Jab It Up!

Have you have your jab yet? I haven't but both my parents, my eldest nephew (he works in a school for children with special needs), and some of my friends, have had their first one - and they're all quite happy about that. I've never been a fan of injections, a bit squeamish about needles - which is silly as I've had loads of dental work and even an operation in which a hole was drilled in the side of my head, but I'll be getting mine as soon as I get the call. It really is our duty to do so.

So when my friend Adam alerted me to an online talk last night, Racing against the virus, and told me it would be hosted by one of the co-developers of the Oxford/AstraZeneca vaccine, Professor Sarah Gilbert, I signed up immediately. I was glad I did. It proved to be very interesting and Sarah Gilbert, modest though she proved, is a genuinely inspiring woman who, with the help of her colleagues, is saving many many people's lives.

Humanists UK present, annually - for International Women's Day (this coming Monday), a Rosalind Franklin lecture, named for the chemist and x-ray crystallographer whose work was central to understanding the molecular structures of, most famously, DNA but also RNA, coal, graphite, and even - topically, viruses. Along with Francis Crick, James Watson, and Malcolm Wilkins. The latter three shared the Nobel Prize for this in 1962.

Franklin, in that era, was, predictably, sidelined. Perhaps it was assumed she just made the tea. We're far from perfect when it comes to equality now but, despite recent setbacks, we are, hopefully, moving in the right direction and after Andrew Copson (Chief Executive of Humanists UK) had given us a brief introduction (and reminded us that if we're not religious it's important to say so in the upcoming census) the reins were passed over to Professor Gilbert and her interviewer, the brilliant Samira Ahmed.

With over two thousand people in attendance, Racing against the virus and Humanists UK were knocking recent talks by Skeptics in the Pub, the London Fortean Society, and SELFS into a cocked hat - and that's completely understandable. Everyone wants to know more about both the virus and the vaccine and, I like to think, come on and show their respect for Sarah Gilbert.

Working at the Jenner Institute at the Nuffield Department of Medicine, Oxford University, Sarah Gilbert started by informing us that most emerging infectious diseases are of a zoonotic nature and the vast majority of them stay within the species in which they originate. Often causing them no harm.

Danger arrives with what is termed a 'spillover'. A zoonotic disease from a camel, a pig, or, of course, a bat, sometimes amplified by an intermediary (turkeys and ducks were singled out - perhaps because people eat those animals), finds itself infecting human beings and, sometimes, killing them. In the case of Covid-19, at time of writing, killing over two and half million people globally.

Covid-19 is, of course, not the first infectious disease, or coronavirus, to have caused problems and Sarah Gilbert ran through a few that will be familiar to us and a few that are less well known. The Ebola outbreak in the western African countries of Liberia, Guinea, and Sierra Leone in 2014 was, of course, big news. 

Ebola, a disease carried by bats, had been known to have been transmitted to people as far back as 1976 but as most examples of the disease in humans had been confined to remote rural locations it had been easy to contain these relatively small outbreaks using quarantine. But when Ebola reached large cities, it began to spread quickly and pass through porous national borders easily.

There was no vaccine for it but there had been some research done in the US. The Americans, aware of just how lethal Ebola was, were fearful that a terrorist group or an enemy state may employ Ebola as a crude weapon against the US. These studies proved helpful when Sarah Gilbert and her team began to work on a vaccine for Ebola.

Once they had developed what they thought was an effective Ebola vaccine, it was tested on volunteers in Oxford to ensure it was safe and then tested in Mali which was near the affected nations but not, itself, affected by Ebola. Once these safety tests are met, the next decision is whether or not to deploy the vaccine. In the urgent case of Ebola, this whole process took about four months but when there is less will, or adequate funding is not forthcoming, vaccine development can take a lot longer.

By the time the vaccine, and another developed elsewhere which proved even more effective, reached Liberia, Guinea, and Sierra Leone, Ebola cases were, thankfully, already going down rapidly due to effective contact tracing and quarantine (although it had already taken over ten thousand lives).

This didn't mean, or shouldn't have meant, that the development of an Ebola vaccine had been a waste of time and money though. Notwithstanding its efficacy in the case of potential future Ebola outbreaks, Sarah Gilbert, and many others, had shown it was possible to develop vaccines speedily and efficiently.

There was, throughout the talk, some scientific stuff and some confusing graphs that I didn't really understand. Stuff about exons, hexons, pentons, and ChAdOx1 nCoV-19 that I'm not even going to pretend I understood. But, luckily for me, Sarah Gilbert remembered her audience and explained most things in layman's terms.

Starting with how our immune system works. Our immune system is constantly scanning our body in a search to find something that shouldn't be there. When it finds something invasive, it springs into action and starts creating antibodies. Sometimes there are foreign agents in our bodies that are so powerful our immune system can't work fast enough. That's when we get ill. Or even die.

Vaccines are designed to push our immune systems into action and they work by becoming that 'foreign' agent in our body. That's why they may, briefly, make us feel nauseous, give us a headache, or muscle pain. That's quite normal. It's analogous to the pain we feel in our muscles after we've been lifting weights or been on a long run. The temporary pain of our body adopting to its new circumstance is outweighed by the long term gain of being fitter, or being resistant, or at the least more resilient, to a deadly virus.

Facing Covid without a vaccine is a bit like entering a marathon without partaking of a single training run. You may be alright but it's not a good idea at all. So don't be fooled by that friend of a friend on Facebook posting weird and dangerous conspiracy theory nonsense about the dangers of vaccine. Take, instead, heed in the words of somebody who is actually an expert in the field.

Sarah Gilbert had worked on various other infectious diseases before. Rift Valley fever was first identified in Kenya but spread out to most of the rest of Africa and over to the Arabian peninsula. It's spread by camels and, more so, by the mosquitoes that feed on their, and our, blood. It can cause sheep to abort in huge numbers (90% of pregnant sheep who contract it will abort) and humans who get Rift Valley fever have a roughly 30% chance of dying.

Both the Smithburn vaccine and the ChAdOx1 vaccine for Rift Valley fever have proved effective only for animals, not humans. That still helped. The less animals that catch it (and ChAdOx1 has proved 100% effective with sheep and goats), the less people do. But with no workable vaccine for humans with Rift Valley fever, outbreaks continue and one is ongoing in Kenya right now.

I'd vaguely heard of Rift Valley fever but I don't think I'd ever heard of the Nipah virus. Which has affected nations from India to the Philippines to Australia. It's spread by bats, specifically large flying foxes who drink date palm sap from pots that humans, and pigs, also drink from. Fatality rate in humans is estimated to be between 40% and 75%.

A similar, related, virus, Hendra, spreads from bats (flying foxes again) to humans but this time via horses. Because the flying fox is prevalent in south and south east Asia, the same region is affected. Although, in the case of Hendra, Australia has seen the worst of it (with Nipah, the biggest outbreak was in Bangladesh). Thanks to the wonders of science a vaccine for horses, Equivac HeV, was developed and proved so effective that no vaccine was needed for humans.

It's suggested that the speed of this vaccine development was due to generous funding and that that funding was because horses can be worth ever such a lot of money. Pigs not so much. Bats, seemingly, even less. It's hard to imagine how one would go about vaccinating a global population of bats but it is interesting how often bats seem to be the carriers of these diseases.

Sarah Gilbert knew at least some of the reasons why. Bats have remarkably strong immune systems and can easily cope with many different viruses, even rabies, without becoming sick. The animals they may pass these viruses on to, including us humans, may not be made of such sturdy stuff.

All of this study of emerging infectious diseases around the world meant that when Covid-19 arrived Sarah Gilbert and her team knew, quite quickly, what needed to be done and were confident that they would, with adequate funding, be able to do it. The World Health Organisation had been warning of a 'Disease X' emerging for some years although most of this had fallen on deaf ears.

Or had been dismissed as scaremongering. The plans they had put in place for Disease X, however, imagined it as a serious of regional, or national, outbreaks and not a global pandemic. With the arrival of Covid-19, however, this was quickly revised and scientists around the world immediately set to studying the novel virus and trying to find a vaccine for it.

By July 2020, Sarah Gilbert and her team were carrying out clinical trials with over one thousand participants but to get a license for the vaccine they would have to prove that it works. Not just in one territory but in several. So testing was carried out in both Brazil and South Africa. Different age groups, also, had to be trialled before the vaccine could be pronounced both safe and effective.

One note of caution or even worry, however, came when it was conceded that the vaccine, the Oxford/AstraZeneca one at least, had yet to be tested on pregnant women. Trials are planned in the future but not yet. I couldn't help wondering why and, on hearing this, it made sense to me that there have been many stories of vaccine hesitant pregnant women. It was the one part of the talk I felt uneasy about.

I hope those trials take place soon and I hope the vaccine is proved to be both effective and safe for pregnant women because it really does need to be administered to as many people as possible as quickly as possible (in the Q&A, Sarah Gilbert said she didn't think we'd be able to achieve herd immunity until even children have been vaccinated against Covid).

This one note of caution should not eclipse the overwhelming good news that has come with the advent of these vaccines and Sarah Gilbert had every right to be proud when she remarked that there have been no hospitalisations or examples of severe disease within twenty-one days of people receiving their first dose of the vaccination.

This, and the prevailing belief that a longer gap - roughly three months - between the two jabs is more effective, has meant that, in the UK at least - thanks to the NHS whose staff have been rewarded by our nefarious government with a real terms pay cut in Rishi Sunak's budget on Wednesday, more and more people are getting their first jab every day.

Elsewhere on the planet, vaccine sharing schemes are making sure that vaccines are getting out to less wealthy countries. Of course, it could be happening much quicker but we need to think back only a few months and remember that there was a genuine fear we would never find a vaccine for this disease. We've come a long way, we've still got much to do, but we are, finally, heading in the right direction.

A Q&A saw Sarah Gilbert answer some very interesting questions. Will the Covid-19 experience mean we are more prepared for potential future pandemics? She hopes so. We all hope so. When asked if we will need annual jabs in the future, the answer was that that is still uncertain but we will know in good time. A personal belief of Sarah Gilbert was that it would be likely that older, and more vulnerable, people with weaker immune systems would need an annual jab but most of us would not.

Concern was raised about viral variants (such as the Brazilian one) but, so far, the vaccine has proved efficacious against every variant that has evolved. There was one digression, which I had some doubts about, that suggested that the reason those of a BAME background were more susceptible to becoming ill with Covid-19 was that those whose ancestors had lived in Europe for centuries had evolved resilience to viruses via earlier plagues and those whose ancestors had lived in Africa and Asia had not.

That didn't make sense to me. Africa and Asia have not been free of plague for centuries. Nowhere has. It was, along with the unanswered question about the effect of the vaccine on pregnant women, one of the two unsatisfactory notes of the whole evening and it would be a harsh critic who would end his appraisal of the evening on that note.

Instead, let's dwell on Sarah Gilbert's wonderful, pithy, answer when one attendee enquired as to which vaccine is the best one to take:- "the one you're offered". I think she's right. If you get offered it, take it. If you get a chance to vote for a party that wants to destroy the NHS, don't do it. If you can persuade someone who is vaccine hesitant to get the vaccine, do it.

I'd like to thank Adam for bringing this talk to my attention (he didn't attend himself, preferring an evening of Dungeons and Dragons - each to their own), to Samira Ahmed, Andrew Copson, and Humanists UK for hosting, and, most of all, to Professor Sarah Gilbert for being so generous with her precious time. Oh, and for saving our lives.