The UK is racing to create the world’s first coronavirus vaccine

Vaccines usually take years to create. But a team at the University of Oxford is hoping to get things done in a matter of months. Here’s how

In early 2018, a condition called “Disease X” was added to the World Health Organisation’s list of threats that could cause a deadly pandemic in the future. Unlike the other diseases on the list, Disease X didn’t yet exist. It was just a placeholder for a novel pathogen unknown to cause human disease at the time but that needed to be planned for. Covid-19 is the first disease to emerge since the term was coined. We are all now living with the consequences of Disease X.

In the four months since the novel coronavirus that causes Covid-19 was first discovered, over 190,000 people have died and much of the world has been put on lockdown. Without a vaccine we are unlikely to be able to put a stop to the transmission of the disease altogether. But now a UK study is hoping to develop a vaccine in record-breaking time.

It normally takes years to develop, approve and produce an effective vaccine. Of the 100 or so Covid-19 vaccine projects that are currently underway, a team at the University of Oxford claims it can have a million doses ready for use by September. This would be the fastest scale-up in vaccine manufacturing history – if it works. And that’s still a big if.

Oxford’s vaccine is one of only six candidate vaccines being evaluated in clinical trials, and the team has been quick off the mark because its underlying technology, called ChAdOx1, was designed as the basis for developing vaccines for a range of diseases including Lassa fever, Middle East Respiratory Syndrome which is caused by another coronavirus, and Disease X.

Sarah Gilbert, a professor of vaccinology who leads the university’s vaccine development programme, seized the opportunity when she first heard the news from Wuhan about the novel coronavirus outbreak in early January. “It looked like it might be something interesting, but we didn’t know if it would spread very far. I decided with colleagues in the lab that we would start making a vaccine as a Disease X lab demonstration project just to see what we could do,” she said at recent press conference. As soon as Chinese scientists released the full genome sequence of the Sars-Cov-2 virus on January 10, Gilbert’s team started work on a vaccine.

Just over three months later, their vaccine is being trialled on humans. In the first phase, 550 participants will be given the ChAdOx1 nCoV-19 vaccine and 550 a control vaccine against meningitis and sepsis for comparison. With a fresh £20 million injection of cash from the UK government, 200 staff will work on a rotating basis to screen healthy volunteers coming into the trial centres in Oxford, Southampton, Bristol and Imperial College in London – which is also working on a different vaccine that will be tested in humans from June – and to take blood samples to track how well their immune system responds to the vaccine.

Participants will be paid up to £625 to be infected with a harmless chimpanzee adenovirus that carries the genetic sequence of the coronavirus surface “spike”, which should trigger an immune response without replicating. The researchers will then be able to track whether the vaccinated individuals are protected against infection, but if the transmission levels of the virus drop to low levels in the wider population, it could take up to six months to collect the necessary data – a first hurdle in the already ambitious development timeline.

If the first trial is successful then it will be extended to volunteers aged 55-70 years and then those over 70 years old, who are most vulnerable to the coronavirus and less responsive to vaccines due to their weaker immune systems. Almost 40 per cent of the Covid-19 deaths registered in England and Wales in the week ending on April 10 were among those aged 75 to 84 years. “If we did see weaker responses in older adults, we also have in our plan that we would look at giving additional doses in that age group to try and improve the immune response,” says Andrew Pollard, chief investigator on the study, and professor of paediatric infection and immunity at the University of Oxford.

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To fast-track the vaccine development and have a million doses on standby in autumn, the team has already lined up seven bioprocessing companies to manufacture the vaccine before knowing whether it will work. Three are in the UK – Pall in Portsmouth, Cobra Biologics in Keele, and Oxford BioMedica in Oxford – two in continental Europe, one in India and one China, which has some of the largest manufacturing facilities in the world. This is a sensible strategy, says Nicola Stonehouse, a professor in molecular virology at the University of Leeds. Hundreds of millions of doses will be needed worldwide and ideally, vaccines should be produced in multiple countries to keep up with demand and avoid shortages. At least seven companies have produced hepatitis B vaccines since 1981, but there was a global shortage when the UK introduced a universal vaccination policy for babies in 2017.

Whether the University of Oxford develops the first coronavirus vaccine, or not, governments and companies will have to place their bets on different vaccine candidates, says Doug Brown, chief executive of the British Society for Immunology. They will have to invest in these development projects even before they can be certain that the vaccines are safe and effective to avoid delays and ensure enough doses can be delivered to low- and middle-income countries as well. “We need to be backing the most promising horses and looking to try and develop at scale, through manufacturing plants in the UK and globally, large doses of the vaccines that we think that have the highest chance of success,” he says.

With scientific, manufacturing and regulatory hurdles to overcome, Oxford’s vaccine is still a long way off. There are many unknowns about the viral infection behind Covid-19. For one thing, it is still unclear what level of vaccination within the population would be needed to reach herd immunity. The highly contagious measles virus requires a 95 per cent vaccination rate to ensure herd immunity. At the early stage of an outbreak, every infected person is thought to pass the Sars-Cov-2 virus along to two or three people on average, which means that 60 to 80 per cent of the population would need to gain immunity through vaccination to shield the most vulnerable.

On April 23, the Department of Health and Social Care announced it will contact 20,000 households in England and invite them to take part in a study to track coronavirus transmission and find out how many have already been infected and developed antibodies to the virus. This will be crucial to know where and how to first roll out vaccine programmes in the country. “There will be parts of the population we might want to target first,” says Brown. “Is it the most vulnerable in our community to protect first? Or is it parts of our community where we’re seeing the transmission of this virus at a fairly high rate? Is that within children or is it within working adults? We just don’t know at the moment.”

By Sabrina Weiss at https://www.wired.co.uk/article/uk-coronavirus-vaccine-trial?utm_medium=applenews&utm_source=applenews