COVID-19 has presented humankind with the challenges expected from a pandemic with over 700 million cases and almost 7 million deaths1. While the mRNA technology was not widely known in the news, it was already understood in the scientific community as the recipe book for the body's cells. The idea of synthetically tweaking the mRNA sequence and injecting it in people so the body could create its defense was already under study, but nothing commercially available. Against all odds, the first vaccine available in the USA and the EU for the public was developed following mRNA technology, proving its potential as a new source for vaccine platforms.
It took forty-two days after the genetic code was released for an experimental vaccine to be produced using mRNA technology, showcasing the platform's remarkable capability and incredible adaptability of the mRNA platform when combating emerging infectious diseases. The pandemic has provided the necessity to ramp up production on a scale never imagined. Constraints in the supply chain were observed; yet over 70% of all doses, including boosters administered in the EU, were based on mRNA technology2. It is expected that Pfizer, BioNTech and Moderna – the main providers of mRNA vaccine against COVID-19, will make pre-tax profits of $34 billion between them, that is $93.5 million a day or $65,000 a minute3. In addition, mRNA technology is also being studied to cure several types of cancers with promising results4.
The beauty of mRNA technology is the modal of action to produce an immune response in the human body. The messenger ribonucleic acid (mRNA) is a molecule that our body can read and uses as an instruction to produce the relevant piece of protein, which stimulates an adaptive immune response, teaching our body to identify and destroy in case of infections. This technology does not rely on injecting viral material into a person, making the entire process simpler and quicker. The platform can be easily adaptable to support targeting different types of infectious diseases and personalized medicine targeting tumors. Ultimately, mRNA technology is well-positioned to revolutionize the treatment of diseases previously neglected by manufacturers due to the time consuming for developments of traditional vaccine platforms.
One of the challenges facing mRNA technology is its reliability over expensive and limited materials, which can swell the cost of the finished product jeopardizing the economy of scale principles, especially when directed to personalized medicine and low-income countries' access to the affordability of the technology.5 Another challenge observed is the concern over its ability to provoke the required level of immune response to protect the individual and the tolerance level when several injections are required, certainly in cases of chronic diseases6.
The delivery method of the mRNA into the target cell can also be tricky. Currently, there are several different methods; however, an optimal result combining efficiency and safety is still to be seen. Furthermore, the challenges of mRNA stability under ultra-frozen storage conditions are another hiccup, which translates into distribution challenges, given that the manufacturing capability is not well distributed across the globe. The storage of dosages in Brazil at the beginning of the pandemic presented several difficulties as the country did not have enough ultra-frozen storage spaces for the observed demand , leading to universities being employed to store vials7.
However, these challenges have not stopped the rapid development of mRNA technology. The pandemic has accelerated the gathering of real-world data worth years of research to improve the design of manufacturing, which can be applied to therapeutical use in the treatment of tumors and chronic diseases. mRNA technology is under development for several viral diseases such as Zika, Influenza, Dengue, Ebola, HIV-1, and Rabies, but it also has different cancer immunotherapy for Skin, Prostate, Lung and Lymphoma8.
Katalin Karikó, an adjunct professor at the University of Pennsylvania who has pioneered the research into the use of mRNA technology for vaccines, says that, in theory, we could make mRNA for pretty much any protein9. This potential could revolutionize the field of Personalized Medicine to treat specific patients' diseases. The exact path forward for this new approach is still unclear; nevertheless, one thing is sure; the industry is moving from the traditional approach – where therapeutics are created for the whole population, towards a more individualized medicine. In this model, therapies are assessed and created based on the characteristics of an individual – the patient. mRNA technology is one of the prominent new technologies that could take the pharmaceutical industry one step forward in the personalized medicine landscape.
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