Over 90 people registered to take part in this live event organised by the Infection and Immunity Research Network alongside our partners the Bristol Vaccine Centre.
The programme followed the path of vaccine development, from the cellular work which identifies how and where to attack a disease pathogen, through to manufacture, implementing vaccine policy, and delivering vaccines to populations. We welcomed 15 invited speakers who delivered 11 talks.
Brief summaries of the presentations are reproduced below, in order of appearance:
- Anu Goenka (Clinical Lecturer, School of Cellular and Molecular Medicine [CMM], University of Bristol [UoB]): Vaccine Antigen Discovery for Group A Streptococcus - A Step into the Multiverse? There are multiple factors in play for the lack of vaccines for clinically important pathogens, such as Strep A. Some progress has been made with methods such as reverse vaccinology (which uses the entire protein repertoire of each pathogen to select the best candidate vaccine antigens) to identify possible vaccine targets, but multiple approaches looking at transmission, colonisation, infection and severe disease of a pathogen need to be used together to address this lack.
- Fred Garzoni (CEO Imophoron Ltd): From bench to bedside: How we developed a thermostable COVID19 candidate vaccine during lockdown in Bristol. Imophoron is a start-up biotech company that developed ADDomerTM, a nanoparticle platform that is a self-assembling, thermotolerant protein, which permits rapid insertion of potentially hundreds of peptide and protein epitopes in each particle. The flexibility to design multi-epitope particles allows for small therapeutic doses of highly immunogenic vaccines. They used this platform to develop a particle targeting the SARS-CoV-2 virus and looked at three different delivery routes: subcutaneous, intramuscular and intranasal. The importance of working with industry to develop products that could be quickly and cost-effectively delivered to market was highlighted.
- Jack Stone (Research Fellow, Bristol Medical School [BMS], UoB): The population impact of herpes simplex virus type 2 (HSV-2) vaccination on the incidence of HSV-2, HIV and genital ulcer disease in South Africa: a mathematical modelling study. Herpes Simplex Virus-2 (HSV-2) is a lifelong sexually transmitted infection which can lead to several disease manifestations, most notably recurrent genital ulcer disease. South Africa (SA) has one of the highest rates of HSV-2 infection worldwide and is home to the largest population of people living with HIV globally. HIV and HSV-2 infections interact biologically, i.e. HSV-2 infection increases susceptibility to HIV; HSV-2 co-infection increases HIV viraemia and transmissibility; and HIV co-infection increases HSV-2 genital shedding and transmissibility. Jack was involved in a project that evaluated the impact of prophylactic and therapeutic vaccines in SA on population health in different settings. They concluded that vaccines offer two complementary approaches for reducing the large burden of HSV-2 infection and disease both in SA and globally, even with low efficacy vaccines.
- Andrea Collins (Senior Clinical Lecturer in Respiratory Medicine and Honorary Respiratory NHS Consultant, Liverpool University Hospitals Foundation Trust, Liverpool School of Tropical Medicine): Pneumonia, pneumococcal vaccinations & human pneumococcal challenge through an evolving landscape. Streptococcus pneumoniae is the main bacterial cause of community-acquired pneumonia, but only a third of children with bacterial pneumonia receive the required antibiotics, despite it being the leading killer of children under 5 - ergo the need for a global vaccination programme. Andrea and her team use controlled infection human models, i.e. they deliberately infect people with agents that cause or can cause disease which allows them to monitor and sample the host over a period of time. The data obtained allows them to test vaccine efficacy. The model allows smaller, more cost-effective data collection without the expense and numbers required for a full clinical trial, while still being able to define mechanisms of protection and control that can be extrapolated to population levels. Read more: The Experimental Human Pneumococcal Carriage (EHPC) collaboration
- Johanna Blee (Research Associate, Department of Engineering Mathematics, UoB): In-silico modelling for targeted drug delivery. Getting a drug to properly target an undesirable presence in the body faces many challenges, including removal by the body as part of its normal “cleansing” process, transport barriers, lack of penetration (for example, from the surface area of a tumour down to the main tumour itself), toxicity of the drug and/or its carrier, and heterogeneity (i.e. will it work the same across different patients and within the target itself). In silico modelling (computer simulations) can help understand the mechanisms the drug uses and identify the best design and dosage for a proposed drug, as well as suggest tailored treatment strategies. The method can process a large number of parameters and is cost and time efficient.
- Lucy Culliford (Senior Research Fellow, BMS, UoB): Delivering vaccine trials at speed - the ComFluCov experience alongside Sarah Baos, Maddie Clout, Rosie Harris and Rachel Todd (all UoB). The ComFluCov clinical trial looked at potential safety concerns and immune response to the COVID-19 and influenza vaccines if given at the same time. The team were approached in March 2021 with final results required by September 2021, which timed with the start of the annual flu jabs campaign. A clinical trial usually takes 8 months to set-up, with recruitment taking place over several years. This phenomenal team completed the set-up in three weeks, with all required paperwork and agreements signed off and approved prior to the April start. This multi-centre and multi-team effort overcame multiple obstacles and published results by the deadline, with the outcome being that it was safe to deliver both vaccines at the same time.
- Adam Finn (Professor of Paediatrics, CMM, UoB): Policy recommendations on COVID19 vaccines – the easy bits and the hard bits. During the COVID-19 pandemic the Joint Committee on Vaccination and Immunisation (JCVI) transformed from an obscure committee which used to meet three times a year to an entity very much in the public eye as they advised the government on a bi-weekly basis on the progress of the infection and the development and distribution of SARS-CoV-2 vaccines. Despite pressure from the government, especially with respect to immunisation of children aged 5-11, vilification in the press and on social media, members of the Committee provided impartial advice based on the scientific data available at the time. It was thanks to JCVI that health care professionals and social care workers were vaccinated in the first instance, followed by other priority groups such as first responders and key workers, in an effort to bring down rates of transmission and deaths which were very high during the first wave. The Committee also advised offering a larger number of the population a first dose to provide greater general immunity rather than focussing on second doses to a smaller number. Many of their decisions were proven by the evidence to be the right ones.
- Sandy Douglas (Pharmaceutical Physician & Wellcome Career Development Fellow, University of Oxford): Vaccine manufacturing for non-manufacturers. Manufacture of a vaccine accounts for a large proportion of a vaccine’s development budget but many researchers are not aware of the process or requirements for manufacture, e.g. immunology costs £150k, toxicology £100k, clinical trial costs £300k, GMP (good manufacturing process) manufacturing costs £1 million and more. Manufacture determines the scale of production and distribution of a product; ensuring equitable access is important. It was the manufacturing process that limited the steps of SARS-CoV-2 vaccines at every step due to approvals, sites, distribution agreements etc. How do you get your candidate vaccine manufactured for clinical trials? Your best bet is to seek help from those who have done it before. The GMP regularity framework is a mixture of international consensus guidance in some areas; national legislation, regularity guidance and regulatory compulsion; and local risk assessment, interpretation and certification. Need help? Speak to the Oxford Bioprocess & Analytical Development (‘BiPAD’) team.
- Sue Jones (Deputy Chief Nurse, Bristol, North Somerset and South Gloucestershire Vaccination Programme, NHS England): Bristol, North Somerset and South Gloucestershire (BNSSG) Vaccination Programme; delivery and uptake. Sue was one of the key people tasked with delivering COVID-19 vaccines in Bristol and oversaw the Ashton Gate vaccine centre. Ashton Gate was administering close to three thousand vaccines at the height of the campaign. However, efforts needed to be made to target more at-risk communities such as those with learning disabilities, ethnic and religious minorities, and pregnant women. They used a number of methods from community-roaming in local businesses (such as barber shops), designing child-friendly areas, home visits and working alongside community groups to address the challenges. A community-focussed approach, working with rather that at, communities, helped deliver tens of thousands more vaccines than the large centres could attract.
- Cat Hyams (Clinical Research Fellow, BMS, UoB): SARS-CoV-2 and other respiratory infections in hospitalised adults during the COVID-19 pandemic. The AVON-CAP study looked at acute lower respiratory tract disease (aLRTD) epidemiology and how incidence trends had been affected by COVID-19 and public health measures implemented to reduce its transmission, i.e. social distancing, the wearing of masks etc. The study took place under Bristol’s Pfizer Centre of Excellence for Epidemiology of Vaccine-preventable Diseases, the second such centre in the world, which launched in May 2021. The Centre is a unique model in that funding comes to Bristol from pharmaceutical companies, which then partners with local NHS care providers who make the data openly available. The study found that COVID-19 disease was a large component of total aLRTD during this pandemic period, but non-SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations.
- Dawn Holford (Senior Research Associate, School of Psychological Science, UoB): JITSUVAX: Psychological inoculation against vaccine-related misinformation. This four-year European Research Council-funded project, running in 6 centres across 5 countries, seeks to develop a “cognitive” vaccine against misconceptions or misinformation when it comes to people’s hesitancy towards vaccination by building defences against misinformation. The team have built a taxonomy of anti-vax arguments comprising themes, or roots, (such as existing health and immunity, lack of trust in the system, religious convictions), which will be used as templates to build empathetic refutation models that take into account the root of concern for the individual whilst providing an acceptable antidote in a safe environment and without judgement. Read more: The COVID-19 Vaccine Communication Handbook.