Another Vaccine Update

More qualified good news, and some infuriating stuff

Hey, everyone—again, sorry for the slow pace of these posts. I’m planning to pick up speed over the next few weeks, but promises don’t count for much; actual words on the digital page do.

This piece is something between another news update and a Sunday respite number. That’s because there’s been some genuinely fine vaccine results lately, and most of this hopefully brief post aims to celebrate these advances in human flourishing.

First up: I was smacked right upside my gob by news of a vaccine that can make a real difference for people with melanoma—if an early trial with 157 patients with advanced cases of the skin cancer pans out in larger sample sizes.

The idea behind the new vaccine, developed by COVID vaccine pioneer Moderna, turns on the fact that every person’s version of the disease is different. Each malignancy accumulates its own mutations that are unique to their tumor cells, and not present in their healthy ones. Genome sequencing has become cheap enough (its own scientific triumph), such changes can be identified patient by patient. With that information in hand, Moderna’s mRNA technology makes it possible to design a vaccine that can teach each person’s immune system to target specific proteins created by such variation in the cancer cell genome.

A phase two trial combined these individualized vaccines with the immunotherapy drug pembrolizumab, sold under the relentlessly advertised name Keytruda. This study showed that those who received both that drug and a vaccine after surgery did much better than those who just got the current standard of care, surgery and Keytruda. Five years after diagnosis and initial treatment, 70% of those in the vaccine group were still cancer free, compared to 49% of those in the control cohort.

Again, this is early days. 157 patients does not a confirmed useful therapy make. A large, phase 3 trial will start next year, which means there’s still a fair amount of time before this new vaccine could possibly enter wide clinical practice.

But this is still a necessary and major step forward—and a reminder of the extraordinary power of what almost 150 years ago Louis Pasteur called “the principle of vaccination.” In the intervening century and a half, researchers have learned how to engineer into the immune system the power to guard ourselves against an ever-lengthening catalogue of threats. Many more such defenses will come—especially if RFK Jr.’s fact-free disdain for mRNA science can be flushed out of the federal government.

Next: A study recently published in The Lancet offered one of the clearest pictures yet of the power of vaccines to save lives. Peter Saiseni and Milena Falcaro looked at cervical cancer death rates following human papilloma virus (HPV) vaccination before and after England introduced universal HPV vaccination in 2008.

The TL:DR is that HPV vaccination works incredibly well to eliminate deaths from cervical cancer. Among the cohort with the highest vaccine uptake following the mandate, about 90%, deaths dropped to zero—nada, none, zilch—in between 2020 and 2024, which, in the desiccated language of scientific community, becomes “a reduction in cervical cancer mortality of 100%” — which translates into 23 lives saved compared with historical averages.

This is a purely observational study, but it is still significant evidence that vaccinating against HPV translates directly into a stunning reduction in both the risk of infection for individuals and the danger of transmission from one viral host-human to another. Which means, as Saiseni and Falcaro write, that their results “support the achievability of the WHO goal of eliminating cervical cancer as a public health problem,” and that “efforts should be made to achieve high vaccine uptake among young adolescents globally.”

So far smallpox is the only human disease that has been fully eradicated—thanks to vaccination. A handful of others have been confined to tiny pockets of in-the-field transmission (which means they could still roar back were vaccine vigilance to slip). So we’ll see how soon we achieve what would seem to be the no-brainer goal of vaccinating our way out of the threat of cervical cancer.

One more thing: the CDC still recommends HPV vaccination as part of the childhood immunization schedule, but the new calendar approved by Robert F. Kennedy cutting the HPV vaccine sequence from two shots (or three, depending on age) to one, with an as yet unknown impact on the lasting immune response. We won’t know for decades how many women may die as sacrifices to the anti-vax idol.

One more quick story (So you say—Ed.) that offers a much swifter insight into the effect of vaccine denialism. You may recall that in April Secretary of Defense* Peter Hegseth announced that military recruits would no longer be required to get the flu vaccination, claiming the mandate was part of “an unrelenting war on our warriors” that “weaken[ed] our warfighting capabilities.” In the wake of that policy shift, flu vaccine rates among Air Force recruits dropped to about 40%.

You can guess what happened next. In June, influenza paid a call on the Lackland Air Force Base in Texas, which sees about 700 new trainees per week. So far almost 300 new members of the Air Force have fallen ill, and one has died of the flu.

To no informed person’s surprise, flu vaccines are once again required at every boot camp.

That’s the right response—but consider the cost of discovering, yet again, that microbes do not care how deeply one believes vaccines are a trick played on the virtuous by mere experts in biology and medicine. That young airman, Keon McDaniel did not have to die six weeks into his military career. He shouldn’t have. But he did, a victim of the willed and chosen ignorance of the current leadership of the United States.

I know I don’t have to bang on that drum for this readership. The good news is genuinely good: the technology and the skills exist to discover new ways of reducing human suffering—and more such discoveries are coming all the time.

The sorrow is that right now the movement that would deny us that extraordinary gift is ascendent, and that means that each advance comes more slowly than it should, each delay carrying its own bodycount.

And with that, enough for now. I really will try to make the next post an unalloyed cheerful one. We can all use such pleasures, me most of all.

Image: Berthe Morisot, “On the beach at Fécamp,” 1874

*Not going to dignify that utterly unqualified parody of a military leader’s cosplay renaming of his office and department.