Speech: Learning lessons from vaccine development

24 June 2021

There are important lessons to be learned from the approaches that led to the rapid deployment of vaccines in the fight against the COVID-19 pandemic, James Naismith, professor of structural biology at the University of Oxford and director of the Rosalind Franklin Institute, told World Nuclear Association's Thinking Outside the Dome - Strategic eForum on Nuclear Innovation. The following is the text of his speech.

Jim Naismith speaking at World Nuclear Association's eForum "Governments across the world have been funding so-called blue-sky research for a long time, and some of these technologies have already come out from academic labs that were funded on the basis of 'doing interesting things'. But one of the things that we struggle with is all the 'snow' - identifying when something will become interesting. It is quite hard to pick in advance, although it's usually good to look in important areas, such as respiratory disease, for example.
In the Oxford [vaccine] case, people had been working based on the SARS-CoV pandemic on vaccines against coronaviruses. So they had taken the technology quite a long way down the road, but there was never a case where there was funding to make that big leap into translation. In Moderna and BioNTech's RNA technology, that had come out of laboratory work and there had been some hope it could be used as a vaccine, but people were unsure whether it would work.
What really shifted all of this was the economic calculus. Once we began to see mass lockdowns and very high numbers of deaths, [and] the cost of dealing with the pandemic - suddenly the cost of accelerating clinical trials was minuscule in comparison, and what we saw was just a sudden rush from the science community to be of service, built on that long-term funding of basic science. In the UK at least, the involvement of Astra Zeneca with the Oxford vaccine was critical in delivering a product that could actually be stuck into arms. The same is true of Pfizer's partnership with BioNTech - large companies have that depth of expertise necessary to take fledgling technologies and turn them into real products.
In China, there has been a lot of investment in vaccine programmes, and China also drove forward its vaccination programmes. So, if I summarise: that technology had been developed; it had never been tested 'in anger', because there had never been the funding or the identified need. Suddenly the need and the funding came along, and you had a science community desperate to show the value of years of investment, and that's what drove this.
It was easy to do clinical trials, because we had vast numbers of patients, and that's an important consideration. It would be very hard to replicate some of this, and my concern would be that there's a lot of promising science directed against treatments of the disease, rather than vaccines, that may struggle to be funded, or may struggle to be tested - and that means that we might not get all the gains we would like from this pandemic, scientifically.
One of the features of the biotech industry and the medical industry in general, is that it's not super-profitable, at least at the cutting edge of technology and medicines delivery and compared with other industries. The profit margin is not great, and it's often quite long term - I suppose that's something that it might share with [the nuclear] industry.
So relying entirely on the market to drive this is not likely to be successful. There has to be an important role in innovation from government where there is an ability to take risks and the payoff may be zero, or it may be just a lot of knowledge that we all feel very good about, but there's no practical product.
I think we saw some of that in the development of the vaccines. Those vaccines all came from academic labs and transferred in to the commercial world, and I think that ability of governments to finance, where there's market failure, the high risk projects with an uncertain return.
I think the problem with that is, often, everybody's very keen on high risk, high return projects. But by definition, where there's high risk, there's also going to be failure, and nobody wants to accept failure, everybody thinks it can be designed out. But by nature, there will be failure. Government is probably about the best way to do that in the type of work in biotech.
But equally, you need a thriving business sector to bring the resources together to take things out of the lab and into people, and we saw that again with the vaccine story, and it's replicated in many different areas. The genomics was done by government funding, and charity funding, but genomic medicine - the benefits of it - will flow from pharmaceutical companies building on that innovation.
So, to me, you need all of them at the table, and underpinning it is public consent, public support. One might hope that's easy to obtain, and certainly there's been a lot of public support for science during the COVID pandemic, but politicisation and a culture that finds it difficult to accept science doesn't help any of us … and so we constantly have to be aware of how we engage the public in what we are doing, how we communicate it and how we get there support."