During the pandemic, the lightning-fast rollout of Covid vaccines highlighted how vital clinical research is to the world. We depend not only on doctors, nurses and paramedics, but also on scientists to prevent millions of deaths.
The UK was the subject of much of this attention due to the Oxford-AstraZeneca (Oxford-AZ) vaccine. Developed in partnership between Oxford University and the British pharmaceutical giant, the vaccine was distributed to 183 countries, more than all of its competitors. This was down to its fridge-standard storage temperature, easy transportability, and comparatively cheap price – AstraZeneca originally agreed not to profit from it.
The vaccine also faced scrutiny for rare side effects, such as blood clots. Last year its use was discontinued as research found that mRNA vaccines such as the Pfizer and Moderna jabs were more effective as boosters. Regardless, the Oxford-AZ partnership is deemed a British scientific success story. The vaccine saved 6.3 million lives globally in the first year of rollout, the most of all the vaccines in circulation at the time.
Professor Andrew Pollard, director of the Oxford Vaccine Group within the university, was one of the three scientists who led on the vaccine. The group designs, develops and tests vaccinations to tackle health emergencies, from Covid-19 to ebola and meningitis. Pollard worked alongside the acclaimed professors Sarah Gilbert and Teresa Lambe. Gilbert led on vaccine development, Lambe on laboratory supervision, and Pollard led on clinical trials that involved more than 23,000 volunteers globally and 2,000 members of staff.
The pandemic has helped to showcase the importance of the life sciences sector, especially to younger people, Pollard tells Spotlight. A 2022 report from the Association of the British Pharmaceutical Industry (ABPI) concluded that the development of the Oxford-AZ vaccine improved perceptions of the industry as a potential employer.
Research from the Medical Schools Council also found that undergraduate medical courses attracted a record number of applications (28,690) in 2021, 20.9 per cent up on the previous year.
“There’s been a lot more applications to medical schools in the last couple of years as a result of the very prominent role the media has played in presenting science to the public,” says Pollard. “Many of us [scientists] have also been lecturing in schools and talking to young people. I think scientists have a really important role in [engagement].”
But despite the Oxford-AZ jab being hailed as a “breakthrough”, the vaccine was in fact born out of decades worth of clinical research around coronaviruses. “I think there’s a lot of work to do for the next pandemic around the different viruses or bacteria that could cause it,” says Pollard. “Although the Covid vaccine has been presented in the media as a rapid development, the truth is it was only rapid if you exclude 20 years of work that had gone beforehand. If something turns up that we don’t know about… we may need months or even years before we could start trials. That’s the chilling thing for me about future pandemics.”
It has therefore never been more crucial to invest in the life sciences, he says. More funding from organisations such as the Medical Research Council and the Wellcome Trust would be instrumental in understanding “preclinical science”, says Pollard: “If you don’t understand the bacteria and viruses, you don’t even know where to start with making a vaccine.”
The industry needs a steady pipeline of scientists to undertake this research. According to the ABPI’s report on bridging the skills gap in life sciences, despite some improvement, certain disciplines are still experiencing shortages. This is particularly true of the more digital and data-driven roles, such as formulation science (designing products such as pharmaceuticals from raw materials) and physiological modelling (developing mathematical models that replicate biomedical organs and systems). There are “persistent concerns”, the ABPI states, across all biological sciences in terms of both “the quality and number of candidates”.
Chronic staff shortages within the NHS also have an impact. Many healthcare staff would normally transition between clinical and research work, says Pollard, but this has reduced as NHS resources have depleted. Doctors often train as medical researchers, who plan and conduct medical experiments, and nurses train as clinical research nurses who carry out day-to-day activities such as collecting blood samples, administering vaccines, and checking lab work. But fewer and fewer medical staff are available to work in research settings.
“Across health and science, we are currently quite short of people,” says Pollard. “The overall number of skilled individuals is low. For [clinical research] jobs where you might have had 200 applicants five years ago, we’ve got a handful of applicants now, which suggests there’s a smaller pool.
“Older people have retired early, some traumatised by the pandemic and some by the current system,” he continues. “Many [doctors] at the lower end are also leaving after qualifying. There’s a shortage of staff, chronically, within the health system. We have to train more people, but we also need to do more about retention.”
The latest statistics show that young people’s interest in medicine remains high but that there are significant barriers to entering the profession. A lack of doctor trainee places made 2022 the hardest year in “living memory” for A-level students to get a place to study, according to heads of medical schools.
To increase staff across medical and research roles, the government needs to invest in clinical research as its own discipline, says Pollard, with more training schemes, such as those provided by the National Institute for Health Research, to prevent the life sciences sector siphoning off valuable NHS staff. “I think it would definitely be a good thing to invest more in clinical research so that it doesn’t compete with other priorities,” says Pollard. “If you’re spending time enrolling your patients into clinical studies, that’s time the NHS doesn’t have to deliver patient care. There’s a tension between research and clinical care unless there’s more capacity in the system. [They] should run in parallel but not in competition.”
Encouraging more people to pursue a career in life sciences starts with education. Better communication around the lifesaving roles of specific scientific disciplines would help. “[Young] people are often driven by what impact they can have in their life,” says Pollard. “They’re not quite as cynical as adults. They’re perhaps thinking about what [they] could do that would be good for the world. Making sure we communicate impact could be a very important thing.”
Better school education on vaccines could also empower people and tackle vaccine scepticism; this was a major barrier to vaccine uptake during the pandemic, which was exacerbated by online misinformation. “This isn’t just to persuade people to come and work in vaccine development – it’s actually a life skill,” says Pollard. “So that when they go into the GP surgery for their own vaccine or for their child, they know exactly what’s happening, and it removes the uncertainty that breeds fear.
“Everyone’s become a bit of a Covid vaccine expert, and I think that needs extending to a much deeper understanding of the biology,” he continues. “Countries that do that well through their education system have a much greater acceptance of vaccines.”
Whether it is another novel virus outbreak or a long-standing health crisis such as cancer, the life sciences sector remains critical in preventing deaths – and an unsung hero.
“In my career, many of the childhood cancers have become curable,” says Pollard. “Those are incredible achievements through clinical research. We are on the verge of a huge sea change in our ability to treat many cancers.”
But “a future pandemic could be an existential threat,” he continues. “We were lucky with Covid, but we might not be so lucky next time. Investment in life sciences not only helps our global standing as a university – our whole future depends on it.”
This feature first appeared in a Spotlight special supplement on Skills and Apprenticeships. Read it in full here.