Professor Andrew Pollard of the Oxford Vaccine Group @OxfordVacGroup speaking to the @theASE #ASEConf2021 this morning. Starting with an overview of the history of the virus. Seems like a lifetime ago...

Reassuring for parents and those of us who work with young people that the risk from Covid-19 is minimal based on worldwide data; but worrying times for adults and older people #ASEConf2021

Impressive that the genome of the virus was available in January 2020 and many researchers groups had it then. A really important step up in terms of our ability to respond with a vaccine. #ASEConf2021

SARS was handled with isolation of infected persons, it also had poor transmission. MERS also didn’t spread easily and symptoms were obvious, and you didn’t shed much infectious material until symptomatic. Allowed containment. #ASEConf2021

Because the SERS and MERS coronaviruses were so deadly work on coronavirus vaccines had already begun.

If this had been a type of virus we had not been working on it would have been much harder to design a vaccine.

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By condensing the development phases it enabled development at pace. Planning of clinical trials at the same time as initial animal studies. Minimising gaps and speeding up where possible. Also manufacture upscaling increased early - moving from lab to mass manufacture is hard!

There are 63 in clinical trials and 172 in lab development. There are multiple different approaches to development of these vaccines!

A huge international effort #ASEConf2021

If we increase the level of neutralising antibody then we increase protection - shown clearly in animal studies #ASEConf2021

Many different possibilities for vaccines - the key is to introduce the spike protein so that the immune system recognises it next time #ASEConf2021

Chemical inactivation is one method. Use aluminium based chemicals to inactivate the virus. The Chinese vaccine follows this approach but it is not licensed yet. Very traditional method similar to polio. #ASEConf2021

Using the genome to develop spike protein which is directly injected into your arm is another traditional method: novavax in late stage trials does this. #ASEConf2021

Also viral vectors (Oxford) and RNA (Prizer). Another method is DNA vaccine which may need a electrical current to uptake the DNA which then produces RNA to convert into spike protein. #ASEConf2021

The RNA vaccines are very flexible as an approach. The low stability of the RNA requires the low temperatures: finding a way to avoid this could make these types of vaccines vital in the future. #ASEConf2021

Viral vector vaccines like Oxford have been used in other diseases, namely Ebola. These types allow the delivery of the spike protein genome using a virus; then this is used to code for the spike protein which the immune system recognises. More info here: https://www.research.ox.ac.uk/Article/2020-07-19-the-oxford-covid-19-vaccine

The more severe lockdown of March has helped us gain time to develop the vaccine. Phase 1 was able to start on 23rd April 2020 with 1077. Because Covid prevalence in the population had reduced it was harder to see if it worked BUT immune response could be studied. #ASEConf2021

Global attention came from fake news that the first volunteer to receive the vaccine had died. The volunteer spoke to the media and said she was alive. But the impact on confidence is an issue. Put huge pressure on volunteers and the team. #ASEConf2021

The Oxford Vaccine clinical trials showed that responses were good after one response but even better after a booster, hence the two dose regimen. #ASEConf2021

Social distancing and anti-transmission caused the problem of testing as not enough spread.

Also problems with transport - at one point a private plane had to be hired to transport the vaccine!

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Very similar immune responses across all age groups. Trials showed the booster dose is important to prevent decline in immunity #ASEConf2021

Lots of people recruited for the phase 3 trial to check the efficacy!

Trials started in the lull between first and second waves. Increasing infections actual helped in the ability to test the efficacy of the vaccine!

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Over 30 trial sites around the world. Astra-Zeneca partnership is not for profit. Enables the vaccine to be available around the world. AZ can manufacture and distribute en-masse. India has the Serum Institute of India doing similar. #ASEConf2021

The database lock is when it can go to regulators. All the data has to be tidied up & submitted.

No severe cases, no hospitalisations & NO DEATHS amongst anyone who received the vacc. So 70% effective at preventing catching it but appears 100% effective at reducing mortality?

By targeting those at most risk we should be able to reduce pressures on the NHS. Vaccines should now be able to play a major part in control of the pandemic.

We still do need to get the mass transmission in the country under control too! #ASEConf2021

Absolutely fascinating talk from Andrew Pollard of @OxfordVacGroup! Thank you!

Now for Q&A! #ASEConf2021

The spike protein is so important for entry to the cell it is unlikely it will make the vaccine ineffective because the virus is so dependent on the ACE-2 receptor to bind with cells. So hopefully a mutation is unlikely to reduce the efficacy of vaccines. #ASEConf2021

Good Q here: what would it have been like 30/40 years ago?

Would have had to be an inactivated vaccine: it would have to be cultured then chemically altered and then injected to see what happened. Doesn’t always produce a good immune response. Summary: it would have been harder

About 2000 people working on the vaccine trials and development! Including 30 sites with clinical control teams and administrators. In Ox there are clinicians, IT to manage the data, 6 statisticians(!), and the laboratory work. Private companies needed to test blood samples!

Origin of the virus is likely to be from the bat coronaviruses. Interaction between people and animals increases this risk.

Pigs can be a vector as they allow mixing of a bat or bird virus with a human one.

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Because of the limited supply of vaccine at the moment we have to prioritise those most at risk from severe disease.

Wrt schools it’s about minimising transmission - if those at greatest risk are protected then we can allow policy to change. Kids & younger teachers v low risk!

Final question: what should we be teaching about this vaccine in schools?

1. They are fascinated by the biology - it draws them in! Tell them about it!

2. We have a responsibility around the understanding of science and combating false vaccine information.

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We need to educate the kids that the impact of vaccines is phenomenal. 200 years go 1/3 children died from infections in childhood!!!!!!!! 100 years ago that was 1/7. Vaccines are revolutionary!! Have to know this before the decision wrt injecting your child arises.

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Brilliant stuff to kick off the day here at #ASEConf2021!