Covid-19 won’t be the last health crisis faced by humanity, but we will be better prepared for the next pandemic, according to co-founder of the Oxford/AstraZeneca vaccine Professor Dame Sarah Gilbert. Here, she explains why to Good Housekeeping.
"In the very early days of Covid-19, I wasn’t thinking about a pandemic. When reports of pneumonia in China emerged at the start of 2020, I thought there could potentially be an outbreak like SARS, a virus we had dealt with before.
On the one hand, it could be something that fizzled out very quickly, on the other, it could be something new that, if we needed a vaccine for it, would mean we would have to get going as quickly as possible.
As a professor of vaccinology at the University of Oxford, I had been developing vaccines for years, most recently against so-called emerging pathogens. These projects were put on hold, as I focused on designing and producing a Covid-19 vaccine.
Working at such speed was new. Normally, vaccine development is very slow. We have to raise funding for the early research, then report on our findings, before going back and asking for more money to fund clinical trials. This time, our work was more urgent. Thanks to the global effort, we could develop, manufacture and roll out a vaccine in less than a year.
When I received a standing ovation on the first day of the Wimbledon Championships last summer, I took that as being not just for the vaccine developers, but for everything that was done to get the vaccine to the people: everyone who worked on the vaccine, all those who volunteered in the clinical trials, and the NHS, which did the roll-out so brilliantly. If we hadn’t had the NHS to get the vaccine into people’s arms, there wouldn’t be much point in what we did.
A few months later, a Barbie doll was created in my image to inspire girls into science. I want to encourage girls to take up careers in science, maths, technology and engineering, but I don’t see a problem in women coming into the sciences. More than half my team is female. It’s only in the senior levels that women are in the minority, so the issue is working out why women don’t progress to the most senior levels as much as men do.
It’s quite a complex issue, but it has a lot to do with the way research is funded, and many scientists being in very insecure, short-term contracts. The challenges of trying to balance that with family can make a career in science almost impossible, because most scientists work very long hours and have vulnerable jobs. It’s very stressful. Personally, I didn’t have a permanent post until just over a year ago.
Looking back, the pandemic taught us that it’s not always obvious when an outbreak is starting. Some diseases, such as ebola, cause severe illness and have a very high fatality rate, so it is obvious who is infected. In 2020, it was only when people in China were admitted to hospital with pneumonia that an investigation began. However, by this point, the virus had already spread into Europe. As we now know, most people with Covid-19 have very mild illness, and some even have asymptomatic infections, but they can still pass it on, and for some people, it is severe or fatal.
We learned that we need to be better prepared to test diseases. We need rapid tests in massive numbers. Rapid testing means people will be much more informed and can quarantine in a targeted fashion to prevent lockdowns. It has also been shown that routine testing of sewage is effective at picking up remnants of viruses in samples. If something starts to appear, samples will signal that it needs investigating. This means you don’t need to sample people and you certainly don’t need to wait for somebody to become ill to have a much earlier signal that something is going on in multiple countries.
The vaccine roll-out proved that vaccines could also be developed very quickly and manufactured on a large scale. There are now talks of having vaccines available in 100 days next time. It’s not possible to go from identifying a disease to completing a phase three trial in 100 days – it took us more than 300 days – but next time, with stockpiles of vaccines against pathogens that we already know about, manufacturers could start making more so a lot of doses will be available very quickly, giving us a much better chance of containing future outbreaks very rapidly.
Of course, these projects need funding. But this is a fraction of the economic cost of a pandemic. Through the pandemic, the world has just lost trillions of pounds. By spending a much smaller amount, we’ll be better prepared.
In the future, I think there will be more research into giving vaccines as pills or nasal sprays. But we can’t just take a vaccine that has been given as an injection, make it into a pill and assume it will work. We have to do the clinical trials again. For example, the flu vaccines given to young children are squirted up each nostril, not to avoid injections, but because it’s how that particular vaccine works best, rather than intramuscular injection.
There’s also progress being made on cancer vaccines, which is a big area of research now. There’s already one vaccine given to adolescents to prevent HPV (human papillomavirus), which causes cervical cancer. But there’s more work now on therapeutic vaccines to treat chronic hepatitis B infection, which can lead to cancer.
We’re aware that increasing contact between wildlife and people also increases the chances of viruses spilling over from animals to humans. Things such as deforestation – clearing areas of formerly wild country for agriculture – mean that wildlife must migrate somewhere, such as into areas inhabited by humans. It’s not just direct physical contact between humans and animals that spreads disease, either, it could just be sharing the same spaces.
For example, Lassa fever virus – a disease that’s endemic in West Africa – is carried in small rodents. When looking for food, they get into people’s homes and contaminate them. The people who are infected may never see one of these rodents, but that’s where their infection came from.
Trust in science
Regarding vaccine hesitancy, one thing that we’ve heard a lot is, ‘We don’t know the long-term effects of the vaccine’, but vaccines have immediate effects, not long-term. We’ve never had a vaccine with adverse effects cropping up years after vaccination. This just doesn’t happen.
Myths that vaccines cause sterility or affect fertility have been completely debunked. We have the data from many different sources. Covid-19 infections can reduce male fertility in the short term, because of the effects of fever on the body, but it’s not permanent. Vaccines really don’t affect fertility.
People were very worried that we didn’t know if Covid vaccines would be safe in pregnancy, but we now have an awful lot of information to show that they are very, very beneficial in protecting both mother and baby. Mothers develop antibodies that are passed on during the pregnancy, so babies already have some protection when they’re born.
I still receive emails from people all over the world who write, ‘I’ve had your vaccine’ or, ‘My parents had your vaccine and we’re so grateful.’ They’re lovely to read. The messages are slowing down, and that’s fine, too; there’s more time for me to get on with my job.
Now, I’m restarting projects that I was working on pre-pandemic. I was working on vaccines against three outbreak pathogens, one of which is a respiratory syndrome that has caused outbreaks in the Middle East. Another is Nipah virus, a serious disease in Bangladesh and India that has a 40% to 75% fatality rate, and the third is Lassa fever virus. I’m also working on producing a vaccine that works against all the influenza A strains.
We’ve certainly learned a lot during the past two years. The pandemic has really highlighted gaps in our knowledge, while also showing which of our responses have worked well. But now we need to put in the work to become much better prepared for next time – because there will be a next time. Future pandemics will come. We shouldn’t allow what we’ve learned to be forgotten."
Vaxxers (Hodder & Stoughton) by Sarah Gilbert and Catherine Green is out in paperback on 26 May 2022.
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