isnaini azizah
In a linguistic landscape reminiscent of the Trump administration’s penchant for redefinition, where "Department of Defense" could be juxtaposed with "Department of War" and the "Gulf of Mexico" might be rebranded, Moderna, the trailblazing COVID-19 vaccine manufacturer, finds itself entangled in a complex naming conundrum. The company’s ambitious endeavors into next-generation mRNA vaccines targeting influenza and emerging infectious diseases have been met with significant headwinds, primarily due to skepticism from federal agencies, a phenomenon amplified by vaccine-hesitant voices within the government. This challenging regulatory environment, characterized by canceled contracts and an increasingly unfriendly bureaucratic climate, has pushed the Massachusetts-based biotech firm to a critical juncture. Last year, Robert F. Kennedy Jr., then at the helm of the Department of Health and Human Services, strategically focused on mRNA technology, leading to the curtailment of support for numerous projects, including a substantial $776 million award earmarked for Moderna’s bird flu vaccine development. By January of the current year, the company issued a stark warning: it might be compelled to cease its late-stage development programs for infectious disease vaccines altogether.
This predicament significantly elevates the stakes for another crucial area of Moderna’s research and development. In a collaborative venture with Merck, Moderna has been leveraging its pioneering mRNA technology to combat cancer. This innovative approach, focused on destroying tumors, is known as a highly promising technique often referred to as a cancer vaccine. However, the nomenclature surrounding this groundbreaking treatment has become a sensitive issue. As the term "cancer vaccine" was about to be uttered, a spokesperson for Merck swiftly intervened, emphasizing, "It’s not a vaccine. It’s an individualized neoantigen therapy." This distinction, while seemingly semantic, carries profound implications for the perception, regulation, and ultimately, the adoption of this potentially life-saving technology.
Yet, by its very definition and mechanism, it is indeed a vaccine. The process begins with Moderna meticulously sequencing a patient’s cancerous cells to identify unique and aberrant molecules on their surface, known as neoantigens. Subsequently, the genetic blueprints for these specific neoantigens are encapsulated into an injectable form. The patient’s immune system is then primed with precise instructions: to identify and eliminate any cells displaying these distinctive, or as the original text describes them, "yucky" surface markers. Mechanistically, this process shares striking similarities with the mRNA COVID-19 vaccines. The fundamental difference, however, lies in the target: rather than immunizing against a viral pathogen, the patient is being immunized against their own cancer.
The results thus far have been exceptionally encouraging, hinting at a genuine breakthrough. This year, joint findings from Moderna and Merck demonstrated that these personalized therapeutic injections significantly reduced the risk of death from recurrence by half in patients who had undergone surgery for the deadliest form of skin cancer.
However, in its formal communications and regulatory submissions, Moderna has conspicuously avoided the term "cancer vaccine" since 2023. This shift in language coincided with its strategic partnership with Merck and the rebranding of the technology as "individualized neoantigen therapy," or INT. At the time of this rebranding, Moderna’s CEO articulated that the name change was intended to "better describe the goal of the program." This strategic linguistic pivot is not an isolated incident. BioNTech, a prominent European vaccine developer also actively engaged in cancer research, has mirrored this trend, transitioning from describing its work as "neoantigen vaccine" in 2021 to "mRNA cancer immunotherapies" in its most recent reports.
The rationale behind framing this innovation as a "therapy" is understandable from a clinical perspective. Since the patient already has cancer, it is fundamentally a treatment rather than a purely preventive measure. However, the underlying motivation for this semantic recalibration extends beyond mere clinical description. A significant driver is the desire to shield crucial scientific innovation from the pervasive fearmongering surrounding vaccines, a phenomenon that has been exacerbated by the pronouncements of high-ranking U.S. officials. Kyle Holen, the head of Moderna’s cancer program, candidly expressed this sentiment last summer during BIO 2025, a major biotech conference held in Boston. He stated, "Vaccines are maybe a dirty word nowadays, but we still believe in the science and harnessing our immune system to not only fight infections, but hopefully to also fight… cancers."
This deliberate wordplay has not been met with universal approval. Dr. Ryan Sullivan, a physician at Massachusetts General Hospital who has overseen patient enrollment in Moderna’s clinical trials, has voiced concerns. He argues that this linguistic shift raises questions about the adequacy of informed consent provided to trial participants. "There is some concern that there will be patients who decline to treat their cancer because it is a vaccine," Sullivan commented, adding, "But I also felt it was important, as many of my colleagues did, that you have to call it what it is." The core of his concern is that patients might forgo a potentially life-saving treatment due to an aversion to the word "vaccine," even if the underlying technology is identical to the one that has proven effective in combating infectious diseases.
The question then arises: is it worth staunchly defending a single word, even when the underlying science and efficacy remain robust? Dr. Lillian Siu, a distinguished medical oncologist at the Princess Margaret Cancer Centre in Toronto, who has been involved in the safety testing of these novel injections, observes the political landscape in the U.S. from afar. She believes that the name change is an acceptable compromise "if it allows the research to continue." Her pragmatic perspective prioritizes the advancement of scientific discovery and patient benefit over linguistic purity.
Holen elaborated on the motivations of those doctors who have expressed reservations to Moderna, suggesting that they are primarily driven by a desire to champion vaccines, which he acknowledges are undoubtedly among the most significant public health interventions in human history. Their concern, he implies, is that the company should stand firm in its scientific convictions and not be swayed by political pressure.
However, this is precisely not what is occurring. When Moderna’s most recent research findings were published in February, the main body of the academic paper conspicuously omitted the word "vaccine." The term was only visible in the footnotes, primarily within the titles of older research papers and patents, a subtle but telling indicator of the strategic avoidance.
This intricate dance of nomenclature and scientific communication could be interpreted as evidence of Kennedy’s strategy proving effective. His administration’s agencies appear to be adept at amplifying public anxieties surrounding mRNA vaccines, thereby impeding their widespread adoption, diminishing their perceived value for companies, and marginalizing their proponents.
Nevertheless, Moderna’s counter-strategy may also be yielding dividends. Thus far, governmental entities have remained notably reticent regarding the company’s cancer vaccine—or, as it is now formally known, its individualized neoantigen therapy. This silence, while perhaps born of a desire to avoid further controversy or to acknowledge the therapeutic nature of the treatment, allows the innovation to progress, albeit under a different banner. The ongoing evolution of this narrative underscores the complex interplay between scientific advancement, public perception, and political influence in shaping the future of medicine. The "vaccine" versus "therapy" debate is not merely an academic exercise; it is a critical battleground for the acceptance and continued development of potentially revolutionary medical interventions.
