Hi. I just dropped in to say....
I have just attended a private webinar given by Professor Sir John Bell, Professor of Medicine at the University of Oxford about Covid-19 and the Oxford vaccine.
Firstly, I should say that the man is absolutely brilliant, and the team at Oxford seems to have done some outstanding work, very quickly.
Some things I found interesting included the following:
The Oxford researchers were actively interested in the potential problem of this (at the time unknown) virus in mid December when initial reports of a new respiratory virus problem were starting to emerge.
By early January they were looking at the genome and protein structures, and actively working on a vaccine.
They had a good fast start because they had been working on viral infections, particularly in the developing world, for 30 years. They also had people who had done a lot of work over the past 10 years or so on using adenoviruses to deliver a variety of different messenger RNA vaccines.
So they were very quick to create the right bits of protein, stick them in the adenoviruses (that they were used to working with) and try them out on animals.
What had been a rapid academic research project became more practically focussed (following urging from the Oxford University Vice Chancellor) in about May when they started to discuss manufacturing and delivery with senior medical people at the Gates Foundation (who know about this stuff) and to look for a commercial partner. They ended up with an agreement with AstraZeneca, which included a commitment to sell the vaccine at cost-plus-20%, which is basically non-profit.
They chose AstraZeneca partly because it is a UK company and they were concerned about the risk of 'vaccine nationalism' (particularly by the USA), although that fear seems to have subsided. By way of disclosure, Professor Bell does seem to have had some commercial relationships with both AstraZeneca and Roche, including being paid quite a lot for Board and Committee work in the past.
Primate trials in late spring were very promising with very clear differences in health outcomes between vaccinated and control animals, which had all been exposed to high doses of the virus.
By the summer they were in 'stage 3' testing, and had vaccinated about 10,000 human subjects in the UK. The main problem was, apparently, that there was so little of the virus endemic in the UK over the summer (between 1st wave and 2nd wave) that it was hard to get enough good data on the level of protection the virus offered in the test population. The research was helped by a further testing in Brazil (and South Africa) where another 10,000 (approximately) people were subjects, and there was much more opportunity (sadly) for people to be exposed to the virus, making testing more effective.
After a nervous wait for the statisticians to do their analysis, it became clear that the virus was very effective indeed in preventing symptoms in the human subjects, but also in preventing replication of the virus in the nasal tract, which is, of course, a key factor in ensuring that vaccinated people are not just protected, but are also much less likely to infect others.
They were aiming for mid 60% efficacy (not quite sure how that is measured), but have been getting over 70% in all trials and over 90% in the most effective delivery format, which is a low dose followed by a high dose. Apparently there is some debate amongst virologists about why this format works best.
They're now scaling up manufacturing in the UK, and also globally. They expect to be mass vaccinating in the UK by January, with the ability to deliver around 5 million doses per week. He didn't seem to be too worried about the ability of the authorities to deliver these vaccines to the population, noting that it is simple to store and delver, and that the health service already delivers 30-40 million flu jabs per year.
Meanwhile, he also had encouraging things to say about other vaccine programmes, notably the leading RNA approaches (Pfizer and someone else – I forget who). He said that the UK authorities might approve the Pfizer vaccine before the FDA in the USA does so, and it might start to be rolled out in the UK slightly before the Oxford vaccine (presumably in December).
He said that the initial priority for vaccinations would be people with high risk of exposure, such as medical staff, and then people with high consequence of exposure, such as old people. But the potential rate of vaccination availability should mean that anyone in the UK willing to be vaccinated could be by the end of April.
On mutation, he said that this virus mutates very slowly, but there is a likelihood of vaccinations driving down the occurrence of the main known variants, and allowing an increased spread of mutated variants. But he feels that they will be able to monitor this and adjust the vaccine, a bit like with flu.
For the long term, he felt that the virus would continue to be endemic at a low level as it is too widespread to be eradicated (and not dangerous enough to be worth eradicating, I think). He pointed out that thousands of people die from flu every year and we cope with that; his implication being that the vaccines and some herd immunity will be sufficient to bring this virus (and ones like it) to a level where we will be willing to tolerate it.
Impressive and encouraging.