Here at VaccineNation we are delighted to kickstart the new year with another one of our recorded interviews from the World Vaccine Congress in Europe. As we look forward to the Congress in Washington in April, we will be releasing further interviews and exploring key themes for the event. For this interview we were lucky to secure a slot with Professor Miles Carroll of Oxford University. A specialist in high consequence emerging viral infections, his insight into how we respond to new threats and prepare for the future is incredibly exciting!
Meeting Professor Carroll
Professor Carroll and his lab are currently focusing on Ebola, Lassa fever, and SARS-CoV-2. He is also on the Pandemic Sciences Institute team, which was established in 2021. He explains that his work is particularly centred on viruses that are not endemic or are restricted to specific countries.
Where should we focus?
As mpox was of particular concern at the time of the Congress, we asked Professor Carroll how we can negotiate the balance between research and development for older threats as new threats continue to emerge. (At the time of our interview the name had not yet been updated.) In terms of “new threats”, many have been around for a long time. There are also newer threats to contend with!
Professor Carroll identifies the momentum that is driven by the United States with a focus on biodefence. However, he believes that “Mother Nature is the best bio-terrorist you can possibly imagine”. Consequently, there is a shift in research to address these issues. He refers to the smallpox vaccine that was prepared and stockpiled, which has since been applied to the mpox outbreak with remarkable success. By contrast, as we have more recently seen in Uganda, the outbreak of Ebola was not so easy to tackle, and although vaccines were sourced, they arrived as the cases were decreasing.
“So I think you’ve got to keep looking behind you, as well as looking forward.”
What does vaccine history teach us about the future?
In the spirit of looking backwards as well as forwards, we asked Professor Carroll what we can learn from vaccine development history to improve its future. Looking back to Jenner, the jump that was made between the milkmaid’s skin and a vaccination was “pretty quick”. Although the connection took some time, the vaccine development was fast. What we can learn from early vaccines is that we need to “cover all bases” in terms of safety and purity of vaccines. Along the way there have been processes that have not been ideal, but Professor Carroll believes that we are learning from these.
“Safety is paramount.”
Furthermore, SARS-CoV-2 demonstrated the possibility of incredibly accelerated licensure processes. From “concept to licensed product in under a year” should be applied to other public health threats.
“I believe that vaccine licensure process will be accelerated in the future on the back of the learning from the COVID pandemic vaccine development.”
Challenges for today
We asked Professor Carroll about the challenges that vaccine developers face at the moment. His overriding answer was simple: “cost”. Within this, availability of “effective animal models” and “concentration of disease” play significant roles. He suggests that “human challenge studies” have an “opportunity” to reduce the cost and the timelines for development. This might enable others, beyond “Big Pharma”, to have more successful attempts at vaccine development.
Advice for global health experts
The importance of a global coordinated response was emphasised during the COVID-19 pandemic, and we asked Professor Carroll what he thinks should be central to future threat anticipation and preparation. He refers to the WHO R&D Roadmap as an example of the importance of prioritising key threats and trying to understand them in time. In 2018 the “most likely culprit” of a future epidemic was agreed to be a “pathogenic respiratory coronavirus”.
Additionally, he reminds us of the need to keep Disease X in mind when developing vaccines and researching threats. Alongside this constant research comes a “shift” in developing vaccines, not just for specific viruses, but for a “genus of families”. This is the direction that Professor Carroll anticipates WHO will take in the next prioritisation of pathogens.
Finally, what about the Congress?
Our interview concluded with the classic question about why the Congress is exciting and or useful for Professor Carroll. If any members of our community are debating the benefits of joining us in Washington or indeed Europe later this year, we hope this encourages you! Professor Carroll has been joining us at our events for 10 years, and highlights the “collaborations” that result from that essential “face to face” contact in between sessions.
It was a pleasure to speak to Professor Carroll and we hope to catch up with him again soon! If you would like to join us at our next event in April, you can get your tickets here. Alternatively, stay tuned for more interviews in the build up.
