Framework for Optimal Global Vaccine Stockpile Design for Vaccine‐Preventable Diseases: Application to Measles and Cholera Vaccines as Contrasting Examples

Abstract

Managing the dynamics of vaccine supply and demand represents a significant challenge with very high stakes. Insufficient vaccine supplies can necessitate rationing, lead to preventable adverse health outcomes, delay the achievements of elimination or eradication goals, and/or pose reputation risks for public health authorities and/or manufacturers. This article explores the dynamics of global vaccine supply and demand to consider the opportunities to develop and maintain optimal global vaccine stockpiles for universal vaccines, characterized by large global demand (for which we use measles vaccines as an example), and nonuniversal (including new and niche) vaccines (for which we use oral cholera vaccine as an example). We contrast our approach with other vaccine stockpile optimization frameworks previously developed for the United States pediatric vaccine stockpile to address disruptions in supply and global emergency response vaccine stockpiles to provide on-demand vaccines for use in outbreaks. For measles vaccine, we explore the complexity that arises due to different formulations and presentations of vaccines, consideration of rubella, and the context of regional elimination goals. We conclude that global health policy leaders and stakeholders should procure and maintain appropriate global vaccine rotating stocks for measles and rubella vaccine now to support current regional elimination goals, and should probably also do so for other vaccines to help prevent and control endemic or epidemic diseases. This work suggests the need to better model global vaccine supplies to improve efficiency in the vaccine supply chain, ensure adequate supplies to support elimination and eradication initiatives, and support progress toward the goals of the Global Vaccine Action Plan.

A shortage risk mitigation model for multi-agency coordination in logistics planning

“…Collaborative efforts ranging from local to the international level are mechanisms to manage complex environmental problems. The fact that disaster operations are often engaged by a relatively large number of relief organizations (Nolte et al, 2012;Li et al, 2018), especially governmental agencies, further complicates an already complex situation because of the diverse goals, values, and access to resources of the participants (Thompson and Duintjer Tebbens, 2016). Governmental agencies have to liaise with a central coordinator which directs their activities (Margaret B. and Marilyn M., 2006).…”

Roadmap for strengthening the vaccine supply chain in emerging countries: Manufacturers' perspectives

“…The WHO Blueprint R&D includes categories of priority diseases, of which 6 were in the midst of outbreaks at the same time in 2018 [27] . There are calls to consider stockpiles for all vaccines with elimination goals and help prevent and control endemic or epidemic diseases [28] . The focus of CEPI 8 on outbreak response already signals the need for investigational stockpiles of candidate vaccines against the diseases it has targeted [29] .…”

Using integrated modeling to support the global eradication of vaccine‐preventable diseases

“…Subsequent work highlighted the fundamental difference in stockpile management for vaccines that remain in production due to the ability to use vaccine before it expires (i.e. rotating stockpile) (Thompson and Duintjer Tebbens, ). This work fits within a growing field that integrates epidemiological modeling with logistics (Gani et al ., ; Lee et al ., ; Arinaminpathy and McLean ; Siddiqui and Edmunds, ; Institute of Medicine, ; Spiliotopoulou et al ., ; Auping et al ., ).…”