There is great enthusiasm for developing new vaccines to combat debilitating diseases, which is spurring improvements in analytical
methods and production strategies that are more efficient and provide greater assurance of product quality. Vaccine production
has become more attractive to pharmaceutical manufacturers seeking new products to help offset the decline in revenues and
profits from patent expirations on blockbuster therapies. Although vaccines may not be big moneymakers for biopharmaceutical
companies, vaccines can produce solid revenues by providing highly cost-effective treatments for stable markets.
There also are strong moral and public health reasons for industry investment in treatments that can prevent the spread of
infectious diseases and new pathogens. The World Health Assembly approved a 10-year Global Vaccine Action Plan in May 2012
to develop and distribute more new preventive drugs around the world, with Dengue fever and malaria at the top of the list
of targeted illnesses. Research on vaccines to treat global diseases also may lead to more lucrative preventives against widespread
conditions such as cancer and other diseases caused by viruses, bacteria, or parasites. Two approved vaccines that prevent
cervical cancer are on the market, Merck's Gardasil and Cervarix from GlaxoSmithKline, along with the first cancer treatment
vaccine, Dendreon's Provenge, for metastatic prostate cancer.
The challenges in devising safe and effective vaccines, however, are all too apparent. Years of research have failed to produce
a vaccine to prevent HIV/AIDS. Therapeutic vaccines are proving elusive, as seen in difficulties using vaccine technology
to treat nicotine addiction, diabetes, and Alzheimer's disease. A notable disappointment is the recent failure of a promising
tuberculosis vaccine following a study on almost 3000 South African infants. Scientists at Oxford University, vaccine maker
Aeras, the Wellcome Trust, and the Bill and Melinda Gates Foundation tried to sound positive in announcing the results, stating
that important evidence was obtained from this model, placebo-controlled trial, and that the vaccine still might be effective
MORE NEW VACCINES
At the same time, there is much good news in the vaccine world. This year started with FDA approval of wider use of Pfizer's
Prevnar 13 vaccine to prevent pneumococcal bacterial infections. That followed approval in 2012 of Glaxo's MenHibrix, a combination
vaccine to protect against meningococcal and Haemophilus influenzae type b (Hib).
Notable advances in formulations and manufacturing processes for influenza vaccines have attracted considerable attention
in this year's more severe flu season. The flu vaccine crop of 2012 included two quadrivalent products (i.e., vaccines that
protect against four virus strains instead of three) from Glaxo and AstraZeneca.
Manufacturers, moreover, are shifting away from producing flu vaccine in chicken eggs, as seen in FDA approval in November
2012 of Novartis' Flucelvax, produced in cultures of dog kidney cells. It will be scaled up at Novartis' new vaccine plant
in Holly Springs, NC, built with some $500 million in support from the US government. Similarly, Protein Sciences Corp. (Meriden,
CT) gained FDA approval in January 2013 for FluBlok, which utilizes recombinant DNA technology to produce large quantities
of flu virus protein using an insect virus (baculovirus) expression system. Protein Sciences also has benefited from more
than $100 million in federal funding and plans production at a former Pfizer manufacturing site in Pearl River, NY.
Many of these advances reflect increased US government investment in vaccine production methods since 2006 when the Department
of Health and Human Services (HHS) provided more than $1 billion to six manufacturers to develop cell-based flu vaccine technology
and production capacity in the US that can ramp up production quickly in case of pandemic or other health crises. The looming
H1N1 swine flu fear in 2009 added funding to expand domestic vaccine production, and in 2012, HHS provided $400 million to
three research consortia to further enhance production of vaccines and medical countermeasures. HHS assistant secretary Nicole
Lurie noted, in an HHS press release, that the three public-private partnerships—which include Glaxo, Novartis, and Maryland-based
Emergent BioSolutions; academic research centers; and small biotech companies—will use the funds to retrofit existing facilities
or build new ones with "flexible, innovative manufacturing platforms that can be used to manufacture more than one product."
A cadre of other new vaccines is in the works. Novartis recently obtained approval in Europe for a new vaccine against meningitis
B, while Glaxo has linked up with an Indian manufacturer to develop a six-in-one combination pediatric vaccine. Baxter has
another cell-based vaccine for avian flu on the market in Europe, and genetically engineered flu vaccines are being tested
by Novavax (Rockville, MD) and Vaxinnate Corp. (Cranbury, NJ). A long-term goal is to develop a universal flu vaccine that
fights multiple virus strains and can be administered every 5 to 10 years. There also is promising research on new vaccine
delivery technologies and products that don't require cold-chain distribution.