Covid-19: Immunology Research

Thursday 9th September 2021 Westminster Hall

13:30

[Dr Rupa Huq (in the Chair)]

Before we begin, may I encourage Members to wear masks when they are not speaking, in line with current Government guidance and that of the House of Commons Commission? Although the Xs on the seats have now gone, please give each other and members of staff space when seated, and when entering and leaving the room.

Members should send their speaking notes to our colleagues at Hansard—the email address is [e-mail]. Similarly, officials should communicate electronically with Ministers rather than pass them notes, as happened in the old days.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the role of immunology research in responding to the covid-19 outbreak.

Thank you for calling me to speak, Dr Huq. I thank the Backbench Business Committee for allowing me the opportunity to highlight one of the many successes for this nation. Unlike yesterday, the Minister will have an easy ride in responding to my comments, and hopefully to the comments of other Members as well.

Every one of us across this great nation of the United Kingdom of Great Britain and Northern Ireland recognises the good work that has brought about the vaccines, to deal with covid-19 in a way that could never have happened if we had still been in the European Union. I am not looking for any discussion about Brexit, but we had the independence to roll out the vaccines. The Government had the foresight to do that, and the Prime Minister put the Minister for Covid Vaccine Deployment, who is present, in charge of making that happen.

Every one of us recognises that the Minister and his team across the whole of the United Kingdom, in co-operation with all the regions of Scotland, Wales and Northern Ireland, have made this happen. We are eternally grateful to them for that. I wanted to put that on the record first, because it is so important to say that we are where we are today because of the strategy of our Government, the work of the vaccine Minister and—I say this as a Christian—the prayers of God’s people. We have seen the championship of community working together.

I participated in a Westminster Hall debate over in Portcullis House; it is so nice to come back to the real Westminster Hall and to claim my seat in this corner of the room. Hon. Members have asked me why I sit here. It is because I always sit here—I think my name is written on the seat. We had a fantastic debate in Portcullis House on the issue of communities working together, and many of us took the opportunity to speak of how our communities had come together. As elected representatives, we can all subscribe to the belief that whenever the chips are down, the goodness of people always shines through. From a community point of view, I am able to convey some of the good things from my community, and I know that others can do so as well. I have been double-vaccinated, as I suspect everyone present has been. The many victories that have happened behind the scenes should be celebrated.

The topic of the debate is immunology research into covid-19, and I thank the Library for its very helpful briefing. Page 3 gives a really good introduction to the subject:

“immunology has changed the face of modern medicine…From Edward Jenner’s pioneering work in the 18th Century that would ultimately lead to vaccination in its modern form (an innovation that has likely saved more lives than any other medical advance), to the many scientific breakthroughs in the 19th and 20th centuries that would lead to, amongst other things, safe organ transplantation, the identification of blood groups, and the now ubiquitous use of monoclonal antibodies throughout science and healthcare.”

Immunology has helped our great health service to move forward. I asked for this debate some time ago, and I want to put on the record our thanks to the immunology experts and scientists. I am going to mention a lot of people in this debate today, because there are a lot of people to thank; I apologise in advance if some people are not mentioned, but that is not because we have forgotten about them. I recognise that, singly and as a team, we all came together to make this happen.

I will then speak to some of the successes that immunology research has had during the pandemic in furthering our understanding of covid-19 and the effects that SARS-CoV-2 has on our immune systems, as well as developing the technologies and therapeutics that are currently allowing us to emerge from lockdown restrictions and return to normal life—this here is the normal life we had prior to covid-19 in Westminster Hall. As I progressed around Westminster Hall, the House of Commons and the House of Lords and Portcullis House, I noticed these wee circles on the carpet. I wondered what they were all about, but then I realised: that is where the wee “Keep two metres apart” signs were. They have all gone away.

Normality is returning for a number of reasons, and I know that the Government and the Minister are committed to returning to normality in every way we can. Yesterday in the House, I asked the Minister how we can better have an agreed covid vaccine strategy within the four regions where one size fits all, as I put it. It would be nice to see that, although I know that the restrictions differ; I know that Scotland is going to do something different, as the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) may mention shortly. Lots of things have been happening, but from a news and media point of view it would have been nice at least to have had the same strategy for everywhere across this great United Kingdom of Great Britain and Northern Ireland.

Over the past 18 months, immunology has had a disproportionately large effect in driving forward our understanding of the science of, and helping us to recover from, the covid-19 pandemic. Immunology has built our understanding of how the body responds to covid-19—and, crucially, has delivered us highly safe and effective vaccines. We all know that. I have had the vaccine, as have others: it does not give us the ultimate assurance, but it gives us a 96% or 98% assurance of being safe and secure, which I believe is our way out of the pandemic.

Immunology is the linchpin linking together many of the sciences that have been used in tackling the covid-19 pandemic, such as virology, respiratory science and epidemiology; for the latter, immunologists have been working with epidemiologists to help make their mathematical models more accurate. I chair the all-party parliamentary group on respiratory health. We have recently had an inquiry on this issue and have done a number of things relating to respiratory health. Through the work of my constituency office, I have become aware of so many people who have issues in relation to asthma, chronic obstructive pulmonary disease or other respiratory problems. I am aware of those issues, and I am interested in them.

We know that a multitude of different reactions of the immune system manifest themselves through the many different symptoms and severities of covid-19 that have been observed—from the acute disease right the way through to long covid, which more and more people are reporting they are suffering from post-infection. I have had a number of people contact me about long covid; I am not sure whether there is a real understanding of how long covid affects people, and why it affects some people and not others.

A lady in my constituency contacted me just the other day, looking for some advice about her job and where she stands. Legally, there may not have been the protection that she had hoped for, but I think the Government have set in process a benefit system whereby if a person has a health condition that prevents them from working, they can claim employment and support allowance, personal independence payment or universal credit. I was pointing her in that direction, but this lady had been perfectly healthy. She worked in a wee bakery just down the street from my office. I got to know her quite well. I had not seen her about as often, but I thought that that was maybe because we were working different shifts.

Perhaps in his response the Minister could give us some idea about how we can help those with long covid. There are a number of them out there—not just that lady, but others who have contacted me recently; we got them on to benefits and tried to help them through the system. However, what that lady really wants, and what they all want, is to return to work and to normality. It may be some time before that happens. The benefits system is in place at least to help them financially, but we need to do more so that they can deal with the issues themselves, now and in the future.

Significant patient benefit and public health improvement directly demonstrate the huge value of investing further in immunology research. The Library paper referred to the

“Important research questions that will take time to answer”.

Research and development are working towards having in place vaccines and responses to diseases as they happen. I will comment on that later. The important research questions that take time to answer are:

“What is the rate of asymptomatic spread, and how does this contribute to transmission? What proportion of infected individuals mount a protective immune response? How long is natural and vaccine immune protection likely to last? What immunological factors correlate with protection to SARS-CoV-2 by vaccines and how effective are vaccines at protecting older people? What is the role of immunogenetics in SARS-CoV-2 infection and what can this tell us about potential therapeutic targets?”

Those are all key questions for those involved in R&D, and they are clear. They help us to prepare for the future. In the research that I did—I want to refer to it later on—I found that R&D was actually working towards this vaccine even before the disease came about. When the Government announced the vaccine, there had already been a number of years of investigation and research and development into this particular subject matter.

Some of the questions that the UK Coronavirus Immunology Consortium were asking were as follows:

“How long does immunity from COVID-19 last? Why are some people’s immune systems better able to fight off the virus?”

That relates to those who can recover quickly and those who have long covid.

“Why do some people’s immune responses cause damage, especially to the lungs? How does the virus ‘hide’ from the immune system and how can this be tackled?”

Right across the United Kingdom of Great Britain and Northern Ireland, again, perhaps the Minister can give us his response to this question as well.

Ulster University in Northern Ireland was working in partnership with some of the larger pharmaceutical companies on vaccine research. How important we all believe those R&D partnerships between universities across the whole United Kingdom—including Ulster University in Northern Ireland, obviously—are in bringing about some of the vaccines that we have!

Vaccines, of course, are no doubt having the most effect on people’s day-to-day lives. Immunology has made other important contributions to the science of covid-19. That includes diagnosis, for example, through antigen testing; the screening of antibodies to determine whether people have had covid-19 previously; and prognosis and patient stratification, such as triaging patients and seeing who will benefit from early ventilation and therapeutics. Why is it, for instance, that, as I heard one of the experts on BBC news say this morning, someone can be free of the symptoms of the disease but unknowingly be a carrier of it, even though they are vaccinated? Again, there are questions to be asked.

Immunology research during covid-19 has been supported well by Government, funding agencies and institutions. Our Ministers and our Prime Minister made it a priority. That is why we are where we are today, to the envy of much of the world. Immunology, especially population-based studies of actual immune responses in real people with and without disease was already a real strength of UK research to start with, and we should be grateful for that. The population-based research is facilitated by standardised procedures for researchers to access patients and their samples across the UK through the NHS. Again, we are eternally thankful for all that. The National Institute for Health Research played a major role in bringing together academic researchers and clinical services during the pandemic, and has played a crucial role in ensuring that we learn as we go, in real time. I especially thank the NIHR for that contribution. Many others have contributed as well, but the NIHR did a fantastic job.

The rapid adaptation of our funding processes to ensure that the Government research funding flowed to collaborative groups of researchers who were well placed to deliver answers to crucial questions quickly was also a major strength. For example, UK-CIC, which I have mentioned, is another visionary group that strategised, planned and responded in a positive way. Its UK-wide study was launched to tackle some of the key questions about the immune system’s response to SARS-CoV-2 and help us control the covid-19 pandemic. It received some £6.5 million in funding over 12 months from UK Research and Innovation and NIHR; that is the largest immunology grant awarded for tackling the covid-19 pandemic. Critically and crucially, it also incorporated a large element of patient and public involvement, bringing laypeople and those who had covid-19 into the scientific process in a scheme of work run by the British Society for Immunology. UK-CIC was funded in a way almost unique to covid-19 research, to encourage collaborative team science, individually but also through teamwork, sharing ideas, coming together, working together, and partnering. Rather than research groups competing against each other, which could have happened, the consortium brought them together with a singular target, a singular goal, and a way of doing it better together.

In UK-CIC some 20 of the UK’s leading immunology research institutes, including Ulster University in Northern Ireland—again, team UK of GB and NI working together in a very positive way—are funded as a consortium and are focused on five themes: primary immunity, protective immunity, immunopathology, cross-reactive coronavirus immunity and immune evasion. Its successes and novel discoveries are numerous. We look at that collective and how 20 different groups came together and how they solved problems collectively. We are four regions of the United Kingdom of Great Britain and Northern Ireland, but we can share the ideas, so we can have the ideas in Scotland in Northern Ireland, Wales or England, and vice versa.

UK-CIC has contributed to the development of covid-19 therapeutics through exploration of the role for interferon therapy and determining the effectiveness of dexamethasone. It has made a major contribution to vaccine development studies including through showing that an extended dosing schedule is more effective than, for instance, a three-week interval. It has shown that there is a stronger antibody response to mRNA vaccines such as Pfizer and that there are stronger cellular immune responses to vaccines such as AstraZeneca. Furthermore, it has curated the largest collection of covid-19 post-mortem tissue in the world, so the evidential base is significant and ready for further investigation. It has defined the four main sub-types of inflammation in covid-19 and opened up avenues for further investigation of therapeutics. It is not just about today; it is about tomorrow and that is what I love about where we are. We are already preparing for the next one. I know the Minister will respond to that because he knows vastly more about it than I do and will be able to explain and explore that for us. UK-CIC has found that our T cell immune responses are likely to overcome mutations in the virus and remain effective. This is an incredibly complex subject matter, and so important as we look to the future and whatever comes our way.

The UK Coronavirus Immunology Consortium model has proved highly effective, and should be strongly considered as a blueprint for future funding of research. Perhaps the Minister will give his thoughts on that. I believe that it is vastly important that we do that. A number of strengths of doing research that way were identified, including avoiding duplication of research, with complementarity built into the project design instead; the standardisation of protocols, to allow science to move forward more quickly; and the ability to carry out larger studies by using patient samples from multiple sites. Again, the teamwork and connectivity brought everyone together. That led to more robust findings being produced and more diverse patient cohorts, as well as regular engagement between groups in the consortium, helping to engender ambition and to foster a sense of scientific community, working better together.

Retaining that funding model will ensure that the infrastructure is already in place should another pandemic event occur. We hope that it does not, but we did not expect the last one; we have to be prepared for the next. That is what the debate is also about: to thank the Minister, our Government and others for our response and to ensure that we are equipped and ready for the future. That infrastructure would also tackle other societal and public health challenges, such as antimicrobial resistance, cancer immunotherapy, and ageing and dementia. In the debate on social care the other day in the House, many referred to dementia, Alzheimer’s and Parkinson’s as diseases that are perhaps more prevalent in society now than in the past. I can vouch for that, as I seem to be dealing with more of those issues in my constituency. Again, these are complex matters, and it is about working better together to try to address them.

No debate on immunology research and covid-19 in the UK would be complete without talking about the world-leading work done by the University of Oxford team in developing the Oxford-AstraZeneca vaccine. We are eternally grateful for all that they have done. It was not until 11 March 2020 that the World Health Organisation declared covid-19 to be a global pandemic, but the work that preceded the release of the Oxford-AstraZeneca vaccine had begun years before. I referred to that earlier, and it is the truth: the Oxford team began its work in 2015. I do not know whether many people know that. I did not until I researched the issue.

That work was funded by the UK Vaccine Network, a partnership between the Department of Health and Social Care and UK Research and Innovation’s Medical Research Council and Biotechnology and Biological Sciences Research Council, to find a vaccine for middle eastern respiratory syndrome, an illness caused by a different coronavirus. Not all the research was in place, but it was during this time that the team fine-tuned the adenovirus vaccine platform, and in 2018 the vaccine entered safety trials and was shown to cause no adverse responses while eliciting both cellular and antibody immune responses, and the trials suggested that two doses would be more effective than one. The lessons learned at that time could be initiated for our response to covid-19 when it started just last year.

The MERS virus has a spike protein on its surface similar to the SARS-CoV-2 spike protein, which meant, along with the previous testing of the vaccine platform technology, that the Oxford team already had an adaptable vaccine that had been tested and proved to be safe in humans. People should be made more aware of that information when they say, “You’ve brought this in. You’ve vaccinated everybody. Where’s the trial?” Well, the research started in 2015 and the trials started in 2018, then were adapted to deal with this particular virus. We should be encouraged by what has taken place. The vaccine has been tested and proved to be safe in humans.

Once the Chinese investigators had shared the genomic sequence of SARS CoV 2, it could then be inserted into the adenovirus to produce the prototype covid-19 vaccine that entered into human trials in April 2020—about the time that covid-19 restrictions came into play. The ability to deliver such a vaccine at pace was a product of long-term funding through UKRI over more than a decade, which ensured there was an existing vaccine platform technology, alongside optimised manufacturing methods.

The Oxford-AstraZeneca vaccine development was also facilitated by a £2.6 million UKRI-NIHR rapid response grant in March 2020, just at the time we needed it. Again, our Government were in place to do that at the right time. That provided funding to conduct pre-clinical investigations and phase 1 and 2 trials, and to scale up production of the vaccine to 1 million doses by summer 2020. The researchers and all those involved were able not only to produce a cure but initiate production at the level that was needed. How grateful we are for all those superhuman efforts to bring out the vaccine to immunise the whole of the United Kingdom of Great Britain and Northern Ireland, and help third-world countries.

That is truly demonstrative of previous immunological research into infectious diseases speeding up our response to SARS-CoV-2. However, after the previous outbreaks, research into these viruses tapered off, which hampered our ability to respond to SARS-CoV-2 with as much information as we would have liked. That was unfortunate. The gaps in knowledge at the beginning of the pandemic led to some of the decisions that were made in public policy and, indeed, some mistakes that, perhaps with hindsight, could have been avoided. We have all made mistakes in life—I include myself in that, and I am sure everyone is the same—and we would change them, but we make decisions at the time that we make them.

We must not make the same mistakes again. Instead, we must continue to invest in SARS-CoV-2 and covid-19 research, immunological and otherwise, so that we are properly prepared should an event like this happen again. We should be ever thankful for where we are. Coronaviruses have particular pandemic potential, as they are able to replicate efficiently on entry to the human population and are thought by experts to be the biggest threat, so we need to get ready for the future. I know the Minister will give us some of his thoughts about how we are doing that so we are ahead of the game when it comes to responding to whatever the future may hold.

The covid-19 pandemic has also acutely illustrated that the importance of both global disease networks and global disease surveillance cannot be overstated. With the truncation or termination of many non-covid-19 immunological research projects that formed the basis of these networks and surveillance due to cuts to the official development assistance budget, it is through investing in covid-19 immunology research that we can build international collaboration, as has happened in the past, and use those relationships to ensure that we are more prepared for future infectious disease outbreaks. Perhaps the Minister can tell us a wee bit more about how we are working internationally. Again, we can do that to everyone’s advantage. We should not be claiming it for ourselves; we can do that with other countries, and do it better together.

Of course, there are still many questions surrounding covid-19 that remain unanswered, including major ones like what the longevity of vaccine-mediated immunity will be and why some people contract long covid and others do not. I refer again to the constituent I spoke about this week. Covid-19 is unlikely to disappear completely, so it is crucial that we invest in discovering the answers to those and other key questions.

If we revert to pre-pandemic-style grant funding for covid-19 research, we will lose the progress that we made on the R&D infrastructure and the good will of the research community, which is needed to tackle these challenges properly. I seek an assurance from the Minister that we will not revert to that, but we will move forward and give the commitment that the R&D sector clearly wants. We must ensure that the current levels of funding are continued. Small studies that look at small numbers of people are not robust enough to achieve statistically significant results that can inform patient care and policy. We need to ensure that the R&D success of the past is a policy and strategy for the future. We must continue to conduct studies at the same scale, with the involvement of hundreds of thousands of people. That is the success of the covid-19 vaccine, and that is the success we want for all other pandemics that come along, to ensure long-term immune monitoring that can be applied to real-world questions and situations.

There has been an immense investment in immunology and covid-19 research over the past 18 months, which has allowed the UK to achieve some truly impressive bench-to-bedside science, such as vaccines that have gone from the laboratory to people’s arms in record time. I know there has been lots of research into how that is done, and we can only be truly impressed by it.

There has also been great leadership from the Government’s chief scientific adviser, Sir Patrick Vallance, and chief medical officer, Professor Chris Whitty, in driving forward conditions that have led to the progress and discoveries made. The pandemic has illustrated the importance of the NHS. We all love the NHS and we know how important it is. There is not a debate where we do not revere what it has done for those it has helped to heal, save and make better, and for the comfort it gives people when they need it most. It is vital to ensure that is not forgotten in future, as it allows science to operate at a huge scale.

We owe a debt of gratitude to the scientists and researchers of many different disciplines, including immunology, for their work during the pandemic. The fruits of their labour can be seen everywhere from the vaccine roll-out to today’s better survival rates for covid-19 patients in hospital, for which we are thankful. It reminds us that the work going on in labs across the country has a tangible effect on everyday life in this country. It is the working together and the investigations and tests done in universities and pharmaceutical companies with the financial backing of our Government and the push from the vaccine Minister and his team. We must ensure in the post-pandemic future that UK R&D is properly funded and given the resources needed to continue having a positive effect for everyone in society.

[Dr Rupa Huq (in the Chair)]

Since no other Back-Bench MP wishes to catch my eye, I will go to the first of our three Front Benchers. For the SNP, we have Anum Qaisar-Javed.

14:03

[Anum Qaisar-Javed (Airdrie and Shotts) (SNP)]

It is a pleasure to serve under your chairship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) who secured this important debate. As a relatively new Member, it is my pleasure to have made both my first hybrid Westminster Hall speech and now my first non-hybrid Westminster Hall speech in debates he has secured. While we differ on the constitution, I know the hon. Gentleman makes a valuable contribution to this House, although I have not yet worked out how he manages to be in three places at once. I gently remind him that Scotland is not a region; it is a nation.

I echo the hon. Gentleman in being grateful for the role of immunology and thanking all who are involved in the sector. Without them, this pandemic may have been very different. The pandemic has forced us in many ways to work collaboratively to overcome the challenges put in place by the virus. In our time of need, scientists from an array of disciplines have done exactly that, and have come together to share their expertise, forming our evidence-based approach to tackling the virus.

Specifically, immunology research has played a pivotal role in linking together many of the sciences that have been used to tackle the covid-19 pandemic, such as virology, respiratory science and epidemiology. Although immunology is most known for its role in the development of the vaccine, it also continues to play a crucial role in providing information that helps to form our ongoing public health response to covid-19. Working with partners across the UK and across the globe, Scotland is leading, enabling and delivering world-class covid-19 research, which is a key element of the Scottish Government’s overall response to the pandemic.

Immunologists have worked tremendously hard to ensure that public understanding of covid-19 is as up to date as possible, with University of Glasgow researchers the first in the world to genomically sequence the Kent variant of the virus. Such work by scientists, medical professionals, researchers and a host of others has developed our collective understanding of the virus, its causes and effects, the mitigation strategies, and the vaccine lifeline.

The Scottish Government emphasised research investment early on in the pandemic, which has contributed to global efforts to understand the effects of the virus, to sequence it and to work on vaccine manufacturing and development. As a result, the Scottish Government supported 55 rapid research projects in 15 Scottish universities and research institutions from April 2020, funding contributions to global efforts to combat the virus and its wider effects. Such research has allowed us to tackle the virus with, as I have said, an evidence-based approach.

Being able to deliver the Oxford-AstraZeneca vaccine at such a pace was the product of long-term funding provided by UK Research and Innovation over more than a decade. It was this long-term funding that ensured there was an existing vaccine platform technology, alongside optimised manufacturing methods, as the hon. Member for Strangford referred to. The Oxford-AstraZeneca vaccine development was also facilitated by a £2.6-million UKRI rapid response grant in early 2020. It was this funding that allowed pre-clinical investigations and a phase 1/2 trial to be conducted, as well as the scaling up of the production of the vaccine to 1 million doses by the summer of 2020.

Although the field of immunology is currently most known for its development of vaccines, it is important to note that it plays just as significant a role in contributing to public health information. As we are currently witnessing across the UK, covid-19 is by no means going away any time soon.

In addition, we are yet to understand fully the extent to which it will impact our population in the long term. Approximately 1 million people in the UK have self-reported symptoms of long covid. Of those people, around two thirds have stated that the symptoms have adversely affected their day-to-day activities. The symptoms reported include fatigue, shortness of breath, muscle aches and difficulty concentrating.

The Scottish Government have invested over £400,000 to enable Chest Heart & Stroke Scotland to deliver a long covid support service, which complements the support being provided by NHS Scotland. Along with the Royal College of Occupational Therapists, the Chartered Society of Physiotherapy and the Queen’s Nursing Institute, CHSS recently published a long covid action plan, which calls on the Scottish Government to make a number of changes. Crucially, these changes include a fund to be set up for health boards to establish a local long covid service, although a figure has not yet been set; the removal of bureaucratic barriers in NHS Scotland; and improved data-sharing, so that patients can be spoken to more quickly. Additionally, the document calls for patient care plans to be developed and for medical staff to be trained on long covid, because, CHSS says, some medical staff do not actually recognise it as a real condition.

At First Minister’s questions last week, the First Minister stated publicly that she wanted to discuss the recommendations with the charity in detail, and will give the capacity fund serious consideration in budget discussions.

[Jim Shannon]

I am very impressed and pleased by Scotland’s long covid planning strategy, which the hon. Lady has outlined. However, it is not all about plans. For many families, it is about how they will survive financially—they all want to get better, but they are not sure if that will happen in the timescale they wish. Apart from the benefits system that we have in place, does the hon. Lady have any ideas as to how we could help them financially?

[Dr Rupa Huq (in the Chair)]

On the Clerk’s advice, let me gently remind the hon. Member that, as we are talking about the Westminster Parliament, she should not stray too much into what goes on in the devolved Parliaments.

[Anum Qaisar-Javed]

I do not know off the top of my head, so I will get back to the hon. Gentleman on that matter.

In light of the statistics and the current rates of covid-19, it is crucial that there is continued investment in immunology research, which will allow us to develop an ongoing public health strategy to minimise and manage the impact of the virus on our population. Thanks to the production of the vaccine, when compared to those who are unvaccinated, those who are double vaccinated are at less risk not only of catching the virus, but of an infection turning into long covid.

Furthermore, it has been found that two doses of the Pfizer or Oxford-AstraZeneca vaccine are 96% and 92% effective against hospitalisation with the delta variant, respectively. While the delta variant is prevalent throughout the country, it is reassuring to know that because of the work of immunologists, our population is trying to live life as normally as possible. The vaccine produced by immunologists has both literally and figuratively provided us with a lifeline—without their work, our economy would remain at a standstill.

Despite the steps we have taken in the battle against covid-19, there is still so much we do not fully understand. By continuing to fund immunology research, population-based studies—a key strength of UK research—can continue to provide us with this knowledge. For example, the National Institute for Health Research has played a major role in bringing academic research together with clinical services during the pandemic, ensuring that we learn as we go. It is this continual production of real-time information about covid-19 that will allow us to overcome and stay ahead of the virus and its long-term impacts.

I therefore ask that the UK Government follow the lead of the Scottish Government’s actions and continue to invest in immunology research and ensure the necessary investment in England’s NHS. It is through further investment in this research that we will get the pandemic under control. In turn, this will ensure that the country is far better prepared for any future outbreaks of emerging diseases. Immunology research has undoubtedly played a pivotal role in our overcoming the pandemic, and it will continue to form the foundation of our public health response and our knowledge of the ever-changing landscape of the pandemic.

14:13

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to wind up for the Opposition with you in the Chair, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for securing this extremely important debate. I know he is hugely passionate about so many issues, and it has been wonderful to hear him set out exactly why this topic is so close to his heart.

So many heroes have emerged from this pandemic: our frontline NHS staff, shopworkers, carers, posties, delivery drivers—the list goes on and on. It is absolutely right that these people’s efforts are recognised, but today we have the opportunity to express our gratitude to a different group of people—a group that is more often found behind the scenes in labs and research facilities up and down the country. Their commitment and dedication to understanding and then eradicating deadly diseases has saved millions of lives over the last two centuries. Immunologists and all their colleagues in biomedical research deserve all the gratitude we can offer.

It is through immunological research that we can treat and prevent the spread of diseases. Although it can be difficult to remember a time when we were not consumed by information surrounding covid, it is important to remember how we got here so quickly. Without this research, we would not be able to develop vaccines or even understand basic principles in reducing infection rates. This work allows us to identify who is most at risk of certain diseases and informs both public health messages and interventions to limit outbreaks.

The work of immunology researchers and scientists led to an almost immediate understanding of this virus. We understood how to limit its spread and, ultimately, how to develop a vaccine to stop it. Considering that very little was known about the coronavirus before it began to spread ferociously around the world, this achievement is even more remarkable. Without this work and dedication, the loss of life worldwide would be far greater. For that, we already owe a huge debt.

It is only right to begin my contribution today by paying my respects to those who work in this field. In particular, I pay respect to the British Society for Immunology and the Royal College of Pathologists. I am sure colleagues will join me in doing so. Those institutions refused to be fazed by covid-19, and the work of their members has been pivotal in delivering a route out of the pandemic. We have a long and proud tradition in this country of pushing advancements in medicine, especially on immunisation. The work of UK scientists has led to vaccines being developed for numerous infectious diseases.

Edward Jenner, often referred to as the father of immunology, discovered the first ever smallpox vaccine in 1796. It had been theorised that exposure to cowpox would protect against infection with the more lethal smallpox. Jenner tested this theory and it was a resounding success. A tribute to Blossom, the cow whose cowpox was used as the first vaccine, can still be found on the wall of the St George’s medical school library, which is attached to the hospital where I work. From that achievement in 1796 to covid vaccines today, we should be proud of this legacy.

The scientific community has always fully endorsed collaboration and working across borders and cultures to foster innovation. Let us be clear: the unsung heroes are our scientists, who went to work day and night throughout the pandemic, even though they were putting their own lives at risk and were concerned for their own families. They are the reason we have a vaccine today—a vaccine that has saved so many lives. For them, we are truly grateful. By collaborating with researchers all over the world, UK scientists have played their part in preventing deaths from some of history’s deadliest diseases. These efforts have resulted in no less than 26 vaccine-preventable diseases, and are estimated to prevent over 2 million premature deaths globally every year.

I am proud to be part of the UK scientific community—as, I am sure, are you, Dr Huq. I am truly honoured to have met so many of the specialists who have been relentless in their struggles to get a handle on covid-19. It is imperative that the Government do all they can to support this work and to facilitate as much international collaboration as they can during the final stretch of covid-19 and long beyond. Despite all we have learned about the virus, there is still so much we do not fully understand: exactly how long immunity lasts following vaccination and whether immunity completely prevents individuals from passing the virus on, or simply prevents them from developing symptoms. Research into those questions is, of course, ongoing, and as greater numbers are vaccinated we should be in a better position to answer them.

With the ongoing threat of new variants emerging, it is vital that we understand their potential effect on immunity. Closely monitoring new variants and their impact on our immune system will help get us to a position whereby we can begin to control the virus and exit the pandemic. It is easy to assume that, now that we have a vaccine, the hard work is over and life will inevitably return to normal. While that is what we all strive for, we cannot allow complacency to creep in. By continuing to support the work of immunologists, pathologists and the wider scientific community, we will be able to face any new emerging challenges and react accordingly.

The UK is a global leader in immunology and infectious disease research, both in the academic environment and in our industrial capabilities. We need to build on those strengths and invest in our workforce, who are the lifeblood of the discipline, to ensure that excellence continues to be recognised at home and abroad. I would be grateful if the Minister could commit to this and outline what support the Government will provide for this highly skilled workforce.

Now is the time to encourage people to take up careers in this field. We need to attract high levels of talent from around the world, while training and developing our own staff and encouraging them to forge long and successful careers here. We must continue to break down the barriers in STEM to ensure that immunology has a representative workforce who can inspire future generations, regardless of their gender, ethnicity or class.

The response from the research community to covid-19 has been immense, but it has also highlighted the need to be better prepared for the next pandemic, whatever it may be and whenever it may come. Governments around the world recognise that and must never lose sight of it. Here in the UK, we cannot afford to take our eyes off the ball. Doing so would jeopardise the results of the sacrifices we have all had to make over the past 18 months, including those in our scientific community. I implore the Government to continue to support our world-leading biomedical science sectors long after covid becomes a distant memory. We were not as prepared as we could have been for the virus’s onslaught. We must learn from that and ensure that we are better prepared for the next threat, even if we do not yet know what it will be.

[Dr Rupa Huq (in the Chair)]

Finally, from the Government, Nadhim Zahawi. It is good to see him in person, and not on a conference call on a Friday.

14:24

[The Minister for Covid Vaccine Deployment (Nadhim Zahawi)]

Thank you very much, Dr Huq. It is a pleasure to be here, in person, to serve under your chairship. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, and of course the hon. Members for Tooting (Dr Allin-Khan) and for Airdrie and Shotts (Anum Qaisar-Javed).

The shadow Minister referred to Edward Jenner and Blossom, and of course we all owe a huge debt of gratitude to Dame Sarah Gilbert, who now has a Barbie from Mattel in her image. I hope that will encourage many young kids to take up science, as a number of us in this Chamber have done. As I am sure colleagues here know, I am a proud chemical engineer from University College London. I think it appropriate, on a day like this, to congratulate the behind-the-scenes group—as the shadow Minister referred to them—of incredible scientists, whose incredible work has allowed us to deal with this pandemic. I am sure the whole House would want to join me in that.

I also congratulate Sir Shankar Balasubramanian and Sir David Klenerman. They have just received the $3 million Breakthrough Prize, which is referred to as the “Oscars of science” for their work at Cambridge on next-generation genome sequencing. To bring that to life for the House, it took $3 billion and about 10 years to sequence the first human genome. Their work on next-generation genome sequencing now allows that same work to take an hour and about $1,000, which makes a real contribution to future discovery.

For those who do not know her, I would also encourage people to look at the work of Professor Katalin Karikó, who has also been awarded the Breakthrough Prize today. She is not from the United Kingdom, but has had to travel a long journey, from Hungary to the USA and the University of Pennsylvania. Her personal struggle and her work on mRNA allowed BioNTech and Moderna, using her patents, to develop those incredible vaccines.

By calling this debate, the hon. Member for Strangford has really provided us with an opportunity to discuss the world-leading contributions that UK researchers have made by increasing our ability to tackle this disease. Investment by the Government has assisted the science underpinning the development of many of the tools we need to harness to ultimately defeat this virus.

UK-based research has provided insights that are crucial to improving surveillance, patient care and management, and developing new diagnostics, therapies and vaccines. Identifying how the immune system responds to covid-19 is critical to understanding so many of the unknowns around this novel virus. For example, why does it make some people sick and not others? What constitutes effective immunity and how long might that immunity last?

The immune system is extremely complex. To make rapid and effective progress in our knowledge, a nationally co-ordinated approach was needed, as the hon. Member for Strangford referred to. That is why £6.5 million of funding has been provided from UK Research and Innovation and the National Institute for Health Research to the UK Coronavirus Immunology Consortium. The UK is world leading in the quality of its immunology research, and this innovative project has enabled us in Government to commission at pace the research needed to understand the immunology of covid-19, and as a result successfully deliver real benefits to patients and public health. The key themes identified by UK-CIC included the understanding of primary immunity, and describing the body’s immune response to covid-19 and how this might explain the different risks presented by the virus to individuals. In other words, why do some get sicker than others?

What constitutes protective immunity? Identifying how an effective immune response can be generated and how it can be maintained to prevent re-infection was essential for the development of effective vaccines and understanding why some people remain vulnerable even after vaccination. Unpicking the mechanism of the disease caused by immunopathology—how the body’s own immune response to the virus can cause damage to tissues and organs, and how that can be stopped—is essential knowledge for the development of effective treatments, along with identifying immune vaccine evasion and how the virus might evade the body’s protective immune response through natural infection or vaccination, leaving people vulnerable to re-infection.

I want to highlight some further research that we have commissioned and funded in the field of diagnostics. The COVID-19 National DiagnOstic Research and Evaluation Platform—the CONDOR study—is accelerating how quickly promising diagnostics make it out of the lab and into real-world use. This will support the diagnosis of infection and the management of patients with suspected covid-19, which is important for the subsequent waves of infection in the post-pandemic setting.

On vaccine development and deployment, we all know the benefits that both doses of the vaccine can bring to many people. Indeed, colleagues have mentioned that today. Data from Public Health England suggests that two doses of the covid vaccine offer protection against hospitalisation of around 96%. The United Kingdom has been at the forefront of vaccine development, helped by the investment that we have made in this vital research. The ChAdOx1 vaccine platform—already shown to be safe and effective through a previously funded phase 1 trial against the middle east respiratory syndrome, or MERS, which the hon. Member for Strangford rightly referred to in his speech—was quickly adapted to develop a vaccine candidate against covid-19 and launched human trials in April 2020.

In parallel, project funding was also provided to investigate and develop more efficient vaccine manufacturing processes, enabling vaccines to be made more rapidly. However, the development of an effective vaccine is just the first step, and I commend the efforts of the NHS in the world-class roll-out of the vaccine programme among adults and young people across our four nations. Our efforts in understanding why some people do not develop a protective response even after receiving two doses of the vaccine are an important next step in our research portfolio, hence the Government have commissioned important studies to understand vaccine responses among the most vulnerable in our society.

However, despite the success of the current vaccination campaign, we are doing more by investing in research that will inform us about how to deliver vaccinations in the future and to help us to understand why some immunosuppressed people are not fully protected. I regularly meet charities that support clinically extremely vulnerable patients, and I share their concerns about the risks to this group from contracting covid-19.

There is a breadth of research activity being funded in order to look at vaccine response in immunocompromised individuals. The OCTAVE—observational cohort trial T cells antibodies and vaccine efficacy in SARS-CoV-2—study is examining covid-19 vaccine responses in clinically at-risk groups, including patients with certain immunosuppressed conditions. Building on the work that we did with the OCTAVE trial, we are funding OCTAVE DUO, which is a new clinical trial to determine whether a third dose of a vaccine will improve the immune response in people who have weakened immune systems. Additionally, the UKRI-funded research to be commissioned following the recent research on vaccine immune failure will investigate the strength and durability of the immune response, which I know colleagues are interested in understanding better in a wide range of people, including those with conditions that result in a weakened immune system, such as HIV.

The development of novel treatments for covid-19 has been made possible by the work and funding that we have provided for immunology research. As referred to by a number of hon. Members, that includes the UKRI and NIHR-funded projects looking at the immune response generated during infection with covid-19, which revealed that the body produces harmful immune responses that attack its own tissues and organs. That leads to severe disease and may underlie some forms of long covid, but further research is needed to better understand this. Research of this type has helped the development of new and effective treatment options, including the recently approved novel monoclonal antibody treatment Ronapreve. This novel treatment development was also supported by a UKRI and NIHR-funded trial.

I will briefly turn to some of the questions that hon. Members asked. The hon. Member for Strangford asked about long covid, which can have very serious and debilitating long-term effects for thousands of people across the UK. It can make daily life extremely challenging. We are providing significant funding for several studies in order to better understand the long covid problem, improve diagnosis and find new treatments. In July, the Department provided just shy of £20 million—I think it was £19.6 million—of funding towards an extensive programme of 15 new research studies, which will allow researchers across the UK to draw together their expertise from analysing long covid among people suffering long-term effects and the health and care professionals supporting them. The projects will better understand the condition and how to identify it, evaluate the effectiveness of different care services on people with long covid, identify effective treatments, such as drugs and rehabilitation, to treat people suffering from long covid, and improve home monitoring, which is a key issue.

[Jim Shannon]

I am very encouraged by that. Is it the intention of the Minister’s Department to share the results of those studies with all the different regions of the United Kingdom, so that we can all benefit? As health matters are devolved, the evidential base and final conclusion of the studies will be very important for us all.

[Nadhim Zahawi]

I completely share the hon. Gentleman’s concerns about that issue, and it is important that we look at it very seriously. He also asked whether we have enough supply of monoclonal antibody treatments. I can tell him that the regulatory approval and clinical policy will provide information on which patients could benefit from the treatments and how much supply is needed. We are working with the companies to ensure that we have a supply of those products in the coming months. Which patients are likely to have access to those treatments? Again, the NHS England antibody expert group is currently designing clinical guidance on how the NHS should use the treatments, which includes defining and identifying the eligible patient cohorts that are likely to benefit following a positive covid test.

In terms of deploying the treatments, part of the work of the NHS England expert group is on the clinical guidance on identifying potential deployment in hospital and possible pathways, especially through clinics and at-home services following a positive test. The hon. Gentleman also asked what research is looking at long-term immune response in individuals who are vaccinated. The Department is funding a number of important studies into immune response: the SARS-CoV-2 immunity and reinfection evaluation, or SIREN, study in healthcare workers; the Vivaldi study in care home residents and workers; and the coronavirus infection survey led by the Office for National Statistics, with repeat household visits looking at who has antibodies to covid from either vaccination or previous infection.

The hon. Gentleman asked about vaccine manufacturing in the longer term. I can tell him that in 2018, UKRI announced £66 million for the UK’s first dedicated vaccine manufacturing and innovation centre, VMIC. The goal was to promote, develop and accelerate the growth of the UK vaccine industry. When the pandemic began, UKRI reacted at unparalleled scale and speed to ensure that all investments were ready and able to respond to the challenge, and that they were plugged in to the UK’s wider vaccine, life science and pharmaceutical ecosystem. An additional £131 million was made available as an investment in, I think, May 2020, bringing the total for VMIC to just shy of £200 million, at £196 million. VMIC will be able to deliver about 200 million doses of vaccine, of any technology, at scale per annum, so it is a big investment.

The hon. Gentleman also asked what the Government are doing to support the development, production and procurement of vaccines for the future. As well as VMIC, we are planning for all scenarios in the fight against covid and its variants. Some of the recent analysis supports our understanding that both the Pfizer BioNTech and AstraZeneca vaccines currently being deployed in the UK appear to work well against the current dominant variants of covid, and continuing to administer those vaccines at scale remains our key to bringing the virus under control.

We are also assessing our existing portfolio against current variants, working closely with vaccine manufacturers and Public Health England, to understand the efficacy of our portfolio. We think we are in a good place vis-à-vis the interim advice from JCVI on the booster campaign, which we hope to begin later this month.

Finally, the hon. Gentleman asked whether there was any existing research that had helped to accelerate the development of vaccines. He quite rightly cited the work of the Oxford team, but even before the covid-19 pandemic, they were already doing that research because of funding from UKRI—and thank goodness for that.

To conclude, I fully recognise the tremendous impact that the pandemic has had on so many people. Commissioning high-quality immunology research is an essential part of our armoury in fighting this virus. We will continue to implement research findings and, at the same time, commission and fund new projects that will deepen our understanding of the disease and identify further defences that will keep us safe. Throughout this pandemic, the Government have been there to support and invest in research. As we shift our focus from the initial impact of the pandemic, we intend to continue to provide funding and support for covid-19 research, underlining precisely why the UK has long been, and continues to be, a great place for world-leading research and researchers.

[Dr Rupa Huq (in the Chair)]

Finally, in this debate where all hon. Members have demonstrated quality, if not quantity, I call Jim Shannon to wind up.

14:39

[Jim Shannon]

I thank everyone for their contributions, starting with the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed). She spoke about devolved matters, as you said Dr Huq, but it is good to share strategies across the whole of the United Kingdom, and I look forward to doing so.

[Dr Rupa Huq (in the Chair)]

Absolutely. I was confused by what was going on as Members were speaking at the same time. I completely agree that the hon. Lady made a powerful speech.

[Jim Shannon]

The hon. Lady referred to 83 venues across the whole of Scotland that are doing research to find and perfect a strategy. We can all take an interest in and learn lessons from that.

I thank the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), for her hard work during the pandemic. She has been on the frontline, and I think we all want to thank her personally for that. I do not think I have had the opportunity to, so I thank her on behalf of a great many patients who are indebted to her and to others for that work.

The shadow Minister also referred to the advances in medication and the cross-border culture of countries working internationally to find a cure, control the virus and exit the pandemic, with the UK as a global leader. Those words are very true and represent the consensus of opinion, as the debate has made clear.

I thank the Minister. Although I said that at the beginning and have just said it again, it does not take away from the quality of our gratitude to the Minister for the work that he does. He referred to all those working in the back room. We all know that there is a team behind the Minister who make it work, and I thank them, because they are the strength behind how it works.

The Minister referred to a better understanding of the immune system and how it works for some and does not work for others. One crux of the matter is about how we can find out why. If we do excellent research on that, we can find a cure. There are 15 new research studies, with significant amounts of money set aside. Many would have tried to accumulate that money, but it has been massive.

We are in a better place today because of our Government and the Minister. This debate has brought everyone together to say the same thing. I thank everyone for their participation and contributions, particularly the Minister.

Question put and agreed to.

Resolved,

That this House has considered the role of immunology research in responding to the covid-19 outbreak.

14:39

Sitting suspended.