The global vaccine market in 2023 has reached an impressive figure of 7 billion doses, translating to a staggering monetary value of $77 billionThis represents approximately 5% of the total revenue generated in the global pharmaceutical marketThe significant increase in market value primarily stems from the rising demand for high-priced adult vaccines.

Among the myriad vaccines available, the Human Papillomavirus (HPV) vaccine stands out by showcasing the most substantial growth in value over the past five yearsIt has generated immense financial growth within the self-paying market in China, similar to the Pneumococcal Conjugate Vaccine (PCV).

However, a report indicated that the overall size of the global vaccine market experienced a dramatic decline compared to the previous year, nearly halvedThis downtrend has been largely attributed to a major reduction in the purchasing volume of COVID-19 vaccines

Nevertheless, it is important to note that despite this decrease, COVID-19 vaccines still accounted for nearly 30% (27%) of global vaccine market sales, thus retaining their position as the highest-valued vaccines of the last yearFollowing COVID-19 vaccinations in terms of market value in 2023 are the HPV, PCV, seasonal influenza, and shingles vaccines.

The dominance of adult vaccines among the top five most valuable vaccines is notableYet, rising concerns over inequitable vaccine distribution accompany the adult vaccination market's growth and the increasing concentration of vaccine manufacturing and supply worldwide.

According to Shenglan Tang, the head of the Vaccine Delivery Research Innovation Lab at Duke Kunshan University, adult immunization will be pivotal in future vaccination effortsHe pointed out that rapid progress in adult immunization is currently observed primarily in a limited number of regions, predominantly in developed countries

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As the global population continues to age, it is crucial for developing nations to strategize long-term plans regarding adult immunizationKey barriers to adult vaccination in these countries include high product pricing and gaps in local vaccine productionThus, there is an urgent need to pilot financing mechanisms that diverge from traditional children's immunization programs.

The HPV vaccine, which has exhibited the most significant increase in value, finds a major contributor to this growth in China's escalating procurement volume.

When reflecting back to 2019, the HPV vaccine has achieved the most considerable value increase over the past five years, boasting a compound annual growth rate of 19%. It is currently the only vaccine capable of preventing cancer globallyData reveals that cervical cancer ranks as the second most common malignant tumor among women aged 15 to 44, with 99% of cervical cancer cases relating to high-risk HPV infections.

As of now, China has approved five types of HPV vaccines: GSK’s bivalent, Merck’s quadrivalent and nonavalent, alongside two domestically produced bivalent vaccines from Watson Biotech and Wantai BioPharma

In July and August, the vaccine application submissions for a quadrivalent HPV vaccine developed by the China National Pharmaceutical Group and a nonavalent vaccine by Wantai BioPharma were accepted by the National Medical Products Administration (NMPA).

With the development and market entry of domestically produced HPV vaccines, prices have seen a downward trend, thereby enhancing vaccination availability for eligible women and increasing the chances of government procurementCurrently, 11 provinces in China have launched favorable policies providing free vaccinations for eligible girls with locally produced bivalent HPV vaccines.

The report also highlights that the growth in the global value of HPV vaccines in 2023 was primarily fueled by improved availability and increased procurement in the Chinese marketHowever, significant disparities in demand and supply persist on a global scale.

Research indicates that 57% of cervical cancer cases occur in countries that have yet to establish an HPV vaccination program

The impact of the COVID-19 pandemic has resulted in a mere 21% vaccination coverage for HPV among women globally by 2023. Furthermore, in 2023 alone, although the vaccination volume grew by 108%, only about half (132) of the countries worldwide purchased HPV vaccines.

The diversity in HPV vaccine supply remains limitedAccording to the report, there are currently eight global HPV vaccine manufacturers, with Wantai Biopharma entering the top 10 global vaccine financial standings due to its sales of HPV and Hepatitis E vaccines, accounting for 1% of the total financial value in the global vaccine marketHowever, strikingly, 80% of the market share, by volume, is still controlled by just two leading pharmaceutical giants.

The increasing demand for adult vaccines amplifies the issues of unequal vaccine distribution around the globeThe problem of "unfair" global vaccine procurement has been exacerbated by the rising demand for high-priced adult vaccines and the introduction of new vaccines

The data shows that in 2023, high-income countries independently procured 72% of the global vaccine market's value, up from 65% in 2022.

Simultaneously, the supply side of the global vaccine market remains highly concentrated, with the top ten vaccine manufacturers claiming 73% of global volume and 85% of its financial valueWhen classifying these leading manufacturers against a threshold of $2 billion in financial value, we find that those below this mark predominantly originate from China and India.

An analysis of specific markets reveals that over fifty percent of the market shares for nearly twenty common vaccines belong to just two suppliersDespite 19 out of the top 20 vaccine types possessing over five manufacturers in 2023, only two markets—hepatitis B and seasonal influenza vaccines—managed to establish diversified supply streams where the leading two manufacturers hold less than 50% market volume share.

Moreover, for seasonal influenza vaccines that have achieved diversified supply, procurements in low and middle-income countries remain infrequent

The report notes that high-income countries maintain a significant advantage when it comes to the financial value of vaccine procurement.

Disparities in vaccine self-sufficiency also vary by regionThe report reveals that the Southeast Asia and Western Pacific regions, according to WHO classification, have achieved a high level of vaccine self-sufficiencyChina provides 54% of the vaccines within the Western Pacific, with 90% of the procured vaccines being domestically producedHowever, it is essential to note that self-procurement can lead to considerable price fluctuations.

"The rapid progress made by developed countries in adult immunization can be attributed to their abundant healthcare resources and investments, along with comprehensive decision-making and recommendation mechanisms related to the incorporation of new vaccines," Shenglan Tang explains"These countries benefit from robust monitoring systems, evidence acquisition, application promotion, financing, and payment mechanisms for adult immunization

However, if newly launched adult vaccines rely solely on out-of-pocket payments, only those with sufficient economic means can afford them, undermining health equity."

He further argues that due to limited resources, ensuring children's immunization programs have higher priority within national frameworks and international aid and procurement support systemsMost developing nations lack clear planning mechanisms for introducing essential vaccinesThere is also a lack of public and policymaker awareness regarding adult immunization, leaving existing systems underprepared for broader adult vaccine coverage.

In some regions of China, local governments have integrated influenza and pneumonia vaccinations for the elderly into public health projects, yielding favorable vaccination outcomesNevertheless, Tang emphasizes, "Relying solely on public finances to expand immunization coverage will prove challenging for advancing adult vaccine adoption." Issues surrounding financing for vaccinations reveal that in developed nations, adult immunization is often covered by medical insurance or specific community insurance plans, which is not the case for most developing regions.

Despite the challenges faced, there are emerging opportunities to enhance vaccine accessibility