London School of Hygiene & Tropical Medicine

Tell us about your current research

Currently I’m a final year PhD student in infectious disease epidemiology working with the tuberculosis (TB) modelling group. My supervisors are Richard White, Rebecca Harris, and Chathika Weerasuriya. My research is developing mathematical models to estimate the potential impacts from new TB vaccines. 

When I tell people my topic, I usually get a chorus of “but isn’t there already a TB vaccine?”, and yes, that is true! But the BCG vaccine has been around for over 100 years and is mostly given to infants in countries with a high burden. This vaccine is good at preventing serious childhood TB, but doesn’t have as strong an impact on adolescent and adult TB (the age groups with the highest burden of disease). A new vaccine is likely going to be key to help prevent the over 1.5 million TB deaths that occur each year.

We have found that a vaccine that is effective in preventing TB disease in adolescents and adults could help prevent millions of cases and deaths over the next few decades and would be cost-effective, particularly in countries with the highest burden. 

How did you first become interested in infectious diseases?

For as long as I can remember, I have wanted to be an epidemiologist. My fascination initially began during an elementary school science project. While researching different diseases that impact cell structure, I came across a rudimentary section listing statistics on the prevalence and incidence of diseases in various countries and I was immediately captivated by this information. When I was in my undergraduate we were taught about the SIR model in a maths course. I thought it was the most amazing thing that infectious disease dynamics could be expressed with mathematical equations. I knew I eventually wanted to do something in that area.  

Describe your career journey so far 

My career journey so far has primarily been in academia. I did my Bachelor of Science in Biology and Mathematics at McMaster University in Canada, and then went on to do a Master of Science in Epidemiology at the University of Alberta. 

During my masters, my research project involved developing risk prediction models for premature ovarian failure in childhood cancer survivors. Part of the project included developing an easily accessible risk calculator which is available online. Before administering treatment, clinicians can use the risk calculator to obtain an estimate of the risk of menopause within 5-years. The risk estimate can promote informed discussions with patients and their families about the need for fertility preservation before treatment, or hormone-replacement therapy after treatment, helping to maximise quality of life. We were able to publish our findings in The Lancet Oncology in 2020.  

I always knew that I wanted to switch my focus back to infectious diseases, and modelling in particular. In the final year of my masters degree, I was researching potential schools to continue my education, and came across the CMMID website. It was so inspiring that there was an entire centre researching exactly what I was hoping to do!

I was very fortunate to be accepted and dive into the world of TB vaccine modelling! In terms of research output so far, our review of the TB vaccine pipeline and modelling studies looking at the impact of vaccines on TB burden was published in the Journal of Internal Medicine in 2020. The first paper for my PhD thesis, where we evaluated the health impacts by 2050 of new TB vaccines in 105 LMICs using our updated model of TB natural history, has just been published at The Lancet Global Health.

What are your goals for the future? 

Ideally I would like to continue in infectious disease research. I want to use and continue to develop my modelling skills to reduce the global burden of disease and help inform health policy makers during decision making. I want to stay in the UK (for as long as I can!) and continue to explore different areas of the country.

What’s your favourite thing about working at LSHTM?

I think there are so many great things about LSHTM. I love that it’s located in central London and so close to everything. I love the research group and community feeling of the TB modelling group, and I love the wide range of lectures and seminars that the school offers to learn about different aspects of health.

Do you have any advice or tips for other early career researchers?

The best advice I always give myself is “Remember why you’re doing this!”. I chose to do a PhD because it was important to me, it wasn’t something I was forced into. And so it’s a good reminder to myself when things get difficult that I chose to be here doing something that I love. 

How can people get in contact with you?

rebecca.clark@lshtm.ac.uk

@ra_clark18

@lshtm_tbmod