(On the question: You have a good overview on the different vaccines which are already delivered worldwide. And from your vaccinology view of the emerging variants of SARS-CoV-2 like the Omicron, where we have seen first data just today coming out about neutralizing antibody capabilities. How good will these different types stand up against the ongoing evolution of this virus? Your statement?)

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Any answer to that is basically pure speculation.But we do see performance differences, right. There is a very nice study in Brazil, for example, where AstraZeneca was compared to CoronaVac, and you could see that the AstraZeneca 6vaccine was doing better. The CoronaVac vaccine was working too, but the vaccine effectiveness was lower, right. We also know, if you look at neutralizing antibody titers, some vaccines induce lower titers than others. Some vaccines have more ability to induce T-cell responses than others. And so the vaccines that I'm more worried about right now are vaccines that are one shot vaccines and vaccines that are basically inactivated vaccines that, by their nature, don't necessarily give you a good T-cell response and might induce low neutralizing antibody titers. I think that's where I would assume that the effectiveness goes down to most.For vaccines that give good T-cell responses or that induce very high neutralizing antibody titers, I am a little bit less worried. But again, this is speculation, we need to wait for the data.And right now, we don't even have effectiveness data with vaccines like BioNTech / Pfizer or Moderna.

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(On the Question: And that is a very important point you raised about this inactivated whole virus vaccines because – like the kind from China for example – we have these vaccines given to lots of people also in Africa and South America. And your point is that, compared to these newer mRNA vaccines, you expect them to be less protective if I understand it correctly?)

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Again, [this is] speculation, but that's what I would expect. There are differences between thein activated vaccines, too. There seems to be data that, for example, the Sinopharm vaccine is doing a little bit better than the CoronaVac vaccine. So, there are differences also between the inactivated vaccines, but that would be what I would expect. Inactivated vaccines are typically not good vaccines to induce T-cell responses. Looking at the data sets from Alex Sigals and Sandra Cieseks lab you see that Omicron is a very strong escape variant when it comes to in vitro neutralization. And so, we might need to rely on our immune system we might need to rely on safety nets like T-cell responses, like not neutralizing antibody responses like anamnestic responses from the B-cell compartment. But the lower your baseline status is, the less antibody you have, the less of a T-cell response you have, the easier it will be for a stronge scape mutant like Omicron to cause disease. So, I think that's what we have to keep in mind.And we have to be honest, it's not that all vaccines are equal. We do see differences.

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(On the question: What role could play the as yet unapproved protein-based vaccines in the international vaccination campaigns because they are maybe easier to distribute. What do you think?)

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I mean, one of them is approved in Indonesia and is used in Indonesia right now. That's the vaccine from Novavax. That's in the second phase of approval in the European Union or at EMA(European Medicines Agency) right now. There are other candidates that have good clinical results globally, the protein-based vaccine from Clover pharmaceuticals for example. So, these vaccines could be used. The question is what's the production capacity? Can they deliver in the end? Novavax had some back and forth and some issues with its production. So, I think they can make a big impact and I think there are also places that can produce them under contract in all kinds of countries, and that would be important. I think they can make a big impact, but unfortunately a lot of or at least one of the protein vaccines was, you know, I wouldn't say leading the field, but was in the back of the quickest developers in the beginning. And so far, this has slowed down quite a bit. So, I think the recombinant protein vaccines can contribute a lot. But we still have to see their full potential not in terms of their immunogenicity – they are great, and we know the clinical data – but in terms of getting them actually delivered and getting the doses shipped and getting the vaccines approved.

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The whole transkription: https://www.sciencemediacenter.de/fileadmin/user_upload/Press_Briefing_Zubehoer/Press_Briefing_Transkript_Covid_vaccines_world_08122021.pdf

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(On the Question: Can you tell us a little bit how the roll-out is going in less developed countries, and what is happening right there at the moment, and what the situation is?)

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So, I'm an academic, I've worked on making vaccines against emerging outbreak pathogens for a number of years now. And at the University of Oxford, we've been fully committed to ensuring the vaccine that we developed would be provided globally and equitably. And we partnered with AstraZeneca to this. And as you've mentioned worldwide, it's been about two billion doses of the Oxford/AZ vaccine distributed with over 7,6 billion doses of vaccines being given out in the world. And unfortunately, only 6,3 percent of low-, middle- and low-income countries have received vaccines. And we need to do more. Over two thirds of our 4vaccine, the Oxford AstraZeneca vaccine, is going to low and lower middle-income countries.But really, I think the emphasis is on us, worldwide, to try and get more vaccines globally. We spend trillions of dollars on defense against each other and we don't spend or have the same investment in protecting each other. That needs to change or will continue to be in this cycle of fighting new and variant viruses continuously.

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(On the Question: There were concerns in some developed countries about the very rare side effect of this specific adenoviral vector vaccine. Is there any data or reports from the less developed countries so far in terms of what you get as feedback?)

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Yes. So, I think you've hit the nail on the head by calling the very rare side effect. It was not picked up in the thousands and thousands of individuals we tested in the UK, said Africa orBrazil or in the US. There does seem to be a higher incidence of this, but still very rare side effect in northern European countries. We're not seeing the same level of reporting of this TTS(thrombosis with thrombocytopenia symptoms) in other countries.

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The whole transkription: https://www.sciencemediacenter.de/fileadmin/user_upload/Press_Briefing_Zubehoer/Press_Briefing_Transkript_Covid_vaccines_world_08122021.pdf

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(On the question: And many will miss the 20 per cent mark COVAX set as a minimum by the end of 2021. And can you comment a little bit on where we stand with vaccinating the world?)

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The good news is that more than eight billion doses have been administered and that now 54 per cent of the world's population has received a first dose and about 42 per cent have received two doses. That is good news, and it is really a public health victory and also a political victory in many senses. But there's also the bad news. The bad news is that the vaccine distribution remains not fairly distributed, inequitable, with many of the low to middle income countries with very low vaccine coverage rates for various reasons.With some other countries hoarding vaccines and now eight times more booster doses being given over a first dose. And some countries have not even started vaccinating yet. So, the current goal is really, you know, we need to accelerate, we need to accelerate further 5production vaccine supply. But we also need to accelerate vaccine delivery. It's not only now about vaccine supply, it is also about vaccine demand and vaccine delivery.

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(On the question: So what are the major bottlenecks in the delivery, which you see?)

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There are many bottlenecks. First of all, we have to acknowledge it's a very challenging task to quickly roll out vaccines to a population that we normally do not vaccinate. And that's the older adults. I know, all countries are used to and have systems in place for their childhood vaccination programs, but really do not have systems in place how do you really get access to older populations? Older populations, you know, in villages may not come forward. Older populations may not be as literate or computer literate to really know that they have to come forward. This vaccine is also not easy just to deliver from house to house, like we did for the oral polio vaccine. So, it needs much more logistics. It needs creative new approaches, how now to reach those most vulnerable, and that's the older people. All these programmatic delivery issues need to be in place at a time – and very rapidly. And furthermore, an other complicating factor is that many countries actually cannot totally predict when the vaccine supply arrives or they have no on and off vaccine supply. They expected the vaccine supply. It didn't come to be prepared. It didn't come or suddenly it comes and they're not prepared.There are multiple factors that make delivery so difficult in some of those low to middle income countries. So indeed, it's not only vaccine supply now, that was [the issue] maybe a year ago.Now it is about: How can we help them also with vaccine delivery?

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The whole transkription: https://www.sciencemediacenter.de/fileadmin/user_upload/Press_Briefing_Zubehoer/Press_Briefing_Transkript_Covid_vaccines_world_08122021.pdf

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(On the question: CEPI is kind of looking into the future of what novel vaccine types we are going to need in the future, not just today where we're trying to roll out as fast as possible the existing vaccines. Can you tell us a little bit about what type of vaccines you are actually testing right now in phase one, phase two, and how that could impact on these newly emerging viruses, which come up at the moment or may come up in the future?)

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Vaccines work, vaccines work against severe disease for the variants so far. Omicron we'll see further data emerging over the next days and weeks. But I would like to start with saying that it is important that we understand what we expect from those vaccines. And we still have a good vaccine efficacy against severe disease, whether or not we maintain efficacy against any severity or maybe even transmission or at the very best and against infection, even, that is to be seen. But as long as we keep our hospitals away from compensation with good vaccines against severe disease, we have already an important step forward. Now we need to see moving forward if this is maintained. So, in light of the different objectives in relation to vaccine efficacy that, which I just mentioned, the two most important characteristics I think that we need to look into moving forward is to maintain vaccine efficacy against severe disease and to have a broad coverage against new variants that may emerge. So, these are probably the two most important characteristics that we need to look into moving forward with the second version future or adapted vaccines. There is a few additional characteristics mentioned already that we need to understand the immune system or protective immune response better. Right now, regulatory pathways are primarily based on neutralizing antibody titers, and if we see an escape variant, you may have really very high antibody titers, but they are gone if they no longer work against the new variant. But we maintain other functions within the immune system, T-cell mediated immune responses, other immune responses that may maintain a certain protection against a severe disease. So, this is something, that we need to look into more broadly moving forward. But obviously, there's a few additional characteristics in terms of improving the longevity of the protective immunity, single dose regimen, maybe even intranasal formulations that have a better protection against transmission or even infection.And then also to speak about other characteristics like shelf life, storage conditions and so on, that reflect the situations in normal income countries or tropical areas, is something that we look at. But again, I'd like to mention the broad coverage against newly emerging variants, so called broadly protective beta coronavirus vaccines, is something that CEPI has a focus on.

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(On the question: ...that is concerning these plans of a ‘one euro vaccine’, so putting down the price to get more vaccines out, more fast, to vaccinate the whole world because it seems with all these ever increasing new variants, we would need a big effort to basically reach most of the world population and not just in specific countries. Is it feasible or realistic or what needs to be done to bring this number of vaccines to the people?)

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Yes, of course, this is important. But we should not address too many aspects in parallel. First of all, we need good vaccines, and we need to have enough vaccine and we need distribution capacities and so on. CEPI calls for new vaccines, second generation vaccines, broadly protective beta coronavirus vaccines investigates the so-called cost of goods. This is certainly one of the aspects that we keep in mind if we do fund additional programs. But first of all, we need good vaccines that tackle new variants, maintain protective efficacy for those in need while at the same time maintaining that discussion. CEPI has created a marketplace where we connect developers with glass vial producers and fill-finish capacities and so on to connect, but also to ...You know, the market, as you can imagine, is a little bit stretched at the moment everyone needing glass vials and so on. So, we try to keep this open and transparent and to help to this end, but obviously the first priority will be enough of good vaccines while at the same time looking at prices.

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The whole transkription: https://www.sciencemediacenter.de/fileadmin/user_upload/Press_Briefing_Zubehoer/Press_Briefing_Transkript_Covid_vaccines_world_08122021.pdf

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