Emmanuel Colliot, Joshua Hattem, Adi Natu, Bora Erdemli and Sarah Grace Tucker co-wrote this blog post with Jennifer Wong.
From April 15-17, ZS attended the World Vaccine Congress in Washington, D.C. for the first time, where more than 1,500 leading vaccines professionals from the pharma industry, academia, government and NGOs gathered to discuss the global future of vaccines. Topics ranged from critical success factors of creating effective private-public partnerships, to deep dives on the clinical challenges behind developing a universal flu vaccine, to the innovation of using microgravity in space to support vaccine development.
Throughout the conference, several critical and urgent challenges emerged:
- Strategies to overcome anti-vaccine hesitancy and cultural conflicts: With the acceleration of anti-vax movements around the world, manifesting most recently in the measles outbreaks in the U.S. and Europe, strategies to combat this sentiment in a world where social media can make or break public sentiment were a hot topic. Discussion revolved around moving beyond data to a clinically-vetted story communicated broadly by all stakeholders with levels of empathy and emotion matching the urgency of the situation. As panelists noted, data itself will not move hearts and minds – we need a bigger picture strategy. To gain momentum on the issue, panelists suggested a bold approach that speaks to cultural norms and involves the perspective of anthropologists and ethnographic experts.
Leveraging the growing collaboration between pharma and other public entities, including public health agencies and NGOs such as the Bill & Melinda Gates Foundation, is an increasingly important tactic. Another piece of the bigger picture is arming physicians with what they need to guide patients and their caregivers to make informed, educated decisions. Many physicians, particularly pediatricians, have never received formal training on how to communicate the value of vaccines to patients and parents, according to recent surveys.
- Shifting towards a “life course” model: As the global population continues to age at an unprecedented rate, there’s a growing unmet public health need for adult vaccines, particularly among the immunocompromised and comorbid population. There is a parallel increasing appetite and pressure to incorporate adult vaccines into national immunization programs, with payers beginning to shift their attention beyond the traditionally considered at-risk (for example, the elderly, who have been traditionally defined as 65 and older) to those 50 and older as a separate risk group.
However, targeting the adult population for vaccination presents a unique set of challenges. Accessing this population can be difficult, as adults don’t tend to attend regular check-ups like pediatric patients. There are fewer resources dedicated to adult vaccination, and adult vaccines also face a different set of clinical challenges. Longstanding investment in adjuvants are helping to serve the adult population and continuing to advance this technology and take it into broader use is key to expanding the vaccines available to adults of different age groups.
- Improving vaccine affordability for middle-income countries: Since the 1970s, global groups such as WHO and UNICEF and foundations such as Gavi, the Bill & Melinda Gates Foundation’s vaccines alliance, have helped implement immunization programs in low-income countries (LICs) to address top global public health crises. Manufacturers historically have partnered with these organizations to provide vaccines at remarkable discounts. In recent years, however, the burden of vaccine-preventable disease has shifted towards middle-income countries (MICs), where budgetary challenges, other pressing healthcare issues and general complacency often prevent the implementation of national vaccination schemes. As manufacturers face pressure to extend LIC prices to these markets, many in the industry have called for a more sustainable pricing model that decreases the reliance on NGOs and other external funding. Manufacturers point out that in addition to the public health benefits, investment in vaccination programs can reduce healthcare resource utilization costs down the road. An evolving pricing model combined with strategies to address complacency and cultural norms will be necessary to increase vaccination in the growing MIC markets worldwide.
Looking ahead: The search for a disruptive model
During the concluding plenary, moderators challenged the audience to think about the future. In a world where the most prominent taxi company, Uber, owns no cabs, and the largest hotel company, Airbnb, owns no property, what could a similarly disruptive model look like for vaccines? Perhaps advanced technology to accelerate production of seasonal vaccines like the flu, a platform to enable the flow of clinical information and improve vaccine development, or an ecosystem or infrastructure that increases real-time, equitable access to vaccines around the world.
Calls to action revolved around several themes:
- Involving a broader set of stakeholders to capture cultural perspectives in creating a bigger-picture strategy that goes beyond a focus on data.
- Investing resources to address the opportunity for improving adult vaccination and elevating its priority status on national levels.
- Developing innovative financing models to expand access and reimbursement for all vaccines, particularly for LICs and MICs who are transitioning to self-supporting funding of their populations rather than relying on partial or full support from external partners.
- Creating infrastructure to support more robust and efficient supply chain models that can anticipate and avoid issues across different environments that translate to significant delays and wastage, and helping first-timers learn from experiences of distribution in similar landscapes, such as refrigeration needs and pre-certification of transport units.
- Strengthening the ability of smaller biotechs and pharma companies who are poised to make their mark in vaccines, but need more support to mitigate initial funding gaps.
Whatever the form, it’s clear that the vaccines industry is ripe for disruption and innovation, and as governments, manufacturers, and other organizations continue to work hand-in-hand towards the goal of improving vaccine access worldwide, a disruptive business model seems likely to follow.