SCIENCE, TECHNOLOGY, ENGINEERING & MATHEMATICS
Meet Paul McKay, an openly gay man who leads our Science, Technology, Engineering and Mathematics category. McKay has created one of the vaccines that will help the world recover from the COVID-19 pandemic in 2021 and beyond
Meet Dr Paul McKay, an openly gay scientist who has played a part in creating one of the vaccines that will help the world recover from COVID-19.
Paul McKay left the small town where he was born in Ireland when he was 18, to begin his degree at Imperial College, London. He arrived in the capital during the height of the Aids crisis. “It was at the end of the 1980s, so it was a fun time in London, but also right in the middle of the HIV pandemic,” Paul tells Attitude. “My friends and peers catching HIV was a huge influence in me deciding to work in the field of vaccines.”
After his BSc, Dr Paul McKay went on to gain a Master’s degree, and then a PhD in molecular immunology. He continued his career working at Harvard in Boston, USA, where Paul developed and tested vaccines, which would eventually lay the foundation>
for his work this year developing a vaccine to help in the fight against COVID-19. Attitude is proud to feature Dr Paul McKay as a worthy leader of the STEM category for our inaugural Attitude 101 list.
What were your thoughts when you first heard about the COVID-19 virus? Did you anticipate it would turn into the pandemic that it has become?
I was already working on a number of emerging diseases that could potentially cause a pandemic — Ebola, Lassa and Marburg — and I also knew that the original SARS and MERS outbreaks could easily have spread more widely. So, the awareness was there that this could potentially become a major problem, but we as a group certainly didn’t expect COVID to become the huge problem that it is now. I don’t know if anyone expected that.
Have you been personally impacted by the outbreak of COVID-19?
Unfortunately, I have. My father had been suffering from prostate cancer for a number of years. Earlier this year, just before the pandemic, tumours were seen on his bladder and he was due to receive radiotherapy treatment. One of the consequences of the spread of the virus, the increase of hospitalised COVID patients and the lockdown, was that people who would normally receive treatment that may reduce the robustness of their immune systems — like chemo or radiotherapy — had their treatment reviewed and reprioritised. As a consequence it became clear that my father would not receive treatment and his medical care quickly became palliative and end-of-life care. He passed away in early November.
I’m sorry to hear that. It’s a terrible example of COVID’s deadly impact on our health and the NHS, regardless of whether people contract it themselves. What do you consider are the most common misconceptions about COVID?
That younger people think there are few consequences of catching this virus. Most believe that they may get COVID and will have a short, cold-like illness, or have virtually no symptoms at all, they will recover completely, and life will barely be interrupted. It’s becoming clear that there are a large number of people, about one in 30 people who are infected, who develop a post-viral syndrome called ‘long COVID’, where they have significant long-term illness and some disability. A few people are experiencing this for nine months now. A lot of people also think that when they recover, they are then back to full health, but approximately 10 per cent of people studied – and this was young men – had clear damage to their lungs, where scarring was noted as well as damage to other organs, blood vessels and even to the brain. So, really, you don’t want to catch this virus, it’s not “just a cold”.
You have been working on a vaccine at Imperial College London. When did you begin working on this?
When the sequence was published by the Chinese scientists in early January, I discussed the possibility of making a vaccine with my professor, Robin Shattock, using the vaccine platform technology we had been developing for several years. After discussing the pros and cons of trying to make a vaccine, we decided to go for it and we never looked back.
“10% of people studied — and this was young men — had damage to their lungs”
How does your vaccine differ from the others being formulated?
Our vaccine uses a self-amplifying RNA [molecule], whereas the other RNA vaccines are made of messenger RNA. Sounds like a small difference, but our particular RNA is able to make new copies of itself, as well as make the coronavirus surface protein in our cells after it is injected. It’s still just a piece of RNA, and so can’t become incorporated into our DNA or change our DNA — RNA is just a coded message to make proteins — but the ability to make new copies of itself means that our version will last longer, make more vaccine protein, and hopefully produce a stronger response in people who receive it. The delivery formulation is pretty much the same for all the RNA vaccines. The other major type that we may get here in the UK is the Oxford/ AstraZeneca vaccine which is a modified adenovirus (a common cold virus) which had the coronavirus surface protein coating the outside.
What is your role and that of others in your team?
In total, there are eight of us working on the vaccine and assay development, and a further six performing the analysis of the human clinical trial samples. I designed and made the vaccine and did all of the early testing in animals, and made sure all of the assays are performed correctly, and that the results are correct. My team help me to do all of this, they produced lots of coronavirus surface protein for the assays, as well as various reagents that didn’t exist in January.
What separates the work you do at Imperial to working in a Big Pharma company?
In comparison to Big Pharma [the global pharmaceutical industry], our team is tiny! Big Pharma have far more people to call upon to join the effort, as well as enormous resources. Our challenge was essentially to do the job of several people and to do it well — but I think we did a great job to get as far as we have.
Is Big Pharma a threat to medical access for those that need it most?
Certainly, Big Pharma has the reputation of being profit-orientated, but I think that has changed over the years — although this is a contentious question and it really does depend on what particular drug or medical intervention is under discussion. As an example, AstraZeneca has agreed with their Oxford academic partners that their COVID vaccine would be made available at cost for the duration of the pandemic. This is obviously a great outcome for global health. So there can be a balance of getting treatments for those who need it most or where it can have a huge impact on community health — and here I’m thinking about the benefits of freely available PrEP — and that advocating for better access from these companies, which are, after all, businesses, can have a beneficial outcome.
What were the challenges you faced creating your vaccine?
Getting a piece of RNA into animal or human cells is not that easy. RNA is extremely fragile and is quickly destroyed by things in the environment. We need to both protect the RNA and also efficiently deliver it to the inside of the cell. Luckily, we have been working on this for some time before the pandemic, so we knew what to do and had a company already lined up who would be able to encapsulate our RNA vaccine into the lipid nanoparticles so that they could be injected into the muscle. Our other challenge is the large
size of our saRNA molecule – most RNA are shorter and so easier to deliver, while ours is about five times the size of the one used in the Pfizer/BioNTech vaccine.
Your vaccine is entering Phase 3 trials. What does this mean?
After Phase I, which assesses initial safety, the vaccine candidate moves into Phase II, where we are able to determine whether it’s working at all. In this phase we need to see that the vaccine is able to produce an immune response against the coronavirus surface protein, or the vaccine is dead in the water. Phase III is the final stage where we look to see if the immune responses have any effect on the virus or the severity of the disease, and this is why the third phase uses so many people. There has to be a very large number of people because we have to be able to see if there is a difference between people who received the vaccine and the control [unvaccinated people]. If there is no difference in the numbers of people catching COVID or in the severity of their infection, then essentially the vaccine doesn’t work. And we rely on the trial participants catching COVID to be able to see this and that takes a large number of people and time.
When do you expect your vaccine to be available to the public?
If the Phase III trials go well, we would hope to have a vaccine ready by mid-year 2021. Even though there are vaccines that have already been approved, we need as many as possible and that’s why it’s important to continue with every possible vaccine. To vaccinate the world, we will need 14 billion doses. And we may need to give annual boosters.
How does it feel to be part of the solution to a problem that has crippled the world?
I’m a very, very small part and there are a huge number of people who have been working day and night on the various vaccines. I’m glad to be part of the global effort and was so happy when the first vaccine was approved for use. That effort also includes the amazing healthcare workers who really have been at the forefront and brunt of this pandemic. They have done the real work and have been the solution for so many people who have been victims of this disease.
What would you say to people concerned about having one of the vaccines?
The concerns I hear most often are either about safety or [I hear] people who think they just don’t need it as they are young and fit. For the safety aspect, these vaccines have been through all of the normal safety assessments that are typically performed on every treatment. And they have passed with flying colours. There have been a few adverse events [reactions], but this is seen with every vaccine. And to me, it’s not surprising, particularly for the RNA vaccines which are so well defined and contain only RNA, fats and sugars which are naturally found in all of us.
The second concern about not needing it – as I said above, even for a young person who is very fit and healthy, they may have significant consequences from the disease that aren’t apparent at the moment but that could have a big impact on your future.
Will COVID vaccinations be part of our future annual vaccination programme?
At the moment that’s not so clear and it depends on two things. The first is how long the antibodies last in our bodies
“To vaccinate the world [against COVID-19], we will need 14 billion doses”
after the vaccine is given, and the second is how high the antibodies need to be. Some animal studies are suggesting that the antibody levels don’t need to be very high, but we need to wait and see.
With enough vaccinations, do you see a possibility that COVID will be eradicated in the future?
That’s also not clear – it’s possible that enough vaccine coverage will stop the spread altogether and it will disappear like SARS-1 did. It could also mutate and become less lethal to us and perhaps become another seasonal cold, we just can’t say at the moment.
Do you expect people who are HIV positive to be a priority for vaccination?
Most people living with HIV in the UK who are diagnosed and under the care of their medical practitioner usually have good T cell levels as they are taking medication that controls the HIV infection. These people are likely to have good, functional immune systems and should respond well to the vaccine. If their immune system is stable and functional, they may not be a priority as there are lots of other conditions that compromise the immune system leading to people becoming vulnerable to a COVID infection. If anyone is concerned, they should consult with their doctor and follow their advice. The situation is very different in many countries where HIV medication is less accessible.
What have you learned about yourself during the pandemic?
That as a group and community we can achieve so much in a very short time, and that it is good to be part of that community. Being ambitious and focused on your career is fine, but the rewards of working within and for the larger society are great, too.
Having faced the personal and professional challenges that you have, how have you looked after your mental health over this past year?
I’m extremely lucky in that I have a superb group of friends and colleagues and an amazing husband who provide support, care and love that gets me through any difficult days. I’m also acutely aware of the terrible strains that many people have gone through this year, healthcare workers who were at the frontline treating COVID patients, as well as all those whose jobs and futures are now on the line.
Where did you grow up?
I grew up in a small town in Northern Ireland, and was born just at the beginning of what was called ‘The Troubles’. It wasn’t a pleasant place to live at that time, but I do think it formed me as a person, giving me the determination to succeed as well as a strong dislike for any kind of inequality of opportunity or discrimination on the basis of any characteristic.
When did you realise you were ‘different’?
I knew I was gay from the age of five or six, but I also knew that in the society where I grew up it was clearly completely unacceptable. When I was a teenager, I probably did try to blend in, but I wasn’t very successful, and was beaten up a few times and received homophobic name-calling, as I was obviously — and now proudly — gay. Though clearly not a good thing to go through, it has made me more resilient as an adult — as Jinkx Monsoon would say, “Water off a duck’s back”. It would be wonderful if our society managed to leave these outdated attitudes behind for good.
When did you decide to embark on the career path that you have followed?
I always liked the science subjects at school — and they were my best subjects, too — but I also was a bit of a geek and loved watching things like Tomorrow’s World, which many of your readers won’t remember, but it was a classic and made science seem exciting!
Has your sexuality helped make you a better scientist? Has it aided your work at all?
Being gay, on the whole, enables you to fundamentally appreciate diversity, and in the job I do there are scientists from all over the world who work together to get the results. Even though I’m from small-town Ireland and grew up among an essentially homogenous society, being gay marked you out as different right from the start, so I see it as an advantage that has helped me to work well and effectively with people from any cultural or ethnic background.
Have you faced any obstacles in your work because of your sexuality?
Being openly gay has not hindered my science at all — the field I work in and indeed healthcare in general is very gayfriendly, and, of course, many other jobs
“Being gay enables you to fundamentally appreciate diversity”
are increasingly LGBTQ+-friendly, which is a great thing for us and for society.
What can the government do to better support STEM in the UK?
The recent COVID outbreak really has alerted people, and hopefully governments, that being able to design, make and produce medical treatments is an important endeavour for the country. Hopefully, this realisation will lead to significant investment by the government in the training and education of young people, so that they can make their careers in the science and tech fields.
What advice would you give young LGBTQ+ people looking to get into STEM fields?
Find a subject you are passionate about and take your time to get as much education and work experience as you can, it’s increasingly important to have both the degrees and the hands-on experience. Many labs are only too happy to take on people and give them some work experience, so don’t be shy about asking. Getting this hands-on experience is really important in helping you to see what opportunities are out there and also what path you may want to follow.