A research and development (R&amp;D) roadmap for broadly protective coronavirus vaccines: A pandemic preparedness strategy

Moore, Kristine A.; Leighton, T.; Ostrowsky, Julie; Anderson, Cory; Danila, Richard; Ulrich, Angela; Lackritz, Eve M.; Mehr, Angela J.; Baric, Ralph S.; Baylor, Norman W.; Gellin, Bruce G.; Gordon, Jennifer L.; Krammer, Florian; Perlman, Stanley; Rees, Helen; Saville, Mélanie; Weller, Charlotte; Osterholm, Michael T.

doi:10.1016/j.vaccine.2023.02.032

Cited by 16 publications

(11 citation statements)

References 86 publications

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“…Adenovirus vectors may be particularly good at inducing mucosal 230 immunity given their biophysical stability and natural mucosal tropism, although other vaccine 231 platforms should also be explored as potential mucosal vaccines. Our data suggest that the 232 development of next generation vaccines that protect against infection with SARS-CoV-2 12,13 233 and other respiratory viruses may be feasible by optimization of mucosal immunity. A…”

Section: Discussionmentioning

confidence: 92%

“…A key problem is that intramuscular immunization with mRNA and adenovirus-vector-based SARS-CoV-2 vaccines does not typically induce robust mucosal immunity 10 , 11 . The coronavirus vaccine roadmap 12 and Project NextGen 13 emphasize the need to develop next-generation SARS-CoV-2 vaccines and vaccination strategies that induce improved mucosal immunity that will block infection and onward transmission. However, the development of immunization strategies that induce consistent and robust mucosal immune responses has proven difficult and may require innovative approaches that are beyond intranasal administration of current vaccines 3 – 5 .…”

Section: Mainmentioning

confidence: 99%

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Mucosal boosting enhances vaccine protection against SARS-CoV-2 in macaques

McMahan,

Wegmann,

Aid

et al. 2023

Nature

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A limitation of current SARS-CoV-2 vaccines is that they provide minimal protection against infection with current Omicron subvariants1,2, although they still provide protection against severe disease. Enhanced mucosal immunity may be required to block infection and onward transmission. Intranasal administration of current vaccines has proven inconsistent3–7, suggesting that alternative immunization strategies may be required. Here we show that intratracheal boosting with a bivalent Ad26-based SARS-CoV-2 vaccine results in substantial induction of mucosal humoral and cellular immunity and near-complete protection against SARS-CoV-2 BQ.1.1 challenge. A total of 40 previously immunized rhesus macaques were boosted with a bivalent Ad26 vaccine by the intramuscular, intranasal and intratracheal routes, or with a bivalent mRNA vaccine by the intranasal route. Ad26 boosting by the intratracheal route led to a substantial expansion of mucosal neutralizing antibodies, IgG and IgA binding antibodies, and CD8+ and CD4+ T cell responses, which exceeded those induced by Ad26 boosting by the intramuscular and intranasal routes. Intratracheal Ad26 boosting also led to robust upregulation of cytokine, natural killer, and T and B cell pathways in the lungs. After challenge with a high dose of SARS-CoV-2 BQ.1.1, intratracheal Ad26 boosting provided near-complete protection, whereas the other boosting strategies proved less effective. Protective efficacy correlated best with mucosal humoral and cellular immune responses. These data demonstrate that these immunization strategies induce robust mucosal immunity, suggesting the feasibility of developing vaccines that block respiratory viral infections.

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Section: Discussionmentioning

confidence: 92%

Section: Mainmentioning

confidence: 99%

Mucosal boosting enhances vaccine protection against SARS-CoV-2 in macaques

McMahan,

Wegmann,

Aid

et al. 2023

Nature

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“…For effective public financial management, the strategic interventions identified in literature were: improving vaccine demand forecasting, budgeting, and procurement 8,[10][11][12][15][16][17][18][19][20] , where accurate market assessments 11,12,15 and ensuring reliable cost and expenditure data by mapping budget processes 11,[18][19][20] were highlighted as critical findings; establishing credible regulatory bodies [10][11][12]16,17,[19][20][21] , to expedite approval processes 11,12 and evaluate program targets 10,19 ; and alternative financing models and funding strategies [1][2][3]6,7,[10][11][12]14,17,19,21,23,25,26 , such as Advanced Market Commitments (AMC) 1,11,12,17 , investing in R&D 1,…”

Section: Diversify Sources Of Financingmentioning

confidence: 99%

Sustainable financing of immunization programs: A narrative review of the literature

Yim,

Cabrera,

Moore

et al. 2024

Popul. Med.

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Countries have varied approaches to incorporating immunization into national health budgets, with little sharing of know-how and best practices. The diversion of resources from routine immunization due to the COVID-19 pandemic, highlights the need to increase the sustainability and resilience of existing vaccination infrastructure. Strategies for sustainable financing of immunization programs were reviewed and assessed on how they fit within the Immunization Agenda 2030 framework proposed by the WHO. We conducted a narrative literature review and analyzed existing knowledge using a thematic framework. The eligibility criteria for review articles were that they were peer reviewed, including grey literature, in English, and focusing on sustainable financing strategies for immunization programs unrelated to COVID-19 at an international or regional level. The review identified 24 articles that met inclusion criteria. The areas identified were ensuring sufficient, predictable resources, securing effective public financial management, enhancing collaborative partnerships and facilitating sustainable transition from external donor support. Recommendations include enhancing public-private partnerships (PPPs), ensuring alternative funding models, establishing credible regulatory bodies, and fostering technology transfer. To achieve sustainable financing, a multi-faceted approach is needed: increasing government funding, diversifying funding sources, investing in vaccine development infrastructure, establishing regulatory bodies, and fostering PPPs.

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“… 1 Since the emergence of the ancestral strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, the virus evolved rapidly and mutated toward increased viral fitness, enhanced transmission kinetics, and immune evasion. 2 , 3 A wealth of evidence indicated that although intramuscular COVID-19 vaccines initially provided significant protection in reducing viral transmission, hospitalizations, and deaths, the ongoing evolution of SARS-CoV-2 variants, especially Omicron sub-lineages, had led to a rapid decline in the effectiveness of both the primary series and booster dose against symptomatic infections. 4 Although the World Health Organization (WHO) announced that COVID-19 no longer constitutes a public health emergency of international concern (PHEIC) on May 2023, repeated reinfections and an increased risk of post-acute sequelae are persistent challenges to human health, especially for elders and those with underlying medical conditions.…”

Section: Introductionmentioning

confidence: 99%

Short-term effectiveness of single-dose intranasal spray COVID-19 vaccine against symptomatic SARS-CoV-2 Omicron infection in healthcare workers: a prospective cohort study

Mi,

Chen,

Lin

et al. 2024

eClinicalMedicine

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A research and development (R&D) roadmap for broadly protective coronavirus vaccines: A pandemic preparedness strategy

Cited by 16 publications

References 86 publications

Mucosal boosting enhances vaccine protection against SARS-CoV-2 in macaques

Mucosal boosting enhances vaccine protection against SARS-CoV-2 in macaques

Sustainable financing of immunization programs: A narrative review of the literature

Short-term effectiveness of single-dose intranasal spray COVID-19 vaccine against symptomatic SARS-CoV-2 Omicron infection in healthcare workers: a prospective cohort study

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