The UK has long been a world leader in vaccine research, from the earliest days of smallpox vaccination to tackling recent outbreaks such as Ebola and COVID-19. This strength comes from a broad biomedical research ecosystem combining a rich tradition of academic research into epidemiology and immunology with a thriving industrial sector, supported by national and international philanthropic and government funding.
The UK is home to several major academic institutions focused on researching and preventing infectious diseases, including the Jenner Institute at the University of Oxford, the Vaccine Network at Imperial College London, the London School of Hygiene and Tropical Medicine, the Liverpool School of Tropical Medicine, and Public Health England’s research facility at Porton Down. In addition, there are numerous institutes, departments and research groups within universities across the nation whose work touches on all aspects of vaccine research.
The academic research community collaborates closely with companies in the pharmaceutical and biotechnology industry, both at home and abroad. These combined efforts translate bright ideas into commercial-grade products that are suitable for clinical trials, large-scale manufacture and regulatory approval.
This flourishing research ecosystem is supported by funding from a range of sources including the UK Government, which funds the overarching UK Vaccine Network and subsidiary specialised research networks. Support also comes from the European Union and non-profit and charitable organisations such as the Wellcome Trust and the Bill & Melinda Gates Foundation.
Past progress, future hopes
One of the UK’s greatest scientific strengths is in the field of immunology research. This ranges from fundamental research into the pathogens that cause disease through to understanding how the immune system builds immunity against them. Detailed structural biology studies are also helping us to discover the precise conformation of vaccine components to find those that will trigger the most protective immune response
We also have particular expertise in maternal, fetal and newborn immunology, studying the immunological ‘conversation’ between mother and child. One important area is the role of vaccination in the later stages of pregnancy, which protects young babies once they’re born. This approach has led to a significant reduction in deaths from whooping cough (pertussis) in the UK, providing a shining example for the rest of the world to follow.
Epidemiology is another area where the UK has excelled for more than 150 years, enhanced by modern DNA sequencing technology. This vital data reveals how new outbreaks arise and spread, informs decision-making about which diseases or at-risk groups should be targeted by vaccines, and shapes strategies for vaccination in outbreak situations or where better utilisation of existing vaccines could make a big difference to public health.
In the UK we benefit from a rounded, complete approach to vaccine development, along with clear vision and leadership - Professor Andrew Pollard, University of Oxford
UK scientists are also hard at work developing the next generation of tools and techniques. These include vaccines based on the genetic code of pathogens and novel immunisation methods like harmless genetically engineered viruses. This is fuelled in part by the rise of gene editing tools such as CRISPR, creating more precise manipulations of bacterial and viral components and triggering the immune system to generate a potent protective effect. There is also significant interest in new approaches for combining, storing, transporting and delivering vaccines to make sure they are as efficacious and accessible as possible.
From the UK to the world
In the UK, we benefit from a rigorous schedule of childhood immunisation, along with vaccines for other groups. This includes seasonal flu vaccines for children, the elderly or vulnerable, and teenage vaccination against human papilloma virus (HPV), which can cause a range of cancers. Our position at the forefront of vaccine research often means that the UK population directly benefits from early access to novel vaccines. For example, we were the first nation in the world to roll out new vaccines against Meningococcal B and C following large-scale UK trials.
But reducing death and disability from vaccine-preventable diseases is a global health challenge, and one that is ever more pressing in a fast-changing and interconnected world. The UK provides significant funding for research into vaccinating against diseases in low and middle income countries, including the £1.5 billion Global Challenges Research Fund, administered by UK Research & Innovation (UKRI). Not only does this save lives and reduce inequality in the poorest parts of the world, but also acts at a distance to protect the health, safety and economy of our own country from the risk of new outbreaks in the globalised world in which we now live.
During the 2013-16 Ebola outbreak, UK researchers played a vital role in monitoring the spread of the disease, studying the virus in detail and developing new vaccines which were first tested in the UK before deployment in West Africa. Similarly, during the 2009-10 H1N1 swine flu pandemic, some of the first vaccine trials were undertaken in the UK. The results helped to shape global health policy through the World Health Organization, as well as our national response.
Tackling antimicrobial resistance through vaccination
Professor Adam Cunningham from the University of Birmingham is co-chair of the BactiVac Network, set up to address the challenges of developing vaccines against bacterial infections.
Bacterial infections kill around six million people each year, with a disproportionately high number of fatalities occurring in low- and middle-income countries. Concerningly, many dangerous bacteria are now developing resistance to antibiotics – so-called ‘superbugs’ – making them even more deadly.
“Vaccinations can remove the need for antibiotics by priming the immune system to eliminate the pathogen before an infection takes hold,” explains Cunningham. “Bacteria can quickly develop resistance to antimicrobial drugs, particularly when they are overused, but resistance to vaccines is largely absent.”
We already have several vaccines against bacterial diseases, including tetanus, pertussis and typhoid. Cunningham hopes that BactiVac can accelerate the development of vaccinations against some of the deadliest remaining bacterial diseases, including those caused by E. coli, Salmonella, Shigella and pneumococcus. “There’s great expertise across the UK and internationally in bacterial vaccinology, but there are also lots of big questions and unknowns in the development process,” he says. “We’re bringing together individuals to share expertise, fill in knowledge gaps, break down barriers and push new vaccines along the development pipeline, so we don’t have to keep relying on antibiotics.”