1
|
Kang G. Success from the South: the rotavirus vaccine story and its lessons. Lancet 2024; 403:111-116. [PMID: 38040012 DOI: 10.1016/s0140-6736(23)02520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Gagandeep Kang
- Enterics, Diagnostics, Genomics & Epidemiology, Bill and Melinda Gates Foundation, Seattle, WA, USA.
| |
Collapse
|
2
|
Stevenson M. A situation analysis of the state of supply of in vitro diagnostics in Low-Income Countries. Glob Public Health 2020; 15:1836-1846. [PMID: 32758073 DOI: 10.1080/17441692.2020.1801791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In vitro diagnostics (IVDs) are medical devices and accessories used to test bodily samples for causative agents of disease. IVDs play a central role in the diagnosis of individuals, in the rationale use of medicines, in burden of disease estimates, as well as in public health surveillance; especially for detection of emerging epidemics, the identification and monitoring of antimicrobial resistance, and the documentation of infection rates in populations. This article examines how the state of (a) product quality, (b) pricing, and (c) development country manufacturing capacity, are affecting the supply of IVDs in Low-Income Countries (LICs). Data informing this work is derived from interviews with representatives of leading stakeholder organisations working in this space, and analysis of secondary literature. The findings of this analysis are that the supply of IVDs in LICs is undermined by (i) significant variation in product quality; (ii) inconsistent market demand from governments; (iii) limited opportunities for pooled procurement; (iv) a lack of transparency and consistency in product pricing; and (v) insufficient competition among producers capable of innovating for populations with limited purchasing power and low-resource settings. The article then examines four strategies for how these challenges can be overcome.
Collapse
Affiliation(s)
- Michael Stevenson
- School of Public Health and Health Systems, University of Waterloo, Hamilton, Canada
| |
Collapse
|
3
|
Sarsenbayeva G, Issagulov T, Kassenov M, Abitay R, Orynbayev M, Stukova M, Pisareva M, Davlyatshin T, Lespek K, Khairullin B. Safety and immunogenicity of trivalent inactivated influenza vaccine in adults 60 years of age and older: a phase II, a randomized, comparative trial in Kazakhstan. Hum Vaccin Immunother 2020; 16:1791-1797. [PMID: 32048890 DOI: 10.1080/21645515.2019.1705691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The study was aimed at comparative evaluation of seasonal influenza vaccine RIBSP versus commercial vaccine VAXIGRIP® for immunogenicity and safety in the course of clinical trial phase II on healthy subjects up to 60 years. METHODS The trial involved 150 subjects in randomized 2:1 groups that received either RIBSP vaccine or comparator vaccine VAXIGRIP®. One dose (0.5 ml) of either vaccine contained 15 µg of hemagglutinin of each influenza virus strain recommended by WHO for the Northern hemisphere in 2016-2017 flu season. The observation period lasted 21 days. The trial was registered at ClinicalTrials.gov identifier NCT03016143. RESULTS Assessment of immunogenic activity of the vaccine under study showed that in 21 days the portion of participants with 4-fold seroconversions was 80.0% to А/H1N1; 65.0% to А/H3N2 and 64.0% to B virus. Antibody titer increase factor in the group of subjects that received RIBSP vaccine was 13.4 for А/H1N1; 5.2 for А/H3N2 and 5.2 for B virus. The subjects that received RIBSP vaccine demonstrated 88% seroprotection rate against А/H1N1; 75% against А/H3N2 and 61% against B virus. In the course of evaluating the vaccine safety, no serious adverse events were recorded. All changes of laboratory data were slight and single in most cases. All recorded local reactions have been light in character and these have been predicted reactions observed at vaccination against influenza. CONCLUSION Comparison vaccines RIBSP and VAXIGRIP®, showed similar immunogenic activity. The RIBSP vaccine is safe and immunogenic for the elderly and conforms to international criteria in CPMP/BWP/214/96.
Collapse
Affiliation(s)
| | - Timur Issagulov
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Markhabat Kassenov
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Ruslan Abitay
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Mukhit Orynbayev
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Marina Stukova
- Influenza Research Institute , St. Petersburg, Russian Federation
| | - Maria Pisareva
- Influenza Research Institute , St. Petersburg, Russian Federation
| | | | - Kutumbetov Lespek
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Berik Khairullin
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| |
Collapse
|
4
|
Badizadegan K, Goodson JL, Rota PA, Thompson KM. The potential role of using vaccine patches to induce immunity: platform and pathways to innovation and commercialization. Expert Rev Vaccines 2020; 19:175-194. [PMID: 32182145 PMCID: PMC7814398 DOI: 10.1080/14760584.2020.1732215] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/12/2020] [Indexed: 01/14/2023]
Abstract
Introduction: In the last two decades, the evidence related to using vaccine patches with multiple short projections (≤1 mm) to deliver vaccines through the skin increased significantly and demonstrated their potential as an innovative delivery platform.Areas covered: We review the vaccine patch literature published in English as of 1 March 2019, as well as available information from key stakeholders related to vaccine patches as a platform. We identify key research topics related to basic and translational science on skin physical properties and immunobiology, patch development, and vaccine manufacturing.Expert opinion: Currently, vaccine patch developers continue to address some basic science and other platform issues in the context of developing a potential vaccine patch presentation for an existing or new vaccine. Additional clinical data and manufacturing experience could shift the balance toward incentivizing existing vaccine manufactures to further explore the use of vaccine patches to deliver their products. Incentives for innovation of vaccine patches differ for developed and developing countries, which will necessitate different strategies (e.g. public-private partnerships, push, or pull mechanisms) to support the basic and applied research needed to ensure a strong evidence base and to overcome translational barriers for vaccine patches as a delivery platform.
Collapse
Affiliation(s)
| | - James L Goodson
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul A Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | |
Collapse
|
5
|
Adnan MM, Yin J, Jackson AM, Tse ZTH, Liang H, Fu KW, Saroha N, Althouse BM, Fung ICH. World Pneumonia Day 2011-2016: Twitter contents and retweets. Int Health 2019; 11:297-305. [PMID: 30476105 DOI: 10.1093/inthealth/ihy087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/04/2018] [Accepted: 11/17/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Twitter is used for World Pneumonia Day (WPD; November 12) communication. We evaluate if themes of #pneumonia tweets were associated with retweet frequency. METHODS A total of 28 181 original #pneumonia tweets were retrieved (21 November 2016), from which six subcorpora, 1 mo before and 1 mo after WPD 2011-2016, were extracted (n=6721). Underlying topics were identified via latent Dirichlet allocation and were manually coded into themes. The association of themes with retweet count was assessed via multivariable hurdle regression. RESULTS Compared with personal experience tweets, tweets that both raised awareness and promoted intervention were 2.62 times as likely to be retweeted (adjusted odds ratio [aOR] 2.62 [95% 1.79 to 3.85]) and if retweeted had 37% more retweets (adjusted prevalence ratio [aPR] 1.37 [95% CI 1.06 to 1.78]). Tweets that raised concerns about vaccine price were twice as likely to be retweeted (aOR 2.29 [95% CI 1.36 to 3.84]) and if retweeted, had double the retweet count (aPR 2.05 [95% CI 1.27 to 3.29]) of tweets sharing personal experience. CONCLUSIONS The #pneumonia tweets that both raised awareness and promoted interventions and those discussing vaccine price were more likely to engage users than tweets about personal experience. These results help health professionals craft WPD messages that will engage the audience.
Collapse
Affiliation(s)
- Md Mohiuddin Adnan
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jingjing Yin
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Ashley M Jackson
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Zion Tsz Ho Tse
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Hai Liang
- School of Journalism and Communication, Chinese University of Hong Kong, Hong Kong
| | - King-Wa Fu
- Journalism and Media Studies Centre, University of Hong Kong, Hong Kong.,MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Nitin Saroha
- Department of Computer Science, University of Georgia, Athens, GA, USA
| | - Benjamin M Althouse
- Institute for Disease Modeling, Bellevue, WA, USA.,Information School, University of Washington, Seattle, WA, USA.,New Mexico State University, Las Cruses, NM, USA
| | - Isaac Chun-Hai Fung
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| |
Collapse
|
6
|
Rey-Jurado E, Tapia F, Muñoz-Durango N, Lay MK, Carreño LJ, Riedel CA, Bueno SM, Genzel Y, Kalergis AM. Assessing the Importance of Domestic Vaccine Manufacturing Centers: An Overview of Immunization Programs, Vaccine Manufacture, and Distribution. Front Immunol 2018; 9:26. [PMID: 29403503 PMCID: PMC5778105 DOI: 10.3389/fimmu.2018.00026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/04/2018] [Indexed: 12/03/2022] Open
Abstract
Vaccines have significantly reduced the detrimental effects of numerous human infectious diseases worldwide, helped to reduce drastically child mortality rates and even achieved eradication of major pathogens, such as smallpox. These achievements have been possible due to a dedicated effort for vaccine research and development, as well as an effective transfer of these vaccines to public health care systems globally. Either public or private institutions have committed to developing and manufacturing vaccines for local or international population supply. However, current vaccine manufacturers worldwide might not be able to guarantee sufficient vaccine supplies for all nations when epidemics or pandemics events could take place. Currently, different countries produce their own vaccine supplies under Good Manufacturing Practices, which include the USA, Canada, China, India, some nations in Europe and South America, such as Germany, the Netherlands, Italy, France, Argentina, and Brazil, respectively. Here, we discuss some of the vaccine programs and manufacturing capacities, comparing the current models of vaccine management between industrialized and developing countries. Because local vaccine production undoubtedly provides significant benefits for the respective population, the manufacture capacity of these prophylactic products should be included in every country as a matter of national safety.
Collapse
Affiliation(s)
- Emma Rey-Jurado
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Tapia
- Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany
| | - Natalia Muñoz-Durango
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Margarita K. Lay
- Departamento de Biotecnología, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta, Chile
| | - Leandro J. Carreño
- Millennium Institute on Immunology and Immunotherapy, Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Claudia A. Riedel
- Millennium Institute on Immunology and Immunotherapy, Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas y Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
| | - Susan M. Bueno
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yvonne Genzel
- Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany
| | - Alexis M. Kalergis
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
7
|
Sarsenbayeva G, Volgin Y, Kassenov M, Issagulov T, Bogdanov N, Sansyzbay A, Abitay R, Nurpeisova A, Sagymbay A, Koshemetov Z, Stukova M, Buzitskaya Z, Кulmagambetov I, Karabayeva D, Davlyatshin T, Khairullin B. Safety and immunogenicity of the novel seasonal preservative- and adjuvant-free influenza vaccine: Blind, randomized, and placebo-controlled trial. J Med Virol 2017; 90:41-49. [PMID: 28842994 DOI: 10.1002/jmv.24922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/04/2017] [Indexed: 11/09/2022]
Abstract
The producers of influenza vaccines are not capable today to meet the global demand for an influenza vaccine in case of pandemic, so the World Health Organization recommends to develop the own influenza vaccine production in each country. A domestic preservative- and adjuvant-free trivalent split vaccine against seasonal influenza was developed at the Research Institute for Biological Safety Problems. The paper presents the results of assessing safety and immunogenicity of the influenza split vaccine after single immunization of healthy volunteers aged 18-50 years in the course of Phase I Clinical Trials. This study was randomized, blind, and placebo-controlled. The volunteers were intramuscularly vaccinated with a dose of split vaccine or placebo. The study has shown that all local and systemic reactions had low degree of manifestation and short-term character, so there was no need in medication. Serious side effects were not observed. On day 21 post vaccination the portion of vaccinated persons with fourfold seroconversions to influenza А/H1N1pdm09 virus was 100.0%, to influenza А/H3N2 virus-95.5%, to influenza B virus-81.8%, and in placebo group this index was 0%. Seroprotection rates against influenza А/H1N1pdm09, А/H3N2 and B viruses were 95.5, 86.3, and 72.7%, respectively. Geometric mean titers (GMT) of antibodies by day 21 post vaccination reached 175.7 for influenza А/H1N1pdm09 virus, 64.2 for influenza А/H3N2 virus, and 37.6 for influenza B virus; in placebo group GMT growth was not observed. So, the seasonal influenza split vaccine is well tolerated and fits all immunogenicity criteria for human influenza vaccines.
Collapse
Affiliation(s)
| | - Yevgeniy Volgin
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Markhabat Kassenov
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Timur Issagulov
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Nikolay Bogdanov
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Abylay Sansyzbay
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Ruslan Abitay
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Ainur Nurpeisova
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | - Altynay Sagymbay
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| | | | - Marina Stukova
- Influenza Research Institute, St.Petersburg, Russian Federation
| | | | | | | | | | - Berik Khairullin
- Research Institute for Biological Safety Problems, Gvardeysk, Kazakhstan
| |
Collapse
|
8
|
van Boxtel RAJ, Verdijk P, de Boer OJ, van Riet E, Mensinga TT, Luytjes W. Safety and immunogenicity of influenza whole inactivated virus vaccines: A phase I randomized clinical trial. Hum Vaccin Immunother 2016; 11:983-90. [PMID: 25751506 DOI: 10.1080/21645515.2015.1012004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Influenza vaccine production capacity is still insufficient to meet global demand in case of a pandemic. To expand worldwide influenza vaccine production capacity, a solid and transferable egg-based influenza vaccine production process was established that is suitable for upscaling and technology transfer to vaccine manufacturers in low- and middle-income countries. As a proof-of-concept, the safety and immunogenicity of a pandemic whole inactivated virus (WIV) vaccine (H5N1) and a monovalent seasonal WIV vaccine (H3N2) were evaluated in a phase I clinical trial in adults. METHODS Subjects were vaccinated with 2 doses of pandemic WIV vaccine (pWIV), or one dose of either seasonal WIV vaccine (sWIV) or a commercially available trivalent comparator vaccine followed by a placebo dose. Haemagglutination inhibiting antibody titres against the influenza strains were determined before and 21 d after each vaccination. RESULTS The frequency and severity of adverse reactions were comparable between groups. No serious adverse events were reported. After a single dose of sWIV the seroconversion rate was 91% (Committee for Proprietary Medicinal Products (CPMP) criterion >40%), the seroprotection rate was 100% (CPMP criterion >70%), and the mean geometric mean titre (GMT) increase was 24.9 (CPMP criterion >2.5). After two doses of pWIV, seroconversion rate and seroprotection rate were both 71%, and the mean GMT increase was 7.8. CONCLUSIONS Both pWIV and sWIV were equally well-tolerated as the comparator vaccine, and both vaccines complied with all 3 CPMP criteria. EudraCT 2011-000159-17. Netherlands National Trial Register 2695.
Collapse
Affiliation(s)
- Renée A J van Boxtel
- a Center for Infectious Diseases Control ; National Institute for Public Health and the Environment (RIVM) ; Bilthoven , The Netherlands
| | | | | | | | | | | |
Collapse
|
9
|
Hamidi A, Verdijk P, Kreeftenberg H. Preclinical evaluation of a Haemophilus influenzae type b conjugate vaccine process intended for technology transfer. Hum Vaccin Immunother 2014; 10:2691-6. [PMID: 25483504 PMCID: PMC4977440 DOI: 10.4161/hv.28924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/03/2014] [Accepted: 04/16/2014] [Indexed: 11/19/2022] Open
Abstract
Introduction of Haemophilus influenzae type b (Hib) vaccine in low- and middle-income countries has been limited by cost and availability of Hib conjugate vaccines for a long time. It was previously recognized by the Institute for Translational Vaccinology (Intravacc, originating from the former Vaccinology Unit of the National Institute of Public Health [RIVM] and the Netherlands Vaccine Institute [NVI]) that local production of a Hib conjugate vaccine would increase the affordability and sustainability of the vaccine and thereby help to speed up Hib introduction in these countries. A new affordable and a non-infringing production process for a Hib conjugate vaccine was developed, including relevant quality control tests, and the technology was transferred to a number of vaccine manufacturers in India, Indonesia, and China. As part of the Hib technology transfer project managed by Intravacc, a preclinical toxicity study was conducted in the Netherlands to test the safety and immunogenicity of this new Hib conjugate vaccine. The data generated by this study were used by the technology transfer partners to accelerate the clinical development of the new Hib conjugate vaccine. A repeated dose toxicity and local tolerance study in rats was performed to assess the reactogenicity and immunogenicity of a new Hib conjugate vaccine compared to a licensed vaccine. The results showed that the vaccine was well tolerated and immunogenic in rats, no major differences in both safety and immunogenicity in rats were found between the vaccine produced according to the production process developed by Intravacc and the licensed one. Rats may be useful to verify the immunogenicity of Hib conjugate vaccines and for preclinical evaluation. In general, nonclinical evaluation of the new Hib conjugate vaccine, including this proof of concept (safety and immunogenicity study in rats), made it possible for technology transfer partners, having implemented the original process with no changes in the manufacturing process and vaccine formulation, to start directly with phase 1 clinical trials.
Collapse
Key Words
- ELISA, enzyme-linked immunosorbent assay
- EP, European Pharmacopeia
- Haemophilus influenzae type b
- Hib, Haemophilus influenzae type b
- IgG, Immunoglobulin G
- Intravacc, Institute for Translational Vaccinology
- LCB, Laboratory of Control of Biological Products
- NIBSC, National Institute for Biological Standards and Control (UK)
- NVI, Netherlands Vaccine Institute
- OECD, Organization for Economic Cooperation and Development
- PRP, poly-ribosylribitol phosphate (Hib capsular polysaccharide)
- PRP-T, Hib capsular polysaccharide conjugated to Tetanus Toxoid
- QC, quality control
- RIVM, The National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu)
- SPF, specific pathogen free
- WHO, World Health Organization
- conjugate
- preclinical
- rats
- technology transfer
- vaccine
Collapse
Affiliation(s)
- Ahd Hamidi
- Support and Global Health; Institute for Translational Vaccinology (Intravacc); Bilthoven, the Netherlands
| | - Pauline Verdijk
- Support and Global Health; Institute for Translational Vaccinology (Intravacc); Bilthoven, the Netherlands
| | - Hans Kreeftenberg
- Support and Global Health; Institute for Translational Vaccinology (Intravacc); Bilthoven, the Netherlands
| |
Collapse
|
10
|
Innovative IPV from attenuated Sabin poliovirus or newly designed alternative seed strains. Pharm Pat Anal 2014; 1:589-99. [PMID: 24236927 DOI: 10.4155/ppa.12.70] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article gives an overview of the patent literature related to innovative inactivated polio vaccine (i-IPV) based on using Sabin poliovirus strains and newly developed alternative recombinant poliovirus strains. This innovative approach for IPV manufacturing is considered to attribute to the requirement for affordable IPV in the post-polio-eradication era, which is on the horizon. Although IPV is a well-established vaccine, the number of patent applications in this field was seen to have significantly increased in the past decade. Currently, regular IPV appears to be too expensive for universal use. Future affordability may be achieved by using alternative cell lines, alternative virus seed strains, improved and optimized processes, dose sparing, or the use of adjuvants. A relatively short-term option to achieve cost-price reduction is to work on regular IPV, using wild-type poliovirus strains, or on Sabin-IPV, based on using attenuated poliovirus strains. This price reduction can be achieved by introducing efficiency in processing. There are also multiple opportunities to work on dose sparing, for example, by using adjuvants or fractional doses. Renewed interest in this field was clearly reflected in the number and diversity of patent applications. In a later stage, several innovative approaches may become even more attractive, for example the use of recombinant virus strains or even a totally synthetic vaccine. Currently, such work is mainly carried out by research institutes and universities and therefore clinical data are not available.
Collapse
|
11
|
Pagliusi S, Leite LCC, Datla M, Makhoana M, Gao Y, Suhardono M, Jadhav S, Harshavardhan GVJA, Homma A. Developing Countries Vaccine Manufacturers Network: doing good by making high-quality vaccines affordable for all. Vaccine 2014; 31 Suppl 2:B176-83. [PMID: 23598479 DOI: 10.1016/j.vaccine.2012.11.060] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/19/2012] [Accepted: 11/19/2012] [Indexed: 11/18/2022]
Abstract
The Developing Countries Vaccine Manufacturers Network (DCVMN) is a unique model of a public and private international alliance. It assembles governmental and private organizations to work toward a common goal of manufacturing and supplying high-quality vaccines at affordable prices to protect people around the world from known and emerging infectious diseases. Together, this group of manufacturers has decades of experience in manufacturing vaccines, with technologies, know-how, and capacity to produce more than 40 vaccines types. These manufacturers have already contributed more than 30 vaccines in various presentations that have been prequalified by the World Health Organization for use by global immunization programmes. Furthermore, more than 45 vaccines are in the pipeline. Recent areas of focus include vaccines to protect against rotavirus, human papillomavirus (HPV), Japanese encephalitis, meningitis, hepatitis E, poliovirus, influenza, and pertussis, as well as combined pentavalent vaccines for children. The network has a growing number of manufacturers that produce a growing number of products to supply the growing demand for vaccines in developing countries.
Collapse
Affiliation(s)
- Sonia Pagliusi
- DCVMN International, Chemin du Canal 5, 1260 Nyon, Switzerland.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Van der Zeijst BAM. Vaccines and global stability: achievements and challenges. Expert Rev Vaccines 2014; 7:1457-60. [DOI: 10.1586/14760584.7.10.1457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
13
|
Enhancing the work of the Department of Health and Human Services national vaccine program in global immunization: recommendations of the National Vaccine Advisory Committee: approved by the National Vaccine Advisory Committee on September 12, 2013. Public Health Rep 2014; 129 Suppl 3:12-85. [PMID: 25100887 PMCID: PMC4121882 DOI: 10.1177/00333549141295s305] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
14
|
Hendriks J, Blume S. Measles vaccination before the measles-mumps-rubella vaccine. Am J Public Health 2013; 103:1393-401. [PMID: 23763422 PMCID: PMC4007870 DOI: 10.2105/ajph.2012.301075] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2012] [Indexed: 11/04/2022]
Abstract
At the beginning of the 1960s, it was clear that a vaccine against measles would soon be available. Although measles was (and remains) a killer disease in the developing world, in the United States and Western Europe this was no longer so. Many parents and many medical practitioners considered measles an inevitable stage of a child's development. Debating the desirability of measles immunization, public health experts reasoned differently. In the United States, introduction of the vaccine fit well with Kennedy's and Johnson's administrations' political commitments. European policymakers proceeded cautiously, concerned about the acceptability of existing vaccination programs. In Sweden and the Netherlands, recent experience in controlling polio led researchers to prefer an inactivated virus vaccine. Although in the early 1970s attempts to develop a sufficiently potent inactivated vaccine were abandoned, we have argued that the debates and initiatives of the time during the vaccine's early history merit reflection in today's era of standardization and global markets.
Collapse
Affiliation(s)
- Jan Hendriks
- International Support, Vaccinology Unit, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | | |
Collapse
|
15
|
Hendriks J, Holleman M, Hamidi A, Beurret M, Boog C. Vaccinology capacity building in Europe for innovative platforms serving emerging markets. Hum Vaccin Immunother 2013; 9:932-6. [PMID: 23563518 DOI: 10.4161/hv.23163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The 2012 Terrapinn World Vaccine Congress held from 16 to 18 October in Lyon addressed in a dedicated session the transfer of innovative vaccine technologies from Europe to emerging markets. Past and recent transfers and experiences from Europe's public domain were summarized by the Netherlands' National Institute for Public Health and the Environment (RIVM) in Bilthoven. The role of capacity building through training courses for developing country partners was highlighted in several recent technology transfer programs developed in collaboration with the World Health Organisation (WHO). In another stream of the Congress, a case of human vaccine technology transfer from Europe's private sector to an emerging economy recipient in India was presented. The continuing globalization of vaccinology is further illustrated by the recent acquisition in 2012 of the Netherlands' public vaccine manufacturing capacity in Bilthoven by the Serum Institute of India Ltd, an emerging vaccine manufacturer. In a parallel development, the Netherlands' government decided to transform RIVM's vaccinology research and development capacity into a new not-for-profit entity: "the Institute for Translational Vaccinology" (see citation 1 in Note section for web address). Under a public private partnership structure, InTraVacc's mission will include the fostering of global health through international partnerships in innovative vaccinology. Projected activities will include training courses and curricula, capitalizing on various currently established platform technologies and the legacy of previous "producer -producer" collaborations between the RIVM and emerging manufacturers over the past 40 y. It is suggested to consider this as a basis for a common initiative from Europe to develop and implement a practical vaccinology course for emerging countries with particular focus to the African region.
Collapse
Affiliation(s)
- Jan Hendriks
- Knowledge Transfer and Partnerships (KTP); Vaccinology Unit; National Institute for Public Health and the Environment (RIVM); Bilthoven, the Netherlands
| | | | | | | | | |
Collapse
|
16
|
Hendriks J. Technology transfer in human vaccinology: a retrospective review on public sector contributions in a privatizing science field. Vaccine 2012; 30:6230-40. [PMID: 22902679 DOI: 10.1016/j.vaccine.2012.07.087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 07/24/2012] [Accepted: 07/31/2012] [Indexed: 01/01/2023]
Abstract
As health intervention, vaccination has had a tremendous impact on reducing mortality and morbidity caused by infectious diseases. Traditionally vaccines were developed and made in the western, industrialised world and from there on gradually and with considerable delay became available for developing countries. Today that is beginning to change. Most vaccine doses are now produced in emerging economies, although industrialised countries still have a lead in vaccine development and in manufacturing innovative vaccines. Technology transfer has been an important mechanism for this increase in production capacity in emerging economies. This review looks back on various technology transfer initiatives and outlines the role of WHO and other public and private partners. It goes into a more detailed description of the role of the National Institute of Public Health and the Environment (RIVM) in Bilthoven, the Netherlands. For many decades RIVM has been providing access to vaccine technology by capacity building and technology transfer initiatives not only through multilateral frameworks, but also on a bilateral basis including a major project in China in the 90 s of the previous century. Looking forward it is expected that, in a globalizing world, the ambition of BRICS countries to play a role in global health will lead to an increase of south-south technology transfers. Further, it is argued that push approaches including technology transfer from the public domain, connecting innovative enabling platforms with competent developing country vaccine manufacturers (DCVM), will be critical to ensure a sustainable supply of affordable and quality vaccines to national immunization programmes in developing countries.
Collapse
Affiliation(s)
- Jan Hendriks
- Knowledge Transfer and Partnerships (KTP), Vaccinology Unit, Centre for Infectious Diseases (CIb), National Institute of Public Health and Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
| |
Collapse
|
17
|
Beurret M, Hamidi A, Kreeftenberg H. Development and technology transfer of Haemophilus influenzae type b conjugate vaccines for developing countries. Vaccine 2012; 30:4897-906. [DOI: 10.1016/j.vaccine.2012.05.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 03/23/2012] [Accepted: 05/23/2012] [Indexed: 10/28/2022]
|
18
|
Tarbet EB, Dorward JT, Day CW, Rashid KA. Vaccine production training to develop the workforce of foreign institutions supported by the BARDA influenza vaccine capacity building program. Vaccine 2012; 31:1646-9. [PMID: 22749796 DOI: 10.1016/j.vaccine.2012.06.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 06/14/2012] [Accepted: 06/14/2012] [Indexed: 11/18/2022]
Abstract
In the event of an influenza pandemic, vaccination will be the best method to limit virus spread. However, lack of vaccine biomanufacturing capacity means there will not be enough vaccine for the world's population. The U.S. Department of Health and Human Services, Biomedical Advanced Research and Development Authority (BARDA) provides support to the World Health Organization to enhance global vaccine production capacity in developing countries. However, developing a trained workforce in some of those countries is necessary. Biomanufacturing is labor-intensive, requiring unique skills not found in traditional academic programs. Employees must understand the scientific basis of biotechnology, operate specialized equipment, and work in an environment regulated by good manufacturing practices (cGMP). Therefore, BARDA supported development of vaccine biomanufacturing training at Utah State University. The training consisted of a three-week industry-focused course for participants from institutions supported by the BARDA and WHO influenza vaccine production capacity building program. The curriculum was divided into six components: (1) biosafety, (2) cell culture and growth of cells in bioreactors, (3) virus assays and inactivation, (4) scale-up strategies, (5) downstream processing, and (6) egg- and cell-based vaccine production and cGMP. Lectures were combined with laboratory exercises to provide a balance of theory and hands-on training. The initial course included sixteen participants from seven countries including: Egypt, Romania, Russia, Serbia, South Korea, Thailand, and Vietnam. The participant's job responsibilities included: Production, Quality Control, Quality Assurance, and Research; and their education ranged from bachelors to doctoral level. Internal course evaluations utilized descriptive methods including surveys, observation of laboratory activities, and interviews with participants. Generally, participants had appropriate academic backgrounds, but lacked expertise in vaccine production. All participants acknowledged the utility of the training, and many expressed interest in receiving additional support to implement new practices at their home institutions.
Collapse
Affiliation(s)
- E Bart Tarbet
- Institute for Antiviral Research, Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT, USA.
| | | | | | | |
Collapse
|
19
|
Abuduxike G, Aljunid SM. Development of health biotechnology in developing countries: can private-sector players be the prime movers? Biotechnol Adv 2012; 30:1589-601. [PMID: 22617902 DOI: 10.1016/j.biotechadv.2012.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 05/12/2012] [Accepted: 05/12/2012] [Indexed: 11/27/2022]
Abstract
Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor.
Collapse
Affiliation(s)
- Gulifeiya Abuduxike
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia.
| | | |
Collapse
|
20
|
An international technology platform for influenza vaccines. Vaccine 2011; 29 Suppl 1:A8-11. [DOI: 10.1016/j.vaccine.2011.04.124] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 04/28/2011] [Indexed: 11/21/2022]
|
21
|
Inactivated polio vaccine development for technology transfer using attenuated Sabin poliovirus strains to shift from Salk-IPV to Sabin-IPV. Vaccine 2011; 29:7188-96. [PMID: 21651934 DOI: 10.1016/j.vaccine.2011.05.079] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Industrial-scale inactivated polio vaccine (IPV) production dates back to the 1960s when at the Rijks Instituut voor de Volksgezondheid (RIV) in Bilthoven a process was developed based on micro-carrier technology and primary monkey kidney cells. This technology was freely shared with several pharmaceutical companies and institutes worldwide. In this contribution, the history of one of the first cell-culture based large-scale biological production processes is summarized. Also, recent developments and the anticipated upcoming shift from regular IPV to Sabin-IPV are presented. Responding to a call by the World Health Organization (WHO) for new polio vaccines, the development of Sabin-IPV was continued, after demonstrating proof of principle in the 1990s, at the Netherlands Vaccine Institute (NVI). Development of Sabin-IPV plays an important role in the WHO polio eradication strategy as biocontainment will be critical in the post-OPV cessation period. The use of attenuated Sabin strains instead of wild-type Salk polio strains will provide additional safety during vaccine production. Initially, the Sabin-IPV production process will be based on the scale-down model of the current, and well-established, Salk-IPV process. In parallel to clinical trial material production, process development, optimization and formulation research is being carried out to further optimize the process and reduce cost per dose. Also, results will be shown from large-scale (to prepare for future technology transfer) generation of Master- and Working virus seedlots, and clinical trial material (for phase I studies) production. Finally, the planned technology transfer to vaccine manufacturers in low and middle-income countries is discussed.
Collapse
|
22
|
Hotez P. A Handful Of ‘Antipoverty’ Vaccines Exist For Neglected Diseases, But The World’s Poorest Billion People Need More. Health Aff (Millwood) 2011; 30:1080-7. [DOI: 10.1377/hlthaff.2011.0317] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Peter Hotez
- Peter Hotez is president of the Sabin Vaccine Institute, in Washington, D.C., and Houston, Texas
| |
Collapse
|
23
|
Mahmoud A. A Global Road Map Is Needed For Vaccine Research, Development, And Deployment. Health Aff (Millwood) 2011; 30:1034-41. [DOI: 10.1377/hlthaff.2011.0391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Adel Mahmoud
- Adel Mahmoud ( ) is a professor in the Woodrow Wilson School of Public and International Affairs and the Department of Molecular Biology at Princeton University, in New Jersey
| |
Collapse
|
24
|
Abstract
A comprehensive 5-week vaccinology course was recently held in Paris (1 March-2 April 2010) hosted by the Institut Pasteur, a world-renowned center for science and vaccinology. A total of 25 young scientists from different parts of the world participated and 63 world experts gave lectures in six specific modules that covered all aspects of vaccinology, from basic research to clinical studies. Students also had the opportunity to attend a 2-day "Pandemic Influenza Workshop". This article summarizes the issues discussed during this course and highlights the importance of global access to vaccines.
Collapse
Affiliation(s)
- Emrah Altindiş
- Research Center, Novartis Vaccines and Diagnostics, Via Fiorentina, 1, 53100, Siena, Italy.
| |
Collapse
|
25
|
Mirzayeva R, Steele A, Parashar U, Zaman K, Neuzil K, Nelson E. Evaluation of rotavirus vaccines in Asia—Are there lessons to be learnt? Vaccine 2009; 27 Suppl 5:F120-9. [DOI: 10.1016/j.vaccine.2009.09.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
Stability testing of vaccines: Developing Countries Vaccine Manufacturers' Network (DCVMN) perspective. Biologicals 2009; 37:360-3. [PMID: 19717310 DOI: 10.1016/j.biologicals.2009.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 08/07/2009] [Indexed: 11/23/2022] Open
Abstract
Stability testing is an integral part of the vaccine manufacturing process and is crucial for the success of immunization programs. WHO (World Health Organization) has recently published guidelines on the stability testing of vaccines. These guidelines enlist scientific basis and principles for stability testing at various stages like development, pre-clinical, clinical, licensing, lot release and post-licensure monitoring. DCVMN (Developing Countries Vaccine Manufacturers' Network) is an international body of developing countries vaccine manufacturers and has viewpoints on technical and administrative issues in stability testing of vaccines. We here highlight viewpoints, possible roles and global expectations of DCVMN in the area of stability testing of vaccines.
Collapse
|
27
|
Global safety of vaccines: strengthening systems for monitoring, management and the role of GACVS. Expert Rev Vaccines 2009; 8:705-16. [PMID: 19485752 DOI: 10.1586/erv.09.40] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vaccines have contributed enormously in reducing the impact of many infectious diseases, and the expanded use of new and existing vaccines provides unprecedented potential for further reducing the global burden of infectious diseases. Yet, as with the deployment of other technologies, their use may also sometimes be associated with undesirable effects that need to be identified rapidly, understood and minimized. In this article, we review the models and systems that have been developed to monitor and respond to concerns regarding vaccine safety and we give illustrative examples of real or perceived vaccine safety issues. The Global Advisory Committee on Vaccine Safety (GACVS) was set up 10 years ago and charged to provide the WHO with independent advice on vaccine safety issues. The role of the GACVS is both to analyze and to interpret reports of the adverse effects of vaccines that impact on global vaccination programs and strategies, and to foster the development of improved surveillance systems to detect any adverse effects of vaccines, particularly in low- and middle-income countries. It also monitors the development of new vaccines during clinical testing and advises on the safe use of vaccines in immunization programs. As success is achieved with reducing the burden of vaccine-preventable diseases, there will be increasing attention focused on potential adverse effects, on the development of effective surveillance systems to detect adverse effects, and on improved methods to manage and control any harmful consequences of vaccination.
Collapse
|
28
|
Jadhav SS, Gautam M, Gairola S. Emerging markets & emerging needs: developing countries vaccine manufacturers' perspective & its current status. Biologicals 2009; 37:165-8. [PMID: 19328010 DOI: 10.1016/j.biologicals.2009.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 02/02/2009] [Indexed: 11/17/2022] Open
Abstract
The success of vaccination has remained an important contribution towards public health in both industrialised and developing countries. However, there are still unmet public health needs in vaccine preventable diseases owing to issues related to affordability, supply, public awareness, research and development, intellectual property, skilled human resource, etc. Various global initiatives are being taken to tackle such issues. DCVMN, Developing Country Vaccine Manufacturers' Network, is one of such novel initiatives by developing countries, and is playing an important role in facilitating cheaper and quality vaccines to children of the world. DCVMN has become an international body for emerging vaccine manufacturers from the developing world. This manuscript provides an overview of DCVMN with respect to its origin, objectives, achievements, limitations and expectations.
Collapse
Affiliation(s)
- Suresh S Jadhav
- Serum Institute of India Ltd, Hadapsar, Pune, Maharashtra, India.
| | | | | |
Collapse
|
29
|
Bottazzi ME, Brown AS. Model for product development of vaccines against neglected tropical diseases: a vaccine against human hookworm. Expert Rev Vaccines 2009; 7:1481-92. [PMID: 19053205 DOI: 10.1586/14760584.7.10.1481] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article provides an overview of the advances in product development and technology transfer of the vaccine against human hookworm, with particular emphasis on the lessons learned and the challenges of developing a vaccine in the nonprofit sector. The comprehensive approach to vaccine development established by the Human Hookworm Vaccine Initiative (HHVI) identifies key operational and technical aspects that are essential for a successful partnership with a developing country vaccine manufacturer. This article also highlights the importance of a global access roadmap to guide the vaccine development program. The advancement of new products for the control of neglected tropical diseases portends great challenges for global access, including aspects related to vaccine design, product development and manufacture, vaccine introduction and distribution, financing, knowledge dissemination and intellectual property management. With only three vaccines for neglected tropical diseases in clinical trials - hookworm, leishmaniasis and schistosomiasis - we are at the nascent stages of developing vaccines for neglected populations. Product development public-private partnerships, such as the HHVI, continue to show great promise on this front and will eventually provide significant control tools for achieving millennium development goals related to poverty reduction, as well as child and maternal health.
Collapse
Affiliation(s)
- Maria Elena Bottazzi
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, 2300 Eye Street NW, Ross Hall, Washington, DC 20037, USA.
| | | |
Collapse
|
30
|
Milstien J. Challenges and potential solutions to innovative vaccine development for developing countries. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.provac.2009.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|