In an interview, BioNTech founders Uğur Şahin and Özlem Türeci explain why booster shots are needed to combat the Delta variant of the coronavirus, and they say that a vaccine for five- to 11-year-old children is on its way.Interview Conducted by Thomas Schulz10.09.2021
Türeci: That depends on how you define “over.” Let’s put it this way: COVID-19 will get less scary.
Şahin: By spring, a large share of people will either have been vaccinated or will have had an infection. However, we are already seeing the virus generate escape mechanisms that allow it to infect humans better and more easily. That means there may even be more waves to come. But the disease will no longer be severe in people who have been vaccinated or who have already had it.Aus: DER SPIEGEL 37/2021
The article you are reading originally appeared in German in issue 37/2021 (September 11th, 2021) of DER SPIEGEL.SPIEGEL International
DER SPIEGEL: For a long time, the hope was that we could vaccinate our way out of the pandemic by achieving herd immunity by autumn. Have we underestimated the virus?
Şahin: No. The virus continues to spread almost exclusively among those who are not protected. We will be facing a pandemic of the unvaccinated in the coming months.
DER SPIEGEL: In your new book “The Vaccine: Inside the Race to Conquer the COVID-19 Pandemic,” you detail how you succeeded in developing a vaccine at a speed few thought possible. Are you angry with all the people who flat-out refuse to get vaccinated?ANZEIGE
Türeci: Not at all. As doctors and scientists, we believe that everyone must decide for themselves whether or not to be vaccinated. Our mission was to provide a vaccine. People have to be able to assess for themselves what it means to be unvaccinated.
DER SPIEGEL: Only a few weeks ago, people were practically snatching the vaccine out of your hands, but now stockpiles are building up. Does the German government need to do more to jump-start a vaccination campaign that seems to have stalled of late?
Şahin: We, as a society, still have about 60 days left to avoid a harsh winter. We should do what we can to mobilize as many people as possible in these two short months. And quite pragmatically: We’re coming up on 70 percent – so, how do we get the others to get it? There can be many answers to that question, and all ideas should be welcomed.
Türeci: Each additional vaccinated person helps. We should not give up.
DER SPIEGEL: The Delta variant is far more contagious than was feared in the spring. The BioNTech vaccine is also having far more problems with the mutant than with the previous variants.
Şahin: Delta, fortunately, is not a super mutant, which are more contagious and also evade immune responses. The variant is spreading very effectively, but still responds well to the vaccine.
DER SPIEGEL: How well, exactly? There are conflicting reports and study data circulating, especially from Israel, about how and when vaccine protection wears off.
Türeci: A lot of things are getting mixed up. First of all: The protection against infections decreases with time, but the protection against serious illness lasts longer. Here, T-cell immunity, which is much more long-lived, provides protection, and that is missing in the data in many of the studies.
Şahin: Delta is characterized by the fact that many virus particles are produced more quickly, meaning a higher antibody level is required than with the wild-type. At the same time, the amount of vaccine-derived antibodies decreases after about six months – and more rapidly if the second vaccination was given after only three weeks. This is shown by the data from Israel. Because of this combination, we are seeing vaccine breakthroughs there, particularly among those who were vaccinated back in January. In Germany, as far as I know, most people were given their doses six weeks apart, so it is to be expected that the vaccination protection will last longer here.
Türeci: Recent data from studies in England show that protection against infection with Delta is still 74 percent. The booster, meaning the third vaccination, will have to come a little sooner than we had hoped. Before Delta, we had expected that 12 to 18 months later would be enough.
DER SPIEGEL: So, you’re already advocating for a booster shot?
Şahin: Let me put it this way: We won’t be able to control Delta sufficiently without a booster.
DER SPIEGEL: Germany’s Standing Commission on Vaccination (STIKO) has not yet issued a recommendation for boosters.
Şahin: I expect to see a lot of study data coming out in the next few weeks that will provide statistically valid evidence of how important it is to get a booster. The Israeli Health Ministry has released preliminary data showing that after a third vaccination, protection against infection with Delta is over 95 percent.
DER SPIEGEL: And if things go badly, then a fourth vaccination will be needed after a few months?
Türeci: We think that this can be done much later. A third dose will result in very, very high antibody concentrations – equal to or higher than the second dose.
DER SPIEGEL: Do you think there are already new mutants circulating against which even a booster wouldn’t do any good, ones that would make a new vaccine necessary?
Türeci: Not yet. But we need to continue to be on alert on that front. It would be dangerous if we got caught up in the operational hustle and bustle and didn’t remain intellectually vigorous.
DER SPIEGEL: What do you mean by that?
Türeci: The urge to change the world production in a panic at every variant and without having assessed its risk on the basis of data. That’s why there are expert panels that closely examine the need. If a variant is indeed identified as being resistant to the current vaccine antigen, the mRNA vaccines can be quickly adapted.
DER SPIEGEL: There is considerable fear among parents that a variant could soon come along that will be more dangerous for teenagers and children. There is also the danger of long COVID. When can we expect a vaccine for children under 12 years of age?
Türeci: In the coming weeks, we will present the results of our study on five- to 11-year-olds to the authorities worldwide and apply for approval of the vaccine for this age group, including here in Europe. The data is currently being compiled. We expect to have the data on the younger children from the age of six months by the end of the year.
DER SPIEGEL: That means that children as young as five could be vaccinated by as early as mid-October?
Türeci: We cannot influence whether the authorities grant approval and how quickly. Nor whether the vaccination commissions make a recommendation.
DER SPIEGEL: Can you give a preliminary assessment of how the child study went? You’ve surely already analyzed the raw data.
Şahin: Things look good, everything is going according to plan.
Türeci: We are already preparing for production. The vaccine is the same, but at a lower dose, and there is less to be filled.
DER SPIEGEL: Critics are demanding that the vaccination of children in industrialized nations be put on hold and that the vaccines instead first be distributed to the regions of the world where few people have been provided with protection so far – to Africa, for example.
Şahin: The number of vaccine doses is no longer a limiting factor. There will be enough vaccine for every person in the world by 2022 at the latest. We have been able to increase our production capacities enormously. This year, we will be able to manufacture 3 billion doses through our network, and next year, if the demand is there, I think 4 to 5 billion doses are feasible. Other suppliers have also managed to overcome their production problems. In Europe alone, vaccine manufacturers will reach capacities of 500 million doses a month next year.
Türeci: Our goal has always been to be able to supply the whole world. By the end of the year, we are positioned for partial production of COVID vaccine in and for Africa.
DER SPIEGEL: Skepticism regarding vaccination appears to be particularly high in Africa.
Şahin: That’s a problem. At the same time, we are also noticing in many conversations that there is interest not only in getting vaccines, but also in manufacturing them locally. That makes a real difference. Our priority is to ensure that the quality of the vaccine produced there does not differ from that produced in the industrialized nations.https://datawrapper.dwcdn.net/GCr47/
Türeci: We are also considering with the governments and authorities of the respective countries what the facilities could continue to be used for after COVID. In Africa, for example, it would be a vaccine against malaria.
DER SPIEGEL: Your company could have run into huge difficulties if the vaccine hadn’t worked out. BioNTech’s original focus was on cancer research, after all, and throwing everything at a new infectious disease was a very risky move.
Türeci: It is a question of values. People first like to look at the risks involved in a scenario that requires strength and commitment. But there are also risks in not doing something. We had the choice of just carrying on as if nothing had happened or that of summoning up the courage to go big. Doing nothing seemed far riskier to us – for our employees, the patients in the clinical trials and the company.
DER SPIEGEL: It paid off though. The share price is climbing ever higher. BioNTech currently has a market capitalization of 70 billion euros, one and half times more than that of German pharmaceutical giant Bayer. Do you think that’s absurd or appropriate?
Şahin: A company’s share price primarily reflects its long-term potential. We believe we are only at the beginning with what we have achieved so far.More on COVID-19
DER SPIEGEL: Will you now be able to develop new drugs much faster than in the 10- to 15-year cycles that were normal before?
Türeci: There are many players involved, from suppliers to regulatory authorities. Of course, the vaccine was a great model project which we implemented together and allowed us to learn how to work together more effectively, faster and with less bureaucracy. Efforts are being made at various levels to formalize these processes.
Şahin: But the model case alone won’t suffice. We need to have a frank discussion as a society: How important is drug development to us? What would have to happen to speed up the development of new drugs and get them to patients faster?
DER SPIEGEL: One of your next big projects is a malaria drug. How is that progressing?
Şahin: Hundreds of thousands of people die each year from malaria and tuberculosis. These have long been major biological and medical challenges. We could now move forward with speed and intensity here, partly because we have many experts working with us who have been working on these diseases for decades.
DER SPIEGEL: When do you expect tangible results?
Şahin: With malaria, we definitely see the opportunity to be fast. We want to start our first clinical trials as early as 2022.
“The Vaccine: Inside the Race to Conquer the COVID-19 Pandemic,” by Joe Miller with Uğur Şahin and Özlem Türeci is to be released by St. Martin’s Press on Feb. 1, 2022. The German edition of the book, “Projekt Lightspeed,” will be released by publisher Rowohlt on Sept. 14.