May 4, 2010
VANCOUVER, British Columbia — Creative vaccine distribution strategies, improved vaccine technologies and more rapid manufacturing timetables were among ideas speakers at the 2010 Pediatric Academic Societies proposed during a symposium on vaccine-preventable diseases in the developing world.
Kathleen M. Neuzil, MD, MPH, professor of medicine at the University of Washington, senior advisor for immunizations at PATH, both in Seattle, and Advisory Committee on Immunization Practices member said that the lessons learned during this past season’s influenza A (H1N1) pandemic can be applied to distributing vaccines to people in low-resource settings.
“The virus was detected and characterized in record time, manufacturing capacity was at all time high and there were rapid organization and distribution efforts,” Neuzil said. “But we didn’t have enough vaccine, we didn’t get it out soon enough and distribution was not equitable.”
She noted that although H1N1 peaked during the third week of October in 2009, many physicians offices did not get the vaccine until much later, and many developing countries are just now getting their first allotment of H1N1 vaccine.
As director of PATH’s Influenza Vaccine Project, Neuzil and colleagues are exploring live-attenuated, recombinant and adjuvant vaccine approaches, as well as more broadly reactive antigens that offer more cross-protection, with longer-lasting immunity than the typical one or two years.
“Most of these are still in very early development,” Neuzil said.
Although the United States and Canada now have universal influenza vaccine recommendations, Neuzil acknowledged that this is a difficult goal to achieve, and highly unpractical for many countries.
Taking a high risk approach may be a more logistically sound strategy. Data from a randomized controlled trial that involved 340 pregnant Bangladesh women who received influenza vaccine, revealed that babies whose mothers received vaccine experienced a 28% reduction in illness compared with the control group.
Furthermore, influenza specific antibodies were higher among vaccinated mothers and infants, and infant geometric mean titers sampled at birth from cord blood were comparable to levels measured in the mother’s serum, according to Neuz.