Originally published on the MRC Insight blog and reproduced under CC BY 4.0, here Peter Openshaw, Professor of Experimental Medicine at Imperial and President of the British Society for Immunology, says we cannot afford to be complacent about vaccines.
As a clinician working in research, I want to improve peoples’ health. The NHS was set up to focus on treating people with disease. But how much better would it be if we could prevent people from getting sick in the first place?
This is where vaccines come in. As vaccinologists, we use our scientific knowledge to design new or improved vaccines to stimulate the immune system. This creates natural protection against infections and prevents disease.
New and improved vaccines
The current vaccines we have are excellent and safe but many could be better. There are also new ways to use vaccines and lots of diseases which do not yet have effective vaccines.
The science of vaccinology advances monthly. There are hundreds of new vaccines at different stages of testing, many of which could lead to improved human health and wellbeing. In response to this fast-changing landscape, the MRC and BBSRC have recently funded five collaborative networks to drive UK vaccinology forward for the benefit of global health.
In 1796, Edward Jenner introduced the first vaccine against smallpox in the UK. He did a radical experiment: he vaccinated a boy with the cowpox virus and demonstrated that this protected him from deliberate infection with smallpox. Despite repeated attempts to infect the boy with this potentially lethal virus, the vaccine protected him. Jenner was an expert publicist. He was persistent in his attempts to convince the public and the politicians of the day about the benefits of vaccination.
When the NHS launched in 1948, it offered vaccination against just two diseases. Almost 70 years on, routine vaccination during childhood, adolescence and adult life protects us against 20 different infectious diseases. Many of these diseases are now rare because of the success of vaccination.
The majority of practising doctors in the UK have never seen a case of diphtheria, tetanus or polio. The success of vaccines is quite amazing. We must celebrate it and not forget how much has been achieved.
Most of these vaccines were invented when we understood little about how vaccines or the immune system actually works. They were based on extracting tiny pieces of the infection-causing bug, inactivating the pieces and then safely injecting them into humans to trigger a protective reaction from the immune system.
This rather hit-and-miss approach worked for many infections. But it is not effective for chronic infections such as tuberculosis, malaria or HIV – major causes of death and disability around the world.
Not an easy road
More recently, substances which boost our inbuilt immune system, combined with fragments of the infectious bug, have enabled development of a new generation of vaccines. However, that does not mean that vaccines are now easy to develop.
The vaccine development programme is long and expensive. Problems can hit even after a vaccine is released for general use. Vaccine development is a risky business for companies: they often make limited profit and are vulnerable to legal action if a few vaccine recipients have related (or even unrelated) side-effects.
The case for public funding of vaccine development is therefore very strong. The importance of supporting the science that underpins vaccination is clear to many research funding bodies, including the MRC.
Exciting times ahead
The next decade looks to be an exciting one for new vaccines. It’s vital, however, that we remember how much we’ve benefitted from vaccines over the past 50 years. We must not become complacent and allow vaccination rates to drop.
We also need to understand the motivations of the anti-vaccine movement. This includes the fears that parents have about the effects of vaccines on their children and how opinions become polarised and fixed.
As scientists, it is our responsibility to provide balanced, reliable information. We need to be tireless in our efforts to educate and involve the public and policymakers in promoting the uptake of the marvellous vaccines that we have, or will soon have, available.
There’s never been a more exciting time to be a vaccinologist!
Peter Openshaw is Professor of Experimental Medicine at Imperial College London and an Honorary Physician in the Department of Respiratory Medicine at the St Mary’s Campus of the Imperial College NHS Trust. He was appointed as an NIHR Senior Investigator in 2013 and became President of the British Society for Immunology in 2014, the first clinician to lead the organisation.