‘Prevention is the best medicine’. This is a saying as old as time, which has never been more relevant, nor more important in our current healthcare climate. Preventative medicine is one of the three key pillars in healthcare, alongside diagnostics and treatment, and is arguably one of the most difficult disciplines. Vaccines, a key tool for preventative medicine, has found itself being questioned across various domains, including industrial, social, and political challenges. Factors such as lack of funding, viral mutations, and more recently, public misinformation, have hampered vaccine development and distribution programs. However, with the occurrence and subsequent persistence of COVID-19, vaccines have found itself back in the spotlight with renewed interest. In the post-COVID era, what does this mean for vaccines, viruses, and their variants in the future?

Let’s jump into the biggest question that we are all wondering about. Many countries are finally re-opening their borders and re-establishing travel and tourism. Does this mean that the pandemic is finally over?

This is definitely a hard question to answer. In many ways, the COVID-19 pandemic has been challenging for everybody. I think it would be prudent to continue to monitor the progression of the pandemic and development of new vaccines. With the continuous occurrence of new mutations and sporadic outbreaks, it is extremely hard to predict what will happen next. Since over 70% of the population is fully vaccinated, I do not believe that we need to revert to quarantines and shutdowns; however, keeping up to date with COVID booster shots and ensuring your own safety during traveling is still essential, especially for the at-risk populations.

The development and distribution of vaccines was a pivotal factor during the COVID pandemic. With most of the population being fully vaccinated, what is the future of COVID vaccines?

The vaccines that were initially developed and distributed were based on the wild-type of SARS-CoV-2, the lineage that was found in Wuhan at the end of 2019. Since then, new variants have replaced the original as the dominant variant. Currently, this refers to BA.4 and BA.5, with a subvariant BA.2.75, which is widely predicted to be the next dominant variant.

A key thing to note is that these new variants are a culmination of over 30 or more mutations. The viral structure has already completely changed, affecting the efficacy of the original vaccines developed. Currently, the existing vaccines still prevent severe illness and death, but are increasingly unable to manage infection.

As such, the development of newer vaccines, such as bivalent vaccines or mutant-specific booster shots, are becoming a priority to recharge everybody’s immunity, prevent disease spread, and protect the at-risk population.

Do you believe that the existing vaccine boosters are sufficient to stop the further development of the COVID-19 pandemic?

Several studies have confirmed that vaccine boosters can increase the titer of neutralizing antibodies and improve overall vaccine protection. Especially with the upcoming booster & bivalent vaccines from Pfizer and Moderna, initial clinical results have proven that these new mutant-specific boosters are more effective against the current dominant strains than the original booster shots. As more mutant-specific booster shots and bivalent vaccines begin to launch, it can be expected that infection rates will decrease along with hospitalization and deaths. Whether it is sufficient to stop the pandemic remains to be seen, as vaccine development is only the first step toward infection management. However, with the new mRNA vaccine technology platform, newer, variant-specific vaccines can be developed in a shorter amount of time. This is a huge advantage when combating highly infectious diseases.

During vaccine development, a big point of contention was over its efficacy, especially between the two technological platforms available (mRNA vs live attenuated). Which vaccine development platform is better and how are they evaluated?

With the recent development of vaccines using the mRNA platforms, there are currently 7 different types of vaccines, each of them with their own advantages and disadvantages. Certain types of vaccines might be more effective when targeting specific viruses, but there is no clear winner between the types of vaccines.