“Look me in the eyes,” the doctor ordered, staring at me from behind her plastic face guard. Her eyes were blue, almost as blue as her hospital mask. Yet, after a moment, I started to turn and face the doctor on my left, who was jabbing a long needle deep into the muscle of my upper arm. “No!” the first doctor snapped. “Look at me!”
Then she explained. Because I was part of a double-blind clinical trial of an experimental covid-19 vaccine, they had to make sure that I didn’t get any clues about whether I was being injected with a real dose or merely a placebo made of saline solution.
It was early August, and I had enlisted in the clinical trial for the vaccine that has just reported very promising results: the one developed by Pfizer with the German company BioNTech. It is a new type of RNA vaccine that has never before been deployed.
Vaccines work by stimulating a person’s immune system. One traditional approach is to inject a weakened version of the dangerous virus. That’s the way we now fend off measles, mumps, rubella and chickenpox. Another method is to use a version of the virus or a part of the virus that has been totally killed.
The success of the Pfizer vaccine means that the plague year of 2020 will be remembered as the time when traditional vaccines began to be supplanted by genetic vaccines. Instead of delivering tiny and safe doses of the virus itself, these new vaccines deliver a piece of genetic coding that will instruct human cells to produce, on their own, components of a targeted virus. These safe components can then stimulate the patient’s immune system.
It is another wondrous miracle from a biotech revolution in which knowledge of genetic coding will become as important as digital coding and molecules will become the new microchips.
Carrying genetic instructions
I enrolled in the trial at Ochsner Hospital in my hometown of New Orleans partly to be a good citizen but also because I’m writing a book about the gene-editing tool known as CRISPR, and the star molecule in the book is RNA. The vaccine that was developed by Pfizer and BioNTech makes use of the most basic functions that RNA performs: serving as a messenger RNA (mRNA) that carries genetic instructions from DNA, which is bunkered inside a cell’s nucleus, to the manufacturing region of the cell, where it directs what protein to make. In the case of the covid-19 vaccine, the mRNA instructs cells to make a version of the spike protein that is on the surface of a coronavirus. That spike protein can then stimulate our immune system to create antibodies that will protect against the real coronavirus. In addition to the Pfizer version, the Cambridge, Mass.-based company Moderna is also making an mRNA vaccine.
When I volunteered, I was told that the study could last two years. That raised a few questions. What would