The 12 priority diseases to develop a vaccine, according to Sarah Gilbert, creator of the Oxford vaccine against covid-19

Science has transformed the pandemic, and experimental technologies that helped develop covid-19 vaccines in record time have fueled scientific ambitions. Could we be entering a golden age of new vaccines?

At the forefront of vaccination is Jenner Institute Professor Sarah Gilbert, the architect of the Oxford COVID-19 vaccine.

Using revolutionary technology, the Oxford team managed to have a vaccine ready to begin clinical trials in just 65 days. In partnership with the pharmaceutical giant AstraZeneca, they have distributed more than 1.5 billion doses worldwide.

You might suppose that when you reach the top of your professional life, it is possible to have thoughts that go beyond the limits of human knowledge.

Yet almost every time I interview Professor Gilbert, I have the feeling that a great deal of her time is spent shopping for refrigerators and freezers.

After all, if you can’t keep viral samples and vaccine prototypes cold, you cannot continue your investigations about vaccines.

“They still ask me for more,” Professor Gilbert tells me.

But the kitchen, where these appliances are typically found, is not a bad place to understand the leap in vaccine science made by her and her contemporaries.

“It’s like decorating a cake”

The new generation of vaccines is advancing rapidly and in a very flexible way. “It’s like decorating a cake,” says Gilbert.

The old-school method of developing vaccines is to go back to raw materials and start from scratch for every vaccine that is made.

It’s like starting with flour, sugar, eggs, and butter. The next step is to take the offending virus or other disease-causing microbes and kill or weaken it to make the vaccine.

For the two seasonal flu vaccines given each year, adult pricks were made by growing flu viruses inside eggs.

The viruses are then purified and killed in order to produce the vaccine.

Children’s nasal spray contains live virusBut they were weakened and destabilized so that they could grow in the colder temperatures of the nose, and not in the heat of the lungs.

It takes a lot of work to start a vaccine from scratch with every disease that arises and there are many things that could go wrong.

During the development of the Oxford vaccine a completely different approach known as “plug-and-play”.

With this type of vaccine, most of the work has already been done: the cake has been previously baked and you just have to “decorate” it to meet your goal.

“We have the cake. We can put a cherry on top or we can put some pistachios if we want a different vaccine, we just add the last piece and then we are good to go, ”Gilbert explained on the BBC’s Inside Health program.

A platform to develop the vaccines of the future

The Oxford vaccine “cake” -o platformTo use the scientific term, it is a virus that causes the common cold in chimpanzees.

It has been genetically modified so that it is safe and does not infect people.

The “decoration” is whatever genetic blueprint is needed to train the immune system to attack. Said blueprint is added to the cake and the job is done.

It was this work, applied to the Sars-Cov-2 coronavirus, that made Professor Gilbert receive many accolades, ranging from an honorary title of “Lady” in the UK to a Barbie made in her image and likeness.

“The Barbie is comfortably installed in my office, but yes, I’m thinking of sending that Barbie as my understudy,” he tells me.

“It would be helpful to have a stunt double who could go to do interviews for me”.

Two of the other great covid-19 vaccines, one made by Pfizer-BioNTech and the other by Moderna, use another style of “plug-and-play” technology and are highly adaptable.

All these technologies should facilitate and accelerate the development of the vaccines of the future.

“There is a lot of work to do in the field of vaccine development now that we can do it”, apunta Gilbert.

The 12 priority diseases

At the top of your target list are official “priority pathogens.”

Although the covid arrived in a surprising way, there are other threats that have emerged and that have the potential to cause large outbreaks and probably other pandemics in the future.

Vaccines against these diseases could save lives

• Middle East Respiratory Syndrome (MERS)
• Lassa
• Crimean-Congo hemorrhagic fever
• Nipah
• Zika
• Ebola
• Rift Valley fever
• It’s raining
• Dengue
• Hantavirus
• Over
• Marburg
• Q fever

Part of this work is already underway. Oxford has begun clinical trials of a plague vaccine using its technology plug-and-play.

The plague caused the infamous Black Death pandemic that killed hundreds of millions of people.

On the other hand, Moderna is already considering using its own mRNA technology to make a vaccine against the Nipah virus. This virus kills up to three-quarters of infected people.

The great barrier: money

However, the great barrier to dealing with these diseases will remain the same as always: money.

These are diseases that affect some of the poorest regions of the world and there is concern that, even after this pandemic, it is not possible that the investigation is financed.

And while vaccine technology has advanced, the old enemies remain the same and there are quirks that create monumental challenges.

All vaccines need a target, called an antigen, and they train the immune system to attack it.

Some vaccines are much more complicated

Despite all the problems that covid has caused, the virus it was a pretty simple beast and its antigen was obvious.

The outer surface of the virus is covered with spike-shaped proteins. So all the researchers had to do was connect the genetic blueprints for the spike protein, train the body to recognize it, and make sure the vaccine would work.

However, the antigen is not obvious in other more complex microbes, such as the big three killers: malaria, HIV and tuberculosis.

HIV has a constantly moving target. It rapidly mutates to alter its appearance and outwit our immune system. It is difficult to know how to identify it.

We already have vaccines against malaria and tuberculosis, but they are far from perfect.

Next jump

The world rightly celebrated the launch of the first malaria vaccine in Africa, but the truth is that it is only 30% effective in preventing serious diseases.

That is because the malaria parasite has a complex life cycle, during which it transforms into a variety of distinct ways, through two species.

A tuberculosis bacterium is also much more complex than a coronavirus.

There is a long list of antigens to choose from in tuberculosis and malaria, and the correct one remains frustratingly elusive.

“There is a wide variety of options and it’s not obvious which one we should use”, explica Gilbert.

“It takes a long time to find the correct antigen, so it is much more difficult. Much more than with these outbreak pathogens, which are quite simple viruses ”.

However, BioNTech is using its technology to try to develop an HIV vaccine.

“I think the next big leap in vaccines, rather than totally new technologies, is make the technologies we have more stableThat would be great, ”says Gilbert.

Vaccines need the most favorable conditions: they must be kept at the right temperature from the moment they are prepared until the moment they are administered.

For this, there is a global network of freezers, refrigerators, cold boxes, etc., known as the cold chain.

But it is difficult to get vaccines to some remote places and the world’s poor, particularly where there is no electricity.

The teacher also points out that it would be “really nice” if we could get vaccines that don’t require needles.

It may be better to stop giving some vaccines in the form of shots. A better immune response to some lung infections (such as COVID) may be obtained if they are administered as an aerosol.

“That is where the virus would normally go, it is different if you have a blood-borne infection such as dengue fever,” he explains.

“But that is something that cannot be done quickly, there are still many vaccines that need to be tested.”