Pandemic influenza vaccines: meeting the supply, distribution and deployment challenges
Pandemic influenza vaccines: meeting the supply, distribution and deployment challenges
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DOI：
10.1111/j.1750-2659.2009.00085.x
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发表时间：
2009-07-01
影响因子：
4.4
通讯作者：
Hessel, Luc
中科院分区：
文献类型：
--
作者：
Hessel, Luc
流感大流行将给世界疫苗生产、分配和管理系统带来巨大压力。在宣布大流行之后，疫苗行业的首要任务将是在尽可能短的时间内提供尽可能多的疫苗。针对这一挑战，生产商已成功制定了保留抗原的战略，并大幅提高了产能，并计划在对季节性疫苗需求持续增长的情况下进一步增长。这些因素结合在一起，有可能通过增加大流行和大流行前疫苗的供应，比以往任何时候都更好地满足全球对疫苗供应的需求。与H5N1病毒的交叉进化枝反应性的证明使大流行前储备和接种该亚型疫苗的概念成为现实。确保及时向需要者提供这些疫苗将是一项重大挑战。对于地方当局、国家政府和国际组织来说，这意味着要确定疫苗分配和采购流程，加强并在必要时建立疫苗部署所需的关键卫生系统和基础设施。对于疫苗生产商来说，这意味着解决与供应有关的技术和后勤问题。这包括与监管机构合作，简化关键程序，包括通用标签和批次放行，同时建立供应形式的灵活性，包括散装和成品，以最大限度地提高交付速度。同样，在紧急情况下部署大量疫苗需要适当的运输基础设施和相关医疗用品的分配。除了解决这些问题外，还必须具体考虑与储存大流行前疫苗有关的后勤和储存问题。最后，生产商与政府或国际机构之间相互商定的合同安排是应对供应挑战和帮助疫苗生产商满足国内和国际需求的最佳方法。为了有效，这些合同应基于准确的预测、明确的疫苗接种战略和公共卫生基础设施的能力。
P>An influenza pandemic will place an enormous strain on the world's vaccine production, distribution and administration systems. Following a pandemic declaration, industry's priority will be to deliver as much vaccine in as short a timeframe as possible. In respect to this challenge, manufacturers have successfully developed antigen-sparing strategies and significantly increased production capacity, with further growth planned assuming ongoing rising demand for seasonal vaccines. The combination of these factors has the potential to closer meet global needs for vaccine supply than ever before through increased availability of pandemic and pre-pandemic vaccines. The demonstration of cross-clade reactivity with H5N1 viruses makes the concept of pre-pandemic stockpiling and vaccination a reality for this subtype. Ensuring these vaccines are made available in a timely fashion to those who need them will present significant challenges. For local authorities, national governments and international organisations this means defining vaccine allocation and procurement processes as well as strengthening, and where necessary establishing, the critical health systems and infrastructure required for vaccine deployment. For vaccine producers this means addressing the technical and logistical issues associated with supply. This includes working with regulators to streamline key procedures, including generic labelling and batch release, while establishing flexibility in supply formats, including bulk and finished products, to maximise the speed of delivery. Similarly, the deployment of large quantities of vaccines in an emergency situation requires appropriate transport infrastructure and the distribution of associated medical supplies. As well as addressing these issues, specific consideration must be given to the logistics and storage aspects associated with stockpiling pre-pandemic vaccines. Finally, mutually agreed contractual arrangements between manufacturers and governments or international institutions represent the best approach toward addressing supply challenges and assisting vaccine producers meet national and international demand. To be effective, these contracts should be based on accurate forecasts, clearly defined vaccination strategies and the capabilities of public health infrastructure.