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The 100 greatest innovations of 2021

Across all our 10 categories, gains in efficiency showcased our collective drive to optimize our world. A new hair-washing system creates a luxurious lather with less water, a spin on steelmaking spits out a mere fraction of the carbon, a clever AI plans airline routes for maximum efficiency, and a simple riff on a remote control zaps the need for disposable batteries. And, all the while, our push against the pandemic netted gains in prevention, testing, and treatment that will form the backbone of our resistance to the disease for years to come.

Never in recent history has the world been so engrossed by the most mundane stages of the scientific process. But for the last two years, each incremental step in science—from lab research to understand the evolution of COVID-19 and develop a vaccine to fight it, to clinical trials, to pharmaceutical approval—meant one thing: Hope. And that’s what this list of the year’s best health innovations highlights. In addition to two novel vaccines released to combat the most deadly pandemic of our time, the world also saw the first-ever drug approved to treat rare progeria, a new insulin formulation that might finally make the life-saving therapy affordable for all, and a malaria vaccine decades in the making.

To pull humankind out of the COVID-19 pandemic, doctors and public health experts knew we would need a safe and effective vaccine. Pharmaceutical companies around the world have raced to characterize the SARS-CoV-2 virus, understand how it invades our immune systems, and develop a targeted injection to prevent it. As of November 2021, at least 28 promising vaccines have been trialed in humans, and 15 have been authorized for emergency use around the world. But two stood out enough to win our top award: Pfizer’s Comirnaty, developed in partnership with Germany-based biotechnology company BioNTech, and Moderna’s SpikeVax, which the Cambridge, Mass., company developed with the help of the National Institutes of Allergy and Infectious Disease.

The jabs are unlike any other inoculation on the market today. They are the first so-called mRNA vaccines—a technology that has been in development for decades. They work by harnessing messenger RNA, the genetic bits of code that tell our cells how to make proteins. The vaccines carry mRNA with instructions for making a protein found on the outside of SARS-CoV-2, the novel virus that causes COVID-19. Our bodies quickly destroy the errant mRNA instructions, but not before our cells build the corresponding proteins. Those proteins then attach to specialized immune cells, triggering the system to recognize them as invaders and develop antibodies against their ilk. If a vaccinated person comes into contact with SARS-CoV-2, those antibodies can spring into action, reproduce, and destroy the virus before it replicates out of control, thwarting the disease.

People diagnosed with Hutchinson-Gilford progeria syndrome rarely live beyond 15 years of age, and until now treatments could only target its symptoms and complications. The disease occurs when a genetic mutation changes the shape of a protein in the nuclei of a carrier’s cells. The faulty protein, called progerin, causes cells to prematurely die. Zokinvy prevents the buildup of defective progerin, thereby minimizing the damage it can do. In addition to prolonging lifespan by several years, the new drug also reduces symptoms of heart and bone problems associated with the rare condition, which affects roughly 400 children worldwide.

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