Vaccines are the most effective preventive healthcare intervention ever deployed, and save between 2 and 3 million lives every year worldwide. The Vaccines for Emerging and Endemic Diseases theme will provide a key bridge between researchers at the University of Oxford and Oxfordshire’s NHS teaching hospitals. It will focus on the creation and clinical development of new vaccines against a wide range of infectious diseases, and will also extend the use of leading vaccine technologies into immunotherapy (treatments that boost the immune system to help it fight infectious diseases, chronic diseases and cancer).
The University of Oxford now has one of the largest university-based vaccine centres in the world, with a wide range of vaccine development programmes. The Theme is headed by Prof Adrian Hill from the Jenner Institute together with Prof Andrew Pollard from the Oxford Vaccine Group. Most of the new vaccines which we are developing and testing have been designed in our local research laboratories.
In addition to vaccine research, the Oxford Vaccine Group has developed the Vaccine Knowledge Project, which aims to provide accurate, independent information on vaccines and infectious diseases. The content is targeted at, but not limited to, the general public to improve understanding of the NHS vaccination programme and provide information about how vaccinations work, therefore enabling people to make informed decisions about vaccine issues.
The research programmes of the Theme are closely aligned with the priorities of the Department of Health and Social Care (DHSC) and cover four major research areas:
1. Vaccines for Emerging Diseases
The World Health Organization (and the DHSC-supported UK Vaccine Research Network) have identified several high-priority pathogens (viruses and bacteria) that could be the source of outbreaks or epidemics in the future. Oxford has probably the broadest effort internationally in designing and developing new vaccines to target these pathogens, with ten new vaccines funded or in clinical development currently. These include vaccines for Zika, MERS (Middle East Respiratory Syndrome), Chikungunya, Plague, Rift Valley Fever, Ebola (Sudan and Zaire strains), Crimean-Congo Haemorrhagic Fever, Lassa Fever, Nipah and recently the novel coronavirus SARS-CoV-2. During the West African Ebola outbreak, Oxford was able to assess for the first time in humans four new potential Ebola vaccines. Additionally, we have undertaken several clinical trials of a potential universal flu vaccine, which could target a very wide range of influenza virus strains.
2. Vaccines for Major Endemic Infections
The Oxford vaccines team is developing new vaccines against some of the world’s most common endemic infections, including malaria, tuberculosis (TB) and typhoid fever.
The Jenner Institute has the largest malaria vaccine programme globally and is working with many partners, including the Serum Institute of India, the world’s largest manufacturer of vaccines. We are undertaking trials in the UK and Africa of vaccine candidates against all four stages of the P. falciparum malaria parasite’s life cycle.
The theme is also developing vaccines for the second most common species of malaria parasite, P. vivax, which is the most frequent cause of recurring malaria. We have developed the first controlled human malaria infection (CHMI) model for P. vivax in Europe, which allows us to better study the parasite infection under very controlled conditions. Additionally, the first trial looking at the efficacy of a new vaccine candidate targeting blood stage P. vivax has recently been carried out.
Our typhoid and paratyphoid programme tests new vaccines that could reduce the burden of the disease globally and improve the health of travellers. New vaccines are tested through specialist typhoid and paratyphoid challenge models, developing our understanding of how these infections work.
Our TB programme is the world’s leading aerosol vaccination programme. The first clinical trial with the BCG vaccine delivered by aerosol has been successfully completed and a second trial is currently underway. We are also carrying out research studies on samples collected from previous trials to identify indicators of both protection against TB and risk of TB.
Work is also being carried out on new vaccines for HIV/AIDS, in particular vaccines that induce a broad and potent T-cell (white blood cell) response.
3. Childhood Infection Vaccines
The Oxford Vaccine Group has designed a new vaccine against Group B meningococcal disease (MenB), which has shown itself to be very immunogenic (creating a strong immune response) in laboratory studies. The first-in-human study of this vaccine is now being carried out. We are also studying whether the licensed MenB vaccines can prevent carriage of the bacteria in teenagers and testing how well a booster dose of the vaccine would work in teenagers who were vaccinated in early childhood in some of the first ever trials of the vaccine.
We are undertaking research on the burden of respiratory syncytial virus (RSV) in children and adults to underpin future NHS programmes for the control of RSV, which can cause serious disease in babies and the elderly. We are investigating biomarkers associated with severity or susceptibility to the disease. The aim is to inform and support development of new vaccines and monoclonal antibodies to prevent RSV and reduce unnecessary antibiotic use.
The theme is also studying pertussis (whooping cough) vaccines to investigate the reasons behind the recent resurgence of pertussis, and identify a more durable vaccination strategy.
Additionally, we are testing the hypothesis that the UK immunisation programme could be redesigned with fewer vaccine doses, thereby saving the NHS money.
4. Therapeutic Vaccines
The theme has designed phase I and II trials of a T-cell inducing vaccine against prostate cancer. This was found to be safe and immunogenic in a phase I trial and has progressed to a phase IIb trial, testing efficacy in later stage prostate cancer patients.
The theme is currently initiating trials in humans for new vaccines against chronic hepatitis B (HBV) disease and human papilloma virus (HPV) infection. The drugs currently available for chronic HBV can only reduce its effects but cannot clear the virus completely. The vaccine will aim to help the body to eradicate the HBV virus in patients with chronic HBV, which usually requires life-long treatment and can lead to severe liver disease and liver cancer. The HPV vaccine is aiming to clear that virus in women with early stage infection.