Vaccine production, distribution, access, and uptake

Abstract

Making human vaccines available on a global scale requires the use of complex production methods, meticulous quality control and reliable distribution channels that ensure the products are potent and effective at their point of use. The technologies involved in manufacturing different types of vaccines may strongly influence vaccine cost, ease of industrial scale-up, stability and ultimately world-wide availability. Manufacturing complexity is compounded by the need for different formulations for different countries and age groups. Reliable vaccine production in appropriate quantities and at affordable prices is the cornerstone of developing global vaccination policies. However, ensuring optimal access and uptake also requires strong partnerships between private manufacturers, regulatory authorities and national and international public health services. For vaccines whose supplies are limited, either due to rapidly emerging diseases or longer-term mismatch of supply and demand, prioritizing target groups can increase vaccine impact. Focusing on influenza vaccines as an example that well illustrates many of the relevant points, this article considers current production, distribution, access and other factors that ultimately impact on vaccine uptake and population-level effectiveness.

A novel hepatitis B vaccine containing Advax™, a polysaccharide adjuvant derived from delta inulin, induces robust humoral and cellular immunity with minimal reactogenicity in preclinical testing

“…influenza [20] or Japanese encephalitis [18] antigen. Antigen-sparing capability is critical for pandemic vaccines, where antigen supply is limiting but could also be useful for vaccines such as rabies, polio or Japanese encephalitis, to make them more affordable for developing world immunization programs [37]. …”

Evaluation of hyaluronic acid-based combination adjuvant containing monophosphoryl lipid A and aluminum salt for hepatitis B vaccine

“…Although more than 2 billion people worldwide have been infected with hepatitis B virus (HBV) [1], current prophylactic hepatitis B vaccines based on recombinant hepatitis B surface antigen (HBsAg) have been highly successful in preventing infection and transmission [2][3][4]. The hepatitis B surface antigen has poor immunogenicity [5], so the HBV vaccine requires the use of adjuvants.…”

“…Mice (n = 5) were intramuscularly immunized twice at a 2-week interval with the indicated amount of antigen alone or together with adjuvant in 50 l PBS. Antibody titer: (a) IgG, (b) IgG1, (c) IgG2c were measured by ELISA [(1,4,7,10); antigen alone,(2,5,8,11); HBsAg Alum,(3,6,9,12); HBsAg Alum MPLA/HA].…”

Socioeconomic, cultural and behavioural features of prior and anticipated influenza vaccine uptake in urban and rural Pune district, India: a mixed-methods case study

“…Although a recent assessment of the role of human vaccines for the control of pandemic and seasonal influenza acknowledges the importance of community acceptance and popular ideas that discourage the use of safe and effective vaccines, they focus on questions of production and distribution 8. Production capacity is required, but it is not by itself sufficient for effective policy.…”