Technologies in Support of
Immunization Programs
GAVI R&D Task Force
August 2001
GAVI R&D Task Force
• The Task Force has been asked to select three
technologies or categories of technology (not
including new vaccines) that could have a major
impact on immunization programs in the short
(less than 5 years) or longer term (less than 10
years).
• Input from Technet and SIGN members is
requested in the selection of these technologies.
Challenges in Immunization
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Unsafe administration
Wasted vaccine
Spoiled vaccine
Additional vaccines
Decaying cold chain
Poor infrastructure
Outreach - the most
difficult ‘last mile’
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Poor management
Wars and conflicts
HIV/AIDS
Hostile environments
Resistance to change
Lack of disease
burden data
GAVI R&D Task Force
Three Teams
Safety :
Hardware Solutions
•Prevent contamination
•Prevent syringe re-use
•Prevent heat damage
•Prevent freezing
•Safe disposal
•Reduce wastage
•Simplify systems, e.g.
Self-contained, unit-dose
administration systems
Access,
Management
& Operations:
Operational &
Field Research &
ICT solutions
•Coverage
•Management systems
•Logistics
•Management efficiency
•Surveillance research
Vaccine
Formulation
& Process
Solutions
•Sugar/Glass stabilisers
•Reduce number of
contacts
-adjuvants
-combinations
• Formulations for
alternative routes of
administration
Team Members (* Coordinator)
Safety :
Hardware Solutions
Michael Free*
Gordon Larsen
Umit Kartoglu
Bruce Weniger
Ticky Raubenheimer
Rudolph Cumming
Punnee PitisuttithumJohn
John Lloyd
Access,
Management
& Operations:
Op & Field & ICT
solutions
To be selected*
Steve Landry
Deborah Lans
Hans Everts
Robert Steinglass
Soren Spanner
Serge Ganivet
Souleymane Kone
Vaccine
Formulation
& Process
Solutions
Gordon Dougan*
Reinhard Gluck
Richard Strugnell
Peter Carrasco
(R. Kerry)
(Rip Ballou)
GAVI Survey
(41 responses)
Short Term
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Improved management and tracking systems in the field
Temperature stability technologies
Combination vaccines
Fix cold chain
Monodose/self-contained unit-dose
administration`systems (SCUDAS)
• Sharps management
Longer Term
• Non-invasive administration
· More Temperature stability
• More combination vaccines
Focus for Technology
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Safe and effective vaccines
Safe administration
Vaccine accessibility
System efficiency
Assuring Safe and Effective Vaccines at
Point of Administration
• No heat damage
– Vaccine vial monitors
(VVMs)
– Fail-safe refrigeration
– Ice-free cooling
– Vaccine stability
• No freezing damage
– Fail-safe refrigeration
– Freeze indicators
• No contamination
– ‘Monodose’
– Self-contained unit
dose administration
systems (SCUDAS)
– Auto-disable
reconstitution syringes
– Auto-reconstitution
Assuring Safe Administration
• Assuring Sterile Injections
– Auto-disable Syringes
– Heat re-enabled sterilizable syringes
• Self-contained Unit Dose Administration Systems
 ( SCUDAS, e.g. Uniject, Oral, Transdermal, Nasal dispenser etc.)
• Preventing Collateral Sharps Injury
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Needle-free administration
Needle extraction (‘defanging’)
Low capacity waste destruction systems
Anti-stick devices
Waste collection infrastructure
Increasing Vaccine Accessibility
• Adequate and timely delivery of supplies
– Outsourced transport and logistics systems
– IT for logistics management information
– Freight tracking technologies
• Assured availability of means of administration
– ‘Bundling’ of indispensable commodities
– SCUDAS
– Adequate storage capacity
– Some vaccine (with VVM) at ambient temp.
– More frequent deliveries
– High-efficiency solar refrigeration
• Adequate outreach capacity
– Adapted motorcycles, ATVs or boats
– Ice-free cooling systems
Achieving System Efficiency
• Fewer administrations
• Reduced cold chain dependency
• No vaccine wastage
• Simplified logistics
• Reduced training burden
• Minimum equipment down time
Status of Technologies
R&D (5-10 years)
• Alternative thermostability technologies
• Auto-reconstitution
• Non-invasive SCUDAS
• Multivalent vaccines
Applications Development
(1-7 years)
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Glassification drying
Injection SCUDAS
Reconstitution ADs
Adapted sharps disposal
solutions
Status of Technologies (continued)
Validation (1-3 years)
Roll Out (0-3 years)
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• Monodose vials
• Injection SCUDAS HBV,TT
• VVMs -all vaccines
• AD syringes for routine
• Outsourced transport
• Bundling of ADs and
waste solutions
• Multivalent vaccines
High-efficiency fridge
Ice-free cooling
Outsourced logistics
Out-of-the-cold chain
protocols
• Multi-dose jet injectors
(next generation)