Battling the Other Virus: Moderna’s HIV Vaccine

Image Source: Gorry and others – (2007). “Pathogenicity and immunogenicity of attenuated, nef-deleted HIV-1 strains in vivo” – CC BY 2.0

Covid isn’t the only killer virus out there. Don’t forget HIV. Unfortunately, lots of people do, partly because HIV has an old association with what many average, well-off Americans consider the dregs of society, meaning mostly drug addicts. Also, there was HIV’s provenance in the 1980s, as a disease that afflicted gay men. And then it ravaged Africa. So generally, white, non-drug abusing heterosexual Americans don’t give HIV much thought. The virus inaugurated an era of safe sex decades ago, as it slunk along, under the headlines.

Meanwhile the HIV death rate dropped steeply over the past 30 years. According to Statista, this decline “can be attributed to an increase in access to HIV medications.” Those antiretroviral medicines have prolonged millions of lives. But the long-sought medical prize of a vaccine remained elusive. Until now.

A new vaccine has arrived; it’s from Moderna and uses mRNA technology. This HIV vaccine prompts “white blood cells to turn into antibodies that can neutralize HIV,” WebMD reported January 28. “A booster shot to work with the HIV vaccine is also being studied.”

The booster works differently from the first shot. According to Fierce Biotech on March 14: “Moderna’s second HIV shot, mRNA-1574, takes a different approach to the first by targeting HIV envelope trimers via mRNA instead of eliciting broad antibodies against the virus.”

This is a huge deal all over the globe. “Nearly a million people still die every year from the virus,” according to the World Health Organization, “because they don’t know they have HIV and are not on treatment, or they start treatment late.” WHO recommends that anyone with HIV get antiretroviral treatment “as soon as possible after their diagnosis.” Lots of people don’t.

Moderna’s victory over HIV is on a par with its triumph over covid. But declaring the battle over would be jumping the gun – trials are still on-going. The first vaccinations were given in late January, and the boosters began in mid-March. These trials take place in Washington, D.C., Atlanta, Georgia and San Antonio, Texas, all at university medical centers. “The immunogens,” reports WebMD “that are being tested…will be delivered using the same messenger RNA technology” as in Moderna’s covid vaccine.

“About 1.2 million people in the United States had HIV at the end of 2019…” the report continues, “with more than 36,000 people being diagnosed in 2019.” According to WHO, over 37 million people globally had HIV in 2020. More dreadfully, WHO estimates that 36 million people died since the first cases appeared in 1981. As of a decade ago, the percentage of people contracting HIV grew faster than the percentage of global population growth.

Compare that to covid, now in its third year: worldwide, 445 million cases and over six million deaths. Of the two plagues, covid, being airborne, is by far the more contagious and, killing at a rate of three million per year, will have killed 120 million people, if it kicks around for 40 years like HIV.

That may seem a gloomy prediction for a disease already conquered by a vaccine, except…the application of that vaccine has been spotty at best. In wealthy countries, anti-vax lunatics spread their nonsense on social media, with the result that millions avoid the shot. Then lots of those benighted people catch the illness and die. Meanwhile in the Global South, even those eagerly awaiting inoculation can’t get it, because rich countries hoard it. The solution to this problem is obvious to anyone with a brain: break the patents so that medicine factories like India can produce cheap generic covid vaccines. But, surprise! Western countries regard those profits…er, patents, as sacred and would rather see millions of poor people sicken and die than deprive those precious pharmaceutical companies of their loot.

There are other similarities between covid and HIV. Known precautions exist for both diseases. Condoms for HIV, masks for covid. The HIV safeguards long ago became standard practice. So you’d think, for covid, which still kicks around, to say the least, sickening and killing, that people would continue wearing masks. But no. Too many politicos believe their careers depend on lying that everything’s fine now, we can go back to normal.

That’s our president’s message – even though anybody who has contact with him is tested beforehand. One rule of medical safety for the bigwigs and another for us hoi polloi. I guess our elites figure we’re just chumps. We oblige by being so eager to pretend this virus ended that we drop our guard and check our common sense at the door every time we enter an enclosed public space. And now the Pollyannas, backed up by a feckless federal judge (Trump-appointed, of course), claim we don’t even need masks on planes or in airports. Who cares if those are enclosed spaces where any luckless person without a mask will breathe in the virus? We’re getting back to normal! Even if we have to drop dead in the process. I guess the lugubrious conclusion that we’re the chumps after all is correct, amirite?

Though any vaccine is better than nothing, the one for covid has lots of drawbacks. It doesn’t stop transmission or breakthrough cases, and it only lasts about four months. Let’s hope the one for HIV works better. Let’s hope that it blocks infection. Because it’s hard to see how a mild case of HIV would in any way resemble in lack of severity the mild covid vaccinated people get. The two diseases differ dramatically, while mRNA technology has proven weaknesses – and strengths – which could play out very differently with a blood-borne pathogen that attacks the immune system.

The only thing to relax about is the anti-vax psychosis. Rabid anti-vaxxers probably won’t foam at the mouth over the HIV vaccine. It’s just a hunch, but I think these fanatics couldn’t care less what happens to HIV sufferers. The illness doesn’t affect anti-vax cuckoo-birds’ “freedom” to spread it in the same way, never interfered with the usual rapacious functioning of capitalism and overall failed to become a rocket-launcher in the culture wars. True, there were all those laws basically criminalizing the HIV infected, but the excuse was that the uninfected deserved protection. However, all that’s in the past, sort of, and the anti-vax maniacs are no doubt more focused on making life miserable for those of us who exercise caution about covid. They want all covid precautions tossed to the winds. And they’ve done a bang-up job of that. The covid death rate still hovers between 500 and 1000 a day, and with the omicron variant spreading like wildfire, it’ll probably zoom up soon. Anti-vax nuts – take a bow.

Eve Ottenberg is a novelist and journalist. Her latest book is Hope Deferred. She can be reached at her website.