What’s in a name? Moderna’s “vaccine” vs. “therapy” dilemma

The Language of Life: How Words Are Reshaping the Future of mRNA Medicine

In the high-stakes world of biotechnology, a single word can be the difference between billions in funding and a project’s abrupt cancellation. For Moderna, the Massachusetts-based pioneer behind one of the most widely used mRNA vaccines during the pandemic, the battle is no longer just about science—it’s about semantics. As the company pivots from pandemic defense to cancer treatment, it faces a linguistic paradox: Is its groundbreaking technology a vaccine or a therapy? And more importantly, does the label determine its fate in an era of political skepticism and regulatory scrutiny?

The answer lies not just in molecular biology, but in the shifting tides of public perception, government policy, and the evolving definition of what it means to prevent—or treat—disease.

The Semantic Shift: From “Vaccine” to “Therapy”

In 2023, Moderna quietly made a pivotal change in its public communications. The company stopped referring to its experimental cancer treatment as a “cancer vaccine.” Instead, it adopted the term individualized neoantigen therapy (INT). This wasn’t just a branding exercise—it was a strategic recalibration in response to a hostile regulatory climate and growing vaccine hesitancy within federal leadership.

The science behind the technology, however, remains unchanged. Like the mRNA vaccines used against SARS-CoV-2, Moderna’s cancer treatment delivers genetic instructions to the body’s cells. But instead of teaching the immune system to recognize a virus, it trains it to identify and destroy cancer cells by targeting neoantigens—unique proteins found only on the surface of malignant cells. Each patient’s tumor is sequenced, and a personalized mRNA shot is crafted to match their specific cancer profile.

The shift in terminology reflects a deeper philosophical divide: Is this a preventive measure or a curative one? Traditional vaccines, like those for measles or polio, are given to healthy individuals to prevent infection. But Moderna’s cancer shot is administered after a patient has already been diagnosed—making it, by definition, a treatment. Calling it a “vaccine” could confuse regulators, patients, and policymakers, especially in a political environment where mRNA technology has become a lightning rod for controversy.

A Political Storm Brews Over mRNA

The rebranding comes at a critical moment. In early 2025, the U.S. Department of Health and Human Services (HHS), under the leadership of Robert F. Kennedy Jr., launched a sweeping review of mRNA-based programs. Kennedy, a longtime vaccine skeptic, questioned the safety and necessity of mRNA platforms, particularly for non-pandemic uses. His administration canceled or delayed numerous federal contracts, including a $776 million award to Moderna for developing an mRNA-based bird flu vaccine.

The fallout was immediate. Moderna warned investors it might have to halt late-stage development of several infectious disease vaccines. The company’s stock dipped, and morale within its research divisions waned. For a firm that had risen to global prominence during the pandemic, the political headwinds were a sobering reminder: scientific innovation is only as strong as the policy environment that supports it.

This erosion of trust has forced biotech firms to rethink not just their science, but their messaging. By distancing cancer treatments from the “vaccine” label, companies like Moderna and BioNTech hope to sidestep political resistance and reassure regulators that their products are safe, targeted, and fundamentally different from the pandemic-era shots.

The Science Behind the Shot: How INT Works

At its core, individualized neoantigen therapy is a marvel of precision medicine. The process begins with a biopsy of a patient’s tumor. Scientists sequence the cancer’s DNA to identify mutations that produce abnormal proteins—neoantigens—that are absent in healthy cells. These unique markers are like molecular “wanted posters” for the immune system.

Using artificial intelligence, Moderna’s platform predicts which neoantigens are most likely to trigger a strong immune response. Then, it synthesizes mRNA strands encoding those targets and packages them into lipid nanoparticles—the same delivery system used in the COVID-19 vaccines. When injected, the mRNA instructs the patient’s cells to produce the neoantigens, which are then displayed on the cell surface like flags. Dendritic cells pick up these signals and activate T-cells, which go on the hunt for any cell bearing the same markers—effectively turning the body’s immune system into a personalized cancer-killing machine.

The therapy is not without challenges. Each dose is custom-made, requiring weeks of sequencing, analysis, and manufacturing. The cost is steep—estimated at over $100,000 per patient—and scalability remains a hurdle. But the potential is enormous. If successful, INT could be adapted to treat a wide range of cancers, from lung and breast to pancreatic and brain tumors.

Why Words Matter in Medicine

The debate over “vaccine” versus “therapy” is more than academic. Language shapes perception, and perception influences policy, funding, and public acceptance. In the case of mRNA technology, the word “vaccine” has become politically charged. To some, it evokes memories of rapid development, mandates, and misinformation. To others, it represents scientific triumph.

By calling its cancer treatment a “therapy,” Moderna is attempting to reframe the narrative. It’s not about preventing disease in the healthy—it’s about saving lives in the sick. This distinction is crucial in an era where vaccine hesitancy has spilled over into broader distrust of biotechnology.

Similarly, the shift from “gene therapy” to “gene editing” in the 2010s helped rebrand a controversial field as a precise, controllable tool. Language, in medicine, is never neutral.

The Global Race for mRNA Cancer Treatments

Moderna isn’t alone in this linguistic and scientific journey. BioNTech, its German counterpart and co-developer of the Pfizer-BioNTech COVID-19 vaccine, has also pivoted away from the “vaccine” label. In its 2024 annual report, the company referred to its oncology pipeline as “mRNA cancer immunotherapies,” avoiding the V-word altogether.

Other players are following suit. Gritstone Bio, a California-based biotech, calls its personalized cancer treatment a “therapeutic vaccine”—a hybrid term that acknowledges its preventive mechanism while emphasizing its use in diagnosed patients. Meanwhile, academic researchers continue to debate the taxonomy: Is a treatment that trains the immune system to attack existing disease still a vaccine, even if it’s not given preventively?

This global momentum underscores a broader truth: the future of medicine may depend not just on what we invent, but on how we talk about it.

The Road Ahead: Can Language Save Innovation?

For Moderna, the path forward is fraught with challenges. Rebranding its cancer treatment as a “therapy” may help navigate political headwinds, but it doesn’t guarantee success. The company still faces manufacturing complexities, high costs, and the need for large-scale clinical validation.

Yet the potential rewards are transformative. If individualized neoantigen therapy proves effective across multiple cancer types, it could revolutionize oncology—turning deadly diseases into manageable conditions, much like HIV is today.

And perhaps, in time, the stigma around mRNA will fade. As patients begin to associate the technology not with pandemic mandates, but with life-saving cancer treatments, the word “vaccine” may regain its scientific dignity.

After all, medicine has always been a story of language evolving alongside science. From “bloodletting” to “antibiotics,” from “radiation” to “immunotherapy,” the terms we use reflect our understanding—and our fears. The challenge for Moderna, and for all of biotechnology, is to ensure that the words we choose don’t hold back the cures we’re trying to create.

In the end, it’s not just about what’s in a name. It’s about who gets to define the future of health—and who gets to benefit from it.

This article was curated from What’s in a name? Moderna’s “vaccine” vs. “therapy” dilemma via MIT Technology Review