Vaccine Landscape
description
Transcript of Vaccine Landscape
Vaccine Landscape Implications for 202X
May 2, 2011
1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s 2000s 2010s 2020s
Yellow Fever(1948)
BCG(1926)
IPV(1955)
OPV(1963)
Rabies(1880s) Measles
(1963)DTP(1948)
Rubella(1969)
Mumps(1967)
EPI Introduced(BCG, DTP, Measles, OPV)
(1974)
<5% of infants immunizedglobally each year
Vaccine Characteristics
• Relatively low price for most vaccines (<$1.00/treatment)
• Large multi-dose vial sizes (minimize cost/dose and immunization logistics impact)
• Typically high wastage (25 – 70%)
Vaccine Characteristics
• Relatively low price for most vaccines (<$1.00/treatment)
• Large multi-dose vial sizes (minimize cost/dose and immunization logistics impact)
• Typically high wastage (25 – 70%)
FIR
ST
Vx
LIC
EN
SU
RE
EPI catalyzed the strengthening of
country supply logistics systems
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Smallpox(1903)
MMR(1971)
Vaccine Landscape (1920 – 1979)
1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s 2000s 2010s 2020s
Yellow Fever(1948)
BCG(1926)
IPV(1955)
OPV(1963)
Rabies(1880s) Measles
(1963)DTP(1948)
Rubella(1969)
Mumps(1967)
Vaccine Characteristics
• Hib 1st of the higher priced vaccines (>$3.00/dose)
• High wastage comes at a higher cost trend toward smaller multi-dose vials
• Shift to pentavalent combination vaccine
Vaccine Characteristics
• Hib 1st of the higher priced vaccines (>$3.00/dose)
• High wastage comes at a higher cost trend toward smaller multi-dose vials
• Shift to pentavalent combination vaccine
HepB(1981)
Hib(1988)
FIR
ST
Vx
LIC
EN
SU
RE
EPI Introduced(BCG, DTP, Measles, OPV)
(1974)
<5% of infants immunizedglobally each year
DTP-HepB+HibPentavalent
Vaccine(1998)
Smallpox(1903)
MMR(1971)
Vaccine Landscape (1980 – 1999)
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Health Systems Investments (1980-1999)
Medical Products, Vaccines, and Technologies
HealthInformation
System
HealthService Delivery
Leadership and Governance
HealthFinancing
HealthWorkforce
1975 1980 1985 1990 1995 2000
CCL training modules
Equipment info sheets
WHO PQestablished
VVMs available
Joint statement on AD syringes
TechNet e-Forum
PAHORevolving Fund
established
UNICEF Vaccine Independence Initiative
established
WHO GAGestablished
SAGEestablished
TechNetestablished
Bu
ild
ing
Blo
ck
s o
f a
Hig
hly
Fu
nc
tio
na
l H
ea
lth
Sy
ste
m*
WHO standardized immunization schedules
BMGFestablished
EPIintroduced
GPVestablished
* Everybody’s Business: Strengthening Health System's to Improve Health Outcomes, WHO’s Framework for Action, 2007
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Source: WHO Global Atlas http://apps.who.int/globalatlas/dataQuery/default.asp
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Aver
age
% V
acci
ne C
over
age
Rate
s in
Low
& Lo
wer
Mid
dle
Inco
me
Coun
trie
s
Year
BCG DTP3 MCV Pol3
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
5
Investment = Impact (1980 – 2000)
1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s 2000s 2010s 2020s
Yellow Fever(1948)
BCG(1926)
HepB(1981)
Hib(1988)
IPV(1955)
OPV(1963)
Rabies(1880s)
Measles(1963)DTP
(1948)Rubella(1969)
Mumps(1967)
Cholera(2009)
MenA(2009)DTP-HepB+Hib
Pentavalent Vaccine(1998)
PCV7(2000)
Cervarix(2007)
PCV 10(2009)
Smallpox(1903)
PCV 13(2009)
MMR(1971)
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Vaccine Landscape (2000 – 2010)
FIR
ST
Vx
LIC
EN
SU
RE
Vaccine Characteristics
• Multinational suppliers targeting low income markets earlier than in past
• Prices >$3.00 per dose becoming the norm
• Different product profiles for vaccines targeting the same disease
Vaccine Characteristics
• Multinational suppliers targeting low income markets earlier than in past
• Prices >$3.00 per dose becoming the norm
• Different product profiles for vaccines targeting the same disease
JE(2010)
RotaRix(2006)
Gardasil(2006)
RotaTeq(2006)
Medical Products, Vaccines, and Technologies
HealthInformation
System
HealthService Delivery
Leadership and Governance
HealthFinancing
HealthWorkforce
1980 1985 1990 1995 2000 2005 2010
Effective Vx Stores Mgmt
rollout
CCL training modules
WHO PQestablished
VVMs available
WHO PQS devices and equip specs
TechNet e-Forum
cMYP rollout
Effective Vx Mgmt rollout
CCEM rollout
GAVI ISS
GAVI HSS
Project Optimizeinitiated
PAHORevolving Fund
established
UNICEF Vaccine Independence Initiative
established
GAVI Allianceestablished
WHO GAGestablished
SAGEestablished
TechNetestablished
VPPAG established
CCLTask Force established
IPAC established
Bu
ild
ing
Blo
ck
s o
f a
Hig
hly
Fu
nc
tio
na
l H
ea
lth
Sy
ste
m*
WHO standardized immunization schedules
EPIintroduced
GPVestablished
FSP rollout
VMA rollout
UNICEF includesVVMs in tender &
bundles AD syringe for each dose
* Everybody’s Business: Strengthening Health System's to Improve Health Outcomes, WHO’s Framework for Action, 2007
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Global Health Workforce Alliance
created
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Health Systems Investments (2000 – 2010)
Equipment info sheets
Joint statement on AD syringes
BMGFestablished
8*2009 and 2010 forecasted data for Pol3 not available
8
Investment = Impact (2000-2010)
1920 – 1939: 1 vaccine1940 – 1959: 3 vaccines1960 – 1979: 4 vaccines1980 – 1999: 3 vaccines2000 – 2019: >13 vaccines 9
1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s 2000s 2010s 2020s
Yellow Fever(1948)
BCG(1926)
HepB(1981)
Hib(1988)
IPV(1955)
OPV(1963)
Rabies(1880s)
Measles(1963)DTP
(1948)
Rubella(1969)
Mumps(1967)
Rota(2006)
HPV(2006)
JE(2010)
Cholera(2009)
TyphoidConjugate(~2013)
Malaria(~2014-2016)
rBCG(~2014-2018)
MenA(2009)
Dengue(~2015-2016)
ETEC(~2013-2016)
Shigella(~2011-2015)
FIR
ST
Vx
LIC
EN
SU
RE
DTP-HepB+HibPentavalent
Vaccine(1998)
Pneumo(2000)
Smallpox(1903)
MMR(1971)
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Vaccine Landscape (2000 – 2019)
TyphoidPS
(2011)
Leishmaniasis(~2016-2018)
Characteristic Change Implication
PriceMany have higher costs
(> $10/treatment)Impacts affordability &
vaccination sustainability
PresentationMany have smaller vial sizes
(1-2 dose vials)
Minimizes vaccine wastage, increases cold chain needs
& waste disposal costs
Target Population
Birth Doses, Infants, Adolescents, & Adults
More vaccines delivered outside the EPI system
Vaccination Strategy
Routine + catch-up, mass campaigns,
school-based routine, school-based mass campaigns
Significant immunizationlogistics implications
Product Profile
Not all vaccines the same – differ by dose schedule, serotypes, route of
administration, preservative use
Country preferences becomea greater factor, immunization logistics need to be managed
InterventionPortfolio
More interventions available at the same time than ever before
Country decision-making in face of much greater complexity
(which disease, which product, what timeframe, what trade-offs)
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New Vaccine Characteristics
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Currently At Scale
Being Scaled Up
Waiting for Scale Up
Currently Under Development
Licensed or WHO PQ’d prior to 2011 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hib
Pneumo
Rotavirus
MenA
HPV
Cholera
Typhoid
Typhoidconjugate
JE
Pneumo(common protein)
Rotavirus (116E)
Pneumo(Killed whole cell)
Pneumo(conjugates)
Lowerpriced IPV
HexavalentDTwP-HepB-Hib-IPV
BCG
OPV
MCV
DTP-HepB
YF
Td / TT
Rotavirus(BRV)
Malaria(RTS,S)
Dengue
ETEC
Hookworm
BCG Boost
Shigella
Flu(Lentigen)
Leishmaniasis
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CURRENT VACCINE LANDSCAPE
rBCG