well good evening everyone and welcome uh i'm brian cox professor of public engagement in science at the royal society now this evening's event is kobit 19 the race for a vaccine and it's part of a series of events held by the royal society discussing the scientific landscape of the ongoing covid19 pandemic these events aim to discuss the scientific response to the pandemic and tackle issues around the ongoing global health crisis that we find ourselves in and tonight we'll be exploring the development of the kobit 19 vaccines now we have a great expert panel joining us for tonight's discussion but also you can get involved um you can go to slido.com and type in the code c281 so slider slido.com c281 and you can also follow the link in the video description that you'll see on your screen you can submit questions for the panel there and i will ask as many of those questions as i can and you can also upvote your favorite questions and again i'll endeavor to ask as many as i can to the panel now we also have live captioning available i should say this evening and if you'd like to see that you can click on the subtitles closed captions button in the bottom bar and also finally we'd like to tweet then we have a hashtag which is hashtag covid science with that i'd like to welcome our panel good evening um i'm charles bank i'm an immunologist at imperial college in london and i work on the immune response to viruses and also the virology of persistent viral infections my name is melinda mills i'm a professor at the university of oxford and director of the leveraging center for demographic science i'm also on sage spy b looking at behavioral aspects i speak in a personal capacity of course and look at behavior misinformation and vaccine deployment and hesitancy over to reno hi reno rappoli based in italy and i spent my entire life developing vaccines uh and right now i'm chief scientist uh gsk vaccines among the vaccines that developed at the meningococcal vaccines which are being used a lot in the united kingdom well thank you all and now just just to get you going on slide though before we start um if you go to slider now and enter the code c281 and enter your name you'll see a question which is in one word describe how you are feeling about the kobit 19 vaccine so it's an introduction to slido but also we'll we intend to make a word cloud of that at the end so we can see your thoughts your initial thoughts in one word brief thoughts on the vaccine and so now if i start with you reno um how have these vaccines been developed so quickly i mean 12 months is is unprecedented isn't it amazing as i said i've been spending my entire life developing vaccines usually has taken me between 10 and 15 years to develop one vaccine and um a year ago when the pandemic started people were asking how long is going to take if you were saying well if we're lucky we'll be in 18 months uh maybe three years but indeed we have been much faster than any prediction and the reason we've been fast has been twofold one is the incredible advance in technology the last few years especially synthetic biology the ability to use synthetic genes to make synthetic vaccines like rna vaccines or other technology like viral vectors so that's one thing technology but the huge huge difference has been made by the public sector investment you know the u.s government the uk government europe have put together more or less 15 billion that has been given to vaccine manufacturers and they were told to not to do what we usually do to develop vaccines which is to do discovery then you do phase one then if i do clinical studies phase two phase three and so on and takes many years but basically the answer the question was do everything in parallel so that you will not skip any of the important steps to do safety and to monitor safety and efficacy vaccines but you will do them in parallel so you can do much faster and so thanks to that investment we have been able really to do uh all the steps to develop a vaccine they usually take years one uh in parallel with the other and that allow really to back get the first vaccines approved in 10 months incredible never done before now charles reno mentioned that um the this process has been aided by great investment everything's been done in parallel and as you mentioned um nothing has been skipped there it's the investment the parallel development but how do we know that these vaccines are safe yes thank you as reno's just mentioned the phases the clinical trials are normally done successively one after the other but in this case they've been done in parallel now normally the the last phase of the clinical trial is the biggest one that's phase three and that's designed to test the efficacy of the vaccine in other words does it really work does it really prevent disease and later transmission and normally a phase three trial of a new vaccine will be done in a few thousand people um say two or three thousand might be a typical number and the other point is that um the great majority of the side effects and the address events associated with a new vaccine are evident within either hours or days and any events that are evident within weeks or rather uncommon in the case of the kovid vaccine the phase three trials were actually carried out in something like 10 times that number of people so of the order of 20 to in some cases more than 30 000 patients and they were followed as usual for a few weeks a couple of months and in fact the incidence of severe adverse events was extremely low so because of this enormous scale we have great confidence that the incidence of serious adverse events in the longer term will be very low and indeed that the vaccines are very safe unfortunately of course they also turn out to be extremely effective yeah it's a very interesting point actually the the actual number of people in the phase three trials was significantly greater than is usually the case um which is a point that isn't always clear i think um melinda i wanted to ask you in the uk actually it seems that polls indicate that people are um very ready to to accept the vaccine the uptake numbers seem to be in excess of 80 percent not the case entirely everywhere else across the world but um so are there any concerns both here in the uk and across the world and are there any missing pieces in that picture yeah well vaccine hesitancy so people that are doubting the doubters of whether they should take it or not is actually a substantial group in some countries so as you said in the in the uk 70 or 80 percent of people are saying no i will take it if if offered and it's actually comparatively internationally very high so there's a high trust in um the whole vaccine and there's been a lot of different you know vaccines and and a lot of discussion about it and then in the uk you have about a quarter of people and it's up to 40 percent in some places um who are uncertain so people that really have you know legitimate questions and knowledge voids that they want to discuss and have answered and they have around five to seven percent of the resistors and the rejectors that you know spread information and really um are against it and i think if you ask people you know the main reasons are are some of the things that have been discussed or will discuss um i'm sure now which is you know who has it been tested on which which was just which charles and reno just talked about you know is it is it on certain groups people have concerns about that um what's in it what are the ingredients um you know and um in side effects people are really concerned about that and also you know just just concerns about efficacy as well so just communicating that often very clearly and very consistently is is really important because trust is the main thing underlying everything and actually the the the most upvoted question at the moment is from math matthew neyman um who asked the question he said that he does find himself being uh approached his family members and friends discussing this it does seem to be a live issue even though 80 percent of people say they would take it when offered and he asked what's the best way in your view of engaging someone who is skeptical or perhaps even frightened about taking a vaccine yeah so the the most important thing is to just engage in dialogue i mean what we need is to establish trust that people have really legitimate questions so um it's important to to not say oh that's misinformation or disinformation but ask them you know people have concerns about the speed what we were just talking about about what's in the vaccine about you know how long can i wait can i all of these different aspects so it can't be one-way communication and i think that's where a lot of us can do better from government to scientists to actually engage with people where they are um so knowledge can't just be this one-way passive website you've got to engage in and talk with people and that can happen at this level but it should also happen at the community level as well with leaders and you know gps but also you know religious leaders and um you know local people that everyone trusts and i think you know that's going to be we've got to arm people with tool kits and the answers that we're talking about today you know should be laid out in in plain language and i think you know we really have to also understand and i'm sure we'll come to this later is counter the misinformation there's a lot of rumors out there and i think we have to you know give um you know who asked the question you know give people the arsenal to be able to inoculate people against misinformation as well too because the information is out there it just has to be really clear and communicated and transparent yeah so trusted sources um i should say we have a lot of information on the royal society website about about these issues and so um let's let's move on to the science um how the vaccines work before i do i should say we also have a series of polls on slido that you can participate in and we just thought it'd be interesting to know if you go to polls now if you go to slido and it's a c281 um if you haven't done it before there's a poll which is how would you rate your understanding of how vaccines work and we just thought it'd be interesting it goes from excellent to poor and of the people that are listening we get a snapshot of how confident you are um that you know how the vaccines work and if you do that now because i'm about to ask the experts how they work so it should all be excellent in about three or four minutes time perhaps i'll go to reno because then you mentioned actually you use the word the mrna vaccines there's this new way of developing a vaccine um so could you perhaps comment on that and that the difference between the more standard vaccines that we may all have taken in the past mmr and so on well it's amazing the progress that technology has done usually we used to make vaccines by growing viruses bacteria and injecting killing and injecting them or attenuating injecting them and now the new vaccines we actually not injecting the vaccine itself we are injecting the information which is encoded in the rna in a synthetic gene and that information is basically injected into our body and our cells we read the information and make their own vaccines so i think we even in vaccinology we are getting into what i call the digital era of vaccinology because we in not only in not anymore uh injecting vaccines by injecting information to make vaccines now and charles the there are several vaccines out there so the oxford vaccine the fisa vaccine are probably the two that people have heard of most widely in the uk so can you comment on the differences between the vaccines that we might expect to get in the next few months yes thank you um the the way in which a vaccine work is by making the immune response to a virus or bacterium quicker and stronger than it would naturally be on the first encounter and what that does is to reduce the replication of a virus or a bacterium and so it reduces the risk of serious disease and of passing the agent on to another person so the um the mrna vaccine that reno just mentioned um indirectly encodes one of the proteins of the coronavirus and that goes into the mra goes into the cell it the mrna makes protein and that elicits the immune response and that's antibodies and t lymphocytes but in fact the oxford vaccine is a recombinant virus and that contains the gene that encodes that same protein and of course that what the gene does is make the mrna so after the mrna stage they're actually doing exactly the same thing so it's it's a misconception to think that they are so fundamentally different and in fact the nature of the immune response that the two vaccines um elicit that evoke is very very similar and and so i think it's important to realize although superficially they look very different the way in which they work in the cell and the way the immune response that they make they're really very similar so the two really important the only important measures of the efficacy of a vaccine how good it is are really two things one how much disease it presents and secondly how much onward transmission it prevents um again it's often thought that it will completely prevent an infection in fact it's very rare for a vaccine to completely prevent an infection and the reason we know that is if a vaccinated person is then exposed to a virus we can detect a little boost in their immune response to that virus and that boost to the immune response means that the virus has got in in other words they have been reinfected but the important point is it doesn't matter because the immune response as i mentioned a moment ago is faster and stronger and so it curtails the replication of the virus it squashes it earlier on and prevents disease and prevents onward transmission yeah actually when you say it doesn't matter this is a question from jenny west i think he's a question that's widely asked which is if you've been vaccinated can you still transmit the disease given that as you say you still catch the disease again and again and again can you still transmit yes it's a very important question and to be to be brief we need to see more data on this it's not yet clear in principle yes you can but it's likely that the risk is very much lower if you've been vaccinated because as i say a vaccinated person will have much less virus replication so even if it does replicate it will be a much lower risk of passing it on to someone else reno would you like to comment on that question i fully agree the once you get vaccinated obviously a virus will have more more problems to replicate so the number of viruses will be lower and will be much more difficult to transmit it's clear that we don't have all the data from the clinical trials yet to answer this question so we need to wait for more information that will probably come during the next six months but my prediction is that vaccination will either eliminate which i hope or reduce a lot the transmission of the virus and the effectivity of the people and and you mentioned actually which relates to a question that a lot of people are asking about we're moving into the digital age of vaccine production which suggests a very a faster response time that in particular perhaps the new variants a lot of people are asking whether we can be confident these vaccines first of all will work against new variants but also if one comes along that is that they don't work against how long does it take given this new technology to respond well i i believe that uh we have seen that we've been able to develop vaccines from scratch in 10 months against a totally unknown virus we know that with the rna vaccines and also with the viral vectors we can make new synthetic genes very quickly actually i would say overnight so in a couple of months should be possible to get vaccines against the new variants and since now we have experience with these vaccines both rna vaccines and viral vectors i think in a really in the questions or very few months will be able to deploy other vaccines against variants if needed so i'm very confident we're going to be able to control these things but obviously we should not uh be complacent we need to need need to continue to monitor see how the virus changes and adapt and make sure that we are always one step ahead of the virus and with these small tweaks that we can make as you said almost overnight which is a remarkable thing do you have to go through the full clinical trial procedure or is it a sufficiently small tweak that you can say okay we'll change the manufacturing process i believe that that is a discussion we need to have the regulatory authorities before we have a final answer but my prediction will be that we will not need to redo everything because will be very minor changes of the existing vaccines so we can rely on the data that we already have on the safety and efficacy of the existing vaccines for the new ones and melinda i wanted to actually be discussing different vaccines i mean as i mentioned in the uk it's very much the oxford vaccine the price of actually at the moment but there'll be many more on the market is the does that suggest a level of choice um i suppose not in the way that i mean at the moment but is there a confusion there for people do you envisage people saying well i want this one i want that one i want the other one for some reason yeah there is some confusion about not just choice about the different vaccines but also just um you know some central concepts around them so when um so for example the messenger rna versus the oxford astrazeneca people are trying to understand there was people talking about different efficacy well could i get this one instead of that one and you know trying to understand which groups they've been compared um or which groups they've been studied on and i think there was a lot of confusion there there's a lot of confusion as well about um ethnic minority groups and you know which which ones are effective and other ones and which ones have been tested so i think we can uh charles and others can can speak on that and people were just um really uncertain about um um herd immunity which i'm sure we'll come to um soon as well too and and just you know the reason that people are saying that they might not be vaccinated is they think well one i've already been vaccinated and it might be against seasonal flu so just a misunderstanding there um but also just um that they think well enough people have been infected in the uk so i don't need to be um uh vaccinated so they can become complacent so it's that kind of information that we have to keep talking about and also you know as information changes just keep being transparent keep being open and keep giving out uh simple messages and perhaps as you mentioned the um the efficacy and take up in different groups um you mentioned about the well there's the the current several controversies but questions arising one one is that in in germany the oxford vaccine is not yet as far as i understand it recommended for people over 65. i think
it's been approved but not recommended um could you comment on that and what we're to take how we're to understand that move in germany i can say something but i think charles is is better positioned to say this so this will create some confusion amongst the general public and um so so those kind of messages cannot be very helpful but i turned it to charles so for an answer thank you i think the problem is we they simply haven't included enough people in the trials in that age range in order to get a significant difference between the control group and the vaccinated group so it's not that it's been shown to be ineffective it's just that we're waiting for the data to come so i think it's important to realize that if we expect it to be effective many vaccines can be a little less effective in the elderly but um i i have always said if i was going to be offered a covered vaccine i would take whichever one i was offered first reno would you would you echo that sentiment no i fully agree i get that question as you can imagine by many people by many friends many doctors since i've been developing vaccines they come to me and they say which one should i take or should i take any vaccine what do you think about the rna vaccines are you scared about them they're new vaccines we do we don't know anything about and my answer is always the same i have two answers actually one is that i'm gonna take the first one is gonna be available for me and then the second answer is that when i see the people have questions they'll say well my son works in the hospital has been offered a vaccine and he asked the same question i said do the first one that comes in and he has done it and i'm very happy about it well before we we move on that we we have the poll the your understanding of how vaccines work excellent for um we've got another poll actually and which feeds into some discussion that i want to have with the panel which is um who do you think should be vaccinated first so so in what order this is obviously not well it's partly a scientific question but also a policy question for older people with health conditions and so on so it would be interesting because if you um voted on that poll and we'll take a look at that a little bit later on and coming on to uh those questions and the uk strategy again it has been slightly different um in terms of the follow-up vaccine the booster vacancy and what the delay is uh between or the gap between your first vaccination and your second vaccination um reno first could you comment on that um what what we know i mean i suppose basically also the underlying science of why we need two vaccinations at least for these two vaccines that are available now the pfizer and the oxford vaccine well the usually we for most vaccines we need two or three doses in the case of the coffee vaccines we have been actually pretty lucky because the vaccines do work after one dose so both the moderna and the pfizer vaccine and the astrogenic vaccines they do provide protection significant protection after one dose especially after two weeks of the first immunization you start you start to see protection going up to very high levels the most important thing is that also not only they prevent disease but if you look at the they prevent the severe disease so if you look in the clinical trials the after one dose the only cases of hospitalizations where disease happen in the placebo group so the vaccines after one dose they do protect completely from severe disease and pretty well from the infection so the second dose is important for duration of protection to make sure that protection lasts longer and to boost the immune response to a level that will be protective for a long time so i believe we are being extremely lucky i would say with this type of vaccines because efficacy is very high and is very high after one dose at charles would you like to have it yes absolutely correct but to go further than that in fact the data from the phase three clinical trial on the oxford astrazeneca vaccine show that the both the immune response the antibody response and the efficacy of protection were actually better after a long interval between the two doses and in fact in that trial more than half of the participants had the second dose more than 12 weeks after the first dose anyway so we've already got a large amount of data and as reno's just mentioned in the intervening time between the between the first and the second dose the degree of protection was very good against severe disease and this is the rationale for the uk policy to get the first dose out to as many people as quickly as possible and just very briefly there's a question from dom which has been voted a lot so people are interested in it which is partly we've discussed the government strategy for the second vaccine dose and delaying it somewhat um but the question was also can this strategy increase the risk of creating new variants highly resistant to the vaccine itself i i think that it it's clear that the the new facts the new variants that have arrived uh have already arisen it's very unlikely that the vaccine has been the main force that's driven their emergence it's much much more likely that those variants have arisen just by random mutation and they've been selected in evolution for quick spread you can imagine that if there are several variants spreading around in the population and then a new mutant a new variant arises by random mutation which is what these viruses do all the time the new variant arises by random mutation and that spreads more quickly then it will very quickly displace the others and out outrace them and this is what's happened with the new variants in both this country and in south africa and in japan and brazil and so on so at the moment it's almost certainly that they've been selected for rapid spread rather than by the immune response but i think the question was also whether there's any sense or worry that by by increasing the gap between the doses that may encourage new variants to emerge because of that particular choice the the risk of a vaccine selecting a variant would be increased if the if the immune response becomes partly effective but in fact the evidence we have so far is that the immune response after the first dose is pretty well maintained up to the 12 weeks so in fact we would expect again we need to see more data on this but i think i would expect it not to be a major force that's driving the new variant okay thank you melinda i wanted to with the poll that we had which is very much a public policy choice i suppose to an extent or a health policy choice but the order in which people get vaccinated particular occupations age groups and so on would you like to comment on that ordering and your feelings on uh what it should be and and what it is yeah so i think the jcvi made a very good choice in looking at you know vaccinating those that um you know we're more likely to uh to die from from covent frankly so people that were more at risk healthcare workers care home workers those above 80 and then going down through the different risk groups but that's based on a health and mortality choice and there's been a lot of public discussion about well what about the economy or what about teachers what about you know people that are also on the front line and i think what we know from occupations if we look at the mortality um you know statistics we see that actually in the in the first wave those that that um died were um you know for for men it was taxi drivers bus drivers security guards they had a higher rate than male doctors because they didn't have the ppe so i think we have to start thinking about you know those different groups and we can we can look at it also by location so where are we seeing you know more locations on where there's been a spread and we've looked at that you know from the royal society as well and um look at factories look at schools you know look at at prisons and different places so there's room to think about that in different ways and think about people that have front-facing interacting jobs so to protect them and i don't think we we always did and the royal society made a strong point about face coverings um in in june which was gratefully you know acknowledged and taken over so so some of those workers didn't have that protection so we have to keep that protection up but yeah there's definitely some room for discussion about thinking okay once we vaccinate you know these these groups that are more at risk let's start thinking about the other groups that have a lot of interaction um to to also think about the economy and other aspects yeah and we've got a question actually which is that from felix and i he says some countries eg indonesia and i don't know if that's correct but some countries are prioritizing the working age population so 18 to 59 um i suppose for economic reasons but also i suppose you said that the people who have to mix will spread the virus more and what is your feeling on those different choices that different countries have made so countries have made very different choices and there's two aspects there so one felix is is correct that has been circulated that information um but you have to think of the so i'm a demographer so you have to think of the population age composition as well too so that's a younger population as well so you have to think about so italy um you know the uk some of these countries have been hit much harder because they have older populations as well and they have the population composition so um you know there is room to think about um if you have a younger population or the older population has been vaccinated to look at you know where will the infections be spread and i think we have to come back to you know if you're able to effectively um you know test and trace and isolate where infections are um that will be very important so yeah there is there is open for discussion to look at in different populations um you know looking at where the spread is occurring and then there's a question um from lawrence tilley president charles initially and i don't know it's precisely your field but it's interesting which is um are we any closer to understanding why some people just seem to well they're asymptomatic or recover very quickly whereas other people obviously die from the disease do we have any understanding of why people's reactions are so different and i suppose the following question would be is that any difference to other diseases and viral diseases that we know no it's a very good question um the short answer is it's not different and even with for example influenza some people get influenza and they're completely unaware that they've got it they're completely asymptomatic and others will get severe pneumonia and some of them may even die so it's the same actually with any infection bacterial or viral or fungal or any other infection they all all vary now it's well known that some co-morbidity is so called if you've got severe kidney disease or heart disease or lung disease and of course obesity and most of all age are strongly associated with um with severe disease why age is quite so strongly associated is not fully understood so the answer to that is no we don't yet know and it's a very important question that needs to be looked into but in general with any infections i say some people get severe disease and some people mild disease or even asymptomatic and what happens with covid is it's a biphasic disease so the virus replicates mainly during the first week but as we know from for example a prime minister he had a very typical case he started to feel better after one week and then he suddenly started feeling much worse that's typical and in fact the reason is the the main immune response has to try and get on top of the virus during the first week now if you have the right genes because it's the genes that control the efficiency of your immune response if you're lucky and you have the right genes to combat that particular virus you'll make an early effective immune response and prevent the virus from replicating too much and so the second phase in the second week which is very inflammatory will be milder but if you are unlucky and you happen to have the wrong genes then you may make a slower or slightly less powerful less strong response during the first week and the virus is able to race ahead and replicate to a higher amount so that the consequent inflammation that happens in the second week is much more severe so the answer is there is a degree of genetic control of the efficiency of the immune response but that's just one of many factors and reno would you like to comment on that i'll say where vaccines are tailored in some sense to the genetics of the specific individual i suppose we're not there yet well i fully agree with charles that the uh we we don't know exactly which are the genetic mechanisms of the genetic background that makes some people more susceptible than the others and we do not understand yet why older people are have such higher mortality than younger people there are some uh preliminary uh there is some preliminary evidence that some what we call innate mechanism the ability of our bodies to understand that we have been infected uh basically are very important so for instance at the beginning we thought the children were not infected now we start to understand the children are infected and they have pretty high viral replication but they don't get disease and apparently that's due to the fact that they are able to respond with the innate response with a lot of interference and basically they stop the infection pretty quickly like a while for the elderly people uh as charles was saying i mean it's more often that you get the second wave because you don't control what well the first wave so uh we really do not understand fully understand what's going on uh but we start to understand that there is a really some innate mechanism uh which is mostly genetic that basically is behind the fact that some people get severe disease other people get very mild disease but this pretty preliminary we still will take a long time before we can fully understand what's going on and as charles said it's not different from many other viral infections or bacterial infections uh different individuals who respond differently sorry if i could just add to that reno's of course absolutely right that the the early so-called innate immune response before the antibodies and t cells appear is really critical and one of the rather pernicious aspects of this coronavirus is that it encodes certain genes in its own genome that suppress this innate immune response that's one of the reasons why this coronavirus is worse is more severe than the other coronaviruses there are four coronaviruses that circulate every year in the in the population and by and large cause little or no disease or a mild head cold this this is rather like sars it actually suppresses that immune response and one of the rather hopeful aspects of the vaccines is of course that they encode some of the viral proteins that elicit the immune response but they don't encode those those genes of the virus that suppress it so it's even possible that the immune response that the vaccine will generate might even be better than the immune response that follows natural infection that that's interesting it brings me on actually to the topic that we we should discuss which is herd immunity we hear a lot about it um first of all maybe charles since you're there and you can define define what it is how many people need to have been vaccinated or have had the disease so that we can declare whatever it is that we do that there is heard immediately in a particular country what does it mean the herd immunity means it's really the proportion of the whole population that need to be immune either are following natural infection or vaccination to prevent an epidemic from being able to spread so the more infectious a virus is the higher the proportion of people that need to be immune immune to that virus in order to achieve this population level immunity or so-called herd immunity so for the covid coronavirus um this can be for any virus it can be estimated by the famous r naught number which is broadly speaking a measure of how fast a virus spreads so for coronavirus the r naught is between about two and a half and three and that means that roughly 60 to 70 percent of the population need to be immune in order to prevent um a new variant a new epidemic from taking hold and catching fire and spreading through the population but contrast that with for example measles virus where the r naught is much higher is between 12 and perhaps even 15. what that means is that to prevent a measles epidemic you need more than 90 of the population to be immune so it does depend very strongly on how infectious the virus is and the r naught is that is the number of people on average that a person passes it to yeah you know imagine a fully susceptible population that's right and reno would you like to to comment on the herd immunity issue well as charles said basically the herd immunity is that level of immunity that will prevent a virus or a pathogen to spread in the population and that depends uh how many people you need to have immune by vaccination or following infection uh depends on how fast the virus can multiply uh and and how how quickly or easily can transfer from one person to another in the absence of immunity we basically know that this virus will every every positive person will infect three two three people uh and so in order to get the uh i mean to have a population immune so that the virus will not be able to find a susceptible person so will not be able to spread you need to have between 60 and 70 percent of the population immunized so that's the target that we need to have clearly we are still very far away by infection and by vaccination so we'll have a long way to go before we get there melinda this is where um public trust and public behavior matters a lot because there's two there's two issues there's the protection of the individual we get vaccinated we've protected ourselves the virus necessarily but the suppression of the virus in the community as a whole yeah so there's been quite a bit of confusion around this um you know whole concept of herd immunity and it's actually really interesting that that phrase has even been used often in the public it's used on instagram and tick tock and you know in places you wouldn't expect scientific terms to come up and i think that's actually created quite a bit of confusion and you know some some reason a recent study showed that people really misunderstood what herd immunity was and their their you know it was pitted um you know in the beginning between you know uh lockdown and and so protecting vulnerable groups and now we're discussing herd immunity in relation to how many people need to be vaccinated and there is some confusion there and i mentioned it i alluded to it earlier that people think well if i've been you know if i've had covet or such a large population you know amount of the population has had it already then i probably don't need to be vaccinated right so it's those kind of discussions that have to to take place and have to happen and i'm sure that that that charles arena can say more on that but it's you know getting that information out that if you've had it it's not dangerous to to have the vaccination and we need to get up to that level of people that have been vaccinated that's a very good point actually because i have friends who've had the virus who asked that question and perhaps charles and we know do you need to be vaccinated if you've had the disease are you in some sense taking a vaccine away from somebody who needs it more what's or should you take it yes very interesting question um the duration of the of immunity there is a lot between different virus infections so again to get back to measles if you've been infected with measles then it seems that most people are pretty well protected for life and it's remarkably effective but in some other cases it wanes after even a year or two in the case of covid19 we don't yet know because of course it's only been around for a year so we don't know how long it will last but as reno mentioned earlier the second dose the second time you meet a virus or if you're vaccinated if you've been infected before so the second contact with a virus it will boost your immune response but importantly it will make the memory the duration of immunity longer so even if you've been infected you're more likely to be in uh protected for longer if you take a vac if you get the vaccine so i would suggest yes take it um i wanted to just go to we've got one final poll which we should take um which is uh about the vaccine vaccine hesitancy i suppose it's called the question is have you seen or heard messages encouraging people not to get a vaccine and if so where was it from um was it from a family member a celebrity social media uh online sources that or do you not know so that's an interesting poll actually and we'll start to um melinda i think about that what we know about the sources of disinformation but it'd be interesting for us to know where if you've heard this information on the vaccines where you heard that information and whilst we gathered that date i wanted to go back you know um it's a question from steve hedge which is um you've touched on it a little bit i think but will we be taking this annually now will it be will it be like the flu jab may we even uh and steve asked this question see it merged into the flu jabs i suppose in the way that mmr vaccines have been put together well uh i wish i knew uh obviously we are very early in in this in getting to know this virus [Music] i mean this virus hasn't changed for a year more or less now it started to generate several variants so as we were mentioned before we may need to adapt the vaccines to match balance but the whether this will change annually like influenza or weather will be we'll need to a vaccines annually or whether we'll need vaccines once every few years is too early to say uh whatever is going to happen i think we are ready with technologies with the technologies to have we have to have those vaccines but we'll need to follow the epidemiology of the virus understand how it spreads the mechanism behind that and come up with the appropriate vaccination policy when we know more about it charles um yes i entirely agree i i think we we simply need to find out how it plays out i think from the early days of the pandemic we have most of us have suspected that the virus is here to stay in the population but of course we think that it's likely to um that we will continue to control it with vaccines but it really remains to be seen whether one or two variant vaccines are going to be enough or whether we're going to have to continually adjust it like the flu vaccine i think most people think that it won't be necessary um to change it quite as often as the flu vaccine because flu is notorious for the speed with which it does change from year to year um i'm just looking at the results of the poll actually i want to ask melinda that most people who've said yes they've seen disinformation about their magazine they've got it from social media and we see a lot of discussion about how we should um regulate control social media or if we should regulate it at all what's your feeling on given the seriousness of this situation on how we should manage misinformation particularly on social media because that seems to be where most people are seen yeah so i'm not surprised to see the results of the poll and that would be what would research shows as well so i mean it really varies by the platform as well too so we've we've seen that some companies such as facebook and twitter are actually taking some action and you know discussing with moderators of groups or if you're on twitter asking you have you seen you know have you actually read this uh document before you share it and things so so there's definitely they're taking some action but um for example a study on youtube found that about 65 of the information about vaccines was negative and it was um produced mostly by individuals so you know we have to think about who's producing this information and and you know it's it's based on it's very visual it's very shareable it's uh engaging it's the dialogue that people want to have but it's very emotional um as well and if we we go to these platforms that you know the algorithms put us into rabbit holes and echo chambers so your watch history is tailored or your like history is tailored you will soon get to you know a more narrow echo chamber and i think i saw a question by chris who was 13 and he was asking about this as well he was talking about misinformation and i thought it was a really good question um and you know so what do we do well they they feed on this mistrust and and all of this different information and someone comes out and says it can't be above age 65 and that scene is you know that this this isn't uh trustworthy but science changes and people interpret it differently so i think there's a few things you can do one is you can you can bring in legislation or criminal procedures some countries have done it and it doesn't work very well because it can mean limit free speech or too much censorship but i think we have to engage with social media companies as well they're not considered as publishers so so they don't have to present balanced information but we might want to you know have them do that and just as i said before inoculate the public really you know check the source who's saying it is it traceable where their revenue because people are making a lot of money from this you know start to be really critical and people are clever so i think those are the kind of things we can do well we're coming towards the the end of our time so i want to begin to wrap up with two um broad questions i think about the future and perhaps to you reno first um the as you said earlier the the efforts and the investment in developing a vaccine or vaccines has been unprecedented and how has that changed the future of vaccination research because i suppose this is going to echo in a very positive way through the industry and it affects our ability to deal with other diseases well definitely uh i mean this pandemic has accelerated the science and the development of new technologies in a way that is really remarkable in the absence of this pandemic rna vaccines were probably going to become uh available in between seven and ten years from now and now they're already out there and so obviously the next question is how can we employ this use this technology now for how many other diseases can we use for other to be better prepared for other infections other pandemics influenza uh uh can we think of using this uh new technology for cancer for uh i mean to approach other other things so what immunity it so really is opening an entirely new field and accelerated the development of science and new drugs and vaccines by a long time so i think it's a it's a kind of i mean it's terrible we have a pandemic but we should take really take the opportunity to see how science has been advanced perhaps i should just add i completely agree with with reno i think one of the most exciting things is the speed with which um the mrna vaccine has been delivered been developed it's also worth emphasizing that before this no one really knew how effective the mrna vaccines were going to be we didn't know how they how good they would be whether they would be a good as good as more conventionally designed vaccines but and to remarkably they seem to be um as good if not even better in some cases and so this really gives enormous help hope that new vaccines can be developed more quickly and that they may they will be at least as effective as the existing vaccines it's really very promising i guess if i can add to that too i think what this pandemic has has shown us is the value of uh science and the value of different types of science as well so we need we need the vaccine development but we also need you know people understanding behavior and how people interpret it you can develop these things but if people don't understand them or or you know and i think uh emily has mentioned that in her questions um about you know we should talk about education uh gina's asked about she's of childbearing age and and um you know there's no bio there's no plausible evidence that that will cause fertility problems gina but there's all these sort of questions and i and i think that it's shown as the value of science and and working together as well thank you for filling in there i had a internet problem there and so we're almost at the end um i don't know what questions you covered there but um there's a question a final question a lot of people are asking which is whether the covid vaccines will bring back normality whether they really will be the way out of this pandemic and i suppose the follow-up is if so when will that be um perhaps perhaps i'll start with charles yeah well again i think it's been clear from the from the outset that um we will get back to a more normal situation when now that we know that the vaccines are so effective but it will be a new normal and we're going to have to keep a constant vigilant eye on not only that virus but other viruses and be quicker i hope in our response if a new one should arise so i think that it will be a much more normal i i would hope within a year or so um if not earlier as the vaccine becomes more widely spread out but i think it will be as i say a new normal and the main aspect is that we'll have to keep a sharper eye out and be prepared to make a quicker and more decisive response if a new one should arise well yeah it's interesting because because i i don't know how many discussions i've shared about the existential threats when we talk about asteroid impacts and climate change and so on pandemic disease has always been high up on the list from experts but i don't think it's been taken as seriously as as it um mike's i mean that's essentially what you're saying isn't it this will remind us that pandemic disease has always been a grave threat i think it's really noticeable that some of the countries that have done best in the epidemic in the pandemic for example taiwan um they have made a completely different response they responded very quickly and very um decisively and the reason they have explained why is because they had the experience of sars in 2003 they had the sars epidemic and they suffered very badly and so they had a review of this and they realized what they needed to do if a new one should arise and they learnt the lessons and they applied them and crucially i would say they included scientists at the highest level very early on in advising the government and as it happens the vice president of taiwan is himself a professor of epidemiology so he had a very good input into the decision making that's an interesting suggestion on the way forward i echo it and reno would you like to final thoughts on that um well that central question that whether the vaccine will bring us back to some level of normality and when well i believe so i think the vaccines are being deployed right now the so i do believe that by the end of the year we'll start to see new normality but as charles was saying will i mean this pandemic should let us think a little bit what the new normality should be and clearly we need to be better prepared to face new pandemic be ready and uh invest we basically did not have any doubt invest in 15 billion to develop the vaccine but was too late and all the scientists have been telling for many years we should invest in these things before people investment was not done so i think hopefully we learn the lesson so that's one thing we should invest more to be better prepared in the future for pandemics but the other thing we also need to think is that i mean this pandemic did not come by chance i mean we are taking too much away from this planet uh for the population that we have and and there's a global warming deforestation all these kind of things that favor basically in a lot of things including new pandemics so i think we need to find a better equilibrium with our planet and that's hopefully will be the new norm basically we will move towards a more sustainable uh life in this planet and melinda to you that that last question i suppose um it's interesting that charles and reno have seen a a silver lining if that's the appropriate term in that our response to this pandemic will teach us something uh about how we should respond in the future to this and other threats yeah i completely agree with their point but i guess just to to be realistic as well too there will still be a period where we're wearing face coverings and and you know social distancing for quite some time still until the vaccine gets rolled out and and kovit has real uh revealed some really deep structural inequalities in the uk in many countries it's hit some populations disproportionately harder than others and we should really think about that and think about who was hit and why they were hit and and you know and who suffered and i and i just the last point would be to say think about the world as well too so it's not just vaccination in the uk it's globally so we have to think there's the kovacs project there's other things we have to think about how we're going to vaccinate the world and prepare the world as well too well thank you we've run out of time very unfortunately but thank you to the panel it's been i think a fascinating discussion thank you to all who participated in the polls and asking questions and this series the kobe 19 series will continue in march and it'll be streamed live here on youtube but in the meantime there's an another event the next upcoming event from the royal society which will be actually echoing what the panel said there at the end then an event entitled you and the planet and that will air on the 16th of february um so thank you again to everyone who's participated if you'd like to know more you can subscribe to the royal sciences youtube channel to stay up to date on latest events all across the sciences and you can also find a lot of information on the royal society website about covid and again about pretty much every issue you can think of in science and uh you'll find a link on the youtube description as well if you want to um go to that and there's also a short evaluation survey i should say 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2021-01-30