Exceptional Circumstances: lessons learned from working on a COVID vaccine trial
The race to develop a COVID vaccine at the onset of the pandemic was aided by vaccine trials across the world. Emily Boyd, a 4th year medical student from Queen's University Belfast, recounts her experience helping to support the trial and shares her views on how it offered an insight into clinical research.
When COVID-19 began to spread across the globe in early 2020, it soon became apparent that the best hope of a definitive solution would be the development of a vaccine. This led to a massive global research effort, trying to develop a safe and effective vaccine against COVID-19. The Novavax study is the largest double-blind, placebo-controlled trial to be undertaken in the UK to date, with 15,000 participants recruited from 35 sites (1). With healthcare staff required to care for patients with COVID, the exceptional decision was made in Belfast to recruit nursing, physiotherapy, and medical students from local universities as trial support workers. This would allow the trial to be delivered in a safe and efficient manner.
I was one of these medical students. This role offered me the unique opportunity to contribute to development of a vaccine for COVID-19, and to gain first-hand experience of the practical delivery of clinical research. However, the decision to accept this position was not straightforward. At this time, Belfast City Hospital, where the trial was being held, was also the Nightingale Hospital for Northern Ireland. This meant mixing with patients with a high prevalence of COVID and sharing facilities with the staff caring directly for them. I knew that I had to consider the risk to myself and my family, and to balance this with the unique opportunity I was being offered. Ultimately, I decided to take the role. The opportunity to be involved with vaccine trials was exciting as it appealed to my interest in research, and the clinical aspects of the role gave me the patient contact I was missing, after my intercalated degree had moved online.
A year later, I have had time to reflect on my experience. There were many challenges in this role, including the fear of COVID, working long hours wearing PPE, and adapting quickly to changes in the trial protocol. Working within a large, diverse, and continually evolving staff team meant learning to work with new people each day and learning to adapt the roles appropriately to suit the knowledge and abilities of staff members from a wide range of disciplines. It was stressful at times to balance work on the trial with studying, due to the pressure on staff to deliver the trial as efficiently as possible.
Despite the challenges, through my role as a trial support worker, I believe I have improved how I prioritise, adapt to change, and manage stressful situations. Working within such a diverse staff team enabled me to enhance my interpersonal skills and emphasised to me the strengths of the multidisciplinary team. Knowing that the work in Belfast contributed to the results of this multi-centre study was fascinating and highlighted to me how clinical research relies on individuals to act as the link between lab-based research and clinical medicine.
Working in a motivated team, united by a sense of duty and pride in our work was extremely rewarding. The dedication of the participants was humbling and motivated me each day. I am grateful to have had this unique opportunity, which would not have happened if not for COVID, and I am proud to say that I played a small role in the development of a COVID vaccine.
"I am proud to say that I played a small role in the development of a COVID vaccine."
I would encourage any student to seek opportunities such as this. I have improved my understanding and appreciation of clinical research and improved skills which are directly transferrable to medicine. This experience has helped me to feel more confident, to contribute more readily as a member of the ward team on placement this year and has undoubtedly encouraged me to engage with research as part of my future career.
Beyond these immediate benefits, I believe there are wider implications for medical student engagement in clinical research, with the potential to increase clinician engagement with research in the future. Although most medical students are motivated to engage with research, many do not know how, have low confidence in their abilities, or are unaware of research activities within their own institutions (2). Early research experience has been shown short-term to increase medical students’ engagement with research and to increase their interest in pursuing an academic career. Long-term, medical students who engage with research are more likely to pursue a career in clinical academia (3). Therefore, recruiting medical students to support the delivery of clinical trials provides a unique opportunity for them to experience clinical research, to learn about its delivery in a practical way, and to develop new, transferrable skills. This may also lead to an increased number of doctors who wish to engage with research in their future careers, helping to counteract the declining numbers of clinical academics in the UK (4). Furthermore, it has been demonstrated that hospitals that engage with research have lower patient mortality than those that do not (5).
Engaging medical students in clinical research by recruiting them to work to support trial delivery is a novel concept, which may not have happened if it were not for the exceptional circumstances brought about by COVID-19. I feel that this represents an exciting opportunity to increase medical student engagement with research in the future.
"Engaging medical students in clinical research by recruiting them to work to support trial delivery is a novel concept... this represents an exciting opportunity to increase medical student engagement with research in the future."
I would like to thank Dr Claire Potter for her encouragement to write this article and Professor Judy Bradley who provided me with this unique opportunity.
About the Author
Fourth year medical student at Queen's University Belfast
1. HSC Public Health Agency. Novavax COVID-19 Vaccine 89% Effective. Northern Ireland. Public Health Agency. 2021. [Accessed 20 Oct 2021]. Available from https://research.hscni.net/novavax-covid-19-vaccine-89-effective.
2. Burgoyne LN, O'Flynn S, Boylan GB. Undergraduate medical research: the student perspective. Medical Education Online. 2010;15 [Accessed 11 Oct 2021]. Available from: https://www.tandfonline.com/doi/full/10.3402/meo.v15i0.5212.
3. Solomon SS, Tom SC, Pichert J, Wasserman D, Powers AC. Impact of medical student research in the development of physician-scientists. Journal Investigative Medicine. 2003;51(3):149-56
4. Fitzpatrick S. Medical Schools Council. A study of staffing levels of medical clinical academics in UK medical schools as at 31st July 2012. 2012.
5. Ozdemir BA, Karthikesalingam A, Sinha S, Poloniecki JD, Hinchliffe RJ, Thompson MM et al. Research activity and the association with mortality. PLoS One. 2015;10(2):e0118253.