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Transcript: Episode 32
Is the vaccine the beginning of the end?
SUMMARY KEYWORDS
vaccine, logistics, ucl, manufacturing, pandemic, oxford, programme, centre, uk, people, absolutely, middle income countries, vaccine manufacturer, podcast, martina, christmas, technologies, year, factories, pfizer
SPEAKERS
Martina Micheletti, Vivienne Parry
Vivienne Parry 00:00
Hello and welcome to Coronavirus: The Whole Story. My name is Vivienne Parry. I'm a writer, broadcaster, UCL alumna and the host of this award winning podcast, which brings you a unique perspective on the pandemic, by telling its story through UCL research and researchers. If you told me back in March that just before Christmas, the first people would be receiving a COVID vaccine with 90% efficacy, I wouldn't have believed you. But this week, we finally got there, with Margaret Kenan becoming the first person in the world to receive a COVID vaccine outside of a trial. And yes, of course, we know that this is only the beginning of the end, and that there's a long hard road to travel still. But it doesn't take away from the extraordinary achievement that this represents. You know, despite the assertions of various ministers, does it do anything else but highlight the value and importance of collaboration across borders and across disciplines? We've talked about vaccines before on this podcast, but now we're returning to the topic and to that hard road ahead and how best to negotiate it. If you want to listen to the previous episodes on vaccination, or indeed any of the other fascinating subjects we've covered in the 32 episodes of the pod to date, and I certainly never saw that one coming. All of our previous episodes are available on the UCL Minds website. For this week's episode, I have only one guest to introduce, and she's the only guest we need. Professor Martina Micheletti is professor of bioprocess fluid dynamics in the department of Biochemical Engineering, and co director of the future vaccine manufacturing hub Vax Hub, which works to secure the supply of essential vaccines. Welcome, Martina. And let's just start
Martina Micheletti 01:44
cavion. Thank you for inviting me to this podcast. It's a pleasure for me to be here.
Vivienne Parry 01:51
And did you celebrate when that first shot of vaccine went in to the arm of Margaret Keenan,
Martina Micheletti 01:59
it was definitely very important today, you know, in general, for you know, our global society, in particular, probably for the scientific community working on vaccine manufacturing.
Vivienne Parry 02:09
So it was a day of celebration. But as I said, there's a long hard road still to travel. Let's start if we may, with an overview of the current vaccine situation. So currently Pfizer is being used in a mass vaccination programme here. And I think I'm right in saying that Canada also has authorization, but there are other vaccines still in development? How are they different? And how are they doing?
Martina Micheletti 02:30
Yes. So the second one online, I would say is there more than one, I believe they have submitted approval definitely in in the US. So it seems that they are next one online, still, like similar to the Pfizer biotech one, that's the vaccine that requires quite a cold temperature. So minus 270, which obviously might involve some some logistics challenges there. And then we obviously have the Oxford AstraZeneca. The press in the UK have greatly covered this, this vaccine, and it looks like is again, close to approval, this vaccine is has different characteristics and requires only four degrees for each temperature. So in the way logistics there is it easier, I felt
Vivienne Parry 03:19
a bit sorry for the developers of the vaccine, because it kind of got given a b minus when in fact tach was it was a triumph. And it was just how it appeared, I guess, next to the others. But it is still a very important vaccine. And this idea that there might be a different dosing regime is one that also needs to be sorted out, isn't it?
Martina Micheletti 03:42
Definitely. So I feel sorry, of course for for my colleagues or for having some sort of negative press there. So as you probably know, a pharma company has to announce, you know, as soon as they have their first analysis of the clinical trial state that they have to announce the results, because obviously, they have smokiness, isn't it? Exactly, yes, they have an impact on on their share prices. And that doesn't give scientists the opportunity to publish the data. Now Oxford has now published their data on the Lancet, which is a peer reviewed journals. And obviously, that is very important for the scientific community to have a look at this data and then realise for themselves the efficacy and the strength of those of those two studies.
Vivienne Parry 04:29
And what's exciting about the oxy vaccine is it seems to play a role in the reduction of transmission. And that's something that we're all very keen to see. Because if you stop people being very old with COVID, that's great. But actually, if they can still infect other people because they are still shedding virus, if they get it, that's not so good.
Martina Micheletti 04:53
Yeah, absolutely. Absolutely. And this is something that they have an on demonstrate that to a certain extent with this data and I would also make another point that, you know, the, we do need a large number of doses in order to cover the entire population. So we do need this sort of multiple approach to, you know, different vaccines that that work. Because we need to be realistic about this. If we live in a global society, we have never get rid of this infection in unless the vaccine reached out to the wider the wider world and populations of different countries in terms of
Vivienne Parry 05:29
the vaccination programme. And I should come clean here and say that I was a member of the Joint Committee on vaccination and immunisation for many years, actually, at the time of the last pandemic. And I I know that one of the big things is that for each and every disease, there's a different roster of people who are vulnerable. So in terms of this vaccination programme, who's been vaccinated first, and why,
Martina Micheletti 05:54
it really depends on I think that regulatory approval, and obviously, different clinical trials might have addressed a, you know, certain group of population of, you know, different ages, for example, you know, it was in the press, and it is in The Lancet communication, for example, the Oxford vaccine AstraZeneca vaccine has targeted a population that is up to 55 years old. And so there are good literary bodies, we look at those data, and then, you know, design, essentially define who can get that vaccine.
Vivienne Parry 06:28
And there's some logistics here too, because, for instance, because of the need for the rather extreme cold chain for the Pfizer vaccine, that puts a limit on where you can roll it out to
Martina Micheletti 06:42
Yeah, absolutely. So that vaccine is manufactured, I believe in in Belgium, so of course, that is no sort of easiest, the, it's easier to be transported to to to the UK, and then and then store to so there are logistics challenges. But it is possible, in my opinion, you know, within Europe to have, you know, this this sort of cold chain distribution. And when it comes really challenging is for for this to be distributed to Asia and to different African countries, for example.
Vivienne Parry 07:13
And if you have a vaccine that shows very good efficacy in the under 50s, but not so good efficacy in the older age group who are more at risk from COVID. Is there an argument there that actually then the vaccine should be given to younger age groups in order to prevent some transmission?
Martina Micheletti 07:32
I mean, absolutely, this is essentially what probably is going to happen once this, this vaccine is going to is going to get approval. And we shouldn't also forget that, you know, lots of clinical trials are still ongoing. And my colleagues and for me, I think last week, they are planning clinical trials, for example, on pregnant women, and as well as on children. So we're sort of in a category of population. So we will have this data, essentially in different categories, but we just need to wait a little bit longer.
Vivienne Parry 08:04
Luckily, pregnant women don't seem to be particularly at risk. Whereas in with the swine flu pandemic, pregnant women were very seriously affected. So that's a that's that's a good thing. But the next question, of course, is logistics. Now, I spent one of the most thrilling evenings of my life. I'm not sitting next to a man from Tesco once who told me how lemonade, which apparently is the thing that we all drink at Christmas, I don't know why, but we do. How lemonade is transported around the country at Christmas time. And what an extraordinary logistics exercise that is. Well, this is lemonade plus, isn't it?
Martina Micheletti 08:48
Yeah, absolutely. So in what we what we have read in the process is really they disrupt the logistics effort to their Pfizer biotech put in place in the site, you know, almost I think 1000 BIOS boxes with sensors inside so that they sort of you know, there must be a sort of logistics centre, at the Pfizer side as the company is going to be responsible for the vaccine to be still a fictitious at the time over the time of distribution. So they need to to have temperature sensors to monitor that. So that I would say that has been, you know, quite quite costly,
Vivienne Parry 09:21
but some of the logistics, you know, that's what drug companies are really good at. But sometimes it's the last mile where logistics fail. Tell me a bit about the last mile.
Martina Micheletti 09:34
Well, you know, I mean, I'm not an expert on on the logistics there but i think it's it's quite a we need quite a big design exercise in at least in engineering terms to make sure that you know, once this this embedding potent box is open, you know, for the vials to actually be distributed effectively the in this four or five days that that's allowed to to happen. thing?
Vivienne Parry 10:00
Where are the weak spots in our logistics chain at the moment? And I'm assuming we're recording this, by the way, before there's been any decision about Deal or No Deal. But what are the and that, of course, might delay lots of things. But what are the weak points in the supply chain for vaccines?
Martina Micheletti 10:20
Well, in in general, you know, in the vaccine manufacturing process, there's lots of different types of supplies, feeding from, you know, the sort of cell engineering work down to the actual manufacturing process, you know, down to sort of feeling and preparing, preparing the vital started the logistics of the actual of the actual distribution. So it is, indeed, a very, very, very complex chain. And I think this is probably one of the things that in the UK, we have learned to, you know, that the supply chain, and especially the modelling of that is nice to be really looked at, especially in the case of a pandemic, where we want to work at a much, much, much faster rate,
Vivienne Parry 11:05
it is just extraordinary, really, the rates that this is developed, has the speed surprised you? I mean, you're in vaccines, has it surprised? You that it's been quite so quick?
Martina Micheletti 11:18
Well, maybe. Yeah. So yes, and no, it is, you know, in comparison to, you know, the ears, which are usually required to, to, to get the vaccine from, from discovery, let's say to being a product commercially available. You know, that has been quite an extraordinary speak to that, you know, different companies and universities have achieved in this instance, I would say that there has been large investments, obviously, because, you know, there was a pandemic, where the UK Government, you know, for example, in different other governments in Europe, and in the US, they were sort of losing. So there's a very big impact on the economy. And so there was lots of lots of cash from the UK, but also from from the US in today, for example, the Oxford is designing vaccines, which obviously, in a way supported the speed at which this, this has happened, I should also say that, specifically for the for the Oxford boxing within our vaccine manufacturing hub, we were already working on, you know, essentially ensuring the supply of essential vaccines in the case of an epidemic for that. So we were already working on technologies that could, in a way, speed up process development and manufacturing of those vaccines. And I think this has also sort of provided the basis for the work that then in Oxford, it took is provided in a way they the basis for for their work and why they the vaccine was developed. So quickly, do you think in some ways that this ushers in a golden age of vaccines, because there's been a lot of investment, and we're getting these RNA vaccines, which we've not seen before, and which are relatively easy to manufacture? Do you see those being used much more widely in the future, building on what we hope is the great success of this COVID vaccine, so you're correct their vision. So there is no commercially available product, which has been licenced using that technology. But it is remarkable how that technology could be in a way developed and manufacture. You know, quite quickly for for this pandemic, I would say that the the minus at the stability, the stability of those vaccines is something that definitely we want to do more research on in the future. But definitely, this is going to be one of the technologies that in the future to make at least a specific type of vaccine. And
Vivienne Parry 13:42
one of the interesting things I think, is we all rant on about pharmaceutical companies, and you know how bad and evil they are. But actually, this has shown that when there is a global crisis, the fact that they've got all those research laboratories, you know, ready and waiting to go, and that they're prepared to take these big risks. After all, they've been pre manufacturing, haven't they? They've been producing this stuff in advance. And actually, if the trials have gone wrong, they would have had to throw the whole lot away and lost absolute fortunes. So we do need the pharmaceutical companies to be making profit much there. We might hate it, because we need them in this kind of crisis.
Martina Micheletti 14:30
Yeah, absolutely. As you as you said that they have been in manufacturing early on and at risk. And that's not something that that happens. That happens in sort of a normal, you know, usual conditions for manufacturing or in your product.
Vivienne Parry 14:44
So let's now think globally, because of course, until everyone's safe, none of us are safe. water issues, and we've mentioned the cold chain, but what other issues do we need to overcome to ensure vaccine can reach everyone, even income immunities that are quite hard to access.
Martina Micheletti 15:02
Yeah. So I would say that we can what has happened before in the sort of vaccine manufacturing space in a Western Western countries and larger biopharma, you know me to those, those vaccines and then distributed to low and middle income countries, but there is, you know, maybe there's something different that we can do. And I'd like to suggest here. So within vac sub, we work with the low and middle income countries manufacturers, so that they can adopt some of their technologies, maybe make some efforts towards, you know, innovate in their processes, so that they become essentially better producers of the vaccines for their own people. And I think that in, you know, we work with companies, for example, in Indonesia, in Vietnam, in India, and they are only interested is to really make the vaccines for their own people when they need it. And I think that there could be an approach that could ensure a better access to vaccines for, you know, the larger population.
Vivienne Parry 16:06
And it's interesting, because organisations like GAVI, which sort of brings together people to develop new vaccines for low and middle income countries, they've always said that there should be, I don't know, factories somewhere that should be essentially, dark factories until you need them, because we tend to all scramble about at the last minute, but you do need this capacity, don't you to manufacture? And you've mentioned places in Indonesia, but actually, it's that it's also true of the UK, because we only used to have one vaccine manufacturing centre, which I think I'm right in saying was up in Liverpool. Now we have a couple more.
Martina Micheletti 16:45
Yeah, absolutely. So this is a probably stick capacity that either we need, but also, you know, imagine the older scientist and working into factories do who's training them? How can they be knowledgeable about, you know, new technologies, that are that are appealing etc, in order to, you know, in a way be current on process development, and new ways of manufacturing so that they can make the vaccines in and the number of sufficient a sufficient number of those is indication of an epidemic, for example. So in a very, very quickly and rapidly, it's true regarding the UK, my hub is a sort of 7 million investments for in West started in 2018. And that is equivalent one or a 10 million investment from you know, led by peers. So that is, you know, in a way, this the money of the investment made in fundamental vaccine, vaccine research, but it is true that in terms of the, you know, the actually manufacturing centres, until a few years ago, they were probably lacking. Now, the government has indeed invested in new centres. So you might have heard about vaccine manufacturing Innovation Centre, Vivek is going to be close to close to Oxford, it was not planned to do it independently. It was, you know, there were already plans in in place, but the pandemic as men that that their plans for opening going to be anticipated. And I mean, I was told that in summer, next year,
Vivienne Parry 18:18
we will have the first opening of the process development labs in the centre. Yes, that is if it's Phil and finished machine is not delayed on the high seas because of Brexit.
Martina Micheletti 18:29
Yeah, that's true.
Vivienne Parry 18:32
I just throw that out there. And the other thing that we should say is that we all assume that vaccines can be manufactured a bit like widgets in a factory that you put your, you put your metal in, or whatever it is, and then you get screws out the other end. But actually, vaccine manufacturers have biological process and sometimes it can go wrong for reasons that are not actually that
Martina Micheletti 18:54
clear. Yeah, absolutely. I mean, some of the the new technologies for example, the Oxford has is Annika vaccines relies on infecting mammalian cells. So when we talk about biological organisms use this sort of host expression systems. This is where there is a lot of inherent variability. And a lot of things as you say, could could go wrong. You need to make sure that you remove the impurities and the process related product related impurities and you don't have those are so you know, this is definitely I hope that the the defending for fundamental research is going to carry on to look at these issues and be better prepared in the future. Now machines
Vivienne Parry 19:35
now I don't know the answer to this, but is there a specific UCL course that trains people in the manufacturer of vaccines? Can I do an MSc in vaccine manufacturer,
Martina Micheletti 19:49
so I don't think that he's ever see. Well,
Vivienne Parry 19:54
David Price if you're listening, I think we need one of them.
Martina Micheletti 19:58
So they're different efforts. So they there are a number of courses on different aspects of vaccine manufacturing, not in a package of an MSc degree. But you know, for example, within the backs of We Are One of our aim was to support low and middle income countries, manufacturers employees to actually come to those courses. So we sponsored, we sponsored them. And you know, there is a variety of courses provided by the University of Oxford and probably other institutions in the UK, and in other institutions in the UK.
Vivienne Parry 20:32
And this particular, there are no other institutions. I was, I was wondering, because actually, we've, we used to say, with flu vaccines, you would have to have one egg to prepare one vaccine. But the problem with eggs is that they come from chickens, obviously, and chickens are prey to bird flu. And we've got an outbreak of bird flu at the moment, and in the flocks around the place. So, you know, you can see that actually, that approach really was very worrying place to put, if I can put it this way all our eggs. And actually, these new vaccines with so many different ways of production really do give us a much better and more assured range of products for the future that are less risky. And I don't mean risk in terms of health, I mean, risk in terms of manufacture.
Martina Micheletti 21:30
Absolutely. So you know, in some some, some of them are cheaper to make than others, we have not talked about cost, but the cost of making or manufacturing is definitely important factor here. And yeah, and there are ways in which we can further further reduce the cost, as well. And yeah, I totally agree. So the multiple approaches and the novel approaches that has been investigated the due to you know, the challenges of the pandemic, has been incredibly beneficial for for us for forever vaccine production in the future. But especially for low and middle income countries where commonly you know, which Sorry, I'm more and more definitely more subjected to the risk of an epidemic.
Vivienne Parry 22:12
So one final question. Often in these programmes, I give people my magic wand, and I am passing it's to you, Martina, because what would be the one thing that you could wave your magic wand, you think would most help the vaccine rollout and programme?
Martina Micheletti 22:31
In a way a difficult one, but, I mean, I really wish that we have enough doses to vaccinate the global population, approximately at the same time. Yeah.
Vivienne Parry 22:44
Well, I think that's a very good use of my my magic wand. Thank you so much. You've been listening to Coronavirus: The Whole Story. This episode was presented by myself Vivienne Parry, produced by UCL with support from the UCL Health of the Public and the UCL Grand Challenges and edited by the very splendid Cerys Bradley. I was joined today by Professor Martina Micheletti. If you'd like to hear any more of these podcasts from UCL Minds, subscribe wherever you download your podcasts, or visit ucl.ac.uk forward slash Coronavirus. This podcast is brought to you by UCL Minds bringing together UCL knowledge, insights and expertise through events, digital content and activities open to everyone. Now, this is our last episode until after Christmas, and I recorded pretty sure that I now have COVID a great Christmas gift for my sister. Thanks, sis. Although I assure you I'm doing fine. And all I can say to the fabulous UCL community out there is we know you've been working harder than perhaps ever in your lives over the last nine months. But it's okay to stop completely over Christmas to relax to recharge your batteries ready to come back for the fight that still remains. So however few of you there are around your table this Christmas. Have a good one and raise your glasses to a better year ahead. Bye for now. See you all in the new year!