Value of Vaccines - Q4 2021

Q4 2021 | A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its content

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Value of Vaccines

02 Emla cream.

To avoid the

OUCH! of needles

The world must be prepared to prevent the next “Disease X” from becoming a pandemic. ~James Anderson Executive Director, Global Health, IFPMA

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The lack of sustainable access [to vaccines] in many low-income countries puts millions of lives at risk. ~Dr Philippa Whitford MP Chair, APPG on Vaccinations for All

Apply Emla before vaccines, blood tests or jabs to reduce needle pain. Emla can also be used before tattoos and cosmetic needles.

Emla cream. For topical anaesthesia of the skin. Always read the label. Aspen Pharmacare UK Limited.UK-LIDP-11-21-00007. November 2021.

pharmacy-strength numbing cream

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IN THIS ISSUE

Supporting vaccine rollout in developing countries.

Dr Juan Pablo Uribe Global Director for Health, Nutrition and Population, World Bank

Ramping up and sustaining the production of vaccines

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The biopharmaceutical industry stands ready to partner in current and future efforts for pandemic preparedness.

Vaccine trial participants support a vaccine for the world.

Dr Samantha Vanderslott University Research Lecturer Dr Kate Emary Clinical Research Fellow, Oxford Vaccine Group

ONLINE

Learning lessons from the implementation of COVID-19 vaccinations.

Dr Lisa Cameron MP Chair, All-Party Parliamentary Group on Health Becky Rice Head of Health, Policy Connect

ONLINE

@HealthawarenessUK

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t is difficult to predict the nature of the next health threat. We do not know where, how or when it will hit.

What we know is that playing catch is a lost battle.

In a matter of months, vaccine developers and manufacturers have developed multiple COVID-19 vaccines and forged collaborations to ramp up production. Decades of scientific exploration and investment enabled technologies such as mRNA and viral vector COVID-19 vaccines. But next time we can be even faster, if there is sufficient, sustainable financing and technical assistance to support early procurement and country readiness.

Building back better The world must be prepared to prevent the next “Disease X” from becoming a pandemic. The G7 agreed to a vision for a 100-day response to an emerging threat, shrinking the already unprecedented 326 days achieved for first COVID-19 vaccine approval.

The biopharmaceutical industry has committed to invest in R&D on pathogens with pandemic potential and to build a portfolio of promising candidate vaccines. It will also continue to invest in “established” and new mRNA technologies, seeking ways to strengthen immune response and duration of protection whilst looking at reducing manufacturing complexity.

Industry will play its part alongside other key stakeholders to be as well prepared as we can be. It will require a multi-layered effort to build systems, infrastructure and an effective global governance to ensure relevant stakeholders are utilised, coordinated and integrated around agreed shared objectives. A comprehensive multilateral commitment for immediate sharing of pathogens and data is needed to ensure that no time is lost, alongside global clinical trial infrastructure, regulatory convergence and reliance.

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The G7 agreed to a vision for a 100-day response to an emerging threat, shrinking the already unprecedented 326 days achieved for first COVID-19 vaccine approval.

Upscaling vaccines for pandemic preparedness In building back better, we aim for enough vaccines to be produced for deployment around the world within the first 100 days of a pandemic. A strategic vision and roadmap for flexible, sustainable global manufacturing capacity needs to be developed with relevant public and private stakeholders, accounting for the extensive COVID-19 vaccine production capacity, location of new capacity across all regions and expert staff ready to deliver surge volumes when needed.

Creating demand for vaccine manufacturing capacities during inter-pandemic times The goal should be to achieve a healthy market dynamic over time, including in inter-pandemic periods that provides appropriate incentives to balance global access and innovation. Demand for lifelong immunisation will not only improve health and wellbeing but will also build the needed vaccine delivery infrastructure and sustain manufacturing capacity.

WRITTEN BY

James Anderson Executive Director, Global Health, IFPMA

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The power of vaccines to help protect us throughout life Vaccination is one of the most successful and cost-effective public health tools available.1 Taking up the offer of a vaccine when eligible helps us to protect not only ourselves but also the wider community.

T WRITTEN BY Susan Rienow Head of Vaccines, Pfizer UK

he COVID-19 pandemic has undoubtedly been a tragedy, but it has also brought out the best in humanity. We’ve seen ingenuity and innovation on a scale rarely seen, with the public and private sector – scientists, medical professionals and politicians – working together in search of a common goal.

The anniversary of the start of the COVID-19 vaccine rollout provides an opportunity to reflect on all that has been achieved over the past 20 months.

As healthcare providers and public bodies valiantly tackled the immediate impact of the disease, the pharmaceutical and life sciences industry stepped up too.

The power of immunisation The pandemic has also, once again, demonstrated the power of immunisation, as one of the most successful and cost-effective public health tools available.2 Its impact can be measured not just in terms of direct health benefits, but in terms of economic ones too: reducing healthcare costs, decreasing lost labour productivity, and contributing to social and economic development.

We must take action and ensure that the vaccines we have access to in the UK today do more to protect us throughout our lives, from childhood through to old age.

The value of vaccination across the life course A key part of this is understanding the value of vaccinations over the course of life and especially into older age. The UK continues to see high vaccination rates in children, and we should be rightly proud of our successful childhood immunisation programme.

However, while last year’s decision to expand eligibility for the winter flu vaccination programme via the NHS was a significant moment, much more could be done to improve the awareness and uptake of vaccines in adults.

Vaccination is critical to the Government’s Autumn and Winter Plan. An increase in vaccinepreventable respiratory diseases, such as influenza and pneumococcal disease, has the potential to add substantially to the pressures already facing the UK’s health service.

Ageing populations also place stress on health systems and vaccinating people throughout their lives is a clear example of where a greater emphasis on prevention could significantly improve both our nation’s health and our nation’s economic prosperity.1 Over 70s are eligible for vaccination against shingles, but by the age of 77 around one in four are still unvaccinated.3 Just one in eight 65-year-olds were immunised against pneumococcal READ MORE AT HEALTHAWARENESS.CO.UK

disease in England between April 2019 and March 2020 despite the NHS recommending it as part of the routine immunisation schedule.4 Protecting our most vulnerable from these diseases and keeping them out of hospital, by taking up the offer of a vaccine when eligible, is not just the right thing to do, it will relieve the burden on the NHS too.

Paid for by Pfizer

Barriers to uptake There are still many barriers to uptake, including lack of access, misinformation, complacency and health inequalities. This needs to change.

We must take action and ensure that the vaccines we have access to in the UK today do more to protect us throughout our lives, from childhood through to old age. Much has been learnt from the pandemic about how we manage our health and about the value of vaccination, particularly in helping to protect older adults. Now is the time for the UK to consolidate these learnings so we can more ably manage another winter where there will be acute additional pressure on the health service exacerbated by respiratory diseases.

Given the demonstrable benefit to public health, we all have a duty to be aware of vaccine eligibility and take action to protect ourselves, our communities and our health service. With a renewed focus on keeping people well, rather than just making them better, and by adopting a missionled approach, we believe that we can contribute to a more sustainable NHS and build a healthier and more resilient future for Britain.

This content has been developed and paid for by Pfizer UK. References 1. ABPI. What are the economic and societal impacts of vaccines? Available at: https://www.abpi.org.uk/new-medicines/vaccines/economic-and-social-impactof-vaccines/. [Accessed November 2021] 2. WHO, Vaccine Effectiveness and Protection. Available at: https://www.who.int/ news-room/feature-stories/detail/vaccine-efficacy-effectiveness-and-protection [Accessed November 2021] 3. PHE. Shingles (quarter 1) vaccine coverage report (adults eligible from April to June 2020 and vaccinated to end of September 2020) in England. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/939915/hpr2320_shngls-vc.pdf. [Accessed November 2021] 4. PHE. Pneumococcal Polysaccharide Vaccine (PPV) coverage report, England, April 2019 to March 2020. Available at: https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/attachment_data/file/899458/hpr1320_ ppv-vc.pdf. [Accessed November 2021]

Find out more at pfizer.co.uk PP-VAC-GBR-2003 November 2021

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Achieving vaccine equity through robust data Real-time temperature data monitoring of vaccine storage fridges is a critical step towards more effective immunisation programmes in lowand-middle-income countries.

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eliable data is a key component in helping achieve greater vaccine equity. Central to that is access to and utilisation of real-time data to ensure vaccines are always stored at the correct temperatures so they remain effective and deliver immunity.

Temperature monitoring As donations of COVID-19 vaccines to poorer countries continue, there remains a gap between distribution and effective delivery of doses. This is according to non-profit technology company Nexleaf Analytics, which partners with countries to make sure they have the data they need to improve the health of their people.

Nexleaf has created a real-time temperature monitoring device that alerts health officials to fridges that are too warm, or if there are power outages, which could see vaccines kept at the wrong temperature, rendering them less effective, or ineffective. The data is stored on a dashboard, allowing health staff to remotely monitor the performance of cold chain equipment and effectively plan for fridge maintenance or replacements.

The company’s CEO and Co-Founder, Nithya Ramanathan, underlines the importance of strong data systems to monitor vaccine cold chain temperatures and also help in better planning and execution of vaccine distribution and delivery in low-and-middle-income countries.

Sustainable solutions With increased global investment in vaccine systems in response to COVID, now is a critical time to ensure that these investments not only benefit the current delivery of COVID vaccines but for a range of vaccines needed for existing and potential future conditions.

Vaccine equity Ramanathan also emphasises that the needs of low-and-middle-income countries have to be listened to, enabling them to take ownership of their data and health resources with sustainable country-led solutions.

She points to Kenya’s success in delivering 1.1 million doses of COVID vaccine across the country in two months, achieved by having access and ownership of its cold chain management and vaccine distribution data to find and use existing fridges that worked.

“Our goal is vaccine equity and having strong data systems and infrastructure in place is absolutely necessary for achieving that,” says Ramanathan.

INTERVIEW WITH

Nithya Ramanathan CEO and Co-Founder, Nexleaf Analytics WRITTEN BY

Mark Nicholls

Paid for by Nexleaf Analytics Find out more at nexleaf.org/

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Lack of international action on global vaccination puts lives at risk Lower income countries are in desperate need of access to life saving vaccines, but with cuts to the overseas aid budget, the hoarding of vaccines and broken promises, millions of lives are being threatened.

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he eradication of smallpox and near eradication of wild polio are testament to the efficacy of vaccines in protecting us from lifechanging or fatal diseases. Their importance has been amplified with the spread of COVID-19.

The success of the COVID vaccine roll out In late 2020, the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) gave the green light to the use of the Pfizer and AstraZeneca vaccines. The health services of the four UK nations subsequently rolled out the vaccines at an incredible pace and achieved very high coverage, a scientific and logistical endeavour that deserves high praise.

Lack of access for lower income countries Last spring, as the warm words emanating from the international community combined with the billions invested by governments into vaccine R&D, hopes were high that the COVID-19 pandemic would inspire an equitable global response. High international vaccine coverage was rightly determined to be key in ending the pandemic.

However, the successful vaccine rollout in the UK contrasts with a lack of access for lower income countries, where only 2% of the population have been vaccinated. Expressions of solidarity have been undermined by rich countries, including the UK, hoarding vaccines and failing to fulfil their promises to donate excess doses. Shockingly, only 6% of the 80 million doses promised by the UK, through the WHO’s COVAX mechanism, have been distributed so far.

Although dose sharing is necessary, it is also vital to expand overall global production if we are to vaccinate the world’s population and limit the pandemic. Unfortunately, the UK is among the countries limiting the sharing of intellectual property and technology which would allow manufacturing to be significantly scaled up.

Shockingly, only 6% of the 80 million doses promised by the UK, through the WHO’s COVAX mechanism, have been distributed so far.

A call for action While the UK and other wealthy countries enjoy access to life saving vaccines, both for COVID-19 and other vaccine-preventable diseases such as polio and tetanus, the lack of sustainable access in many low-income countries puts millions of lives at risk. The UK has consistently championed the improvement of health globally through vaccination, but the ongoing cuts to the overseas aid budget, such as the 95% cut to polio-eradication funding, are undermining that reputation.

The failure of the international community to ensure equitable dose sharing and massive expansion of production will result in the COVID-19 virus continuing to circulate in unvaccinated populations.

Our actions directly threaten the lives of millions of people and risk the emergence of further vaccineresistant variants.

WRITTEN BY Dr Philippa Whitford MP Chair, APPG on Vaccinations for All, MP for Central Ayrshire

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Collaboration in the race to develop a COVID vaccine

syringes which have been distributed globally to support vaccination programmes, with over 102 million syringes for the vaccination programme in the UK and Ireland.

“I think collaboration from government, health-tech, [pharma], and the NHS and HSE to vaccinate patients has been an incredible success story.”

But he stresses the need for further development in terms of more efficient vaccines and better delivery of those vaccines to patients, including via the use of pre-filled syringes.

Cohesive and coordinated partnerships across governments, industry and healthcare were a critical facet of the race to develop and deliver vaccines during the COVID-19 pandemic.

A INTERVIEW WITH Tony Kirk Country Business Leader, Medication Delivery Solutions, BD WRITTEN BY Mark Nicholls

s COVID-19 swept the globe, an urgent drive was launched to implement restrictions to slow the spread and join the race for a vaccine.

Yet beyond ground-breaking research and science to develop the vaccine, there were logistical issues of manufacturing, distributing and delivering the vaccine across populations. Global med-tech company Becton Dickinson (BD), the world’s largest manufacturer of syringes, was among industry partners involved in aspects of the vaccine development.

Vaccine response Tony Kirk, BD’s Country Business Leader for Medication Delivery Solutions (UK and Ireland), explains

the company provided products for the research process, clinical trials, developed point-of-care diagnostic tests, as well as supporting delivery of vaccinations.

Underlining the importance of collaboration in the process of an effective vaccine response, he says: “Collaboration is paramount. In the COVID pandemic, if we did not have collaboration, we would not have achieved what we did, at the pace we did in the past 18 months.

“There was a call to action globally to develop a vaccine in record time.

We have been able to produce that in terms of developing a vaccine and then delivery to patients and as a company, I feel we have really contributed to that.”

To date, BD has produced two billion

Openness and transparency Alongside collaboration, he emphasises the need for transparency, openness, forward-planning and information sharing at a time of pandemic.

“One of the key lessons learned from COVID is the need for governments to engage early with med-tech to identify the most effective way to deliver vaccines, but also in terms of capacity and supply-chain resilience,” adds Kirk.

“We know that there have been some challenges in terms of vaccines and volume required but globally, the response to the pandemic was a remarkable success. Although there are learnings we need to take away, particularly in terms of speed of decision making and transparency.

“But partnership and collaboration with government and drug companies is key in the future of handling these pandemics.”

Paid for by BD

Find out more at bd.com/en-uk

However, the successful vaccine rollout in the UK contrasts with a lack of access for lower income countries, where only 2% of the population have been vaccinated. ~Dr Philippa Whitford MP Chair, APPG on Vaccinations for All, MP for Central Ayrshire

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Microneedle patch technology is helping deliver vaccines faster A new ceramic skin patch is being used as a rapid response to control outbreak situations. It is also helping deliver vaccinations more easily and efficiently.

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ike de Leeuw, CEO of MyLife Technologies, the pharmaceutical company which has created the ceramic skin patch for vaccine delivery says: “With only five grams of mRNA-vaccine, basic field labs can produce up to one million vaccine patches within a few days to protect healthcare workers as a virus outbreak unfolds, anywhere in the world. Today, with standard jabs, that is less than 50,000.”

MyLife Technologies has partners in a clinical trial using an approved mRNA COVID-19 vaccine. It is demonstrating the benefits of their patches with HPV vaccines for low-and-middle-income countries; and it is accelerating scale-up to full-scale manufacturing.

Alternative vaccine delivery The ‘patch’ is smaller than a fingertip and features a hundred, minute ceramic microneedles. De Leeuw says: “These microneedles are like a ceramic sponge, yet are very strong and can carry, stabilise and quickly release most types of vaccines.

They are applied within 30 seconds like any other skin patch. The microneedle tips never touch a nerve or a blood vessel, making vaccination painless.”

Microneedle patch-technology is listed number one for the future of global vaccination by VIPS, the largest NGOconsortium evaluating vaccine technology.

This is because top layers of the skin contain specialised immune cells that process vaccines against viruses and bacteria.

Delivering vaccine in the first 150-400 micron of skin is much more efficient than vaccination with jabs into muscle tissue, where these cells are not found normally.

The company has shown efficacy in Influenza-A trials in animals, and it successfully demonstrated safety/ tolerability with human volunteers.

Various clinical trials with different vaccines have shown that skin vaccination requires 5-20 times less vaccine to achieve equivalent protection compared to standard jabs.

De Leeuw concludes: “We offer our patches for NGO-backed projects to speed-up vaccinations in LMIC’s. Our ceramic patches avoid needle stick anxiety and can eliminate expensive cold chain distribution. Especially with HPV, the cause of many smaller cancer diseases, this can help to raise the vaccination rate in adolescents worldwide.”

INTERVIEW WITH

Mike G.W. de Leeu CEO, MyLife Technologies BV WRITTEN BY Mireille in’t Veld

Paid for by MyLife Technologies mylifetechnologies.nl

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Supporting vaccine rollout in developing countries Equitable access to vaccines is key to stop the spread of COVID-19, yet just 4% of people in low-income countries are vaccinated.

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o save lives around the world, COVID-19 vaccines must be shared more equitably and become widely available in low- and middleincome countries. However, obtaining enough vaccines is only the first hurdle. To get shots into arms rapidly, developing countries have to be prepared and equipped for mass vaccination.

Following a needs assessment conducted in more than 140 countries, the World Bank committed $20 billion to help countries purchase vaccine doses and strengthen their health infrastructure to prepare for vaccination rollout.

By explaining the benefits of vaccination, countries can combat misinformation and improve vaccination uptake.

A complex and massive task Large-scale immunisation campaigns involve complicated operations from the moment vaccines arrive at the border until they reach their intended recipients. After identifying the most vulnerable people and setting priorities, countries need to boost their health infrastructure, equip health centres, expand storage and cold chains while also training the health workers who will carry out the vaccination. Transport to remote areas often requires complex logistical planning.

Supporting countries and addressing specific needs Beyond access to vaccines, needs vary from one country to the next. In Ecuador, for example, the World Bank financing is helping the country to purchase vaccines, manage supply chains and logistics for storage and handling, and provide PPE for health workers. In Nepal, World Bank financing helps strengthen the health system and procure diagnostic tests, laboratory equipment and therapeutics. The country is also expanding surveillance and monitoring – crucial to track vaccination progress – using digital technology.

Overcoming vaccine hesitancy Community engagement and outreach are critical to the success of COVID-19 vaccination campaigns. By explaining the benefits of vaccination, countries can combat misinformation and improve vaccination uptake. After early immunisation efforts faced resistance, Cote d’Ivoire launched an awarenessraising drive, enlisting the help of media influencers, religious and community leaders and local elected officials to reach the population. Within a few weeks, daily vaccination rates increased tenfold.

With just 4% of people vaccinated in low-income countries, efforts to prevent the spread of COVID-19 and mitigate its impact are still ongoing. We will continue to work with countries and partners like the COVAX facility and the Africa Vaccine Acquisition Trust to make life saving vaccines available to all everywhere.

WRITTEN BY Dr Juan Pablo Uribe Global Director for Health, Nutrition and Population, World Bank

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Ensuring vaccine self-sufficiency for every global region

livelihoods, as well as to the rise of variant viruses. We are learning the hard way that infectious diseases can spread anywhere unless they are stopped everywhere.

Creating regional vaccine ecosystems To increase vaccine access, effectiveness and uptake worldwide, we must abandon the “one size fits all” approach to vaccine R&D and make it more regionally responsive. That means building the entire vaccine ecosystem—spanning discovery through development, clinical trials, manufacturing, distribution and administration—to meet the specific needs of each region, along with the necessary infrastructure and workforce.

Establishing vaccine ecosystems in each global region will make the whole world healthier, safer and more prosperous. Estimates of the investment necessary to accomplish this comprise a tiny fraction of what COVID-19 has already cost the global economy. Now is the time for national governments, donors, and development banks to recognise the value of regionally responsive vaccine ecosystems and to provide the ongoing investment necessary to create and sustain them.

Inequitable vaccine distribution has exacerbated the COVID-19 crisis for the world’s poorest populations and prolonged the pandemic. Regional vaccine self-sufficiency will boost global health and economic security.

WRITTEN BY Stacey L. Knobler, MSc Vice President, Vaccine Innovation and Global Immunization, Sabin Vaccine Institute

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stonishingly effective vaccines against COVID-19 were created, tested and manufactured in an all-out push to stop the pandemic. That effort has fallen short in part because wealthy countries locked up access to an outsized share of those vaccines and not for the first time: a similar scenario occurred during the 2009 H1N1 influenza pandemic. To meet future pandemic threats that inevitably will arise—as well as pressing local needs—every global region must gain the ability to discover, develop, manufacture and distribute vaccines.

Recognising the value of vaccines A growing body of evidence shows that vaccines offer far more than disease protection.

Vaccinated populations enjoy increased educational economic productivity and financial security, along with reduced healthcare expenditures and pressure on health systems. Vaccines therefore not only

improve the lives of the individuals who receive them, but also their households, their communities and the whole of society. Gaining these benefits requires investment in vaccine R&D infrastructure to serve the entire world, not just wealthy countries. It is time to build capacity in every global region—and especially in the Global South—to deliver vaccines tailored to local needs that are safe, effective and affordable.

Expanding vaccine access Today, vaccine R&D largely happens in the high-income countries from which vaccine makers reap most of their profits. There has been little privatesector interest in pursuing vaccines against diseases such as malaria and tuberculosis that mainly threaten low- and middle-income countries.

Similarly, there is little profit incentive in designing vaccines for places that lack refrigeration, or where needle injections are culturally unacceptable or difficult to administer safely.

These constraints limit the benefits of vaccination in much of the world and, in the COVID-19 pandemic, have contributed to the loss of lives and

To meet future pandemic threats that inevitably will arise—as well as pressing local needs—every global region must gain the ability to discover, develop, manufacture and distribute vaccines.

Building back better While COVID-19 exposed gaps in global pandemic preparedness, it also proved the value of several novel vaccine technologies, most notably the potentially adaptable mRNA platforms.

The “plug-and-play” design of mRNA vaccines, and their relative simplicity of manufacture, puts them within reach of countries that now lack vaccine infrastructure. It also makes possible the production of vaccines to stop viral threats whenever and wherever they emerge, forestalling future pandemics. mRNA vaccines and other advances spurred by the COVID-19 experience offer the technical means to better prepare the world for pandemics to come. When regionally responsive vaccine ecosystems exploit such breakthroughs to protect local populations from a myriad of viral threats, we truly will have “built back better.”

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