The article “Facilitating the Development of Urgently Required Combination Vaccines,” published in The Lancet Global Health, was developed through the collaboration of multiple international organizations, including PATH, the Bill & Melinda Gates Foundation, Gavi, and WHO. It underscores the urgent need to accelerate the development and deployment of multipathogen combination vaccines, particularly in the context of increasingly crowded immunisation schedules, stagnating global coverage, and the rising number of high-priority vaccines.
Although combination vaccines offer clear advantages—such as reducing logistical burden, improving programmatic efficiency, and enhancing vaccine uptake—they remain underprioritised. Progress has been constrained by scientific and regulatory complexity, lack of global policy preference, limited market-shaping incentives, and inadequate financing mechanisms. Existing regulatory frameworks and funding instruments were not designed with combination vaccines in mind, and global vaccine policy and national planning still tend to focus on single antigens. Without systemic change, combination vaccines will continue to lag in development and adoption, leaving countries at risk of missing opportunities to introduce essential vaccines.
The article calls for a paradigm shift in global vaccine policy and outlines strategic actions for stakeholders—including WHO, Gavi, UNICEF, national immunisation technical advisory groups (NITAGs), and regulatory bodies. These actions include: conducting extensive country and regional consultations to identify and validate priority pathogen combinations that are technically feasible and regionally appropriate; incorporating these vaccines into global and national procurement and financing strategies based on country preferences and WHO recommendations; and adapting regulatory frameworks to accommodate multi-antigen products by considering the total clinical benefit and practical advantages of reducing the number of administrations without compromising safety.
Regulatory guidance should support the use of immunological data and immunobridging in clinical evaluations, and consider broader public health, programmatic, and socioeconomic impacts beyond immunogenicity and safety. Insurance policies should allow for equitable reimbursement of combination and standalone vaccines to avoid disincentivising their use. Early engagement with immunisation programme managers, providers, and caregivers is critical to evaluate system-level impacts and understand acceptability.
The article outlines six categories of tangible, innovative steps to overcome current barriers, including: stakeholder consultation, value assessment, regulatory adaptation, financing alignment, post-licensure safety monitoring, and coordinated market-shaping strategies. Importantly, the authors argue that the value of combination vaccines should not be seen as the sum of individual components but as a public health solution with intrinsic programmatic and socioeconomic benefits.
By advocating for coordinated, forward-looking strategies, the article makes a compelling case for investing in combination vaccines—not as novel technologies, but as practical solutions to deliver existing vaccine targets more efficiently and equitably. The authors stress that without proactive reforms, combination vaccines will remain an underused opportunity in addressing preventable disease burdens worldwide.
More can be found in the article:
Hausdorff, W. P., Madhi, S. A., Kang, G., Kaboré, L., Bayona, M. T., & Giersing, B. K. (2024). Facilitating the development of urgently required combination vaccines The Lancet Global Health, 12(6), e1059-e1067.
Content Editor: Ziqi Liu
Page Editor: Ziqi Liu
