(Medicine BMBS, 1989)
Read our interview with alumnus Professor Andrew Pollard, Director of the Oxford Vaccine Group, to gain an insight into the development of the Oxford-AstraZeneca vaccine, which has now been given regulatory approval and is being rolled-out to the most vulnerable people in the UK and globally. Professor Pollard also reflects on his time at Barts and his fondness for mountaineering.
You studied Medicine at Barts and qualified in 1989. Did you have a particular career path in mind or an area of medicine you wanted to specialise in? I enjoyed everything I encountered throughout my degree so choosing a specialism was quite difficult because it wasn’t initially obvious which direction I should travel in once I qualified. When I completed my house jobs at Barts and Whipps Cross, I did a job in A&E whilst deciding what to focus on in my career. At the time it was much easier to switch between different areas early on after you had qualified compared with now. In the end I decided to specialise in paediatrics.
What was so special about your time at Barts? I was fortunate enough to meet some great long-term friends and my overall experience was amazing. The dominant fun from being at Barts was the mountaineering club, which was called the Barts Alpine Club at the time. I spent a large amount of my free time climbing and travelling to different mountain ranges outside of my lectures.
Do you still go mountaineering? Yes, I try to get to the hills mostly via walking or mountain biking, but the reality is, this year, there has been none of that. In fact, there has been no free time. My work has been constant, seven days a week, and I don’t see that letting up at the moment but I certainly, like everyone else, look forward to the day when everything gets back to normal.
Can you describe your career path since you qualified and how you landed your current role as Director of the Oxford Vaccine Group? I started in paediatrics in Birmingham, where I did my rotations, and worked as as a registrar before deciding to move to London to St Mary’s to do my PhD. In London, I worked on meningitis in order to understand immunity in children who had been infected with the organism that causes meningococcal disease. Alongside my studies, I worked in intensive care for children. I then undertook a fellowship in Vancouver, Canada, where my wife and I soon warmed to the idea of putting down roots, but I was then asked to apply for this job here in Oxford, which is what I have been doing for almost twenty years now!
What were you working on prior to the COVID-19 crisis? Did you and your team have to shift your focus? As part of my role at Oxford, as well as leading the paediatric infectious disease clinical service in the hospital, I run a research programme comprised of about 120 staff here in the UK and wonderful local teams working on research programmes in South Asia, Africa and Latin America. We work on lots of different activities and projects, but the biggest programme we had prior to COVID was working on typhoid for projects both here in the UK and in Nepal and Bangladesh, alongside 30 smaller projects. In January 2020, we switched almost entirely to working on COVID.
How have you been collaborating with other scientists, both in the UK and internationally? For the COVID studies, we have six clinical trial sites in both Brazil and South Africa, a small trial in Kenya and nineteen trial sites here in the UK; the activities I’ve undertaken this year have been around coordinating the work in these areas. We have a large team running the trial in Oxford but around 2,000 more are in the national and international sites. Unfortunately, I’ve been unable to travel to these sites so most of our coordination of the work has been done over the internet, but we’ve now got more than 23,000 people in trials across these countries so there is quite a lot of day-to-day interaction and activity. We obviously stay in touch with our teams in Nepal, Bangladesh and Uganda, but most of the activities in these countries concern other diseases but our research on these is much less active right now.
Now that the Oxford-AstraZeneca vaccine has passed the approval process and the first members of the public have received it, what are the next steps for its rollout? The vaccine is being rolled out by the Government focussing on the priority groups who are at risk of severe disease, such as older adults and those with other health conditions, and those at increased risk of disease, especially those working in health and social care.
How does your vaccine differ from the other COVID vaccines? How does it work to prevent the virus? All of the vaccines, which are currently being developed, essentially work in the same way: the spike protein of the virus is used to generate an immune response, which then means that if you meet the virus in the real world, you will be protected. The difference between each of the vaccines is the way in which the spike protein is introduced into our bodies. The Pfizer vaccine uses a bit of genetic code called RNA and our cells turn this RNA into spike protein so that our immune system can work against it. However, the Oxford-AstraZeneca vaccine takes a common cold virus - which is unable to cause infections in humans and which has a genetic code for the spike protein inside it - which, when injected, uses the machinery of our cells to make a spike protein for our immune system to work against.
In your opinion, what are some of the benefits of your vaccine compared to its competitors? And what are the advantages of having a UK-produced vaccine? “Competitors” is the wrong word because we need as many vaccines as possible for the world. The new variant that has arisen in the UK, and which is spreading at a much faster rate, shows what a terrible situation we face globally. But from the perspective of our mission, we have fulfilled our goal of developing a vaccine not-for-profit that can easily be distributed to every corner of the world in fridges and which can get into remote villages in Africa just as easily as it can into an NHS hospital. One of the key things is that even if there are restrictions on movement from within the UK, as seems to be the case recently, this doesn’t matter for the vaccine because AstraZeneca has a supply chain in each region of the world to make sure that the vaccine can be made and distributed. This is a major success. I don’t think being nationalistic is the right way to think about our vaccine. Most of the vaccines in late phase development come from commercial organisations but because of good investment in UK science, we have been able to make a vaccine and run the trials ourselves, which has allowed us to be ahead and to hopefully contribute to public health. There is clearly a supply chain advantage in that we’re able to manufacture the vaccine and put it into vials here in the UK but what we really need is to be able to get it to everyone, everywhere. We are not safe until we achieve this, I think that is very clear with this virus. It is important that we help other countries for if they are still in the pandemic, then it affects our economy and health security. I, for one, won’t be travelling to other regions at the moment due to the risk of either taking the virus to other places or bringing it back to the UK as there remain many vulnerable people in our communities. So, let’s hope that we do get to a point where this is all behind us.
It is such a remarkable achievement to have been instrumental in pioneering the first UK-produced vaccine. How does it feel to be a part of history and, more importantly, to play a part in potentially saving millions of lives globally? We are all just doing our day jobs - this is the kind of work I’ve been doing at Oxford for twenty years. However, there are moments in which it becomes obvious that the world is watching and we become aware of the sheer scale of numbers of people we could potentially help. These moments include positive celebratory moments, such as when our vaccine got regulatory approval, but also intense moments of scrutiny from the media, which puts a huge pressure on our team. One good thing is that we are a big team of people so we can share some of the pressures of trying to run a trial of this scale in the media spotlight and in a pandemic. Overall, the success of the vaccine to date is a real tribute to the 1,000-plus people working on the trials and on this programme globally.
Now that vaccines are being developed, in the future, do you think we will be able to live with the virus in the same way that we currently live with different strains of the flu? I am optimistic that we will find ways of containing the virus. I think vaccination is the most likely way that we can do this in the short term and there is no doubt that treatments have improved so that the recovery rates of people who do get infected have increased throughout the course of the virus. But I do think there is uncertainty about whether this virus will change in a way that we will need to make new vaccines over the next few years. This needs to be investigated very thoroughly going forwards. Our vaccine is the first stage in a long journey ahead.
A lot of social commentary reports that the public feels quite jaded in the sense that the situation seems to improve but then regresses again, but for people working behind the scenes and on the frontline it has been constant. How do you keep your team going while also making sure that everyone is looking after themselves? It has been relentless. I remember when we first went into lockdown in March, I was still going into work every day when the streets were deserted, and I was jealous of everyone at home doing their DIY and hoovering. Unfortunately, our workload hasn’t really eased since and I think resilience is key and trying to maintain the commitment and enthusiasm of the team. There is no doubt that people have been under enormous strain, but we cannot stop; what we are working on potentially has enormous public health benefit so there is an absolute obligation to keep on going and I think this been the motivating factor for the team. There is a bit of me that can’t imagine what life will be like after COVID or working on anything else, but I do think it is important that the team has breaks. We tried very hard over Christmas to minimise the amount of work that people have had to do. Obviously, we have a lot of ongoing responsibility to participants in the trials, but a lot of the other day-to-day activities were really slimmed down over the period and we will continue to do this now after Christmas to give people some space. But it isn’t easy.
What are your thoughts on the current restrictions we are living under in the UK? Currently, hospitals are awful and the virus is spreading at a much faster rate than previously. Until we have widespread use of vaccines, we need to be in lockdown. I can’t imagine how difficult it must be in No. 10, with people accusing the Government of not being straightforward with the public, but based on the data, which I have seen lots of, these are impossible but necessary decisions.
What do you think the future of vaccine pioneering and public health will look like now that we have seen an increased use of technology since the outbreak of the pandemic? I think the increased use of technology is here to stay and it will completely change the way that we do things in science. Since the pandemic, I have given a lot of lectures to conferences online, which has allowed me to be in more than one place at once and to attend more meetings, but there is a loss of the coffee conversation with a student who then becomes your postdoc, and of interactions with friends and colleagues. For example, this year I was unable to go to our annual meeting for paediatricians working with infectious diseases, which is important professionally but also for the sharing of experiences and so on. We do need to find a balance. From a research perspective, travelling to sites and being seen to be present and supportive of the teams on the ground is quite important and to lose that completely would be quite a problem, however, there is a lot that can be done online which we never could have imagined possible around training and regulatory approval. We have had a lot of interactions with regulators in different countries virtually, whereas in the past we would have had to travel for these meetings.
When we get through to the other side, if you could visit any mountain, which one would you choose? I would be perfectly happy being in the Lake District as I would in the Himalayas - to me I feel at this moment it would be nice to escape and be somewhere where there is no phone signal and just you and the hill. However, it is quite difficult to see the other side. It feels like we’ve still got a big mountain to climb with the pandemic and, even if we do, I think many of the places I’d like to visit tend to be in more remote areas of the world where the roll out of vaccines will take longer. So, this brings me back to my earlier point - there are good reasons, morally, why we should be trying to help people in other countries around the world and we’re going to have to continue to think about how we will protect the vulnerable in populations for the foreseeable. I don’t think we should look at “getting back to normal” in the foreseeable, for even if we have reduced pressure on health systems or we can get a long way past this, this virus is likely to be with us globally for many years and potentially decades.
If you would like to get in touch with Professor Andrew or engage them in your work, please contact the Alumni Engagement team at alumni@qmul.ac.uk.