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

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

Another wave of Covid-19 is reported to be on the way. To what extent can you 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 needs to be tested and approved. What has been happening, as we go through wave after wave, is that the virus has come too fast. Regulators can’t approve a vaccine unless they can see the clinical data, so you have to scale up manufacturing to produce the vaccine in quantity. The developers are still using the original vaccines, which provide good protection against the disease.

In his book, he responds to some people’s fear that the vaccine was produced too quickly.
We moved from vaccine production to licensing as quickly as possible. But everything that we normally do when we develop a vaccine has been done, we just worked really hard to eliminate all the delays in that process. This was only possible because there was a 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 about what would work; it was important to have as many development options as possible. We had multiple successful vaccinations, which was wonderful. Pfizer, Moderna and AstraZeneca were licensed for emergency use early, yet there was still a shortage in vaccine production.

His book powerfully reassures vaccine doubters. I wonder if you agree that the psychology behind vaccine aversion could be in part a reaction to months of being told how to live or not live, and be a desire to regain control.
There may be something to that. In some countries, people don’t want to get vaccinated because their government recommends it and they don’t trust their government. I don’t think that has been a feature in the UK because, whatever people’s views on government, they recognize the contribution of the NHS. But much of the hesitation among young people was because they were receiving misinformation, sometimes from friends whose opinions they trusted.

Is there any risk that Covid-19, instead of becoming more transmissible and less lethal, will return as a more serious variant?
The truth is that we do not know where Covid-19 is headed. It could continue to get milder or turn back into a more serious disease.

Are we too dependent on the effectiveness of the vaccine in the UK and getting careless by stopping wearing face masks? Do you still wear a mask?
I have more or less stopped. I had about a year of always following the guide. But recently, there has been no guidance. I have traveled by subway without a mask. I got Covid, for the first time, about 10 days ago. It was like having a nasty cold and I didn’t care. It only lasted a few days and I was fine again.

To what extent was having triplets a good preparation for the energy you needed professionally?
If you’ve been through triplets, you realize that when the chips are low and you have to do something, you can do it. People often do more than they expect of themselves, when it is necessary to find the strength and energy to get a job done.

What was your most stressful moment?
Ironically, that’s 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. Everyone had been working flat out for months and was very tired. Those leading the project had to engage in quite grueling media interviews. I was doing two hours of consecutive 15-minute interviews without a break. It was wonderful to have the result, but having to explain it was a challenge.

And yet you somehow found time to write a book.
I would do it whenever I had a free moment. A small part of it, I dictated as I walked. Sometimes I walk to work when the weather is nice, as that gives my brain a break and no one can interrupt me.

It must have been hard on your family having you consumed with work..
It’s hard to take time away from the work I do. I have a hard time disconnecting. I need to improve on that. It was hard for all of us, they did their best to support me.

Oxford has made him professor of vaccinology; It must be a pleasure to have that recognition..
I have the title since 2010 but now I have an endowed professorship. It’s very rewarding, but none of the people who work for me have a secure job, so I continue to fundraise to keep them on the job. I’m recruiting for my research group (on non-Covid vaccines and on vaccine technology) and I’m very, very busy. We have lost a large number of staff who are exhausted and no longer willing to take short-term, not particularly well-paying jobs. Funding really needs to change, although I don’t see any short-term prospects for it to improve.

Gilbert with her Barbie doll.
Gilbert with her Barbie doll. Photograph: Andy Paradise/REX/Shutterstock

You’ve had a Barbie doll named after you. How is she? And a baby penguin at the London Zoo?
Can i show you [she produces a bespectacled Barbie with straight red hair, face mask dangling from her hand]. You can see? She doesn’t look bad and, look, I really like the little mask on her. I visited the baby penguin and fed him some fish, it was so much fun.

You have a mug that says “Keep Calm and Develop Vaccines”. Who gave it to you?
It was a secret Santa present at work. The cup is now in 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 have read that he keeps calm and works in the garden when he can. How is she doing in her garden?
Very very bad. He has been overtaken by weeds. It’s a small garden and because I’ve been busy all my life I designed it to be low maintenance but it does require some intervention and recently it hasn’t had any.

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

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