Will Moderna's mRNA CMV vaccine be approved by 2024?
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resolved Jan 6
Resolved
NO
Close date updated to 2024-01-01 11:59 pm
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📢Resolved to NO : Proof In comments

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CMV doesn't seem to be first or second priority: https://www.wsj.com/articles/modernas-ceo-on-its-new-covid-19-booster-prospects-for-cancer-vaccines-11663339811?st=g35ngyhihv9fpil&reflink=desktopwebshare_permalink

CMV is a very complicated virus to design vaccines for. It is a virus that most people get without any complications in their childhood and that stays with them for the rest of their life. It is just problematic if you are immunocompromised (e.g. in transplant patients), if you acquire your first infection as you are pregnant, or if you have a reinfection or reactivation as you are pregnant. In the last two cases the risk is transmitting the virus to the fetus, which leads to stillbirth, spontaneous abortions or babies born with hearing loss, developmental and motor delay, vision loss or even microcephaly. Only about 1 in 1,000 births have symptoms or long-term health problems due to congenital CMV, which makes it very complicated to prove statistically that a vaccine works to prevent CMV complications in newborns. The alternative is to prove that the vaccine actually prevents infection.

But if a vaccine only works in preventing infection, then the target population would be very small unless you vaccinate close to birth–given how prevalent the virus is in adults (almost 100% in most countries, 60-80% in the US). And the problem then is that you would be vaccinating to try to prevent future infections during pregnancy and it is very difficult to prove that the vaccine effect will not wane from vaccination to adulthood.