How to supply the world with billions of doses of vaccine against COVID-19 virus

The world is suffering from the spread of the COVID-19 infection, and we are all waiting for a vaccine against the disease.   

All the large vaccine companies are working hard to develop a new vaccine and there are also many smaller companies that work together with institutions like NIH and FDA to bring a vaccine forward as soon as possible.

The major vaccine players like GSK, Sanofi, Pfizer, Serum Institute of India etc. have their own large R&D groups and they also have quite a large capacity for the manufacturing of the vaccine.

But what will the new vaccine look like?

Will it be a traditional cell-culture based viral vaccine? Those production processes are typically rather slow.

Can or will we use the extensive vaccine capacity which is normally used for the seasonal flu for this new vaccine? – The vaccine for seasonal flu is normally produced in eggs from June to October – the rest of the time these facilities are standing empty.

Will it be an RNA vaccine (the molecule that tells cells what to build, mRNA, are encoded to build antigens) or a DNA vaccine (meaning DNA sequences encoded to create the antigen) that can be produced at high yields in for instance E. Coli?

Will it be an adjuvanted vaccine that helps to produce more antibodies, in order to reduce the amount of active antigen?

The answer is that we don’t know yet.

Either way, it will have to be produced in a very short time – actors all over the world will fight for the honor of being the first player to provide the vaccine. And it will have to be formulated and filled into vials and Pre-Filled-Syringes (PFS) and then distributed all over the world. Here lies one of the biggest issues  – the filling capacity is not there, at least not in one company only.

One good and efficient solution of the problem could be to produce the active component in a few different places in the world, and then distribute the formulated vaccine to filling facilities all over. This is not something new, it has already been done within the large companies – they ship bulk or formulated bulk to different filling facilities in-house.

Nevertheless, doing it for billions of doses would be a challenge. Most such vaccines would have to be transported refrigerated and potentially also with mixing during the transport. And that will require significant amounts of transportation containers/equipment that can fulfil the requirement of mixing and cooling during transportation.

WHO already have channels for distribution of final vaccine to almost everywhere in the world, so that issue should not be the limiting factor for getting the population vaccinated.

The biggest issue will be to get the bulk vaccine produced and transported to the filling facilities and get it filled into vials and PFS. These challenges require key players from the public sector as well as the pharmaceutical industry to join efforts in the measures against the COVID-19 pandemic.