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Researchers are in their laboratories looking for new and innovative ways to protect people from infectious diseases – seeking effective vaccines to fight bacteria and viruses that have eluded them for decades. The technology used to produce vaccines in record time during the recent Corona epidemic marked the beginning of a new era in the field of vaccine development.

Today, scientists are turning to a host of new approaches to preventing life-threatening diseases. Their ambitions include targeting more pathogenic organisms and strains by producing vaccines that stimulate stronger immune responses, provide longer-lasting protection and help tackle infectious diseases that are taking a heavy toll around the world despite tremendous progress.

To learn about some of the secrets of vaccines, their importance, and the method of manufacturing and producing them, we reviewed the invitation submitted by GSK, the well-established global biopharmaceutical company, which is one of the largest manufacturers and producers of vaccines. It works to combat diseases and aims to positively impact the health of 2.5 billion people. person over the next ten years. As part of a scientific and educational meeting and event, we visited the largest vaccine manufacturing site in the world in the city of Wavres, which is called “the heart of vaccine production,” in Belgium, where the site was opened in 1995, and we held a number of scientific meetings with senior scientists and researchers responsible for vaccines.

The story of vaccines

Dr. Madeleine Breckon, Vice President of Vaccine Production Lines and Government Affairs, spoke, stressing that vaccinations help protect people at all stages of their lives, from infancy, childhood and adolescence to adulthood and old age, and they prevent 3.5 to 5 million deaths globally. every year. The estimated return for every dollar invested in vaccination was found to be more than $52 in 94 low- and middle-income countries for the period (2011-2030), according to the World Health Organization.

She added that the wide range of vaccines available targets infectious diseases at every stage of life, which helps protect people from serious diseases, such as meningitis, shingles, influenza, polio, measles, and others. There are currently more than 20 vaccines available and 20 other vaccine candidates in the pipeline.

Dr. Rudi Rosolen, Vice President and Head of Operations in Belgium, spoke, stressing that the need for vaccines is constantly growing with the growing world population, and the best example is the birth of 25 million children annually in India, reaching more than two billion people over the age of 60 years. In 2050.

Protecting individuals means protecting societies and countries. There are 4 out of 10 children in the world who receive vaccination annually, and more than 500 million vaccine doses were produced by GSK alone for the world in 2022. What is reassuring is that 90 percent of the vaccines that were used were at their level of effectiveness. 90 percent.

Burden of infectious diseases

Dr. Yan Sergerie, Vice President and Global Medical Production Leader, described the global burden of infectious diseases as still high. Here are some examples:

* Herpes Simplex Virus (HSV): It infects an estimated half a billion people between the ages of 15 and 49 with type 2, and 3.7 billion people under the age of 50 with type 1.

* Shingles: In general, it is estimated that 1 in 3 people will develop the disease in their lifetime in the United States.

* Malaria: It led to about 619,000 deaths in 2021.

* Clostridium Difficile: About 500,000 patients and 30,000 deaths annually in the United States.

* Meningitis (ABCWY): About 1 in 6 people infected with this bacterial type dies, and 1 in 5 develops severe complications.

* Chronic Hepatitis B: 820,000 annual deaths due to cirrhosis or liver cancer.

* Respiratory Syncytial Virus (RSV): An estimated 470,000 hospitalizations and 33,000 deaths in adults over the age of 60 in high-income countries.

* Pneumococcal: More than 800,000 deaths of children each year (globally), and about 150,000 hospitalizations each year in the United States.

Vaccine platforms

Vaccines stimulate immunity by mimicking natural infection. However, immunity from vaccination may wane over time, so maintaining immunity through boosting it may be necessary to generate an immune response without causing disease.

The choice of vaccine platform is determined by two factors; The first is what provides optimal results in terms of safety/immunity, and the second is what can be achieved using available technology.

There are types of vaccines:

* Whole virus vaccine: Viruses are inactivated using chemicals, heat, and ultraviolet light. These include attenuated viruses that are weakened by passage in cell culture or genetic manipulation to produce mutations that limit their ability to cause disease.

* Viral vector vaccines: Viruses are weakened so that they cannot cause disease, and are genetically modified to allow the production of target proteins inside cells. Such as measles and adenoviruses.

* DNA and RNA vaccines: Introduce DNA or RNA that encodes a peptide specific to the pathogen, which enhances the immune response in human cells, which then produce large amounts of specific DNA or RNA, including an RNA vaccine (with a layer lipid), and DNA vaccine.

* Subunit vaccine: Protein subunits of peptides derived from pathogens are used directly with/without an adjuvant, for example: spike protein; A virus-like particle that mimics the structure of the target pathogen, but lacks genetic material.

Vaccines versus medications

There is less potential for risks with vaccines than with medications. Large surveillance programs are necessary to detect and investigate minor adverse events. The threshold of vaccination coverage required to stop transmission varies between infectious diseases as follows:

* The proportion of the population that must be vaccinated to provide complete protection for the herd (for the community) depends on the transmissibility of the pathogen, and the demographic characteristics of the population.

* Herd immunity, through vaccination, provides indirect protection to unvaccinated individuals in the population.

* An individual becoming infected with a pathogen increases the risk of other individuals becoming infected by increasing their likelihood of exposure.

* For many pathogens, the population exposure threshold for the pathogen to spread must be successful. If the proportion of the population that is immune (through vaccination or natural infection) exceeds the threshold, the incidence of the disease will decrease. Individuals exposed to the disease benefit from indirect protection by vaccinating those around them.

* Vaccination provides significant health, social, and economic benefits, both direct and indirect, to individuals and society, through disease prevention, increased long-term productivity, reduced absenteeism, increased life expectancy, increased ratio of workers to dependents, improved school enrollment, and higher per capita GDP, greater job creation, and a better educated workforce.

Maintaining high immunization rates at all stages of life protects against diseases through:

– Extending protection beyond the patient by protecting the herd.

– Contributing to the prevention of antimicrobial resistance.

– Beneficially impact growth, productivity and workforce participation.

A changing “vaccine landscape” for aging

Dr. Piyali Mukherjee, Vice President and Global Chief Medical Officer for Vaccines, spoke about the demographic trend of an aging population, with life expectancy expected to increase by 4.4 years between 2016 and 2040. It is also expected that the number of people over the age of 60 will outnumber those between the ages of 10 and 24 by 2050. By 2100, approximately 30 percent of the population will be over 60 years of age.

Vaccinations will provide an additional preventative measure to the health of these older adults, and can support healthy aging alongside other lifestyle factors such as smoking cessation, a healthy diet, and exercise.

The immune system changes over the course of an individual’s life. It develops in newborns during childhood and into adulthood, and then gradually weakens with age, in a process called age-related immune decline. Aging is a risk factor for hospitalization and death.

– Rates of severe consequences of COVID-19 were high in older people, and the high risk was contributed by the presence of comorbidities and cumulative effects of unhealthy lifestyles.

Hospitalization and death rates due to influenza are highest among the elderly.

The incidence of respiratory syncytial virus (RSV) disease is higher in infants and young children, but the mortality rate is higher in the elderly, with the risk of hospitalization increasing with age and chronic medical conditions.

The rate of access to hospitalization is higher among older adults with certain chronic medical conditions.

The incidence of herpes zoster and the incidence of postherpetic neuralgia increases with age.

Aging is also a risk factor for infectious diseases such as:

Severe influenza infection may contribute to cardiovascular disease in people at risk, as the coronary arteries become inflamed and constricted, the linings of the arteries are damaged, clotting begins, and oxygen levels and blood pressure decrease. Prevention of influenza disease through vaccination may reduce the risk of major adverse cardiovascular events in patients with acute coronary syndrome and cerebral infarction—even years after vaccination.

– Respiratory tract infection (RTI), can increase rates of myocardial infarction (MI) by 3-5 times, and remain high for up to 91 days.

– Infectious diseases exacerbate the chronic condition and expose it to more likely complications due to infection. Prevention is key to avoiding complications.

It has been proven that preventing infectious diseases helps:

– Reducing the risk of downstream effects that may follow acute infection, including the potential effect of preventing influenza infection.

– The overall risk of death from cardiovascular disease was reduced by 56 percent, the risk of myocardial infarction was reduced by 14 percent, and the overall risk of stroke was reduced by 16 percent.

– Reducing the potential effect of preventing shingles infection.

Seniors and vaccines

There are a number of vaccines currently recommended for older adults in order to promote healthy aging, avoid secondary complications and reduce the burden on healthcare systems:

– Some vaccines are recommended to reduce the risk of mortality: pneumococcal, tetanus, diphtheria, hepatitis A and B, RSV, and influenza.

– Some vaccines are recommended in order to maintain quality of life: whooping cough, shingles.

Hepatitis B vaccine is recommended for elderly people at risk of infection.

– Shingles: Dr. Raunak Parikh, Medical Director of Global Medical Affairs, presented a case study of shingles, which is a common disease characterized by severe pain, a rash and blisters on the skin, and is caused by a virus that remains dormant in the nervous system in 90 percent of those over the age of Over 50 years of age and are at risk of infection at any time. One in three will develop this disease at some time in their life. The pain may last for months or even years, and has long-term complications, especially on the nervous system. It also affects the eyes (10-25) percent of those affected, and may end in loss of sight. It also affects the cardiovascular system, clots, hearing loss, and color change. Permanent skin. The disease affects quality of life and has a significant economic burden.

Vaccinations help protect a person at all stages of his life… from infancy and childhood to old age