As a vaccinologist, to see your creation – in this case the Oxford AstraZeneca vaccine – administered more than 2.2 billion times in fighting a raging pandemic is probably close to the pinnacle of success.
This is the remarkable achievement of Irish scientist Prof Tess Lambe, who with Prof Sarah Gilbert and a team at the University of Oxford, co-designed the AZD1222 vaccine.
According to Airfinity data company, the vaccine "is almost certain to have saved more lives than any other". It is destined for accelerated rollout throughout the developing world.
Lambe was awarded an honorary OBE in the Queen Elizabeth's birthday honours this year, marking her contribution to science and public health. All told, a great year in spite of Covid-19. And it is about to get even better; she is to follow eminent scientists in delivering a Royal Institution Christmas lecture on Thursday. It will be broadcast on BBC Four television (on Thursday, December 30th) at 8pm.
Carlow-born John Tyndall, who in 1859 discovered "the greenhouse effect", was the first Irish person to fulfil the role but recently more Irish scientists are being asked.
This year is a deep dive into the science of vaccines. “They weren’t seen as being very exciting... now we seem to think they’re really cool,” Lambe explains.
Christmases in Kilcullen, Co Kildare, were a world away from that great British tradition, but she is very taken with the Royal Institution's ethos in helping children from under-represented areas immerse themselves in science. She likes engaging with children on science and fielding their unabashed questions.
Lambe studied pharmacology and genetics in UCD before doing a PhD there in how cells develop and die.
Speaking almost a year to the day since her team announced impressive efficacy results with their candidate vaccine, she says “in some ways it feels like it was yesterday, and in other ways it feels like a lifetime ago”.
Days merged into nights; it did not matter what day of the week it was. She and a colleague co-designed the vaccine over a weekend, and within 103 days it was being put into people. They could move quickly, building on “platform technology” in development for years. A remarkable head start, when the world was crying out for an effective jab – the norm is anything up to 10 years in development.
“We didn’t see it as work, we saw it as: ‘what we can try and do to help’.” Hand on heart, in January 2020 after the genetic constituents of SARS-Cov-2 became known, she could not say if theirs was a vaccine guaranteed to work. But the situation was “so dire and so horrid...that anything we could do, we would do.”
From there a team of just two was scaled up rapidly. Critically, there was lots of help from friends, colleagues and other scientists around the world.
The Oxford team is very much multinational with a strong Irish presence. Its hallmark is a mix of curiosity; hard work, willingness to try again after getting things wrong and above all “a streak of stubbornness”, she believes – including “young people prepared to give anything a go”.
Their latest creation will increasingly be used – and manufactured – in low and middle income countries, especially those with poorly-equipped healthcare systems; “that’s where vaccines can have a big impact”. It is being channelled through the Covax global sharing mechanism; 65 per cent of the initial vaccine doses from this source (some 500,000 jabs) have been Oxford AZ.
She agrees the situation in Africa is challenging and uncertain. A low incidence of cases in many areas is likely due to a combination of under-reporting and demographics; having younger populations compared to Europe – Covid-19 is predominantly a disease of older adults.
Lambe, none the less, points to significant impacts there, and the high number of deaths in India. Also, the immune system is influenced by where you live; a combination of scientific, social and environmental factors.
She strongly encourages use of booster vaccines where Governments recommend their use. This is because of waning immunity and the vulnerability of older people and those with compromised immune systems. Because they have a sell-by date, they should not go to waste. For her, however, the most important need is to “get vaccines to those who have not got their first dose”.
“The pandemic will end; the virus will become endemic,” she stresses. “This is where I get a little macabre. It’s likely that we will get another pandemic of some virus at some point in the future.”
So the good and bad lessons need to be learned, notably on the need for effective co-operation between government, academia and industry, Lambe underlines. “We need to keep it going – we need to ensure walls don’t go back up.”
It has not been a fun two years and all have suffered in some way, she notes, but heeding those lessons is essential to improved preparedness.
Scientists for the most part got it right, Lambe insists, in explaining and reassuring people while not dumbing down, which built trust and confidence. “You need to let people know what you do and give them results so they can make informed decisions.”
She always thought scientific work spoke for itself and did not need to be explained but admits she was wrong. “There has to be more onus on myself and others to clearly communicate what we’re doing.”
Positive outcomes include the ability to make a vaccine within nine to 12 months; to do test and trace and to make therapeutics quickly, but “vaccine nationalism and a myopic outlook is not going to end the pandemic”.
With cases surging in Europe and elsewhere, she doesn’t know when the endpoint will be, especially when vaccination is so uneven. Their vaccine is effective against the Omicron variant, while work has begun on an Omicron-targeted version in case it is needed.
As for Covid-19’s origins, Lambe says it’s not her area of expertise but acknowledges most viruses have a “zoonotic reservoir” – emerging from infectious diseases circulating between animals and humans. Not wishing to be flippant, she prefers to focus on the present: “We are where we are, we need to get out of where we are, and get back to new normal.”
For her personally, that means coming home to see her parents Mary and Anthony Lambe and extended family, and for her father to be able to travel to the UK to help out with her children, which made for happy pre-Covid times. "That has stopped. Hopefully, it will start back up. But I do miss Ireland. "