How Can We Effectively Prepare for Catastrophic Pandemics? Q&A with Lead Oxford Covid-19 Vaccine Researcher
Summary
At a recent conference, Sir Andrew Pollard, a leading scientist and expert in vaccinology, shared his insights on the importance of pandemic preparedness, the role of vaccines in global health, and the lessons learned from the COVID-19 pandemic. His expertise and thought leadership have shaped much of the ongoing efforts to combat infectious diseases.
Preparing for the Worst
Andrew began by addressing the critical need for better pandemic preparedness. He highlighted the disparity in global investment, pointing out that while countries spend billions on military defense, far less is allocated to preparing for future pandemics.
“Pandemics are one of the greatest global threats we face, yet we underfund the research and infrastructure needed to respond,” Sir Andrew stated. “The reality is that the next pandemic could be around the corner, and we must be ready to act swiftly.”
He stressed the importance of investing in both vaccine development and manufacturing capabilities, noting that many countries, including the UK, lack the infrastructure to produce vaccines on a large scale when a crisis hits. Andrew called for substantial funding and long-term planning to ensure that the world is not caught off guard again.
Lessons from COVID-19
Reflecting on the global response to COVID-19, Andrew emphasised the unprecedented collaboration across borders that allowed for the rapid development and distribution of vaccines. However, he also acknowledged the challenges faced, including misinformation and vaccine hesitancy.
“The scale of the collaboration during COVID-19 was remarkable,” he said. “Governments, scientists, and manufacturers came together to produce vaccines at a pace that was previously unimaginable. But we also saw the impact of misinformation and the resistance to vaccines, which presented a significant barrier.”
He believes that addressing vaccine hesitancy requires ongoing efforts to provide accurate information, engaging with communities, and building trust in public health systems. He added that it is crucial to focus on creating positive, accessible messages about vaccines, rather than reacting to every negative claim.
Tackling Global Health Inequities
Andrew also discussed the need to address global health inequities in vaccine distribution. The COVID-19 pandemic exposed significant disparities in access to vaccines, especially in low-income countries. He pointed out that without a concerted effort to ensure equitable vaccine access, the world risks prolonged outbreaks and the emergence of new variants.
“Global cooperation must be at the heart of pandemic response,” Sir Andrew noted. “We cannot leave any country behind. If we don’t ensure that everyone has access to vaccines, we all remain vulnerable.”
He praised initiatives like COVAX, which aims to provide vaccines to lower-income countries, but stressed that more work is needed to overcome logistical challenges and ensure equitable distribution in future crises.
Looking Ahead
Looking to the future, Andrew remains cautiously optimistic. While he believes that significant progress has been made in vaccine technology, he recognises that more must be done to prepare for the next pandemic.
“The next pandemic could be much sooner than we think,” Sir Andrew warned. “With climate change, increasing population densities, and the growing interconnectedness of the world, the risks are higher than ever. We need to continue investing in research, infrastructure, and collaboration to stay ahead of the threat.”
He concluded with a call to action, urging governments, scientists, and the public to remain committed to pandemic preparedness, invest in global health systems, and work together to build a safer, healthier future for all.
“This is not just about responding to crises,” he said. “It’s about making sure we’re ready for what comes next, so we can save lives and protect future generations.”
To summarise:
Be proactive: The next pandemic could hit sooner than we think, so it’s crucial to start preparing now—investing in research, infrastructure, and systems to protect global health.
Build trust through transparency: Communicating clearly and honestly is crucial for gaining public trust, especially when it comes to vaccines. It’s not just about the science—it’s about making sure people feel confident in it.
Health for everyone: No one should be left behind. To truly protect the world, we need to ensure everyone has access to vaccines, no matter where they live.
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Moderator 00:00:00: Of the development before all of the COVID-19 vaccines, as you pointed out, a lot of groundwork had already taken place, which was essential for everything to happen as quickly as it did. How do you prioritize which research to focus on?
Andrew 00:00:44: In that case, once you’ve got the technology down, you can very rapidly transfer it to lots of different things. So, that starting place—the 20 years of development—was crucial. What was it like during those first years?
Well, I think there are two aspects to consider. First, there’s the vaccine platform itself. Using vectors as the foundation is key, and the technical platform development is really important because, in pandemics, it’s going to be the backbone of whatever we do. The fact that we now have two main technologies that allow for relatively rapid development is a major advantage.
We were discussing this over lunch, and the great strength of RNA technology is its speed. If you know what you're manufacturing, you can produce millions of doses within six weeks. Compare that to viral vectors, which take about three months to reach just thousands of doses and much longer to scale up to millions.
Andrew 00:01:16: So, RNA is just incredible. Most of the other technologies don’t scale up that quickly, which is why platform technologies are so important to continue investing in.
The second issue is the individual microbes—viruses and bacteria. From a scientific perspective, for most of them, we actually already know what needs to be done. For instance, with coronaviruses, if you’ve spent 20 years studying them, you know that one particular protein—in this case, the spike protein on the surface of the virus—is the critical one to target and include in a vaccine.
Andrew 00:01:50: Vaccines work by training the immune system to recognize and fight a virus when it encounters it. For coronaviruses, as with most other threats, we already know what needs to be done. The research is straightforward, so there aren’t any major scientific obstacles for most viruses. What’s really needed is sustained investment to carry out that work.
Take, for instance, the Coalition for Epidemic Preparedness and Innovation (CEPI). It’s a major funder of pandemic preparedness, but it only focuses on about ten different pathogens. That’s a start, but there’s so much more to do.
Andrew 00:02:20: So, the science is there—we know how to solve these problems. The bottleneck isn’t in the scientific process; it’s in getting the funding and resources in place. The challenges lie in vaccine rollout, expanding access, and addressing economic barriers, like creating incentives to pull investments forward.
Yes, money is the central issue here. It’s about investing in the research upfront to generate the necessary knowledge, and then having governments ready to commit significant funding for development when a pandemic begins.
Andrew 00:02:57: For example, in the U.S., they had systems in place, like Operation Warp Speed, where the government allocated billions of dollars to vaccine developers. But in the UK, there was no such system at the start, and they had to figure it out on the go. This delay highlights the importance of having processes and funding mechanisms ready in advance.
At the end of the day, we need to ask ourselves: Where do we want to go with this? Are we willing to make the necessary investments to ensure we’re prepared for future pandemics?
Andrew 00:03:33: When it comes to pandemic vaccines, you want to rely on big pharmaceutical companies because they know how to produce them at scale. While universities, like Oxford, are great for research and development, large-scale production is where big pharma excels. The challenge is that the pharmaceutical companies that make the vaccines we routinely use for our children and adults are often hesitant to take on pandemic vaccines.
Andrew 00:04:08: The hesitation isn’t due to scientific difficulty—it’s about risk. For big pharma, investing heavily in a pandemic vaccine is risky because while there might be short-term success, the demand can drop off quickly after the pandemic subsides. That financial uncertainty is a big deterrent. The reality is that money remains a central issue across all parts of the vaccine process, from development to rollout. Without proper funding and financial incentives, it's hard to get the key players involved.
Moderator 00:04:44: Beyond pandemic preparedness, you’ve done significant work on vaccines for diseases like pneumonia in children and older adults, which have saved countless lives. Can you share more about that work and how it differs from pandemic vaccine efforts? Also, related to the financial risks you mentioned, there seem to be several infectious diseases for which vaccine technology already exists, but we haven’t rolled them out globally. Is this because the health economics don’t align with broad implementation?
Andrew 00:05:21: Most of my career has been dedicated to developing vaccines for young children, particularly targeting bacterial infections that result in high mortality rates. Pneumonia, for example, has been a major focus for me because it impacts children across the globe, whether they’re in high-income or low-income countries. Fortunately, vaccines for pneumonia have received sufficient funding and support over time.
Andrew 00:05:59: Another area I’ve worked on is typhoid, a bacterial infection caused by drinking contaminated water. Typhoid affects millions of children every year, causing hundreds of thousands of deaths. The vaccine technology for typhoid has existed since the 1980s, but it wasn’t widely developed or rolled out until 2022. The reason? There was no commercial or financial incentive to produce a vaccine for low-income populations.
Andrew 00:06:49: What changed in 2022 was a decade of persistent effort to generate demand for the vaccine. Indian companies, such as the Serum Institute of India, stepped in to produce the vaccine at scale. They realized that even with a small profit margin, the demand made it viable. Unfortunately, the lack of financial incentives has held back many other vaccines. Diseases that occur in specific regions, like certain viral outbreaks in Africa, struggle to attract investment because the market is too small for pharmaceutical companies to profit.
Andrew 00:07:15: This is a significant challenge in vaccine development. We know these vaccines can have a massive impact, but without financial incentives, progress is slow. It takes time, dedicated effort, and often alternative funding models to ensure these life-saving vaccines reach the people who need them most.
Andrew 00:07:31: One critical part of vaccine development is building evidence to show the burden of disease. For example, we conducted a large-scale study in Africa and Asia, involving three countries and 300,000 people, to demonstrate the significant impact of certain diseases. This evidence is crucial because it helps make the case to governments that vaccines should be a priority for the population.
Andrew 00:08:09: A major challenge in low-income countries is the lack of infrastructure to measure the burden of disease effectively. Health ministries often want to introduce vaccines but struggle to convince finance ministries to allocate the necessary funds. What makes the difference is having reliable data to show the true extent of the problem. When we’ve been able to provide this evidence, it has created demand for vaccines and helped governments justify the investment.
Andrew 00:08:52: It's not just about having the technology to solve the problem; it's also about generating the evidence and creating systems that connect public health priorities with financial decision-making. Without this, it’s difficult to move forward, especially in resource-limited settings.
Moderator 00:08:52: Let’s move to audience questions now. We’ve received a lot of them, and I’ll start with the most upvoted. First up: Do you feel more confident after COVID that we’re now better prepared for future pandemics?
Andrew 00:09:32: I think there’s definitely some improvement. Certain parts of the ecosystem needed to respond to pandemics have gained knowledge, which will help in the short term. However, I’m not confident this will be sustained over the long term. Governments, for instance, often lack continuity in their preparedness plans. While there’s more awareness now, I’m concerned about whether it will translate into long-term readiness.
Moderator 00:09:57: A very popular question: Do you know why AstraZeneca decided to make their COVID-19 vaccine not-for-profit?
Andrew 00:10:22: Yes, there are a couple of reasons. One is commercial. AstraZeneca had to reassure their investors about this decision, and there’s a business logic behind it. For big pharmaceutical companies, making a profit during a pandemic isn’t the primary goal—it’s more about stepping in to solve a crisis. By addressing the pandemic, they can resume their usual operations and development afterwards.
It’s also interesting that their involvement with the vaccine coincided with a lot of public goodwill, though whether that’s directly related, I’m not sure.
Andrew 00:10:52: Then there’s a second, more personal reason. Pascal Soriot, AstraZeneca’s CEO, talked about consulting his kids on the decision. Apparently, their perspective influenced him—they encouraged him to go for it. It’s an example of how personal values can play a role in these big decisions.
Moderator 00:11:19: Let me combine two related questions: What if the next pandemic involved a virus that was deliberately manmade? If a malicious actor created a more pathogenic or dangerous strain, how would that impact our ability to respond?
Moderator 00:12:12: A tough question: How would we handle a pandemic if a virus was deliberately manipulated by a malicious actor?
Andrew 00:12:12: That’s a challenging one because the answer depends on how the virus was engineered. Let me frame it differently: nature has already produced viruses we struggle to respond to, like HIV. HIV emerged in the early 1980s, and despite decades of work, we’re still far from a vaccine.
Andrew 00:12:47: The problem with HIV is that it mutates so rapidly. By the time a vaccine is developed, the virus has already changed. It evolves even within a single individual’s infection. So, it’s possible to imagine engineered viruses that are even more mutable or transmissible, which would make them incredibly difficult to counter.
Advances in synthetic biology are a double-edged sword. On one hand, they help us better understand proteins and antigens, which could aid vaccine development. On the other hand, they might provide tools that bad actors could exploit to create something more potent than anything nature could produce.
Andrew 00:13:42: History tells us pandemics are inevitable. Nature isn’t “trying” to cause harm, yet we’ve had six influenza pandemics in the last 150 years, along with the ongoing HIV pandemic and outbreaks of diseases like smallpox and the plague. If malicious actors enter the picture, it’s reasonable to expect them to develop pathogens that could surpass anything we’ve encountered naturally.
Andrew 00:14:19: The best strategy to prepare for such threats is to focus on cross-viral research. For example, with coronaviruses and influenza, we already know the pathways to develop vaccines. The challenge is to continue expanding this knowledge across other viral families to be better prepared for both natural and engineered threats.
Moderator 00:14:50: You’ve highlighted a lot of challenges, but let me ask: if the UK government suddenly decided to allocate £2 billion for pandemic preparedness and made you responsible, how would you use it to maintain vaccine production capabilities and readiness?
Andrew 00:14:50: That’s a great question. First, it’s essential that any manufacturing infrastructure built for pandemics is also used in peacetime. You need facilities producing something useful day-to-day, not sitting idle waiting for the next crisis. If you don’t, when the pandemic hits, no one will know how to operate the technology effectively.
Andrew 00:15:59: Right now, the UK has limited vaccine manufacturing. For example, the only vaccine manufacturing we have onshore is near Liverpool, focused on influenza vaccines for children. Even that process isn’t fully localized—vaccines are manufactured in Liverpool, shipped to the U.S. to be bottled, and then sent back here for use. We lack a complete, self-sufficient ecosystem for vaccine production.
Andrew 00:16:36: Beyond building manufacturing capacity, securing the supply chain is crucial. Producing high-quality vaccines requires specialized components that meet rigorous standards. For instance, during the COVID-19 pandemic, the cell-growing bags needed for manufacturing vaccines were in short supply globally. The Trump administration even blocked their export, which created massive bottlenecks.
Andrew 00:17:15: So, if I had £2 billion, I’d focus on three things:
Building a state-of-the-art facility that produces vaccines during peacetime and can rapidly pivot during a pandemic.
Developing a resilient supply chain to ensure uninterrupted access to critical components.
Training and maintaining a skilled workforce that can operate this infrastructure effectively, both in calm times and crises.
Moderator 00:17:46: Those are excellent points. It really underlines how much investment is needed to create a system that’s prepared for the next global health threat.
Andrew 00:20:09: To maintain pandemic vaccine production capabilities, facilities must remain active during peacetime by producing vaccines or other critical products for regular use. This keeps the infrastructure and workforce operational. Additionally, ensuring a resilient supply chain is crucial. For example, during the COVID-19 pandemic, reliance on specific U.S. suppliers for cell culture bags created vulnerabilities when exports were restricted. An end-to-end supply chain strategy is essential to reduce dependencies and increase preparedness.
Moderator 00:21:02: Over lunch, we discussed the challenges posed by the anti-vaccine movement, which limits vaccine rollout. A question has come in about addressing vaccine hesitancy, particularly among outspoken Christian groups. How should this be approached?
Andrew 00:21:46: The key to addressing vaccine hesitancy lies in providing positive, accessible information and ensuring access to both vaccines and trusted health professionals who can answer questions and reassure individuals. Hesitancy often stems from rational concerns—parents, for instance, want to understand vaccines better before deciding for their children. Many people simply need access to credible advice, which is a logistical issue rather than an ideological one.
The truly anti-vaccine movement is a small minority. While conspiracy theories can fuel unshakable beliefs in some, the focus should be on the majority who can be reassured with accurate, positive messaging. Attempting to counter negative messages directly often backfires by amplifying those messages, so communication strategies must focus on promoting trust and positive narratives.
Moderator 00:23:38: That’s insightful. Another question relates to safety concerns and the long-term effects of vaccines. How can we reassure patients about potential effects decades down the line?
Andrew 00:25:15: Concerns about long-term safety are valid, but there are key points to consider. Pandemic vaccines, despite being developed quickly, underwent extensive trials with an unprecedented number of participants. Billions of doses have since been administered, providing robust data on safety and effectiveness. Routine vaccine trials also meet stringent regulatory standards, testing thousands before approval.
While rare side effects—occurring in fewer than one in a million cases—might not appear during trials, strong post-rollout monitoring systems ensure they are identified and addressed promptly. This allows adjustments for specific population groups as needed.
As for effects decades later, most vaccine side effects emerge within four to six weeks after administration, linked to the immune response. There’s no evidence from any vaccine developed to date of issues emerging 12 or more years after administration. While it’s scientifically impossible to predict 50 years into the future, the current data is very reassuring.
Moderator 00:28:11: This is the most upvoted question, so we should address it directly. What probability would you assign to COVID-19 having originated from a lab?
Andrew 00:28:50: I don’t think COVID-19 came from a lab. Here’s why: a colleague of mine in Australia was part of a team studying viruses in parts of China before the pandemic. His team investigated the wet market thought to be the outbreak's source. Despite efforts by Chinese authorities to clean the area and remove animals, they found traces of the virus in spots linked to sick animals and early human cases.
Regarding the speculation about the furin cleavage site in the virus, which some argue could only be lab-engineered, there’s evidence of similar sequences in other naturally occurring coronaviruses. These findings make a natural origin far more plausible.
That said, whether the virus originated from the wet market or a lab isn’t the central issue. The real concern is transparency and biosecurity. Even if this virus didn’t escape from a lab, ensuring strong lab safety protocols worldwide is critical to preventing future outbreaks.
Moderator 00:30:52: Many questions have come in about the intense experience of responding to the pandemic. How did you approach solving such an urgent problem while avoiding burnout and maintaining a balance between work and rest?
Andrew 00:30:52: That period was incredibly intense, but it taught me the importance of focusing on teamwork and prioritization. Solving such a vast, urgent problem required collaboration with others who shared the ambition to make a positive impact. Delegating responsibilities and trusting team members allowed me to focus on key areas while ensuring the workload was distributed.
Maintaining balance was challenging but necessary. Building short breaks into the day, even just a walk or stepping away from the desk, helped maintain focus and perspective. Beyond that, staying connected with the team—acknowledging successes, however small—kept morale high. Ultimately, it’s about remembering why you’re doing the work: the impact it can have and the lives it can save.
Andrew 00:31:29: It’s a great question. I thought you might ask about my emotions during that time, but as a scientist, I try to focus on the things I can control. My daughter often points out that I stick to this belief. One thing I learned during the pandemic was the importance of not dwelling on things outside your control. A lot of the emotional strain comes from trying to manage what you can’t change.
However, there was a moment in July 2020 when we got the first results from the phase one trials, and the media frenzy became overwhelming. Every hour, we were getting inquiries from journalists all over the world, and it was impossible to manage the narrative. I was overwhelmed, trying to respond to everyone, but at a certain point, it became clear that controlling it wasn’t possible. That was a humbling experience.
Andrew 00:32:23: The major takeaway for me is that the pandemic response is a shared responsibility. It wasn’t just about the scientists or the leadership; it was about everyone—from the cleaner ensuring the lab was safe to the runners who kept the lab functioning. The whole team was crucial. It’s that support system, including from senior leaders, that gets you through stressful times.
Moderator 00:33:48: Who were the unsung heroes of the pandemic? I hope that helps answer that question as well.
Andrew 00:33:48: Absolutely. The unsung heroes were all those behind the scenes—those making sure everything ran smoothly, everyone in the labs and the logistical support teams. The pandemic response was a collective effort, and everyone played an essential role.
Key Takeaways on Impact in working on Pandemic Preparedness:
20 years of development and groundwork was foundational to the establishment of the Covid-19 vaccine.
Investment into pandemic preparedness is in greater demand than research.
Big Pharmaceutical companies are often reluctant to invest in pandemic preparedness due to risk of mere short-term success, but their involvement is important for vaccine production.
Necessity of investment - the vaccine for typhoid has existed since 1980 but wasn’t widely rolled out until 2022 due to little financial incentive to support low-income countries.
