As vaccinations for COVID-19 continue to roll out across the country, the need for advocacy and information around vaccines and immunizations has never been more important. In a normal year, the University of Minnesota’s Center for Disease Research and Policy (CIDRAP) plays an important role in this. During a global pandemic, their work has become even more important. With World Vaccination Week taking place during the last week in April, the Medical Alley Association caught up with CIDRAP to discuss their work and what the future of immunizations look like in a post-COVID world.
CIDRAP’s mission is to prevent illness and death from infectious diseases through research and the translation of scientific information into real-world, practical applications, policies, and solutions. Immunizations remain one of the most important tools we have for disease prevention and control. Thus, raising awareness about the benefits of existing vaccinations as well as identifying gaps and opportunities for improved vaccines are among CIDRAP’s top priorities.
CIDRAP works to connect researchers, funders, policymakers, industry leaders, regulators, and communications/advocacy specialists in raising awareness around vaccines. Along with our partners, CIDRAP has developed roadmaps that address diagnostics, therapeutics, and vaccines for Lassa, Nipah, Ebola/Marburg, and Zika viruses.
Currently, CIDRAP is facilitating the development of a globally oriented R&D roadmap to improve vaccines against seasonal and pandemic influenza. Implementation of the roadmap will involve a communications and advocacy effort to increase awareness of the importance of influenza prevention, as well as the need to improve the effectiveness of seasonal influenza vaccines and how long they protect—and to develop more effective tools against pandemic influenza.
Immunizations are one of the most effective strategies we have to prevent and control infectious diseases. Herd immunity can be achieved with very high levels of vaccination in a community and can protect even those who are unable to be vaccinated themselves by making person-to-person spread unlikely. The rapid spread of SARS-CoV-2, the virus that causes COVID-19, has shown us just how quickly infectious diseases can spread in a population that does not have immunity to a pathogen.
As vaccination rates decline, we risk seeing outbreaks of diseases that have previously been eliminated. In recent years, declining levels of vaccination coverage for routine childhood diseases, such as measles, led to outbreaks in the United States and globally. One major contributor to these outbreaks is vaccine hesitancy, which is considered by the World Health Organization to be one of the top ten threats to global health.
Maintaining high rates of vaccine coverage for vaccine-preventable diseases, even during the pandemic, is essential to protect public health and prevent the emergence (or reemergence) of these diseases. While resources may be diverted to address the current pandemic, maintaining funding and infrastructure for routine childhood vaccinations is critical. This was poignantly illustrated when a recent Ebola epidemic broke out in the Democratic Republic of the Congo, and the ensuing measles outbreaks, as a result of decreased vaccinations, ultimately caused more deaths than Ebola.
We are witnessing a transformative change in the field of vaccinology. Prior to COVID-19, many promising vaccine platforms were in clinical development, but the funding and public support needed to move these platforms through critical phases of clinical development was lacking. The response to the COVID-19 pandemic has shown us how efficiently we can test new vaccine platforms when government, philanthropies, and industry coordinate efforts, bolstered by an influx of funding, and engaged volunteers.
COVID-19 vaccines were developed in record time because vaccine platforms were already in development, but the field needed money and volunteers to conduct the critical safety and efficacy trials. Lessons learned from the development of COVID-19 vaccines provide an opportunity to revolutionize vaccinology for many other pathogens. Promising platforms and technology used for COVID-19 vaccines, such as mRNA, viral vectors, and VLP/nanoparticles can be made in advance using new vaccine platforms that are amenable to rapid production, scale-up, and stockpiling for rapid deployment anywhere in the world. This could allow for a rapid response to detection of the next pathogen of pandemic potential, with the goal of stopping future infectious disease outbreaks from becoming pandemics.
Influenza and its ability to cause a pandemic remains a threat. With dedicated research and funding, in less than a decade we could have a universal influenza vaccine that protects against multiple strains, including strains of pandemic potential, that doesn’t need to be administered yearly. This will require major funding commitments from government, philanthropies, and industry to support basic science research on vaccine design, which includes identifying antigens that induce broadly neutralizing antibodies effective against multiple strains of influenza viruses, coronaviruses, or other pathogens.
The number of volunteers participating in trials around the world has been nothing short of amazing. Phase 3 clinical trials require a huge number of participants and recruiting volunteers in a high-incidence setting is always a challenge. If these platforms are able to be leveraged to fight other diseases, then the return on investment for the COVID-19 vaccines will continue to multiply. Volunteers should feel proud of their contributions in the fight against COVID-19 as well as their contributions to science.
We’ve seen what can be done when society makes a concerted effort and major funding commitments to develop new vaccines. While the road to developing successful vaccine candidates is long and fraught with hurdles, the success we’ve seen with the novel COVID-19 platforms brings excitement for future possibilities to the vaccine community at large.
Strong vaccination programs and infrastructure help to prepare for the next pandemic. Having these systems in place (and maintained) facilitates distribution of pandemic (or crisis) vaccines. This is a push more for low- and middle-income countries. Countries that don’t have annual influenza vaccination programs are less able to roll out vaccines during a public health emergency because they don’t have the infrastructure in place.
If you’re eager to follow along with CIDRAP’s efforts, you can subscribe to their podcast, the Osterholm Update, sign up for the CIDRAP newsletter, or donate to the CIDRAP fund to help the organization continue its work.