HUGE leaps in scientific knowledge mean Britain has a well-established vaccine programme among all ages to combat common but potentially deadly diseases and infections.
Diphtheria, tetanus, whooping cough and polio are among the conditions the NHS can prevent with a simple jab and Oxford plays a key role in the next stage of protection.
The Oxford Vaccine Group’s work to provide more vaccinations of meningitis are among the hundreds of trials that take place in the city each year.
Dr Katie Ewer, right, with the the lab team in Banfora in south western Burkina Faso where the malaria vaccine trials are being held
Oxford University, for example, is currently the lead organisation for 560 trials and a further 287 were put forward for consideration in the 12 months from April last year.
It also runs the Oxford Clinical Trials Research Unit at Headington’s Old Road campus, the biggest clinical trial centres in Britain and a leading hub of activity throughout the world.
Dr Matthew Snape, of the Oxford Vaccine Group at the Churchill Hospital’s Oxford Biomedical Research Centre, is one of the leading doctors at the unit.
The consultant in general paediatrics and vaccinology said of the centre’s past two decades: “It has been a very exciting period of vaccine development, more recently there is the meningitis B vaccine.”
More than 1,000 children and adults took part in studies in an eight-year programme – funded and assisted by global pharmaceutical giant Novartis – for a vaccine for bacterial meningitis B.
This led to the announcement in March that it is set to be made part of the national vaccination programme to tackle an infection that impacts on about 1,760 people a year, with one in ten resulting in death.
Dr Snape has been at the centre for 11 years. Of the meningitis B vaccination trial he said: “That is a really considerable achievement and we feel very proud to be have been involved in the vaccination’s development.”
The centre was also involved in trials of two vaccines for swine flu in 2009 and 2010, which Dr Snape said was “critical” to the Department of Health’s decision to choose Pandemrix.
But the drug ran into controversy in 2013 when the British Medical Journal reported a possible link with narcolepsy, a condition which causes people to fall asleep suddenly without warning.
Risk is a factor that plays a major role in clinical trials. “With any vaccine you can only provide so much information through research studies.
“That is an important point to make, even if you do studies of several thousands of children, it is important to follow it up to see if there are consequences.”
Those who take part in clinical trials sign a consent form are “fully informed about the vaccine and potential risks and benefits” by the team, he said, though the study sponsor, be it a firm or university, bears final responsibility.
“Ultimately it is a decision for the participant or parent to take part. All studies are voluntary.
“Often people have had a family member who has suffered from the disease and recognise the importance of testing a vaccine.
“Some are from a medical, background and recognise the important role of research, there is an altruistic side.”
Another challenge for immunisation is the risk of unsound conclusions tainting faith in inoculations, particularly in the internet age.
This was most evident in the controversy over the measles, mumps and rubella (MMR) vaccine, after unfounded allegations published in the medical journal The Lancet in 1998 linked the jab to autism.
Dr Snape said: “Generally, the uptake rates in the UK are very good, they are generally in the realms of 90 to 95 per cent and that is because of the efficient ways of delivering vaccines like parents being sent letters.
“Most people will go for the mainstream website like the NHS to get their information.”
While Britain has benefitted from immunisation programmes, developing countries battle diseases that have never troubled the UK or, like tuberculosis, have long been all but eradicated.
Senior immunologist Dr Katie Ewer visits African countries like Burkina Faso and Senegal as part of Oxford University’s clinical trials in the continent, through its The Jenner Institute, based in Roosevelt Drive.
A key issue for her is an elusive vaccine for malaria, a serious tropical disease spread by mosquitoes that, if not treated properly can prove fatal, as well as treatments for HIV, tuberculosis and flu. Current studies include 700 children in Burkina Faso.
She said: “Tuberculosis, malaria and HIV are the big three global killers. 630,000 people, mostly children, die a year, mostly under the age of five.
“It would be fantastic if we made a malaria vaccine that could save that many lives.”
The mother of two children, aged six and three, said: “I travel quite a lot to the clinical trials so it is a huge motivator to keep going, these could be my kids. It is heartbreaking.”
Anti-malaria medication can ward off the disease but is not feasible given its cost, she said, while it is hoped a one-shot vaccine would produce white blood cells to kill infected cells.
Dr Ewer added: “Developing a vaccine takes 10 years. There is lots of funding going into vaccines now, we have a lot from the [Microsoft founder] Bill & Melinda Gates Foundation.
“We are making good progress with malaria vaccines, our trials have shown good data, we are encouraged by the progress.”
‘There was no question I wouldn’t do it’
PARKINSON’S disease sufferer Lucy Norman said she didn’t hesitate to take part in research after being diagnosed aged 38.
The Barford St. John, North Oxfordshire, resident said: “When I went to see my neurologist at the end of the session she asked if I would be interested.
“There was no question I wouldn’t do it.
“You can’t say ‘there is no cure, they are chucking money at it’. You need people for research.”
The former NHS personal assistant took part in a five-year study at Oxford’s John Radcliffe Hospital, which has a year left, to discover a test to speed up diagnosis.
While some clinical research involves testing treatments, Mrs Norman has contributed by allowing herself to be studied, from MRI scans to mental tests to a lumbar puncture, where a needle is inserted into the lower part of the spine.
Mrs Norman, married to Angus, 64, was diagnosed after an initial misdiagnosis of repetitive strain injury after struggling to take notes in her job, which went on to a tremor in her foot.
“I had beautiful, big writing and it got very scrawny, I would write half a dozen words and my hands would seize.
“I was absolutely shocked with my diagnosis. You don’t know until it happens. It was petrifying because I knew nothing about Parkinson’s. It is a massive and scary word.”
She is now a volunteer with charity Parkinson’s UK and involved in village life, from being co-chairwoman of the village hall management committee, to helping run the monthly market.
“You have to keep positive and keep going. Keeping moving, that is half the battle.”
BRITAIN’S VACCINATION SCHEDULE (BY AGE)
- Two months: five-in-one vaccine jab for diphtheria, tetanus, whooping cough (pertussis), polio and haemophilus influenzae type b, known as Hib, a bacterial infection that can cause severe pneumonia or meningitis Pneumococcal (PCV) vaccine. Rotavirus vaccine
- Three months: five-in-one vaccine second dose. Meningitis C. Rotavirus vaccine, second dose
- Four months: five-in-one vaccine third. dose Pneumococcal (PCV) vaccine, second dose
- From 12 to 13 months: Hib/Men C booster, given as a single jab containing meningitis C (second dose) and Hib (fourth dose). Measles, mumps and rubella (MMR) vaccine, given as a single jab. Pneumococcal (PCV) vaccine, third dose
- Two, three and four years: Children's flu vaccine (annual)
- Three years and four months, or soon after: measles, mumps and rubella (MMR) vaccine, second dose. Four-in-one pre-school booster, given as a single jab containing vaccines against diphtheria, tetanus, whooping cough (pertussis) and polio
- About 12 to 13 years (girls only): HPV vaccine, which protects against cervical cancer – two injections given between six months and two years apart
- About 13 to 18 years: Three-in-one teenage booster which vaccines against diphtheria, tetanus and polio
- About 13 to 15 years: meningitis C booster.
- 18 to 25 years: meningitis C vaccine for students
- 65 and over: flu (every year). Pneumococcal (PPV) vaccine
- 70: Shingles vaccine
Team aims to prevent heart attacks
TACKLING heart attacks remains high on the agenda for the Oxford Clinical Trials Research Unit, which played a major role in how the NHS treats victims.
In the 1980s and 1990s it famously ran the International Studies of Infarct Survival (ISIS) trials of drugs to treat heart attacks, with more than 134,000 taking part around the world.
Dr Martin Landray
This led to frontline healthcare teams using asprin and clot-busting thrombolytic drugs to break down artery-clogging blood clots, while later studies encouraged the use of preventative statin drugs.
Dr Martin Landray, a consultant physician at the JR and a senior leader at the unit, said its 250 staff enjoy “fabulous” support from county residents: “It has been very valuable, not only are they contributing to the overall project, but it helps us to understand how the clinical trial affects real people.
“Heart disease is an ongoing issue, it is the leading cause of death amongst the British population.
“There have been substantial advances from the results of previous trials but there is still more work to do.”