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

Dame Sarah Gilbert, 60, is Professor of Vaccinology at the Jenner Institute in Oxford and author, along with Catherine Green, Head of Clinical Biomanufacturing Facility at the University of Oxford, of Vaxxers – a gripping account of the development of the AstraZeneca vaccine 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 on the way. How good are you at anticipating what the virus will do next and preparing yourself?
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 become dominant, our problem is that making a new version of the vaccine takes time and has to be tested and approved. What is happening, as we go through wave after wave, is that the virus has been too fast. Regulators can’t approve a vaccine unless they can see the clinical data, so you have to ramp up manufacturing to produce the vaccine in quantity. The developers still use the original vaccines, which provide good protection against the disease.

In your book, you respond to the fear, felt by some, that the vaccine was produced too quickly.
We have moved from vaccine production to licensing as quickly as possible. But everything that we normally do when developing a vaccine has been done, it’s just that we have worked very hard to eliminate all delays in this 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, no one had any certainty about what would work; it was important to have as many development options as possible. We had several effective vaccines, which was wonderful. Pfizer, Moderna and AstraZeneca were cleared for emergency use early on and yet there were still shortages in vaccine production.

Your book powerfully reassures those who doubt vaccines. I wonder if you agree that the psychology behind vaccine aversion could be partly a reaction to months of being told how to live or not live – and part of a wish to resume the control ?
Maybe there’s something in there. In some countries people don’t want to be vaccinated because their government recommends it and they don’t trust their government. I don’t think that’s a feature in the UK because whatever people think of government, they recognize the contribution of the NHS. But much of the young people’s hesitation was due to them being given the wrong information, sometimes through trusted friends.

Is there a risk that Covid-19, instead of becoming more transmissible and less lethal, will return as a more severe variant?
The truth is, we don’t know where Covid-19 is going. It could continue to subside or become a more serious illness again.

Are we overly dependent on vaccine effectiveness in the UK and becoming careless by not wearing face masks anymore? Are you still wearing a mask?
I more or less stopped. I had about a year of still following the advice. But recently there has been no guidance. I traveled on the metro without a mask. I caught Covid, for the first time, about 10 days ago. It was like having a nasty cold and that didn’t worry me. It only lasted a few days and I was fine again.

How good was having triplets preparation for the stamina you needed professionally?
If you’ve ever had triplets, you realize that when the chips are down and you need to do something, you can. People often do more than they expect of themselves – when it’s necessary to find the strength and energy to get the 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 hard for months and were very tired. Those running the project had to take part in some pretty 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 difficult.

And yet, you have found the time to write a book.
I would do it when I had a free moment. I dictated a small part of it while walking. I sometimes walk to work when the weather is nice because it gives my brain a rest and nobody can interrupt me.

It must have been hard for your family to have you devoured by work.
It’s hard to take time off from the work I do. I really have a hard time shutting down. I have to get better at this. It was difficult for all of us – they did everything they could to support me.

Oxford has appointed you Professor of Vaccinology – it must be a pleasure to have this recognition.
I had the title since 2010 but now I have an endowed chair. It’s very rewarding, but none of the people who work for me have stable jobs, so I keep fundraising to keep them there. I’m recruiting staff for my research group (non-Covid vaccines and vaccine technology) and I’m very, very busy. We have lost many exhausted employees who no longer want to accept short-term and not particularly well-paid jobs. Funding really needs to change although I see no prospect of improvement in the short term.

Gilbert with his Barbie doll. Photography: Andy Paradise/REX/Shutterstock

You 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 visited the baby penguin and fed him some fish – it was quite fun.

You have a mug saying “Keep Calm and Develop Vaccines”. Who gave it to you?
He 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’ve read that you keep calm and garden when you can – how’s your garden?
Really, really bad. It was overgrown with weeds. It’s a small garden and because I’ve been busy all my life I’ve designed it to be low maintenance, but it does need some attention and haven’t had any recently.

Your 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 epidemics, but we don’t yet have a vaccine against them. We should now develop vaccines against all of these and prepare them so that in the event of an epidemic, we have the vaccine to deal with it.

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Edward L. Robinett