A vaccine supply setback

It wasn’t until I became involved with the issue of pandemic influenza that I realized vaccines were a finite commodity produced by a finite manufacturing infrastructure. Vaccine availability was just something I took for granted. If the world should enter a pandemic phase there will be many who come to the same understanding I did several years ago: Vaccines are a finite commodity with a finite manufacturing infrastructure.

Such a sterile sounding phrase as the above doesn’t give expression to the human anguish that will be experienced if we experience an influenza pandemic prior to solving the vaccine manufacturing problems. Currently the world’s vaccine manufacturing capacity is [optimistically] thought to be ~1.5 billion non-adjuvanted vaccines ¹ with 24/7 operation of facilities. We need to halve that figure though because a novel strain such as H5N1 would require a two-dose vaccination, leaving us with 750 million people covered by conventional vaccine technology/capacity. And, to be clear – that’s the world’s annual production capacity.

There are many scattered around the globe who are working to solve the vaccine supply problem. Efforts are aimed at increasing capacity as well as utilization of adjuvants and non-egg based technology. Given enough time we will solve the vaccine supply problem, but no one knows how much time we have to work on the problem.

Advancements are meaningful because they translate to an increase in the number of people being protected. Conversely, every set back carries a potential increase in victims than otherwise might have been.

Given the need to increase manufacturing capacity I read this from the Taiwan News with disappointment:

Taiwan puts vaccine project on hold

A build-own-operate (BOO) project to manufacture influenza vaccine has been called off after years of delays, delivering a setback to the country’s ambitious plan to be the first developing country to build an independent and self-sufficient vaccine manufacturing capacity, government and pharmaceutical industry sources said last week.

The project, which was launched in 2004, will be put on hold, as an operation plan submitted by Dutch pharmaceutical company Akzo Nobel was rejected by the Department of Health (DOH) earlier this month for failing to meet criteria stipulated in the Act for Promotion of Private Participation in Infrastructure Projects, a senior DOH official said on condition of anonymity.

Continues…

The push to have production capacity within one’s own country is driven by the assumption that if a pandemic happens the countries with capacity will not allow any vaccine to be exported to another until all of their own citizenry is vaccinated. This is the very reason the United States has invested in bolstering its own capacity, and even with that bolstering our own capacity is woefully inadequate.

The influenza vaccine is not the only vaccine that has a finite production capacity far less than what a pandemic situation would need. The pneumonia vaccine, recently highlighted with the publication of pneumonia’s role in the illness severity of an influenza infection ², is even more limited than the influenza vaccine.

I often wonder how many others “out there” have the same uninformed view of vaccines as I had several years ago: you need a vaccine and it is there for your arm’s receiving.