Vaccine for new variant unlikely to be quick fix

The world has limited vaccine manufacturing capacity and its factories are currently running full speed producing vaccines for existing variants of the coronavirus. It raises the question: if a new vaccine is really going to be needed to fend off the new B.1.1.529, or omicron, strain of the virus, where is it going to be made and how long will it take to get it into UK arms?

Some may also ask: if it is going to take six months to a year – as seems likely –how does that fit with the Government’s strategy of living with the virus? Are we really going to keep Britain’s borders locked down for that long?

The impact the variant will have on existing vaccines is not yet known, but scientists are already turning their minds to a new vaccine. “I think we, as a world, could consider in the not too distant future starting to use at least a proportion of MRNA vax-manufacturing capacity to make B.1.1.529-targeted vaccines,” tweeted Theo Sanderson, a Sir Henry Wellcome Fellow at the Francis Crick Institute, on Thursday.

In theory, MRNA vaccines like Pfizer and Moderna are quicker to make than conventional versions. Changes to the synthetic code used to stop the virus locking on to human cells can be made within days in the right lab, assuming its weak points are obvious. The manufacturing process is also easier.

Biontech, the German company behind the Pfizer jab, said yesterday it would know in “two weeks” if a new vaccine was needed. After that, it would take just three months to produce a new jab. “Pfizer and Biontech have taken actions months ago to be able to adapt the MRNA vaccine within six weeks and ship initial batches within 100 days in the event of an escape variant,” the company said.

If a vaccine against the omicron variant can be produced that fast, we might expect it to become available by the end of February. But is that really feasible?

Experts warn of regulatory hold-ups and manufacturing hurdles. Unless a new vaccine is just a small tweak away from the original, regulators and citizens alike will want to assure themselves it is safe – and that almost certainly will involve human trials.

Take the beta variant, which gave the world a fright when it emerged in South Africa earlier this year. Astrazeneca launched a trial of a vaccine to fight it in June, but that trial – involving more than 2,800 participants – is still running five months later.

John Roberts, a member of the Covid-19 Actuaries Response Group, entered that trial. “I was impressed with the onboarding, which was quick, but I find it very disappointing the trial itself is taking so long… the ship has already sailed on beta,” he said.

Richard Hatchett, the chief executive of the Coalition for Epidemic Preparedness Innovations, said developing a new vaccine in the lab should be “straightforward” but warned that “regulatory requirements” on testing could slow things down as the existing vaccine would require more than a tweak.

“In this case, we’re really talking a new vaccine, used as a boost for most people. [There is] no direct [regulatory] guidance for this [at the moment], but I suspect this may be forthcoming soon,” he said.

The other potential hitch concerns manufacturing and purchase. Demand currently outstrips supply for the Covid vaccines, with countries across Europe now scrambling for booster jabs to protect against the delta variant.

There is also the difficult question as to when to switch manufacturing from one jab to another. This would be especially difficult if the new jab protected against the new variant but not earlier ones.

“The same issue comes up when we face a new potentially pandemic strain of flu,” said Dr Hatchett. “Do we switch over to manufacturing the new strain, or do we complete our runs of seasonal flu vaccine?

“These decisions are fraught and have unpredictable consequences.”

Sir John Bell, regius professor of medicine at the University of Oxford, put the timeline for a new vaccine at six months at best. “I think you could turn around a new vaccine using the MRNA technology in three to four months… the [Oxford] adenovirus platform would take a little bit longer, six months, shall we say. But then you’ve got to scale up the manufacturing, you’ve got to get it deployed, you’ve got to get it approved”, he said.

Politics will inevitably play a part. Countries with manufacturing capacity, notably the US, Europe and India, will want their factories churning out jabs against the variants that are most relevant to them – and that need may not be the same the world over.

The UK and Israel, for instance, are all but finished boosting their populations against delta, and might look to quickly acquire a jab against omicron. The US, India, and continental Europe, on the other hand, still have a long way to go in inoculating against delta.

The UK still has no significant manufacturing capacity of its own. The Vaccines Manufacturing and Innovation Centre, a facility near Oxford intended to make the nation self-sufficient in vaccines, is still not open nearly two years into the pandemic.

In May 2020, the Government announced it would invest up to £93 million to accelerate construction of the plant. The funding was intended to “ensure the centre opens in summer 2021, a full 12 months ahead of schedule”, but this has not happened.

Yesterday, ministers closed Britain’s borders to much of southern Africa.

Cases of the new variant were also reported in Belgium, Israel and Japan, and it seems likely other countries will be added to Britain’s red list in the next few days.

Most experts support the travel bans as a short-term precaution. It gives us time to learn about the new variant and the challenges it poses.

But if a new vaccine is needed, there will be no quick fix – and that will present a major policy challenge to ministers.

“The notion of ‘living with the virus’ implies living with new variants, and our reaction to any new variant has to be measured, proportionate and sustainable,” said Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh.

“That is an argument for making travel safer – by enhanced screening and testing – rather than banning travel altogether.”