COVID-19 - a possible vaccine


We are all thinking of when we can return to normality. When we can return to seeing friends, going to big sports events or social celebrations. When our children can go to school and our relatives can come out again, and for us all to meet together in the way we are used to being able to. 

The best chance of this happening is to be find an effective vaccine to this Coronavirus, one that gives enough immunity in the population for the virus to no longer be able to circulate. 

We are lucky in Oxford to be a part of this quest. Two weeks ago, I entered into the trial of this vaccine. Partly motivated by curiosity, partly by self-interest and partly to feel like I can do a tiny amount to help.

The experience of being part of this trial is fascinating. As a medic I obviously have a reasonable understanding of how a trial such as this works, but it is hard to appreciate the scale and the complexity without seeing it. 

The trial is the second phase of testing of a vaccine. The first phase is a smaller safety trial to make sure there aren’t any major side effects. The second phase is a larger trial to work out if the vaccine provides an immune response to the virus, and if it provides protection against getting the virus (the two aren’t necessarily the same, see below). 

This vaccine being tested is a modified adenovirus (similar to viruses that cause the common cold), the adenovirus has had the ‘spike’ protein from the Coronavirus added genetically. This in theory would then allow our immune systems to ‘learn’ how to defend against the Coronavirus but without being exposed to the actual infection. 

There are often concerns about vaccination, most of them seem more like internet conspiracy theories, but it seems very few people get any side effects to this. All I had was a slightly sore arm for a day. 

The only slight problem is that I don’t know if I had the Covid vaccine, the trial is a ‘double blinded randomised controlled trial’. This means that 50% of people get another vaccine – in this case the Meningitis C vaccine (which at the moment is given to students only). This is to make sure that any success is actually due to the real vaccine. 

The only real down-side to the trial is blood tests and regular swabbing, but this means that I know I hadn’t already had the virus and that every week so far I am not carrying it – which is reassuring for others I am in contact with!

I am not a natural patient, I’m more of a doctor avoider (do as I say not as I do!). I also need to confess; I don’t like blood tests. But the staff of the trial are exceptionally professional, it is a highly slick and professional operation, noticeably efficient compared to other experiences of medical appointments. The research nurses, and medical students involved are bursting with enthusiasm and hope that their programme will be successful. It has been very easy to be involved in it, which is good news as they are looking for 10,000 volunteers in the UK: they are still recruiting- especially keen on local people and healthcare workers.

What the trial is looking for are two things; firstly an antibody response to the vaccine; secondly a reduction in infections (or at least less severe infections). Interestingly no-one still knows whether the first thing, the antibody response, will actually stop infections. That may be the million-dollar question here. The vaccine may give some protection to individuals but not reduce the incidence in the community enough to eradicate the virus properly. Results are expected over a year, although I suspect if there are good early results things will move quicker than that.

Anyway, the race is on, there are several vaccines being trialled, Oxford is doing well but it looks like a marathon rather than a sprint. But the real race is being run against the virus itself, a race that we must win sooner rather than later. 


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