Overview of the global vaccine ecosystem

ABSTRACT

Introduction

Vaccination is an effective, relatively inexpensive, and easy to deliver approach to combating infectious diseases. Widespread vaccination of children has led to the eradication of smallpox and allowed for regional elimination or control of diseases like polio, measles, mumps, tetanus, diphtheria, and whooping cough. But, as we learned from efforts to combat the COVID-19 pandemic, a successful global vaccination program must overcome several hurdles. Failure at any stage can limit vaccine uptake and disease control.

Areas covered

In this review, we break down the vaccine journey from research and development to delivery into several steps. We also list all the important international organizations trying to support this ecosystem. Then we identify the role of each of these organizations in supporting each of the necessary steps for a successful vaccination program.

Expert opinion

The bottlenecks in vaccination can be different for different countries, based on their income and geography. Policy makers need to identify the weaknesses of this ecosystem in different regions of the world and make sure there is adequate global and local support to fill the gaps in the system.

KEYWORDS:

• Vaccine
• vaccine ecosystem
• vaccine market
• global vaccination
• pandemic
• covid-19
• outbreaks
• vaccination policy

Article highlights

• The vaccine ecosystem is complex, with many different public and private organizations each attempting to advance vaccines along the different stages of the vaccine development pathway. In this paper, we review these different stages, from basic R&D to ‘shots in arms,’ and identifying all the major organizations globally that are active at each stage.

• The vaccine development pathway starts with basic research, proceeding through clinical development for manufacturing, regulatory approval, procurement, and delivery.

• There are a large number of international players in the vaccine ecosystem involved at each stage, including multilateral organizations, philanthropic organizations, governmental institutions, non-governmental organizations (NGOs), and vaccine companies. These organizations interact in various ways, including through formal partnerships.

• These international players can be grouped into funders, facilitators, or implementers. Funders provide the necessary money for filling the gaps in each stage. Facilitators come up with needed supporting policies and coordination strategies. Implementers bring the supporting policies into action.

Declaration of interest

J Moradpour is supported by a MITACs post-doctoral fellowship which is supported by the Government of Canada and Sanofi. S O. Besada-Lombana Castro and A Chit are employees of Sanofi and may hold shares and/or stock options in the company. P Grootendorst has consulted for both generic and branded drug companies on pharmaceutical intellectual property-related issues. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they are a vaccine scientist and developer for global health COVID vaccines. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

Javad Moradpour wrote the paper. Paul Grootendorst, Sandra O. Besada-Lombana Castro and Ayman Chit helped with designing the research question, and revised the paper for important intellectual content.

Acknowledgments

We warmly thank Emmanuel Audusseau and Alejandra Martinez for their advice and feedback. Moreover, two summer students Abhishek Chopra and Abraam Ghattas, assisted us with collecting information about international organizations. We have these persons’ permission to mention their names in the manuscript for publication.

Data availability statement

All data sources used in this paper are publicly available.

Additional information

Funding

This study was supported by a seed funding grant from the Leslie Dan Faculty of Pharmacy at the University of Toronto. The open-access fees for this publication were paid by Sanofi.