All I want for Christmas is a VACCINE

...but here’s why I don’t think I’ll get it!

With just two months until Christmas, it is time to start thinking about presents. This year, what I would love to give my 91-year-old mother who has been self-isolating since March due to her age, is a safe and ef f ective Covid-19 vaccine.

But how likely is it that there will be one by then, let alone that it will be offered to vulnerable people, like my mother?

Last week, I read two conflicting views. One expert said a vaccine could be ready ‘this side of Christmas’ but another was much more pessimistic, saying we might not have one until spring 2021, or even later.

So who is right? I contacted someone I know well who has real insight into the situation — Professor Robin Shattock, head of mucosal infection and immunity at Imperial College London, who runs the team at the forefront of developing a Covid-19 vaccine.

What he had to say, while making me appreciate the scale of the challenge, left me reassured that science will save us. Robin believes a safe and effective vaccine is on the horizon, but how soon we get it, ‘depends on the numbers’.

One of the most critical factors is the percentage of people given a vaccine who go on to develop Covid-19. No vaccine will be 100 per cent protective (the flu vaccine is around 40 to 60 per cent effective), but even if the new vaccine is only 50 per cent effective, Robin says it will still have an enormous impact.

Anynew vaccine is tested for safety in a ni mals a nd smaller human trials, before moving on to larger scale randomised trials i nvolving tens of thousands of volunteers. In these trials, some get the real vaccine, while others get a placebo. Then the researchers have to wait for a reasonable number of the volunteers, say 200, to actually catch the Covid-19 virus.

This is the bit they can’t predict or control. It can take weeks, or it can take months, depending on how much virus there is in circulation.

All the while, i ndependent researchers are busy checking how many of those infected were given the real vaccine, and how many got the placebo. Only when they have good evidence that the vaccine offers better protection than the placebo can they apply for approval to use it more widely.

There is one way to speed up this process and that is to do so-called human challenge studies. Once volunteers have been vaccinated they are deliberately exposed to Covid-19. There is a danger, of course, that if it doesn’t work, you could make people seriously ill.

Nonetheless, it was announced this week that Imperial College, in partnership with others, hopes to start doing the f i rst human challenge trials at the Royal Free Hospital i n London ( my old medical school) early in 2021.

The good news is that, so far, of the leading nine or so most promising vaccine candidates, all seem to be safe and to induce a good immune reaction.

But which ones, I asked Robin, are people like my mother most likely to access, and when?

He wouldn’t put a definite timescale to it, but thought the vaccines being produced by drug giants Pfizer and AstraZeneca (working with the University of Oxford) were the closest to getting approval from regulators. ‘I’d put them neck and neck,’ Robin said, ‘ with all bets off as to who will be first’.

Pfizer has already produced hundreds of thousands of doses and could be ready for approval by the end of November. Oxford is also expected to report results within the next two months, and i ts partner plans to produce 400 million doses by the end of the year.

There are, of course, no guarantees, and as Robin pointed out to me, ‘just because it is the first, does not mean it is the best’. The vaccine his team are working on is a few months behind the current leaders, and there are many others at different stages of testing.

There are more hurdles ahead, including the legitimate worry that large numbers of people may refuse to get vaccinated, as some fear the process is being rushed.

But the good news is you need less than 60 per cent of the population to have a vaccine to make a real impact, and I think there are enough sensible people to make that happen.

The scientists are well aware that nothing can be rushed because the worst thing that could happen would be a vaccine with unexpected side-effects.

Because of the need to be ultracautious, Professor Shattock says it would be ‘a minor miracle’ to have a vaccine that’s proven to be safe and effective by the end of the year. But if you can’t hope for a miracle at Christmas, when can you?