This week in science: a paralyzed man walks again and a sticker

Emily Kwong

Regina G. Barber

Short Wave hosts Emily Kwong and Regina Barber talk about a paralyzed man that walked again, a sticker vaccine and the science behind a crop of new RSV vaccines.

AILSA CHANG, HOST:

Time now for some science news from our friends at NPR's Short Wave podcast. Emily Kwong and Regina Barber are the hosts, and they're here now for our science roundup. Hey to both of you.

REGINA BARBER, BYLINE: Hey, Ailsa.

EMILY KWONG, BYLINE: Ailsa, hi.

CHANG: So what have you got for us this week?

BARBER: We've picked out three biomedical stories for you.

KWONG: Yeah. One is about a new vaccine to protect adults against respiratory syncytial virus - or RSV. One is about a measles sticker vaccine.

CHANG: Sticker?

BARBER: Yeah (laughter).

KWONG: Sticker. And finally, one is about technology that's letting a paralyzed man walk again.

CHANG: Oh, my God. Where do we even begin? Emily, what are we going to start with?

KWONG: Let's start with RSV. You know, for most people, it feels like the common cold, Ailsa, but it can make infants and older people really sick. Complications from RSV, like pneumonia and bronchiolitis, is the No. 1 cause for hospitalizations in infants. And for adults 65 and older, the CDC - the Centers for Disease Control and Prevention - estimate that RSV leads to tens of thousands of hospitalizations every year and between 6,000 and 10,000 deaths.

BARBER: Wow.

CHANG: Wow. I had no idea that RSV could be that serious for certain populations. Tell me more about this new vaccine.

KWONG: Yeah, so RSV researchers have been working for decades on a vaccine, and now there are two on the horizon for older adults. The first, made by GSK, got FDA approval last month, and the second, made by Pfizer, was approved this week. In clinical trials, both appear to significantly reduce RSV-associated lower respiratory tract disease in older adults. And this comes on the heels of an RSV vaccine for infants that could get recommended for FDA approval, too. That could happen this summer.

CHANG: Right. And why have these RSV vaccines taken so long to develop if this has been around for a while - this virus?

KWONG: This is such a good question. You know, it just took time to get the science right - for the vaccine to be safe and effective. The big breakthrough came from a group of NIH scientists who mapped the hidden structure of surface proteins. That's what allows the virus to infect human cells.

CHANG: OK.

KWONG: Over a decade ago, this team found a way to hack the virus, preventing those surface proteins from transforming in a way that makes them a lock-and-key fit for our cells. Here's lead researcher Barney Graham, who is now based at Morehouse School of Medicine.

BARNEY GRAHAM: It's like the Transformer toys. If what you want is a car and what you have is a robot, you have to lock the car.

CHANG: OK, I love this Transformer analogy, so let me make sure I get it. They need to catch this virus protein before it morphs into its most destructive phase and infects you.

KWONG: It is, like, a superhero-stakes situation.

CHANG: (Laughter) OK.

KWONG: Yeah, yeah - something like that. Barney, by the way - he stands to earn capped royalties on the sale of the RSV vaccines using this design.

CHANG: OK, so now that the FDA has approved these vaccines, when will they actually become available?

KWONG: This is the key question. So for the vaccine to be pushed to the marketplace, the CDC's Advisory Committee on Immunization Practices - or ACIP - has to recommend it for older adults. They are meeting on June 21 through 23 to make that decision. So there's a regulatory hurdle, but there's also an uptake hurdle. People might not know about the vaccine or not want to get it or not know where to get it. Vaccination just takes buy-in from family doctors and internists, and some health care providers may not think that RSV is a big deal for adults and not advise their patients to get vaccinated. And if the CDC's advisory committee doesn't recommend the RSV vaccine in a few weeks, insurance won't cover it, so people will have to pay out of pocket.

CHANG: OK. Now, for our second story, we're going to stay on the topic of vaccines. I want to get to this sticker vaccine. This is for the measles?

KWONG: Yeah, so this is a clinical trial for the vaccine to protect against measles and rubella. Both are characterized by fevers and red rashes. Measles, in particular, can be really serious. In 2021, it killed more than 100,000 people worldwide, mostly kids under 5.

BARBER: Yeah, so health correspondent Fran Kritz wrote about this vaccine for Goats And Soda, NPR's global health and development blog. And she said that the thing that has researchers excited isn't the vaccine itself. The vaccine has been around for decades. What researchers are excited about is the new way the vaccine is delivered, which has been in works for more than two decades.

CHANG: And let me guess, it's getting delivered by a sticker?

BARBER: Truly - a sticker.

KWONG: Yeah.

CHANG: (Laughter) You just slap it on?

BARBER: Yeah. It's just a small, like, white adhesive patch, about the size of a quarter.

CHANG: Wow.

BARBER: And within a few minutes of the patch being gently pressed onto the patient's wrist, the vaccine dose is delivered.

CHANG: So it doesn't hurt?

KWONG: It is practically pain-free. One of the researchers actually compared it to the feeling of Velcro on your skin.

CHANG: Cool.

BARBER: And it's hopefully a huge step towards wider vaccine accessibility, since it's not a needle, and it's a better option for areas where there's few health facilities and clean water.

KWONG: Yeah. This this uptake question, which we heard about in the earlier story - it's a real issue with vaccines. The patch also doesn't need to be refrigerated, which many vaccines usually do, so there's more accessibility there, too.

CHANG: And what about the effectiveness here? Like, this patch that feels like Velcro - it's a sticker. It's not a shot. Is it as effective as a shot?

BARBER: Yeah, it is. It produced the same sort of immune response. Now, this was a small trial - just a couple hundred babies, toddlers and some adults. So this still needs to be tested on a much larger scale and then get authorization from countries' regulatory agencies. So it could be another 5 to 7 years before we see it being used, but it's a promising first step.

KWONG: Yeah, it's a big deal.

CHANG: Fascinating. OK, so last up, Regina, you have a story about an intervention that could help people with paralysis walk again - am I clear on this? I mean, it sounds like it's made for a movie.

BARBER: Yes. I love movies.

CHANG: (Laughter).

BARBER: Yes. Yes. Over a decade ago, Gert-Jan Oskam was paralyzed from a cycling accident, and that injury interrupted the communication between his brain and spinal cord. And recently, researchers have reconnected them so he can walk again.

CHANG: Wow. OK. So how does this technology work?

BARBER: Yeah. So first, they need to figure out what his brain signals look like when he's thinking about walking. And they interpret that with something called a brain-computer interface. And that's not new technology. That's been around for a while to, like, move cursors on a screen, to control small robots by just thinking. And in this case, a brain implant decodes Gert-Jan's thoughts. Then, those thoughts are sent wirelessly to a wearable processor that looks like a backpack, and it detects his intentions to move and translates these brain signals into electric pulses. These pulses are sent to another implant that stimulates his spinal cord, allowing him to actually make those movements.

CHANG: And all this happens in, like, just split seconds?

BARBER: Yes.

CHANG: Wow. OK, so you've mentioned parts of this have been done before. So what is actually new here?

BARBER: Yeah. So what's new here is how they combine these two known technologies - of reading the brain's thoughts and using them to stimulate the spinal cord. That's according to Marco Capogrosso, a spinal cord injury researcher at the University of Pittsburgh. He's not associated with the study, but he is very impressed on how real this walking looks. The patient could even go up and down ramps, navigate obstacles, go up stairs. And in the past, patients have only been able to kind of have these choppy steps, and it was hard for them to move on anything that wasn't flat ground.

CHANG: This is incredible. But, wait - this, so far, has just been tested on this one individual, right? Like...

BARBER: Yeah.

CHANG: ...So how might this technology be rolled out more widely?

BARBER: So same answer as the sticker vaccine - Marco says probably about 5 to 7 years. More research has to be done to see who else this can help - like, level of injury - make sure it's safe. And it's pretty expensive right now.

CHANG: So cool.

That is Regina Barber and Emily Kwong. They are the hosts of NPR's science podcast, Short Wave, where you can learn about new discoveries, everyday mysteries and the science behind the headlines.

Emily and Regina, thank you so much, as always.

BARBER: Thank you, Ailsa.

KWONG: Thank you, Ailsa.

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