Vaccine cold chain management and cold storage technology to address the challenges of vaccination programs

Thermostabilization of a model viral-vectored oral thin film vaccine

Vaccines rely on a global cold chain to maintain vaccine potency throughout the product life cycle. Existing vaccine thermostabilization methods like lyophilization and spray-drying impart significant stress on the vaccine, reducing its potency. Therefore, dissolvable oral thin films (OTFs) have emerged as an alternative thermostabilizing vaccine delivery platform wherein the vaccine is immobilized in a polymer-sugar matrix and administered to the oral mucosa. Herein, we demonstrate the feasibility of incorporating a model adenovirus vector into an OTF (Ad5 OTF) using a simple one-hour solvent casting process, and we demonstrate retention of the adenovirus infectious titer during storage, as assessed by flow cytometric titering. Increasing Tris buffer concentration and changing the surfactant from a nonionic Tween 80 to a zwitterionic poly(maleic anhydride-alt-1-octadecene) substituted with 3-(dimethylamino)propylamine (PMAL) and increasing its concentration improved the six-day ambient temperature stability by nearly 4-fold. A 23 full factorial design of experiment investigating the influence of PMAL, trehalose, and PEG concentration demonstrated that PMAL and trehalose concentration have the greatest impact on stability of Ad5 OTFs, improving the six-day ambient temperature stability by 250-fold, compared to the first formulation evaluated herein. The thermal stabilization of Ad5 OTFs prepared with a simple one-hour casting process demonstrates the scale-up and scale-out potential for this OTF formulation as a vaccine delivery platform, improving the accessibility of vaccines.

Vaccine-Preventable Diseases in Pediatric Age Group in India: Recent Resurgence, Implications and Solutions

This review examines the recent increase and the changing epidemiology of vaccine-preventable diseases (VPDs) in pediatric age group in India, explores the current challenges, and outlines strategies to restore and sustain vaccination coverage gains in the country. Data were sourced from the desk review of published literature, WHO Global Health Observatory and the Integrated Disease Surveillance Programme (IDSP) of India. Authors analysed trends in immunization coverage and outbreak patterns. The findings show that the vaccination coverage and basket of vaccines being offered to children in India is increasing and vaccine preventable diseases burden has come down. However, in the recent years, there has been spikes in reported measles cases in Indian states. There has been a notable rise in mumps cases, particularly among older children. The overall incidence of rubella has declined, but pockets of under-immunized populations continue to impede elimination efforts. There has been re-emergence of diphtheria cases in states such as Kerala and Assam, accompanied by a shifting disease burden towards adolescents and adults. India's childhood immunization program has matured and coverage is more than ever; however, there are geographical and income inequities in coverage and surges in pediatric age group about vaccine-preventable diseases. There is a need for regular field assessments for these factors to ensure high and sustained coverage with quality vaccines. There is also a need for Digital platforms like Co-WIN and U-WIN which are pivotal for real-time tracking and enhanced vaccine delivery. Alongside, there is a need for making India's Universal Immunization Programme (UIP) a truly integrated effort of life course vaccination; that is how we can control the future surge in pediatric or any other age group.

Enhancing vaccine stability in transdermal microneedle platforms

Micron-scale needles, so-called microneedles (MNs) offer a minimally invasive, nearly painless, and user-friendly method for effective intradermal immunization. Maintaining the stability of antigens and therapeutics is the primary challenge in producing vaccine or drug-loaded MNs. The manufacturing of MNs patches involves processes at ambient or higher temperatures and various physio-mechanical stresses that can impact the therapeutic efficacy of sensitive biologics or vaccines. Therefore, it is crucial to develop techniques that safeguard vaccines and other biological payloads within MNs. Despite growing research interest in deploying MNs as an efficient tool for delivering vaccines, there is no comprehensive review that integrates the strategies and efforts to preserve the thermostability of vaccine payloads to ensure compatibility with MNs fabrication. The discussion delves into various physical and chemical approaches for stabilizing antigens in vaccine formulations, which are subsequently integrated into the MNs matrix. The primary focus is to comprehensively examine the challenges associated with the translation of thermostable vaccine MNs for clinical applications while considering a safe, cost-effective approach with a regulatory roadmap. The recent cutting-edge advances facilitating flexible and scalable manufacturing of stabilized MNs patches have been emphasized. In conclusion, the ability to stabilize vaccines and therapeutics for MNs applications could bolster the effectiveness, safety and user-compliance for various drugs and vaccines, potentially offering a substantial impact on global public health.

A Nationwide Seroprevalence Study for Measles in Individuals of Fertile Age in Romania

Background/Objectives: Romania remains endemic for measles due to suboptimal vaccine coverage rates. During the last three epidemics, the highest incidence of measles was recorded in children younger than 1 year, who should have been partially protected by maternal antibodies. A nationwide cross-sectional seroprevalence study was conducted on persons of fertile age, to evaluate potential immunity gaps in the population. Methods: Between June and October 2020, 959 serum samples were collected from individuals aged 25-44 years (46.5% females) from all the geographic regions in Romania. Measles IgG antibodies were assessed using an enzyme-linked immune assay (DIA.PRO-Diagnostic Bioprobes Srl, Italy). Statistical analysis was performed in IBM SPSS Statistics 27.0, using Fisher's exact and chi-squared tests to test for associations between seropositivity and demographic factors, with p < 0.05 considered statistically significant. Results: The overall measles seroprevalence was 77%, without gender- or geographic region-related differences. Both the seropositivity rate and the measles antibodies titers increased with age, with the highest difference between the oldest and the youngest age group (p = 0.057), suggesting persistent immunity after natural infection in older individuals or anamnestic responses in vaccinated persons, caused by repeated exposures to the circulating virus. An additional confirmatory pilot study on 444 pregnant women confirmed the low level of measles seroprevalence (68.4%), with a significant upward trend in older ages (75% in those aged >40 years old vs. 65% in those aged 25-29 years, p = 0.018 and mean reactivity of measles antibodies 3.05 ± 1.75 in those aged >40 years vs. 2.28 ± 1.39 in those aged 25-29 years, p = 0.037). Conclusions: This study signals critical immunity gaps in the population that contribute to the accumulation of susceptible individuals and recurrent measles outbreaks. The absence of measles antibodies in women of childbearing age increases the newborn's susceptibility to infection, with potentially severe complications.

Thermostability of tetanus toxoid vaccine encapsulated in metal-organic frameworks

Most vaccines require refrigerated transport and storage, which is costly, challenging in low-resource settings, and results in the loss of up to 50% of vaccines globally due to "cold-chain" failures. Here, tetanus toxoid vaccine (TT) was thermostabilized by encapsulation within a metal-organic framework (MOF), zeolitic imidazolate framework-8 (TT@ZIF-8). Its physicochemical properties were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, and confocal microscopy. Unencapsulated TT fell below the 80% activity threshold within 4 days at 40˚C and 60˚C according to immunoassay analysis. Aqueous suspensions of TT@ZIF-8 also declined below 80% activity within a week at both temperatures, likely due to MOF degradation in water. Dried TT@ZIF-8 performed better, retaining 80% stability for 33 days at 40˚C and 22 days at 60˚C. When TT@ZIF-8 was suspended in a non-aqueous mixture of propylene glycol and ethanol, it remained 80% stable for approximately 4 months at 40˚C and 2.5 months at 60˚C. Arrhenius modeling predicted this formulation may qualify for "controlled temperature chain" designation, allowing partial vaccine removal from the cold chain. These studies suggest that MOF encapsulation of vaccines like TT can enable dramatic improvements in vaccine stability during storage without refrigeration.

Calboxyvinyl polymer adjuvant enhances respiratory iga responses through mucosal and systemic administration

Adjuvants play a crucial role in enhancing vaccine efficacy. Although several adjuvants have been approved, there remains a demand for safer and more effective adjuvants for nasal vaccines. Here, we identified calboxyvinyl polymer (CVP) as a superior mucosal vaccine adjuvant from pharmaceutical base materials using our screening systems; single nasal vaccination of the CVP-combined influenza split vaccine-induced antigen-specific IgA and IgG antibodies and provided protection against lethal influenza virus infection. Furthermore, nasal vaccination with CVP-combined severe acute respiratory syndrome coronavirus 2 antigen protected against the virus and stimulated the production of highly cross-reactive IgG antibodies against variants XBB1.5 and JN.1. Intriguingly, intramuscular vaccination of the CVP-combined vaccine also elicited the production of IgA antibodies in both nasal wash and bronchoalveolar lavage fluid in mice and cynomolgus monkeys. CVP therefore offers superior adjuvanticity to existing adjuvants and is anticipated to be a safe and effective adjuvant for mucosal vaccines.

Enhanced and Prolonged Immunogenicity in Mice of Thermally Stabilized Fatty Acid-Conjugated Vaccine Antigen

BACKGROUND/OBJECTIVES

Influenza vaccines require good thermal stability without the need for refrigerator storage. Although the fatty acid-conjugated hemagglutinin (Heg) vaccine antigen provides good stability in both solid and liquid states, its therapeutic effectiveness must be validated in vivo. This study aimed to investigate the immunogenicity of the thermally stabilized Heg-oleic acid conjugate (HOC) and compare it with native Heg as a reference.

METHOD

To evaluate HOC immunogenicity, an enzyme-linked immunosorbent assay was used to measure hemagglutinin inhibition (HI) titers, serum IgG antibody titers (IgG1, IgG2a), and cytokine secretion levels (IFN-γ, IL-4) in BALB/c mice after intramuscular (IM) injection.

RESULTS

Thermally stabilized HOC induced higher and more sustained serum IgG1 and IgG2a responses than the native Heg vaccine antigen. IgG1 is typically associated with a Th2 response, whereas IgG2a is associated with a Th1 response. HOC appeared to enhance both responses, inducing a more balanced immune response. Moreover, HOC antigens stimulate broader immune responses, suggesting stronger and longer-lasting immune memory. The cytokine levels of IFN-γ (2.8-fold) and IL-4 (6-fold) were significantly increased in the HOC-immunized group compared to the Heg group. IFN-γ, a cytokine that activates the Th1 immune response, demonstrated the enhanced ability of HOC to induce a Th1 response. IL-4, a cytokine that promotes the Th2 response, indicated that HOC also strongly induced a Th2 response. The thermal stability of HOC antigens was crucial for maintaining their structural integrity, enabling the continuous exposure to the stable antigen without denaturation. This allows immune cells to recognize stable antigens efficiently and form long-term immune memory.

CONCLUSIONS

The stability of HOC antigens enhanced the antigen processing efficiency of antigen-presenting cells (APCs) and stimulated immune responses. The fatty acid-conjugated vaccine antigen could provide improved storage stability but also enhance immunogenic efficacy compared to the native antigen, supporting its potential for further applications.

Assessment of eVIN (Electronic Vaccine Intelligence Network) in utility and constraints of various stakeholders in Nainital District: A mixed method study

Vaccines are important tools in the fight against many diseases for which eVIN was created. eVIN is working exceptionally, but the remaining gaps (electronic or non-electronic generated) are still present and cannot be assessed solely by the quantitative method. Thus, the objective of the present study was to assess the eVIN (Electronic Vaccine Intelligence Network) in utility and constraints of various stakeholders in Nainital District: A mixed method study. Methodology: This cross-sectional study was carried out among 8 available stakeholders in district Nainital, Uttarakhand. Open-ended KII was conducted individually. Results: Key informants comprised eight Stakeholders (7 medical officers in charge and one senior medical officer). The informants had a mean age of 40 ± 8 years with a mean experience of 10 ± 5 years. Big changes and benefits to the immunization program from eVIN were stated by all the stakeholders. The lacunas that remained and need further lookout, were the funds (for minor maintenance and purchase), the capacity building, more technical training, and the regular practices of vaccination. While in low-lying areas there were no major issues stated but for high altitude blocks, all stated persisting facing issues of road accessibility, mobile network, and CCE wear and tear, which makes them tough to carry for outreach sessions on foot. Thus, the findings suggest positive changes in the regions of vaccine usage, stock management distribution, and documentation. However, an Unreliable power supply at public health centers appears to be a continuous major challenge in maintaining the recommended temperature range. Adherence to good storage and handling practices, Supportive supervision, regular training, and budgetary provisions require the attention of higher-level management.

Rabies in rural northeast India: A case report emphasising the urgency of the One Health approach

Dog-mediated rabies is endemic in India. The country records the highest mortality due to dog-bite-related rabies despite the availability of interventions to prevent deaths. We present a case study of the death of a 59-year-old man in a suburban town of Northeast India after a dog bite from an owned pup. Through this case study, we investigate various omissions and commissions in communities and health professionals that make rabies rampant in India. The circumstances surrounding the death were investigated by interviewing the wife, relatives, neighbour, the hospital/nursing home where the bite case was reported, the district Rapid Response Team (RRT), and the Veterinary and Animal Health Department Officer and through the information recorded in the disease outbreak report. While the biting animal was not vaccinated and had no restriction over its movement imposed by the owners, the response of the hospital staff and public authorities was delayed and inadequate. A poignant reminder of the complexities surrounding dog-mediated rabies in India, this case study calls for a holistic protocol to address dog bites through ensuring the One Health approach encompassing education, provision of post-exposure prophylaxis (PEP) and canine rabies vaccines for dogs, promotion of responsible dog ownership, and intersectoral collaboration. Moreover, strengthening communication channels through effective data exchange and encouraging synergy among healthcare, veterinary, and public health sectors is indispensable to maximize the impact of rabies prevention and control interventions.

Sucrose versus Trehalose: Observations from Comparative Study Using Molecular Dynamics Simulations

Binary mixtures of sucrose and trehalose in water were investigated using classical molecular dynamics (MD) simulations and free energy calculations. By classical MD simulations, the behavior of sugars was studied across the entire range of concentrations, from 0 to 100 wt % of water. Sugar-sugar and sugar-water affinities in diluted systems were in focus when using umbrella sampling and well-tempered metadynamics calculations. Moreover, in classical MD simulations, two approaches for system equilibration were applied: in the first, mixtures were preheated (using simulated annealing) before simulations under desired conditions, while in the second, no preliminary heating was used. It was discovered that sucrose has a stronger tendency to aggregate than trehalose, while the latter forms more hydrogen bonds with water. Below the concentration of 10 wt % of water, the number of hydrogen bonds between sugars is higher than the number of hydrogen bonds between sugars and water. The free energy calculations and hydrogen bonding analysis reveal certain dissimilarities in the hydration of oxygen-containing molecular groups. While there are noticeable differences in the hydration of various hydroxyl groups in sucrose and trehalose, all hydroxyl groups are clearly more hydrated than the ether oxygens in both sugars. Three factors contribute to the lower hydration of ether oxygens: they do not donate hydrogen bonds, they are slightly less polar than the oxygen atoms in hydroxyl groups, and they are less accessible to the solvent. Moreover, hydroxyl groups play the main role in binding water, and the geometry of trehalose is energetically preferable compared to the geometry of sucrose. Effects of preheating were demonstrated at water concentrations below 70 wt %, with more significant differences between mixtures observed at water concentrations below 40 wt %. Disaccharides bind stronger to each other and weaker with water molecules in preheated systems than in mixtures that were not preheated. The hydroxyl groups of sucrose and trehalose in preheated mixtures rotate slower than in systems that did not undergo thermal treatment. Therefore, while preheating is not necessary for liquid solutions, it is vital for the equilibration of samples in their amorphous solid state. In the experimental community, these findings are relevant for decision-making when choosing one of the disaccharides as a preservative.

Prophylactic and therapeutic vaccine development: advancements and challenges

Biomedical research is fundamental in developing preventive and therapeutic vaccines, serving as a cornerstone of global public health. This review explores the key concepts, methodologies, tools, and challenges in the vaccine development landscape, focusing on transitioning from basic biomedical sciences to clinical applications. Foundational disciplines such as virology, immunology, and molecular biology lay the groundwork for vaccine creation, while recent innovations like messenger RNA (mRNA) technology and reverse vaccinology have transformed the field. Additionally, it highlights the role of pharmaceutical advancements in translating lab discoveries into clinical solutions. Techniques like CRISPR-Cas9, genome sequencing, monoclonal antibodies, and computational modeling have significantly enhanced vaccine precision and efficacy, expediting the development of vaccines against infectious diseases. The review also discusses challenges that continue to hinder progress, including stringent regulatory pathways, vaccine hesitancy, and the rapid emergence of new pathogens. These obstacles underscore the need for interdisciplinary collaboration and the adoption of innovative strategies. Integrating personalized medicine, nanotechnology, and artificial intelligence is expected to revolutionize vaccine science further. By embracing these advancements, biomedical research has the potential to overcome existing challenges and usher in a new era of therapeutic and prophylactic vaccines, ultimately improving global health outcomes. This review emphasizes the critical role of vaccines in combating current and future health threats, advocating for continued investment in biomedical science and technology.

Improving the last mile delivery of vaccines through an informed push model: Experiences, opportunities and costs based on an implementation study in a rural district in Uganda

Developing countries face challenges in ensuring equitable, timely, and efficient vaccine availability at health facilities. In Uganda, the distribution of vaccines from district stores to the last-mile health facilities is hindered by an unpredictable and unreliable mixed push-pull delivery system. This system often results in poor vaccine management, stock-outs, and missed vaccination opportunities. This pilot study aimed to enhance the efficiency of last-mile vaccine delivery by implementing an informed push model. The specific goals were to improve vaccine lead time, standardize cold chain management during transportation, and evaluate the costs of implementing the informed push model. A mixed methods approach was used to evaluate the impact of the informed push model in Gomba district, Uganda. Both quantitative and qualitative data were collected at baseline and endline. Quantitative data included mode, frequency, lead-time, and costs of vaccine delivery, vaccine stock status, and cold chain maintenance during transportation, gathered through semi-structured interviews. Qualitative data on experiences and challenges were collected using a guide. Descriptive statistics were used for quantitative data analysis, while an ingredients approach was used for costing data. Thematic analysis was applied to qualitative data. The informed push system significantly improved vaccine delivery efficiency and quality in Gomba district. The average lead-time for vaccine delivery reduced from 14 days at baseline to 5 days at endline. Timely vaccine receipt at health facilities increased from 36.8% to 100%. Temperature monitoring during transit improved from 26.3% to 100%. The proportion of facilities experiencing stock-outs dropped from 79.0% to 36.8%. Monthly distribution costs decreased from $494.8 ($0.07 per child) to $445.9 ($0.06 per child). The informed push model is a cost-effective strategy for improving last-mile vaccine delivery by reducing lead times, enhancing cold chain management, and decreasing stock-outs. Integration into the national immunization program is recommended for broader adoption in Uganda.

Assessments of effectiveness of technologies utilizations in VIHSCM among selected health facilities in Tanzania mainland

Immunization coverage remains a challenge in many developing countries Tanzania being no exception. The current increase in technology adoption in the immunisation supply chain promises the attainment of universal health coverage and Sustainable Development Goals (SDGs) on immunisation. This study evaluates the effectiveness of technology integration in Vaccine and Immunization Health Supply Chain Management (VIHSCM) in Tanzania. This study adopted an exploratory descriptive cross-sectional design. The study collected data using structured questionnaires from health facilities that adopted VIHSCM technologies in Arusha, Mwanza, Morogoro and Mbeya regions, Tanzania. Data were analysed using descriptive statistics and cross-tabulations with the aid of the Statistical Package of Social Sciences 23rd Edition (SPSS). The study included 37 health facilities in Tanzania, mainly district hospitals (59.5%). Respondents were mostly female (70.3%), averaging 45 years old, with 1-5 years of immunization experience. While all facilities had refrigerators, digital reporting tool usage was low, with many relying on paper forms. District hospitals and health centres had higher digital tool adoption rates compared to dispensaries. Despite the underutilization of systems like ILS, TImR, and GoTHOMIS, digital tools were deemed crucial for vaccine supply management. While District Hospitals report high relevance of digital tools, Health Centres and Dispensaries show moderate relevance. Challenges include incomplete technology adoption, inadequate infrastructure, and variable perceptions of technology effectiveness. Digital technologies significantly improve vaccine and immunization supply chain management, particularly in larger facilities. Technologies like the Tanzania Immunization Registry (TImR) and Integrated Logistics Systems (ILS) enhance data accuracy and efficiency. Addressing facility-specific challenges and increasing investment in digital tools are crucial for optimizing vaccine supply chains and achieving immunization targets in Tanzania. Future research should involve larger samples to generalize findings and further explore technology impacts on VIHSCM.

Spatial targeting and integration across vaccination, vitamin A and deworming programs throughout India 2019-21

BACKGROUND

Currently, most large-scale public health programs, such as immunization or anti-parasitic deworming, work in relative isolation. Integrating efforts across programs could potentially improve their efficiency, but identifying populations that could benefit from multiple programs has been an operational challenge.

METHODS

We analyzed a nationally representative survey conducted in India between 2019 and 2021 to assess and map coverage of seven vaccines [Bacillus Calmette-Guérin (BCG), hepatitis B, polio, diphtheria-tetanus-pertussis (DTP), haemophilus influenza type b (Hib), rotavirus and measles-containing vaccine (MCV)], plus Vitamin A supplementation and anti-parasitic deworming treatment among 86 761 children aged 1-3 years old.

RESULTS

National coverage varied widely by program, from 42% (rotavirus) to 95% (BCG). There was high correlation between district-level coverage estimates (r ≥ 0.7) and extensive spatial overlap in low-coverage populations. In simulated implementation strategies, we show that an integrated strategy that targets full immunization coverage for four core vaccines (BCG, polio, DTP, MCV) would achieve similar coverage to an optimal (but unrealistic) implementation strategy and far better coverage than multiple efforts focused on individual vaccines. Targeting the most under-vaccinated districts within states based on spatial clustering or coverage thresholds led to further improvements in full coverage per child targeted. Integration of anti-parasitic deworming or rotavirus vaccination into a core vaccine delivery mission could nearly double their coverage (from ∼45% to ∼85%).

CONCLUSIONS

Integrated delivery and geographic targeting across core vaccines could accelerate India's progress toward full immunization coverage. An integrated platform could greatly expand coverage of non-core vaccines and other child health interventions.

Human papilloma virus vaccination in the resource-limited settings of sub-Saharan Africa: Challenges and recommendations

Human papillomaviruses (HPV) cause 99% of all cervical cancer cases globally, with the high-risk genotypes 16 and 18 causing at least 70% of these cases. An estimated 90% of the global cervical cancer burden occurs in low-to-middle-income countries (LMICs), particularly in sub-Saharan Africa (SSA). Primary prevention through the administration of efficacious HPV vaccines is key to the World Health Organization's global strategy for accelerating the elimination of cervical cancer as a disease of public health concern. The rollout of HPV vaccination in SSA is faced with several challenges, such as the high cost of vaccine procurement, a lack of funding and political will from the central governments of countries, and inadequate infrastructure for vaccine cold chain storage and transport. Stigma, misinformation, lack of education and awareness, and vaccine hesitancy constitute the social factors that affect the successful rollout or implementation of vaccination programs in SSA. Based on the challenges SSA faces in rolling out HPV vaccination, we recommend using strategies that address both the demand-side and supply-side obstacles to HPV vaccination uptake. These include costs and availability, fighting vaccine hesitancy, and increasing vaccine confidence.

Stability Preparedness: The Not-So-Cold Case for Innovations in Vaccine Stability Modelling and Product Release

The rapid development of equitably accessible vaccines is paramount in addressing emerging global health challenges. The safety and efficacy of vaccines hinge significantly on their ability to remain stable from manufacturing throughout the supply chain and up to administration. Furthermore, the release of vaccines requires sufficient understanding of the stability profile to allow for expiration dating. In the event of a public health crisis, the time to generate the necessary stability data and the need for rapid product release are in direct opposition. Developing manufacturing platforms with thermostable product formulations for rapid response is therefore key to meeting CEPI's 100 Days Mission goal. This Review aims to highlight the need for stability preparedness through developing thermostable vaccine platforms and exploring innovative stability monitoring strategies that leverage advanced technologies, predictive modelling, and adaptive methodologies. By doing so, we seek to enhance the efficiency and effectiveness of stability assessments, supporting rapid development, regulatory approval, and widespread, equal distribution of vaccines-especially in an outbreak scenario. Finally, enhanced thermostability will allow for simplification across the supply chain, which will reduce the financial burden of vaccination programmes and enhance equitable access.

A rationally designed antigen elicits protective antibodies against multiple nosocomial Gram-positive pathogens

ESKAPE pathogens are responsible for complicated nosocomial infections worldwide and are often resistant to commonly used antibiotics in clinical settings. Among ESKAPE, vancomycin-resistant Enterococcus faecium (VREfm) and methicillin-resistant Staphylococcus aureus (MRSA) are two important Gram-positive pathogens for which non-antibiotic alternatives are urgently needed. We previously showed that the lipoprotein AdcA of E. faecium elicits opsonic and protective antibodies against E. faecium and E. faecalis. Prompted by our observation, reported here, that AdcA also elicits opsonic antibodies against MRSA and other clinically relevant Gram-positive pathogens, we identified the dominant epitope responsible for AdcA cross-reactive activity and designed a hyper-thermostable and multi-presenting antigen, Sc(EH)3. We demonstrate that antibodies raised against Sc(EH)3 mediate opsonic killing of a wide-spectrum of Gram-positive pathogens, including VREfm and MRSA, and confer protection both in passive and active immunisation models. Our data indicate that Sc(EH)3 is a promising antigen for the development of vaccines against different Gram-positive pathogens.

Cancer Nanovaccines: Nanomaterials and Clinical Perspectives

Cancer nanovaccines represent a promising frontier in cancer immunotherapy, utilizing nanotechnology to augment traditional vaccine efficacy. This review comprehensively examines the current state-of-the-art in cancer nanovaccine development, elucidating innovative strategies and technologies employed in their design. It explores both preclinical and clinical advancements, emphasizing key studies demonstrating their potential to elicit robust anti-tumor immune responses. The study encompasses various facets, including integrating biomaterial-based nanocarriers for antigen delivery, adjuvant selection, and the impact of nanoscale properties on vaccine performance. Detailed insights into the complex interplay between the tumor microenvironment and nanovaccine responses are provided, highlighting challenges and opportunities in optimizing therapeutic outcomes. Additionally, the study presents a thorough analysis of ongoing clinical trials, presenting a snapshot of the current clinical landscape. By curating the latest scientific findings and clinical developments, this study aims to serve as a comprehensive resource for researchers and clinicians engaged in advancing cancer immunotherapy. Integrating nanotechnology into vaccine design holds immense promise for revolutionizing cancer treatment paradigms, and this review provides a timely update on the evolving landscape of cancer nanovaccines.

Chitosan non-particulate vaccine delivery systems

Chitosan is an extensively used polymer for drug delivery applications in particulate and non-particulate carriers. Chitosan-based particulate, nano-, and microparticle, carriers have been the most extensively studied for the delivery of therapeutics and vaccines. However, chitosan has also been used in vaccine applications for its adjuvant properties in various hydrogels or as a carrier coating material. The focus of this review will be on the usage of chitosan as a vaccine adjuvant based on its intrinsic immunogenicity; the various forms of chitosan-based non-particulate delivery systems such as thermosensitive hydrogels, microneedles, and conjugates; and the advantages of its role as a coating material for vaccine carriers.

Thermostable vacuum foam dried Newcastle disease vaccine: Process optimization and pilot-scale study

Vacuum foam drying (VFD) has been shown to improve the thermostability and long-term shelf life of Newcastle Disease Virus (NDV). This study optimized the VFD process to improve the shelf life of NDV at laboratory-scale and then tested the optimized conditions at pilot-scale. The optimal NDV to T5 formulation ratio was determined to be 1:1 or 3:2. Using the 1:1 virus to formulation ratio, the optimal filling volumes were determined to be 13-17% of the vial capacity. The optimized VFD process conditions were determined to be at a shelf temperature of 25℃ with a minimum overall drying time of 44 h. The vaccine samples prepared using these optimized conditions at laboratory-scale exhibited virus titer losses of ≤ 1.0 log10 with residual moisture content (RMC) below 3%. Furthermore, these samples were transported for 97 days around China at ambient temperature without significant titer loss, thus demonstrating the thermostability of the NDV-VFD vaccine. Pilot-scale testing of the NDV-VFD vaccine at optimized conditions showed promising results for up-scaling the process as the RMC was below 3%. However, the virus titer loss was slightly above 1.0 log10 (approximately 1.1 log10). Therefore, the NDV-VFD process requires further optimization at pilot scale to obtain a titer loss of ≤ 1.0 log10. Results from this study provide important guidance for possible industrialization of NDV-VFD vaccine in the future. KEY POINTS: • The process optimization and scale-up test of thermostable NDV vaccine prepared through VFD is reported for the first time in this study. • The live attenuated NDV-VFD vaccine maintained thermostability for 97 days during long distance transportation in summer without cold chain conditions. • The optimized NDV-VFD vaccine preparations evaluated at pilot-scale maintained acceptable levels of infectivity after preservation at 37℃ for 90 days, which demonstrated the feasibility of the vaccine for industrialization.

Frost fighters: unveiling the potential of microbial antifreeze proteins in biotech innovation

Polar environments pose extreme challenges for life due to low temperatures, limited water, high radiation, and frozen landscapes. Despite these harsh conditions, numerous macro and microorganisms have developed adaptive strategies to reduce the detrimental effects of extreme cold. A primary survival tactic involves avoiding or tolerating intra and extracellular freezing. Many organisms achieve this by maintaining a supercooled state by producing small organic compounds like sugars, glycerol, and amino acids, or through increasing solute concentration. Another approach is the synthesis of ice-binding proteins, specifically antifreeze proteins (AFPs), which hinder ice crystal growth below the melting point. This adaptation is crucial for preventing intracellular ice formation, which could be lethal, and ensuring the presence of liquid water around cells. AFPs have independently evolved in different species, exhibiting distinct thermal hysteresis and ice structuring properties. Beyond their ecological role, AFPs have garnered significant attention in biotechnology for potential applications in the food, agriculture, and pharmaceutical industries. This review aims to offer a thorough insight into the activity and impacts of AFPs on water, examining their significance in cold-adapted organisms, and exploring the diversity of microbial AFPs. Using a meta-analysis from cultivation-based and cultivation-independent data, we evaluate the correlation between AFP-producing microorganisms and cold environments. We also explore small and large-scale biotechnological applications of AFPs, providing a perspective for future research.

Construction of a Robust Radiative Cooling Emitter for Efficient Food Storage and Transportation

Nowadays, food safety is still facing great challenges. During storage and transportation, perishable goods have to be kept at a low temperature. However, the current logistics still lack enough preservation ability to maintain a low temperature in the whole. Hence, considering the temperature fluctuation in logistics, in this work, the passive radiative cooling (RC) technology was applied to package to enhance the temperature control capability in food storage and transportation. The RC emitter with selective infrared emission property was fabricated by a facile coating method, and Al2O3 was added to improve the wear resistance. The sunlight reflectance and infrared emittance within atmospheric conditions could reach up to 0.92 and 0.84, respectively. After abrasion, the sunlight reflection only decreased by 0.01, and the infrared emission showed a negligible change, revealing excellent wear resistance. During outdoor measurement, the box assembled by RC emitters (RC box) was proved to achieve temperature drops of ∼9 and ∼4 °C compared with the corrugated box and foam box, respectively. Besides, the fruits stored in the RC box exhibited a lower decay rate. Additionally, after printing with patterns to meet the aesthetic requirements, the RC emitter could also maintain the cooling ability. Given the superior optical properties, wear resistance, and cooling capability, the emitter has great potential for obtaining a better temperature control ability in food storage and transportation.

Internet of Things (IoT)-enabled framework for a sustainable Vaccine cold chain management system

Vaccines are a unique category of drugs sensitive to temperature and humidity and whose effectiveness directly impacts public health. There has been an increase in vaccine-related adverse events worldwide, particularly in developing countries, attributed to suboptimal temperatures during transport and storage. At the same time, the Internet of Things (IoT) has ushered in a paradigm shift in vaccine information and storage monitoring, enabling continuous 24/7 tracking. This further reduces the dependence on limited human resources and significantly reduces the associated errors and losses. This paper presents an IoT-driven framework that aims to improve the sustainability of medical cold chain management. The framework promotes trust and transparency in vaccine surveillance data by accessing and authenticating IoT devices. The proposed system aims to improve the safety and sustainability of vaccine management. Moreover, we provide detailed insights into the design and hardware components of the proposed framework. In addition, the specific use of the framework in a particular province is highlighted, covering the design of the software platform and the analysis of the hardware equipment.

Time-traceable micro-taggants for anti-counterfeiting and secure distribution of food and medicines

This study presents an innovative solution for the enhanced tracking and security of pharmaceuticals through the development of microstructures incorporating environmentally responsive, coded microparticles. Utilizing maskless photolithography, we engineered these microparticles with a degradable masking layer with 30 μm thickness that undergoes controlled dissolution. Quantitative analysis revealed that the protective layer's degradation, monitored by red fluorescence intensity, diminishes predictably over 144 h in phosphate-buffered saline under physiological conditions. This degradation not only confirms the microparticles' integrity but also allows the extraction of encoded information, which can serve as a robust indicator of medicinal shelf life and a deterrent to tampering. These findings indicate the potential for applying this technology in real-time monitoring of pharmaceuticals, ensuring quality and authenticity in the supply chain.

Riding the wave of innovation: immunoinformatics in fish disease control

The spread of infectious illnesses has been a significant factor restricting aquaculture production. To maximise aquatic animal health, vaccination tactics are very successful and cost-efficient for protecting fish and aquaculture animals against many disease pathogens. However, due to the increasing number of immunological cases and their complexity, it is impossible to manage, analyse, visualise, and interpret such data without the assistance of advanced computational techniques. Hence, the use of immunoinformatics tools is crucial, as they not only facilitate the management of massive amounts of data but also greatly contribute to the creation of fresh hypotheses regarding immune responses. In recent years, advances in biotechnology and immunoinformatics have opened up new research avenues for generating novel vaccines and enhancing existing vaccinations against outbreaks of infectious illnesses, thereby reducing aquaculture losses. This review focuses on understanding in silico epitope-based vaccine design, the creation of multi-epitope vaccines, the molecular interaction of immunogenic vaccines, and the application of immunoinformatics in fish disease based on the frequency of their application and reliable results. It is believed that it can bridge the gap between experimental and computational approaches and reduce the need for experimental research, so that only wet laboratory testing integrated with in silico techniques may yield highly promising results and be useful for the development of vaccines for fish.

Recent advances in nano- and micro-scale carrier systems for controlled delivery of vaccines

Vaccines provide substantial safety against infectious diseases, saving millions of lives each year. The recent COVID-19 pandemic highlighted the importance of vaccination in providing mass-scale immunization against outbreaks. However, the delivery of vaccines imposes a unique set of challenges due to their large molecular size and low room temperature stability. Advanced biomaterials and delivery systems such as nano- and mciro-scale carriers are becoming critical components for successful vaccine development. In this review, we provide an updated overview of recent advances in the development of nano- and micro-scale carriers for controlled delivery of vaccines, focusing on carriers compatible with nucleic acid-based vaccines and therapeutics that emerged amid the recent pandemic. We start by detailing nano-scale delivery systems, focusing on nanoparticles, then move on to microscale systems including hydrogels, microparticles, and 3D printed microneedle patches. Additionally, we delve into emerging methods that move beyond traditional needle-based applications utilizing innovative delivery systems. Future challenges for clinical translation and manufacturing in this rapidly advancing field are also discussed.

Properties of a tardigrade desiccation-tolerance protein aerogel

Lyophilization is promising for tackling degradation during the drying and storage of protein-based drugs. Tardigrade cytosolically abundant heat soluble (CAHS) proteins are necessary and sufficient for desiccation-tolerance in vivo and protein protection in vitro. Hydrated CAHS proteins form coiled-coil-based fine-stranded, cold-setting hydrogels, but the dried protein remains largely uncharacterized. Here, we show that dried CAHS D gels (i.e., aerogels) retain the structural units of their hydrogels, but the details depend on prelyophilization CAHS concentrations. Low concentration samples (<10 g/L) form thin (<0.2 μm) tangled fibrils lacking regular structure on the micron scale. Upon increasing the concentration, the fibers thicken and form slabs comprising the walls of the aerogel pores. These changes in morphology are associated with a loss in disorder and an increase in large β sheets and a decrease in α helices and random coils. This disorder-to-order transition is also seen in hydrated gels as a function of concentration. These results suggest a mechanism for pore formation and indicate that using CAHS proteins as excipients will require attention to initial conditions because the starting concentration impacts the lyophilized product.

Does the rise in cases of Kyasanur forest disease call for the implementation of One Health in India?

The viral hemorrhagic illness known as Kyasanur forest disease (KFD), also referred to as monkey fever, is transmitted by ticks. The etiological agent, which was formerly isolated from monkeys, is Kyasanur forest disease virus (KFDV), an RNA virus belonging to the family Flaviviridae. Since 1957, India has reported 400-500 cases annually, with a case fatality rate of 1-3%. Shiroma, Chikkamagalore, Uttara Kannada, Dakshina Kannada, and Udupi are the five regions in Karnataka, India where KFD is highly prevalent, with around 3263 notified cases reported between 2003 and 2012, of which 823 cases were laboratory confirmed. The symptoms of monkey fever can range from mild sickness to severe neurological sequelae. Currently, prophylaxis involves administration of formalin-inactivated tissue culture vaccine. Despite the continuing vaccination programs in endemic areas for KFD, new cases are being reported. The current availability and effectiveness of the vaccine are not enough to provide protective immunity and thus prevent new outbreaks. Our study examined the known literature, knowledge gaps, and host responses associated with KFD. There is a need for robust vector control, public awareness campaigns, mass vaccination programmes, a full understanding of the eco-epidemiological elements of the disease, and implementation of a One Health program. These could all support prevention and management protocols, and thus help to address the issue.

Massive Fabrication of Flexible, Form-Stable, and Self-Repairing Brine Phase Change Material Gels toward Smart Cold Chain Logistics

Cold chain logistics plays an extremely important role in the storage and transportation of perishable products. Nowadays, phase change materials (PCMs) have been applied in emerging cold chain logistics to overcome the problems of low stability, high energy consumption, and high cost in mechanical refrigeration-based cold chain logistics. Mass production of high-performance phase change cold storage materials toward cold chain logistics is still a major challenge. Herein, self-repairing brine phase change gels (BPCMGs) massively fabricated by ionic cross-linking, covalent cross-linking, and hydrogen bond cross-linking are proposed. Brine containing 23.3% sodium chloride (NaCl) is selected as the phase change component because its phase change temperature is suitable for the cold storage demand of aquatic products. The proposed BPCMGs demonstrate superior thermophysical properties in terms of no phase separation, no supercooling, high form stability, high latent heat, high thermal conductivity, high cyclic stability, and high self-repairing rate. Meanwhile, the BPCMGs present high cost-effectiveness. Given these advantages, BPCMGs are utilized to assemble smart cold storage equipment for the storage and transportation of aquatic products. The cold storage time reaches 36.73 h for aquatic products when the stored cold energy is 364078 J. The location and temperature of the refrigerated products are monitored in real-time. The state-of-the-art BPCMGs provide diversified possibilities for the advanced smart cold chain.

A plant-produced SARS-CoV-2 spike protein elicits heterologous immunity in hamsters

Molecular farming of vaccines has been heralded as a cheap, safe and scalable production platform. In reality, however, differences in the plant biosynthetic machinery, compared to mammalian cells, can complicate the production of viral glycoproteins. Remodelling the secretory pathway presents an opportunity to support key post-translational modifications, and to tailor aspects of glycosylation and glycosylation-directed folding. In this study, we applied an integrated host and glyco-engineering approach, NXS/T Generation™, to produce a SARS-CoV-2 prefusion spike trimer in Nicotiana benthamiana as a model antigen from an emerging virus. The size exclusion-purified protein exhibited a characteristic prefusion structure when viewed by transmission electron microscopy, and this was indistinguishable from the equivalent mammalian cell-produced antigen. The plant-produced protein was decorated with under-processed oligomannose N-glycans and exhibited a site occupancy that was comparable to the equivalent protein produced in mammalian cell culture. Complex-type glycans were almost entirely absent from the plant-derived material, which contrasted against the predominantly mature, complex glycans that were observed on the mammalian cell culture-derived protein. The plant-derived antigen elicited neutralizing antibodies against both the matched Wuhan and heterologous Delta SARS-CoV-2 variants in immunized hamsters, although titres were lower than those induced by the comparator mammalian antigen. Animals vaccinated with the plant-derived antigen exhibited reduced viral loads following challenge, as well as significant protection from SARS-CoV-2 disease as evidenced by reduced lung pathology, lower viral loads and protection from weight loss. Nonetheless, animals immunized with the mammalian cell-culture-derived protein were better protected in this challenge model suggesting that more faithfully reproducing the native glycoprotein structure and associated glycosylation of the antigen may be desirable.

DECOLONISING VACCINE PRODUCTION: UNPACKING GHANAIANS’ SUPPORT FOR MADE-IN-AFRICA VACCINES

Localisation of vaccine production is essential worldwide, but it is particularly crucial for Africa. This continent is more vulnerable to disease burdens and also lags behind other continents regarding access to vaccines. Moreover, many people in Africa have a long-standing apathy towards locally made products and services. This mindset raises the question of whether Africans will support African-made vaccines and what the associated reasons are. Guided by the theories of nationalism and import substitution industrialisation, we formulated and tested eight hypotheses. To answer these, we analysed survey data from 6,731 residents backed by key informant interviews in Ghana. Our findings identified three types of local vaccine consumers: Afrocentric-ethnocentrics, Apathetic-Afrocentrics and Afrocentric-Fence Sitters. Four out of the eight hypothesised factors explain why some individuals have a positive attitude towards locally made vaccines, compared to those who are unsure of their stance. The proposed typology of local vaccine consumers and their defining characteristics can help design public health campaigns to mobilize support for locally produced vaccines.

Vaccine Cold Chain Management and Associated Factors in Public Health Facilities and District Health Offices of Wolaita Zone, Ethiopia

Background

Vaccines are medical products with a short shelf life and are easily damaged by deviations in temperature from the recommended ranges. Vaccines lose their quality if the cold chain system is not properly managed. Cold chain management is still a major challenge in developing countries, including Ethiopia. Thus, this study aimed to assess vaccine cold chain management and associated factors at public health facilities and district health offices.

Methods

A facility-based cross-sectional study design was applied from March 1-28, 2021. One hundred and thirty-six health institutions were selected by simple random sampling method. Data was collected using the observation check list and interviewer-administered pre-tested structured questionnaires. Data was analyzed using SPSS version 25. The binary logistic regression was employed and those variables with a p-value less than 0.25 in the bivariate analysis were used for multivariable logistic regression. Then multivariate analysis at a p-value <0.05 and AOR with 95% CI was used to measure the degree of association between independent variables and the outcome variable.

Results

The study indicates that 83 (61%) public health facilities had good cold chain management practice at 95% CI (52.2-68.4). Experience greater than 2 years (AOR=2.8, 95% CI=1.13-6.74), good knowledge on cold chain management (AOR=3.02, 95% CI=1.2-7.4), training on cold chain management (AOR=1.86, 95% CI=1.36-9.84), and supportive supervision on cold chain management (AOR=2.71, 95% CI=1.1-7.14) were statistically significantly associated with good cold chain management practice.

Conclusion

The result of the study indicated that there was low cold chain management practice in the study area. Strengthening the knowledge of healthcare workers and supportive supervision on cold chain management by giving training and monitoring their practice toward cold chain management may help to improve the cold chain management practice.

Deployment of Smart Specimen Transport System Using RFID and NB-IoT Technologies for Hospital Laboratory

In this study, we propose a specimen tube prototype and smart specimen transport box using radio frequency identification (RFID) and narrow band-Internet of Things (NB-IoT) technology to use in the Department of Laboratory Medicine, King Chulalongkorn Memorial Hospital. Our proposed method replaces the existing system, based on barcode technology, with shortage usage and low reliability. In addition, tube-tagged barcode has not eliminated the lost or incorrect delivery issues in many laboratories. In this solution, the passive RFID tag is attached to the surface of the specimen tube and stores information such as patient records, required tests, and receiver laboratory location. This information can be written and read multiple times using an RFID device. While delivering the specimen tubes via our proposed smart specimen transport box from one clinical laboratory to another, the NB-IoT attached to the box monitors the temperature and humidity values inside the box and tracks the box's GPS location to check whether the box arrives at the destination. The environmental condition inside the specimen transport box is sent to the cloud and can be monitored by doctors. The experimental results have proven the innovation of our solution and opened a new dimension for integrating RFID and IoT technologies into the specimen logistic system in the hospital.

Sporozoite immunization: innovative translational science to support the fight against malaria

INTRODUCTION

Malaria, a devastating febrile illness caused by protozoan parasites, sickened 247,000,000 people in 2021 and killed 619,000, mostly children and pregnant women in sub-Saharan Africa. A highly effective vaccine is urgently needed, especially for Plasmodium falciparum (Pf), the deadliest human malaria parasite.

AREAS COVERED

Sporozoites (SPZ), the parasite stage transmitted by Anopheles mosquitoes to humans, are the only vaccine immunogen achieving >90% efficacy against Pf infection. This review describes >30 clinical trials of PfSPZ vaccines in the U.S.A., Europe, Africa, and Asia, based on first-hand knowledge of the trials and PubMed searches of 'sporozoites,' 'malaria,' and 'vaccines.'

EXPERT OPINION

First generation (radiation-attenuated) PfSPZ vaccines are safe, well tolerated, 80-100% efficacious against homologous controlled human malaria infection (CHMI) and provide 18-19 months protection without boosting in Africa. Second generation chemo-attenuated PfSPZ are more potent, 100% efficacious against stringent heterologous (variant strain) CHMI, but require a co-administered drug, raising safety concerns. Third generation, late liver stage-arresting, replication competent (LARC), genetically-attenuated PfSPZ are expected to be both safe and highly efficacious. Overall, PfSPZ vaccines meet safety, tolerability, and efficacy requirements for protecting pregnant women and travelers exposed to Pf in Africa, with licensure for these populations possible within 5 years. Protecting children and mass vaccination programs to block transmission and eliminate malaria are long-term objectives.

Impact of Improper Storage of ChAdOx1-S (AstraZeneca) Vaccine on Its Efficacy and Safety

Background: In May 2021, there was an incident regarding giving patients AstraZeneca vaccines stored improperly. They were stored at room temperature (21 degrees centigrade) for 18 h, 12 h longer than the producer recommends. Aim of the study: The paper aims to contribute to the body of knowledge concerning the efficacy and safety of the ChAdOx1-S (AstraZeneca) vaccine concerning the requirements for cold supply chain specification. Patients and methods: Improperly stored vaccines were given to 44 patients, and 39 of them decided to take part in the study. The Control group consisted of 56 people vaccinated on the same days by the same medical teams, using properly stored medicines. Results: The concentration of anti-S1 SARS-CoV-2 Spike protein IgG antibodies did not differ significantly between the groups. Examined group median 70 kU/L (20;100). Control group median 66 kU/L (32.75;100), p = 0.751. We did not observe any COVID-19 infections in either the control or examined group for half a year after the incident. People from each group reported that local and systemic adverse events occurred directly after the first and second doses. In the control group, one case of spontaneously subsiding face edema and joint pain was observed. There were no severe or fatal adverse events. There were no significant differences between the groups, besides the fatigue, after the second dose. Conclusion: AstraZeneca vaccine ChAdOx1-S stored at 21 degrees centigrade for 18 h before vaccination has the same safety profile (p < 0.05) and the same efficacy (p < 0.05) as the vaccines stored in conditions recommended by the producer.

Vaccine management practices among healthcare workers in Morogoro, Tanzania: a cross-sectional study

BACKGROUND

Effective vaccine management is essential to maintain the quality of vaccines, minimise wastages, and prevent missed opportunities for vaccination at service delivery points.

OBJECTIVES

This study aims to assess vaccine management practices among vaccinators at health facilities in the Morogoro region, Tanzania.

METHODOLOGY

A descriptive cross-sectional study design involved health workers from 77 health facilities offering vaccination services. The study population consisted of vaccine handlers and vaccinators working in public health facilities in the Morogoro region. The vaccine management practices were assessed using data collected from ledgers and the Vaccine Information Management System (VIMS). The temperature records were downloaded from the Fridge-tag® 2 and Coldtrace5 devices.

RESULTS

The findings indicated that 65 (84%) health facilities had functional refrigerators and are using power from 26 (34%), 28 (36%), and 23 (30%) of grid electricity, solar, and Liquefied Petroleum Gas (LPG), respectively. Besides, 27 (35%) health facilities have an alternative energy source as a backup. In general, healthcare workers had a good knowledge of cold chain management, including the World Health Organization recommended storage temperatures for vaccines. Furthermore, vaccine stockout was found in 12 (15.6%) health facilities for at least one antigen and 4 (5.1%) health facilities for all five antigens under observation. This current study also revealed that the average calculated vaccine wastage rates for DTP, Measles-Rubella and Rotavirus vaccines were 7%, 19%, and 15%, respectively. More than half of health workers did not perform monthly temperature data reviews. In addition, poor performance led to high wastage rates, including the Rotavirus vaccines, and a change in VVM to discard points. Finally, a small number of 5 (6.5%) health facilities consecutively reported temperature exposure beyond + 8 Celsius (between 5.9 and 281 h).

CONCLUSIONS

Healthcare workers' vaccine and cold chain management knowledge were good for temperature data reading and documentation. However, the practices were poor for some health facilities. The gaps observed in this study inform health managers and policymakers toward establishing interventions to improve health workers' knowledge and practice, including mentorships, supervision, and training to guarantee that each child in all communities reaps the benefits of immunisation services.

Experimental performance of a finned spherical container in cold thermal storage for tropical buildings

The heating and cooling of buildings consume almost 40% of global energy consumption. Cooling building spaces require more input energy compared to heating in tropical buildings. The power tariff varies according to the base and peak demands. This research mainly minimizes peak electricity demand by operating cold thermal storage using deionized water as a phase change material (PCM). The experimental work investigates the partial charging of deionized water in an internally finned stainless steel spherical container immersed in a constant temperature bath. Encapsulated PCM is tested with constant bath temperatures of - 6 ℃, - 9 ℃, and - 12 ℃. Radial copper fins with a diameter of 3 mm are attached inside the container. The selected fin lengths are 7.5 mm, 13.5 mm, and 19.5 mm. The fin length of 13.5 mm is significantly reducing the freezing period. An effective reduction in the charging duration of 52% is observed at - 6 ℃ bath temperature. Partial charging is recommended by incorporating twice the amount of PCM in the design stage and utilizing 50% freezing during operation to achieve up to 52% energy savings. Therefore, the current findings help design effective cold storage for large-scale air-conditioning in buildings.

Effectiveness and profitability of preventive veterinary interventions in controlling infectious diseases of ruminant livestock in sub-Saharan Africa: a scoping review

Agriculture in general, and livestock production in particular, serve as a livelihood source for many people in sub-Saharan Africa (SSA). In many settings, lack of control of infectious diseases hampers livestock productivity, undermining the livelihood of rural populations. This scoping review sought to identify veterinary interventions previously evaluated as well as their relative effectiveness in controlling infectious livestock diseases. To be included, papers had to be written in English, German or French, and had to describe the effectiveness and/or profitability of preventive veterinary intervention(s) against anthrax, blackleg, bovine tuberculosis, brucellosis, contagious bovine pleuropneumonia, contagious caprine pleuropneumonia, foot-and-mouth disease, goat pox, lumpy skin disease, pasteurellosis, peste des petits ruminants, and/or sheep pox in any SSA country. Of the 2748 publications initially screened, 84 met our inclusion criteria and were analyzed. Most of the studies (n = 73, 87%) evaluated the effectiveness and/or profitability of vaccination, applied exclusively, applied jointly with, or compared to strategies like deworming, antimicrobial treatment, surveillance, feed supplementation, culling and dipping in reducing morbidity and/or mortality to livestock diseases. The effectiveness and/or profitability of antimicrobial treatment (n = 5), test and slaughter (n = 5), and use of lay animal health workers (n = 1) applied exclusively, were evaluated in the other studies. Vaccination was largely found to be both effective and with positive return on investment. Ineffective vaccination was mainly due to loss of vaccine potency under unfavorable field conditions like adverse weather events, cold chain failure, and mismatch of circulating pathogen strain and the vaccines in use.In summary, vaccination is the most effective and profitable means of controlling infectious livestock diseases in SSA. However, to achieve effective control of these diseases, its implementation must integrate pathogen surveillance, and optimal vaccine delivery tools, to overcome the reported field challenges.

Stochastic ice nucleation governs the freezing process of biopharmaceuticals in vials

Biopharmaceuticals commonly require freezing to ensure the stability of the active pharmaceutical ingredients (APIs). At commercial scale, freezing is typically carried out over the course of days in pallets comprising tens of thousands of vials. The selected process conditions have to ensure both complete freezing in all vials and a satisfactory manufacturing throughput. Current process design, however, is mainly experimental, since no mechanistic understanding of pallet freezing and its underlying phenomena has been achieved so far. Within this work, we derive a mechanistic modeling framework and compare the model predictions with engineering run data from the Janssen COVID-19 vaccine. The model qualitatively reproduced all observed trends and reveals that stochastic ice nucleation governs both process duration and batch heterogeneity. Knowledge on the ice nucleation kinetics of the formulation to be frozen thus is required to identify suitable freezing process conditions. The findings of this work pave the way towards a more rational design of pallet freezing, from which a plethora of frozen drug products may benefit. For this reason, we provide open source access to the model in the form of a python package (Deck et al., 2021).

Bi-objective optimization for a multi-period COVID-19 vaccination planning problem

This work investigates a new multi-period vaccination planning problem that simultaneously optimizes the total travel distance of vaccination recipients (service level) and the operational cost. An optimal plan determines, for each period, which vaccination sites to open, how many vaccination stations to launch at each site, how to assign recipients from different locations to opened sites, and the replenishment quantity of each site. We formulate this new problem as a bi-objective mixed-integer linear program (MILP). We first propose a weighted-sum and an ϵ -constraint methods, which rely on solving many single-objective MILPs and thus lose efficiency for practical-sized instances. To this end, we further develop a tailored genetic algorithm where an improved assignment strategy and a new dynamic programming method are designed to obtain good feasible solutions. Results from a case study indicate that our methods reduce the operational cost and the total travel distance by up to 9.3% and 36.6%, respectively. Managerial implications suggest enlarging the service capacity of vaccination sites can help improve the performance of the vaccination program. The enhanced performance of our heuristic is due to the newly proposed assignment strategy and dynamic programming method. Our findings demonstrate that vaccination programs during pandemics can significantly benefit from formal methods, drastically improving service levels and decreasing operational costs.

A Multivalent Vaccine Based on Ferritin Nanocage Elicits Potent Protective Immune Responses against SARS-CoV-2 Mutations

The SARS-CoV-2 pandemic has created a global public crisis and heavily affected personal lives, healthcare systems, and global economies. Virus variants are continuously emerging, and, thus, the pandemic has been ongoing for over two years. Vaccines were rapidly developed based on the original SARS-CoV-2 (Wuhan-Hu-1) to build immunity against the coronavirus disease. However, they had a very low effect on the virus' variants due to their low cross-reactivity. In this study, a multivalent SARS-CoV-2 vaccine was developed using ferritin nanocages, which display the spike protein from the Wuhan-Hu-1, B.1.351, or B.1.429 SARS-CoV-2 on their surfaces. We show that the mixture of three SARS-CoV-2 spike-protein-displaying nanocages elicits CD4+ and CD8+ T cells and B-cell immunity successfully in vivo. Furthermore, they generate a more consistent antibody response against the B.1.351 and B.1.429 variants than a monovalent vaccine. This leads us to believe that the proposed ferritin-nanocage-based multivalent vaccine platform will provide strong protection against emerging SARS-CoV-2 variants of concern (VOCs).

Investigating sustainable development for the COVID-19 vaccine supply chain: a structural equation modelling approach

Purpose

Immunization is one of the most cost-effective ways to save lives while promoting good health and happiness. The coronavirus disease 2019 (COVID-19) pandemic has served as a stark reminder of vaccines' ability to prevent transmission, save lives, and have a healthier, safer and more prosperous future. This research investigates the sustainable development (SD) of the COVID-19 vaccine supply chain (VSC).

Design/methodology/approach

This study investigates the relationship between internal process, organizational growth, and its three pillars of SD environmental sustainability, economic sustainability and social sustainability. Survey-based research is carried out in the hospitals providing COVID-19 vaccines. Nine hypotheses are proposed for the study, and all the hypotheses got accepted. The survey was sent to 428 respondents and received 291 responses from health professionals with a response rate of 68%. For the study, the healthcare professionals working in both private and public hospitals across India were selected.

Findings

The structural equation modelling (SEM) approach is used to test the hypothesis. All nine hypotheses are supported. This study examines a link between internal processes and organizational learning and the three sustainability pillars (environmental sustainability, economic sustainability and social sustainability).

Practical implications

This study will help the management and the policymakers to think and adopt SD in the COVID-19 VSC. This paper also implies that robust immunization systems will be required in the future to ensure that people worldwide are protected from COVID-19 and other diseases.

Originality/value

This paper shows the relationship between organizational learning and internal process with environmental sustainability, economic sustainability and social sustainability for the COVID-19. Studies on VSC of COVID-19 are not evident in any previous literature.