The challenges of COVID-19 Vaccine delivering to the developing countries

¹University of Baghdad, College of Medicine, Baghdad, Iraq

^&Corresponding author
Hashim Talib Hashim, University of Baghdad, College of Medicine, Baghdad, Iraq

Commentary    

The COVID-19 pandemic is now placing immense pressure on scientists to produce vaccines that are safe and reliable. Its formulation acts as a bridge between stages of product production in this race to produce a vaccine and must be considered in the process of development [1]. Pharmaceutical formulation science plays a critical role in the race for a safe and effective coronavirus disease vaccine COVID-19 in the production, manufacturing, distribution, and vaccination processes. Proper selection of the type of vaccine, carrier or vector, adjuvant, excipient, dosage form and route of administration which directly affect not only the induced immune responses and the subsequent efficacy against COVID-19, but also the production, storage and distribution logistics and mass vaccination of the vaccine [2]. In the early stage, the most important role in the formulation is to pick the required antigen, adjuvant, and delivery vehicle, which involves an understanding of the working mechanisms and biophysical characteristics of the vaccine antigen. Then the focus of the formulation shifts to formulate the vaccine in a particular type of dosage that is safe and feasible for large-scale development. Aspects of product delivery and route of administration should be considered at this point as well. Needle-free intranasal or pulmonary mucosal vaccination has benefits for the protection of COVID-19 as well as for mass immunization [2,3].

The dry powder formulation of vaccines will help increase the thermostability of the vaccines and eventually reduce vaccination costs. For needle-free intranasal or pulmonary vaccination, technologies are available for the transformation of vaccines from liquid to thermally stable solid powder. Even if they are not implemented in the current race for safe and successful COVID-19 vaccines, it is not too early to promote the commercialization of these technologies by government agencies and non-profit organizations around the world to prepare for the world's need for rapid mass vaccination in the next pandemic [3]. More than one successful vaccine strategy is needed because of the global need for vaccines and the broad geographical diversity of the pandemic. Collaboration between biotechnology and pharmaceutical companies, both of which put forth a number of approaches to vaccines, will be important. The complete development process for an effective SARS-CoV-2 vaccine will entail the cooperation of industry, government, and academia in unprecedented ways, each contributing its individual strengths. We are discussing one such collaboration program recently developed: the public-private partnership between ACTIV (Accelerating COVID-19 Therapeutic Interventions and Vaccines) [4]. The selection of vaccine platforms must be aware of the complexities of vaccine administration for a global pandemic. Simple incorporation into systems designed to be supplied far and wide, assembled at low costs and delivered with limited monitoring would be an ideal vaccine platform. Several formulations of vaccines require continuous refrigeration. The need for a cold chain makes its global distribution and deployment logistically challenging and virtually impossible for underdeveloped and developing countries with tropical climates. In reality, reliance on refrigerated transport of solution-based vaccines has been one of the biggest challenges [5]. The WHO also announced that, due to cold chain failures, 2.8 million vaccines were missed in five countries, and fewer than 10% of countries followed WHO guidelines for good vaccine management practices. While certain lyophilized vaccines that can be stored at room temperature are available, these solutions are difficult to generate and present difficulties for healthcare professionals who need to reconstitute them on site.

Successful vaccination programs often include access to health care professionals (HCP), which under normal circumstances is difficult in resource-poor or heavily populated developing countries, but poses a greater challenge during a global pandemic where the health care infrastructure is already strained or broken [5,6]. Modern solutions to such difficulties in delivery and access have recently emerged, such as single-dose slow-release implants, film-based vaccines, and microneedle-based patches, which could minimize cold-chain dependency and ensure vaccination even in situations where eligible HCP is uncommon or in high demand [7]. It would also be possible to self-administer microneedle-based patches, which would significantly speed up the roll-out and dissemination of such vaccines and reduce the burden on the health care system. These modern vaccine delivery devices can be produced or manufactured by traditional polymer melt processing by solution methods (for example, injection moulding) [8]. The benefit of melt-processing equipment lies in its capacity for rapid, large-scale development and its long-term stability, independent of the cold chain. A number of companies such as Veleritas Inc., Zosano, Corium International and Debiotech have capitalized on the opportunity to crack the cold chain and alleviate the burden on the medical system by providing a safe and efficient self-administered prophylactic vaccine, leading to the filing of over 10,000 patents worldwide [9,10].

Competing interests     

The authors declare no competing interests.

Authors' contributions     

All the authors have read and agreed to the final manuscript.

References