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One of the first clinical trials of a new mRNA vaccine for HIV is underway

A MARTINEZ, HOST:

During this pandemic, scientists around the world made history as they developed and launched a new vaccine in record-breaking time. Researchers estimate the COVID-19 vaccines have saved more than a million lives in the U.S. and prevented more than 10 million hospitalizations. mRNA technology made that breakthrough possible, and it's now giving a much needed boost to the fight against another global killer - HIV. NPR's Michaeleen Doucleff has the story.

MICHAELEEN DOUCLEFF, BYLINE: About a year ago, Dr. Jesse Clark was doing what many doctors were doing across the country - taking care of people hospitalized with COVID. Clark is an infectious disease doctor at the University of California, Los Angeles. One weekend, he was checking on patients, and...

JESSE CLARK: I went into one room, and there was a guy in his 30s who I thought was sleeping.

DOUCLEFF: But he wasn't sleeping.

CLARK: And I found that he was actually facing the wall, and he was crying.

DOUCLEFF: Then he said something that Clark will never forget.

CLARK: And he looked up at me and he said, my mother just died of COVID.

DOUCLEFF: She had caught it from another family member.

CLARK: And he said, my cousin brought this into the family. She said she was wearing a mask, but she didn't. I saw it on social media. She got COVID. Now she's dead, too. He's like, she has two kids. What's going to happen to them? And he looks at me and said, am I going to die of COVID?

DOUCLEFF: That moment reminded Clark of another incredibly scary, sad moment when he was a teenager during the beginning of the HIV pandemic.

CLARK: I am a gay man. I grew up in the '80s and the '90s. This was long before we even had effective treatment.

DOUCLEFF: Catching HIV was a death sentence.

CLARK: So I grew up during the period of time where, you know, friends, colleagues, people were dropping dead left and right. And the question was always, you know, am I next? And there was nothing you could do about it.

DOUCLEFF: That fear of losing his life was constantly hanging over Clark. And at the time, many people outside the LGBTQ community didn't understand what that felt like until COVID hit.

CLARK: I think COVID brought that home to a lot of people in a way that HIV had not. You're trying to help take care of people around you, but you're also wondering, is this going to happen to me next?

DOUCLEFF: And the shift in that perspective, Clark says, has reignited the fight against HIV.

CLARK: It has spurred people to try to end the HIV epidemic again.

DOUCLEFF: And on top of that, the pandemic did something remarkable for that fight. It cleared the way for scientists to use a whole new tool for making an HIV vaccine - the mRNA vaccine technology. And, gosh, the field really needs this tool. For the past 40 years, the U.S. government and institutes all over the world have spent $15 billion trying to develop an HIV vaccine and have really made little progress.

DESIREE ARCHARY: Up until this point, we failed. And I hate to say this, but we failed dismally.

DOUCLEFF: That's Desiree Archary (ph). She's an immunologist at CAPRISA. It's an AIDS research center in Durban, South Africa. She says an HIV vaccine would be absolutely transformative in many parts of the world where the virus still kills about 700,000 people each year.

ARCHARY: Absolutely. I mean, if you take South Africa itself - I live in KwaZulu-Natal, and basically you're looking at between 25% to 30% of girls aged between 16 to 25 at any one time would test positive for HIV.

DOUCLEFF: The reason why it's been a challenge to make the HIV vaccine is the same reason SARS-CoV-2 keeps coming back over and over again.

WILLIAM SCHIEF: Variants.

DOUCLEFF: That's William Schief. He's a immunologist at Scripps Research Institute. He says HIV has many, many, many more variants than SARS-CoV-2.

SCHIEF: SARS-CoV-2 has a few variants. You know, they keep emerging, but in each person that's infected with HIV, there are thousands of variants.

DOUCLEFF: So you're saying, like, we have, you know, beta and delta and omicron. Like, there's millions of those for HIV.

SCHIEF: Yeah. On the Earth right now, there are. And we need to protect against basically all of them.

DOUCLEFF: Which sounds nearly impossible, Schief says. But nevertheless, he and his colleagues have been working to develop a vaccine that, if it works, will teach the immune system to recognize and stop thousands of HIV variants. It's arguably the most sophisticated vaccine ever developed. And it requires a whole series of shots with different versions of the virus.

SCHIEF: Based on what we're seeing, we think it'll be four or five.

DOUCLEFF: This takes a huge amount of testing, and that's where the mRNA technology comes to the rescue. mRNA vaccines have immense flexibility. They can be tweaked, tinkered with and optimized very easily.

SCHIEF: For RNA, it's much faster, and it doesn't cost as much.

DOUCLEFF: So serendipitously, the COVID pandemic greatly accelerated the development of this experimental vaccine - actually made it plausible - because the pandemic pushed researchers to test the mRNA technology to show that it not only works but works really well.

SCHIEF: We didn't know that RNA was going to be as safe and as immunogenic as it has proven to be. You know, the mRNA vaccines induce really good responses.

DOUCLEFF: So this past March, the National Institutes of Health, together with Moderna and Schief's lab, launched one of the first clinical trials of the mRNA vaccine for HIV. Back in Los Angeles, Dr. Jesse Clark is helping to lead the trial at UCLA's Vine Street Clinic, which also helped to test Moderna's COVID vaccine. While chatting with Clark at the clinic, I can see how proud he is to be a part of this historic trial.

CLARK: So I actually went into medical school to be an HIV specialist to help people that other people didn't seem to really want to help that much, partly because I could see myself in that and also probably just because people needed help.

DOUCLEFF: Although he says an approved vaccine is still years away, the path toward that seems much more viable now. Michaeleen Doucleff, NPR News. Transcript provided by NPR, Copyright NPR.