Lessons from Covid: Pharma firms turn attention to adult vaccination

Vaccine companies have warmed up to the idea of adult vaccines for other diseases such as pneumonia, flu and shingles as well

The Covid-19 pandemic led to the world’s largest adult vaccination campaign, with more than 13 billion doses administered globally, so far. Around 2.5 million doses of Covid-19 vaccines are being administered daily now across the world. Vaccine companies have thus warmed up to the idea of adult vaccination against non-Covid infections, as well  — pneumonia, flu, and shingles, to name a few.
 

According to Pfizer India country president S Sridhar: “While India’s largest vaccination programme for Covid-19 demonstrated utility, acc¬ep¬tance, and system readiness for adult immu¬nisation, a lot more needs to be done. Therefore, Pfizer has been a frontrunner to fulfil the need for adult immunisation, a requisite of the country’s National Health policy, by partnering with both public and private sectors.”
 

Sridhar said that Pfizer has helped set up over 150 vaccination centres in hospitals across India to drive scientific conversations around vaccines and provide an opportunity to immunise the vulnerable pop¬ulation. “We have also initiated collaboration with insurance companies and corporates to increase awareness and adoption of adult vaccination. For next year, Pfizer envisions championing the cause of extending vaccination benefits to families and help develop clinics across the country to amplify the immunisation benefits,” Sridhar said.        

Companies are, in fact, creating new teams as their focus on adult vaccination increases.
 

“To ensure readiness, we have created new roles via which we collaborate with institutions, doctors, and hospitals to provide customised strategic solutions,” he said.
 

A GSK India spokesperson said the company is in the middle of hiring a new team that will drive its adult vaccination campaign. GSK India is readying to launch a shingles vaccine (a vaccine that protects against the Herpes Zoster) next year.

“The channels, pathways for paediatric vaccination and adult vaccination are different. Therefore, while we have a paediatric vaccine team in place, we felt that we need to create a new team that will work on adult vaccines like shots against shingles and flu,” the spokesperson added.
 

Demand for pneumonia vaccines for adults has shot up during the last two years. Apart from Pfizer’s (Prevnar) and GSK’s (Synflorix) indigenously developed pneumonia vaccines, which are making a mark, Serum Institute of India (SII) has launched its pneumonia vaccine for children up to 2 years. Zydus Lifesciences is also working on a pneumococcal vaccine.
 

SII launched its pneumonia vaccine in December 2020 for children, and has plans to conduct studies on older age groups. SII CEO Adar Poonawalla said: “In the future, we seek to conduct more studies to have it licenced for older age groups. Prevnar and other Pneumococcal and Flu vaccines have seen a considerable rise in usage ever since people have realised the power of vaccines efficacy and necessity.”
 

SII has also recently got the drug regulator’s nod for an indigenously developed vaccine for cervical cancer, caused by the human-papillomavirus (HPV). Priced competitively at Rs 200-400 a dose, this vaccine can be a game-changer for adolescent HPV vaccination in India. The Centre, too, has plans to procure the vaccine for its National Immunisation Mission.

Malaria vaccines in the works are another major adult vaccination focus area for companies.

SII’s malaria vaccines are undergoing trials in Africa, and licensure of this vaccine is expected by 2023. Production may start soon if things go well.

The University of Oxford has partnered with SII to make the R21/Matrix-M. SII will supply over 200 million doses every year of this vaccine after licensure. Its malaria vaccine will initially be for African countries.

SII’s peers Bharat Biotech (through a partnership with GSK) and Zydus Lifesciences, too, are bringing malaria vaccines to the market, which is expected to heat up in the next two to four years.

According to Bharat Biotech, its vaccines are already prescribed by paediatricians and general physicians. Its typhoid vaccine is recommended for both adults and children, the company said. Japanese encephalitis vaccine Jenvac, too, is prescribed for adults and children. The company claimed that Chirorab is the largest-selling rabies vaccine in the country. It did not give details of its marketing plans for adult vaccines.

According to the US-India Strategic Partnership Forum’s (USISPF) white paper titled Life Course Immunisation -- Pulse of a Resilient Health System released last week, the vaccine supply chain infrastructure has been ramped up over the past two years.

“With multiple indigenously developed vaccines, enhanced production capacities, trained frontline workers, over 70,000 vaccination centres, and an indigenously developed end-to-end digital platform ‘CoWIN’, India is now better prepared than ever before to broaden its immunisation programme to include other risk groups among the adult population of the country,” it said.

It recommended vaccination as a tool to reduce burden on health-care systems as India ages. “As India’s population rapidly ages, it is expected to have the largest geriatric age cohort in the world by 2050…. Immunisation should be integrated and prioritised for this risk cohort to enable healthy ageing.”

This segment has some of the highest incidences of co-morbid conditions.

Randeep Guleria, former director, AIIMS said: “Focus on adult immunisation is needed because of an ageing population and those with co-morbidities.”

By 2036, the population above 60 years will be almost three times the 0-4 years old population. “This requires the expansion of immunisation programme as per changing demographic profile,” the USISPF paper noted.

Adults need shot in the arm

125+ mn:   Population aged 50-60 years in 2021

135 + mn:  Those over 60 years in 2021

400 + mn:  Population of those over 50 years in 2036

4x:  50-yr+ population vs below-5-yr children by 2036  

Every 4th person will be 50+ years in the next 15 years
 

Source: US Population Prospects 2019, MoHFW estimates (Report of the Technical Group on Population Projections, July 2020)