When predicting the future, some of the world’s best forecasters always make sure to leave at least some room for rare events to upset their predictions. This time last year, the main focus of the British political system was the changing relationship with the EU, and there was little to no attention given to the small risk of a worldwide pandemic. Having had a very grim demonstration that small risks can blow up in your face with devastating consequences, the Government should be doing everything it can to mitigate the risk to the UK’s vaccine supplies by expanding domestic manufacturing of vaccines.
Alhough the current rollout is going well, there remain two major threats to the success of the UKs vaccination programme: first, that supplies of the vaccine are cut. Already, there has been a fire at a factory producing the vaccine for India, and production problems at the Astrazeneca (AZ) plant in Belgium in part led to the events of the last week, where the massive cut in the expected deliveries of the AZ vaccine to the EU led the European Commission to threaten to restrict exports. Closer to home, floods posed a very serious threat to the AZ plant in Wrexham. Clearly, factors outside our government’s immediate control can influence our supply of vaccines.
This risk is mitigated by vaccine manufacturing plants in the UK itself. As well as the AZ factory in Wrexham, there is also the Novavax plant in Teesside and the Valneva plant in Scotland. Ultimately, had the EU’s export ban taken effect, then the UK would at least have been able to produce these vaccines domestically.
Currently, none of these plants currently produce mRNA vaccines, the type being produced by Pfizer/BioNTech and Moderna. In the UK, the Pfizer vaccine is currently being distributed alongside the AZ vaccine. Understanding a little about how vaccines work makes it easier to understand why acquiring domestic mRNA production is so crucial.
Simply put, the AZ vaccine uses another virus to carry and deliver the instructions to produce the spike protein of covid-19, triggering our immune system to produce antibodies targeting that spike protein. On the other hand, mRNA vaccines like Pfizer do not contain a virus, just some chemicals and the mRNA instructions to our cells to create proteins which also trigger an antibody response. Because these mRNA vaccines are instructions rather than another virus, new vaccines can be updated as soon as the genetic code of new variants is known: that’s why Moderna was able to develop its vaccine candidate in just two days. Although both kinds of vaccine are safe and effective, the value of an mRNA vaccine is that new, updated versions can be developed exceptionally quickly.
With various major Covid variants already circulating, several of which are already less well targeted by current vaccines, there is clearly a substantial risk that our current vaccines will be much less effective in the face of the further variants that are almost certain to emerge.
Those new variants are the second threat to the vaccination programme; the very real risk that new mutations will bypass the vaccines that we are now producing. That would effectively put us back almost at square one in terms of vaccination.
Although this is definitely something to worry about, it is not a novel issue. Flu shots are given annually because of the changes in the flu virus, for instance. But, given the deadliness of Covid and how quickly it spreads, we need to be prepared to mass produce updates quickly. It has taken a year from knowing the genetic code of Covid to getting mass vaccination under way, at immense human and economic cost. Although not all of the steps, such as phase 1 and 2 clinical trials, need to be repeated, the UK cannot afford to wait so long after a new mutation – or an entirely new virus – before we vaccinate again.
In the VMIC of time
Thankfully, a solution is on its way. In 2018, construction began on the Vaccines Manufacturing and Innovation Centre (VMIC). This facility will be an immensely useful asset, enabling the UK to quickly respond to mutations in Covid, as it will be able to produce ten of millions vaccines a year.
Although the completion date has been brought forward a year, the Government has only spent £131 million to accelerate this, a tiny amount of money compared to the £156 billion cost of another six months of lockdown while we wait for a new vaccine. The Government could pay the developers £10million for every day ahead of schedule the plant comes online and it would still save money. Even if the Treasury has no appetite for such radical schemes, the Government should be doing much more.
This is the sort of capability we need to be able to stop a future new variant or some different virus spreading quickly. The only way to be sure of avoiding the hundreds of billions of pounds of economic damage that we have suffered over the last year again is to accelerate this factory, and to continue to fund it even if we don’t meet any new deadly viruses for a few years.
This is not the only instance where splashing the cash can help. AZ does not currently make a profit on its doses, and although it has done a great job so far, more doses produced faster will always be welcome. Novavax, which has recently reported extremely promising results for its vaccine, should also be paid more if they can deliver significant supply ahead of schedule. In any event, while the MHRA checks the Novavax vaccine is safe, the Government should commit to paying for the firm to produce vaccines so hundreds of thousands of doses, if not millions, are ready to ship, even if the MHRA doesn’t end up approving the vaccine.
Measures to increase domestic vaccine production will undoubtedly help bring a faster end to the pandemic, but these also need to be accompanied by continued funding for surveillance and testing of new variants. Reducing the potential for new variants to be introduced to the UK from abroad should be simply done by closing the border, at least for the next few months. The costs to airlines may be great, but offering affected businesses financial support would be far cheaper than allowing new variants to undo the progress we have made.
The decisions taken in the first three months of 2020 defined the rest of the year. Driving down the risk of nasty surprises in 2021 should be a no brainer for this Government, and increasing domestic production of vaccines is a clear place to start.
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