COVID-19 vaccine development and distribution

The COVID-19 pandemic triggered a sense of vulnerability and urgency that led to concerted actions by governments, funders, regulators, and industry to overcome traditional challenges for the development of vaccine candidates and to reach authorization. The unfolding pandemic triggered an unprecedented effort to accelerate vaccine development. Enabling factors, challenges, and funding innovation are examined along with vaccine platforms, innovative mRNA vaccines, effectiveness, and new clinical development challenges. Homologous and heterologous prime-boost vaccination strategies and vaccines are discussed. Vaccine safety issues have retained the attention of developers, regulators, and users. Vaccine just distribution and equity remain a global challenge that deserves major attention for access to low- and middle-income countries. New avenues have been opened to delocalize vaccine manufacturing (for example, the mRNA hub in Africa), retain and train healthcare workers, and create a global manufacturing training hub. These major efforts are necessary to ensure the success of the preparation for future pandemics through the 100 Days mission of the Coalition for Epidemic Preparedness Innovations (CEPI) within the global framework and commitment of the Pandemic Treaty, a new international instrument to advance collective action for pandemic prevention, preparedness, and response.