Chapter 9 - mRNA vaccines: public health and societal challenges

Abstract

This chapter considers mRNA technology and vaccines within a broader sociocultural context, beginning with the issue of vaccine hesitancy – a crucial concern, because the best science in the world is pointless if people refuse to be vaccinated. The psychological, social, cultural, economic, political, moral, historical, and ethical factors that affect public trust in vaccines are described, as well as measures that can be taken to address the problem and increase vaccination uptake. A particular concern expressed about the mRNA COVID-19 vaccines is that they were developed too quickly, and that safety must have been comprised for speed. In response, the discussion moves to a detailed look at the various factors that facilitated their expedited development, including the leveraging of prior foundational knowledge, the organization of the clinical trials, at-risk manufacturing, ample funding, cooperative regulatory support, and a collaborative, global response which included initiatives such as the Access to COVID-19 Tools Accelerator (ACT-A). The discussion then broadens to a global context and considers the problem of global vaccine inequality and the countermeasures taken to address it, including COVAX and the TRIPS waiver. The chapter concludes with a discussion on pandemic preparedness. Valuable lessons learned from the COVID-19 experience are described, as are measures necessary to improve future pandemic responses and global health security, to ensure that the world is better protected against future threats.