The university was in the spotlight on Monday for the vaccine which reported encouraging efficacy results, but it is also leading the world’s largest clinical trial of Covid-19 treatments and leading an academic analysis of infections for the UK Office national statistics, among other coronavirus projects.
No other university can match what Oxford has achieved, according to Peter Hale, executive director of the Foundation for Vaccine Research in Washington DC. “They were the first not to participate in coronavirus research in January and have retained their favorite status,” he said. “I see them as ‘the little engine that could’.”
Although many large universities have larger medical facilities, Oxford has led the Times Higher Education World Ranking for Medicine for nine years. “People don’t realize the enormous power of medical research in Oxford,” says Gavin Screaton, head of its medical sciences division.
Added to this global strength is the university’s policy, which dates back decades, to develop expertise in diseases in the poorest countries – with particular emphasis on emerging infections. It operates nine overseas medical centers in Asia and Africa, with 2,000 employees and a research portfolio of £ 340 million.
Oxford scientists have long worked on pathogens with the potential to cause a pandemic, including coronaviruses. “You could say that Oxford has been practicing this crisis for decades,” Professor Screaton said.
“Our deep engagement with the developing world has informed not only science, but also our attitude towards the vaccine – and in particular our insistence that the vaccine be available at cost to the developing world,” said Louise Richardson, Vice-Chancellor of Oxford.
As soon as news reached Oxford in January of a serious new coronavirus disease in China, medical officials from the university gathered to plan a full-scale research attack on the infection. “By mid-February everything was running at full speed,” said Sir John Bell, Regius professor of medicine.
“We probably had over 800 people working on different aspects of the pandemic,” added Professor Screaton.
The research that particularly caught the attention of academic authorities early in the pandemic was taking place at the Jenner Institute, which focuses on innovative vaccines against emerging diseases.
One of its scientists, Sarah Gilbert, already had an experimental product in development for Middle East Respiratory Syndrome (Seas), a coronavirus disease that sometimes passes from camels to humans in the Arabian Peninsula and has caused 858 deaths since 2012. Professor Gilbert was confident. that she could quickly convert her Mers adenovirus vaccine to immunize it against Covid-19.
“It was operating with few resources, without external funding, so the university immediately agreed to underwrite the project to the tune of £ 1million,” said Professor Richardson.
The Coalition for Epidemic Preparedness Innovations (Cepi) and other funders quickly stepped in to support Jenner’s Covid-19 vaccine work, and in the spring, the project’s results were encouraging enough for Sir John Bell to lead research for university for a vaccine manufacturing partner in the pharmaceutical industry.
Sir John and his colleagues spoke to several companies, including Merck, which was shut down in part because its main manufacturing base was in the United States. GlaxoSmithKline, a UK-based company with a large vaccine business, was also considered, but “they didn’t have enough leeway to undertake our project,” he said.
Then AstraZeneca stepped in. “Pascal Soriot [AZ chief executive] contacted me and told me they would do it, ”Sir John recalls. “They didn’t have a lot of vaccine business back then, but they have a huge business in biologics,” making drugs such as antibodies.
The resulting deal with Oxford requires AstraZeneca to produce the two-dose vaccine at a price that only covers company costs while the pandemic is ongoing in the industrialized world. The company will do this at cost price in perpetuity for developing countries.
On Monday, Oxford and AstraZeneca published the first results of Phase 3 trials of the vaccine in the UK and Brazil, which showed 70% efficacy overall, but 90% in a subset of participants in which a first dose contained only half as much active ingredient as the second.
This low-high dosing regimen was at least in part the result of a lucky mistake. Due to a formulation error, some participants in the early clinical trial received a low initial dose.
“We ended up having a lot of vials with half the dose,” Sir John said. “Because we had discussed a lower dose anyway, we thought it might be better to have a smaller first dose, so we used them in the clinical trial.”
It may have been a fortuitous accident – although the vaccine’s efficacy figures have yet to be confirmed as more trial results are analyzed.
But Oxford’s overall success so far in the battle against the coronavirus owes nothing to chance, said Professor Richardson: “This is not an accident but the result of decades of hard work together with other. “