4/3/2021
NOTE: This is part four of a four-part series presented by the WHO. It is excellent and worth sharing.
Manufacturing, Safety, and
Quality Control of Vaccines
Once a vaccine has reached pre-approval stage following clinical trials, it is assessed by the relevant regulatory body for compliance with quality, safety, and efficacy criteria. Following regulatory approval, manufacturers can submit a vaccine to WHO for prequalification (PQ), an assessment process that ensures quality, safety and efficacy and helps the UN and other international procurement organizations determine the programmatic suitability of a vaccine.
During global health emergencies, the WHO Emergency Use Listing Procedure (EUL) may be
used to allow emergency use of the vaccine. The EUL exists because, in a pandemic situation,
products that could benefit the lives of people all over the world may be prevented from coming
to market with sufficient speed. The EUL is a fast-tracked but rigorous process, designed to
bring impactful products to all those in need, as quickly as possible, on a time-limited basis and
based on a risk-versus-benefit evaluation. The WHO PQ/EUL recommendation may be used by
UN agencies such as UNICEF and the Pan American Health Organization Revolving Fund for
Manufacturing, Safety, and Quality Control of Vaccines procurement decisions in low- and middle-income countries. Gavi also relies on WHO EUL/PQ to specify which vaccines its funds may be used to purchase.
How it is made
Typically, companies will work independently to complete clinical development plans for
a vaccine. Once a vaccine is authorized, manufacturing begins to scale up. The antigen
(part of the germ that our immune system reacts to) is weakened or deactivated. To
form the full vaccine, all ingredients are combined.
The whole process, from preclinical trial to manufacture, can sometimes take over a
decade to complete. In the search for a COVID-19 vaccine, researchers and developers
are working on several different phases in parallel, to speed up results. It is the scale of
the financial and political commitments to the development of a vaccine that has
allowed this accelerated development to take place. Also, nations and international
health organizations are working together through COVAX to invest in development
capacity upfront to streamline the process, as well as to ensure equitable distribution of
vaccines.
How it is packaged
Once the vaccine has been made in bulk quantities’, it is bottled in glass vials and then
carefully packaged for safe cold storage and transport.
Vaccine packaging must be able to withstand extreme temperatures, as well as the
risks involved in being transported globally. Therefore, vaccine vials are most commonly
made from glass, as it is durable and able to maintain its integrity in extreme
temperatures.
How it is stored
When a vaccine is too hot or too cold, it becomes less effective or even inactive. If
stored at the incorrect temperature, vaccines can be ruined or unsafe for use. Most
vaccines require refrigerated storage at between 2 and 8 °C. Some vaccines require
temperatures as cold as -20°C. Some of the newer vaccines need to be kept ultra-cold
at -70°C. For frozen vaccines some of them can be safely stored for a limited time
between 2 and 8°C.
Regular refrigerators cannot maintain an even temperature consistently, so specialized
medical refrigerators are required for these precious products.
How it is shipped
To maintain this cold chain, vaccines are shipped using specialized equipment that
does not compromise the integrity of the product. Once shipments land in the
destination country, refrigerated lorries transport the vaccines from the airport to the
warehouse cold room. From there, portable iceboxes are used to transport vaccines
from the cold room to regional centers where they’re stored in refrigerators. If
vaccination takes place outside of the regional facility, the final step often requires
portable iceboxes to transport the goods to local areas for vaccination campaigns. New
technologies have invented some portable devices that can keep vaccines at their cold
temperature for several days without needing electricity.
Quality control
Once vaccines start being administered, national authorities and WHO constantly
monitor for – and establish the severity of – any possible adverse side effects and
responses from people who have received the vaccine. The safety of the vaccine is
paramount, with regular assessments and post-approval clinical studies to report on its
safety and effectiveness.
Studies are often conducted to determine how long a given vaccine remains protective.
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