Following the announcement that a COVID-19 vaccine has been approved for use in the UK, one frontline physician reflects on their experience of taking part in one of the major clinical trials. This RCP fellow has chosen to stay anonymous on the advice of the trial organisers.
Since March 2020, I have been dealing with the coronavirus pandemic at close quarters in a very busy district general hospital in south Wales. In June, once the initial first wave of the virus was receding, I was offered the opportunity to take part in a trial of the Oxford/AstraZeneca COVID-19 vaccine.
This is the first time I have ever been a subject on any medical trial
I saw a post on my health board’s Facebook page appealing for volunteers to enrol in the trial. At the time, with the numbers of cases dwindling, and the shock of the first devastating wave behind us, an eerie sort of calm had descended.
My normally very busy job, while still demanding, was less intense than usual, and I now felt a little bewildered, not just by the effects of the first wave, but also in wondering how else I could contribute in a positive way to fighting this horrible disease. I didn’t know if I would be eligible to be randomised, but I filled in the application and waited.
After just 24 hours, I was contacted by an enroller
I was given an appointment at a research centre close by in a neighbouring health board. That first appointment was long, but efficient. I sat through videos from the trial organiser, was given large amounts of paperwork to read and sign and underwent a brief medical and blood tests before consenting to the trial.
A week later, having no signs of coronavirus antibodies, I was enrolled into the double-blind randomised trial to either a proven meningitis vaccine as a placebo, or the Oxford COVID trial vaccine. I had no reactions and felt well afterwards. I then started the somewhat tedious process of regular throat swabbing – this involves registering the test online, taking it (after nearly 6 months the swabbing gets no easier), assembling the little kit and finding the special post box to put it in. The results arrive a few days later. This weekly routine has probably been the worst part of the whole trial – and it is, at worst, a minor inconvenience.
A few weeks later, after more blood tests, I returned for a second dose, and again, there were no issues or side effects from this second dose, except for a tiny bruise at the injection site. The research centre staff are friendly and efficient, and there are almost weekly emails from the centre about what to do if we develop symptoms or return a positive test.
And then the second wave hit us in late September
I knew that my exposure to patients (and staff) with COVID-19 was going to be helpful to progress the trial, but I was apprehensive about what lay ahead. This second wave has felt infinitely worse than the first, and far more of my colleagues and friends have been affected. I continued with my personal protective equipment (PPE), handwashing and weekly swabs, and it felt like we were all digging in for the long haul.
And then came the news that the Pfizer vaccine was successful. The trial organisers immediately contacted us to say that if this (or another vaccine) was approved and offered to me, I could be unblinded and receive a proven vaccine if I’d had the placebo. Or, if I’d had the trial vaccine, advice would be given as to whether to accept the approved vaccine. Not long after this came the news that the Oxford vaccine was effective.
That day I felt very proud that my own tiny contribution to the trial had helped us to develop not one, but three effective vaccines for a disease that didn’t exist a year ago.
A truly amazing feat for all involved
With the news that my health board will be hoping to roll out the Pfizer vaccine in just a few weeks, I have some decisions to make – but they won’t be too difficult. In my role, I will certainly be offered a vaccine, so I will need to have the trial organiser unblind me, and it’s a very easy decision if I have had the placebo. I will have whatever COVID-19 vaccine I am offered without any hesitation. If I have had the Oxford vaccine, given the news that it too appears to be effective, I intend to continue with the trial if I am able to.
I have every confidence in the trial organisers, both at the local and the international level, and a great deal of respect for their professionalism and the very hard work they have put in. If the opportunity presented itself to enrol in a clinical trial like this again, I would not hesitate to sign up.
The demands of my job make formal participation in research difficult, although I do all I can to support the improvement of day-to-day services). For most clinicians I work with, having the time to really dedicate to clinical research is impossible with the current pressures we face, and I’ve never had any formal training in undertaking ‘serious’ research projects either. Having experienced the amount of hard work required in hosting a trial such as this, it is obvious that dedicated research centres are essential, and having the staff to support this is crucial.
The author is a frontline physician working in a large district general hospital in south Wales.
On 17 December 2020, the author wrote to us to say that it turned out they had received the Oxford/AstraZeneca placebo, and would be receiving the Pfizer/BioNTech vaccine the following week, just before Christmas.