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As proud COVID Community Champions, Wolverhampton GP, Dr Amanda provides regular guest blogposts on the ACCI website to educate the local community about COVID-19 and the vaccine.

Dr Amanda Chisholm

If you asked yourself in December 2020 when the roll out of the vaccine was first announce- “Wow that was quick! How did they do it? Hasn’t it been less than a year? Is this safe? Will it work?”- then you weren’t alone. I myself had that exact reaction, from my knowledge it usually takes 10-15 years to develop a vaccine right?! And that’s on the faster side of things… When COVID-19 first hit the world my colleagues, family and friends all discussed how on earth we were going to get out of this, and for me what kept coming back to my mind time and time again was we need a vaccine, and hopefully if we all work really hard they can get one together in maybe 2 years, but I prayed for something to come along sooner. I actually think a lot of people prayed and hoped for a way out as quick as possible, but when the vaccine did hit the public in record time we all felt a little apprehensive and had questions!

I love questions, ever since I was a child- I remember my grandma asking me again and again “why do you ask so many questions?” I would always respond “well how will I learn anything?”. That’s why I love questions because it means there is knowledge to be gained and answers to be found. There are very good reasons why this vaccine was developed so quickly, I hope to explain them in this article for you and that it puts some ease to your mind and confidence as it did for me.

THE FOUR STAGES OF MEDICINE AND VACCINE DEVELOPMENT

First of all it’s important to understand the actual process involved in developing all the vaccines and medicines that we use at mass today. It is a four stage detailed process:

  • Research and Pre-clinical trials

This is the part where the very intelligent scientists do lots of research in laboratories and develop the vaccine itself, it involves taking knowledge from past diseases and medicines and combining that with our ever evolving technologies. This is where the vaccines are also tested on animals.

For the COVID-19 vaccine this process began at the start of 2020 just as the impact of COVID-19 was being realised. The scientists were able to build on decades of knowledge from other coronaviruses such as SARS and MERS, use the latest technology that was already in development and do many parts of the process simultaneously rather than consecutively- all leading to a huge amount of time being spared.

  • Three stages of clinical trials

This is where the testing on real people comes into play.

Stage 1- dozens of peoples are used to test for the vaccines safety.

Stage 2- hundreds of people are used to test for their immune response to the vaccine.

Stage 3- thousands of people are tested for long term effects of the vaccine.

For the COVID- 19 vaccine stages 2 and 3 were done at the same time making the process quicker once again.

  • Independent regulatory approval

All medications in the UK must be approved by an independent non biased regulator. For us that is the Medicines and Healthcare Products Regulatory Agency (MHRA), before a vaccine can be distributed it must meet safety, quality and effectiveness measures. In a careful and methodical manner expertly trained and experienced scientists will review all the data from lab studies and clinical trials, to manufacturing and testing data, before giving it the green light for distribution.

  • Manufacturing and distribution

Specific facilities need to the be built to enable the production of the vaccine in sufficient numbers. These locations started being built in the early stages of vaccine development so were ready after stage 3 rather than waiting till the end of stage 3 to start building, once again saving valuable time.

FIVE REASONS THE VACCINE CAME OUT SO QUICKLY

Right at the start of this article I informed you that I had predicted that the vaccine could come together in about 2 years, this was significantly shorter than previous vaccines. Smallpox which was eradicated in the western world thanks to vaccinations in the 1950’s took centuries to develop. In 1945 the first influenza vaccine was developed after around 15 years of development but within 2 years was found to need serious revisions, and the HPV vaccine distributed more recently in the 21st century took over two decades to be developed. Vaccine development is long and expensive with many delays caused by applying for funding, ethical approval and recruiting volunteers, not to mention the negotiating and scaling of projects that need to take place.

So my very optimistic prediction for a 2 year turn around was based on many factors but the main one being the emergency state the entire world was in due to COVID-19 virus. COVID-19 spared no one, even those that are often shielded from the health concerns of the world were being affected by this. Every country and continent, and every industry was being shut down or put under strain. The world’s economy was breaking down, so all the people in the all the places had an invested interest, including the ones with the money and decision making powers. Here are five further reasons to explain the speed of development:

  • A collaborative effort: scientists, doctors, ethics boards, manufacturers and regulatory boards, all worked together to make the fight again COVID-19 their number 1 priority. Information and research was shared in a way we have never seen before.
  • Advances in science: after hundreds of years of research and vaccine development and the knowledge and experience gained from that it is no surprise that a vaccine being developed in 2020 would take so much less time compared to 1920. Think about any task or skill you have developed- for example my video editor (who also happens to be my husband), when he first started editing it took him in excess of 3 hours for a 20 minute video, whereas now it can be as quick as 30 minutes.
  • Willing volunteers: usually the recruitment process for clinical trials can be very slow, however as COVID-19 was so well known and so many people had time and willingness to help participants were quickly found.
  • Doing things at the same time: usually stage 3 is done after stage 2, and stage 2 after stage 1, however with good planning and access to funding stage 1, 2 and 3 could all be carried out at the same time.
  • Money, money, money: governments and funding bodies had all joined together to remove the financial obstacles, this was the catalyst to allow all the above things to work so successfully.

Well there you have it, that is how the vaccine was developed in record time. I do hope some questions were answered, but I know you have many more. I can hear you asking already: “what are the 5 or 10 year effects?” and “what about the new complications being discovered?”- so let’s discuss those in my next post.

For information about Dr Amanda Chisolm, Wolverhampton GP, MBChB MRCGP:

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