LSTM hosted a unique convening of expertise on vaccination in honour of World Immunization Week 2020.
A range of research knowledge was brought to the table, showcasing the academic excellence that Liverpool has to offer. High-level policy engagement ensured that questions of science were rooted in practical, real world challenges.
The UK Secretary of State for International Development, Rt Hon Anne-Marie Trevelyan MP, used the symposium to reiterate the UK government's generous commitment, made a few hours before in Parliament, to fund Gavi, the Vaccine Alliance, for an amount of £330 million a year for the next five years. Given the COVID-19 pandemic many of the discussions were tailored to how the response can be supported.
Knowledge
The vaccine development work that is being done for other diseases and pre-existing scientific knowledge is feeding into COVID-19 work.
Professor Julian Hiscox of the University of Liverpool reminded participants that Corona viruses are not new, and they have been studied since the 1930s. This provides the audience with a base of evidence to work from. He reflected on how previous work on Severe Acute Respiratory Syndrome (SARS) and Middle-Eastern Respiratory Syndrome (MERS) could assist in work to develop a vaccine for COVID-19 and also help better understand how to reduce the R number and improve contact tracing.
LSTM's Professor Daniela Ferreira talked through the use of Controlled Human Infection studies to accelerate the development of vaccines. In these studies, a strain of infection is given to adults to find new ways to prevent and treat illnesses.This is a way of discovering and testing vaccine efficacy which is far cheaper and quicker than conventional methods. She explored some of the ethical and practical challenges that there might be in applying these methods to COVID-19 such as whether the benefits would outweigh the risks, whether it is ethical to use Personal Protective Equipment (PPE) in trials when there are shortages among health care workers and how to exclude participants with risk factors for disease severity.
Aurélia Nguyen explained how Gavi is lending its expertise to the COVID-19 response in terms of building vaccine systems, delivering at scale, strengthening health systems, controlling other infectious diseases and leveraging private sector funding. In common with many organisations, Gavi is drawing on its key strengths to support the response. It is also being flexible, for example in using its health system strengthening budget lines to support the purchase of PPE for health care workers.
Equity
Throughout the symposium therew was broad agreement that an equity focused approach to vaccine development, deployment and access should be taken.
It is likely that initial COVID-19 vaccines will be given to those most vulnerable such as health care workers, the elderly and people at high risk of serious disease. There was also discussion of the importance of ensuring that the needs and views of low- and middle-income countries were placed on an equal footing with richer countries when it comes to vaccine development. Drawing on the work of the ARISE Consortium, Dr Rachel Tolhurst stressed the need to consider the most marginalised people living within urban informal settlements in low- and middle-income countries when it comes to vaccination. She drew a vivid picture of the daily challenges of life and work for people in informal spaces, which have been both made more visible and severely exacerbated by the COVID-19 pandemic. Lack of water for handwashing, overcrowding that prevents physical distancing, poor access to health services, little mental health provision, intimate partner violence – all of these issues hamper the response to COVID-19 and are the result of political economic and social processes and structures of exclusion, including failures of governance.
Gavi's CEO, Dr Seth Berkley, explained that the COVID-19 pandemic and subsequent lockdowns and curtailment of movement have disrupted ongoing vaccination programmes. This could have devastating effects in terms of deaths to preventable illnesses and it would also hamper eventual delivery of a COVID-19 vaccination as these systems are vital for this process. This is likely to be felt most acutely by the poorest and most marginalised.
Solidarity
There was a strong message from the UK Government on the need for solidarity across countries. The Secretary of State, Rt Hon Anne-Marie Trevelyan MP, reiterated that lesson learning and sharing, of the type that occurred in the symposium, is vital. Dr Chris Lewis of the UK Department for International Development pointed out that no one country has the capacity to tackle COVID-19 alone; it requires government, industry and international cooperation. It needs a global perspective as viruses do not respect borders. As is known for so many infectious diseases, COVID-19 infection somewhere is COVID-19 infection everywhere.
The audience then heard about the Solidarity Trial, an international clinical trial to help find an effective treatment for COVID-19, over 100 countries are working together to find effective therapeutics as soon as possible. Dr Soumya Swaminathan, WHO's Chief Scientist, led participants through the Access to COVID-19 Tools (act) Accelerator, which is a collaboration of academics and researchers that seeks to accelerate the development, production and equitable Access to new COVID-19 diagnostics, therapeutics and vaccines. She also pointed to the WHO Research Roadmap as a key tool to prioritise and coordinate research action.
The future
The Global Vaccine Summit will take place virtually on 4 June 2020. Ahead of this event The Rt Hon Anne-Marie Trevelyan MP announced that the UK Government have pledged £330 million per year to Gavi from 2021-2025. This is a tremendous boost for work on immunization and most welcomed.
There are many challenges that need to be overcome to ensure the accessibility of a COVID-19 vaccine when it becomes available. But it is possible that this is a process that may make the world fully appreciate the need for vaccines and breakdown some of the ‘vaccine hesitancy’ that has been a cause of preventable illness and death for too long.
As the development of a vaccine is eagerly awaited, sustainable partnerships need to continue to be build supporting the delivery of COVID-19 interventions equitably and accountably. The interdisciplinary and global research relationships matter and will be a source of sustenance in responding to this pandemic.
This symposium is the first in a series of three which will be advertised on LSTM's website and social media channels. The second symposium is scheduled to be held on the 27th of May, the third towards the end of June. Do not miss out on the chance to register as soon as the programme becomes available.
A recording of the first symposium can be found here: