Vaccine Shortage Research Articles

A perspective on the widening gap between Covishield vaccine doses in India

The Oxford University-AstraZeneca’s vector-based vaccine called Covishield (ChAdOx1 nCoV- 19 Vaccine) is being manufactured and distributed by Serum Institute of India (SII). National roll out of this vaccine was in a phased manner starting from 16th January 2021. At present, many states are facing shortage of vaccines. Government of India kept changing its policy on dosing gap of Covishield vaccine based on researches. The latest recommendation citing “real-life evidence” from the UK is to extend the two doses of Covishield to 12-16 weeks. This reasonable approach will not only a breathing space for the government but also aids in free up doses for a larger number of people to get their first dose of the vaccine.

National introduction of HPV vaccination in Senegal—Successes, challenges, and lessons learned

Following successful school-based demonstration programs in 2014–2016, the human papillomavirus (HPV) vaccine was introduced nationwide in Senegal for 9-year-old girls in 2018, using a routine service delivery strategy at health facilities, schools, and other outreach sites. We reviewed the HPV vaccine introduction in Senegal to understand the successes, challenges, and lessons learned.Focusing on three key domains (program decision-making, planning, and implementation), we conducted ten semi-structured interviews during 2019–2020 with purposively selected national-level stakeholders (government, expert advisory committee, key technical and implementation partners) and comprehensive desk reviews of country documents on HPV vaccine introduction.Due to the global HPV vaccine shortage, the introduction was limited to a single-age cohort; therefore, 9-year-old girls were chosen. This strategy enabled Senegal to potentially reach more girls in primary education because school enrolment rates decline thereafter. Vaccination through routine delivery platforms (i.e., health facility, school-based, and community outreach) was perceived to be more cost-effective than a campaign approach. High-level political commitment and collaborations between immunization and education partners were frequently cited by key informants as reasons for a successful vaccine introduction. All key informants reported that the health care worker (HCW) strike, rumors, and vaccine hesitancy negatively impacted the introduction. Other challenges noted included insufficient information on attitudes towards HPV vaccination among HCWs, teachers, and community members.Senegal successfully introduced HPV vaccine into the national immunization schedule, using a routine delivery strategy. Strong leadership and a multi-sectoral approach likely contributed to this success. To build sustainability of the HPV vaccination program in the future, it is important to improve the understanding and engagement among all stakeholders, including HCWs and community members, and to strengthen and innovate communication and crisis management strategies. To better understand the efficiency and effectiveness of Senegal's vaccination strategy, additional assessments of the operational costs and coverage achieved are needed.

COVID-19 vaccination campaign trends and challenges in select Asian countries

ABSTRACT How successful have countries in Asia been at vaccinating their populations against COVID-19? What explains the broadly similar pace of rollout across countries in the region despite diverse governance capacities, demographic compositions, resources and economies? This paper presents a comparative analysis of the planning and implementation of national vaccination drives against COVID-19 across 21 South and East Asian countries. We advance an analytical framework to understand the different challenges countries encounter and distinguish three key factors on both the national and international level—vaccine shortages, governance capacity for mass vaccination and vaccine hesitancy. We apply the analytical framework to national vaccination drives, offering a snapshot of countries’ vaccination progress as of early 2021, and conclude with general trends for the COVID-19 vaccine rollout across the region.

Physical activities, nutrition, and mental health of people in the community during the outbreak of coronavirus disease 2019: A review study

Background: At the end of December 2019, the spread of a new infectious disease was reported in Wuhan, China, which was officially named coronavirus disease 2019 (COVID-19) by the World Health Organization. The epidemic not only causes high rates of death due to viral infections but also has led to psychological catastrophe worldwide. Uncertainty and unpredictability of this disease have created a high potential for psychological fear of disease transmission. To prevent further outbreaks of COVID-19, it may be necessary to adopt such measures as non-pharmacological interventions, quarantine, and social distancing due to vaccine shortages. However, the implementation of these health policies, despite the positive consequences, has created negative psychological effects on society. Fear of disease, fear of death, spread of false news and rumors, and reduction of social relations threaten the health of people in society. It is not yet clear that how much and to what extent this issue will affect mental health in such long-term social isolation. It is supposed that the post-COVID-19 era will be coincided with the emergence of a large number of individuals with such problems as anxiety, obsession, hypochondriasis, depression, and mental disorders. Therefore, the adoption of appropriate solutions to prevent these consequences would contribute people to be encouraged to move from a loneliness and introversion state to an active and energetic one. Regular physical activity and exercise and proper nutrition can be among the ways to prevent such mental disorders.

Single-Dose Messenger RNA Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 in Healthcare Workers Extending 16 Weeks Postvaccination: A Test-Negative Design From Québec, Canada.

IntroductionIn Canada, first and second doses of mRNA vaccines against SARS-CoV-2 were uniquely spaced 16 weeks apart, but the duration of single-dose protection remains uncertain. We estimated one- and two-dose mRNA vaccine effectiveness (VE) among healthcare workers (HCWs) in Quebec, Canada including protection against varying outcome severity, variants of concern (VOC), and the stability of single-dose protection out to 16 weeks post-vaccination.MethodsA test-negative design compared vaccination among SARS-CoV-2 test-positive and weekly-matched (10:1), randomly-sampled, test-negative HCWs using linked surveillance and immunization databases. Vaccine status was defined by one dose ≥14 days or two doses ≥7 days before illness onset or specimen collection. Adjusted VE was estimated by conditional logistic regression.ResultsPrimary analysis included 5,316 cases and 53,160 controls. Single-dose VE was 70% (95%CI: 68-73) against SARS-CoV-2 infection, 73% (95%CI: 71-75) against COVID-19 illness and 97% (95%CI: 92-99) against associated hospitalization. Two-dose VE was 86% (95%CI: 81-90) and 93% (95%CI: 89-95), respectively, with no associated hospitalizations. VE was higher for non-VOC than VOC (73% Alpha) among single-dose (77%, 95%CI: 73-81 versus 63%, 95%CI: 57-67) but not two-dose recipients (87%, 95%CI: 57-96 versus 94%, 95%CI: 89-96). Across 16 weeks, no decline in single-dose VE was observed with appropriate stratification based upon prioritized vaccination determined by higher versus lower likelihood of direct patient contact.ConclusionOne mRNA vaccine dose provided substantial and sustained protection to HCWs extending at least four months post-vaccination. In circumstances of vaccine shortage, delaying the second dose may be a pertinent public health strategy to consider.

Profile of patients wishing to be vaccinated against Covid-19 in primary care practice

In the context of a coronavirus pandemic, immunization of the population is a priority task for the reduction of the virus. The participation of general practitioners in the immunization campaign is crucial to ensure rapid access to vaccination for any interested citizen. A study was made of the health and demographic profile of the patients who expressed a desire to be vaccinated in primary care practice in the city of Varna, in the fourth phase of the National Vaccination Plan for Covid-19 - immunization of vulnerable groups of patients in order to determine whether they meet the criteria for vaccination and how to optimize it in conditions of vaccine shortage. The results show that the majority of those wishing to be vaccinated are around 65 years old and have chronic diseases - cardiovascular, oncological, respiratory diseases. The formation of groups among those wishing to be vaccinated according to the risk of serious illness (low risk and high risk) is proposed, as well as according to the willingness of patients for vaccination (without contraindications, with contraindications, requiring additional consultations).

SOCIO-POLITICAL DETERMINANTS OF SUSTAINABILITY OF IMMUNIZATION COVERAGE IN RESOURCE-CONSTRAINED TERTIARY HEALTH INSTITUTIONS IN BENUE STATE, NIGERIA

Background: Sustainability and healthy preservation of human species is feasible via the instrument of childhood immunization. In Nigeria, this cost-effective strategy (immunization) is targeted at the vulnerable groups who are mostly pregnant women and children under five years of age. Aim: This study assessed childhood immunization coverage and the determinants of its full coverage among children between the ages of 0-12 months in tertiary health centres in Makurdi, according to National Programme of Immunization (NPI) schedule. Materials and Methods: The study used a mix-methodology relating the sustainable development theory and sound deductive reasoning with a cross-sectional study design via the instrument of a structured questionnaire. The determinants of full coverage of childhood immunization were considered in relation to parents/guardians, children, tertiary health facilities and other factors like man-made/ natural disasters, religious and political factors from secondary data. Results: The results of the study generally revealed optimum coverage (95-100%) of childhood immunization according to NPI schedule. Shortage of vaccines at the health facilities, child illness and “no reasons” were revealed determinants of full immunization coverage after analysis. Conclusion and Recommendations: The health of the future generation will be more secured if the Government and parents/guardians join hands in ensuring effective and timely immunizations of her/their children through appropriate legislation, provision of potent vaccines and tackling of the prevailing security challenges.
 
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Comparison of SARS-CoV-2- and HCoV-Specific T Cell Response Using IFN-γ ELISpot.

Herd immunity is essential to control severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), especially in immunocompromised patients. Convalescent individuals should be vaccinated later due to vaccine shortage, as studies show that neutralizing antibodies generated during infection are stable for at least 6 months. Cellular immunity is also detectable for months. However, there is evidence of cross-reactivity of T cells with human endemic coronaviruses (HCoVs). Here, we show that cross-reactivity—which may prevent the specific detection of SARS-CoV-2-specific T cell responses—can be avoided if cells are stimulated with the N-terminus of the spike protein in IFN-γ ELISpot. In contrast to previous studies, we examined T-cell responses against all four known HCoVs using IFN-γ ELISpot in 19 convalescent volunteers and 10 fully vaccinated volunteers. In addition, we performed Spearman analyses to detect cross-reactivity of T cells. We observed no correlation between T-cell responses against SARS-CoV-2 and human endemic coronaviruses, either in the whole cohort or in the individual groups. The use of the respective stimuli could lead to a more accurate assessment of cellular immunity in recovered individuals. This testing procedure could help to define the best time point at which convalescents should receive SARS-CoV-2 vaccination.

COVID-19 Vaccination in Lower-Middle Income Countries: National Stakeholder Views on Challenges, Barriers, and Potential Solutions.

The development of COVID-19 vaccines does not imply the end of the global pandemic as now countries have to purchase enough COVID-19 vaccine doses and work towards their successful rollout. Vaccination across the world has progressed slowly in all, but a few high-income countries (HICs) as governments learn how to vaccinate their entire populations amidst a pandemic. Most low- and middle-income countries (LMICs) have been relying on the COVID-19 Vaccines Global Access (COVAX) Facility to obtain vaccines. COVAX aims to provide these countries with enough doses to vaccinate 20% of their populations. LMICs will likely encounter additional barriers and challenges rolling out vaccines compared HICs despite their significant experience from the Expanded Programme on Immunisation (EPI). This study explores potential barriers that will arise during the COVID-19 vaccine rollout in lower-middle-income countries and how to overcome them. We conducted sixteen semi-structured interviews with national-level stakeholders from Ghana and Bangladesh (eight in each country). Stakeholders included policymakers and immunisation programme experts. Data were analysed using a Framework Analysis technique. Stakeholders believed their country could use existing EPI structures for the COVID-19 vaccine rollout despite existing challenges with the EPI and despite its focus on childhood immunisation rather than vaccinating the entire population over a short period of time. Stakeholders suggested increasing confidence in the vaccine through community influencers and by utilising local government accredited institutions such as the Drug Authorities for vaccine approval. Additional strategies they discussed included training more health providers and recruiting volunteers to increase vaccination speed, expanding government budgets for COVID-19 vaccine purchase and delivery, and exploring other financing opportunities to address in-country vaccine shortages. Stakeholders also believed that LMICs may encounter challenges complying with priority lists. Our findings suggest that COVID-19 vaccination is different from previous vaccination programs, and therefore, policymakers have to expand the EPI structure and also take a systematic and collaborative approach to plan and effectively rollout the vaccines.

The COVID-19 pandemic increased the demand for pneumococcal vaccination in Japan

ABSTRACT Although routine vaccinations in children decreased during the coronavirus disease 2019 (COVID-19) pandemic, pneumococcal vaccine coverage in older adults has remained unknown. This study was performed to investigate the impact of the COVID-19 pandemic on pneumococcal vaccination in Japan. The numbers of 23-valent pneumococcal polysaccharide vaccines (PPV23) shipped was obtained from an office memorandum released by the Ministry of Health, Labor and Welfare. The results showed that the COVID-19 pandemic increased the need for pneumococcal vaccination, causing shipping restrictions of pneumococcal vaccines. Regular vaccination is still important because there may be a shortage of vaccines during a pandemic.

Towards integrated production of an influenza A vaccine candidate with MDCK suspension cells.

Seasonal influenza epidemics occur both in northern and southern hemispheres every year. Despite the differences in influenza virus surface antigens and virulence of seasonal subtypes, manufacturers are well-adapted to respond to this periodical vaccine demand. Due to decades of influenza virus research, the development of new influenza vaccines is relatively straight forward. In similarity with the ongoing coronavirus disease 2019 pandemic, vaccine manufacturing is a major bottleneck for a rapid supply of the billions of doses required worldwide. In particular, egg-based vaccine production would be difficult to schedule and shortages of other egg-based vaccines with high demands also have to be anticipated. Cell culture-based production systems enable the manufacturing of large amounts of vaccines within a short time frame and expand significantly our options to respond to pandemics and emerging viral diseases. In this study, we present an integrated process for the production of inactivated influenza A virus vaccines based on a Madin-Darby Canine Kidney (MDCK) suspension cell line cultivated in a chemically defined medium. Very high titers of 3.6 log10 (HAU/100 µl) were achieved using fast-growing MDCK cells at concentrations up to 9.5 × 106 cells/ml infected with influenza A/PR/8/34 H1N1 virus in 1 L stirred tank bioreactors. A combination of membrane-based steric-exclusion chromatography followed by pseudo-affinity chromatography with a sulfated cellulose membrane adsorber enabled full recovery for the virus capture step and up to 80% recovery for the virus polishing step. Purified virus particles showed a homogenous size distribution with a mean diameter of 80 nm. Based on a monovalent dose of 15 µg hemagglutinin (single-radial immunodiffusion assay), the level of total protein and host cell DNA was 58 µg and 10 ng, respectively. Furthermore, all process steps can be fully scaled up to industrial quantities for commercial manufacturing of either seasonal or pandemic influenza virus vaccines. Fast production of up to 300 vaccine doses per liter within 4-5 days makes this process competitive not only to other cell-based processes but to egg-based processes as well.

Biomaterials and Oxygen Join Forces to Shape the Immune Response and Boost COVID-19 Vaccines.

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has led to an unprecedented global health crisis, resulting in a critical need for effective vaccines that generate protective antibodies. Protein subunit vaccines represent a promising approach but often lack the immunogenicity required for strong immune stimulation. To overcome this challenge, it is first demonstrated that advanced biomaterials can be leveraged to boost the effectiveness of SARS‐CoV‐2 protein subunit vaccines. Additionally, it is reported that oxygen is a powerful immunological co‐adjuvant and has an ability to further potentiate vaccine potency. In preclinical studies, mice immunized with an oxygen‐generating coronavirus disease 2019 (COVID‐19) cryogel‐based vaccine (O2‐CryogelVAX) exhibit a robust Th1 and Th2 immune response, leading to a sustained production of highly effective neutralizing antibodies against the virus. Even with a single immunization, O2‐CryogelVAX achieves high antibody titers within 21 days, and both binding and neutralizing antibody levels are further increased after a second dose. Engineering a potent vaccine system that generates sufficient neutralizing antibodies after one dose is a preferred strategy amid vaccine shortage. The data suggest that this platform is a promising technology to reinforce vaccine‐driven immunostimulation and is applicable to current and emerging infectious diseases.

Prioritizing the First Doses of SARS-CoV-2 Vaccine to Save the Elderly: The Case Study of Italy.

SARS-CoV-2 is currently causing hundreds of deaths every day in European countries, mostly in not yet vaccinated elderly. Vaccine shortage poses relevant challenges to health authorities, called to act promptly with a scarcity of data. We modeled the mortality reduction of the elderly according to a schedule of mRNA SARS-CoV-2 vaccine that prioritized first dose administration. For the case study of Italy, we show an increase in protected individuals up to 53.4% and a decrease in deaths up to 19.8% in the cohort of over 80's compared with the standard vaccine recalls after 3 or 4 weeks. This model supports the adoption of vaccination campaigns that prioritize the administration of the first doses in the elderly.

Nutritional Impact and Its Potential Consequences on COVID-19 Severity.

Background: During late 2019 a viral disease due to a novel coronavirus was reported in Wuhan, China, which rapidly developed into an exploding pandemic and poses a severe threat to human health all over the world. Until now (May 2021), there are insufficient treatment options for the management of this global disease and shortage of vaccines. Important aspects that help to defeat coronavirus infection seems to be having a healthy, strong, and resilient immune system. Nutrition and metabolic disorders, such as obesity and diabetes play a crucial role on the community health situation in general and especially during this new pandemic. There seems to be an enormous impact of lifestyle, metabolic disorders, and immune status on coronavirus disease 2019 (COVID-19) severity and recovery. For this reason, it is important to consider the impact of lifestyle and the consumption of well-defined healthy diets during the pandemic.Aims: In this review, we summarise recent findings on the effect of nutrition on COVID-19 susceptibility and disease severity and treatment. Understanding how specific dietary features might help to improve the public health strategies to reduce the rate and severity of COVID-19.

Process intensification for the production of yellow fever virus-like particles as potential recombinant vaccine antigen.

Yellow fever (YF) is a life-threatening viral disease endemic in parts of Africa and Latin America. Although there is a very efficacious vaccine since the 1930s, YF still causes 29,000-60,000 annual deaths. During recent YF outbreaks there were issues of vaccine shortage of the current egg-derived vaccine; rare but fatal vaccine adverse effects occurred; and cases were imported to Asia, where the circulating mosquito vector could potentially start local transmission. Here we investigated the production of YF virus-like particles (VLPs) using stably transfected HEK293 cells. Process intensification was achieved by combining sequential FACS (fluorescence-activated cell sorting) rounds to enrich the stable cell pool in terms of high producers and the use of perfusion processes. At shaken-tube scale, FACS enrichment of cells allowed doubling VLP production, and pseudoperfusion cultivation (with daily medium exchange) further increased VLP production by 9.3-fold as compared to batch operation mode. At perfusion bioreactor scale, the use of an inclined settler as cell retention device showed operational advantages over an ATF system. A one-step steric exclusion chromatography purification allowed significant removal of impurities and is a promising technique for future integration of upstream and downstream operations. Characterization by different techniques confirmed the identity and 3D-structure of the purified VLPs.

БЮДЖЕТНІ МОЖЛИВОСТІ УКРАЇНИ ЩОДО ФІНАНСУВАННЯ ВАКЦИНАЦІЇ ПРОТИ COVID-19 В УМОВАХ РОЗВИТКУ ГЛОБАЛЬНОГО РИНКУ ВАКЦИН

Оцінено бюджетні можливості України щодо проведення вакцинації проти COVID-19 в умовах становлення нового глобального ринку вакцин. Розкрито засади сучасного етапу формування глобального ринку вакцин проти COVID-19. Визначено передумови формування глобального дефіциту вакцин проти COVID-19, які спричинені, передусім, обмеженнями і глобальною нестачею виробничих потужностей вакцин і дефіцитом сировини та компонентів для їх виробництва. Виявлено фактори формування політики ціноутворення на сучасному глобальному ринку вакцин проти COVID-19, основними з яких є: невизначеність і широкий діапазон встановлених виробниками цін на вакцини; високий рівень конкуренції між виробниками вакцин і боротьба за захоплення більшого сегмента глобального ринку; гостра конкуренція між державами за доступ до потенційно необхідного обсягу доз вакцин. Показано розрив у доступі до вакцин проти COVID-19 у розвинутих країнах і країнах, які розвиваються, що поглиблює нерівність між ними в плані постпандемічного економічного відновлення. Акцентовано увагу на тому, що повільна і нерівномірна вакцинація проти COVID-19 зумовлює втрати ВВП як у розвинутих країнах, так і в країнах, що розвиваються. Розглянуто один з підходів міжнародних інституцій, застосування якого на практиці може сприяти подоланню глобального дефіциту вакцин і стимулювати їх виробництво, а саме тимчасова відмова від захисту інтелектуальної власності та патентів на вакцини проти COVID-19. Доведено необхідність збільшення бюджетних можливостей для проведення вакцинації проти COVID-19 в Україні з метою досягнення колективного імунітету і захисту різних груп населення.

COVID-19 Vaccine: A Case of Compulsory Licensing for Social Utility!

After a long and tough battle with COVID-19, people were given a ray of hope with the emergence of vaccines across the globe. However, it is safe to say that things have not quite gone according to plan. Vaccine shortages, debates over patents, hoarding, re-infections despite vaccines etc. have taken over the discourse. In this paper, the authors seek to examine one of these aspects: the need to treat vaccines as a “social utility” tool essential for saving lives worldwide. We will delve into the compulsory licensing prospects in India, the debate around the recent patent-waiver calls on vaccines, and the dilemma between IP rights and social utility for COVID-19 vaccines. India and South Africa have led the calls for this waiver based on concerns of supply and price affordability. In this backdrop, we shed light on the process and need for compulsory licensing for the vaccine in India and how, in a sense, India is contradicting its call on the international front and its efforts back home, domestically. “Necessity is the mother of innovation” – but what happens when that innovation does not reach those for whom it is a necessity? The legal dilemma arises when the jurisprudence of public welfare entangles with the jurisprudence of patent law under the principles of Intellectual Property Rights.The epidemic of COVID-19 has led to the development of the COVID-19 vaccine. The pharmaceutical sector has been upfront to develop a cure to bring normalcy back into the world. There have been billions of dollars invested to develop the vaccine and the institutions have secured a patent on the technology and the formula. The conclusive standing shall be observed by understanding the legislative intent under the Indian Patents Act 1970 (hereinafter referred to as “the Act”).

A qualitative interview study with parents to identify barriers and drivers to childhood vaccination and inform public health interventions

ABSTRACT Vaccination coverage in the Federation of Bosnia and Herzegovina, in Bosnia and Herzegovina, has been declining since 2014. This qualitative study aimed to identify barriers and drivers to childhood vaccination for parents. The COM-B (capability-opportunity-motivation-behavior) model was the underpinning theoretical framework. Face-to-face interviews with 22 parents of fully (n = 6), delayed/partially vaccinated (n = 9) and unvaccinated (n = 7) children were conducted. Interviews explored individual factors (capability–knowledge and skills; motivation–attitudes, confidence and trust) and context factors (physical opportunity–information, access, health systems; and social opportunity – social support, norms). Data were analyzed in NVivo using content analysis exploring differences in COM factors by vaccination status and location. Parents of fully vaccinated children typically reported individual and context drivers to vaccination. They accepted vaccination, trusted health workers, and were content with services. Parents of delayed/partially vaccinated children fell into two subgroups: (1) Those who accepted vaccination and attributed delays to their organizational skills or frustration with appointment times. (2) Those fitting the profile of “vaccine hesitant” – generally valuing vaccination and health worker advice, yet with concerns often triggered by media/social media. Parents of unvaccinated children mentioned individual and context barriers to vaccination, notably significant concerns about safety, some distrust of health workers and resentment of mandatory vaccination. Urban/rural differences included urban parents being more likely to report experiences with vaccine shortages and very few had received information leaflets. The study identified complex and inter-related barriers and drivers to parents’ childhood vaccination behaviors. These insights have informed the development of tailored interventions to improve coverage.

Deep GRU-CNN Model for COVID-19 Detection From Chest X-Rays Data.

In the current era, data is growing exponentially due to advancements in smart devices. Data scientists apply a variety of learning-based techniques to identify underlying patterns in the medical data to address various health-related issues. In this context, automated disease detection has now become a central concern in medical science. Such approaches can reduce the mortality rate through accurate and timely diagnosis. COVID-19 is a modern virus that has spread all over the world and is affecting millions of people. Many countries are facing a shortage of testing kits, vaccines, and other resources due to significant and rapid growth in cases. In order to accelerate the testing process, scientists around the world have sought to create novel methods for the detection of the virus. In this paper, we propose a hybrid deep learning model based on a convolutional neural network (CNN) and gated recurrent unit (GRU) to detect the viral disease from chest X-rays (CXRs). In the proposed model, a CNN is used to extract features, and a GRU is used as a classifier. The model has been trained on 424 CXR images with 3 classes (COVID-19, Pneumonia, and Normal). The proposed model achieves encouraging results of 0.96, 0.96, and 0.95 in terms of precision, recall, and f1-score, respectively. These findings indicate how deep learning can significantly contribute to the early detection of COVID-19 in patients through the analysis of X-ray scans. Such indications can pave the way to mitigate the impact of the disease. We believe that this model can be an effective tool for medical practitioners for early diagnosis.

Better Pandemic Influenza Preparedness through Adjuvant Technology Transfer: Challenges and Lessons Learned.

Adequate global vaccine coverage during an influenza pandemic is essential to mitigate morbidity, mortality, and economic impact. Vaccine development and production needs to be sufficient to meet a vast global demand, requiring international cooperation and local vaccine production capacity, especially in resource-constrained countries. The use of adjuvants is one approach to augment the number of available vaccine doses and to overcome potential vaccine shortages. Appropriately selected adjuvant technologies can decrease the amount of vaccine antigen required per dose, may broaden or lengthen the conferred protection against disease, and may even allow protective single-dose vaccination. Here we describe a technology transfer collaboration between Switzerland and Indonesia that led to the establishment of a vaccine formulation platform in Surabaya which involved the transfer of equipment and expertise to enable research and development of adjuvanted vaccine formulations and delivery systems. This new Indonesian capability aims to facilitate local and regional access to know-how relating to adjuvanted vaccine formulations, thus promoting their application to local vaccine developers. In this review, we aim to share the “lessons learned” from this project to both support and inspire future scientific collaborations of a similar nature.