I have just read the book ‘The Vaccine’ by Joe Miller, Uğur Şahin and Özlem Türeci. More precisely, I read the German version which is called ‘Projekt Lightspeed’ but I am assuming that the contents are not too different. The quality of the language in the version I read is high and I conclude from this that it is likely that both the quality of the language in the original and the quality of the translation are high. Miller is a journalist while Şahin and Türeci are the main protagonists of the story told in the book. It is the story of how the husband and wife team of researchers developed the BioNTech vaccine against COVID-19, a story which I found more gripping than fictional thrillers. The geographical centre of the story is Mainz. Şahin and Türeci live there and the headquarters of BioNTech, the company they founded, is also there. In fact when I moved to Mainz in 2013 I lived just a couple of hundred metres from what is now the area occupied by the BioNTech. Since I was interested in biotechnology the building was interesting for me. My first encounter with Şahin was a public lecture he gave about cancer immunotherapy in February 2015 and which I wrote about here. I heard him again in a keynote talk he gave at a conference at EMBL about cancer immunotherapy in February 2017. I was interested to hear his talk but it seems that it did not catch my attention since I did not mention it in the account I wrote of that meeting. One of the last lectures I attended live before the pandemic made such things impossible was at the university medical centre here in Mainz on 13th February 2020. Şahin was the chairman. The speaker was Melanie Brinkmann and the subject the persistence of herpes viruses in the host. I did not detect any trace of the theme COVID-19 in the meeting that day except for the fact that the speaker complained that she was getting asked so many questions on that subject on a daily basis. Later on she attained some public prominence in Germany in the discussion of measures against the pandemic. The book is less about the science of the subject than about the human story involved. I have no doubt that the scientific content is correct but it is not very deep. That is not the main subject of the book.
I now come to the story itself. Şahin and Türeci are both Germans whose parents came to Germany from Turkey. They studied medicine and they met during the practical part of their studies. They were both affected by seeing patients dying of cancer while medicine was helpless to prevent it. They decided they wanted to change the situation and have pursued that goal with remarkable consistency since then. They later came to the University of Mainz. They founded a biotechnology company called Ganymed producing monoclonal antibodies which was eventually sold for several hundred million Euros. They then went on to found BioNTech with the aim of using mRNA technology for cancer immunotherapy. An important role was played by money provided by the Strüngmann brothers. They had become billionaires through their company Hexal which sold generic drugs. They were relatively independent of the usual mechanisms of the financial markets and this was a big advantage for BioNTech. (A side remark: I learned from the book that the capital NT in the middle of the company name stands for ‘new technology’.) In early January 2020 Şahin foresaw the importance of COVID-19 and immediately began a project to apply the mRNA technology of BioNTech to develop a vaccine. The book is the story of many of the obstacles which he and Türeci had to overcome to attain this goal. In the US the vaccine is associated with the name Pfizer and it is important to mention at this point what the role of Pfizer was, namely to provide money and logistics. The main ideas came from Şahin and Türeci. Of course no important scientific development is due to one or two people alone and there are many contributions. In this case a central contribution came from Katalin Karikó.
How does the BioNTech vaccine work? The central idea of an mRNA vaccine is as follows. The aim is to introduce certain proteins into the body which are similar to ones found in the virus. The immune response to these proteins will then also act against the virus. What is actually injected is mRNA and that is then translated into the desired proteins by the cellular machinery. To start with the sequences of relevant proteins must be identified and corresponding mRNA molecules produced in vitro based on a DNA template. The RNA does not only contain the code for the protein but also extra elements which influence the way in which it behaves or is treated within a cell. In addition it is coated with some lipids which protect it from degradation by certain enzymes and help it to enter cells. Karikó played a central role in the development of this lipid technology. After the RNA has been injected it has to get into cells. A good target cell type are the dendritic cells which take up material from their surroundings by macropinocytosis. They then produce proteins based on the RNA template, cut them up into small peptides and display these on their surface. They also move to the lymph nodes. There they can present the antigens to T cells, which get activated. For T cells to get activated a second signal is also necessary and it is fortunate that mRNA can provide such a signal – in the language of vaccines it shows a natural adjuvant activity. In many more popular accounts of the role of the immune system in the vaccination against COVID-19 antibodies are the central subject. In fact according to the book many vaccine developers are somewhat fixated on antibodies and underestimate the role of T cells. There Şahin had to do a lot of convincing. It is nevertheless the case that antibodies are very important in this story and there is one point which I do not understand. Antibodies are produced by B cells and in order to do so they must be activated by the antigen. For this to happen the antigen must be visible outside the cells. So how do proteins produced in dendritic cells get exported so that B cells can see them?
I admire Şahin and Türeci very much. This has two aspects. The first is their amazing achievement in producing the vaccine against COVID-19 in record time. However there is also another aspect which I find very important. It is related to what I have learned about these two people from the book and from other sources. It has to do with a human quality which I find very important and which I believe is not appreciated as it should be in our society. This is humility. In their work Şahin and Türeci have been extremely ambitious but it seems to me that in their private life they have remained humble and this makes them an example to be followed.
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