🔒 A vaccine for Covid-19 is in sight – Oxford professor Adrian Hill

The coronavirus is spreading around the world at an alarming pace, but there is still no drug to treat it or a vaccine to protect against Covid-19. Several research institutions around the world have joined the race to find life-saving vaccines and the Jenner Institute at Oxford University are enrolling the first volunteers in the United Kingdom to test their vaccine on humans. Biznews managed to track down the Director of the Institute, Prof Adrian Hill who said he was optimistic that their inoculation could work and said it could be ready later this year. Prof Hill also had a word of caution for those who think it may not affect them. He wanted people to take it seriously because months ago people in Europe were saying “This is a problem for someone else… the real nightmare is if it takes off in Africa.” – Linda van Tilburg

Oxford University professor Adrian Hill joins me now. Adrian you’re currently working on a vaccine, how are things progressing?

Well, we’re at an exciting stage. We just opened the trial to recruitment two days ago. We’ve been overwhelmed. Thousands of people have expressed interest and I think that just reflects what we know, that there’s a real desire out there to help design a vaccine and make a vaccine available for lots of reasons. Obviously, to prevent disease and deaths from this dreadful virus but also, to let a much larger number of people out of being locked in or down or whatever you want to call it. It’s really the exit strategy for this pandemic.

What is different about your trial and your vaccine?

There are a lot of people trying to make vaccines and of course, the problem is that generally, it takes many years to design, test a vaccine, bring it into clinical trials, go through various phases and eventually, get it licensed for use. We, in Oxford, have experience of this being done much faster than usual when we were helping out with the Ebola emergency back in 2014. We tested 4 of the Ebola vaccines that went to Africa, one of which was tested successfully there and that was easier than this because those Ebola vaccines existed. They simply hadn’t been tested clinically so we moved very rapidly into clinical trials. This time, at Oxford University, we’ve had to make a vaccine from scratch, which started in the middle of January when the sequence of the virus was released and it’s quite remarkable to have it manufactured round about now and ready to go into the clinic in about a few weeks’ time. So, this has been extraordinarily fast. It’s luckily, a vaccine-type we know a lot about. It’s been in clinical trials for lots of other diseases but we know that it looks safe. We have to show that for Covid-19 as well, but we should be able to do that fairly quickly, so that’s the stage where we’re at – recruiting for the trial. So, this trial is happening in Oxford at our clinical centre. We have asked for volunteers aged 18 to 55 and that’s very standard. We are looking for people who are fit and well. We are very experienced at doing what these are called (phase one trials) and then measuring the response it produces. One of the advantages of this vaccine type is that we probably only need to give one dose and that’s advantageous for lots of reasons. It’s quicker to vaccinate. It’s less expensive. It’s logistically easier, so that’s the first approach to see how well we get with just a single dose. Over that trial span of several weeks, we’ll be looking for about 500 people to vaccinate going from one individual to three individuals and dosing larger and larger numbers.

You mentioned how fast it was to get it to this stage, because normally, you would be testing on animals first but apparently, you’re doing both at the same time, this time around.

We started on animal testing a couple of months ago and we’ve been discussing with the experts in this area – the regulators – what would be an appropriate time to start human testing, given the scale of this emergency and they’ve been very sensible, very helpful and as I say, starting in a few weeks sounds about right. I think that is the right balance. Most vaccines are very safe. We’re pretty confident this one will be too, but we have to show that. It’s not that we’ve taken any shortcuts. We’ve done all the things you would normally do. It’s just been possible to do them much more quickly because the committees that need to review all of this, have done so immediately. The regulators have been asking for its motion, rather than us waiting for the decisions. It’s been very interactive and very encouraging.

Do you have a timescale if it proves to be successful, when it can be rolled out en masse?

This depends on manufacturing scale and this is a vaccine type that we can manufacture in vary large amounts, so millions of doses would certainly be feasible. The problem I see is that we need more than millions of doses – hundreds of millions, maybe even billions – and of course, it depends on how this pandemic proceeds. Our real concern is that we have enough vaccine doses to vaccinate basically, high-risk people. They would be the first priority: those with underlying diseases, high risk of infection, and then the general population. Of course, the key question is ‘where’ because the vaccine is needed in Europe. It’s needed in North America and increasingly, it’s needed in Africa and our real nightmare is that this could take off in Africa in the way that it did in Wuhan, China and has in Italy etc. and now in Spain. Of course, in Africa (widely), the health services are not as well-funded and resourced. Public health infrastructure may not be as good so there’s the potential for a much more serious pandemic and much greater loss of life in many parts of Africa than in Europe or the Americas.

If we can bring it to South Africa; we’ve seen something quite strange in our country in that people are not taking it too seriously, especially within parts of the black community, kind of saying: “It’s a white, rich person’s disease” and they’re the people who brought it over. So, what kind of message would you give to South Africa, to people who are basically ignoring the advice they get?

I would remind them that two months ago, people in Europe and America were pointing out that this was a Chinese problem and was unlikely to be significant in Europe or America and in America, less than a month ago, people were playing down the importance of this problem so it’s very easy to get it wrong and underestimate what just takes time to build up. The virus will keep on growing. It will keep on spreading. Unless people can practice isolation or we get a good vaccine, this is going to cause many more deaths. There’s no reason why it shouldn’t spread in Africa.

The Flu vaccine you have to get every year because there’s a different strain. What happens? Is this still a specific strain? Can it mutate?

It can mutate and people have looked at that. It doesn’t mutate as much. It’s not as quick as Flu in terms of changing. Luckily, what’s been seen so far should not interfere with vaccines at least, in the immediate future and remember, we’re trying to put out a fire here. We’re dealing with it this year. We want a vaccine this year and not next year. It would be, in many ways, too late. So, the target is to be vaccinating in the second half of this year and we will see how many doses we can manufacture but the more financial support we can get and raise for manufacturing, the more doses will be available.

For this vaccine, would it be different for different geographies or would the same vaccine apply to everybody across the world?

We believe it would be absolutely fine in every territory because the virus has not diverged very much and frankly, we don’t have time to make different strains for specific vaccines at the moment. Luckily, nobody thinks we need to but that’s being looked at and watched very carefully. Viruses tend to mutate but we’ve had a few months to look at how quickly this one mutates and it’s not too high.

You’ve worked in Africa before you said, with the Ebola virus.

My day job is making malaria vaccines. I’ve done that for 20 years. There’s been a lot of progress in that field and some very promising vaccines coming through now. We’ve been doing our own clinical trials recently in Burkina Faso and in Kenya, and will extend that to other countries so yes, huge progress in malaria vaccines. That’s all very exciting. We didn’t expect this would turn up and just as with Ebola, the teams in Africa that were working on malaria and other diseases, rapidly turned to vaccinating against Ebola and doing those trials, and we’re beginning to see the same thing happening in Africa so it’s definitely moving in that direction. The numbers in both those countries – Burkina Faso and Kenya – are rising very quickly and of course, South Africa, with the biggest number of all so far.

So, we are worried about people who have HIV and also TB patients.

Well, that has yet to be seen but it’s a reasonable supposition. Certainly, being immuno-suppressed in any way – and HIV is a common way of being immuno-suppressed – is a problem for dealing with many other infections, including famously, tuberculosis, so we will be watching that very carefully. Certainly, lung disease or pre-existing lung disease is a very high-risk factor and so is older age but in South Africa, those factors may be different and I think they need to be looked at again.

When will you know when the trials have been effective?

What irritates us is out there in the press, is the idea that it will take at least a year and probably 18 months to have a vaccine out there. We think it can be done faster than that. We’re convinced that if our vaccine works, we could be manufacturing later this year. On the other hand, that’s the best-case scenario and with most vaccines, there are risks that it doesn’t go to plan. Luckily, the world is developing dozens of vaccines to our own clinical trial already. We may be the third and things are moving very quickly. The reason it’s important to know that there may be a vaccine later in this year is that it affects your management strategy and how you’re going to deal with the lockdown etc. If there is a vaccine in sight, then people are likely to be more likely to practice good containment if there is a solution at the end that they can see. I’m pretty optimistic about vaccines. I’d just like people to take this seriously because lots of people, months ago, said ‘this was a problem for somewhere else’. It’s nearly completely global now. It’s going to spread even more so just because there is a small number in any country at the moment, doesn’t mean it’s not going to take off in that country. It’s much easier to put this out when there are only hundreds of cases, not thousands or tens of thousands, so we really must try.

Do you think that in the UK, they didn’t take it seriously enough from the beginning?

I think we were a bit slow, to be honest, in responding and a lot of people thought that it wouldn’t really come in very much from China where it started out, and that is just clearly wrong.

There seems to be a reluctance to lock down places like New York where it’s mushrooming.

Yes, New York has been an awful problem. Absolutely. We need to learn this lesson now and not wait to see further examples and it’s hard. It’s not fun not being able to go out and shop maybe once a week or whatever but it’s going to be worthwhile, particularly if there’s a way out with a vaccine.

Do you think the cases are going to start coming down now that we are on lockdown in the UK? South Africa has an even more severe lockdown.

We’re not seeing that. A severe lockdown should work in weeks but we haven’t had that for three weeks yet, so the numbers are going to go up anyway. The question is not ‘will they carry on going up’, it’s really, ‘when will they plateau’ and we’re looking at April or May for the peak, so we’re not there yet even with the lockdown.