Vaccine innovation prioritisation strategy: Findings from three country-stakeholder consultations on vaccine product innovations

Abstract

As part of the Vaccine Innovation Prioritisation Strategy (VIPS), three immunization-stakeholder consultations were conducted between September 2018 and February 2020 to ensure that countries’ needs drove the prioritization of vaccine product innovations. All consultations targeted respondents with immunization program experience. They included: (1) an online survey to identify immunization implementation barriers and desired vaccine attributes in three use settings, (2) an online survey to identify and evaluate the most important immunization challenges for ten exemplar vaccines, and (3) in-depth interviews to better understand the perceived programmatic benefits and challenges that could be addressed by nine innovations and to rank the innovations that could best address current challenges. The first consultation included responses from 442 participants in 61 countries, representing 89% of the 496 respondents who correctly completed at least one section of the online survey. For facility-based settings, missed opportunities for vaccination due to reluctance to open multidose vaccine vials was the barrier most frequently selected by respondents. In community-based (outreach) and campaign settings, limited access to immunization services due to geographic barriers was most frequently selected. Multidose presentations with preservative or single-dose presentations were most frequently selected as desired vaccine attributes for facility-based settings while improved thermostability was most frequently selected for outreach and campaign settings. The second online survey was completed by 220 respondents in 54 countries. For the exemplar vaccines, vaccine ineffectiveness or wastage due to heat or freeze exposure and missed opportunities due to multidose vial presentations were identified as the greatest vaccine-specific challenges. In-depth interviews with 84 respondents in six countries ranked microarray patches, dual-chamber delivery devices, and heat-stable/controlled temperature chain qualified liquid vaccines as the three innovations that could have the greatest impact in helping address current immunization program challenges. These findings informed the VIPS prioritization and provided broader application to designing immunization interventions to better meet country needs.

Controlled temperature chain for vaccination in low- and middle-income countries: a realist evidence synthesis

“… 35 We anticipated vaccine damage due to cold chain failures (freezing or heat exposure) to be a contextual driver of controlled temperature chain demand. While in two surveys, national and global stakeholders saw utility of such approach to avert these problems, 41 , 46 vaccine damage as a driver of demand was only cited in four unique implementations. 16 , 17 , 21 , 34 , 36 …”

“…Three surveys indicated that 72% (18/25) to 75% (21/28) of national and global policy-makers showed a demand for controlled temperature chain use. 19 , 41 , 46 Awareness raised through policy adaptations, including WHO endorsement for controlled temperature chain-relevant storage of the HepB birth dose, predicated uptake in two implementations. 20 , 22 Awareness via endorsement from implementation partners was noted to influence uptake by health ministries in oral cholera vaccine and tetanus toxoid-containing vaccine experiences.…”

“… 24 , 28 , 29 , 40 , 42 However, fears of higher vaccine procurement costs, training feasibility and use of controlled temperature chain leading to poor cold chain practices dampened stakeholders’ demand for the controlled temperature chain. 19 , 41 , 46 …”

Immunogenicity of COVID-eVax Delivered by Electroporation Is Moderately Impacted by Temperature and Molecular Isoforms

“…Although this issue has been faced in the smallpox global vaccination campaign [ 28 ], it became more evident for the novel mRNA-based vaccines that currently require continuous storage at ultra-cold temperatures, which is not feasible in many parts of the world. The need for thermostable vaccines had already been recognized before the COVID-19 pandemic, for example, in a study by the Vaccine Innovation Prioritization Strategy (VIPS) [ 29 ], in which the ability to withstand heat exposure was identified as the most desired characteristic for vaccines used in outreach and campaign settings by experienced immunization staff. Lack of vaccine thermostability leads to limited or no access to vaccinations by people living in remote areas or low-resource settings.…”

Meeting Summary: Global Vaccine and Immunization Research Forum, 2021

“…To improve vaccine administration, VIPS has assessed innovative technologies and conducted stakeholder consultations to develop consensus on what new vaccine technologies are needed to increase coverage. VIPS partners are now accelerating the advancement of selected new technologies [39] , [40] , [41] .…”