recommendations to assure the quality, safety and efficacy of tetanus vaccines

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Aref farrokhi [email protected] Reference: WHO-TRS 1

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Page 1: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

Aref farrokhi

[email protected]

Reference: WHO-TRS

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Page 2: Recommendations to assure the quality, safety and efficacy of tetanus vaccines
Page 3: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

گر بدين سان زيست بايد پست

من چه بی شرمم اگر فانوس عمرم را، به رسوائی نياويزم

بر بلنِد کاجِ خشِک کوچه بن بست

گر بدين سان زيست بايد پاک

من چه ناپاکم اگر ننشانم از ايمان خود چون کوه،

شاملو... يادگاری جاودانه بر تراز بی بقای خاک

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Page 4: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

TERMINOLOGY

0Master seed lot

A quantity of bacterial suspension that is derived from a single strain.

Has a uniform composition.

It is used for inoculating media for preparation of the working seed lot.

The master seed lot should be stored as a frozen stock or as a lyophilized stock at a temperature known to ensure stability.

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Page 5: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

TERMINOLOGY

0Working seed lot

0 A bacterial culture derived from the master seed lot.

0 The working seed lot should be prepared from the master seed lot by as few cultural passages as possible, having the same characteristics as the master seed lot and intended for inoculating media for the preparation of single harvests.

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Page 6: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

TERMINOLOGY

0 Seed lot A quantity of bacterial suspension that is derived from one strain, is used for preparing the inoculum for the production medium.

0 Single harvest The toxic filtrate or toxoid obtained from one batch of cultures inoculated, harvested and processed together.

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Page 7: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

TERMINOLOGY

0 Bulk purified toxoid The processed purified material, prepared from either a single harvest or a pool of a number of single harvests. It is the parent material from which the final bulk is prepared.

0 Final bulk The homogeneous final vaccine present in a single container from which the final containers are filled either directly or through one or more intermediate containers.

0 Final lot A collection of sealed final containers that is homogeneous in all respects. In principle, a final lot must therefore have been filled and further processed (e.g. freeze-dried) from a single final bulk container in one continuous working session.

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Page 8: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

Key standards used in the control of tetanus vaccines

The fourth International Standard for Tetanus Toxoid, Adsorbed

The second International Standard of Tetanus Toxoid for Flocculation

The first International Standard for Tetanus Immunoglobulin

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Page 9: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

Part A. Manufacturing recommendations

0A.1 Definitions

A.1.1 International name and proper name :“tetanus vaccine adsorbed”

A.1.2 Descriptive definition :

Tetanus vaccine adsorbed is a preparation of tetanus toxoid prepared by treating tetanus toxin by chemical means to render it nontoxic without losing its immunogenic potency.

The toxoid is adsorbed onto, or precipitated with, a suitable adjuvant.

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Page 10: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

Part A. Manufacturing recommendations

0A.2 General manufacturing recommendations

0 Good manufacturing practices: main principles for pharmaceutical products

0 Good manufacturing practices for biological products

0 This includes demonstration of the purity and quality of the production strain and seed lots, in-process control testing, testing for process additives and process intermediates, and the development and establishment of lot release tests.

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Page 11: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

Part A. Manufacturing recommendations

0A.3 Production, processing and control

A.3.l Production precautions

A.3.2 Production strain and seed lots

A.3.3 Single harvests

A.3.4 Bulk purified toxoid

A.3.5 Final bulk

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Page 12: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.3.2 Production strain and seed lots

A.3.2.1 Strains of Clostridium tetani

A.3.2.2 Seed lot system

1. multilocus enzyme electrophoresis (MEE),

2. matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF)

3. mass spectrometry

4. pulsed-field gel electrophoresis (PFGE)

5. multiple-locus sequencing typing (MLST)

6. restriction fragment length polymorphism (RFLP) analysis

A.3.2.3 Culture medium for production of toxin

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Page 13: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.3.3 Single harvests

A.3.3.1 Control of bacterial purity

A.3.3.2 Filtration

A. 3.3.3 Determination of crude toxin concentration

Manual for the production and control of vaccines: tetanus toxoid

The WHO manual for quality control of diphtheria, tetanus and pertussis vaccines

A.3.3.4 Detoxification and purification

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Page 14: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.3.4 Bulk purified toxoid

A.3.4.1 Preparation

A.3.4.2 Sterility General requirements for the sterility of biological substances (Requirements for biological substances No. 6, revised 1973, amendment 1995)

A.3.4.3 Antigenic purity

A.3.4.4 Specific toxicity WHO manual for quality control of diphtheria, tetanus and pertussis vaccines

A.3.4.5 Reversion to toxicity

A.3.4.6. Storage of bulk purified toxoid WHO’s Guidelines on stability evaluation of vaccines

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Page 15: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.3.4.3 Antigenic purity

Each bulk purified toxoid should be tested for antigenic strength and purity by determining the antigen concentration in Lf units and the concentration of protein (nondialyzable) nitrogen.

Manual for the production and control of vaccines: tetanus toxoid WHO manual for quality control of diphtheria, tetanus and pertussis

vaccines.

Physicochemical analysis, using methods such as SDS-PAGE and HPLC, may be used to monitor antigenic purity and to provide additional information on antigen integrity and the extent of aggregation and proteolysis. These additional characterization tests should be performed whenever a new working seed is introduced.

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A.3.4 Bulk purified toxoid

Page 16: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.3.5 Final bulk

A.3.5.1 Preparation

WHO’s Guidelines on regulatory expectation related to the elimination, reduction or replacement of thiomersal in vaccines should be followed

A.3.5.2 Control tests

WHO Manual for quality control of diphtheria, tetanus and pertussis

vaccines

A.3.5.3 Storage of final bulk

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Page 17: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.3.5.2 Control tests

• A3.5.2.1 Preservative

• A.3.5.2.2 Adjuvants

• A.3.5.2.3 Degree of adsorption WHO Manual for quality control of diphtheria, tetanus and pertussis vaccines

• A.3.5.2.4 Sterility General requirements for the sterility of biological substances (Requirements for biological substances No. 6, revised 1973, amendment 1995)

• A.3.5.2.5 Specific toxicity

• A.3.5.2.6 Potency WHO manual for quality control of diphtheria, tetanus and pertussis vaccines

• A.3.5.2.7 Amount of residual free detoxifying agent

• A.3.5.2.8 pH

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A.3.5 Final bulk

Page 18: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.4 Filling and containers

Good manufacturing practices: main principles for pharmaceutical products

Good manufacturing practices for biological products

0 Single-dose or multiple-dose containers may be used.

0 Vaccines in multidose containers should contain a suitable antimicrobial preservative .

0 The filling process should be suitably validated by comparison of key parameters measured in the final bulk and the final lot. Such studies should include measurement of the degree of adsorption.

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Page 19: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.5 Control of final product

A.5.1 Identity

A.5.2 Sterility

A.5.3 Potency

A.5.4 Innocuity

A.5.5 Adjuvant content

A.5.6 Degree of adsorption

A.5.7 Preservative content

0 A.5.8 pH

0 A.5.9 Extractable volume

0 A.5.10 Inspection of final containers

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Page 20: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.6 Records

Good manufacturing practices: main principles for pharmaceutical products

Good manufacturing practices for biological products

0Written records should be kept of all tests, irrespective of their results.

0The records should be of a type from which annual trends can be determined.

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Page 21: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.7 Samples

The recommendations given in Good manufacturing practices: main principles for

pharmaceutical products and Good manufacturing practices for biological products ,

should apply.

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Page 22: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.8 Labeling

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1. the words “Tetanus Vaccine Adsorbed” and/or the proper name of the product

2. the licence number of the product

3. the name of the manufacture

4. the number of the final lot

5. the identity of any preservative or adjuvant

6. the amount of antigen in Lf and/or minimum potency in IU per SHD

7. the recommended storage temperature and the expiry date if kept at that temperature

8. the recommended SHD and the route of administration

9. the statement that the vaccine satisfies the requirements of this document

10. the address of the manufacturer

11. the recommended temperature for transport

12. a warning that the adsorbed vaccine should not be frozen

13. a warning that the adsorbed vaccine should be shaken before use

14. instructions for the use of the vaccine, and information on contraindications and the reactions

that may follow vaccination

Page 23: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.9 Distribution and transport

0The requirements given in:

Good manufacturing practices: main principles for pharmaceutical products

Good manufacturing practices for biological products should apply

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Page 24: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

A.10 Stability, storage and expiry date

0 A.10.1 Stability :

WHO’s Guidelines on stability evaluation of vaccines

the vaccine should meet the requirements for final product at expiry date for sterility,

potency, adjuvant content, degree of adsorption, preservative content, pH and

extractable volume, where applicable

0 A.10.2 Storage conditions

0 A.10.3 Expiry date

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Page 25: Recommendations to assure the quality, safety and efficacy of tetanus vaccines

SEPAS

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