Vaccine vs. Virus – carving a path towards normalisation

Sarah Gilbert, Professor of Vaccinology at the University of Oxford shares the extraordinary development of the Oxford/AstraZeneca Covid-19 vaccine

In a recent Markets 360 Unplugged LIVE event, Reena Patel, Senior Credit Trading Desk Analyst, Markets 360 at BNP Paribas, spoke to Sarah Gilbert, Professor of Vaccinology at the University of Oxford who has devoted her career to developing vaccines against infectious diseases. Prof Gilbert became the Oxford University project leader of the Oxford/AstraZeneca (AZ) Covid-19 vaccine in January 2020. She has played an integral role in the accelerated process of the vaccine’s development.

When the news of a new virus first emerged in early January 2020, it caught Prof Gilbert’s attention. Within two weeks, human-to-human transmission was confirmed. She immediately started developing a vaccine in case of an outbreak, without knowing this would turn into a global pandemic.

Vaccine development & manufacturing

Many are amazed by how quickly the vaccine development has proceeded. It was made possible by the years of work and collective learnings of scientists around the world, building the foundations for the platform technology from which the vaccine arose.

A lot of foundation work has already been done. It is a well-developed and well-tested technology.

Sarah Gilbert, Professor of Vaccinology at the University of Oxford

With years of experience in vaccine design, manufacturing and clinical development, Prof Gilbert’s team was able to plan for the entire programme in the beginning of the pandemic, from the early design work to large-scale clinical trials and manufacturing processes. Everything happened rapidly thanks to the groundwork, experience and collaboration of the teams involved, and close relationships with manufacturers across the globe.

Efficacy vs. effectiveness

Prof Gilbert stressed that vaccine efficacy and effectiveness are two different matters. Efficacy is measured in a clinical trial. It defines exactly what symptoms a person has to have before they count as a case and how they need to be tested. Those definitions vary between different clinical trials. The only way to compare its efficacy is to test two vaccines head-to-head in the same clinical trials, with the same protocol and at the same time. The aim of a clinical trial is to demonstrate that the vaccine is safe and effective for regulatory approvals.

The effectiveness of a vaccine can be measured once it is widely used by the public, in preventing hospitalisation, severe or symptomatic disease and deaths. For instance, a study from Public Health England showed the first dose of the Oxford/AZ Covid-19 vaccine provide up to 60% protection against symptomatic Polymerase Chain Reaction (PCR) positive disease for people over age 70. It also provide 80% protection against hospitalisation for those above age 80. (Source: Public Health England, March 2021)

Variants of concern

Variants arise in any virus as it evolves. While most mutations tend to worsen the performance of a virus, some may occasionally become ‘fitter’. Works on a number of new versions of Covid-19 vaccines have kicked off since December 2020, to meet new, higher risk variations of the original virus, which may have evolved to evade the immune response induced by infection with the original virus, or from vaccination.

“Developing newer versions of the vaccine can be much quicker now,” explained Prof Gilbert. “Just like the flu vaccine that is being assessed every year for some modifications, which involve small clinical trials of few hundreds or thousands of volunteers, similar can be done for the Covid-19 vaccines.”

Vaccine hesitancy

Education is vital in helping people to better understand the risks and benefits associated with a vaccine.

“We try to approach it by explaining how the vaccine works and why it can progress so quickly, without missing any step in vaccine development. With the platform technology, we front-loaded the development process and kick started with the manufacturing early,” explained Prof Gilbert.

What have we learnt?

Prof Gilbert emphasised the importance of being better prepared for similar future events because there will always be another pandemic. More investment will be needed, along with stronger global coordination especially on large-scale vaccine manufacturing facilities. On top of that, more surveillance in detecting new variants will be crucial. This will better equip ourselves for the next health crisis and in turn protect our societies.

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