The Ref Stop

National League bites the bullet

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No, it's not "a nasty virulent cold virus" - that's like saying, "all dogs are mammals, therefore all mammals are dogs."

It's a virus from a very broad family of viruses that are grouped together because they appear similar to the human eye when looked at under a microscope. It doesn't mean the four coronaviruses that cause colds (229E, NL63, OC43, and HKU1) are that similar to SARS-CoV-2 in terms of how they work and therefore how you would go about creating a vaccine. For instance, the receptor of the most prevalent cold-causing coronaviruses is aminopeptidase N, while the receptor of SARS-CoV is ACE2 - so their methods of infection (and the means you would use to combat them) are quite, quite different.

There has never been a particularly urgent need to produce a vaccine for the common cold in general - it's a mild, self-limiting disease with extremely low mortality and so the time, money and effort required just can't be justified. When using the older, more normal vaccine platforms, it could to take up to $1 billion dollars and 5 - 15 years to develop a typical vaccine, with as I mentioned before, only a 6% chance of success, on average. And there's even less chance that the money, time and effort could be justified for each of the four different coronaviruses that cause colds, since even taken all together, they only account for around 20 to 30% of cases.

On the other hand though, vaccines have been developed for the coronaviruses that are most similar to SARS-CoV-2 (SARS and MERS) - they just haven't been fully trialled and implemented, again mainly because the financial incentive wasn't there. SARS died out by itself before a vaccine was fully tested and MERS only kills around 200 people a year in only a few countries so it isn't seen as a massive global threat. One of the more promising candidate vaccines for MERS that has gone through several stages of trials, was developed by the Oxford University and Jenner Institute team including Professor Gilbert.


I've looked up Professor Sarah Gilbert - she seems to be a world-renowned and highly respected vaccinologist with nearly 3 decades of experience in the field of vaccine development and implementation. If she is highly confident of success, it's probably because she has extensive practical knowledge of not just developing vaccines in the lab but actually testing them on people. She has been involved in the development of and clinical tests for, over 50 different vaccines for various diseases in humans. Also as mentioned, her team has already developed a MERS-CoV vaccine which has successfully progressed in all its trial phases so far. So I think if anybody is in a position to know how promising her team's candidate vaccine for SARS-CoV-2 is, then it's her.

See the clip below where she talks about viral vectored vaccines, which is the kind of vaccine that her team is developing for use against SARS-CoV-2.


If you want a further illustration of just what a comprehensive knowledge she has in the field of vaccines, here's another video where she talks about their work on developing an improved flu vaccine that would work against all strains of the flu and wouldn't need to be updated each year. It's a bit long at nearly forty minutes but it's a fascinating lecture (if you're interested in that kind of thing).

Was the September quote taken out of context or blown out of proportion by the Media? If not, my money is on the community, not the individual (no matter her credentials). That said, she's clearly a leader in her field and it would be awesome if she steers the pack in the right direction
 
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The Ref Stop
If not, my money is on the community, not the individual (no matter her credentials).
Well exactly, which is the main reason why I said I was relatively optimistic about a vaccine, just because of the sheer volume of different vaccine development efforts underway.

Still, as it stands the Jenner Institute/Oxford University candidate vaccine is the one that at the moment, is the most advanced, time-wise, so let's hope the confidence expressed in it is not misplaced. News stories about it in the last two days continue to be promising.

Oxford University vaccine successful in trials on macaques

Indian institute to start manufacturing Oxford University vaccine in 3 weeks

As the first article states, "Immunity in monkeys is no guarantee that a vaccine will provide the same degree of protection for humans. [...] Which potential vaccine will emerge from the scramble as the most successful is impossible to know until clinical trial data becomes available."
Was the September quote taken out of context or blown out of proportion by the Media?
I think it was slightly. As I understand it what she was saying was that just possibly, if everything goes perfectly, they would be ready for phase 3 trials by September and that with an emergency use authorization, the vaccine could at that point be given to a more wide-ranging group of people than normal including for instance frontline health care workers.

At the same time, due to the urgent nature of the situation they would ramp up manufacturing in parallel with the trials and would hope to have as many as a million doses of the vaccine ready by September in anticipation of the vaccine proving safe and effective. However, according to her and other members of the team, a full rollout of the vaccine on a global basis would probably not be possible before the end of the year at the earliest.
 
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Another point is that even if the Oxford University vaccine pans out (and it may not) it would be better if we could get more than one vaccine to use (and preferably several) . There's always a good chance that some may work better in different groups than others, like children or older people, or at different costs. Having more than one safe and effective vaccine in production would also help with the problem of manufacturing enough doses to supply the entire world.
 
Another point is that even if the Oxford University vaccine pans out (and it may not) it would be better if we could get more than one vaccine to use (and preferably several) . There's always a good chance that some may work better in different groups than others, like children or older people, or at different costs. Having more than one safe and effective vaccine in production would also help with the problem of manufacturing enough doses to supply the entire world.
And more importantly a company with the patent holding the world to ransom
 
And more importantly a company with the patent holding the world to ransom
Well, the Oxford University/Jenner Institute group for one, are not likely to do that. As an interview with the BBC's Andrew Marr shows, they are not in it as a money-making venture.
Prof Gilbert also said that Oxford is not looking to make money out of the vaccine, adding they are concentrating on making it available for public health use.

“The university is looking to protect people’s health,” she said. “And to do that as widely as possible across the world. It’s not just for this country, we need to make a vaccine for the world.”

Discussions are going on about fair access to all vaccines that work at a global level, she added.

Actually, that's another area where I'm cautiously optimistic. Groups like the Coalition for Epidemic Preparedness Innovations (CEPI), the Global Alliance for Vaccines & Immunisation (GAVI) and the WHO are working hard to ensure that all the research work - and any eventual solutions in terms of vaccines or therapeutics, will be shared and distributed equitably. CEPI for instance, is funding at least eight of the most promising studies including several that have already started human clinical trials such as Moderna, Inovio and the Oxford University/Jenner Institute. The whole ethos of CEPI is that everything they work on is globally available.

The WHO meanwhile, has over a hundred different government, academic and private pharmaceutical organisations signed up to its "Public statement for collaboration on CoVid-19 vaccine development" wherein they pledge to work together to make vaccines available to everyone.
 
No cancellation of ANY football in Wales.
It looks like the FAW are trying to finish the season for all levels - yet many councils have already taken down goalposts, and where applicable, getting the cricket squares up and ready......
Due to the wet January, February & early March many Leagues still have clubs who have only played 50% of their matches!
 
More encouraging news about the Oxford University vaccine trial, this time from a different member of the team. Sir John Bell talks about how they're hopeful of getting an indication by as early as June, of whether the vaccine might work.

 
More encouraging news about the Oxford University vaccine trial, this time from a different member of the team. Sir John Bell talks about how they're hopeful of getting an indication by as early as June, of whether the vaccine might work.

So basically sounds like a good chance of efficacy, but the safety profile is the usual gotcha. That said, the safety profile of the disease isn't gonna take much beating
 
So basically sounds like a good chance of efficacy, but the safety profile is the usual gotcha. That said, the safety profile of the disease isn't gonna take much beating
That's true - the paramount concern in developing any vaccine is that it must be safe. You're going to be giving it to completely healthy individuals so the overriding principle of "First, do no harm," is uppermost in the minds of any vaccine development team.

It's perhaps worth pointing out that in this particular instance, the vaccine delivery method has already been used in the development of vaccines for over 10 different diseases and has an excellent track record for safety. It uses a non-replicating chimpanzee cold virus into which they splice a small but critical part of the target pathogen's genome, in this case the spike protein for SARS-CoV-2. Since neither the cold virus nor the spike protein are capable of replicating, they cannot cause an infection in the test subjects. The fact that this same method has been used to produce a MERS-CoV vaccine which has successfully gone through all its safety and efficacy trials so far (and is currently undergoing human trials in Saudi Arabia) is probably the main reason why they have such high confidence in their current effort.

Oxford Vaccine Group CoVid-19 vaccine trial

The main fear as I understand it, is not from the components of the vaccine but from the phenomenon known as "vaccine-induced enhancement of inflammatory response." This was seen fairly recently in a candidate SARS vaccine which produced a dangerous over-reaction in the immune system of older mice. However this was a vaccine using a whole, double-inactivated virus (DIV) and as mentioned, the viral vectored vaccine approach used by the Oxford University project has not been known to produce such an enhanced response in the past.

Anyway, let's keep our fingers crossed that either the Oxford effort or one of the other 100+ vaccine development efforts is successful and in the not too distant future.
 
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