Logistical challenges for potential SARS-CoV-2 vaccine and a call to research institutions, developers and manufacturers

Kartoğlu, Ümit; Moore, Kelly L.; Lloyd, John S.

doi:10.1016/j.vaccine.2020.06.056

Cited by 34 publications

(30 citation statements)

References 1 publication

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“…A SARS-CoV-2 vaccination campaign would be greatly facilitated if vaccine delivery were simplified. 19 While a one dose vaccine would be ideal, initial Phase 1 data indicate that two doses will likely be needed. 2 Nasal spray or transdermal patch vaccines that could be administered by trained lay persons would free skilled health workers to provide other essential services, but no such vaccines are currently in human trials.…”

Section: Discussionmentioning

confidence: 99%

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The operational impact of deploying SARS-CoV-2 vaccines in countries of the WHO African Region

Ortiz

Robertson

Hsu

et al. 2020

Preprint

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Background: After SARS-CoV-2 vaccines become available, they will be deployed to many countries with limited immunization systems. Methods: We conducted a cold chain capacity assessment of a simulated country in the WHO African Region. We combined region-specific data regarding immunization, population, healthcare workforce, and cold storage capacity (upper and lower range and quartile values for national and subnational levels). We used seasonal influenza vaccines as proxies for SARS-CoV-2 vaccines. We evaluated the increase in vaccine doses to be administered, doses administered per vaccinator, and cold storage volumes for SARS-CoV-2 campaigns targeting risk groups compared to routine immunization baselines. Findings: Compared to routine immunization, a SARS-CoV-2 vaccination campaign would increase monthly doses administered when targeting risk groups: ≥65 years (29.9%), chronic diseases patients (101.5%), and healthcare workers (1.2%). SARS-CoV-2 vaccination campaigns would increase doses administered per vaccinator for risk groups: ≥65 years (32.5%), chronic diseases patients (110.4%), or healthcare workers (1.4%). Routine vaccine volumes already exceed national level storage capacity for at least 75% of African Region countries, but subnational levels would have sufficient storage capacity for SARS-CoV-2 vaccines in all but the lower 25% of African Region countries. Interpretation: SARS-CoV-2 vaccination campaigns would substantially increase doses per vaccinator and cold chain capacity requirements over routine immunization baselines. Pandemic vaccination campaigns would add volume to national level stores already at their limits, but substantial capacity exists at subnational levels for SARS-CoV-2 vaccines. Immediate attention to strengthening delivery systems is essential to support pandemic vaccine responses in the African Region. Funding: None

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Section: Discussionmentioning

confidence: 99%

“…15 Vaccine vials used in most developing countries carry individual thermo-chemical temperature monitors that indicate when a vial has been outside of the recommended storage temperature range and should be discarded. 18 , 19 …”

Section: Methodsmentioning

confidence: 99%

The operational impact of deploying SARS-CoV-2 vaccines in countries of the WHO African Region

Ortiz

Robertson

Hsu

et al. 2020

Preprint

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“…Storage requirements will be enormous and the vaccine may need to be either frozen or refrigerated, presenting cold-chain issues. The decision about whether to prepare the vaccine in single-dose or multi-dose vials will impact manufacturing, storage, delivery and potential infection risks ( 182 ). Infrastructure and manpower will be required to distribute and administer the vaccine.…”

Section: Potential Challenges In Sars-cov-2 Vaccine Developmentmentioning

confidence: 99%

Progress and Pitfalls in the Quest for Effective SARS-CoV-2 (COVID-19) Vaccines

et al. 2020

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There are currently around 200 SARS-CoV-2 candidate vaccines in preclinical and clinical trials throughout the world. The various candidates employ a range of vaccine strategies including some novel approaches. Currently, the goal is to prove that they are safe and immunogenic in humans (phase 1/2 studies) with several now advancing into phase 2 and 3 trials to demonstrate efficacy and gather comprehensive data on safety. It is highly likely that many vaccines will be shown to stimulate antibody and T cell responses in healthy individuals and have an acceptable safety profile, but the key will be to confirm that they protect against COVID-19. There is much hope that SARS-CoV-2 vaccines will be rolled out to the entire world to contain the pandemic and avert its most damaging impacts. However, in all likelihood this will initially require a targeted approach toward key vulnerable groups. Collaborative efforts are underway to ensure manufacturing can occur at the unprecedented scale and speed required to immunize billions of people. Ensuring deployment also occurs equitably across the globe will be critical. Careful evaluation and ongoing surveillance for safety will be required to address theoretical concerns regarding immune enhancement seen in previous contexts. Herein, we review the current knowledge about the immune response to this novel virus as it pertains to the design of effective and safe SARS-CoV-2 vaccines and the range of novel and established approaches to vaccine development being taken. We provide details of some of the frontrunner vaccines and discuss potential issues including adverse effects, scale-up and delivery.

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“…1 ). In particular, transport and storage of vaccines present a significant obstacle, especially in developing countries and remote areas (Kartoglu et al 2020 ). Who is running faster—the virus or the vaccine—will not only depend on when the vaccines become available but where and how we vaccinate a global population in a safe and most efficient manner.…”

Section: Lab-to-jabmentioning

confidence: 99%

“…For instance, manufacturers firstly need to test the effectiveness of vaccines in the widest possible temperature ranges (Zipursky et al 2011 ), and make their data accessible to allow enough time of preparation for the upcoming logistics. Thermostable vaccines, albeit difficult to develop, is one way to circumvent these issues (Kartoglu et al 2020 ).…”

Section: Bumpy Roadmentioning

confidence: 99%