The importance of vaccine stockpiling to respond to epidemics and remediate global supply shortages affecting immunization: strategic challenges and risks identified by manufacturers

Jarrett, Stephen; Pagliusi, Sonia; Park, Rachel; Wilmansyah, Taufik; Jadhav, Suresh; Santana, Patricia Correia; Krishnamurthy, Komarapuram R.; Yang, Lingjiang

doi:10.1016/j.jvacx.2021.100119

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…Heath authorities were unprepared to deal with the dangerous virus, and the country accounted with the solidarity of private hospitals 22 , the training of Mexican doctors by Cuban physicians 19,20 , and the acquisition of 250 million vaccines 33 . The lack of initial vaccines due to the stockpiling in industrialised countries 32 and its high prices by pharmaceutical enterprises allied with the governments of Argentina and Mexico to produce massively Astra Seneca inoculations 34 , distributed at cost to all Latin American countries. The whole subcontinent was hit by multiple unexpected problems and CEPAL estimated that during 2021, 86 million people had fallen into extreme poverty, due to the sanitary and economic crises 87 .…”

Section: Discussionmentioning

confidence: 99%

“…The Ministry of Health confirmed on February 2023 31 that 7.39 million infections of SARS-CoV-2 with 801,994 additional suspected, 11.2 million negative cases, 6.6 million patients recovered, and officially 332,483 deaths, while excess mortality was estimated by 600,590 persons. This high mortality was also related to the stockpiling of vaccines against COVID-19 in industrialized countries 32 , which allowed the dissemination of new strengths of the virus, often more contagious (delta, omicron). This occidental behaviour increased all over the world costs, including the vaccine destruction in their own countries at the time of expiration.…”

Section: Covid-19 Policy In Mexicomentioning

confidence: 99%

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Meeting the COVID-19 Pandemic: Complex Health, Socioeconomic, Gender, and Cultural Nexuses in Mexico

Spring

2023

MRAJ

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COVID-19 met Mexico with a fragmented healthcare system, where governmental and private corruption limited the reconstruction of hospitals after the earthquakes in 2017. Monopolies in the purchase of drugs, lack of trained medical personnel, badly equipped hospitals, obesity, and chronic diseases produced excess mortality from SARS-COV-2. Further, industrialized countries monopolized vaccines and protective gear against the pandemic and the UN-COVAX system for buying them failed. Mexico was forced to purchase vaccines worldwide at speculative prices. The country received also specialists from Cuba, purchased ventilators, trained hospital staff, and separated hospitals only for COVID-19 attention, while 145 private hospitals provided medical attention at public prices. In December 2020 first vaccines arrived and in July 2022 71.3% of the adult population was immunised. The government rejected the pressure of the International Monetary Fund for supporting big companies. Instead, direct money transfers for survival to elderlies, students, youth in apprenticeship, and peasants planting timber and fruit trees alleviated rising poverty and unemployment during the confinement. The cash for youth also moved them away from organised crime and drug production. Agreements with supermarkets and producers lowered the inflation in basic food prices and systematic increases in minimum wage improved Mexicans' purchasing power parity. Less corruption permitted the construction of new megaprojects in the poorest regions. Infrastructure in these marginalised regions recovered formal jobs, generating also labour for Central American migrants, thus reducing the political tensions on both national borders. Additionally, energy transition and subsidies of internal oil prices strengthened economic stability and the peso against the US dollar without new foreign debts. This rigorous macroeconomic policy, free vaccination, the start of a new public health system, and direct cash transfers allowed Mexico to recover in March 2022 from the 12.5 million lost jobs. The unemployment rate was in March 2023 2.4%. The complex nexuses of socioeconomic, health, youth, and gender policies promoted also an alternative social care system, reduced excess mortality and improved the living conditions of the impoverished population in the indigenous southern regions.

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Section: Discussionmentioning

confidence: 99%

Section: Covid-19 Policy In Mexicomentioning

confidence: 99%

Meeting the COVID-19 Pandemic: Complex Health, Socioeconomic, Gender, and Cultural Nexuses in Mexico

Spring

2023

MRAJ

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“…Global vaccine stockpiles are insurance for reducing the scale of outbreaks when they occur 4 , however they remain unused if no outbreak occurs before the vaccines expire. Evidence is needed to quantify the value of vaccine stockpiles for ORI to inform future investment.…”

Section: Introductionmentioning

confidence: 99%

Estimating the historical impact of outbreak response immunization programs across 210 outbreaks in LMICs

Delport,

Muellenmeister,

MacKechnie

et al. 2024

Preprint

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BackgroundOutbreaks of vaccine-preventable diseases continue to occur in low- and middle-income countries (LMICs), requiring outbreak response immunization (ORI) programs for containment. To inform future investment decisions, this study aimed to estimate the cases, deaths, disability-adjusted life years (DALYs), and societal economic costs averted by past ORI programs. Outbreaks of measles, Ebola, yellow fever, cholera, and meningococcal meningitis in LMICs between 2000-2023 were considered.Methods210 outbreaks (51 measles, 40 cholera, 88 yellow fever, 24 meningitis, 7 Ebola) were identified with sufficient data for analysis. Agent-based models were calibrated for each disease such that after controlling for baseline vaccine coverage, ORI initiation time, speed of vaccine delivery, environmental variables, or endemic prevalence of the disease, observed outbreaks were within the distribution of simulated outbreaks. A status-quo and no ORI scenario were compared for each outbreak.FindingsAcross 210 outbreaks, ORI programs are estimated to have averted 5·81M [95% uncertainty interval 5·75M–5·87M] cases (4·01M measles, 283K cholera, 1·50M yellow fever, 21·3K meningitis, 820 Ebola), 327K [317K–338K] deaths (20.0K measles, 5215 cholera, 300K yellow fever, 1599 meningitis, 381 Ebola), 14·6M [14·1M–15·1M] DALYs (1·27M measles, 220K cholera, 13·0M yellow fever, 113K meningitis, 16·6K Ebola), and US$31·7B [29·0B–34·9B] (US$710M measles, US$156M cholera, US$30·7B yellow fever, US$97·6M meningitis, US$6·72M Ebola) in societal economic costs. In general, the more rapidly the ORI was initiated the greater the impact.InterpretationORI programs are critical for reducing the health and economic impacts of outbreaks of vaccine-preventable diseases.FundingGavi,the Vaccine Alliance.

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“…It has been estimated up to 80% of the cost of vaccination programs are related to cold chain requirements [3]. Another concern for public health is the need to build both static and rotating stockpiles of vaccines for outbreaks, which is also heavily dependent on stable vaccine products [4].…”

Section: Introductionmentioning

confidence: 99%

Improved Thermal Stabilization of VSV-Vector with Enhanced Vacuum Drying in Pullulan and Trehalose-Based Films

Iwashkiw,

Mohamud,

Kazhdan

et al. 2024

Preprint

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One major limitation of effective vaccine delivery is its dependency on a robust cold chain infrastructure. While Vesicular stomatitis virus (VSV) has been demonstrated to be an effective viral vaccine vector for diseases including Ebola, its -70oC storage requirement is a significant limitation for accessing disadvantaged locations and populations. Previous work has shown thermal stabilization of viral vaccines with a combination of pullulan and trehalose (PT) dried films. To improve the thermal stability of VSV, we optimized PT formulation concentrations and components, as well as drying methodology with enhanced vacuum drying. When formulated in PT films, VSV can be stored for 32 weeks at 4oC with less than 2 log PFU loss, at 25oC with 2.5 log PFU loss, and at 37oC with 3.1 log PFU loss. These results demonstrate a significant advancement in VSV thermal stabilization, decreasing the cold chain requirements for VSV vectored vaccines.

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The importance of vaccine stockpiling to respond to epidemics and remediate global supply shortages affecting immunization: strategic challenges and risks identified by manufacturers

Cited by 11 publications

References 15 publications

Meeting the COVID-19 Pandemic: Complex Health, Socioeconomic, Gender, and Cultural Nexuses in Mexico

Meeting the COVID-19 Pandemic: Complex Health, Socioeconomic, Gender, and Cultural Nexuses in Mexico

Estimating the historical impact of outbreak response immunization programs across 210 outbreaks in LMICs

Improved Thermal Stabilization of VSV-Vector with Enhanced Vacuum Drying in Pullulan and Trehalose-Based Films

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