Vaxxers: A Pioneering Moment in Scientific History

by Sarah Gilbert

‘OK,’ I said. ‘Let’s go for it.’ I was in. The CBF would make the starting materials for the vaccine – about 100 ml of ‘seed stock’ from which all batches of clinical-grade vaccine would be made. Sarah would approach a selection of manufacturers we had worked with before to try to secure manufacturing slots to make the clinical-grade vaccine later in the year, and also, as a backup, feel out the funders of our next clinical-grade manufacturing project, due to start later that year, about the possibility of delaying if necessary.

In January, Tess and I were interested in how quickly we might be able to make a vaccine against a brand-new pathogen – understanding that it might turn out to be nothing more than an intellectual exercise. By the middle of April, the whole world wanted to know.

We had been working flat out and were continuing to do so, and at first, having AstraZeneca on board felt like an additional problem rather than a solution. Looking back I realise how negative and unreasonable this sounds. We could not have got anywhere without them, and we all get along very well now. But at the time, when we were already working eighteen-hour days, we were not always happy about our demanding new team member. Especially when it felt like our new team member was actually our new boss. (For a while I changed my WhatsApp bio to ‘working for the man’.)

Early on, the meetings – all done remotely on our computers of course – felt slightly haphazard. AstraZeneca is an enormous entity, with multiple teams across the UK and the US with quite specialised roles, whereas everyone at our end was involved in and knew about everything.

We were essentially a family-run pizzeria, doing everything ourselves, from checking with the clinics how many doses they needed each day to sticking on labels and arranging couriers, and they were Pizza Express, with software and huge systems and outsourcing to run global operations. They also used a lot of abbreviations that we didn’t understand, and we sometimes felt foolish having to ask them to explain what they were talking about. They must have thought we were so basic. So there was a steep learning curve on both sides of the deal in the first month.

Although these kinds of conferences are sometimes seen as pointless, unproductive jollies, the relationships I had built there over years of soggy quiche slices and partially-frozen cheesecake turned out to be very important. It meant that when I came to these people with urgent and unprecedented requests in the coming weeks, there was great trust between us. So when I asked Netty at the BIA to put a call out explaining the work we already had in train, our confidence in our technology, and our need for assistance from industry, the response was heart-warming and incredible. We immediately received offers of support, equipment loans and expertise-sharing from across the UK.

By mid-April everything was in place to make our vaccine at scale: the production instructions or recipe, the starting material, the production cells, the funding, and a group of manufacturers to work with. Sandy and Adrian Hill had also brought the Serum Institute India (SII) on board. The SII are the world’s biggest vaccine manufacturer. Their involvement would make it possible to produce enough vaccine not just for the UK but for the whole world, and irrespective of a country’s ability to pay. Then the AstraZeneca deal was announced on 30 April and things really took off. With their existing relationships with major manufacturing sites and the financing power to be able to commit to contracts, AstraZeneca was able to activate a programme of global production that was entirely beyond the scope of a UK university-led project.

All of those international conferences also came good. It meant that we had a huge network of trusted colleagues all over the world. When we wanted to set up trials in Brazil or South Africa, Andy wasn’t just pitching up unannounced at a hospital in Rio or Johannesburg. We had existing relationships, we knew all the people already, and we knew they would be able to conduct high-quality clinical trials because they already had the infrastructure and experience.

I joined calls led by the WHO in which many groups developing vaccines presented their plans and reported on progress. We all wanted to learn from each other, and knew that, unlike normal, this was not a race or a competition for a limited market where the winner would take all.

For some commercial vaccines, being first means making the most money, because it is difficult for other companies to break into the market once the first vaccine is in widespread use. With 7 billion people at risk, it was going to take lots of vaccines made by different companies in different countries and in different ways to beat the virus, and we needed to share our knowledge to get there as fast as possible.

From a very early stage, Richard Cornall, the head of the university’s Nuffield Department of Medicine, had instituted weekly meetings of everyone working on Covid-19-related research projects. The idea was to discuss findings, share progress, and bring our knowledge to bear on each other’s work. This was extremely unusual – some of these academics were more used to competing than collaborating – and I thought Richard’s initiative showed great foresight. Every week the Zoom call was full of up to fifty people representing the teams developing the Covid testing, developing the Covid track and trace app, running the RECOVERY trial testing potential Covid treatments, looking at the immunology in infected people, understanding the virus protein structure, making antibodies, doing the genome sequencing, trying to set up challenge studies in animals, and so on. I am sure that this is part of the reason that the University of Oxford led on so much Covid-19-related research that year.

At the CBF we had our glum days, because there was a lot of work to catch up on, and we were still socially distancing and missing the normal social interactions that glue a team together.

So, there is an enormous imperative for us to learn as much as we can from our experiences of the last year. This pandemic was not unexpected. In my line of work, we had been expecting it, and worrying about it, for years. But it was not properly prepared for. It would be terrible to have gone through everything we have all gone through, and then find that the economic losses that have been sustained (and they will be enormous) mean that there is still no funding for pandemic preparedness. We need to make sure that when Disease Y arrives, we are better prepared for it than we were for X.