So, in the ideal situation what happens is you get a bunch of vaccines that can
be produced at a huge scale for everybody who needs it in the world, and that when
you give that vaccine to someone they are then protected against this
infection for, say, five or 10 years or something.
If you can get that, it's a really big if,
if you can get that then you can start to think about
a vaccination programme to achieve what we've heard of as herd immunity.
Now, herd immunity just means that so many people are protected against
a virus or immune against it that the outbreaks, when there are some,
when the infection comes in, that it doesn't spread and an epidemic doesn't grow.
The principle of a vaccine is simple, you basically fake an infection.
so what you do is you either take a little part of the virus that doesn't cause any harm
on its own or you can even take the virus itself and irradiate it or kill it in some way,
inactivate it, and inject that into the body or it goes up your nose in a nasal spray.
The body will recognise it even though it won't be harmful, the body will still
prepare an immune response against it so you'll have all these
antibodies and other cells in your immune system and the whole idea is that
that immune response is sufficient and long-lasting enough so that when the
real live virus comes along, when you pick up the bug, then your immune system is
already primed and knows how to kill off the virus. It's as simple as that.
What's complicated is all the steps involved in making a good vaccine, making one that's safe
and then getting it out to all the people who need it to protect against that infection.
What's different with a vaccine than, like, a drug you might be developing
for people with coronavirus, is that a drug's going into people who are gonna be ill
maybe even really ill, whereas a vaccine goes into potentially billions of people who are healthy.
It has to be absolutely incredibly safe.
Beyond actually creating a working vaccine, probably the biggest issue is
how do you get it to everybody?
I mean in this country, shots of vaccine, they will go into vaccination programmes
and people will be given shots depending on who is deemed to be
sort of most appropriate to get the vaccination at what time.
You still then have to find a facility to build it, to make it, to churn out
all these, all these doses.
Is this a one-shot vaccine? If so, great because you need
half as much as if it's a two-shot vaccine, or you know some vaccines
you need three shots of it, or you'll need, you know, boosters and all sorts of things.
There will obviously be some people who don't want to have a vaccine,
they may just not agree with vaccines and think vaccines are dangerous full stop.
But obviously the point is that the more people who do have an effective
and safe vaccine the better because that will protect those people,
you know, elsewhere in the community.
Something I expect to happen is that we may well end up with different vaccines
for different people, and we actually already do this with the flu vaccine each year.
Certainly in this country, the live attenuated flu vaccine which is the
most potent vaccine, flu vaccine, is given is given to the kids
whereas the over-65s get a different type of vaccine.
So, it's not a straightforward situation that will have one vaccine for all, by any means.
So early on in March, April, we had a lot of very prominent medics and scientists
saying it's going to be 12 to 18 months before we get a vaccine.
That's actually massively accelerated compared to any other vaccine that's ever been produced.
The fastest that we've had a vaccine out is for mumps and that took four years.
Dengue fever; the virus was identified in 1943, I think, the first vaccine
was released in December, this December just gone.
So, why does it take so long? I mean 18 months is still a long time.
Well, the problem is that for any vaccine you have to go through three stages of trials,
OK, and these all take months.
Often you have to look at the data after each trial, or even as the trial is ongoing,
and you have to think: is this working?
Do we have to make any sort of chemical changes to what we've got in the vaccine?
And then do we have to go back and sort of start this again?
It's entirely plausible that we will now be living with this coronavirus for
a long long time, years, whether we have a vaccine or not
because a vaccine is absolutely not guaranteed to get rid of the virus
everywhere in the world and, as long as it's somewhere in the world,
then it can infect anywhere in the world.
That all sounds very downbeat and miserable but what we haven't talked about
which is going to be hopefully really important as a third pillar to this
is the work on the other medicines.
So unlike vaccines, which are trying to protect, things like antivirals and
other kinds of interventions so that when you do have people still going into hospital
that you'll have some treatment you can give to them.
So, this is the scenario we want to end up in and I think is the one
that's realistic to hope for, is that yeah the virus is still around
in some places in the world and we do get used to flare-ups in this country but they
but they are quickly contained and dealt with, and when people go in a hospital
we at least have some treatments to give to them
so that they don't end up in intensive care and worse dying.