Covid vaccinations: Twenty million reasons to be looking forward
There are many challenges to come, but experts today explain why there is room for optimism as we look ahead.
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While Britain's response to the coronavirus pandemic has faced criticism, there is no doubting the success of the vaccine roll out.
When it comes to delivering jabs the UK is towards the head of the pack, vaccinating more than 20 million people so far while other nations play the blame game as the row over supply issues rumbles on.
Across the country the vast majority of the most vulnerable people have had their first dose, and with the roll out ahead of schedule, those aged 60-64 will start to receive invitation letters from this week.
After initially looking for a vaccine that would be 50 per cent effective, developing ones that give 95 per cent protection is almost miraculous.
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To get to this stage has taken months of hard work and dedication from teams of scientists, who have worked at a faster speed while maintaining the usual safety standards.
The West Midlands, Shropshire and Staffordshire have been at the forefront of the vaccine race, with researchers from the University of Birmingham providing crucial work in support of the jab's development.
Dr Chris Green, a consultant in infectious diseases who has researched vaccines for the past decade, said the UK was now "in a very good position", with "several safe and effective vaccines" available.
He said they had been left with no choice but to do things differently due to need to get Covid under control as quickly as possible.
"We've certainly done things quicker," he said. "But we haven't taken any shortcuts whatsoever. We have done trials very quickly but to the same standard.
"That's because of the huge amount of resource commitment that the NHS and people from the public have done to enable that piece of work in the first place."
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Dr Green, who was principal investigator for four of the five vaccine trials that have taken place in the West Midlands, said the genetic code technology used in some of the vaccines against Covid had already been in development before the pandemic hit.
He said this fast-tracked the process of preparing them to be deployed at scale.
"By using genetic code technology, so it could be DNA which we had in the AstraZeneca/Oxford product, or RNA as we have in Pfizer... it has been a very good platform for developing vaccines quickly to be tested in clinical trails that are accelerated so we can get to where we are today," he explained
"A lot of these technologies were already being developed for other infectious diseases and cancer therapies... so it wasn't about them starting from scratch, it was about adapting what we already had for the new disease that was coming through.
"In fact, a lot of these platforms have always been particularly attractive because of that adaptability to be brought onto another target.
"If you think about Zika and Ebola and all these other outbreaks of infectious diseases, the same principles were followed to get the same result quickly.
"Of course, this was much bigger than we have ever done before."
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Dr Green said one of the main challenges in the coming months was over new variants of coronavirus, such as the South African strain that has been found in parts of the West Midlands.
He said: "There is a kind of arms race that goes on between us and the virus.
"It is right and proper that we consider whether we need new vaccines against new variants, but at the moment we don't really know whether our current vaccines are going to be good enough as they are."
Professor Alex Richter, a consultant immunologist, said studies were "up and running" trying to understand the difference in the immune response to different variants.
"There is some evidence that immunity against the South Africa variant is not as effective, which is why the AstraZeneca vaccine was not initially taken up in South Africa," she said.
"But what we are finding from some studies is that if you have a very good immune response, either to natural infection or to any of the vaccines, then actually you will get some cross-reactive protection against the South African variant and other variants.
"Think of it as a 'worst to best' scenario.
"The best scenario is this really exciting 95 per cent protection that we are talking about. But what we might find, as these variants come through, is that we are getting more like 60 per cent or 70 per cent.
"So whilst it is not as great as the initial response to what we call the 'wild type' virus, which is our first virus that we've been having to deal with as a global population, as these variants come through it is likely that we will have some cross protection.
"So the viruses with these mutations are unlikely to sweep through the world as the virus did in the first wave."
She added: "The best example is flu – our winter pressures enemy every winter. We are fighting a new, slightly different strain every year, and it is possible that is what will happen with coronavirus.
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"With the flu vaccine you don't get vaccinated against one strain. Most years we are vaccinated against four different types of flu. The World Health Organisation predicts, from what's happening in the southern hemisphere, which are the ones we need the most protection from.
"Then the vaccine companies very rapidly, within a few months, develop a flu vaccine with these variants. So mixing strains in a vaccine is not new, we do it all the time."
Prof Richter said it was "absolutely extraordinary" how so many people had been vaccinated in the UK.
She said that while falling infection rates were linked to lockdown measures, vaccines would "start to play a role soon" in reducing rates and "stopping people becoming unwell enough to have to come into hospital".
Although vaccine take up has been high across the West Midlands, there are still concerns over vaccine hesitancy, with some people unwilling to take the jab.
Dr Green said it was vital that as many people as possible got vaccinated against Covid for immunity to work.
"Vaccines don't save people, but vaccinations do," he said. "Some people have real concerns about whether to accept a vaccine and people have their own reasons.
"Some questions don't have an answer yet... what are the one, two, five, 10-year safety data around these vaccines? It's obvious that we don't have that data yet.
"People have to make an individual decision, and I fully accept that some people feel they are having to make a decision a bit earlier than they might feel comfortable about."
While the vaccine rollout may still be in its early stages, scientists already believe the work done over the past 10 months will continue to have an impact in years to come.
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Professor Paul Moss runs national studies on immunity for Sir Patrick Vallance, the Government's chief scientific adviser.
He said the expertise and technological advances that have developed over the past year will lead to breakthroughs in the treatment of other diseases, including cancer.
"We're going to have an amazing legacy from this," said Prof Moss, who last year led a major study into immune responses to Covid.
"We've done incredibly well in vaccine technology and incredible expertise has developed over the last year.
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"The UK has been leading this, so we are now developing manufacturing capability and research capability, so we will see this apply to other areas, and not just infections."
Dr Green added: "The technology has a major role to do with cancers in particular as we get older.
"It is far too early to start thinking about how many different directions this technology will go, but it is going to be very exciting for the next few years as we explore the potential."
*The three researchers took part in a vaccine roundtable event hosted by West Midlands Mayor Andy Street.