Naheed Ali, MD, PhD

Vaccine developers are facing new and complex challenges because of the changing dynamics of emerging infectious diseases. In post-COVID times, it has become essential to devise ways by which any other such pandemic can be tackled with minimum loss in the future. Vaccines play a pivotal role in the management of epidemic diseases. Vaccine manufacturers must look to formulate ways to increase manufacturing speed and ease licensure and authorization in case of emergent circumstances.

Pharmacovigilance of vaccine safety and inspection of different variants of viruses is also crucial. Work needs to be done to make vaccines easily accessible to people in countries with middle to low socioeconomic status. The success of these efforts will be demonstrated by better handling of future epidemics and preventing them from becoming pandemics.

Viral diseases have emerged and reemerged over the course of years to pose threats to humanity and expose loopholes in the healthcare system. Dense urbanization and population explosion, along with enhanced modes of transformation, have modified the demographic trends in several ways. Alterations in ecosystems and inappropriate mechanisms of public health control have hastened the spread of zoonotic pathogens, posing threats to human existence.

SARS-CoV-2 swallowed the whole world in less than six months, unsettling the economy of the world. Social distancing, lockdowns, wearing masks, and constraints on traveling and congregations were the initial methods applied by the WHO and other organizations to control the spread of infection but failed heavily, resulting in about 2 million casualties and 100 million infections [1].

The vaccine was developed quite late and without authentic proof of efficacy and safety but still proved to be the best hope of winning or at least surviving the battle. Researchers and policymakers need to cautiously reevaluate their approach to these emergent threats. Vaccines act as the foundations of infection management systems, but standard vaccine manufacturing cycles are not appropriate for explosive outbreaks. Using modern technologies might speed up this development cycle and help with timely infection control. mRNA technology was used to produce vaccines for COVID-19. This technology is being applied to produce vaccines for other pathogens as well. mRNA vaccines are beneficial evidence of concept, yet their large-scale deployment is still questionable.

Pharmacovigilance and surveillance are necessary before the introduction of a vaccine into a community. The effects of a certain vaccine during pregnancy, its teratogenic potential, efficacy and longevity, and other adversities must be assessed. Clinical trials and protocols for vaccines should be reviewed by committees consisting of experts. Follow-up monitoring is also emphasized as it helps in understanding the antibody titer trends and other post-vaccination/immunization parameters [2].

Though vaccine manufacturers can produce and distribute millions of doses of vaccine in a short time, the manufacturing equation is multifaceted and subject to delay. The methodological platform employed to synthesize a vaccine (whole attenuated virus, vector/plasmid, protein with or without adjuvant, mRNA), the dosage, the vaccination calendar, and the manufacturer’s capacity are a few of the significant aspects considered by WHO and other health organizations [3]. There are many big names in manufacturing industries with huge production capacity, yet they could not produce the desired amount of vaccine during COVID times. The stakeholders have learned a lot about the efficient development of vaccines, yet there are voids that need to be filled.

References:

[1] Mallah SI, Ghorab OK, Al-Salmi S, et al. COVID-19: breaking down a global health crisis. Ann Clin Microbiol Antimicrob. 2021;20(1):35. Published 2021 May 18.

[2] Oliver SE, Gargano JW, Marin M, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine – United States, December 2020. MMWR Morb Mortal Wkly Rep. 2020;69(50):1922-1924. Published 2020 Dec 18.

[3] Travieso T, Li J, Mahesh S, Mello JD, Blasi M. The use of viral vectors in vaccine development. NPJ Vaccines. 2022;7(1).