s current vaccine is a “very complex” shot that involves six different mRNA strands per vial. Despite those challenges Bancel says that so far, “the phase 1 and phase 2 data look very strong.”
Repairing Hearts
The versatility of the mRNA technology means it can be used to treat a variety of diseases, says Bancel. “mRNA is code,” he says. In vaccines, mRNA encodes proteins that are intended to provoke an immune response, but there’s nothing stopping the technology from producing proteins that could heal the body in other ways. For example, one of the therapies Bancel is most excited about is a treatment that Moderna is studying in partnership with AstraZeneca that uses injected mRNA to create new blood vessels. This could mean that damage caused to the cardiovascular system by heart failure could be repaired and heart tissue could even be regenerated, helping patients lead healthier lives.
Fixing Broken Genes
The newest and most radical use for mRNA likely comes in the form of gene therapies — treatments that alter faulty genes that can cause severe disease. Moderna, in partnership with Vertex Pharmaceuticals, is working on gene therapy for cystic fibrosis, a deadly lung disease. “You can use mRNA to do gene editing,” Bancel says, “because what you put in the mRNA is the instruction for the enzyme that will cut the DNA.”
Many of these treatments under discussion are still a few years off, but Bancel says their potential paints a picture of what the future could look like when mRNA is a normal tool for drug development. Eventually, Bancel says, “you’re going to have mRNA as another leg on the stool that clinicians will be using” to help patients. When might that happen? According to Bancel, “mRNA is going to be gigantic in the next 10 [to] 20 years.”
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