vaccines_the week in review_17 oct 2011

8/3/2019 Vaccines_The Week in Review_17 Oct 2011

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Vaccines: The Week in Review17 October 2011Center for Vaccine Ethics & Policy (CVEP) http://centerforvaccineethicsandpolicy.wordpress.com/A program of- Center for Bioethics, University of Pennsylvania

http://www.bioethics.upenn.edu/- The Wistar Institute Vaccine Center

http://www.wistar.org/vaccinecenter/default.html- Childrens Hospital of Philadelphia, Vaccine Education Center http://www.chop.edu/consumer/jsp/microsite/microsite.jsp

This weekly summary targets news and events in global vaccines ethicsand policy gathered from key governmental, NGO and industry sources, key

journals and other sources. This summary supports ongoing initiatives of theCenter for Vaccine Ethics & Policy, and is not intended to be exhaustive in itscoverage. Vaccines: The Week in Review is now also posted in pdf form andas a set of blog posts at

http://centerforvaccineethicsandpolicy.wordpress.com/. This blog allows full-texting searching of some 2,000 content items.

Comments and suggestions should be directed toDavid R. Curry, MSEditor andExecutive Director

Center for Vaccine Ethics & Policy [email protected]

WHO released the WHO 2011 global tuberculosis control report,noting that for the first time that the number of people falling illwith tuberculosis (TB) each year is declining. New data also show thatthe number of people dying from the disease fell to its lowest level in adecade. The new report noted:- the number of people who fell ill with TB dropped to 8.8 million in 2010,after peaking at nine million in 2005;- TB deaths fell to 1.4 million in 2010, after reaching 1.8 million in 2003;- the TB death rate dropped 40% between 1990 and 2010, and all regions,except Africa, are on track to achieve a 50% decline in mortality by 2015;- in 2009, 87% of patients treated were cured, with 46 million peoplesuccessfully treated and seven million lives saved since 1995. However, athird of estimated TB cases worldwide are not notified and therefore it isunknown whether they have been diagnosed and properly treated. The reportis available in various formats here:http://www.who.int/entity/tb/publications/global_report/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2011/tb_20111011/en/index.html
http://centerforvaccineethicsandpolicy.wordpress.com/http://www.bioethics.upenn.edu/http://www.wistar.org/vaccinecenter/default.htmlhttp://www.chop.edu/consumer/jsp/microsite/microsite.jsphttp://centerforvaccineethicsandpolicy.wordpress.com/mailto:[email protected]://www.who.int/entity/tb/publications/global_report/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2011/tb_20111011/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2011/tb_20111011/en/index.htmlhttp://www.bioethics.upenn.edu/http://www.wistar.org/vaccinecenter/default.htmlhttp://www.chop.edu/consumer/jsp/microsite/microsite.jsphttp://centerforvaccineethicsandpolicy.wordpress.com/mailto:[email protected]://www.who.int/entity/tb/publications/global_report/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2011/tb_20111011/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2011/tb_20111011/en/index.htmlhttp://centerforvaccineethicsandpolicy.wordpress.com/


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NIH said it awarded five-year contracts which could total $150million to four companies to develop broad-spectrum therapeutics.

The NIAID awards will support research on antibiotics, antivirals and anantitoxin to prevent or treat diseases caused by multiple types of bacteria orviruses. The contracts are designed to support essential research anddevelopment activities to enable promising investigational therapies to move

toward early-phase clinical studies and, if successful in clinical studies, on toeventual licensure. The ultimate goal is to develop products that the U.S.government can stockpile to protect the public in the event of a bioterrorattack or public health crisis. NIH said the contracts are to focus oncandidate therapies that can be used against classes of pathogens ratherthan being agent-specific. Such broad-spectrum therapeutics would improvepreparedness for all infectious threats, whether they occur naturally or aredeliberately introduced. More on the companies involved and their researchfocus areas here:http://www.nih.gov/news/health/oct2011/niaid-13.htm

The International Finance Facility for Immunisation (IFFIm)announced the renewal of its Treasury Management Agreement withthe World Bank for a five year period. Alan Gillespie, IFFIm Board Chair,said, this has been an effective partnership that has positioned IFFImexceptionally well in markets and contributed greatly to the GAVI Alliance'srole in vaccinating children in developing countries against serious, butpreventable diseases. Under the agreement, the World Bank managesIFFIm's finances according to prudent policies and standards. This includesIFFIm's funding strategy and its implementation in the capital markets, ratingagency and investor outreach, hedging transactions and investmentmanagement. The World Bank also coordinates with IFFIm's donors andmanages their pledges and payments as well as IFFIm's disbursements forimmunisation and health programmes through the GAVI Alliance. IFFIm wasset up in 2006, to help save millions of children's' lives by increasing fundingfor the purchase and delivery of vaccines and by strengthening healthservices in developing countries through the GAVI Alliance. IFFIm's donors arethe United Kingdom, France, Italy, Spain, Australia, the Netherlands, Sweden,Norway and South Africa. Brazil has also announced that it will become anIFFIm donor.http://www.gavialliance.org/library/news/press-releases/2011/iffim-and-world-bank-renew-commitment-to-raise-funds-for-gavi-programmes/

WHO Meeting Announcement: World Conference on SocialDeterminants of HealthPlace: Rio de Janeiro, BrazilDate: 1921 October 2011

This conference will bring together Member States and stakeholders tobuild support for the implementation of action on social determinants ofhealth to reduce inequities. The conference is being organized in accordance
http://www.nih.gov/news/health/oct2011/niaid-13.htmhttp://www.gavialliance.org/library/news/press-releases/2011/iffim-and-world-bank-renew-commitment-to-raise-funds-for-gavi-programmes/http://www.gavialliance.org/library/news/press-releases/2011/iffim-and-world-bank-renew-commitment-to-raise-funds-for-gavi-programmes/http://www.nih.gov/news/health/oct2011/niaid-13.htmhttp://www.gavialliance.org/library/news/press-releases/2011/iffim-and-world-bank-renew-commitment-to-raise-funds-for-gavi-programmes/http://www.gavialliance.org/library/news/press-releases/2011/iffim-and-world-bank-renew-commitment-to-raise-funds-for-gavi-programmes/


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with a 2009 World Health Assembly Resolution (WHA62.14) and will behosted by the Government of Brazil.

The event will provide a global platform for dialogue on how the 2008recommendations of the WHO Commission on Social Determinants of Healthcould be taken forward. Specifically, the conference will provide a process forthe sharing of national experiences and technical knowledge on addressing

social determinants of health.The conference will aim to catalyse coordinated global action in five key

areas:governance to tackle the root causes of health inequities: implementingaction on social determinants of health; the role of the health sector,including public health programmes, in reducing health inequities; promotingparticipation: community leadership for action on social determinants; globalaction on social determinants: aligning priorities and stakeholders;monitoring progress: measurement and analysis to inform policies on socialdeterminants.

Member States are expected to endorse the Rio Declaration, therebystrengthening their political commitment to reducing health inequities

http://www.who.int/mediacentre/events/meetings/2011/social_determinants_health/en/index.html

The MMWR for October 14, 2011 / Vol. 60 / No. 40- Progress Toward Implementation of Human Papillomavirus Vaccination ---the Americas, 2006--2010- Establishment of a Viral Hepatitis Surveillance System --- Pakistan, 2009--2011- Recommendation of the Advisory Committee on Immunization Practices(ACIP) for Use of Quadrivalent Meningococcal Conjugate Vaccine (MenACWY-D) Among Children Aged 9 Through 23 Months at Increased Risk for InvasiveMeningococcal Disease

The Weekly Epidemiological Record (WER) for 14 October 2011, vol.86, 42 (pp 457468) includes: Recommended composition of influenzavaccines for use in the 2012 southern hemisphere influenza seasonhttp://www.who.int/entity/wer/2011/wer8642.pdf

Twitter WatchA selection of items of interest from a variety of twitter feeds associated withimmunization, vaccines and global public health. This capture is highlyselective and by no means intended to be exhaustive.

GAVIAlliance GAVI AllianceFirst child in Ethiopia receives pneumococcal vaccine...millions more to follow11 hours ago
http://www.who.int/mediacentre/events/meetings/2011/social_determinants_health/en/index.htmlhttp://www.who.int/mediacentre/events/meetings/2011/social_determinants_health/en/index.htmlhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a2.htm?s_cid=mm6040a2_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a2.htm?s_cid=mm6040a2_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a3.htm?s_cid=mm6040a3_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a3.htm?s_cid=mm6040a3_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.who.int/entity/wer/2011/wer8642.pdfhttps://twitter.com/#!/GAVIAlliancehttps://twitter.com/#!/GAVIAlliance/status/125547885705179136http://www.who.int/mediacentre/events/meetings/2011/social_determinants_health/en/index.htmlhttp://www.who.int/mediacentre/events/meetings/2011/social_determinants_health/en/index.htmlhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a2.htm?s_cid=mm6040a2_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a2.htm?s_cid=mm6040a2_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a3.htm?s_cid=mm6040a3_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a3.htm?s_cid=mm6040a3_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a4.htm?s_cid=mm6040a4_whttp://www.who.int/entity/wer/2011/wer8642.pdfhttps://twitter.com/#!/GAVIAlliancehttps://twitter.com/#!/GAVIAlliance/status/125547885705179136


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GAVIAlliance GAVI AllianceEthiopia is 1 of 10 pilots where #GAVI funds civil society organisations to helpwith immunisation- ht.ly/6Ywkd15 Oct

pahowho PAHO/WHOWorld Conference on Social Determinants of Health who.int/sdhconference/14 Oct

PublicHealth APHACervical cancer kills 36,000+ women each yr in the Americas. HPVvaccination varies widely, says MMWR study: goo.gl/aTZZZ14 Oct

WHO_Europe WHO/Europeby EurovaccineInvestment in building relations with media, parent communities, and other

stakeholders helps in #vaccine safety events bit.ly/reIO2q13 Oct

Journal Watch[Editors Note]Vaccines: The Week in Review continues its weekly scanning of key journalsto identify and cite articles, commentary and editorials, books reviews andother content supporting our focus on vaccine ethics and policy.JournalWatch is not intended to be exhaustive, but indicative of themes andissues the Center is actively tracking. We selectively provide full text ofsome editorial and comment articles that are specifically relevant to ourwork. Successful access to some of the links provided may requiresubscription or other access arrangement unique to the publisher. If youwould like to suggest other journal titles to include in this service, pleasecontact David Curry at: [email protected]

Annals of Internal MedicineOctober 4, 2011; 155 (7)http://www.annals.org/content/current[Reviewed earlier; No relevant content]

British Medical BulletinVolume 99 Issue 1 September 2011http://bmb.oxfordjournals.org/content/current[Reviewed earlier; No relevant content]

British Medical Journal
https://twitter.com/#!/GAVIAlliancehttps://twitter.com/#!/search?q=%23GAVIhttp://t.co/3bYr9YAOhttps://twitter.com/#!/GAVIAlliance/status/125347089566806017https://twitter.com/#!/pahowhohttp://t.co/VtseCVH1https://twitter.com/#!/pahowho/status/124944414006190081https://twitter.com/#!/PublicHealthhttp://t.co/Rp3Z01orhttps://twitter.com/#!/PublicHealth/status/124895627372003328https://twitter.com/#!/WHO_Europehttps://twitter.com/#!/search?q=%23vaccinehttp://t.co/yHl3NpLxhttps://twitter.com/#!/WHO_Europe/status/124496158830759937mailto:[email protected]://www.annals.org/content/currenthttp://bmb.oxfordjournals.org/content/currenthttps://twitter.com/#!/GAVIAlliancehttps://twitter.com/#!/search?q=%23GAVIhttp://t.co/3bYr9YAOhttps://twitter.com/#!/GAVIAlliance/status/125347089566806017https://twitter.com/#!/pahowhohttp://t.co/VtseCVH1https://twitter.com/#!/pahowho/status/124944414006190081https://twitter.com/#!/PublicHealthhttp://t.co/Rp3Z01orhttps://twitter.com/#!/PublicHealth/status/124895627372003328https://twitter.com/#!/WHO_Europehttps://twitter.com/#!/search?q=%23vaccinehttp://t.co/yHl3NpLxhttps://twitter.com/#!/WHO_Europe/status/124496158830759937mailto:[email protected]://www.annals.org/content/currenthttp://bmb.oxfordjournals.org/content/current


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15 October 2011 Volume 343, Issue 7827http://www.bmj.com/content/current[No relevant content]

Cost Effectiveness and Resource Allocation

(accessed 16 October 2011)http://www.resource-allocation.com/[No new relevant content]

Emerging Infectious DiseasesVolume 17, Number 10October 2011http://www.cdc.gov/ncidod/EID/index.htm[No relevant content]

Health Affairs

October 2011; Volume 30, Issue 10Agenda For Fighting Disparitieshttp://content.healthaffairs.org/content/current[Reviewed earlier]

Health Economics, Policy and LawVolume 6 - Issue 04 - 01 October 2011http://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissue[Reviewed earlier]

Human VaccinesVolume 7, Issue 10 October 2011http://www.landesbioscience.com/journals/vaccines/toc/volume/7/issue/10/[Reviewed earlier]

International Journal of Infectious DiseasesVolume 15, Issue 10 pp. e655-e730 (October 2011)http://www.sciencedirect.com/science/journal/12019712[Reviewed earlier]

JAMAOctober 12, 2011, Vol 306, No. 14, pp 1513-1614http://jama.ama-assn.org/current.dtlCommentariesA Model for Dissemination and Independent Analysis of IndustryDataHarlan M. Krumholz, Joseph S. Ross

JAMA. 2011;306(14):1593-1594.doi:10.1001/jama.2011.1459
http://www.bmj.com/content/currenthttp://www.resource-allocation.com/http://www.cdc.gov/ncidod/EID/index.htmhttp://content.healthaffairs.org/content/currenthttp://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissuehttp://www.landesbioscience.com/journals/vaccines/toc/volume/7/issue/10/http://www.sciencedirect.com/science/journal/12019712http://jama.ama-assn.org/current.dtlhttp://www.bmj.com/content/currenthttp://www.resource-allocation.com/http://www.cdc.gov/ncidod/EID/index.htmhttp://content.healthaffairs.org/content/currenthttp://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissuehttp://www.landesbioscience.com/journals/vaccines/toc/volume/7/issue/10/http://www.sciencedirect.com/science/journal/12019712http://jama.ama-assn.org/current.dtl


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ExtractEach day, patients and their physicians make treatment decisions with

access to only a fraction of the relevant clinical research data. Many clinicalstudies, including randomized clinical trials, are never published in thebiomedical literature. 1, 2 Among those that are published, key information isoften not presented, such as data on specific outcomes and safety end

points. 3, 4 Moreover, patient-level data from clinical trials are rarely publiclyavailable, leaving investigators to conduct meta-analyses of summary-leveldata, an approach with limitations. 5

Current clinical research standards lack sufficiently strong requirements fortransparency and availability. There are no uniform international standardsrequiring that study protocols, statistical analysis plans, and study results bemade available, and there are no requirements that completed clinical trialdata be publicly available or posted for independent analysis. Even datasubmitted to the US Food and Drug Administration are not made publiclyavailable.

Journal of Infectious DiseasesVolume 204 Issue 10 November 15, 2011http://www.journals.uchicago.edu/toc/jid/current[No relevant content]

The LancetOct 15, 2011 Volume 378 Number 9800 p1355 - 1438http://www.thelancet.com/journals/lancet/issue/current[No relevant content]

The Lancet Infectious DiseaseOct 2011 Volume 11 Number 10 p721 - 800http://www.thelancet.com/journals/laninf/issue/current[Reviewed earlier]

Medical Decision Making (MDM)September/October 2011; 31 (5)http://mdm.sagepub.com/content/current[Reviewed earlier]

NatureVolume 478 Number 7368 pp155-280 13 October 2011http://www.nature.com/nature/current_issue.html[No relevant content]

Nature MedicineOctober 2011, Volume 17 No 10
http://www.journals.uchicago.edu/toc/jid/currenthttp://www.thelancet.com/journals/lancet/issue/currenthttp://www.thelancet.com/journals/laninf/issue/currenthttp://mdm.sagepub.com/content/currenthttp://www.nature.com/nature/current_issue.htmlhttp://www.journals.uchicago.edu/toc/jid/currenthttp://www.thelancet.com/journals/lancet/issue/currenthttp://www.thelancet.com/journals/laninf/issue/currenthttp://mdm.sagepub.com/content/currenthttp://www.nature.com/nature/current_issue.html


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http://www.nature.com/nm/index.html[No relevant content]

New England Journal of MedicineOctober 13, 2011 Vol. 365 No. 15

http://content.nejm.org/current.shtml[No relevant content]

The Pediatric Infectious Disease JournalNovember 2011 - Volume 30 - Issue 11 pp: A7-A8,921-1016,e203-e224http://journals.lww.com/pidj/pages/currenttoc.aspx[No relevant content]

PediatricsOctober 2011, VOLUME 128 / ISSUE 4

http://pediatrics.aappublications.org/current.shtml[No relevant content]

PharmacoeconomicsNovember 1, 2011 - Volume 29 - Issue 11 pp: 913-1009http://adisonline.com/pharmacoeconomics/pages/currenttoc.aspxThe Importance of the Comparator in Economic Evaluations: Workingon the Efficiency FrontierNeyt, Mattias; Van Brabandt, HansPharmacoeconomics. 29(11):913-916, November 1, 2011.doi: 10.2165/11595260-000000000-00000[No abstract]Rotavirus Vaccine RIX4414 (Rotarix): A Pharmacoeconomic Reviewof its Use in the Prevent ion of Rotavirus Gastroenteritis inDeveloping CountriesPlosker, Greg L.Pharmacoeconomics. 29(11):989-1009, November 1, 2011.doi: 10.2165/11207210-000000000-00000

Abstract:This article provides an overview of the clinical profile of rotavirus vaccine

RIX4414 (Rotarix) in the prevention of rotavirus gastroenteritis (RVGE) indeveloping countries, followed by a comprehensive review ofpharmacoeconomic analyses with the vaccine in low- and middle-incomecountries.

RVGE is associated with significant morbidity and mortality among children


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vaccination programmes with RIX4414 in Latin American countries. The WHOrecommends universal rotavirus vaccination programmes for all countries.

Numerous modelled cost-effectiveness analyses have been conducted withrotavirus vaccine RIX4414 across a wide range of low- and middle-incomecountries. Although data sources and assumptions varied across studies,results of the analyses consistently showed that the introduction of the

vaccine as part of a national vaccination programme would be very (orhighly) cost effective compared with no rotavirus vaccination programme,according to widely used cost-effectiveness thresholds for developingcountries. Vaccine price was not known at the time the analyses wereconducted and had to be estimated. In sensitivity analyses, rotavirus vaccineRIX4414 generally remained cost effective at the highest of a range ofpossible vaccine prices considered. Despite these favourable results,decisions regarding the implementation of universal vaccination programmeswith RIX4414 may also be contingent on budgetary and other factors,underscoring the importance of subsidized vaccination programmes for poorcountries through the GAVI Alliance (formerly the Global Alliance for Vaccinesand Immunization).

PLoS One[Accessed 16 October 2011]http://www.plosone.org/article/browse.action;jsessionid=577FD8B9E1F322DAA533C413369CD6F3.ambra01?field=date7-Valent Pneumococcal Conjugate Vaccination in England and Wales:Is It Still Beneficial Despite High Levels of Serotype Replacement?

Yoon Hong Choi, Mark Jit, Nigel Gay, Nick Andrews, Pauline A. Waight, AlessiaMelegaro, Robert George, Elizabeth MillerPLoS ONE: Research Article, published 14 Oct 201110.1371/journal.pone.0026190

PLoS Medicine(Accessed 16 October 2011)http://www.plosmedicine.org/article/browse.action?field=date[No new relevant content]

Proceedings of the National Academy of Sciences of the UnitedStatesof America(Accessed 16 October 2011)http://www.pnas.org/content/early/recent[No new relevant content]

Science14 October 2011 vol 334, issue 6053, pages 145-276http://www.sciencemag.org/current.dtl[No relevant content]
http://www.plosone.org/article/browse.action;jsessionid=577FD8B9E1F322DAA533C413369CD6F3.ambra01?field=datehttp://www.plosone.org/article/browse.action;jsessionid=577FD8B9E1F322DAA533C413369CD6F3.ambra01?field=datehttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0026190http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0026190http://www.plosmedicine.org/article/browse.action?field=datehttp://www.pnas.org/content/early/recenthttp://www.sciencemag.org/current.dtlhttp://www.plosone.org/article/browse.action;jsessionid=577FD8B9E1F322DAA533C413369CD6F3.ambra01?field=datehttp://www.plosone.org/article/browse.action;jsessionid=577FD8B9E1F322DAA533C413369CD6F3.ambra01?field=datehttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0026190http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0026190http://www.plosmedicine.org/article/browse.action?field=datehttp://www.pnas.org/content/early/recenthttp://www.sciencemag.org/current.dtl


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Science Translational Medicine12 October 2011 vol 3, issue 104http://stm.sciencemag.org/content/current[No relevant content]

Tropical Medicine & International HealthNovember 2011 Volume 16, Issue 11 Pages 13531464http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-3156/currentissue[No relevant content]

Vaccinehttp://www.sciencedirect.com/science/journal/0264410XVolume 29, Issue 46 pp. 8175-8470 (26 October 2011)Regular PapersReasons related to non-vaccination and under-vaccination ofchildren in low and middle income countries: Findings from asystematic review of the published literature, 19992009Pages 8215-8221

Jeanette J. Rainey, Margaret Watkins, Tove K. Ryman, Paramjit Sandhu, AnneBo, Kaushik Banerjee

AbstractObjectiveDespite increases in routine vaccination coverage during the past threedecades, the percent of children completing the recommended vaccinationschedule remains below expected targets in many low and middle incomecountries. In 2008, the World Health Organization Strategic Advisory Group ofExperts on Immunization requested more information on the reasons thatchildren were under-vaccinated (receiving at least one but not allrecommended vaccinations) or not vaccinated in order to develop effectivestrategies and interventions to reach these children.MethodsA systematic review of the peer-reviewed literature published from 1999 to2009 was conducted to aggregate information on reasons and factors relatedto the under-vaccination and non-vaccination of children. A standardizedform was used to abstract information from relevant articles identified fromeight different medical, behavioural and social science literature databases.Findings

Among 202 relevant articles, we abstracted 838 reasons associated withunder-vaccination; 379 (45%) were related to immunization systems, 220(26%) to family characteristics, 181 (22%) to parental attitudes andknowledge, and 58 (7%) to limitations in immunization-relatedcommunication and information. Of the 19 reasons abstracted from 11identified articles describing the non-vaccinated child, 6 (32%) were relatedto immunization systems, 8 (42%) to parental attitudes and knowledge, 4(21%) to family characteristics, and 1 (5%) to communication andinformation.
http://stm.sciencemag.org/content/currenthttp://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-3156/currentissuehttp://www.sciencedirect.com/science/journal/0264410Xhttp://www.sciencedirect.com/science/article/pii/S0264410X11013661?_rdoc=9&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=efcdcab776488fac35352803a5a602c6http://www.sciencedirect.com/science/article/pii/S0264410X11013661?_rdoc=9&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=efcdcab776488fac35352803a5a602c6http://www.sciencedirect.com/science/article/pii/S0264410X11013661?_rdoc=9&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=efcdcab776488fac35352803a5a602c6http://stm.sciencemag.org/content/currenthttp://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-3156/currentissuehttp://www.sciencedirect.com/science/journal/0264410Xhttp://www.sciencedirect.com/science/article/pii/S0264410X11013661?_rdoc=9&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=efcdcab776488fac35352803a5a602c6http://www.sciencedirect.com/science/article/pii/S0264410X11013661?_rdoc=9&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=efcdcab776488fac35352803a5a602c6http://www.sciencedirect.com/science/article/pii/S0264410X11013661?_rdoc=9&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=efcdcab776488fac35352803a5a602c6


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ConclusionsMultiple reasons for under-vaccination and non-vaccination were identified,indicating that a multi-faceted approach is needed to reach under-vaccinatedand unvaccinated children. Immunization system issues can be addressedthrough improving outreach services, vaccine supply, and health workertraining; however, under-vaccination and non-vaccination linked to parental

attitudes and knowledge are more difficult to address and likely require localinterventions.Attitudes and perceptions of private pediatricians regarding polioimmunization in IndiaPages 8317-8322Panna Choudhury, Naveen Thacker, Lisa M. Gargano, Paul S. Weiss, Vipin M.Vashishtha, Tanmay Amladi, Karen Pazol, Walter A. Orenstein, Saad B. Omer,

James M. HughesAbstractBackgroundIndia has faced considerable challenges in eradicating polio. Uttar Pradesh(UP) and Bihar are the two states in India where transmission of polio has

never been interrupted. Private pediatricians are important stakeholders forvaccine delivery and maintaining public confidence in vaccines. The purposeof this study was to investigate the attitudes and perceptions of pediatriciansin India regarding polio immunization and their opinions about variousstrategies regarding polio eradication in the country.MethodsA random sample of 785 pediatricians belonging to the Indian Academy ofPediatrics (IAP) were selected for the survey with over sampling of memberslocated in Bihar and UP. Potential participants were either contacted byphone or sent a self-administered anonymous questionnaire by mail. For thisanalysis both sets of responses were combined. Surveys were conductedfrom June 2009 to June 2010.ResultsA total of 398 surveys were completed (51%). Nearly all respondentsindicated that polio eradication is still an important priority (99.7%). Ninety-six percent of pediatricians believed that strengthening routine immunizationefforts remains the best way to eradicate polio in endemic areas. Othermeasures thought to be important in eradicating polio are mass campaignswith IPV (73%) and mass campaigns with bivalent OPV (59%). Pediatriciansalso identified several barriers to polio eradication which included parentslack of awareness of the importance of polio vaccination (88.8%), parentslack of confidence in polio vaccine (64.0%), religious beliefs (59.2%), fear ofside effects (59.2%), lack of time or priority (56.6%), superstition (50.3%) andcultural beliefs (46.4%).Conclusion

There is still strong support for polio eradication efforts among IAP members.Pediatricians in India strongly believe that improving the coverage of routineimmunization remains the best way to eradicate polio. There is an urgentneed to improve awareness, build confidence in the program, and removebarriers among parents.The cost-effectiveness of male HPV vaccination in the United StatesPages 8443-8450
http://www.sciencedirect.com/science/article/pii/S0264410X11013697?_rdoc=22&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=1674b108acc85f2744fe3b7a9a6947d0http://www.sciencedirect.com/science/article/pii/S0264410X11013697?_rdoc=22&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=1674b108acc85f2744fe3b7a9a6947d0http://www.sciencedirect.com/science/article/pii/S0264410X11011467?_rdoc=38&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=7f1f5d6d52f2d8ff107b6bbda53eb7e0http://www.sciencedirect.com/science/article/pii/S0264410X11013697?_rdoc=22&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=1674b108acc85f2744fe3b7a9a6947d0http://www.sciencedirect.com/science/article/pii/S0264410X11013697?_rdoc=22&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=1674b108acc85f2744fe3b7a9a6947d0http://www.sciencedirect.com/science/article/pii/S0264410X11011467?_rdoc=38&_fmt=high&_origin=browse&_srch=hubEid(1-s2.0-S0264410X11X00440)&_docanchor=&_ct=42&_refLink=Y&_zone=rslt_list_item&md5=7f1f5d6d52f2d8ff107b6bbda53eb7e0


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Harrell W. Chesson, Donatus U. Ekwueme, Mona Saraiya, Eileen F. Dunne,Lauri E. Markowitz

AbstractIntroduction

The objective of this study was to estimate the cost-effectiveness of addinghuman papillomavirus (HPV) vaccination of 12-year-old males to a female-

only vaccination program for ages 1226 years in the United States.MethodsWe used a simplified model of HPV transmission to estimate the reduction inthe health and economic burden of HPV-associated diseases in males andfemales as a result of HPV vaccination. Estimates of the incidence, cost-per-case, and quality-of-life impact of HPV-associated health outcomes werebased on the literature. The HPV-associated outcomes included were: cervicalintraepithelial neoplasia (CIN); genital warts; juvenile-onset recurrentrespiratory papillomatosis (RRP); and cervical, vaginal, vulvar, anal,oropharyngeal, and penile cancers.Results

The cost-effectiveness of male vaccination depended on vaccine coverage of

females. When including all HPV-associated outcomes in the analysis, theincremental cost per quality-adjusted life year (QALY) gained by adding malevaccination to a female-only vaccination program was $23,600 in the lowerfemale coverage scenario (20% coverage at age 12 years) and $184,300 inthe higher female coverage scenario (75% coverage at age 12 years). Thecost-effectiveness of male vaccination appeared less favorable whencompared to a strategy of increased female vaccination coverage. Forexample, we found that increasing coverage of 12-year-old girls would bemore cost-effective than adding male vaccination even if the increasedfemale vaccination strategy incurred program costs of $350 per additionalgirl vaccinated.ConclusionsHPV vaccination of 12-year-old males might potentially be cost-effective,particularly if female HPV vaccination coverage is low and if all potentialhealth benefits of HPV vaccination are included in the analysis. However,increasing female coverage could be a more efficient strategy than malevaccination for reducing the overall health burden of HPV in the population.

Value in HealthSeptember 2011, Vol. 14, No. 6http://www.valueinhealthjournal.com/home[No relevant content]
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vaccines_the week in review_17 oct 2011

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