The 2014 outbreak of Ebola virus disease in West Africa highlighted the lack of preparedness for combating infectious disease outbreaks. Since 1976, vaccine development had proceeded slowly and no candidate vaccines had progressed further than phase I trials. Ebola is only one of many known viruses with the potential to cause outbreaks. With the support of the WHO in identifying priority pathogens, and the formation of CEPI to provide funding, vaccine development was initiated with the aim of having vaccines available in readiness for future disease outbreaks.
‘Disease X’, to represent a disease caused by a previously unknown pathogen, was also considered. In the first days of 2020, the first ‘Disease X’ outbreak, caused by a virus later named SARS-CoV-2 occurred. Vaccine developers found ourselves attempting to put into place plans that were at an early stage of development, had not been funded and had not therefore been tested. Rather than working to produce a vaccine which could then be deployed in the ‘outbreak area’ we found ourselves attempting to develop a vaccine against a novel pathogen that was causing a pandemic whilst we ourselves were in the grip of that pandemic with every aspect of our work affected.