Evolving pharmacovigilance requirements with novel vaccines and vaccine components

Abstract

This paper explores the pipeline of new and upcoming vaccines as it relates to monitoring their safety. Compared with most currently available vaccines, that are constituted of live attenuated organisms or inactive products, future vaccines will also be based on new technologies. Several products that include such technologies are either already licensed or at an advanced stage of clinical development. Those include viral vectors, genetically attenuated live organisms, nucleic acid vaccines, novel adjuvants, increased number of antigens present in a single vaccine, novel mode of vaccine administration and thermostabilisation. The Global Advisory Committee on Vaccine Safety (GACVS) monitors novel vaccines, from the time they become available for large scale use. GACVS maintains their safety profile as evidence emerges from post-licensure surveillance and observational studies. Vaccines and vaccine formulations produced with novel technologies will have different safety profiles that will require adapting pharmacovigilance approaches. For example, GACVS now considers viral vector templates developed on the model proposed by Brighton Collaboration. The characteristics of those novel products will also have implications for the risk management plans (RMPs). Questions related to the duration of active monitoring for genetic material, presence of adventitious agents more easily detected with enhanced biological screening, or physiological mechanisms of novel adjuvants are all considerations that will belong to the preparation of RMPs. In addition to assessing those novel products and advising experts, GACVS will also consider how to more broadly communicate about risk assessment, so vaccine users can also benefit from the committee's advice.

Keywords: immunisation; vaccines.

Figure 1

Overview of the PDVAC pipeline by novel antigen presentation platform. Regimens involving heterologous prime boost approaches, or candidates incorporating more than one platform are shown as stripped bars. Ebola virus vaccines are overseen by the R&D blueprint, but are included in this PDVAC overview to reflect the pipeline status of novel platforms for this antigen. ETEC, enterotoxigenic Echerichia coli; GAS, group A streptococcus; GBS, group B streptococcus; HSV, herpes simplex virus; PDVAC, product development for vaccines advisory committee; R&D, research and development; RSV, respiratory syncytial virus; TB, tuberculosis.

Figure 2

Publications on DNA and RNA vaccines 1990–2019.