How British research could hold the key to taming Monkeypox and fridge-free vaccines

As the country wound down for the long bank holiday weekend, Professor Jonathan Heeney was juggling a mountain of work in Cambridge. “The thing is, what we’re doing is really timely,” he says.

For years, Heeney and his team at biotech company DIOSynVax had been working on creating a vaccine suitable for three infectious viruses – ebola, lassa and marburg. But as monkeypox cases started to pick up around the world, the virus that DIOSynVax and researchers from the University of Cambridge had based their jab on was drawing attention.

“Just like Oxford chose to use a chimpanzee adenovirus for their Covid vaccine, we chose a weakened smallpox vaccine to carry the payload for all these hemorrhagic fever viruses. And so, we would not only be able to vaccinate against lassa, ebola and marburg, but also fortuitously monkeypox,” says Prof Heeney.

With positive monkeypox cases spreading worldwide, focus is turning to what approach countries should take — and the role of vaccines. The World Health Organisation (WHO) has said Europe is now at the “epicentre of the largest and most geographically widespread monkeypox outbreak ever reported outside of endemic areas in western and central Africa”.

Yet, so far, it adds, “monkeypox has not been at the forefront of research and development in the field of infectious diseases”. Britain has bought more than 20,000 doses of a smallpox vaccine in the scramble to secure supplies to inoculate those at risk.

In the background, however, work has been underway in Britain on research which insiders say could hold the key to entirely stamping out such viruses.

Last Monday, officials from InnovateUK were on the phone with Heeney. The government funding arm recently handed his project another £500,000 to expand its vaccine project to protect against four fevers plus monkeypox, on top of a previous £2.3m grant.

“We want to do this as fast as possible,” says Heeney. “We want to get our vaccine into the countries where monkeypox is a real problem.”

DIOSynVax’s potential, he says, is significant – not just for monkeypox but the other viruses, too. Its vaccine work was recently expanded to see if the jab could be used for a fourth virus – Crimean-Congo haemorrhagic fever.

“We’d only have to make one vaccine for all those viruses, and vaccinate people once or twice with it, rather than having to keep launching different campaigns. It would be cheaper and, simply, more effective.”

Some within the scientific community are sceptical. Clive Dix, the former chair of the UK vaccine taskforce, argues the chances of success in making a virus to tackle three or four different things appear “very slim”.

“The issues of developing it are horrendous, because if you have a vaccine, you need to show it works and get it approved. Well you’d need to show it works against all the things you’re trying to get approved for. These have to be full scale trials, so doing that multiple times over, you’re talking 20-year development plans.”

The question of funding is central. Heeney may be optimistic the rise in monkeypox cases could help his company secure more funding, yet not everyone is convinced.

“Current smallpox vaccines are something like 85pc effective against monkeypox,” says Paul Hunter, professor in medicine at the University of East Anglia. “That’s pretty damn good. We could spend a lot of time, effort and money, and two years down the line have a specific monkeypox vaccine, and it’s no better than what we’ve got at the moment.”

While DIOSynVax’s jab is intended to help multiple viruses, experts argue funding for vaccine development in any form remains a major issue.

“A key question is, where is the pull at the other end of the market?” says Professor Andrew Pollard, of the Oxford Vaccine Group. “There is a question about the incentive for a commercial manufacturer to actually make a vaccine if it’s not going to be used.

“Obviously, from a pandemic preparedness perspective, we need to work out how to make vaccines for these diseases, because we may need them in the future, like for Covid. But there’s still a practical issue of the financial model. Who is funding this?”

Still, there are pockets of scientific progress in Britain which could make a major difference to stamping out diseases such as monkeypox, even without huge investment and lengthy development periods.

Vaccine tsar Dix says there is scope to “hold back the tide” of viruses in developing countries through technologies which stabilise vaccines, meaning they can be stored at any temperature.

Making vaccines that do not require fridges, or to be kept at certain temperatures, is key. Estimates suggest half of the world’s vaccines are wasted because they have not been stored at the right temperature.

Özgür Tuncer, CEO & Executive Chairman of British start-up Stablepharma, is one expert working in this area. A former Pfizer manager, Tuncer understands this is something that urgently needs to be addressed.

“Pfizer said numerous times that they’re making mRNA vaccines available to Africa, and it’s funny, because I worked for Pfizer for a long time and just making vaccines available to Africa does not solve the issue,” he says.

So far, Bath-based Stablepharma is working on tetanus diphtheria vaccines and mRNA Covid vaccines — a process which involves adapting existing vaccines. Smallpox and monkeypox vaccines are also on their radar.

Pharma giants such as Moderna, which have said they are looking at monkeypox virus, “are going to need somebody like us to create fridge-free versions of these vaccines,” insists Tuncer.

The potential benefit, he says, could be huge. “We’ve shown as humankind that infectious diseases are eradicated because of vaccines. There’s no other reason. It’s all down to vaccines and vaccinating people relentlessly over long periods of time and building immunity. That all relies on access.”

As focus remains firmly on the response to the current outbreak, the hope is that such messages will ring loud and clear for pharma executives and governments.

“It’s easy to eradicate viruses in Europe,” says Tuncer. “But it’s much more difficult to eradicate viruses or any infections in Africa, and that’s because of vaccination rates and access.” If Britain’s scientists could solve that, he says, situations like the current one could be a thing of the past.


Cambridge scientists win fresh government funding for Monkeypox vaccine

Scientists from the University of Cambridge have won fresh government funding for new vaccine work which aims to stamp out Monkeypox and Ebola in one swoop.

The Department of Health is funnelling just under £500,000 into a project to develop a next-generation jab to protect against four infectious diseases, as well as monkeypox.

It would use a proven safe smallpox virus as a vector, which would carry and deliver the payload of vaccine antigens that educates a person’s immune system against ebola, lassa fever and marburg.

The grant funding, delivered by government funding arm InnovateUK, will go towards adding Crimean-Congo haemorrhagic fever to the all-in-one vaccine. If successful, it could protect against the four major haemorrhagic fevers in West and Central Africa as well as monkeypox.

It comes as cases of monkeypox rise. By last Monday, there had been 172 cases in England since May 7, four in Scotland, two in Northern Ireland and one in Wales.

Cambridge University and its spin-out, DIOSynVax, are working together on the project for the multi-valent vaccine, following on from previous work to make one to protect against the first three of those four fevers. It previously received a £2.3m grant from Innovate UK. That project came to an end last December.

Professor Jonathan Heeney, the head of the laboratory of viral zoonotics at the University of Cambridge and chief executive of DIOSynVax, said the process to develop the vaccine would require more trials than typical vaccine development. “But at the same time, once we’ve got it nailed, we’re gonna cover if not four then five viruses in one.”

The Government has so far bought more than 20,000 doses of a smallpox vaccine, supplied by Bavarian Nordic, which is being offered to close contacts of those infected. That vaccine is thought to be around 85pc effective against monkeypox. Ministers are also working with suppliers to produce extra doses should they be needed.

Prof Heeney said latest monkeypox outbreak in Europe would hopefully help funnel more funds into its work, and that a next-generation multi-valent vaccine would be easier to roll out in developing nations. “If there’s a real international push to get more vaccines out there that can not only protect against monkeypox, but these other viruses, then it certainly would be of great benefit.”

“We would like to be able to get this done within a year, but it’s going to take more investment and a bigger push to get these trials going.”

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