Authorization procedure for COVID-19 vaccines: United States of America, European Union and Latin America

Authors

  • María Esther Ruiz Sayritupac de Nué Universidad Complutense de Madrid https://orcid.org/0000-0001-5801-7970
  • María del Carmen González Leonor Universidad Complutense de Madrid

DOI:

https://doi.org/10.30827/ars.v64i1.26392

Keywords:

USFDA, European Union, Latin America, COVID-19, Legislation, WHO

Abstract

Introduction: The recognition of the COVID-19 disease as a pandemic posed a challenge to the National Drug Regulatory Authorities (NRAs). They had to develop guidelines, procedures, create working groups and partnerships to maximize the efficiency of vaccine evaluation, review and licensure.

The aim of this article is to present the procedures used in the United States, European Union and Latin America to license the use of vaccines against COVID-19; in order to determine whether the multiplicity of procedures has led to the registration of a large number of vaccines.

Method: A review of the pharmaceutical legislation used for the issuance of COVID-19 vaccines licenses during the health emergency was carried out. The information was collected up to October 15, 2022. The sources consulted were government websites of the NRAs: United States, European Union, and Latin America.

Results: The United States and the European Union used activities included in their standard flows, such as pre-Investigational New Drug, scientific advice and rolling review, respectively. Latin America, on the other hand, made extensive use of reliance and emergency use authorization in order to access as many vaccines as possible.

Conclusions: The procedures used are diverse, but all of them are oriented to provide a rapid pandemic containment product. This diversity results in the presence of different vaccines in the United States, European Union and Latin America.

Downloads

Download data is not yet available.

References

World Health Organization. Archived: WHO Timeline - COVID-19 [Internet]. 2020 [citado 7 de febrero de 2022]. Disponible en: https://www.who.int/news/item/27-04-2020-who-timeline---covid-19

World Health Organization. Conferencia 25/08/2022 [Internet]. Brote de enfermedad por coronavirus (COVID-19). [citado 30 de agosto de 2022]. Disponible en: https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019

Escalante S. Accelerating regulation in response to COVID-19. Bull World Health Organ. 1 de agosto de 2020;98(8):514-5. DOI:10.2471/BLT.20.020820

Organización Mundial de la Salud. Reglamento Sanitario International (2005) [Internet]. 3a. Organización Mundial de la Salud; 2016 [citado 22 de julio de 2022]. 93 p. Disponible en: https://apps.who.int/iris/handle/10665/246186

World Health Organization. Regulation and Prequalification [Internet]. Covid-19 Vaccines. [citado 7 de julio de 2022]. Disponible en: https://www.who.int/teams/regulation-prequalification/eul/covid-19

Organización Panamericana de la Salud. La pandemia de COVID-19 en la Región de las Américas [Internet]. Organización Panamericana de la Salud; 2020 [citado 11 de julio de 2022] p. 35. Report No.: CD58/6. Disponible en: https://www.paho.org/es/documentos/cd586-pandemia-covid-19-region-americas

Sánchez E. El principio de precaución: implicaciones para la salud pública. Gac Sanit. 2002;16(5):371-373. DOI: 10.1016/S0213-9111(02)71944-4

Kesselheim AS, Darrow JJ, Kulldorff M, Brown BL, Mitra-Majumdar M, Lee CC, et al. An Overview Of Vaccine Development, Approval, And Regulation, With Implications For COVID-19: Analysis reviews the Food and Drug Administration’s critical vaccine approval role with implications for COVID-19 vaccines. Health Affairs. 2021;40(1):25-32.

Estados Unidos. Federal Food, Drug and Cosmetic Act [Internet]. 21 U.S.C. Sec. 360bbb–3 - Authorization for medical products for use in emergencies. Disponible en: https://www.law.cornell.edu/uscode/text/21/360bbb-3

Departament of Health and Human Services, Food and Drug Administration, Center for Biologics Evaluation and Reseach. Emergency Use Authorization for Vaccines to Prevent COVID-19; Guidance for Industry [Internet]. 2022 [citado 15 de abril de 2022]. Disponible en: https://www.fda.gov/media/142749/download

COVID-19: Renewal of determination that a public health emergency exists [Internet]. Administration for Strategic Preparedness and Response. 2022 [citado 15 de octubre de 2022]. Disponible en: https://aspr.hhs.gov:443/legal/PHE/Pages/covid19-13Oct2022.aspx

Departament of Health and Human Services, Food and Drug Administration, Office of the Commisioner, Office of Chief Scientist, Office of Counterterrorism and Emergency Threats. Emergency Use Authorization of Medical Products and Related Authorities. Guidance for Industry and Other Stakeholders [Internet]. 2017 [citado 11 de marzo de 2022]. Disponible en: https://www.fda.gov/media/97321/download

Departament of Health and Human Service, Food and Drug Administration, Center for Drug Evaluation and Research, Center for Biologics Evaluation and Research. COVID-19 Public Health Emergency: General Considerations for Pre-IND Meeting Requests for COVID 19 Related Drugs and Biological Products. Guidance for Industry and Investigators [Internet]. 2020 [citado 11 de marzo de 2022]. Disponible en: https://www.fda.gov/media/137927/download

Food and Drug Administration. Emergency Use Authorization (EUA) for an Unapproved Product Review Memorandum Pfizer-BioNTech COVID-19 Vaccine/BNT162b2 [Internet]. Estados Unidos: Food and Drug Administration; 2020 [citado 22 de abril de 2022] p. 57. Report No.: 27034. Disponible en: https://www.fda.gov/media/144416/download

Food and Drug Administration. Emergency Use Authorization (EUA) for an Unapproved Product Review Memorandum Moderna COVID-19 Vaccine/mRNA-1273 [Internet]. Estados Unidos: Food and Drug Administration; 2020 [citado 22 de abril de 2022] p. 61. Report No.: 27073. Disponible en: https://www.fda.gov/media/144673/download

Food and Drug Administration. Emergency Use Authorization (EUA) for an Unapproved Product Review Memorandum Janssen COVID-19 vaccine (Ad26.COV2.S) [Internet]. Estados Unidos: Food and Drug Administration; 2021 [citado 22 de abril de 2022] p. 69. Report No.: 27205. Disponible en: https://www.fda.gov/media/146338/download

Food and Drug Administration. Emergency Use Authorization (EUA) for an Unapproved Product Review Memorandum Novavax COVID-19 Vaccine, Adjuvanted/NVX-CoV2373 [Internet]. Estados Unidos: Food and Drug Administration; 2022 [citado 20 de agosto de 2022] p. 89. Report No.: 28237. Disponible en: https://www.fda.gov/media/160082/download

Food and Drug Administration. Letter of Authorization: Pfizer-BioNTech COVID-19 Vaccines [Internet]. 2022 [citado 15 de octubre de 2022]. Disponible en: https://www.fda.gov/media/150386/download

Food and Drug Administration. Coronavirus (COVID-19) Update: FDA Authorizes Moderna, Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose [Internet]. FDA. 2022 [citado 1 de octubre de 2022]. Disponible en: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-moderna-pfizer-biontech-bivalent-covid-19-vaccines-use

Food and Drug Administration. Pfizer-BioNTech COVID-19 Vaccines [Internet]. FDA. 2022 [citado 15 de octubre de 2022]. Disponible en: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccines

Unión Europea. Decisión n ° 1082/2013/UE del Parlamento Europeo y del Consejo, de 22 de octubre de 2013, sobre las amenazas transfronterizas graves para la salud y por la que se deroga la Decisión n ° 2119/98/CE Texto pertinente a efectos del EEE [Internet]. oct 22, 2013. Disponible en: http://data.europa.eu/eli/dec/2013/1082/oj/spa

European Medicines Agency. EMA plan for emerging health threats [Internet]. Reino Unido: European Medicines Agency; 2018 [citado 22 de abril de 2022] p. 15. (Policy and Crisis Managment). Report No.: EMA/863454/2018. Disponible en: https://www.ema.europa.eu/en/documents/other/ema-plan-emerging-health-threats_en.pdf

European Medicines Agency. Mandate, objectives and rules of procedure of the COVID-19 EMA pandemic Task Force (COVID-ETF) [Internet]. Ámsterdan: European Medicines Agency; 2021 [citado 23 de abril de 2022] p. 5. (Biological Health Threats and Vaccines Strategy). Report No.: EMA/166423/2020. Disponible en: https://www.ema.europa.eu/en/documents/other/superseded-mandate-objectives-rules-procedure-covid-19-ema-pandemic-task-force-covid-etf_en.pdf

Unión Europea. Reglamento (CE) nº 507/2006 de la Comisión, de 29 de marzo de 2006 , sobre la autorización condicional de comercialización de los medicamentos de uso humano que entran en el ámbito de aplicación del Reglamento (CE) nº 726/2004 del Parlamento Europeo y del Consejo (Texto pertinente a efectos del EEE) [Internet]. mar 29, 2006. Disponible en: http://data.europa.eu/eli/reg/2006/507/oj/spa

European Medicines Agency. EMA initiatives for acceleration of development support and evaluation procedures for COVID-19 treatments and vaccines [Internet]. Ámsterdan: European Medicines Agency; 2022 [citado 24 de agosto de 2022] p. 7. Report Nº.: EMA/213341/2022 Rev. 4. Disponible en: https://www.ema.europa.eu/en/documents/other/ema-initiatives-acceleration-development-support-evaluation-procedures-covid-19-treatments-vaccines_en.pdf

Commitee for Medicinal Products for Human Use. European Public Assessment Report: Comirnaty [Internet]. Ámsterdam: European Medicines Agency; 2021 [citado 25 de abril de 2022] p. 139. Report No.: EMA/707383/2020 Corr.1. Disponible en: https://www.ema.europa.eu/en/documents/assessment-report/comirnaty-epar-public-assessment-report_en.pdf

Marinus R, Mofid S, Mpandzou M, Kühler TC. Rolling Reviews During COVID-19: The European Union Experience in a Global Context. Clin Ther. 2022;44(3):352-363.

Commitee for Medicinal Products for Human Use. European Public Assessment Report: COVID-19 Vaccine Moderna [Internet]. Ámsterdam: European Medicines Agency; 2021 [citado 25 de abril de 2022] p. 154. Report Nº.: EMA/15689/2021 Corr.1. Disponible en: https://www.ema.europa.eu/en/documents/assessment-report/spikevax-previously-covid-19-vaccine-moderna-epar-public-assessment-report_en.pdf

Commitee for Medicinal Products for Human Use. European Public Assessment Report: Nuvaxovid [Internet]. Ámsterdam: European Medicines Agency; 2022 [citado 25 de abril de 2022] p. 161. Report Nº.: EMA/783213/2021. Disponible en: https://www.ema.europa.eu/en/documents/assessment-report/nuvaxovid-epar-public-assessment-report_en.pdf

Commitee for Medicinal Products for Human Use. Guideline on the scientific application and the practical arrangements necessary to implement Commission Regulation (EC) No 507/2006 on the conditional marketing authorisation for medicinal products for human use falling within the scope of Regulation (EC) No 726/2004 [Internet]. Reino Unido: European Medicines Agency; 2016 [citado 24 de abril de 2022] p. 16. Report Nº.: EMA/CHMP/509951/2006, Rev.1. Disponible en: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-scientific-application-practical-arrangements-necessary-implement-commission-regulation-ec/2006-conditional-marketing-authorisation-medicinal-products-human-use-falling_en.pdf

Commitee for Medicinal Products for Human Use. European Public Assessment Report: COVID-19 Vaccine AstraZeneca [Internet]. Ámsterdam: European Medicines Agency; 2021 [citado 25 de abril de 2022] p. 174. Report Nº.: EMA/94907/2021. Disponible en: https://www.ema.europa.eu/en/documents/assessment-report/vaxzevria-previously-covid-19-vaccine-astrazeneca-epar-public-assessment-report_en.pdf

Commitee for Medicinal Products for Human Use. European Public Assessment Report: COVID-19 Vaccine Janssen [Internet]. Ámsterdam: European Medicines Agency; 2021 [citado 25 de abril de 2022] p. 210. Report Nº.: EMA/158424/2021. Disponible en: https://www.ema.europa.eu/en/documents/assessment-report/covid-19-vaccine-janssen-epar-public-assessment-report_en.pdf

Unión Europea. Reglamento (CE) nº 1234/2008 de la Comisión, de 24 de noviembre de 2008, relativo al examen de las modificaciones de los términos de las autorizaciones de comercialización de medicamentos para uso humano y medicamentos veterinarios (Texto pertinente a efectos del EEE) Texto pertinente a efectos del EEE [Internet]. may 13, 2021. Disponible en: http://data.europa.eu/eli/reg/2008/1234/2021-05-13/spa

European Medicines Agency. Spikevax (previously COVID-19 Vaccine Moderna) [Internet]. European Medicines Agency. 2022 [citado 3 de septiembre de 2022]. Disponible en: https://www.ema.europa.eu/en/medicines/human/EPAR/spikevax

European Medicines Agency. Comirnaty [Internet]. European Medicines Agency. 2022 [citado 3 de septiembre de 2022]. Disponible en: https://www.ema.europa.eu/en/medicines/human/EPAR/comirnaty

European Medicines Agency. EMA recommends standard marketing authorisations for Comirnaty and Spikevax COVID-19 vaccines [Internet]. European Medicines Agency. 2022 [citado 30 de septiembre de 2022]. Disponible en: https://www.ema.europa.eu/en/news/ema-recommends-standard-marketing-authorisations-comirnaty-spikevax-covid-19-vaccines

European Medicines Agency. EMA recommends Valneva’s COVID-19 vaccine for authorisation in the EU [Internet]. European Medicines Agency. 2022 [citado 30 de junio de 2022]. Disponible en: https://www.ema.europa.eu/en/news/ema-recommends-valnevas-covid-19-vaccine-authorisation-eu

Commitee for Medicinal Products for Human Use. European Public Asssessment Report: COVID-19 (inactivated, adjuvanted) Valneva [Internet]. Ámsterdam: European Medicines Agency; 2022 [citado 30 de junio de 2022] p. 129. Report Nº.: EMA/627695/2022. Disponible en: https://www.ema.europa.eu/en/documents/assessment-report/covid-19-vaccine-inactivated-adjuvanted-valneva-epar-public-assessment-report_en.pdf

Rodríguez Pacas FG. La respuesta política al COVID-19 en Centroamérica: El Salvador, Nicaragua y Costa Rica. Real Reflexión. 2022;1(55):59-76. DOI: 10.5377/ryr.v1i55.14413

Pan American Health Organization. Regulatory Emergency response to the COVID-19 pandemic in the Americas. En: Regulatory System Strengthening in the Americas. Lessons learned from the National Regulatory Authorities of Regional Reference [Internet]. Estados Unidos: PAHO; 2022 [citado 30 de junio de 2022]. p. 95-100. Disponible en: https://iris.paho.org/bitstream/handle/10665.2/53793/9789275123447_eng.pdf?sequence=5&isAllowed=y

Organización Panamericana de la Salud. Utilización de decisiones de otras autoridades regulatorias para autorizar el uso de emergencia de medicamentos y otras tecnologías sanitarias en una pandemia (por ejemplo, COVID-19) [Internet]. OPS; 2020 [citado 30 de agosto de 2022]. Disponible en: https://iris.paho.org/handle/10665.2/52037

Organización Panamericana de la Salud. Recomendaciones sobre los procesos regulatorios y elementos relacionados con la introducción de vacunas durante la pandemia de COVID-19 y otras situaciones de emergencia [Internet]. OPS; 2021 [citado 30 de agosto de 2022]. Disponible en: https://iris.paho.org/handle/10665.2/54330?show=full

Organización Panamericana de la Salud. Principios relativos a la utilización de decisiones regulatorias de otras jurisdicciones: nota conceptual y recomendaciones. IX Conferencia de la Red Panamericana para la Armonización de la Reglamentación Farmacéutica (Red PARF) (San Salvador, 24 al 26 de octubre de 2018) [Internet]. Estados Unidos: Organización Panamericana de la Salud; 2019 [citado 30 de agosto de 2022] p. 17. Report Nº.: OPS/HSS/19-03. Disponible en: https://iris.paho.org/handle/10665.2/51550

World Health Organization. COVID-19 Vaccines with WHO Emergency Use Listing [Internet]. WHO - Prequalification of Medical Products (IVDs, Medicines, Vaccines and Immunization Devices, Vector Control). 2022 [citado 30 de agosto de 2022]. Disponible en: https://extranet.who.int/pqweb/vaccines/vaccinescovid-19-vaccine-eul-issued

Ecuador. Reforma Parcial a la normativa técnica sustitutiva para autorizar la importación por excepción e importación por donación de medicamentos, productos biológicos, dispositivos médicos y reactivos bioquímicos y de diagnóstico [Internet]. Resolución ARSCA-DE-037-2020-MAFG. Disponible en: https://www.registroficial.gob.ec/index.php/registro-oficial-web/publicaciones/registro-oficial/item/14152-registro-oficial-no-363

World Health Organization. List of Stringent Regulatory Authorities [Internet]. World Health Organization. [citado 2 de septiembre de 2022]. Disponible en: https://www.who.int/initiatives/who-listed-authority-reg-authorities/SRAs

Organización Panamericana de la Salud. Control de calidad de medicinas - OPS/OMS | [Internet]. Organización Panamericana de la Salud. [citado 2 de septiembre de 2022]. Disponible en: https://www.paho.org/es/temas/control-calidad-medicinas

Brasil. Dispõe sobre as medidas excepcionais relativas à aquisição de vacinas e de insumos e à contratação de bens e serviços de logística, de tecnologia da informação e comunicação, de comunicação social e publicitária e de treinamentos destinados à vacinação contra a covid-19 e sobre o Plano Nacional de Operacionalização da Vacinação contra a Covid-19. [Internet]. Lei No 14.124 mar 10, 2021. Disponible en: https://www.in.gov.br/web/dou

Panamá. Que establece el procedimiento para la emisión de la Autorización de Uso de Emergencia (AUE) de las vacunas contra el SARS-COV-2 y los requisitos para la autorización de importación de las mismas [Internet]. Resolución No 037 feb 17, 2021 p. 15. Disponible en: https://www.gacetaoficial.gob.pa/pdfTemp/29220_B/GacetaNo_29220b_20210217.pdf

Van der Zee IT, Vreman RA, Liberti L, Garza MA. Regulatory reliance pathways during health emergencies: enabling timely authorizations for COVID-19 vaccines in Latin America. Rev Panam Salud Pública. 2022;46:7. DOI: 10.26633/RPSP.2022.115

Durán CE, Cañás M, Urtasun MA, Elseviers M, Andia T, Vander Stichele R, et al. Regulatory reliance to approve new medicinal products in Latin American and Caribbean countries. Rev Panam Salud Pública. 2021;(45):10. DOI: 10.26633/RPSP.2021.10

Bolivia. Autoriza a las entidades competentes la contratación directa, bajo los principios de transparencia y legalidad, de vacunas, pruebas diagnósticas, medicamentos, dispositivos médicos, insumos, reactivos, equipamiento médico, así como otros bienes, obras y servicios, para la contención, diagnóstico y atención de la COVID-19. [Internet]. Decreto Supremo No 4432 dic 29, 2020. Disponible en: https://app.vlex.com/#vid/853618359

Paraguay. Resolución por la que se autoriza en carácter de emergencia vacunas contra el COVID-19 [Internet]. Resolución S.G. No 746 dic 29, 2020. Disponible en: https://www.mspbs.gov.py/dependencias/portal/adjunto/6902dc-Resolucin746vacunascontraelcovid.pdf

Perú. Decreto Supremo que aprueba el Reglamento para el Registro Sanitario Condicional de Medicamentos y Productos Biológicos [Internet]. D.S. N° 002-2021-SA ene 10, 2021. Disponible en: http://busquedas.elperuano.pe/normaslegales/decreto-supremo-que-aprueba-el-reglamento-para-el-registro-s-decreto-supremo-n-002-2021-sa-1918580-1/

Argentina. Autorizase con carácter de emergencia la vacuna Gam-COVID-Vac, denominada Sputnik V, desarrollada por el Centro Nacional Gamaleya de Epidemiología y Microbiología de Rusia [Internet]. Resolución 2784/2020 dic 24, 2020. Disponible en: https://www.boletinoficial.gob.ar/detalleAviso/primera/239160

Infobae. Invima recomienda el uso de emergencia de Zifivax, otra vacuna anticovid producida en China [Internet]. infobae. 2022 [citado 2 de septiembre de 2022]. Disponible en: https://www.infobae.com/america/colombia/2022/01/27/invima-recomienda-el-uso-de-emergencia-de-zifivax-otra-vacuna-anticovid-producida-en-china/

Ministério da Saúde. Comirnaty (Pfizer/Wyeth) [Internet]. Agência Nacional de Vigilância Sanitária - Anvisa. 2022 [citado 15 de octubre de 2022]. Disponible en: https://www.gov.br/anvisa/pt-br/assuntos/paf/coronavirus/vacinas/pfizer

Ministério da Saúde. Oxford/Covishield (Fiocruz e Astrazeneca) [Internet]. Agência Nacional de Vigilância Sanitária - Anvisa. 2022 [citado 15 de octubre de 2022]. Disponible en: https://www.gov.br/anvisa/pt-br/assuntos/paf/coronavirus/vacinas/astrazeneca

Ministério da Saúde. Janssen Vaccine (Janssen-Cilag) [Internet]. Agência Nacional de Vigilância Sanitária - Anvisa. 2022 [citado 15 de octubre de 2022]. Disponible en: https://www.gov.br/anvisa/pt-br/assuntos/paf/coronavirus/vacinas/janssen

Published

2022-12-20

How to Cite

1.
Ruiz Sayritupac de Nué ME, González Leonor M del C. Authorization procedure for COVID-19 vaccines: United States of America, European Union and Latin America. Ars Pharm [Internet]. 2022 Dec. 20 [cited 2024 Jul. 22];64(1):28-52. Available from: https://revistaseug.ugr.es/index.php/ars/article/view/26392

Issue

Section

Review Articles