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Review
. 2023 Jun;8(6):e011879.
doi: 10.1136/bmjgh-2023-011879.

Factors, enablers and challenges for COVID-19 vaccine development

Jean-Louis Excler  1 , Melanie Saville  2 , Lois Privor-Dumm  3 , Sarah Gilbert  4 , Peter J Hotez  5 , Didi Thompson  6 , Salim Abdool-Karim  7 , Jerome H Kim  8   9
Affiliations
Review

Factors, enablers and challenges for COVID-19 vaccine development

Jean-Louis Excler et al. BMJ Glob Health. 2023 Jun.

Abstract

The COVID-19 pandemic triggered a sense of vulnerability and urgency that led to concerted actions by governments, funders, regulators and industry to overcome traditional challenges for the development of vaccine candidates and to reach authorisation. Unprecedented financial investments, massive demand, accelerated clinical development and regulatory reviews were among the key factors that contributed to accelerating the development and approval of COVID-19 vaccines. The rapid development of COVID-19 vaccines benefited of previous scientific innovations such as mRNA and recombinant vectors and proteins. This has created a new era of vaccinology, with powerful platform technologies and a new model for vaccine development. These lessons learnt highlight the need of strong leadership, to bring together governments, global health organisations, manufacturers, scientists, private sector, civil society and philanthropy, to generate innovative, fair and equitable access mechanisms to COVID-19 vaccines for populations worldwide and to build a more efficient and effective vaccine ecosystem to prepare for other pandemics that may emerge. With a longer-term view, new vaccines must be developed with incentives to build expertise for manufacturing that can be leveraged for low/middle-income countries and other markets to ensure equity in innovation, access and delivery. The creation of vaccine manufacturing hubs with appropriate and sustained training, in particular in Africa, is certainly the way of the future to a new public health era to safeguard the health and economic security of the continent and guarantee vaccine security and access, with however the need for such capacity to be sustained in the interpandemic period.

Keywords: COVID-19; Health economics; Health policy; Immunisation; Vaccines.

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Conflict of interest statement

Competing interests: JLE is an employee of the International Vaccine Institute. He is chair of the Military HIV Research Program/Emerging Infectious Diseases Branch/Henry M Jackson Foundation Safety Monitoring Committee and member of the Benefit-Risk Assessment of Vaccines by Technology Working Group (BRAVATO) of the Brighton Collaboration. MS is employed by the Coalition for Epidemic Preparedness and Innovation (CEPI) and is a member of the Board of Trustees of the International Vaccine Institute. LP-D served on an advisory board for GSK. SG is an inventor of intellectual property licensed by Oxford University Innovation to AstraZeneca. PJH is a co-inventor of a COVID-19 recombinant protein vaccine technology owned by Baylor College of Medicine (BCM) that was recently licensed by BCM non-exclusively and with no patent restrictions to several companies committed to advance vaccines for low/middle-income countries. The co-inventors have no involvement in license negotiations conducted by BCM. DT is the director of Research and Content at the World Innovation Summit for Health, an initiative of Qatar Foundation. SA-K serves as special advisor (on pandemics) to the Director-General of the WHO. He is a commissioner of the African Union Commission on COVID-19. He has served in the past on the SANOFI medical advisory board for COVID-19 vaccines and as a commissioner of the Lancet Commission on COVID-19. JHK was a consultant for SK bioscience and is an unpaid consultant to the scientific advisory board of Everest.

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