{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:02:33Z","timestamp":1781251353673,"version":"3.54.1"},"reference-count":67,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Technology transfer (TT) has been identified as a global health priority due to its impact on improving access to vaccines, including for pandemic influenza preparedness and response through bilateral and multilateral mechanisms. This study aimed to (1) characterize examples of influenza vaccine TT (IVTT) and (2) identify key lessons learned that may inform future activities relevant for next-generation influenza vaccine technologies. Methods: Using a contingent effectiveness model, a convergent mixed-methods study was conducted with vaccine manufacturers and global experts to capture quantitative survey data on IVTT activities and enablers and qualitative data on successes, challenges, and opportunities for IVTT through interviews, complemented by secondary data from peer-reviewed and grey literature to characterize additional IVTT observations. Results: This study included 24 participants, including 14 representatives from 13 vaccine manufacturers and 10 experts. Interviews were conducted with representatives from eight manufacturers and seven experts. Eighteen IVTT observations were identified through the surveys and interviews, of which 15 IVTT transfers were completed and 13 resulted in an approved vaccine. Secondary data provided additional evidence on eight IVTT recipients and one supplier, expanding the range of institutional and programmatic contexts assessed. Shorter IVTT completion and vaccine approval timelines were observed in association with prior TT experience and private management structures for manufacturers, for pre-pandemic\/pandemic influenza vaccines versus seasonal influenza vaccines, and among bilateral transfer mechanisms (versus multilateral mechanisms) and fill\/finish transfer methods. Manufacturers also described spillover benefits, including the use of IVTT-related know-how for the development of COVID-19 and routine vaccines. Both manufacturers and experts generally agreed on a list of 17 enablers for successful IVTT and ranked government commitment to vaccine production and procurement as the top enabler. Findings from the literature-based observations were consistent with primary data and included additional public sector recipient experiences, evidence of widespread human capital development, and a commentary on the importance of the demand environment. Conclusions: Assessed IVTT activities across primary and secondary data sources yielded commercial and spillover benefits as described in the contingent effectiveness model and provided a triangulated analysis of IVTT experiences across manufacturers, experts, and documented cases. Participants agreed that effective technology transfer is contingent upon a host of determinants. Using a systematic application of the contingent effectiveness model to IVTT, this study provided an exploratory analysis of past activities among vaccine manufacturers and experts. While certain nuances for influenza were identified, the lessons learned from this study may be applicable for other TT activities, including those to support pandemic preparedness. The contingent effectiveness model is a useful tool to inform and evaluate future TT activities.<\/jats:p>","DOI":"10.3390\/vaccines14060522","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:53:10Z","timestamp":1781247190000},"page":"522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influenza Vaccine Technology Transfer: A Mixed-Methods Study with Vaccine Manufacturers and Global Experts to Assess Successes, Challenges, and Opportunities"],"prefix":"10.3390","volume":"14","author":[{"given":"Christopher","family":"Chadwick","sequence":"first","affiliation":[{"name":"Institute of Global Health, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3912-2550","authenticated-orcid":false,"given":"Erin","family":"Sparrow","sequence":"additional","affiliation":[{"name":"World Health Organization, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Nannei","sequence":"additional","affiliation":[{"name":"World Health Organization, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Taaffe","sequence":"additional","affiliation":[{"name":"Global Renaissance Enterprises, Washington, DC 20011, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7208-0829","authenticated-orcid":false,"given":"William","family":"Ampofo","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences & Virology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra 23321, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6957-2977","authenticated-orcid":false,"given":"Antoine","family":"Flahault","sequence":"additional","affiliation":[{"name":"Institute of Global Health, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"},{"name":"Universit\u00e9 Paris Cit\u00e9, Xavier Bichat Hospital, Inserm, 75018 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Berkley","sequence":"additional","affiliation":[{"name":"Pandemic Center, School of Public Health, Brown University, Providence, RI 02912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"World Trade Organization, World Health Organization, and World Intellectual Property Organization (2020). Promoting Access to Medical Technologies and Innovation\u2014Second Edition: Intersections Between Public Health, Intellectual Property and Trade, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240008267.","DOI":"10.30875\/fa323700-en"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/1469-0691.12568","article-title":"Role of vaccine manufacturers in developing countries towards global healthcare by providing quality vaccines at affordable prices","volume":"20","author":"Jadhav","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_3","unstructured":"World Health Organization (2011). Increasing Access to Vaccines Through Technology Transfer and Local Production, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241502368."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Gadamasetti, K., and Kolodziej, S.A. (2024). Three Decades of Advancements in Technical Transfer of Biologics: A Blueprint for Advanced Therapeutics. Bioprocessing, Bioengineering and Process Chemistry in the Biopharmaceutical Industry: Using Chemistry and Bioengineering to Improve the Performance of Biologics, Springer Nature.","DOI":"10.1007\/978-3-031-62007-2"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1108\/JHLSCM-12-2014-0038","article-title":"Systemic barriers and enablers in humanitarian technology transfer","volume":"6","author":"Santos","year":"2016","journal-title":"J. Humanit. Logist. Supply Chain. Manag."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.spacepol.2014.04.003","article-title":"A systematic review of the Space technology transfer literature: Research synthesis and emerging gaps","volume":"30","author":"Venturini","year":"2014","journal-title":"Space Policy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101826","DOI":"10.1016\/j.biologicals.2025.101826","article-title":"Multiple factors shape technology transfer for the development and manufacture of vaccines in Latin America and the Caribbean","volume":"90","author":"Campos","year":"2025","journal-title":"Biologicals"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4124","DOI":"10.1016\/j.vaccine.2014.05.023","article-title":"Lessons learned during the development and transfer of technology related to a new Hib conjugate vaccine to emerging vaccine manufacturers","volume":"32","author":"Hamidi","year":"2014","journal-title":"Vaccine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S0048-7333(99)00093-1","article-title":"Technology transfer and public policy: A review of research and theory","volume":"29","author":"Bozeman","year":"2000","journal-title":"Res. Policy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.respol.2014.06.008","article-title":"The evolving state-of-the-art in technology transfer research: Revisiting the contingent effectiveness model","volume":"44","author":"Bozeman","year":"2015","journal-title":"Res. Policy"},{"key":"ref_11","first-page":"6230","article-title":"Technology transfer in human vaccinology: A retrospective review on public sector contributions in a privatizing science field","volume":"30","author":"Hendriks","year":"2012","journal-title":"Vaccine"},{"key":"ref_12","unstructured":"Clinton Health Access Initiative (2025, October 18). A Database of Local Vaccine Manufacturing Commitments and Tech-Transfers. Available online: https:\/\/www.clintonhealthaccess.org\/database\/a-database-of-local-vaccine-manufacturing-commitments-and-tech-transfers\/."},{"key":"ref_13","unstructured":"Medicines Patent Pool (2025, October 18). mRNA-Based Vaccine Initiatives\u2014Up to May 2025. Available online: https:\/\/medicinespatentpool.org\/what-we-do\/mrna-technology-transfer-programme\/resources#pills-Technical-Resources."},{"key":"ref_14","unstructured":"Seventy-Eighth World Health Assembly (2025, June 15). WHA78.1 WHO Pandemic Agreement. Available online: https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA78\/A78_R1-en.pdf."},{"key":"ref_15","unstructured":"Fifty-Eighth World Health Assembly (2025, June 15). WHA58.5 Strengthening Pandemic Influenza Preparedness and Response. Available online: https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA58-REC1\/english\/A58_2005_REC1-en.pdf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6367","DOI":"10.1016\/j.vaccine.2006.07.021","article-title":"A global pandemic influenza vaccine action plan","volume":"24","author":"Kieny","year":"2006","journal-title":"Vaccine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"A2","DOI":"10.1016\/j.vaccine.2011.02.079","article-title":"WHO initiative to increase global and equitable access to influenza vaccine in the event of a pandemic: Supporting developing country production capacity through technology transfer","volume":"29","author":"Friede","year":"2011","journal-title":"Vaccine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5420","DOI":"10.1016\/j.vaccine.2016.07.047","article-title":"Challenges and successes for the grantees and the Technical Advisory Group of WHO\u2019s influenza vaccine technology transfer initiative","volume":"34","author":"Grohmann","year":"2016","journal-title":"Vaccine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4673","DOI":"10.1016\/j.vaccine.2022.06.057","article-title":"Technology transfer programme for influenza vaccines\u2013Lessons from the past to inform the future","volume":"40","author":"Chadwick","year":"2022","journal-title":"Vaccine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"A8","DOI":"10.1016\/j.vaccine.2011.04.124","article-title":"An international technology platform for influenza vaccines","volume":"29","author":"Hendriks","year":"2011","journal-title":"Vaccine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"A37","DOI":"10.1016\/j.vaccine.2011.04.125","article-title":"The Vaccine Formulation Laboratory: A platform for access to adjuvants","volume":"29","author":"Collin","year":"2011","journal-title":"Vaccine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1016\/j.vaccine.2012.06.041","article-title":"Vaccine production training to develop the workforce of foreign institutions supported by the BARDA influenza vaccine capacity building program","volume":"31","author":"Tarbet","year":"2013","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1002\/bmb.20817","article-title":"Comprehensive hands-on training for influenza vaccine manufacturing: A WHO\u2013BARDA\u2013BTEC partnership for global workforce development","volume":"42","author":"Ruiz","year":"2014","journal-title":"Biochem. Mol. Biol. Educ."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"A45","DOI":"10.1016\/j.vaccine.2011.02.078","article-title":"WHO influenza vaccine technology transfer initiative: Role and activities of the Technical Advisory Group","volume":"29","author":"Francis","year":"2011","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1586\/erv.12.76","article-title":"PATH Influenza Vaccine Project: Accelerating the development of new influenza vaccines for low-resource countries","volume":"11","author":"Neuzil","year":"2012","journal-title":"Expert Rev. Vaccines"},{"key":"ref_26","unstructured":"National Academies of Sciences Engineering and Medicine (2022). Countering the Pandemic Threat Through Global Coordination on Vaccines: The Influenza Imperative, The National Academies Press."},{"key":"ref_27","unstructured":"World Health Organization (2021). Pandemic Influenza Preparedness Framework for the Sharing of Influenza Viruses and Access to Vaccines and Other Benefits, WHO. [2nd ed.]."},{"key":"ref_28","unstructured":"World Health Organization (2026, May 21). Category A: SMTA2 and Other Agreements with Vaccines & Antiviral Manufacturers. Available online: https:\/\/cdn.who.int\/media\/docs\/default-source\/pip-framework\/smta2\/20241025-smta2-benefits-cat-a.pdf?sfvrsn=17bc74dd_4."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"126408","DOI":"10.1016\/j.vaccine.2024.126408","article-title":"Advancing influenza vaccines: A review of next-generation candidates and their potential for global health impact","volume":"42","author":"Taaffe","year":"2024","journal-title":"Vaccine"},{"key":"ref_30","unstructured":"Center for Infectious Disease Research and Policy (2026, May 21). Universal Influenza Vaccine Technology Landscape. Available online: https:\/\/ivr.cidrap.umn.edu\/universal-influenza-vaccine-technology-landscape."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"126839","DOI":"10.1016\/j.vaccine.2025.126839","article-title":"Global production capacity of seasonal and pandemic influenza vaccines in 2023","volume":"51","author":"Taaffe","year":"2025","journal-title":"Vaccine"},{"key":"ref_32","unstructured":"Creswell, J.W., and Clark, V.L.P. (2017). Designing and Conducting Mixed Methods Research, Sage Publications."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.vaccine.2020.12.018","article-title":"Global production capacity of seasonal and pandemic influenza vaccines in 2019","volume":"39","author":"Sparrow","year":"2021","journal-title":"Vaccine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"100066","DOI":"10.1016\/j.jvacx.2020.100066","article-title":"Emerging vaccine manufacturers are innovating for the next decade","volume":"5","author":"Hayman","year":"2020","journal-title":"Vaccine X"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5397","DOI":"10.1016\/j.vaccine.2017.03.094","article-title":"Advancing new vaccines against pandemic influenza in low-resource countries","volume":"35","author":"Scorza","year":"2017","journal-title":"Vaccine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"A48","DOI":"10.1016\/j.vaccine.2011.02.080","article-title":"United States of America Department of Health and Human Services support for advancing influenza vaccine manufacturing in the developing world","volume":"29","author":"Perdue","year":"2011","journal-title":"Vaccine"},{"key":"ref_37","unstructured":"International Federation of Pharmaceutical Manufacturers & Associations (2025, June 15). Technology Transfer: A Collaborative Approach to Improve Global Health. Available online: https:\/\/www.ifpma.org\/publications\/technology-transfer-a-collaborative-approach-to-improve-global-health\/."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2020529","DOI":"10.1080\/21645515.2021.2020529","article-title":"Capacity Building for Vaccine Manufacturing Across Developing Countries: The Way Forward","volume":"18","author":"Kumraj","year":"2022","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1177\/00491241231156971","article-title":"Inter-rater reliability methods in qualitative case study research","volume":"53","author":"Cole","year":"2024","journal-title":"Sociol. Methods Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1111\/1475-6773.12117","article-title":"Achieving integration in mixed methods designs-principles and practices","volume":"48","author":"Fetters","year":"2013","journal-title":"Health Serv. Res."},{"key":"ref_41","unstructured":"World Health Organization (2011). Report of the Fourth Meeting with International Partners on Prospects for Influenza Vaccine Technology Transfer to Developing Country Vaccine Manufacturers, Cancun, Mexico, 4\u20135 May 2011, WHO. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/44750\/9789241502597_eng.pdf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"A26","DOI":"10.1016\/j.vaccine.2011.04.121","article-title":"Domestic influenza vaccine production in Mexico: A state-owned and a multinational company working together for public health","volume":"29","year":"2011","journal-title":"Vaccine"},{"key":"ref_43","unstructured":"World Health Organization (2016). Technical Report of Consultations with the Mexican Secretary of Health on Key Elements of Sustainability for Local Production of Influenza Vaccine Within the Context of Global Pandemic Preparedness, World Health Organization."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5414","DOI":"10.1016\/j.vaccine.2016.07.025","article-title":"A decade of adaptation: Regulatory contributions of the World Health Organization to the Global Action Plan for Influenza Vaccines (2006\u20132016)","volume":"34","author":"Palkonyay","year":"2016","journal-title":"Vaccine"},{"key":"ref_45","unstructured":"World Health Organization (2010). Meeting with International Partners on Influenza Vaccine Production Technology Transfer to Developing Countries, 5\u20136 May 2010, Nha Trang, Vietnam, WHO. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/70502\/WHO_IVB_10.10_eng.pdf?sequence=1."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1080\/21645515.2015.1111495","article-title":"Technology transfer of oil-in-water emulsion adjuvant manufacturing for pandemic influenza vaccine production in Romania: Preclinical evaluation of split virion inactivated H5N1 vaccine with adjuvant","volume":"12","author":"Stavaru","year":"2016","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Blume, S., and Baylac-Paouly, B. (2021). Immunization and States: The Politics of Making Vaccines, Routledge.","DOI":"10.4324\/9781003130345"},{"key":"ref_48","unstructured":"(2026, January 05). Latin-American Institute of Biotechnology Mechnikov. Available online: https:\/\/mechnikov.com\/en\/main."},{"key":"ref_49","unstructured":"World Health Organization (2015). Report of the Eighth Meeting with International Partners on Prospects for Influenza Vaccine Technology Transfer to Developing Country Vaccine Manufacturers: Sao Paulo, Brazil, 17\u201318 March 2015, WHO. Available online: https:\/\/iris.who.int\/bitstreams\/7cac40ac-df24-4053-8af7-e2ae0e29e4b9\/download."},{"key":"ref_50","unstructured":"World Health Organization (2026, January 05). WHO\/UNICEF Joint Reporting Form on Immunization: Influenza Vaccination Policy. Available online: https:\/\/immunizationdata.who.int\/global\/wiise-detail-page\/influenza-vaccination-policy."},{"key":"ref_51","unstructured":"World Health Organization (2026, January 05). WHO Public Inspection Report: Instituto Latinoamericano de Biotecnologia Mechnikov SA. Available online: https:\/\/extranet.who.int\/prequal\/sites\/default\/files\/whopir_files\/WHOPIR_Mechnikov_24-28April2023.pdf."},{"key":"ref_52","unstructured":"World Health Organization (2008). Meeting with International Partners on Prospects for Influenza Vaccine Technology Transfer to Developing Countries, 27\u201328 November 2008, Pune, Maharashtra, India, WHO. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/70016\/WHO_IVB_09.06_eng.pdf."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.vaccine.2008.10.080","article-title":"Technology transfer hub for pandemic influenza vaccine","volume":"27","author":"Friede","year":"2009","journal-title":"Vaccine"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"932","DOI":"10.4161\/hv.23163","article-title":"Vaccinology capacity building in Europe for innovative platforms serving emerging markets","volume":"9","author":"Hendriks","year":"2013","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_55","unstructured":"World Health Organization (2012). Report of the Fifth Meeting with International Partners on Prospects for Influenza Vaccine Technology Transfer to Developing Country Vaccine Manufacturers, Belgrade, Serbia, 27\u201328 March 2012, WHO. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/44869\/9789241503518_eng.pdf."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/jmv.24922","article-title":"Safety and immunogenicity of the novel seasonal preservative-and adjuvant-free influenza vaccine: Blind, randomized, and placebo-controlled trial","volume":"90","author":"Sarsenbayeva","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1080\/21645515.2017.1387345","article-title":"Immunogenicity and safety of a novel seasonal influenza preservative-free vaccine manufactured in Kazakhstan: Results of a randomized, comparative, phase II clinical trial in adults","volume":"14","author":"Sarsenbayeva","year":"2018","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1080\/21645515.2019.1705691","article-title":"Safety and immunogenicity of trivalent inactivated influenza vaccine in adults 60 years of age and older: A phase II, a randomized, comparative trial in Kazakhstan","volume":"16","author":"Sarsenbayeva","year":"2020","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.provac.2010.07.010","article-title":"Influenza Vaccine Production Capacity Building in Developing Countries: Example of the Serum Institute of India","volume":"2","author":"Jadhav","year":"2010","journal-title":"Procedia Vaccinol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"A16","DOI":"10.1016\/j.vaccine.2011.04.119","article-title":"A pandemic influenza vaccine in India: From strain to sale within 12 months","volume":"29","author":"Dhere","year":"2011","journal-title":"Vaccine"},{"key":"ref_61","unstructured":"World Health Organization (2016). Report of the Ninth Meeting with International Partners on Prospects for Influenza Vaccine Technology Transfer to Developing Country Vaccine Manufacturers: Geneva, Switzerland, 17 November 2016, WHO. Available online: https:\/\/iris.who.int\/bitstreams\/f4cd2ff5-5add-43f6-b318-e8e06dd72fe3\/download."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1111\/poms.12948","article-title":"When the Big One Came: A Natural Experiment on Demand Shock and Market Structure in India\u2019s Influenza Vaccine Markets","volume":"28","author":"Adbi","year":"2019","journal-title":"Prod. Oper. Manag."},{"key":"ref_63","unstructured":"(2026, January 05). Egypt National Strategy for Vaccine Manufacturing Localization 2024\u20132030, Available online: https:\/\/upa.gov.eg\/wp-content\/uploads\/2025\/06\/National_Vaccine_Manufacturing_Localization_Strategy.pdf."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"5393","DOI":"10.1016\/j.vaccine.2016.08.040","article-title":"Stakeholders\u2019 perceptions of 10 years of the Global Action Plan for Influenza Vaccines (GAP)\u2013Results from a survey","volume":"34","author":"Nannei","year":"2016","journal-title":"Vaccine"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"344","DOI":"10.2471\/BLT.24.291388","article-title":"An mRNA technology transfer programme and economic sustainability in health care","volume":"102","author":"Dutt","year":"2024","journal-title":"Bull. World Health Organ."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1177\/15586898231188500","article-title":"Integrating Literature as a Data Source in Mixed Methods Research","volume":"18","author":"Cooper","year":"2024","journal-title":"J. Mix. Methods Res."},{"key":"ref_67","first-page":"281","article-title":"A typology of mixed methods sampling designs in social science research","volume":"12","author":"Onwuegbuzie","year":"2007","journal-title":"Qual. Rep."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/6\/522\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:41:07Z","timestamp":1781250067000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/6\/522"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":67,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["vaccines14060522"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14060522","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]}}}