Professor Sir Jonathan Van-Tam became a familiar public figure in the UK during the COVID-19 pandemic through his role as Deputy Chief Medical Officer for England – a senior government position responsible for advising ministers, shaping public health strategy, and communicating scientific guidance to the public. Frequently appearing in televised briefings, he played a key role in explaining evolving evidence on the virus, vaccines, and mitigation measures.

Now, as Sanofi’s recombinant protein-based COVID-19 vaccine (Nuvaxovid JN.1) is introduced into the UK’s Spring 2026 vaccination program, we spoke with Van-Tam about the current landscape of COVID-19 prevention.

In this interview, Van-Tam outlines the continued burden of COVID-19, particularly for vulnerable populations, and considers the role of established vaccine technologies alongside mRNA approaches, set against a backdrop of declining vaccination rates.

How concerned should we be about the ongoing impact of COVID-19, given the hospitalizations and deaths reported last year?

The source I go back to, to put this into the right context, are ONS data comparing seasonal flu and COVID in March 2020 – when the virus had just emerged. At that point, COVID and flu had about the same lethality in a 20-year-old. But after that, there was a divergence in the curves. By the time you got to somebody who was my age at the time, almost 60, COVID was something like 17 to 18 times more lethal than seasonal flu, and that divergence continued in older age groups. You could see it beginning around 30 years of age.

If you look at those same data in early spring 2022, what you see is that COVID and flu had returned to a similar lethality. That's partly because vaccination had provided strong protection against death, and partly because the Omicron family of variants were less lethal than the original Wuhan variant. In the UK's case, vaccination was the dominant factor.

So to answer your question directly: yes, COVID remains a concern, but it's now in the same ballpark as seasonal flu – and we are concerned about seasonal flu every winter.

The nuance is that seasonal flu occurs in a distinct winter peak, typically eight to 12 weeks long. COVID doesn't follow that same seasonal pattern; instead, we see peaks at different times of year, each triggered by the emergence of a new variant. Each peak may be smaller than a flu peak, but there are more of them. What matters for overall burden is the area under the curve – and that is broadly similar. So, although COVID's impact can appear less obvious than seasonal flu, the burden is still there. My short answer: it represents about the same public health concern as seasonal flu.

During the pandemic, mRNA vaccines dominated the conversation. How has the vaccine technology landscape evolved since then?

What you have to remember is that when SARS-CoV-2 emerged, the UK Vaccine Taskforce pursued a deliberately broad range of vaccine types: an adenovirus vector vaccine, two mRNA vaccines, a protein subunit vaccine – which is the subject of Sanofi's announcement regarding Nuvaxovid – and a whole-virus vaccine. All of them achieved successful licensure, at different time points.

The reason the landscape came to be dominated by the adenovirus vector vaccine and the two mRNA vaccines is straightforward: it was a public health emergency that demanded the use of whatever was available and ready first.

What difference does Nuvaxovid, the new protein-based vaccine, make compared with the mRNA vaccines already available?

Both the adenovirus vector and mRNA vaccines work by getting your body to produce the antigen – the spike protein – at the injection site in your deltoid. Your immune system then recognizes those foreign proteins and mounts an antibody response. A protein-based vaccine skips that step: it delivers the proteins directly. Your immune system still recognizes and responds to the foreign proteins, but they're delivered in the vaccine itself rather than produced by your own cells.

This is actually a very well-established technology, used in countless vaccines before COVID. In the vaccine world, protein-based vaccines are the bread and butter of everyday immunization practice.

Do you think offering a non-mRNA option could help address vaccine hesitancy in the UK?

Based on the data I know, there is no scientific basis for hesitancy about either adenovirus vector or mRNA technology. That said, even where I have no scientific concerns, some people will reach their own conclusions. There may be individuals who would simply prefer not to have an mRNA vaccine – I can't say that's logical, but it doesn't mean those people don't exist.

That said, it's worth being clear about how Nuvaxovid is being introduced in the UK. It's being added to the spring booster program, but not in a way that allows patients to choose from a menu. That's not how vaccine distribution works here, and for practical reasons it would be very difficult to operate that way. There is no preference expressed by UKHSA, JCVI, or any other official body for one vaccine over another. Nuvaxovid is simply considered a highly acceptable addition to be folded into the supply chain alongside the others.

Based on your experience during the COVID-19 pandemic, what are the most important lessons vaccine developers should carry forward?

Given how we essentially rescued ourselves through vaccines – and given the near-certainty of future pandemics – rapid access to vaccines is going to become more important, not less. Having a range of platforms and vaccine types available is absolutely key, because you can never be certain that any one technology will work. That's precisely why the Vaccine Taskforce spread its bets across four different technologies. All four came in, at different time points – but they might not have. That variety is critical.

The other major point is demographic. Most countries are now experiencing the challenge of aging populations. The older people live, the more comorbidities and disabilities they accumulate – and yet the ultimate cause of death in older people is very often infection. You can already see this playing out in the adult immunization program, with RSV vaccine being added alongside flu, and there will be more additions in the future. Adult vaccination is a space that is only going to grow in importance.

Anything you'd like to add?

Speaking with my academic hat on, I’d add that having a non-mRNA option in the program creates a genuine research opportunity. There's no good evidence yet that alternating vaccine types produces more durable protection, but it's entirely plausible. Think of it like training at the gym: if you use the same machines, the same weights, the same reps every session, you plateau. Mixing it up produces different results. That's not a scientific argument – just an intuition. But with more than one vaccine platform in the program, our epidemiological scientists can at least begin to explore those questions. That will take time, but it's important that we're now in a position to do it.