How Belgium has become the 'Silicon Valley' of vaccine development

In December 2020, almost exactly a year after Covid-19 began to spread, a key milestone in the fight against the disease was reached: the first vaccine dose was administered outside of a clinical trial. A nurse originally from the Philippines, May Parsons , gave that ground-breaking Oxford-AstraZeneca shot to a woman in the UK, Margaret Keenan, 91. That a vaccine had been developed, tested and approved for emergency use in such a short space of time was remarkable and credited, in part, to huge investments by governments especially. While vaccines from Oxford-AstraZeneca, Pfizer-BioNTech and Moderna were ready to go in rapid time, technical and commercial reasons mean that shorter lead times could become more common in the post-Covid world. Few know this better than Dr Jamila Louahed, global head of research and development for therapeutic vaccines at the pharmaceutical giant GSK, and head of research and development at the company’s site at Rixensart, a town south-east of the Belgian capital, Brussels . Dr Louahed describes Belgium as "the Silicon Valley of vaccines", with the European nation having an ecosystem for vaccines that began to develop in the aftermath of the Second World War. To highlight the time it has taken in the past to develop some vaccines Dr Louahed cited respiratory syncytial virus (RSV), which causes colds and coughs that threaten infants and the elderly. In Europe alone, RSV results in an estimated 20,000 deaths of older people in hospital each year. In 2023, US and European regulators gave approval to a GSK vaccine against the illness, while UAE officials gave the go-ahead this year, and it is being introduced in a number of nations. It has been a long time coming. In the 1960s a different RSV vaccine, based on an inactivated form of the virus that causes RSV, led to respiratory disease in some infants, a setback that considerably slowed development. Also, the task of developing a shot has been made difficult by way that the key F protein on the virus's surface evolves rapidly. "If you think about the time it took to develop some vaccines – let’s say RSV – 60 years. With today’s technology, you could really speed it up – less than 10 years," Dr Louahed said. A key reason cited by Dr Louahed for increased speed is advancement in structural biology, the field that analyses the 3-D shape of biological molecules, such as fats, proteins, carbohydrates and nucleic acids. Without these advances, spurred by improvements in microscopy and computing software, she said neither the Covid-19 vaccines nor the RSV vaccines would have come to market in the way they have. It is hoped that new technology in the form of the antigen presenting system (Maps) could help develop innovative ways to combat antibiotic-resistant bacteria. The goal is to provide broader protection by combining sugar and protein antigens from the surface of the bacteria in one vaccine, which will activate different parts of the immune system, a statement on the GSK website reads. An antigen is a toxin or other foreign substance which causes an immune response in the body. For all that technology has improved, it remains a painstaking process to identify the correct antigen to include in the vaccine. Ian Jones, a professor of virology at the University of Reading in the UK, said vaccine development was now "undoubtedly" faster, possibly twice as quick as in previous decades. He said advances in structural biology meant the process of working out the 3D configuration of critical components of antigens was "much more streamlined and much faster" and Maps technology, too, had been a leap forward. He said with mRNA vaccines, regulation was simpler because with different versions of such vaccines, the safety profile was not likely to change. Also, while he said that safety had not been compromised, the overall regulatory framework was faster. "Now that back has been broken, it will be a lot easier to get a vaccine licensed than it was," he said. "There was a feeling that small companies and new companies could not possibly know what they were doing and couldn’t amass the data to get it through the regulatory authorities – they should leave it to the old timers. Covid has put an end to that." For one candidate antigen for a vaccine, hundreds may have to be screened, so working in the field can be "extremely exciting and extremely frustrating at the same time", said Dr Dunja Sobot, GSK’s head of protein biochemistry for therapeutic vaccines. "We have a lot of back and forth to make sure we have the best possible antigen when it goes further down in development," she added. "We need to make sure we have something that’s functional, efficient and safe. We’re entering an exciting era. We can use many production tools to help us design the vaccine. All of this innovation can be applied to many parts of vaccine development." Another technological advance has been through the use of "digital twins", which Siemens and a digitalisation company called Atos have worked on with GSK. These provide a way to optimise the development and manufacturing of the vaccine through the creation of a "virtual plant". This is the digital equivalent of the real vaccine facility, and it generates data that can be fed back into the vaccine development and manufacturing process, helped by machine learning, a form of artificial intelligence. Aside from technical advances, vaccine development is being sped up by the holding, simultaneously, of different stages of clinical trial. Emmanuel Felix, a GSK vice president who oversees the company’s manufacturing operations, said working in sequence was "not an option any more". Among GSK’s manufacturing sites is a huge complex at Wavre, which lies a short distance east of Rixensart. Employing more than 5,000 people, the campus-like Wavre plant, which is able to produce 1.5 million doses per day and accounts for about 60 per cent of the company’s vaccine manufacturing capacity, continues to expand. Mr Felix said the pandemic had "changed the way we interact with regulators", which is another reason why things are faster now. "A lot of the barriers we thought were there in the past we can overcome," he said. There is also a greater willingness to take commercial risks in the race to create new vaccines. For example, Mr Felix said GSK had already made investments in Belgium in anticipation of the eventual production of a vaccine to combat the herpes simplex virus. An estimated 3.8 billion people under the age of 50 globally have herpes simplex virus type 1 (HSV-1) infection, the main cause of oral herpes, the World Health Organisation (WHO) said. An estimated 519.5 million people aged 15 to 49 worldwide have herpes simplex virus type 2 (HSV-2) infection, the main cause of genital herpes. HSV-2 increases the risk of acquiring HIV infection by about three-fold. In some cases it can even lead to a brain infection. Continued innovation to develop a herpes vaccine is needed because of the "unmet medical need and burden associated with genital herpes". However, last month GSK announced initial results "did not meet the study’s primary efficacy objective". Mr Felix said the company had already made preparations for the vaccine, which will not go ahead in its current form. "We had made some investment in Belgium for that. It’s what it is but we’ve done the right thing," he said. While vaccine development is faster thanks to a new technology and a renewed post-Covid push by pharmaceutical giants to keep up momentum, Mr Felix insisted safety standards remain high. "It doesn’t change anything from a safety risk perspective. We would never, ever compromise on that," he said.

How Belgium has become the 'Silicon Valley' of vaccine development

The demand to develop and deliver new doses has never been more intense - and one country is leading the way in the challenge of meeting it