ImperialCollege

Bill and Wei here: Thank you for the interesting question. We have a lot of sympathy! I would say if you struggle to get up every morning, one possibility is that you have not got enough sleep in general. My suggestion would be to identify if you are an owl (people who go to bed late and want to wake up late) or a lark (those who go to bed earlier and get up earlier). It sounds like you’re an owl - you naturally need to wake up later and go to be later. Ideally, it would be best if employers recognised the different “chronotypes’ of people and allowed them to start with their optimal circadian time. For example, Prof. Russell Foster at Oxford University has been advocating delayed school times because young people are particularly late risers.

Gary here - This is a great question. You have to remember this is a new field so we are at the beginning of our understanding. However, there is interesting research that points out that western diet causes a microbiota that is related to many non-communicable diseases (diabetes, obesity and heart disease). High-fat diets seem to be associated with microbiota patterns that affect your immunity. Low fibre diets also have an effect on the microbiota that have been related to cancer. Alcohol has effects on the microbiome which has been linked to fatty liver disease.

From Anna: Thanks for your thoughtful questions! We are still in the process of observing how long the antibodies persist in humans - we actually can’t answer this question directly in mice. Humans and mice have different immune systems and respond differently to the same vaccine, so this is one of the main things we’re looking at in our clinical trial. Obviously it’s more ideal for the vaccine-induced antibodies to last a long time so that people don’t need to be vaccinated as frequently, which is what we’re striving for.

In our preclinical studies, even the mice that received a dose of 0.01 µg (10 ng, tiny dose!) had antibody titers (a measurement of how much antibody an organism has produced) that were higher than patients at our local hospital that had recovered from COVID-19. At this point, it’s hard to know exactly what antibody levels are required to prevent infection or lessen the severity of the diseases (called the ‘correlate of protection’), so all we can do in the meantime is compare it to a natural infection. As vaccine candidates progress through clinical trials, we’ll have a better idea of what these levels are.

If everyone on the planet were to receive a 100% effective COVID vaccine with long-lasting immunity tomorrow, we would of course have herd immunity! I do think we’ll get there eventually, but it depends on a number of different factors: how long the immunity lasts, how accessible the vaccines are (cost and availability), if the virus mutates, how quickly we’re able to scale-up production once a vaccine is licensed, etc. We’re passionate about making our vaccine accessible to as many people as possible, especially in low- and middle-income countries that may not have vaccine programs of their own, which was our reason for starting VacEquity.

From Anna: As you can imagine, mutations are constantly being monitored globally. Relative to influenza, SARS-CoV-2 is mutating much less quickly, which is quite a relief. As for how much it would need to mutate to render a vaccine ineffective, it’s hard to say! Our vaccine, like other candidates in development, targets only a certain protein on the surface of SARS-CoV-2 called the ‘spike protein’, so this is the most concerning area for mutations. So far, there’s been one notable variation called the ‘D614G’ mutation in the spike protein, which is found globally. There is ongoing research to determine how this changes the conformation of the protein and the efficacy of the current iterations of the vaccine. One major advantage of our vaccine platform is that it’s quick to make a new version, so if there was a disruptive mutation and we needed to make an entirely new vaccine with a different RNA sequence, we’d be able to pivot to address this.

From Paul: We don’t know for sure but hope to have an effective vaccine sometime during 2021 - which is still really soon compared to a standard vaccine development program. The issue of wide availability is more tricky! Hopefully if a low cost and safe vaccine becomes available then it can be supplied globally and is affordable for low-middle income countries.