Today, it’s a better immune system. Tomorrow, who knows?

As I recover from my COVID-19 vaccination side effects, I’ve been thinking about how negatively we perceive vaccines. That seems odd for a country that perfected the idea of machismo you can buy.

I’m not the only one to notice. A narrow but insightful line of inquiry starts with alternatives to our pet names for vaccination, from “shot” to “jab” to “stick.”

My submission would be the techno-optimistic upgrade, the drug-specific bio-upgrade, or even the vaccine-specific immuno-upgrade.

As in, I’m getting a bio-upgrade today.

This would all be just silly, if the consequences weren’t so dire. But a large minority is skeptical of the new COVID vaccines, and something like one fifth of adults will probably refuse it outright. Vaccine hesitancy didn’t start with COVID. Less than half of U.S. adults get the annual flu vaccine. Innoculation’s brand in the U.S. is not good, and it costs lives.

It won’t end with COVID, either. Indeed, the new mRNA platforms may well generate a slew of new therapies in a few short years. This could include more frequently updated flu vaccines, and vaccines for HIV, Dengue, Zika, and even the common cold. We could see combination vaccines as well—maybe even a universal flu vaccine that is more robust to annual variation.

It would be a bitter shame to make all this progress, only to have people shrink from the idea of “yet another jab.”

It’s enough to make me rethink my hatred of direct-to-consumer drug marketing. D2C marketing should absolutely be banned, but I could get behind a public health exception for vaccinations. Go ahead: let Big Pharma show 20-somethings shopping in open-air markets in Mumbai, or 40-somethings on safari, or 70-somethings in a crowded Viennese chamber music hall. Go where you want. Do what you want. Be who you want to be.

The marketing angle is doubly interesting because mRNA platforms are on the short list of tools that could deliver the biohacking explosion that futurists keep claiming is right around the corner. Today, mRNA is used to generate an immunogenic protein using the patient’s own cells. Tomorrow, we might use it to trigger production of proteins that support bulking up, memory formation, or metabolism. Talk about upgrades!

This sort of talk rightly makes biotechies nervous. But it’s worth exploring, if only to push back on the brand of futurism that spews out of Silicon Valley. Why on earth does Elon Musk’s Neuralink get so much airtime, when implanting a microchip in the brain is obviously a worse strategy than growing a bio-port? Surely the ultimate human-computer interfaces will look more like Avatar than The Matrix.

Which would you prefer? Top: Avatar. Bottom: The Matrix.
Which would you prefer? Top: Avatar. Bottom: The Matrix.

Viewed in this light, the next-gen therapeutic platforms (mRNA, immunotherapy, stem cells, gene editing) are probably the greatest marketing opportunity of the 21st century. We’re so accustomed to thinking of “the future” as being delivered in a plastic clamshell that we’ve failed to realize it’s more likely to arrive in a pill.

Or a jab.