By Philip Dormitzer, global head of vaccines research and development, GSK
The vaccines landscape has changed greatly over the last few years in light of the COVID-19 pandemic. New technologies have been applied at scale, innovative vaccine programs rolled out, and supply chains rearranged to help tackle global health challenges. But, while innovation has improved vaccine efficacy, global vaccine uptake can vary, and a decrease in vaccine coverage could put populations at risk.1
A decline in vaccination coverage is especially notable for those at increased risk, such as older adults, as it can disrupt ‘herd immunity’, a way of indirectly reducing transmission and mortality among populations 2 .
As we age, the function of our immune system declines, leaving us at higher risk from many vaccine-preventable diseases. With more than 20% of the EU population currently aged 65 and over3, and this population expected to represent one in four persons living in Europe and North America by 20504, we need to find effective and tailored approaches to help protect older adults.
The swift development, approval and global roll-out of COVID-19 vaccines was a chief achievement of a new ‘golden era’ for vaccine innovation. Scientific activity in vaccines is increasing, as seen in the 91% increase in clinical trials related to vaccines starting between 2020-2021 compared with 2019-20205. Innovations and technologies that scientists like me saw as promising and leading edge when entering this field, such as mRNA vaccines and structure-based antigen design, have become part of the daily lives of vaccine researchers.
The need for new vaccines and technologies is more important than ever. With changes in human demography, encroachment of human populations into natural ecosystems, a changing climate, and increased globalization, the odds of viruses from animal reservoirs threatening human populations has increased dramatically6.
Multiple solutions needed
Recently, the term “tripledemic” was used to describe the intersection of illnesses caused by influenza virus, RSV, and SARS-CoV-2. These viruses – on their own and more so together – threatened not only at-risk populations, such as those over 65, but also health systems globally – demonstrating the need for multiple innovative solutions to protect from infectious respiratory diseases beyond flu.
The accelerated progress in immunization is not limited to the development of new vaccines to counter viruses but also vaccines to combat long-developing issues such as antimicrobial resistance (AMR). AMR has been declared as one of the top 10 global public health threats by the WHO, and with antibiotics becoming less effective against a growing number of pathogens, new antibiotics and prevention tools are needed urgently7.
Novel techniques are being employed to improve our ability to update vaccines and keep up with pathogens that change rapidly, like influenza virus and SARS-CoV-2. For influenza virus, as an example, the system is reactive: we track the strains that may emerge and cause human disease in the coming season8. With machine learning and artificial intelligence, we may be able to improve the accuracy of our selection of virus strains to target with vaccines. With novel technologies like mRNA, we may be able to include more antigens in vaccines to make them more robust to changes in circulating viruses9.
Addressing vaccine challenges that prevent vaccine uptake
Beyond innovation in vaccine technology, there are also ongoing reviews of national immunization policies to help protect those at risk. Organizations such as Vaccines Europe are taking this threat to older adults seriously. In its pipeline review, Vaccines Europe highlighted the impact that COVID-19 had on adult immunization programs, and it called upon European and national authorities to include adults in their national immunization programs and ensure adequate funding10.
Addressing the challenges and barriers that prevent vaccine uptake is as important as developing novel vaccines and vaccine programs targeted to a changing population. From laboratory to vaccine recipient, we must think about how we inspire confidence and trust in our work to ensure that the older adult population continues to be vaccinated against viruses that may have a detrimental impact on their health and well-being.
The research being done today is bringing innovations that would once have been impossible into reach – laying the groundwork for the future of vaccines. As we step into this future, we must ensure that we bring along the people who need vaccines most.
References
1 WHO. Immunization Agenda 2030. https://www.immunizationagenda2030.org/
2 WHO. Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19. https://www.who.int/news-room/questions-and-answers/item/herd-immunity-lockdowns-and-covid-19
3 Population structure and ageing – Statistics Explained (europa.eu): Population structure and ageing – Statistics Explained (europa.eu).
4 United Nations. Aging. https://www.un.org/en/global-issues/ageing.
5 NIH. Clinical Trials comparison between 01/01/2018 – 12/31/2020 vs 01/01/2021 – 12/31/2021.
6 Gavi – The Vaccine Alliance. 5 reasons why pandemics like COVID-19 are becoming more likely. https://www.gavi.org/vaccineswork/5-reasons-why-pandemics-like-covid-19-are-becoming-more-likely
7 WHO. Antimicrobial resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance.
8 Kotey E, Lukosaityte D, Quaye O, Ampofo W, Awandare G, Iqbal M. Current and Novel Approaches in Influenza Management. Vaccines (Basel).
9 Walls AC, Fiala B, Schafer A, et al. Elicitation of Potent Neutralizing Antibody Responses by Designed Protein Nanoparticle Vaccines for SARS-CoV-2. Cell 183.
10 Vaccines Europe. Vaccines Europe reveals its first pipeline review. Vaccines Europe reveals its first pipeline review – Vaccines Europe
Disclaimer: This article has been written by Philip Dormitzer, Global Head of Vaccines Research and Development, GSK, at the invitation of Labiotech, which has maintained editorial control.