Vaccinologist Sarah Gilbert: ‘We need to be better prepared for a new pandemic’

Dame Sarah Gilbert, 60, is a professor of vaccinology at Oxford’s Jenner Institute and author, with Catherine Green, head of Oxford University’s clinical biomanufacturing facility, van Vaxxers – a gripping narrative about developing the AstraZeneca vaccine that is wonderfully accessible and illuminating without dumbing down the science. She lives in Oxford with her husband and grownup triplets.

Another wave of Covid-19 is reported to be on its way. To what extent are you able to anticipate what the virus will do next and prepare?
Anticipating what the virus will do next is the job of those who do surveillance in epidemiology. But if a new sequence is thought to be becoming dominant, our problem is that making a new version of the vaccine takes time and has to be tested and approved. What’s been happening, as we go through one wave after another, is that the virus has been too quick. Regulators cannot approve a vaccine unless they can see the clinical data, then you have to scale up manufacturing to produce the vaccine in quantity. Developers are still using the original vaccines, which are supplying good protection against the disease.

In your book, you answer the fear, felt by some people, that the vaccine was produced too quickly.
We moved from vaccine production to licensure as quickly as possible. But every single thing we normally do when developing a vaccine was done, it was just that we worked very hard to cut out all delays in that process. This was only possible because there was one project in the world that everyone cared about and regulators were able to remove bottlenecks in their process.

The vaccine was presented in the media as a competition between manufacturers.
When we started, nobody had any certainty over what would work; it was important to have as many options in development as possible. We had multiple successful vaccines, which was wonderful. Pfizer, Moderna and AstraZeneca were licensed for emergency use early and yet there were still shortages in vaccine production.

Your book powerfully reassures vaccine doubters. I wonder if you agree that the psychology behind the vaccine-averse might partly be in reaction to months of being told how to live, or not live – and be a wish to reclaim control?
There might be something in that. In some countries, people do not want to be vaccinated because their government recommends it and they don’t trust their government. I don’t think that was a feature in the UK because, whatever people’s view on government, they recognise the input of the NHS. But a lot of the hesitancy among younger people was because they were receiving misinformation, sometimes through friends whose opinions they trusted.

Is there any risk that Covid-19, instead of becoming more transmissible and less deadly, might return as a more severe variant?
The truth is we don’t know where Covid-19 is going next. It could continue to become milder or it could become a more severe disease again.

Are we over-reliant on the vaccine’s efficacy in the UK and becoming slipshod in no longer wearing face masks? Do you still wear a mask?
I’ve more or less stopped. I had about a year of always following the guidance. But recently, there hasn’t been any guidance. I’ve travelled on the tube without a mask. I got Covid, vir die eerste keer, oor 10 days ago. It was like having an unpleasant cold and didn’t worry me. It only lasted a few days and I was fine again.

To what extent was having triplets good preparation for the stamina you’ve needed professionally?
If you’ve been through having triplets, you realise that when the chips are down and you have to do something, jy kan. People often do more than they expect of themselves – when there’s a need to find the strength and energy to get a job done.

What was your most stressful moment?
Ironies genoeg, it was when we got the efficacy result in November 2020. It was complicated because there were different levels of efficacy in different parts of the trial. Everybody had been working flat out for months and was very tired. Those leading the project had to go into pretty gruelling media interviews. I was doing two hours of back-to-back 15-minute interviews without a break. It was wonderful to have the result but having to explain it was challenging.

And yet somehow you found time to write a book.
I’d do it whenever I had a spare moment. A small part of it, I dictated as I was walking. I sometimes walk to work when the weather is nice as it gives my brain a rest and nobody can interrupt me.

It must have been hard for your family having you consumed by work.
It’s difficult to take any time away from the job I do. I find it really hard to switch off. I need to get better at that. It was difficult for all of us – they did whatever they could to support me.

Oxford has made you a professor of vaccinology – it must be a delight to have that recognition.
I’ve had the title from 2010 but now have an endowed chair. It’s very gratifying but none of the people who work for me have secure jobs, so I’m still raising funds to keep them in post. I’m recruiting staff for my research group (on vaccines that are not for Covid and on vaccine technology) and am very, very busy. We’ve lost a lot of staff who are exhausted and no longer willing to put up with short-term, not particularly well-paid jobs. The funding really needs to change though I don’t see any short-term prospect of it getting better.

You’ve had a Barbie doll named after you – what does she look like? And a baby penguin at London Zoo?
I can show you [she produces a bespectacled Barbie with straight red hair, face mask dangling from her hand]. Can you see? She’s not a bad likeness and – look – I really like her little mask. I’ve visited the baby penguin and fed it some fish – that was quite fun.

You have a mug saying “Keep calm and develop vaccines”. Who gave it to you?
It was a Secret Santa present at work. The mug is now with the Science Museum in London. But I want to show you something else: my daughter embroidered this [a little sampler with the same message stitched in place].

I’ve read that you keep calm and garden when you can – how is your garden doing?
Really, really bad. It’s been overtaken by weeds. It’s a small garden and because of being busy all my life, I designed it to be low-maintenance, but it does require some intervention and recently hasn’t had any.

Your book sees a new pandemic as a future certainty. What should we do differently next time around?
We need to be better prepared in many different areas. In vaccine development, there are viruses we already know can cause disease outbreaks, yet we don’t yet have a vaccine against them. We should be developing vaccines now against all those and having them ready so that if there is an outbreak, we’ve got the vaccine to cope with it.

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