Animal data tells them they are on the right track, but Covid-19 is now going to prove or deny whether the approach, using what they call self-amplifying RNA, is a breakthrough .
He is careful not to promise too much, but it is clear that he supports his own horse with more than 120 other candidates in order to develop a vaccine against the coronavirus. “Sure, otherwise I wouldn’t do it,” Shattock told the Guardian.
“I am cautiously optimistic that it will work as well as anything that is developed as it induces good immune responses in animal models, and we expect it to be the same in humans and it will be very safe because we use such low doses.
“What we don’t know is what level of immunity is needed to prevent infection. If we only need a tiny bit, most vaccines will probably work. It will be fantastic for the world.
“If we need a certain high level of immune response, we can see that some vaccines work better than others. I hope ours will be one of the most successful, but there is no guarantee until we get the data to show that it works. ”
The imperial vaccine is based on pieces of genetic code, rather than pieces of the virus itself. The code is inserted into fat droplets in the arm muscle, which then makes the cutting edge protein for which the Sars-CoV-2 virus is famous. This induces the immune system to take action, producing antibodies to fight it and hopefully creating a memory of the virus as an enemy invader to repel in the event of a true infection.
Shattock is targeting a vaccine that will treat all the billions of people on the planet, no matter how small their country’s GDP. This is the real beauty of this approach, he thinks: it is very safe, uses very little material and can be extended very quickly.
And it’s going to be cheap, about £ 2 to £ 3 a dose, he thinks, they’re fleas for a brand new vaccine. The first human papillomavirus (HPV) vaccines, which can cause types of cancer, cost around £ 300 per course.
Imperial Oil receives philanthropic funding from Morningside Ventures, founded by the Chan family of Hong Kong, and formed a social enterprise called VacEquity Global Health to deliver the vaccine. Royalties will be abolished for low-income countries. Shattock says they can charge higher prices for wealthy countries to give the poorest the vaccine for free.
If it’s a race, Imperial will not win it. “We are not going to be the first unless others fail,” he said. This is important because all demand and funding will be focused on the first vaccine to work, although there are accessibility and scaling issues.
Vaccines under development in the United States are likely to remain there, with the Trump administration first guaranteeing all doses that can be produced to protect Americans. “I guess if they work, they will be so busy meeting demand from the United States that there will always be parts of the world that cannot access it,” said Shattock. “The idea that a single vaccine will be deployed in a timely fashion around the world, I think is very naive. ”
The British government has invested large sums in the attempts of the University of Oxford and Imperial Oil. The United States has also invested in Oxford, but Shattock does not regret having offered him nothing. “In some ways, it makes life easier. They have so much money that it comes with some kind of attraction. I think we would be very distracted if we were in this huge race in the United States, “he said.
The first vaccines are unlikely to be 100% effective, and the protection they offer may disappear after some time. Shattock said it was entirely possible that the University of Oxford / Astra Zeneca prototype, which is ahead in the field as the first in large human trials, and the imperial vaccine could be used together.
” It is not a surprise. If you use two different approaches – one to prime the immune system and another to stimulate it, it often gives you a better answer. One of the uncertainties about the AstraZeneca vaccine is whether it could be used to boost the immune system if you need an annual or quinquennial booster, “he said.
Oxford uses a traditional approach, delivering the vaccine with a mild cold virus called adenovirus. This should teach the immune system to fight the coronavirus, but it is possible that the antibodies will also reject the cold virus next time, so additional booster doses will not work so well. The imperial vaccine, however, which consists of two injections to start with, one month apart, can be given as often as necessary.
So is Shattock’s vaccine better? “I think it is a difficult judgment to make,” he said. “If what we see in animals translates into humans, we will have a different quality of immune response.” It’s probably because we can give two doses. I think we will see higher levels of antibodies. Whether it makes a difference in protection or not, again, is an unknown. ”
Imperial Oil will begin human efficacy trials in October. “We need to know if the vaccine is working by the end of the year,” he said. “We have set up the possibility of making 85m doses for the United Kingdom. At two doses each, this could cover 42.5 million adults. “We can do more, but we know we can guarantee that we can do as many doses. We can cover the UK without any problems. ”
He thinks the more vaccines that work, the better, because it will give more coverage around the world. Imperial can be produced in very large quantities so quickly because it uses very little material, but Shattock said, “We have to partner with manufacturers around the world to do this. It could be a huge pharmaceutical company like AstraZeneca, but more likely, he thinks, it will be a variety of small companies currently working on small margins based in different parts of the world, producing in South America, India, Australia and so on to get global spread.
The vaccine success rate at this stage of development is 10%, says Shattock, and there are already probably 10 vaccines in clinical trials, “which means we will definitely have one.”
In the United States, the other highly supported vaccines are Johnson and Johnson, which uses an adenovirus like Oxford, and Moderna, which uses an RNA approach like Imperial, but with a dose 100 times larger. “I suspect their vaccine and ours will be fairly similar in terms of the immune response, but we’re just using a lot less equipment. And they will not be interested in the developing world markets because they are a billion dollar business and have to make big returns on their investment. BioNTech in Germany is testing several RNA candidates, one of which resembles that of Imperial.
While Shattock hopes the imperial vaccine will work against Covid-19, his team sees it as the future. “The next time there is a pandemic, we hope that this technology will be ready for production in many parts of the world much more quickly. We are at a transition point. In five years, everyone will probably use this type of technology for pathogens. ”
It’s fast and inexpensive. If it works, it can mean vaccines not only against viral epidemics, but also against neglected endemic diseases that plague low-income countries, where companies have had little incentive in the past to get involved.