Three Longs & Three Shorts

Covid Vaccine Front-Runner is Months Ahead of Her Competition

The race to develop a coronavirus vaccine is unprecedented in more ways than one. First, the importance of it all – the vaccine is the only logical end to the pandemic without going through the morbid path of achieving herd immunity. Second, it defies all well accepted timelines for a typical vaccine development – typically takes years to develop one and the world is expecting the first Covid vaccine to be available as early as end of the year or early next year i.e, just about year after the outbreak. Given the importance, the world is putting all its resources behind it – as many as 120 vaccines are under development. The front runner so far seems to be the Oxford-Astra Zeneca partnership led by Sarah Gilbert of the University of Oxford. This piece tries to outline the key factors helping Gilbert and team stay months ahead of competition.
Gilbert had a headstart given the progress she had made with her work on the other viruses – Ebola and MERS coupled with the advantage of Oxford’s rather unique in-house vaccine manufacturing unit for a university and the access to Bill Gates for both funding and driving a partnership with Astra Zeneca.
“In the wake of the Ebola outbreak, Gilbert responded to a call from the World Health Organization for researchers to come up with methods to rapidly respond to a clutch of emerging pathogens. It meant having a plan for “Disease X”—that unknown yet inevitable pathogen lurking around the corner. Before Covid-19 presented as the nightmare Disease X scenario, Gilbert began working on Middle East respiratory syndrome, or MERS—another coronavirus that causes pneumonia and had threatened to spark a global health crisis. It first emerged in 2012 in Saudi Arabia, but an outbreak didn’t occur until 2014. MERS is much more deadly than Covid-19, killing about a third of those infected.
…The work gave Gilbert a running start when Covid-19 emerged. “The spike protein of MERS shares a 40% to 50% similarity to the spike of SARS-CoV-2,” says Naif Alharbi, a Saudi scientist who studied under Gilbert at Oxford and is running the trials of the MERS vaccine in Riyadh. “We know the chimp adenovirus is safe in humans, and it’s been tested in humans with the MERS spike. Given the similarities, the only question with the Covid-19 vaccine is whether it’s going to be protective or not.”…As soon as Chinese scientists published the genetic sequence of the novel coronavirus on Jan. 10, Gilbert got to work.
…Oxford had an advantage unusual for an academic institution: its own vaccine manufacturing facility, at which it was able to quickly manufacture the shot for the first phase of human trials. Gilbert arranged for the next, larger batch to come from Italian pharma company Advent, and persuaded the university to underwrite the contract until she could secure further funding. On Feb. 17 her team began injecting mice with the vaccine. To accelerate a process that normally takes months, she was performing several steps at once—testing in animals, applying to regulators for human trials, and talking to manufacturers.
…“Her level of knowledge of the detail is extraordinary,” says Andrew McLean, who worked with her for years as an investor and board member at Vaccitech. “It’s very unusual for a scientist to know the practical parts of getting a drug made and be able to talk to manufacturers on a toe-to-toe basis.”
…She got a small grant from the Coalition for Epidemic Preparedness Innovations, or CEPI, a foundation set up in 2017 with funding from the Bill & Melinda Gates Foundation, the governments of Norway and India, and the Wellcome Trust Ltd., a London-based research charity.
During the search for money, Bill Gates pushed Gilbert and Hill to partner with a big pharmaceutical company, and as a CEPI founder he had leverage. “We went to Oxford and said, you are doing brilliant work,” Gates recalled in a call with reporters in early June. “You really need to team up, and we told them a list of people to go and talk to.”
…Pangalos negotiated the partnership agreement with Bell and the rest of the Oxford team in about 10 days through a flurry of Zoom calls, with Gilbert walking everyone through the data. AstraZeneca agreed to be responsible for worldwide distribution and manufacturing.
After the deal was announced at the end of April, big money followed as Pascal Soriot, AstraZeneca’s chief executive officer, pledged to make the vaccine available at only a “few dollars” per dose. The British government gave £65 million to accelerate the work and secure 30 million doses for the U.K. by September as part of a deal to make 100 million in total, with some reserved for developing countries. Days later, AstraZeneca announced a $1.2 billion deal with the U.S. Biomedical Advanced Research and Development Authority (Barda) to develop and produce 300 million doses, one of the largest deals the agency has announced. AstraZeneca will work with the National Institutes of Health to test it in 30,000 people in the U.S., scheduled to start in August. The company later struck a licensing deal with the Serum Institute of India to produce a billion doses for developing and middle-income countries. Because of expected political pressure—any country with a role in the production of a vaccine might act to secure doses for its own people—AstraZeneca is setting up independent supply chains within countries to prevent delays at national borders.”