Leading COVID-19 Vaccine Scientist Answers Our Questions

Work to accelerate the development of a coronavirus vaccine received a boost last week when the UK government announced £ 42.5 million in funding for the country’s two main efforts at Oxford University and Imperial College London. Last Thursday, the Oxford University program, led by Professor Sarah Gilbert, became the first in Europe to participate in human trials, while the Imperial College team aims to start clinical trials in June. This brings the total number of coronavirus vaccine clinical trials started in 2020 to 11.

At the head of the imperial team is Professor Robin Shattock. In 2019, he spoke at the World Economic Forum Annual Meeting in Davos about the new techniques he was developing to facilitate rapid development, testing and, most importantly, local vaccine production. Together, these techniques help ensure that outbreak responses can be made quickly, without leaving any region or country behind. We spoke with him to find out how his team’s efforts were progressing and to reflect on the overall response thus far.

In 2019, he warned audiences in Davos of the threat posed by a pandemic, calling for action to ensure that the world can respond quickly if it occurs. How did it feel to see the spread of COVID-19 and how do you think the global effort to find a vaccine is doing so far?

It has been an interesting time to live. When we showed up at Davos, we said these things would happen, but we didn’t think it would happen so soon, or that it would be a coronavirus. Everyone was predicting that it would probably be an avian flu outbreak.

In terms of the overall response, it is good news that many different vaccines are being developed, and I think more than 90 at the last count. There is a certain degree of coordination, but all of these groups are working independently on their own approaches or technology. That’s not necessarily a bad thing: since there is so much risk in developing a vaccine, that means the risk is spreading, and I think it’s pretty clear that some groups will get an effective vaccine.

His team has been working on developing a vaccine for COVID-19 since early February. Could you describe to our readers how a typical vaccine is manufactured and how your approach differs from RNA?

Traditional vaccine approaches generally depend on the physical growth of the virus. This can be done by growing the virus in large volumes, 10s or 100s of thousands of liters, and then inactivating it, or by growing viruses over time to gradually weaken them until they are safe. Both methods take a long time before they are ready for clinical use and require a large amount of virus for an effective dose.

Our approach is to focus only on the genetic code of the spike protein on the virus surface and use it as our vaccine. When the vaccine is injected into the body, muscle cells naturally “amplify” it by producing copies of the spike protein that the immune system detects as a threat. This trains the body’s immune system to defend itself against SARS-CoV-2 by being able to recognize the spike protein if it finds it again.

What are the advantages of working with RNA?

Using RNA allows us to be quick because the genetic sequence can be done synthetically in the laboratory, and because it can self-amplify, we only need a very low dose of the vaccine to be effective; we can make the equivalent of a million doses in a liter of reaction material. This allows us to scale very quickly and it is feasible to do tens of millions of doses per week from our laboratory. Adding more vaccine platforms working in parallel will only further increase production capacity.

Is distributed production ready to help and what other steps can be taken to ensure vaccines reach everyone in need?

Right now, the distributed production mechanism is not there. Manufacturing facilities around the world are not configured with the same technology, so identical methods cannot be used. There is also a need to harmonize regulatory approval to ensure that when a vaccine is licensed for use at one location, other manufacturing sites around the world can move quickly to scale production.

I do not expect that such a network will become operational in time to contribute significantly to the COVID-19 response. When effective vaccines are identified, they will likely still be produced through a more traditional approach of working with very large manufacturers. However, developing such distributed production capabilities should be a key part of building global resilience after this crisis has passed.

An example of what can be done more is from the Whey Institute in India and a few others offering to offer royalty-free vaccines to ensure they are available for as many as possible without the obstacle of high costs.

Some researchers report lower than expected levels of viral antibodies in people who have recovered from COVID-19, possibly implying that any immunity obtained will be temporary. Will a vaccine be able to stimulate a stronger response, giving longer lasting immunity?

Yes, a vaccine should work better than natural immunity, and there is strong evidence that it will. COVID-19 is a respiratory infection, and people with a mild infection will not be exposed to many viruses because they will only be on their respiratory surfaces. The natural immune response to such infection will be much lower than that generated by a powerful injection of vaccine. If the vaccine does not generate a strong response, then it should not be extended to the general population.

For a vaccine to be highly effective, it must prevent infection in more than 80% of vaccinated people and give them immunity for a minimum of one year (which would allow for an annual boost) but ideally longer.

In normal times, the development of vaccines takes many years, but today we are seeing accelerated deadlines along with pressure from governments, the media and the public. As a researcher, how are you dealing with this?

It is difficult to obtain the correct balance. It is important for people to understand that we are moving faster than anyone else has ever moved before because our goal is to have a fully tested vaccine within 12-18 months, when it would normally be five to eight years, or longer. That said, when the need is as urgent as it is today, even 12 to 18 months seems slow.

However, expectations need to be slightly tempered, as although we will be testing vaccines soon, we will not have vaccines available worldwide for a much longer period of time.

Vaccination vaccinations have reduced the effectiveness of public vaccination programs in some areas, leading to outbreaks of measles and other preventable diseases. Are you concerned that such behavior may limit the potential of a coronavirus vaccine?

Right now, I think people want a vaccine. I don’t think there is much doubt about having a vaccine while COVID-19 is at the forefront of our minds. The problem with vaccines is that they are so successful in preventing the disease from disappearing, and the reason they are needed becomes less apparent.

If in two, three, or more years, we have had a successful vaccine and do not see new COVID-19 infections, people may increasingly choose not to get vaccinated. That could be due to hesitation or simply not being at the top of your priority list, as the virus no longer appears to be a threat. This could lead to outbreaks and effective public participation strategies will be needed to minimize the risk of this happening.

What message would you like to leave our readers with?

We are already seeing the massive impact of this pandemic on the world’s economies. We must learn from this and make the necessary investments to limit the impact of future pandemics now. The investment required is small compared to the economic and human cost of another pandemic. It just makes total financial sense and anything else doesn’t. The world needs a pandemic insurance policy.

This interview has been edited for brevity and clarity.