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Making the next global vaccine

How are we going to create a vaccine, quickly, before the next pandemic and how will we roll this out worldwide?

In this episode, we speak to Stephen Morris, Lecturer and Senior Outreach and Partnerships Manager at VaxHub, and Ludovica Vaiarelli, VaxHub Partners Relationship Manager, to learn a bit more about vaccine manufacturing and roll out at VaxHub. We'll be hearing from them both on how the process works, and how we're working with partner Universities like Oxford, along with manufacturers and industry contacts, to make sure we can create the next vaccine as quickly as possible. 

During the conversation, we cover notable projects that VaxHub has worked on plus how antimicrobial resistance (so from things like antibiotics in poultry) is affecting global initiatives in vaccine production. 

More about Stephen Morris

Steven looking to the left whilst smiling around a group of people
Following studies in Microbiology (BSc Hons, Cardiff) and Biophysics (Ph.D Kings College London), he worked for many years on research of multi-protein complexes, intracellular trafficking machinery and ion channels, which led to his interest in the cell biology of viruses and the generation of new vaccines. Stephen worked in academic institutions in the UK, Germany and USA, and spent several years developing VLP based vaccines in the UK Biotech Industry. In 2016 he joined UCL Biochemical Engineering as a member of the Ultra low-cost, transferable automated platform for vaccine manufacture (ULTRA) project team. More recently, he was Research Fellow at the Future Vaccine Manufacturing Research Hub (VaxHub, 2018-2023), specialising in the use of high throughput methodologies for vaccine bioprocess development and analytics, with an emphasis on tech transfer for use in Low to Middle Income Countries (LMIC).

 

 

During COVID lockdowns he became increasingly involved in public understanding of vaccines. In 2022, he started the VaxHub Schools Outreach programme. In 2024 he was appointed the hubs’ Outreach and Public Engagement Manager and now focuses on VaxHub Outreach and Training initiatives aimed to actively engage with the wider community to:

  • Reduce vaccine hesitancy by joining conversations to address concerns and to increase understanding of the reasons behind hesitancy.
  • Increase the awareness of the role of engineering in vaccine development and production.
  • Directly support the training of skilled personnel in vaccine bioprocessing.

More about Ludovica Vaiarelli

Ludovica sat down on a chair, looking to the right whilst smiling at someone
She leads efforts to cultivate and strengthen strategic collaborations in vaccine research and production. She works closely with academia, policymakers, and industry partners to drive innovation, enhance pandemic preparedness, and advance global health initiatives. She holds a BSc in Bioprocessing of New Medicines with Business and Management and an MSc in Bioscience Entrepreneurship from UCL. Previously, she served as the Outreach Coordinator for the original VaxHub, spearheading public engagement through webinars and two YouTube series while also developing and managing training programmes in vaccine development and production. Additionally, she co-leads a long-term outreach initiative in schools, inspiring younger generations to explore vaccine development and biochemical engineering.

 

 

 

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Transcript

Ferdouse Akhter  00:05

Hi and welcome to Health in a Handbasket. I'm your host, Ferdouse, Community and Marketing Manager at UCL's Institute of Healthcare Engineering and today we're talking about vaccines. So, most of us have had one at some point, but how are they made? How does something like the COVID vaccine come into the market so quickly we're talking about vaccine hubs around the UK, especially the one we have at UCL. And to do this, I'm joined by Ludovica Vaiarelli and Stephen Morris. So Ludovica, what do you do at UCL? So I

Ludovica Vaiarelli  00:33

So I work in the UCL Biochemical Engineering Department, and I am the partners relations manager for a vaccine research hub, which is a collaboration between UCL and Oxford University. So that is VaxHub  And Steven.

Stephen Morris  00:47

Yeah, I'm also part of the same baxub organization. Originally, I started out I was one of the senior researchers, but my role now has much moved more into education, and my official title is outreach and public engagement management.

Ferdouse Akhter  01:02

Let's start off with VaxHub. You kind of mentioned it a little bit there - Ludovica about it being collaboration with Oxford, but what do you do within the VaxHub.

Ludovica Vaiarelli  01:11

So VaxHub started in 2018 as a collaboration Oxford and University College London, and then it ran for over five years until August 2023. The research mainly was on vaccine manufacturing, vaccine platforms dedicated to the low and middle income countries, so developing and improving vaccine platforms for the benefit of low and middle income countries. Then from september 2023 we started two new initiatives calledVaxHub sustainable and VaxHub global. So these are two separate awards, government funded. So both hubs are working with what we call vaccine platforms. They are not disease specific. When we talk about vaccine platforms, we talk about technologies that can be used and adapted to the targeting of different type of diseases. So we are currently working with RNA vaccines, glyco conjugate vaccines, virus like particle vaccines, adenoviruses and subunit vaccines.

Ferdouse Akhter  02:11

So I guess you're kind of creating the blueprints for future vaccine rollouts and stuff.

Stephen Morris  02:17

Yes, I guess that's, that's that is indeed part of it. So we're very much focusing on methodologies that will enable faster and more cost effective development of vaccines, so physical, experimental methodologies and production methodologies which can be applied not just to the production of one specific type of vaccine to want to a specific disease the same technology, to be able to combat various diseases by producing vaccines using the same platform technology. So examples of that are things like the mRNA, which is easily transferred from one disease to another, the adenovirus vector based vaccines, and to some extent, things like virus like particles, although those are slightly more bespoke in their specific applications.

Ferdouse Akhter  03:07

So when you say hub, I normally think of like a building white lab coats, you know, you know the stuff you see in like movies of like with pipettes and stuff. But I'm guessing that's not what this is.

Ludovica Vaiarelli  03:17

Well, partly the hub itself is structure. It has at the core UCL and Oxford as the two main institutions, the co-lead the hub research. Then we have academic spoke institutions. So for example, other universities such as the University of Leeds, London, School of Hygiene and Tropical Medicine, University of Manchester, Cardiff. And then we have also industry partners. So the idea of the hub is really to bring together all the expertise out there, both from academia and from industry, and to really try to catalyze that meaningful change in developing innovative and more sustainable vaccines for the benefit of all so you can picture the work of the research of the hub, of course, most of it runs into our labs in academia, discoveries that we make in academia to test their scalability, for example, in industry, and to see whether those can actually become vaccines that we can then effectively deploy and ultimately enable the leaders to actually reach the people.

Ferdouse Akhter  04:21

That's something that we forget as well, is that is we always think, why does it take so long to find a cure for cancer or this, that, and the other is that between research and it getting to the people is actually a very long process, yeah. And this kind of helps fasten the process a little bit, I guess, absolutely.

Ludovica Vaiarelli  04:37

Absolutely, And also, I mean, we come from the UCL department of Biochemical Engineering. When we, for example, we did some outreach work in schools, and when we talk with students and we ask them, How do you picture vaccine development, they picture people in the labs. But we tend to forget that actually, when it's about producing a lot of vaccines, what we really need is to have industry capacity to produce those vaccines, and engineers actually involved in the manufacturing process, so to actually scale up the research done in labs and make sure that, you know, from a tiny amount of vaccine, we can actually end up with millions of doses. And those doses, not only we need them for, you know, people that can easily access them, but also people that, for example, live in remote places. So we need to make sure that those vaccines are technologically developed in such ways that can reach everyone. And this is where the platform manufacturing concept comes into play, more than anything, improving those platforms to make those accessible.

Ferdouse Akhter  05:41

Stephen, you do a lot of work in the lab, but like Ludovica said, is also a bit more than that.

Stephen Morris  05:47

I mean, lab, lab work is very much as an essential part. So you're asking about, do you see you say you see it as a sort of people in white coats in labs. But the important thing again, to remember, with, with with vaccine development and all viral manufacturing development is that you've got you go to a whole scale of things. So you start off relatively small, doing lab based experiments in the way that people would most think of science labs, usually university science labs, but can be industry based as well. I've done both at relatively small scale, but then to take the thing out, to make it useful, then we have to scale it up. And a lot of our work is then, once you've got the product that you want, is then the challenges of taking that form a relatively small amount that you can make in a standard science lab, you know, maybe a few liters of product, but for a real vaccine rollout, you probably want 1000s of liters of product. And then how you translate that into an industry scale process. All of that can happen within the different aspects of the VaxHub again. So we have, like labs which are very much involved at the very much of the bench scale development in both at UCL and Oxford and then, but then we also have within the engineering faculty, in the Biochemical Engineering, we have a pilot plant facility where we can scale up from the normal sort of bench scale of a couple of liters all the way up to 100 liters, which is then allows you to solve the various technical issues in scaling things up. So within the VAX hub, we cover all of the different scales of laboratory work, from the very basics of what people think of people in like white coats in labs, through to the sort of medium to large scale engineering and clinical production.

Ferdouse Akhter  08:00

What are some notable case studies that you can tell me about? Of some work that you've done

Stephen Hughes  08:05

notable case well, there's been a number of case studies within the within the hubs as such, probably the one that most people will know about is the work that was done. Some of it was done within the hub, initial on the AstraZeneca COVID vaccine, which was developed initially in Oxford, and various parts of the hub were involved in the scale up process, of which were then allowed the tech transfer to AstraZeneca. That's the one that everyone will know about. But also within within the hub, we've been involved in a number of other partner institutions, one of which is very much with the London School of Hygiene and Tropical Medicine manufacturing processes for what we call glyco conjugate vaccines, which are vaccines to bacteria and are a combination of both sugar and protein antigens. Traditionally, those are very complicated to make. They're very important vaccines. Some of the most important vaccines for global health are glyco conjugate vaccines, but the manufacturing, traditional manufacturing process, are very complicated things. So what the guys at the London School of Hygiene, tropical medicine, they're working on a completely different way of what we call bio conjugation, which is a completely different way, instead of doing chemical reactions, to doing letting the bio part, letting the bacteria do the work for us. So we've made quite a lot of progress on sort of how to scale that into a smooth and industrial type platform every I say, within COVID, everyone knew about the mRNA and the adenovirus based vaccines, but probably also you're aware that not every country got easy access to those vaccines. So for example, our partner in Indonesia, they had difficulty getting enough vaccines, and decided to go down the route of developing their own, what we call a protein subunit based vaccine. So we've been working in partnership with them to improve and tech transfer better.  Scaled up process for that, and we've been working on new ways of making both rabies and dengue virus vaccines within the hub. So there are a number of projects going on within the hub, resistances which will either have made significant impact or will be, I'm sure, will be making significant impact.

Ferdouse Akhter  10:17

Yes. So talking of that, I feel like we're in a very privileged position in the UK, in that we do have quite good access to vaccines. But like you were saying in Indonesia, or I read a stat about Africa, where I think a lot of tropical viruses do come from Africa because of climate change, and, you know, other reasons as well, but they only have 1% of manufacturing capabilities. So how is the VAX hub helping to kind of mitigate that.

Ludovica Vaiarelli  10:41

That's a really good question. The way in which vaccine research is trying to address those. I think there are multiple issues here. One issue is the fact that the manufacturing of vaccines tends to be quite centralized. And as you were saying, there is not enough capability in Africa to produce vaccines for the population. So the majority of it's, as you were saying, imported. So one aspect is enabling localized manufacturing in Africa. The aspect on which Vax Hub have is mainly working on is on enabling more term vaccines. So for example, with the RNA vaccines, Pfizer and moderna had requirements of very low temperatures. It's what we call cold chain so cold chain maintenance can be very difficult in certain areas of the of the world and less developed areas, such as some parts of Africa. And so to reach those communities, it is important to have vaccines that can, for example, stay at fridge temperature, and to do that, we channel our research on those type of technologies that can enable more term, stable formulations of vaccines.

Ferdouse Akhter  11:53

So is that like helping to create specific type of fridges or making sure that the vaccines can work at higher temperatures?

Speaker 1  12:00

Well, there are two aspects of that. We do have partners within the hub who are interested in sort of producing, maybe not necessarily fridges, but containers which are easier to transport. It's not just enough to get a lot of vaccine to a centralized clinic. Usually, when you're talking about a sort of African or low middle income country situations, what you've usually got the biggest challenge is often actually getting that then distributed to local areas for actual injection into people where they need to be. So there are certainly partners within the hub are working on sort of, maybe not partly. So we don't need the cold chain, or where we do need the cold chain having better ways of making it more transportable, more easily transportable. There's more simplified manufacturing technologies, such, for example, such as what I was just describing for the glyco conjugate vaccines. Once those start to come through to manufacturing scale those technologies, because they are much simpler than the traditional ways of doing things, they're going to make it much or should make it much easier to build smaller facilities in countries that, at the moment don't have those capacities for the for the big manufacturing plants, the big complicated chemistry plants, because there won't be any, hopefully there won't be such a need for that to be able to build those sort of facilities much more cost effectively within low income environments and countries.

Ferdouse Akhter  13:22

So do you think things like Dengue will carry northwards?

Stephen Morris  13:25

Yes they already have!

Ferdouse Akhter  13:28

Okay, so how would you say climate change has affected the spread of diseases?

Stephen Morris  13:34

It certainly is affecting the spread of diseases, and it's making them so, you know, especially, especially the sort of things, diseases such such as dengue and Zika, which are insect born carriers. Dengue is a mosquito borne disease, and those insects are starting to travel northwards, and they will become an issue. They bring those diseases with us. It will make an issue, also from the point of view of population changes. So, you know, as long it's not the just the insects that will be moving, but people will be will be moving. And when, when that happens, you get bigger areas of concentration, you can get easily a  transmission of disease that you weren't having before. And new diseases will occur, and we'll have lots of challenges. There is a plus side in that, in the sense, at least, that's the way that I see it is the things that at least, the fact that some of these diseases are becoming more of an issue through the developed world, that maybe has been sort of not ignoring them, but not giving them a high priority in the past, because they weren't an issue for the population. It's quite possible and very highly likely, that these diseases, such as dengue, start to become more an issue to us in the in the richer part of the world, that we'll get the impetus that we haven't had in the past to produce the vaccines and the treatments for them.

Ferdouse Akhter  14:54

I was reading about a recent one like the marbug.

Stephen Morris  14:56

That is one we don't want anywhere.

Ferdouse Akhter  14:59

Yeah. Exactly. I think the fatality rate was something like 85% I guess the quicker we do have vaccines at a stage where they can just be rolled out, the better it is for stuff like Marburg or dengue.

Stephen Morris  15:09

Yeah. I mean, one shouldn't underestimate that the challenge, you know, the biology challenges of developing these things. You know, there are some vaccines are just very hard to make. We don't know enough about the biology of something still certain viruses and certain bacteria and certain, particularly protozoa, are very challenged, still very challenging from the biology in terms of actually producing good vaccines to protect against them. So it's not just manufacturing challenges. There's a lot of basic biology that we need to be able to get better at as well.

Ferdouse Akhter  15:42

How do you tackle viruses evolving after you've created the vaccine?

Stephen Morris  15:46

That is relatively easy, because we, in a way, we've been doing that for decades now with influenza. So every we have flu vaccines, which work very well. Influenza is one of the viruses that does change very quickly, because it has two it doesn't just mutate, but it can make very large jumps in changes, which is what people talk about, h1, n1, h3, those are sort of very big where it makes very big jump changes. But we can accommodate that by changing the character slightly of the vaccines so that they can be still manufacture, usually manufactured being the same, but use the same process, we can just sort of change what we call the the antigens with that we put in there. So we've been doing that with flu for quite a long time. The trick with flu to do it is that we have a global surveillance system, and it's seasonal, so it's fairly easy to predict in advance what the most likely change will be next. Sometimes we get it very wrong, and you will see that some seasonal flu vaccines are actually more effective than others, and that's the that's that's why that happens. But I think once we've got a vaccine, we can usually re accommodate most mutation changes within that

Ferdouse Akhter  17:03

Is that because you monitor on like a global scale, or is that with just within, like England?

Stephen Morris  17:07

flu is monitoring globally, and we'll have to do more of that with other pathogens as well as they as they move. But because the flu is one of these things, which is global and seasonal, so pretty much the viruses, the way it tends to work is that the viruses that Australia has in this season, we will get in the following season, not all viruses are seasonal, and some go through what we call waves. COVID Originally, the what there was a lot of talk about it being seasonal. I think now pretty much the virology community would admit that, agree that that it is not a seasonal virus. It does go in waves of infectivity, but it is not predictable, in the same way that a flu season is predictable. Other things such as respiratory syncytial virus almost go in two year seasons. For some reason, it's a vaccine that the NHS has last year just started to use,

Ferdouse Akhter  18:02

and is that like a emerging kind of virus?

Stephen Morris  18:05

Yeah, it's emerging, but it's also taken us quite a long time to produce it's one of been one of the challenging ones to get an effective vaccine, too. So it's not emerging in the sense that it wasn't new, in the way that COVID 19 was SARS cov two. We've known about RSV for a lot longer, but it has been much more of a challenge to produce an effective vaccine to it.

Ferdouse Akhter  18:25

So how do you monitor these emerging pathogens?

Stephen Morris  18:29

So things like things like influenza, flu, we have a very well established because we know it goes through cycles. We know that hit transfers easily from birds. So we are constantly that we have active, ongoing monitoring, worldwide monitoring programs to monitor what which viruses are at any one point in time, most prevalent at any one location in the world. And there are numerous studies along those sort of lines going on, but there are lots of also smaller scale, but very important, and and hopefully will become more funded and more important, is to try and sort of look at viruses and pathogens that are in animal populations that we know do harbor potentially dangerous viruses that may need vaccines too, but that's much harder to predict. That's that's much harder. One of the challenges all of that is coordination, is trying to bring all of the different monitoring programs to get rapid data sharing and coordination of them so that we can predict what's going to happen faster. Well, the challenges will be faster. AI technology is almost certainly going to help us in that, but it's still not at the stage yet where it's going to solve all the issues we certainly can't at the moment say that virus in in a bat in Southeast Asia is going to transfer to us and cause a problem. That's what we'd like to be able to do, but we're still a long way off being able to do those sorts of things.

Ferdouse Akhter  20:47

Why are we focused on global health instead of just focusing on pathogens in England or in our local communities? People might be like, Oh, why is it the West problem to kind of like, manufacture vaccines for things that happen elsewhere. So why is it that we're helping manufacture vaccines for low and middle income countries, when those pathogens don't exist here?

Ludovica Vaiarelli  21:09

I mean, to an extent, pathogens don't really have boundaries. So especially with, as Stephen was mentioning before, with a world that is so globalized, and with the traveling that we see nowadays, the spread of pathogens is so much quicker. So to an extent, we are never really safe anywhere, until everyone is safe, which is, I guess, one of the reasons why, for from a national health care security sort of strategy, it's also really important to contribute to global health maintenance. And I mean, we've seen it with COVID. It's it has spread everywhere in very short time, and there will be huge pandemics where, no matter where the next epidemics will start, it will likely reach us. Depends on the, obviously, on the, on the pathogens that we are talking about, but I think that the whole idea is just that we are not safe here in the UK, knowing that pathogens are developing and spreading elsewhere, especially if they're becoming resistant, for example, to medicines that we currently use to treat the diseases that are caused by these pathogens, infections. So the whole conversation about antimicrobial resistance, I think, is very relevant here, and we see an increasing number of pathogens globally and also nationally. Here, again, there is no such a defined difference, but of pathogens that are developing resistance to, for example, antibiotics that we have, and once that happens, that becomes a massive health threat of global concern. So I think this is the reason why the government is channeling resources and budget towards the development of manufacturing, well more than manufacturing vaccine accessibility. To improve vaccine accessibility globally, and not only in the UK, because it does affect us all and about antimicrobial resistance, again, the conversation has to be on a global level. We can just think about what's happening right now here. We can predict them to an extent. But I think the best way of approaching this is try to prevent, actually, the spread of of these resistant pathogens, so that we don't even need to use the antibiotics that we have, if we're lucky enough to be able to minimize, you know, the spread of infections we if we don't have people infected, we don't have people that need to be cured with antibiotics. So I think there is growing interest, along with concern, for this sort of matters public health.

Stephen Morris  23:47

Again, this is, this is sort of coming back to a lot of vaccine manufacturers being very much based on the design of very large, centralized, relatively expensive to build, but on an economic model which which is on the theory of economies of scale, that if you build one very big factory, which is usually located somewhere within the US or or Europe, that you'll then be able to make a lot of vaccine, um. Which you which you can then supply relatively economically, but again, movement towards sort of manufacturing technologies which will allow more distributed, smaller scale manufacturing units make them financially feasible and possible, then we'll be able to get more localized manufacture that'll have the advantages that you don't need to transport things you won't necessarily in pandemic situations, run into the the sort of vaccine nationalism that can happen, which is fully understandable any any country is going to say, Well, we are making vaccines. We should protect our own people first. I mean that, I think, is any government's responsibility so, but it's understandable, but it's not good from a worldwide point of view. So new technologies will, will, will enable, hopefully, enable more chance of manufacturing within low income countries situations. We can move much in manufacture to to situations. So, I mean, a lot of people may be not, not aware that India now, I think, is not a low income country, but it was. It certainly was. But India is now, in terms of sheer numbers of vaccine doses produced, is the one of the world's largest producer of vaccine doses, maybe not from the point of view of income generation, because they tend to focus very much on producing vaccines, which will then be for low income settings. But they also that, but they've shown that it is possible to produce large, really become major vaccine manufacturers. You don't have to be located in Western Europe or the US. Africa Has been a problem that I think, partly from the point of view of funding, partly from the point of view of political instability. It's a few decades ago. There was a sort of biome,Well, chemical manufacturing in Africa was was relatively advanced, and that seemed to sort of suffer. It's all it. There are issues. There are lots of complicated issues. Some of it is in terms of having people who are who it's not just enough to be able to see you build a manufacturing facility, you have to have people who can operate that facility. Train people that can operate that facility. If you don't have the manufacturing facilities, then have the people get trained. And you and it is a very sort of chicken and egg situation, trying to move move things that forward. But I think, you know, the success of Indian and Indonesia is following very much along the same same same lines. Indonesia is also becoming a major manufactured vaccine manufacturer, and under other countries which will follow. So I think that if we may enable technologies such as we are trying to do within Vax, harbor things which could be more easily transferred, require less complicated manufacturing facilities to be built, and also that training of personnel, ways that people can get trained, to train local communities more to be able to manufacture. It will happen, but it's not happening rather slowly. I'm afraid.

Ferdouse Akhter  28:03

I did read online as all that, because it's cheaper to manufacture vaccines in India, is it's harder to even start it up in places like Africa, just because, when you can get it cheaper, why would you kind of do it in house?

Stephen Morris  28:16

There is that. So again, there are you've got, you've got to remember that even within the vaccine manufacturing, there is differential pricing. So there are organizations such as Gavi, the Global Alliance for Vaccines and immunization, who do deals with vaccines manufacturers to supply to low income countries at a lower price. So even the big companies will have differential pricing. One of the big established, I'm not going to name anyone, because they but they will, will, will sell vaccines to us and the US the same vaccine at a higher price than they will sell to an African country. It makes, it makes economic sense, because otherwise, if you try and sell at the same price, the price that the African countries, since can't afford then you have no market there. It's better to have some market than liberal market. It is complicated in terms of who gets subsidies and who doesn't. And there is a you know, as you say, that India has become so large and does make it so the African countries maybe are trying to compete with them. I still think that it will happen.

Ferdouse Akhter  29:17

So recently, Chris Whitty, England's chief medical officer said that a future pandemic like COVID is inevitable. So what does he mean by this?

Stephen Morris  29:25

It is inevitable. I mean pathogens will, will evolve and will change, and will will take us by surprise.

Ludovica Vaiarelli  29:32

Yeah, I think it's what we were saying before. I think it's just nature, isn't it? You know, pathogens evolves and again, going back to the antimicrobial resistance topic. It is natural for pathogens to develop resistance to, for example, antibiotics. This is just a natural evolutionary behavior. So I think this is just part of life. I think what vaccines can offer is a way to sort of prevent the spread. And the spread of these pathogens, I think to answer your question is just really what nature pathogens will have always circulated. They have always been infectious diseases, right? And it will keep being like that. I think with technology advancement and medical advancement, what we can do is really try to prevent how those affect us and try to be really preventative, rather than just manage with the treatment.

Ferdouse Akhter  30:26

A lot of anti microbial resistance is kind of linked to like the use of antibiotics, or the overuse of antibiotics in like poultry and stuff like that. How do we tackle that? How do we get to the root of it? How are you helping to get to the root of it?

Ludovica Vaiarelli  30:40

I mean, I think the first thing is to spread awareness of this issue. I don't think we talk enough about that. And in you know, the general population doesn't necessarily know what antimicrobial resistance is of if they've heard of it, they don't probably realize how much it will impact our lives in the future, in the near future. So the predictions of actually, mortality caused by antimicrobial resistance in the western world are increasingly well, are projected to be very, very high, and I don't think there is awareness of that. And this is not to, you know, scare people, but it's just to make people aware of how, how can we try to prevent this? And obviously sanitation is one way of doing that, reducing consumption of certain type of products and just in general, being aware and trying to have a more sustainable behavior.

Stephen Morris  31:30

Antibody resistance occurs due to the use of antibiotics, as you correctly said. So the more you use them, the more evolutionary pressure you put on the microbe to evolve resistance. If you have a vaccine to a disease and people are vaccinated to it, there will still be some people who will become infected, and you'll need to treat them. And again, this is something we shouldn't forget about. We shouldn't sort of say vaccine development versus antibiotic development. We will need both, but in an ideal situation, we will be protecting most of the population from with a vaccine so that so they don't become infected. And then the ones who have been infected, we will have antibiotics to treat, and because we'll be using less of those, then the evolutionary pressure is less on the on the on the microbe to evolve a resistance to it. So anti microbial resistance probably will still happen, but the rate that it evolves will be much slower if we cut down the rate of infection. So I think it's important to remember that we need both working together.

Ferdouse Akhter  32:36

How is the VAX hub team working with policy to achieve things in low and middle income countries, but also in England.

Ludovica Vaiarelli  32:43

So Vax Hub has a policy advisor based at UCL, and she is working heavily in engaging with policy makers and industry as well and academia, and just trying to really come up with the strategies then bring back to policy makers in order to make sure that they understand what the research needs and how we can make sure that we develop policies that are in line with research.

Stephen Morris  33:09

We have some very specific UK issues in terms of certain vaccines that some communities are not happy to take up as readily as some other communities, that very much can have very localized levels of that, and then the more global issues. And I think the policy unit is more sort of, is there to try and sort of make sure that there is still the political aspect is covered in these things, because as developers and manufacturers, we can make a vaccine, but it's only as good as if it get when it gets delivered, if people, either for whatever reason, don't want to take it or can't take it, or don't have the infrastructure which supports them to take it, or the community structure that supports them to take it, these are all important things, which, if we want to have to use vaccines to improve, all the way from local community up to worldwide health, we have to address, and you can't do that without involving policy and politics.

Ferdouse Akhter  34:51

I mean, I guess Vax Hub in itself is a bit of a political statement, because you got funding from the government who had interests in vaccine procurement and so on. And. And that's why, I mean, we're all here today talking about Vax Hub up so guess it does all line very politically. I also want to talk about a bit about your outreach work. So apart from working with politicians or, you know, lobbyists and so on, you do a lot of work with schools and the local community. So can you tell me a bit about what you're trying to achieve there?

Stephen Morris  35:19

One of the aims is to just raise awareness of the importance of vaccines, to try and get and say there are some communities that are not as actively at participating in vaccination programs as they could be, to try and try and understand what the barriers are to those and again, that sort of feeds crossover between outreach and policy through to actually just making promoting better understanding of what vaccines are through this community, and particularly sort of within with a lot of schools programs, and also from the point of view of understanding the interrelationship between science and engineering and policy and Funding and management. Because one example that we both developed this, this program very much together, and our typical thing is, if we go into a school group and we and we ask people, Who do you think makes vaccines, pretty much along the lines of what you said. You know, people talk about people in white, white coats, in laboratories, if we ask them what you want to study to make, if you're interested in making, they'll say, medicine. There's not real public perception of the idea of I mean, they're quite correct. Vaccines are initially developed in laboratories by white coats, but how you get that from a laboratory to those millions of files that that we need to make a worldwide impact? So we want better understanding of that, in the hope that the people understand it better, they'll have more confidence in it. But also from the point of view of as we're talking about we or if we're going to expand this, we need to have people who are interested in working in these fields, and to try and expand young people's horizons in terms of their potential futures. Are you interested in your talk to you about vaccines? Are you interested? Would you like to make a contribution to this? Yes, but I don't think I want to study medicine. Well, you don't need to study medicine. You could study engineering, you could study politics, you could study the business aspect of these things. All of these things make a very big, important contribution, and we try to teach that interrelationship thing. And I think the important thing to remember is that that's not just true of vaccines are my personal obsession and the VAX hub obsession, but those sort of interrelationships are true of anything. Pretty much in the modern world, you're not just making developing a one one product. There's a whole array of occupations and interrelationships that have to go on to bring something from a research point of view to a worldwide useful point of view. We use vaccines as an example, but it applies to most of the modern world,

Ferdouse Akhter  37:54

apart from trying to get more people involved in it. Where does the future of Vax hub stand?

Stephen Morris  38:00

So Vax Hub sustainable is an initiative of seven years and backs up global four years and a half. What we're trying to do now is to build a shared network so that our partners can get the most out of both. But there is a lot of work ahead. Part of it has to do with Vax hub industry interactions. So we will be working with industry partners globally in order to enable, as we were saying before tech transfer, we will be doing that through feasibility studies, so projects mainly in collaboration, could be academia with industry or industry with industry. And then we will keep going with the outreach work, policy work, and also training. So we do have a training strategy in order to, as we were mentioning as well before, enable and promote the upskilling of personnel in the industry, both locally but also globally.

Ferdouse Akhter  39:38

I didn't know it was that complex. And also, I think we can talk about this forever, but we're running out of time. Thank you both for speaking to me today. It's been a pleasure, and showing me or telling me that research isn't just a white lab coat and a pipette like you see on TV, but rather collaborative effort. So thank you both for coming in today.

Ludovica Vaiarelli  39:59

Thank you for. Having us.

Ferdouse Akhter  40:04

This has been held in a hand basket produced by UCL Institute of Healthcare Engineering and edited by Shakira Crawford from Waltham Forest's Futures Formed. What's the Institute of Healthcare Engineering? Well, let me tell you the it brings together leading researchers to develop the tools and devices that will make your life better. We're using this podcast to share all the amazing work taking place, but there's so much more going on, so please check out our website@ucl.ac.uk fourth slash health dash in dash a dash hand basket to find out more, and please share with your friends and family. If you found this interesting, we're available everywhere, especially where you've just listened to us.