Everybody knows the very promising University of Queensland COVID vaccine was killed because it caused HIV tests to register a false positive.
Not so commonly known is that there is another HIV test that isn’t fooled by the vaccine.
If Test A returns a positive in Australia, Test B is used to decide if it was true or false.
And while an initial false positive isn’t nice, it’s hardly earth shattering when people know it could be the vaccine doing it.
A false negative, on the other hand, that would be dangerous.
What’s more, the false positive effect fades away.
When the UQ team announced their vaccine was being dropped, they also reported some of the participants in the trial “had already stopped registering an HIV response, with all of them seeing declining figures over time”.
Importantly, the UQ vaccine approaches its job from a different direction to the Astra Zeneca and Pfizer vaccines. The patented UQ “clamp” technology is a whole other runner in the anti-COVID race.
To recycle a friend’s line, if you simply must pick the winner of a horse race, you bet on all the horses.
The Australian government effectively put all its money on AZ to win, then scraped around to have something on Pfizer for a place as its favourite began to falter and is now trying to make amends.
Further complicating matters is the outlook for the wee virus to keep mutating, to keep challenging the existing vaccines’ efficacy as well as issues with which vaccines may or may not be suitable for different groups of people, never mind global production capacity of the more complicated medicines.
With those complications, it’s beginning to look like you wouldn’t want to leave any horse in the stable for this race.
So why was the UQ vaccine scratched on the verge of its Phase 3 trials that would have established its efficacy and a complete basis for judging the trade-off between the false positives and its contribution to fighting the pandemic?
A doctor friend of long standing gave me an earful about weak decision makers caving in to (expletives deleted) anti-vaxxers, being afraid of ratbatgs.
That might well be read into what the Health Department secretary Brendan Murphy said in the December 11 media conference now infamous for other reasons.
While declaring it was “very, very good technology” and that it “probably would have worked very well as a vaccine”, there was a question of confidence.
“We knew that we didn’t want to have any issues with confidence, and this false-positive test may have caused some confusion and lack of confidence,” Professor Murphy said.
“We can’t have any issues with confidence, and we are as a nation now, with a good portfolio of vaccines, able to make these decisions to best protect the Australian people.”
It’s not stretching far from Professor Murphy’s “confidence” issue to imagine what anti-vaxxers would have made of any mention of a fragment of HIV.
But that was before a rare clotting issue with the AZ vaccine absolutely raised “issues with confidence”.
That was when Prime Minister Scott Morrison could still trot out one of his standard deflections when a journalist asked how confident he was about supply of vaccines given the loss of the 51 million proposed UQ doses.
“I disagree with the premise of your question,” Mr Morrison said. “I think what this demonstrates is the effectiveness of our strategy.
“And what we can do is vaccinate our population twice over. And we have one of the highest ratios of availability of doses of any country in the world.
“So this is a demonstration of the success of the vaccination policy and approach that we have been following. We have prepared for this. We have planned for this.”
Those were the days.
Given the unreliability of the Prime Ministerial statements on the issue, I thought it best to ask one of the members of the UQ team, Professor Trent Munro.
He confirmed that “vaccine hesitancy” was one of the issues that scratched the UQ vaccine, but not the only one.
Key funding and partnership for the UQ work was being provided by CEPI, the Coalition for Epidemic Preparedness Innovations, which works to develop and enable equitable global access to vaccines.
Professor Munro said HIV diagnosis was very complex. The false positives would have created extra complexity for Australian laboratories.
While that might not have been an insurmountable problem here or in other rich nations, it would mean the vaccine could not be used in low-to-middle income nations that have worse HIV problems and only one level of testing.
Exit CEPI and the Australian government withdrew its underwriting of the 50 million doses CSL was to manufacture. The plug was pulled.
“The hardest thing for the team was that all the data looked so very positive,” Professor Munro said. “We also knew developing a vaccine based on a protein was a potentially important part of the future vaccine strategy.”
The science has continued to stand up. The unique UQ “clamp” technology has been peer reviewed, published and accepted in the leading journals.
The team of scientists working around the clock were on to a good thing.
And they still are – they haven’t stopped.
The UQ team is continuing to work on developing a COVID vaccine, “Clamp 2.0”, but this time without an HIV fragment or anything else that could trigger a false positive.
The team has some funding left from last year’s grants of $10 million from the Queensland government and $5 million from the Australian government, an ongoing relationship with CEPI, and support from philanthropic donors, large and small.
What they lack at this stage is the partnership of a global pharmaceutical company with the balance sheet necessary to prove the manufacturability of a vaccine and take it through the extensive and expensive stage-three trials.
But Professor Munro sounds optimistic as the economics and strategy around COVID vaccines have changed.
“When it started, the vaccine development was seen as something philanthropic, a global effort,” he said.
“Now the mRNA companies are making billions of dollars. Companies are looking at strategic niches as variants develop and vaccines for people for whom existing vaccines aren’t suitable.”
COVID isn’t going away and UQ isn’t stopping.
With all the benefit of hindsight that applies to so much of the handling of this still-unfolding pandemic, it looks like a missed opportunity that the “Clamp 1.0” plug was pulled as soon as it was.
The UQ scientists are solid on the decision, as reported by The Saturday Paper, but it infuriates this layman that tinfoil-hatted anti-vaxxers managed to play any role in that decision at all.