To design a solution that meets the requirements for off-site immutable backups for Veeam University Hospital, you need to consider some of the options and features that Veeam products and features offer. This will help you to ensure the security and integrity of your backup data, as well as the compatibility and supportability of the cloud provider that does not currently support immutability.

According to the Veeam Backup & Replication Best Practice Guide, immutability is a feature that prevents backup files from being deleted or modified by anyone until the specified retention period expires. Immutability can be achieved by using S3 Object Lock or Hardened Repository, which are two different solutions that Veeam Backup & Replication supports.

Based on this definition, the best option to still satisfy the requirements for off-site immutable backups is A. Backup copy to a hardened repository.

This option means that:

•The backup copy is a type of job that allows you to create and maintain copies of your backup data on a secondary backup repository. You can use backup copy jobs to send your backup data off-site, as well as to apply different retention settings and policies.

•The hardened repository is a solution that allows you to add a hardened repository based on a Linux server to your backup infrastructure. You can use hardened repository with Veeam Backup & Replication to make your backups immutable on-premises or off-site.

•The backup copy to a hardened repository can be configured and managed by Veeam Backup & Replication, regardless of the cloud provider that does not currently support immutability. You only need to deploy and connect a Linux server with a hardened repository in the cloud environment, and then use it as a target for your backup copy jobs.