Worldwide vaccine summit assembled senior leaders of global organisations including WHO, GAVI, CEPI, UNICEF, etc. to discuss the latest progress, innovations, stumbling blocks, and outlook of vaccine research and development.
The world as we know it has slowed to a standstill with the advent of COVID-19. If anything, the vaccine landscape has been churning away at an unprecedented scale and speed, making progress by leaps and bounds – be it in revolutionary discoveries, record-breaking achievements, and many more.
The 11th Annual Vaccines World Summit, which took place over two days from 19 to 20 May 2021, brought to light a great number of such accomplishments through discourse between global leaders and specialists. Gathering more than 50 expert speakers from different organisations and more than 500 attendees, the virtual conference was held to propel forward technological and industrial advancements in the vaccine industry.
The highlights of the conference included a special emphasis on COVID-19 vaccine progress in developing countries, the next-generation platform of vaccine production, feats in clinical trials, and vaccine manufacturing and validation. Advancements in Influenza, Zika, and Pneumococcal vaccines were also among the many subject matters discussed. But above all, the summit acted as a platform for communication and partnership between researchers, vaccine manufacturers, and global organisations like WHO, UNICEF, CEPI, GAVI, etc.
Key speakers were invited to give presentations on their topics of interest, some of which are elaborated on below.
Vaccines and Preventive Health
In her talk “Vaccines and Preventive Health,” Neelima Dwivedi, Senior Director of External Affairs, Market Access, Policy from MSD, India underscored the need for public-private partnerships to facilitate COVID-19 vaccine rollouts at national and global scales.
Dwivedi shed light on the damaging effects of vaccine hesitancy, which has been one of the largest impediments in the vaccine drive, its uptake, and sustainability. She also highlighted the urgency of boosting vaccine confidence to further vaccine lifecycles and clinical trial participation across countries. Volatile sociocultural norms, ever-changing perceptions of vaccine-preventable diseases, and new technologies are among the many reasons that have fuelled the spread of misinformation and aggravated risk distortion of vaccines. It was pointed out that worries of the disease risk might be outweighed by vaccine safety concerns.
“The reality is that far too many adults become ill or die each year from diseases that can be easily prevented by vaccines,” Dwivedi said as she described the situation of vaccine shortage in India.
With over 95 per cent of deaths amongst adults in India attributable to diseases that vaccines can protect against, there is a pressing need to promote adult vaccinations by establishing national guidelines and educating both healthcare providers and the public to support the initiative.
In concert, public-private partnerships (PPP) are advised to synergise the best practices across markets, support public health initiatives in both discovery and implementation, elevate consumer awareness regarding routine vaccinations, and endorse global partnerships across all levels of healthcare.
“PPPs should be considered the seabed for scientific innovation, as an enabler of patient taxes, as a cornerstone for paving the way forward, engendering goodwill amongst the government, vaccine development companies, and patient,” Dwivedi stated.
Besides PPPs, she urged policy reforms on adult immunisations, universal health packages, and health insurances supporting vaccinations to maximise accessible equitable vaccine coverage.
Keynote Panel Discussion
The primary highlight of the conference was a panel discussion on present vaccine action plans strategised to mitigate the global pandemic. Senior representatives from WHO, UNICEF, GAVI, CEPI, DCBMN were interviewed.
Finding Silver Linings
With rapid and well-coordinated global efforts, the first vaccine was rolled out in a record time of 324 days, and made available to 177 countries worldwide. 1.5 billion doses have been manufactured and supplied to many parts of the world in less than four to five months, and the industry is preparing to ensure that another 10 to 14 billion doses will be distributed by the end of 2021. While a daunting task, 275 partnerships and 214 collaborations to date have exemplified the commendable solidarity that has enabled vaccines access and availability to many countries around the globe.
Martin Friede, Coordinator of the Initiative for Vaccine Research (IVR) from the World Health Organisation (WHO), agreed, “None of us [is] doing anything in the vacuum. We are all doing this in partnership with one another.”
One particular feat that Etleva Kadill, Director Supply Division of UNICEF, regarded as an emotional moment of glory was the landing of the first plane carrying COVID-19 vaccines in Ghana, which arrived in a record time of nine days after the United Nations approved of the vaccines. Through tireless work and collaboration with manufacturers, donors, public health authorities, and many others, the manufacture and delivery of vaccines took place at record speed.
“We are all very proud to have delivered almost 70 million doses to over 124 countries, and many millions of doses on the way to arrive,” Kadilli explained. “A lot of glory and happiness but also a lot of challenges in front of us,” she forewarned and rightly so.
Present Challenges
Presently, several constraints have impaired access and delivery of vaccines, including hiccups in the complex supply chain, shortage of raw materials, vaccine hesitancy, misinformation, and inequitable distribution.
Friede noted that the greatest challenge in vaccine delivery was the lack of equity. Despite the large number of doses that have been produced and delivered, less than 1 per cent of vaccines have been distributed to low- and middle-income countries. One primary reason for this inequitable coverage is low vaccine manufacturing power in many of these countries.
Dominique Maugeais, Vaccine Manufacturing Expert of GAVI, also unveiled an unexpected obstacle that has hindered access to vaccines – border closures. Border closures have restricted the movement of people, components, semi-finished and finished vaccines. This handicap has limited vaccine manufacturers from procuring raw materials to produce finished products for distribution and hampered fair and equitable access.
Friede specified the importance of establishing access to COVID-19 tool accelerators to obtain global consensus on validated diagnostics and therapeutics to establish uniform, accurate and reliable protocols, and bring the pandemic to an end.
Promoting the free flow of goods and workforce is also a key strategy to facilitate the transit of vaccine components and finished products. The panel highlighted the significance of gaining political support for regulatory harmonisation to accelerate manufacturing of not only COVID-19 vaccines but other global public health vaccines and antibody-based products.
Future Outlook on Vaccine Improvement
While such obstacles in supplies and manufacturing may not be apparent to the public eye, the challenge of mutant strains and how to effectively overcome them have been in the limelight.
The array of different vaccines has caused a public divide on which drug would be most effective to combat mutant strains, but the pressing issue appears to be less of vaccine type and more of confidence and coverage. Friede emphasised the urgency to boost vaccine confidence and coverage to lower the risk of mutations developing and spreading. The rampant spread of vaccine hesitancy has been especially fuelled by misinformation through social media platforms.
Besides accommodating the mutations, halal vaccines are in progress to push back vaccine hesitancy. Efforts have been made to ensure correct information about these halal vaccines to boost confidence and increase coverage.
Friede elaborated, “It is an important aspect to consider and one we have been thinking about in terms of assuring halal compliance, to ensure that the people are comfortable in taking the vaccines.”
Global organisations and public health systems have made it a top priority to curb vaccine hesitancy and maximise equitable distribution. To overcome hesitancy, they have been adopting social listening methods to better understand discourse between communities in social media and communicate positive messages to prioritise immunisations. The usage of PPEs, hand washing, and social distancing are also encouraged to realise protection against the virus.
To maximise equity, UNICEF, WHO, GAVI, and many others have been working collaboratively with governments and whistle-blowers underground with micro plans to provide equitable distribution of vaccines for populations at risk, namely marginalised and displaced populations in fragile states, conflict areas or underprivileged countries, and include them as part of national immunisation plans.
Future of Vaccinology
Sanjay Singh, CEO of Gennova Pharmaceuticals in India, offered his insights into the progress of vaccine research. To date, 100 COVID-19 vaccines are in clinical development and 184 more in pre-clinical development, most of which utilise viral protein subunits, followed by viral RNA.
The next generation of mRNA vaccines, known as Vaccine 4.0, is a promising platform, having an edge for being safe and fully synthetic without the need to be grown in eggs, cells, or bacteria as needed in conventional vaccines. With high economics, technical ease, scalability, and quick manufacturability, Vaccine 4.0 offers sustainable availability and affordability for mass production. In short, it boasts of being safe, efficacious, inexpensive, synthetic, and scalable.
One such technology is Gennova’s new mRNA COVID-19 vaccine. Their latest innovation, the HGCO19 vaccine, utilises a spike protein antigen cassette that is cut and inserted into a self-amplifying mRNA platform. Combined, the mRNA is then inserted in a Lipid InOrganic Nanoparticle (LION), thus creating the mRNA-LION complex. HGCO19 has set itself apart with its self-amplifying technology that enables low concentrations of the mRNA to produce sufficient and demonstrable results, sustained protein synthesis and release for a longer duration. It is capable of being stable at 2 to 8°C for two months and uses the most prominent mutant spike protein D614G to accommodate for protection against variant strains.
This modular platform can be quickly adapted for new strains as well. Presently, research teams are exploring methods to adapt multivalent designs of the vaccine candidate to tackle all seven of the COVID-19 variants. The vaccine candidate can be designed to carry different types of mRNA encoding for the equimolar mix of various mutant forms. However, this multi-variant vaccine is expected to be launched for human clinical trials only if the HGCO19 proves to be insufficient to tackle mutant strains.
Establishing Sustainable Manufacturing
To date, multiple platform technologies have acted as ammunition in the battle against COVID-19, but speed, scale, sustainability, and access are vital elements needed to win the war, especially with emerging virus strains in various parts of the world.
Matthew Downham, Sustainable Manufacturing Lead of CEPI in the United Kingdom, also brought to light the issue of sustainable vaccine manufacturing, especially concerning the development of single-use raw materials and other upstream components, which are all building blocks in vaccine development.
Downham expressed concerns regarding the shortage of critical single-use consumables, “There has also been an impact on other vaccines and health products, so things like bioreactor bags, filters, chromatography media. They’re not just used to make COVID vaccines. They’re used to make measles, mumps, rubella, flu [vaccines]. They’re used to make antibody-based products used in oncology treatment.”
The Global COVID-19 Vaccine Supply Chain and Manufacturing Summit, which transpired in March 2021, addressed this pressing issue of single-use components shortage and supply chain effectiveness. The discussion suggested facilitating the free flow of vaccine supply, workforce and expertise, lubricating technology transfer, and supporting manufacturing partnerships to scale up and out vaccine capacity.
To initiate regional health security through the establishment of sustainable regional long-term manufacturing of vaccines, the COVAX Manufacturing Taskforce was deployed to upgrade vaccine manufacturing facilities in low- and middle-income countries, leverage businesses to stimulate public- and private-sector investments, identify policy needs and regulatory capabilities in compliance with global standards, coordinate development of sustainable and resilient regional supply chains across the global manufacturing ecosystem, and upskill vaccine manufacturing workforce and skillsets.
Presently, the COVAX Supply Chain and Manufacturing Taskforce are in the process of developing a schema for scientific research, technology transfer, architectural planning, infrastructure building, fund securing, hub expansion, and personnel training to expand vaccine production in low- and middle-income countries. Once completed, the design model is expected to map out plans to embark on a multi-year journey to establish a sustainable network in the countries’ vaccine landscape.
Concluding Remarks
The latest innovations and new partnerships mentioned above are not exhaustive, and more are expected to spearhead vaccine development and manufacturing. Through global collaboration and speedy technological innovations, vaccine research is making headway in laying the groundwork for a world where epidemics are no longer a threat to humanity. [APBN]
References:
- Dwivedi, N. (2021, May 19). Vaccines and Preventive Health [Webinar]. 11th Annual Vaccines World Summit 2021.
- Suri, R., Downham, M., Kadill, E., Friede, M., Maugeais, D. (2021, May 19). Keynote Panel Discussion: Global Pandemic Vaccine Action Plan in Near- and Long-Term Strategies to Increase the Supply of Pandemic Vaccine to developing countries [Webinar]. 11th Annual Vaccines World Summit 2021.
- Singh, S. (2021, May 20). Future of Vaccinology [Webinar]. 11th Annual Vaccines World Summit 2021.
- Downham, M. (2021, May 20). Establishing Sustainable Manufacturing [Webinar]. 11th Annual Vaccines World Summit 2021.