Emergency response vaccines: lessons learned in response to communicable diseases.

In response to recent political and epidemiological events, the availability of emergency response vaccines has received high priority on the global agenda. An emergency response vaccine is defined as a vaccine of public health importance that should be available to all people at risk against epidemic, pandemic or global threat situations. This review focuses on global threat vaccines, those that would be used in the case of an emerging pathogen or the intentional release of an agent to which there is a low level of population immunity. The development and use of such vaccines requires attention to simultaneous actions on seven fronts: development, forecasting, supply sources, regulation, procurement, financing and allocation. Neglect of any one of these aspects will threaten the success of the project. A case study on smallpox vaccines illustrates this. Although many public health experts fear that attention to stockpiling emergency response vaccines could draw resources from other areas, some aspects of such an effort could positively impact the supply of other needed vaccines.