Professor Andrew Pollard, director of the Oxford Vaccine Group, in a picture provided by the university.
Andrew Pollard (Kent, UK, 55 years old) is aware of the turbulence in the vaccine developed by the University of Oxford and AstraZeneca. As director of the institution's Vaccine Group, it was he who led, in large part, that scientific effort - along with other very relevant ones - to win the race against coronavirus. His view of everything that has happened is neutral and detached enough to remain convinced that the AstraZeneca drug will play a relevant role in the years to come, despite the rare episodes of thrombi detected in a minority of vaccinated people. But that does not prevent him from recognizing that, as some governments have decided - among them, that of Spain - the alternative of combining doses from different manufacturers is safe and effective. Pollard recalls that, in many parts of the world,Unlike Europe, the war against the virus has only just begun. And he rejects the idea of talking about group immunity. The new variants, which do not stop emerging, make it impossible to reach it. Pollard this week addressed a small group of media from the European LENA alliance, including EL PAÍS.
Question
. There is a growing debate in some countries, such as Spain, about the safety or efficacy of combining doses of vaccines from different manufacturers. Specifically, a second from Pfizer for patients who received the first from AstraZeneca.
Answer.
From a biological perspective, the question is simple: can you achieve an immune response if you combine doses?
And the answer is that all the vaccines that we are using in Europe generate an immune system response against the needle-shaped protein of the coronavirus [with which the virus introduces its genetic material into human cells].
There is no doubt, in all cases a good immunity is generated.
What we still don't quite know is which is the best combination.
Which vaccine is preferable to inject first.
That's what the new studies must answer, to optimize the mix.
Ours, called ComCOV, will yield answers in a month or two.
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But there is a second aspect, and that is the level of tolerance.
Some results released last week show that, at least in the adult population, the vaccine mix tends to provoke a greater reaction during the two days after the injection.
Obviously, it is something that can be managed and communicated to the population.
We do not know why, but patients feel a little worse after the second dose if there has been a combination of drugs.
P
.
Isn't it then the right time to decide on these mixes?
R
.
It would be convenient to generate more evidence.
I think there has been new data in Spain this week [the Carlos III Health Institute has concluded in a preliminary study that the combination of AstraZeneca and Pfizer is safe and effective].
I have not seen the full study, so I cannot comment much.
But it seems to support what I have said, that the immune response is good.
We begin to understand certain effects such as fever or joint pain, and that can be communicated in advance to patients.
But it is always better to have more information, and there will be more in a matter of a month.
"Priority groups must be the first to be vaccinated, to recover our lives and return to normality"
P
. Germany has announced that, as of June 7, it will lift the priority population list. Anyone who has an appointment to receive the AstraZeneca vaccine can forgo it and offer it to someone else. Is it a logical decision from an epidemiological point of view?
R
.
It is not a dangerous decision, but it does lead us to the initial question: what are we trying to achieve with the vaccination programs?
We have a pandemic because people end up in hospitals, and it puts enormous strain on our public health systems.
We have seen it in our respective countries.
If it didn't happen, there would be no pandemic.
And the only way to stop it is by focusing on the adult population, those over 50, and the most vulnerable in terms of health.
From an individual point of view, the patient should accept the vaccine that is offered, because that is how they end up protected.
From a population perspective, priority groups must be the first, to recover our lives and our economies and return to normality.
En español
'We should forget about herd immunity.
It's the wrong concept, because of the variants'
P
.
Is it reasonable to allow the patient to choose, with written consent, if they prefer to continue receiving a second dose of AstraZeneca rather than the Pfizer alternative?
A.
Each country must make its own decisions.
Here in the UK we have chosen to have constant communication with the public.
As in other European countries, the supply of vaccines is limited.
It's about optimizing effort.
While we have not had data on the combination of vaccines, we have concentrated on giving two doses of the same drug.
But in our official guidelines it is admitted that, in the absence of supply, if a patient must already receive his second scheduled dose, he can be injected with an alternative vaccine.
It doesn't happen very often, because the system is well organized.
P
.
Is anything new known about the possible link between the AstraZeneca vaccine and these rare and minor cases of thrombi in some patients?
R
. Right now there is a huge effort on the part of regulatory authorities and public health agencies to understand this condition, this incredibly rare event. And also so that, if it happens, we know the best way to treat the patient. The combination of these two efforts, and ensuring that the public is aware of the real risk, have made a difference in the perception that now exists in many countries. But it is the right decision for some governments, such as the United Kingdom, where there is a sufficient supply of vaccines, to use alternative drugs for the younger population, when the balance between benefit and risk can be adjusted more finely because the virus already it does not circulate with such intensity.
"If the solution to release patents began to be implemented today, it would not solve the current problem"
P
.
How about the US decision to release patents on vaccines?
R
. It's an idea that makes all the sense in the world. His approach means that by sharing intellectual property, you can have more production plants around the world, increase manufacturing capacity and save more lives. The problem is that there are many business interests that make the goal difficult to achieve. And very strong political differences between different countries. The process to manufacture vaccines is also very complex, requiring between six months and a year. It is not a chemical product, but a biological one, very difficult to achieve. Many manufacturers will have to throw millions of doses in the trash at first because they will not have reached the optimal measure. This is why problems initially arose in Europe with supply. Not because the effort was not made, but because it is really difficult to produce large-scale doses. So,If the solution to release patents began today, it would not solve the current problem. This month alone, about a million people around the world will die from the coronavirus. Although I still think that patenting is a necessary goal, because we will need doses in 2022 for people who may not have even received their first vaccine yet.
P
. Will we achieve the famous group immunity?
R
. If we were dealing with a virus that did not mutate, mathematicians could, through their models, determine the necessary proportion of the population that must be vaccinated to stop the pandemic in its tracks. We know, for example, that in the case of measles, it is 95%. For other viruses it can be 80% or 75%. But this virus mutates. It would have been possible to achieve group immunity for the original variant, a year ago. Now we are faced with new variants that continue to emerge and be transmitted among vaccinated populations. We should forget about group immunity. It is a wrong concept, because of the variants. The relevant question is to determine the proportion of the population that should be vaccinated to minimize the number of hospital admissions.
“We should forget about group immunity.
It is a wrong concept, because of the variations "
Q.
Are we beating this virus?
R
.
We are making tremendous strides.
If you look at individual countries individually, you see that the battle is slowly being won.
But, from a global perspective, the war has only just begun.
It is still a very worrying situation.
In Europe we can have the sensation of seeing the light at the end of the tunnel, but in Nepal or some parts of India, it seems like something that will never end.
That is why we must abandon this very nationalistic vision - of which we have seen a lot during this year - and remember that we are part of a globally intercommunicating population.
P
. The EU has decided not to renew its contracts with AstraZeneca, and has even taken legal action against the company for its supply failure. Concerned about possible damage to the reputation of the University of Oxford?
R
. There is no evidence that this has occurred. We have been very transparent, and we have even published more data than other developers. There has been some damage to trust in immunization processes, but most countries where the vaccine is distributed are very grateful to have access to it. It is different in rich countries, where they have a wider supply range, and are locked in battles over which vaccine is better. The reality for everyone is that the sooner people are vaccinated, the sooner the pandemic will end. The entire Oxford team is very proud to have been a part of this process.
