The Global Story: Will the new cancer vaccine survive RFK Jr’s America?

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1:00Hey there, it's Asma Khaled, one of the hosts of the Global Story Podcasts from the BBC. And as a bonus for your feed, we're bringing you one of our favourite episodes of the week. Now every weekday on the Global Story, we try to tell one big story in depth about where the world and America intersect. In this episode, we look at a scientific breakthrough that comes with a lot of baggage here in the US, a vaccine for skin cancer that has shown promising results in a recent clinical trial. What's notable is that this is an mRNA vaccine, and you all might recognize that term mRNA because it's the same technology that was used in some COVID vaccines. And that is what is making this new scientific breakthrough so politically tricky. The COVID vaccines led to the rise of vaccine skepticism within the highest ranks of the US government, complicating the future of this potentially life-saving new research in America and around the world.

2:10So I hope you all take a listen to this episode, and if you enjoy it, you can always find more from us by searching for the Global Story wherever you get your podcasts. Now, on to the show. It was 1997 at the University of Pennsylvania in Philly, a Hungarian-American scientist by the name of Dr. Catalan Carico was wandering the holes looking for a copy machine. And when she found one, she came across another researcher, a struck up a conversation. And so I was bragging that I worked with RNA, and then he was telling me that he wanted to develop a vaccine. And that's how we started. Dr. Carico and her research partner would go on to spend years working together on what was sometimes a scientific dead end, an mRNA vaccine. For years, their efforts amounted to little, but in 2023, after the development of the COVID vaccines that used mRNA technology, they were awarded the Nobel Prize for medicine. Together, they have saved millions of lives, prevented severe COVID-19, reduced the overall disease burden, and enabled societies to open up again.

3:18Last week, there was another watershed moment from that same mRNA technology, a potential cancer vaccine. And yet, the news comes in a tough climate for vaccines. Last year, the U.S. Health and Human Services Secretary, RFK Jr., cut half a billion dollars of funding into mRNA research. From the BBC, I'm Asma Khalid in Washington, D.C. And today, on the global story, the new skin cancer vaccine and the promise and politics of mRNA technology. I'm Tom Whipple. I'm a science writer and I present inside science on BBC Radio 4 and the World Service. Well, Tom Whipple, welcome to the global story. It's a pleasure to have you with us. Thanks for taking the time. It's pleasure. Today, on the show, we want to dive into the health and policy debates around mRNA technology, particularly here in the United States, where I sit in this political moment.

4:23But the reason that we wanted to have this conversation today is because of a major medical breakthrough that made headlines just the other day, what is being described as a personalized cancer vaccine. And to be abundantly clear to listeners, it is not like your item could take a jab and have immunity from developing skin cancer. This is a different type of vaccine. Nonetheless, I'm hearing it described as a game changer. Can you explain what was actually announced and why it is being seen as so significant? Yeah, so as you say, so this isn't, this isn't you would get your summer booster shot and then not be able to catch skin cancer for that summer. It's absolutely not that there's a reason which will get into why the word vaccine is still perfectly appropriate. But what this is is that you if you've got a skin cancer or you know in theory, we'd like this to work for lots of cancers, but you remove it. But the real worry is it comes back. We all know about metastases and the idea that cancer spreads in the body, even after you've removed it.

5:28What this is doing is it is training your body to attack it. It's training it to attack the cancer cells that are there in the tumor so that your body's own defenses take it out. And so in that sense, it's very much like a vaccine in that the idea of vaccine as you show it a little bit of the thing, you show your body a little bit of the thing that you want to attack. And then your immune system is trained underway. It goes and attacks it. This is a really big deal. So the caveats are we don't yet know how well this worked. We know this has gone through stage three trials, which is the final stage of trials before you can introduce a drug or a treatment. We know that the companies that made it, Merck and Moderna are confident that this is clinically significant and useful. It prevented cancer from returning in a significant number of patients. It helped them live longer. This isn't a magic bullet.

6:28But the reason it's so significant is because doctors have been trying to do this for 30, 40 years. They've been trying to make a cancer vaccine because it's such a simple and appealing idea. And it seems like it should work. And until now, largely they failed. So the fact that this has succeeded and particularly succeeded using MRNA technology, which is this big coming technology suggests that we could be on the cusp of having a new wing. To our cancer treatments and also a wing that's a lot more gentle than many of the treatments that we used to. So just to make sure I'm following your time, this has gone through all the necessary trials. It has not yet this vaccine received the approval here in the United States from the FDA, the Food and Drug Administration. But it looks like it's on on track to be possibly used by the public in the near future. Yeah, look, once you've gone through phase three trials and being successful in your determination, that's when you gather together all of the data that you've got and you present it to the regulator and you say,

7:36we think we've made something that he will want. And then it is up to the regulator to say, yes, you have, or yes, you haven't. But look, if you want to a sense of the confidence in this, you just have to look at the dollar share price. Oh, yes. This is, this is something where people are betting a lot of billions that actually they've got something that works. So it sounds like we might need to be cautious still, but it sounds like we can be cautiously optimistic at this point. Can you walk us through exactly how this is different from the way that a traditional vaccine would work? So all vaccines, the principle is that your immune system learns by seeing things. So if I get infected by measles, my immune system will learn what the outsides of a measles virus looks like and provided that measles hasn't killed me. When I then see measles again, my immune system will know exactly what to do with it.

8:41It will have the antibodies and T cells ready to chomp it up, get rid of it. And I am completely immune from me. The principle of a vaccine is to do that without having the provided I'm still alive, bit. Excellent. Yes. It's to show you what a virus, a pathogen, some sort of bacteria looks like without actually getting you the infection bit. So there are lots of ways of doing this. Normally what you do, so you get an attenuated version of the virus. What they've done is they've seriously bred the virus to make it weaker and weaker. And so it doesn't give you measles, but it looks similar enough to the measles virus that does give you measles that having had it, your immune system knows exactly what to do with the real thing when it turns up. You have to develop that specifically for that particular virus.

9:41But the thing that made mRNA different is that they were programmable vaccines. Okay. So there is something that's known as the central document of biology and it is DNA makes RNA makes proteins. And what proteins do is make the body work. So I think almost all listeners will be familiar with DNA. It is very crudely the blueprint of you. DNA is like the instruction manual, the thing you get when you get a flat pack furniture. But the instruction manual isn't enough unless you have the person to read it and then turn the flat pack furniture into the bookshelf. And that's sort of what RNA or messenger RNA, that's where it comes in. So there was this idea, could we hijack this process? One of the pioneers of this idea was a Hungarian scientist called Catalan Caracope.

10:41I grew up in Hungary in a very sleepy small town. We did not had the running water, television set, refrigerator and so on, but nobody had, so I didn't know we don't have. She had been plugging away at this from 1985, you know, she studied this at university in Hungary. Quite dramatically, she couldn't do the research she wanted in Hungary. She left with a thousand dollars sewn side of teddy bear, along with her family, to go and do the research she wanted to do. What we had is most important, loving family. And I learned from them that hard work is part of life. She moved to the States, she developed this really simple idea, rather than having to make vaccine idiosyncratic to precisely the virus you're talking about, you effectively have this programmable technique to make the protein you want in the body when you want it and how you want it.

11:42And there was loads of work on this and there was loads of promise and you can understand why investors would want to invest in this idea, which is effectively an idea that you can hack the body to do what you want. It's been decades and decades of research, right? I mean, essentially the people have been thinking about mRNA ever since sort of when? She's been going at it since the mid 80s. Yeah, it's an obvious thing to go for and it is one of these very, very illuring ideas, but the truth is it was very hard. Catalan Carrico was at University of Pennsylvania and she was well, she put it like she was demoted and forced to retire effectively. Before Christmas in 2012, I was told that because I did not get a grant so that I have to pack and that's how I was terminated there. I could also agonize on 24 years, hard work, Saturday, Sunday, I was there, nobody appreciates, you know, don't do that. You have to focus on what next?

12:46So she left for this company called Biontech. That didn't look like a sensible career move. She said they laughed at me and said, Biontech doesn't even have a website. In a sense, she left to go to a company that was full of true believers like her and come 2019, there were mRNA companies and all of them were working pretty much on cancer vaccines. And there was a lot of money going into this technology and there were a lot of growing butterings in the biotech community that it was a hype bubble that actually this technology still hadn't produced anything or done anything good or useful and they put billions into it and maybe it would never happen. I think that most people who may have heard this news last week about a possible mRNA cancer vaccine may have recognized this term mRNA and thought, huh, does that have something to do with the COVID vaccine because that is I think the context in which so many of us first heard about mRNA technology.

13:53And so Tom, how much did the pandemic accelerate the use of this all? Well, he was hugely lucky and didn't realize it that as it happened, all of that 30 years of development happened to have just about come to fruition in January of 2020. I remember chatting to the CEO of biotech midway through 2020 and he described how he'd been reading the paper in early 2020 in January 2020 and decided then there's something happening. This is something we can do something about and he went and had a staff meeting and said, we are no longer a cancer company. We're a COVID company. They switched, you know, a lot of their research trying to make a rapid COVID vaccine and but that's because they were believers in their technology. A lot of people weren't because it's never done anything. This has never been a useful technology.

14:57Until it was with COVID. Until it was. Support comes from wise, the smart way to manage the currencies you need around the globe, fed up with losing out to hidden fees when you send money abroad with your everyday bank, choose the smart way. Wise, you can count on the exchange rate you'd usually find on Google, no one welcomes surprises. Plus, ditch that where's my money feeling? Most transfers arrive in under 20 seconds. Join millions saving billions on hidden fees. Be smart, get wise, download the Wise app today. Teasing sees apply. Incredible true stories shared by people from around the world. Something really strange happened to me. It was getting more and more bizarre. I didn't know who I could trust. I did not think we were ever going to make it out of life.

15:58Life's less ordinary is the podcast where real life is often stranger than fiction. Good day, my name's Brawlger and I am a full-time kangaroo mother. Lives less ordinary from the BBC World Service. Listen now, wherever you get your BBC podcasts. Okay, so you have described a scientific environment in which mRNA seems to be a huge breakthrough success. Not just here in the United States, but around the globe if we look at what happened with the COVID vaccine. At the same time with COVID, the development of the COVID mRNA vaccines.

17:01We also saw the rise of vaccine skepticism. And one man who really developed a big following during this time period and rose to prominence with his views is RFK Jr. Who was appointed by President Trump as the Secretary of Health and Human Services. And we have seen him in recent months take direct aim at what he believes is the safety and efficacy of mRNA. In August of 2025, he announced that the US government would cancel $500 million worth of funding for mRNA vaccines. He also posted a video online in which he said. As the pandemic showed us mRNA vaccines don't perform well against viruses. That in fact, the upper respiratory track anyone on to say that mRNA technology poses more risk and benefits for these respiratory viruses. Look, I come from a family in which there are many folks who work in science. I've certainly heard this widely disputed and an RFK is known as a vaccine skeptic.

18:06But can you explain this all to us and the allegations he is making specifically about the efficacy for upper respiratory viruses? Yeah, it's it's works. We're talking about mRNA, which is a huge boost from the pandemic scientifically in terms of prominence in terms of the ability of these companies to make vaccines. But it's also the case that the year and the young of that has also had a huge boost. And I think probably RFK, Jr. wouldn't be here either without the pandemic. I remember I was working at times during the arrival of those vaccines. And we were looking each day, the UK had some of the best data in the world during the pandemic. There's a lot we did wrong, but the data was astonishing. And you could see the death rate by age group in each day's death data. So how many people have been infected and how many people have died? We also knew that we were vaccinating people starting at the oldest and they're working down.

19:10And what you saw was this astonishing thing in each age group, there would be this sudden dip in the over 85s, this sudden dip in the over 80s, this sudden dip in the over 75s. You could see in real time the effect of the vaccines. And you were saying you would see a drop in the data once the vaccine was given to that age group. Yes, you've got this sort of two, three, four week lag for immunity of mortality rate. They brought it down an order of magnitude. The health and human services secretary saying that mRNA vaccines don't perform well against viruses that infect the upper respiratory tract. And he is saying that the pandemic showed us this. It sounds like you are saying that is just not accurate. The pandemic actually showed us the efficacy of these vaccines. I've long since left the situation where I feel like I can change anyone's mind about anything to do with COVID.

20:11But it's just not true. Look, the fact is before the vaccines, the in a western country with the age stratification that you have in the US and the UK, you're looking at about 1% overall mortality rate. And afterwards, there wasn't that. I mean, look, I do think when you have somebody in a high position of authority in the health department in the United States, saying one thing and you have others in the medical community saying, no, no, this mRNA technology has been effective. It is a scientific breakthrough. People can get confused. I have another question here about an allegation surrounding these mRNA vaccines. And that is that are they less safe than other forms of vaccines? And Tom, the reason I'm asking this is because when the funding for mRNA vaccine research was pulled, the Department of Health and Human Services, you're in the US issued a statement that said in part that technology that failed to meet current scientific standards,

21:17would be phased out in favor of evidence-based, ethically grounded solutions, like whole virus vaccines and novel platforms. So are mRNA vaccines less safe than traditional vaccines? I don't think there's particularly good evidence for that. I mean, every intervention has some side effects. It is going to work. It has side effects. Every intervention will vary on that. I mean, there's certainly going to be whole virus vaccines, which are far less safe. The worst side effects to this, there's myocarditis, pericarditis effects on the heart. They were rare. They were normally not that severe, but they were present to an extent that in the fittest, youngest age groups, at times of low prevalence of COVID, you could make the case that the cost-benefit analysis didn't work. And these were very, very finely balanced arguments.

22:17Now, what I would say is these were signals that were really hard to pick up until you started doing this at population scale. And that gives you a sense of how low the side effects were. But it would be completely irresponsible to say that they weren't there. But let's park this. So you might think, and I disagree with you, but you might think that the side effects of this won't worth it for much of the population for COVID. Fine. But what about cancer? Because even if you think COVID isn't that bad, and for a lot of population isn't that bad, it would be my contention that cancer's pretty bad. And that actually the side effects have to be pretty stonking in order for you not to take a treatment for cancer. And that is indeed why we do surgery and chemotherapy and radiotherapy and all these things.

23:18You definitely wouldn't do for COVID, but do do them for cancer. So, tell me if we can fast forward earlier this month in August, the FDA, the Food and Drug Administration approved the first mRNA flu vaccine made by Moderna, the same company that is being heralded for this new skin cancer vaccine. And my understanding is that initially the FDA had declined to even review Moderna's application for a flu vaccine developed through mRNA technology, but then seemed to reverse course. Why is that? It's slightly different with the flu vaccine in that we do have a flu vaccine that we use every year, that changes every year with the strain of flu that's circulating flu changes a lot. So you have to tweak the vaccine each year. And that's done with a traditional vaccine manufactured technique.

24:18So there's less of an impetus to use something fancy and expensive like mRNA or comparatively expensive. But the mRNA does offer better strain matching. Sometimes you get the strain wrong. What you're generally doing is you have these flu surveillance people who are looking at what's happening in Australia during their winter and then trying to fast forward to what's happening in the northern hemisphere during its winter. And sometimes they get it wrong. Whereas with mRNA, you can match better and you can move more nimbly. So I think there was elements of politics. The word mRNA has become political in a way that isn't helpful. And I don't want to speak to the FDA's particular decisions on the flu vaccine, because I'm not across it. But I would say that there are advantages of the mRNA, but there's less of a compelling public health case than there might be in other uses of it.

25:21From where I sit in the United States, Tom, it seems like there are two conversations happening at one time around mRNA technology. There is the scientific conversation. And in a previous life, in fact, I used to cover some biotech. I was based in Cambridge, Massachusetts. And I remember interviewing one of the co-founders of Moderna. This was years ago. And there were many people in and around that ecosystem really excited about the potential of this type of technology. And that continues to exist, right? And then on the other side, as we've discussed, there's this political conversation we're having with RFK Jr. And his decision to cancel half a billion dollars worth of funding for mRNA research. You know, earlier we mentioned Dr. Carrico, who helped develop this technology. She went on to later win the Nobel Prize, along with her research partner.

26:22And when these funding cuts were announced last year, she spoke with my colleagues here at the BBC in which she said, It was a huge, huge mistake. It was based on misinformation and not evidence. He ignored evidence. He ignored facts. And the US ability to develop vaccine during the next pandemic suffers tremendously. And in her view, I was moving to the United States from Hungary, from Hungary, when I couldn't here in the US, I couldn't do. I moved to another country. So it seems that scientists need to move to another country if they want to advance on this messenger RNA vaccine field. So it is a national security for the US with the suffer. So what does it mean for Americans if the government chooses not to fund these technologies? She's devoted her career to this. So perhaps unsurprisingly, she was cross and baffled. And she moved from Hungary in order to do her science.

27:25So there are plenty of other people who are far less constrained, who will pick up sticks and move to do the science where it works. But if there's another pandemic and it's a worse virus and actually we can make a vaccine quite easily using mRNA, people are going to have to rather rapidly re-evaluate their views. And I suspect having a US that has pulled out of research, probably pulled out of the sort of manufacturing that will be required to make those vaccines at scale will be bad for the US and ultimately very bad for the world as well. So you've got plenty of private companies and you've got particularly in Cambridge, you've got the world's leading biotech scene with a bunch of investors. So I suspect you will find that there's plenty of money swilling around.

28:25And I think a very easy argument for someone like RFK Jr to make is actually look. I don't think this works terribly well in viruses. I don't think it's worth the risk in viruses and I will reflect, you know, I'm making this case, I disagree and I want to say I disagree. It's an easy argument to make say look a virus doesn't kill many people comparatively. I don't think we should be giving them this new technology. It is a far easier argument than say, but cancer is a different issue. Obviously the risk benefit changes completely. So I suspect you might well see that pivot because I suspect the US will want to keep on funding this stuff. Well, Tom, thank you for taking the time to walk us through this all and help us try to make sense of it. Appreciate it. Cheers.

29:25That was Tom Whipple, host of the BBC's Inside Science program and a writer for the Times of London. We contacted the Department of Health and Human Services for comment. They responded in part quote, Secretary Kennedy has been clear that he believes the mRNA products warrant heightened scientific scrutiny. HHS continues to support mRNA research where the science shows promise, including for hard to treat cancers. As always, if you have questions, complaints, stories, you can reach us here at the global story anytime. Our email address is the global story at BBC.com. Our episode today was produced by Lucy Paul and Sam Chanturasek. It was mixed by Travis Evans. Our digital producer was Sam Grooe. Our executive producer was James Shield and our senior news editor was China Collins. I'm Asma Khalid. Thanks as always for spending some time with us and we'll be back again tomorrow. Support comes from Wise. The smart way to manage the currencies you need around the globe. Fed up with losing out to hidden fees when you send money abroad with your everyday bank. Choose the smart way.

30:44Wise. You can count on the exchange rate you'd usually find on Google. No one welcomes surprises. Plus, ditch that where's my money feeling? Most transfers arrive in under 20 seconds. Join millions saving billions on hidden fees. Be smart. Get wise. Download the Wise app today. Teasing sees apply.