Vaccines: The Week in Review

11 October 2010
Center for Vaccine Ethics & Policy
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
- Children’s Hospital of Philadelphia, Vaccine Education Center
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp

This weekly summary targets news and events in the global vaccines field gathered
from key governmental, NGO and company announcements, key journals and
events. This summary provides support for ongoing initiatives of the Center for
Vaccine Ethics & Policy, and is not intended to be exhaustive in its coverage.
Vaccines: The Week in Review is now also posted in a blog format at
http://centerforvaccineethicsandpolicy.wordpress.com/. Each item is treated as an individual
post on the blog, allowing for more effective retrospective searching. Given email
system conventions and formats, you may find this alternative more effective. This
blog also allows for RSS feeds, etc.
Comments and suggestions should be directed to
David R. Curry, MS
Editor and
Executive Director
Center for Vaccine Ethics & Policy
david.r.curry@centerforvaccineethicsandpolicy.org

The GAVI Alliance held its “first replenishment meeting” in New

York last week “to agree on how to fund programmes to avert an
estimated 4.2 million future deaths through immunisation.” GAVI said
the meeting was intended to “…set the stage for a pledging conference in
2011” in the context of efforts to raise US$4.3 billion to scale-up its
immunisation programmes in developing countries between 2010 and 2015.”
GAVI did not release a summary of meeting actions but issued media
releases on a commitment by Canada of $50 million over five years, and a
new pledge by Australia of A$60 million (US$58 million) over three years,
doubling the country’s previous commitment.
Media Releases at:
http://www.gavialliance.org/media_centre/press_releases/index.php

Novartis announced a collaboration with Synthetic Genomics

Vaccines Inc. to “combine synthetic biology and genome sequencing
capabilities with leading edge vaccine technology to create more
flexible processes to generate influenza seed viruses, with the aim
to speed up influenza vaccine production.” The three-year agreement is
supported by a BARDA award. The anno8uncement noted that “currently
Novartis and other vaccines companies rely on the WHO to identify and
distribute live reference viruses to create seasonal or pandemic vaccines.
Under this collaboration, Novartis and SGVI will work to develop a "bank" of
synthetically constructed seed viruses ready to go into production as soon as
WHO identifies the flu strains. The technology could reduce the vaccine
production time by up to two months, which is particularly critical in the
event of a pandemic.”
Rino Rappuoli, Head of Research for Novartis Vaccines and Diagnostics,
said, "Our research strategy has always been to apply new vaccine
technologies and innovation to deliver better prevention methods and meet
patient needs. We are pleased to work in collaboration with Craig Venter and
SGVI to study and develop this promising and important new synthetic
genomics technology. It has the potential to safely reduce the time needed to
develop new vaccines and improve pre-pandemic preparedness."
Novartis said it “plans to test vaccines that could potentially result from this
new approach in large-scale clinical trials. Review and approval from country
health authorities will be obtained before any commercial use.”
http://www.novartis.com/newsroom/media-releases/en/2010/1449685.shtml

Johnson & Johnson and Crucell announced an agreement whereby

Johnson & Johnson will acquire all outstanding equity of Crucell that
it does not already own for approximately € 1.75 billion in a recommended
cash tender offer. Johnson & Johnson currently owns 17.9% of Crucell’s
outstanding shares. J&J said it “expects to maintain Crucell's existing
facilities, to retain Crucell's senior management and, generally, to maintain
current employment levels. Johnson & Johnson also intends to keep Crucell as
the center for vaccines within the Johnson & Johnson pharmaceutical group,
and to maintain Crucell’s headquarters in Leiden. Paul Stoffels, Global Head,
Pharmaceutical Research and Development, Johnson & Johnson, commented,
“Johnson & Johnson and Crucell share a commitment to improving the lives of
people worldwide. This potential combination would provide us with a new
platform for growth and advances our goal to deliver integrated health care
solutions, with particular emphasis on prevention. Operational excellence in
manufacturing and supply chain has made Crucell an established and reliable
supplier of vaccines, in particular to emerging markets. We hope to build on
those capabilities, and the expertise and talent of Crucell’s employees to
continue making a difference in the lives of people worldwide.”
http://www.jnj.com/connect/news/corporate/Johnson-and-Johnson-and-Crucell-
Reach-Agreement-on-Intended-Public-Offer-of-Ordinary%20Share-of-Crucell

NIH announced “three new contracts to fund research on vaccines

to protect against emerging infectious diseases and biological
threats that could be used in a terror attack.” Total funding for the three
awards could reach US$68 million depending on the successful completion of
defined project milestones. NIAID Director Anthony S. Fauci, M.D.
commented, "These new contracts build on NIAID’s commitment to support
the advanced development of products that are important to the public
health but often unattractive to investors in private industry, by bridging the
funding gap with contracts intended to address specific health needs." The
three studies will focus on a dengue vaccine delivered by a needle-free
device, an anthrax vaccine delivered orally, and an anthrax vaccine delivered
in conjunction with an adjuvant. Clinical trials of all three vaccine products
should begin within three years, FDA noted
http://www.nih.gov/news/health/oct2010/niaid-07.htm

The FDA awarded US$904,000 to Pan American Health

Organization (PAHO) “to research and develop an information hub
for medical products and related regulatory processes and systems
in the Americas Region.” FDA said the “hub” will collect and produce data
and map structures and processes in the areas of medical products, including
drugs, biologics, vaccines, medical devices and other medical products, and
related regulatory processes and systems. The award “will help FDA, and all
PAHO member states, to better understand other countries' regulatory
systems, support capacity to use harmonized standards and guidelines
across countries, and prevent, and if necessary respond more quickly to,
problems in the medical product supply chain.” The FDA noted that
“regulatory agencies in the Americas Region have different legal and
regulatory frameworks, different institutional and administrative structures,
different standards and guidelines, and different ways of collecting and
analyzing information. Better collaboration among these agencies will build
confidence and knowledge among the participants, stakeholders, and
ultimately benefit patients and consumers throughout the region.”
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm228423
.htm
PAHO: http://new.paho.org/hq/index.php

BARDA (Biomedical Advanced Research and Development

Authority) announced a three-year, US$57 million contract to Sanofi
Pasteur to “secure a continued year-round supply of eggs and other
essential supplies for pandemic influenza vaccine as part of pandemic
preparedness.” BARDA Director Dr. Robin Robinson commented, “This
contract ensures that progress continues in creating a solid base for
manufacturing pandemic influenza vaccine in the United States. While BARDA
is currently investing in the development of new vaccine technologies, we
must also ensure a robust supply of vaccine for Americans with technologies
currently available.”
http://www.businesswire.com/news/home/20101008005977/en/BARDA-
Funds-Year-Round-Egg-Supply-Pandemic-Flu

The Weekly Epidemiological Record (WER) for 8 October 2010, vol.

85, 41 (pp 401–412) includes: Outbreak news – Yellow fever, Senegal;
Recommended viruses of influenza vaccines for use in the 2011 influenza
season (southern hemisphere)
http://www.who.int/entity/wer/2010/wer8541.pdf

The MMWR for October 8, 2010 / Vol. 59 / No. 39, includes:

- Seasonal Influenza Vaccination Coverage Among Children Aged 6 Months--
18 Years --- Eight Immunization Information System Sentinel Sites, United
States, 2009--10 Influenza Season
- Influenza Activity --- United States and Worldwide, June 13--September 25,
2010
- Announcement: Application Deadline for The CDC Experience Applied
Epidemiology Fellowship --- December 3, 2010
http://www.cdc.gov/mmwr/PDF/wk/mm5939.pdf

WHO released a new issue of Global Immunization News (GIN): 30

September 2010
http://www.who.int/entity/immunization/GIN_September_2010.pdf

Events/Conference Watch
[Editor’s Note]
Vaccines: The Week in Review is now monitoring key events and conferences
and will include summaries of key announcements and other content. Event
Watch is not intended to be exhaustive, but indicative of themes and
issues the Center is actively tracking. If you would like to suggest events
and conferences for coverage, please write to David Curry at
david.r.curry@centerforvaccineethicsandpolicy.org

Conference: New Cells for New Vaccines V: Global Perspectives, 11-13

October 2010, Wilmington, Delaware, USA. (Sponsor/Host: The International
Association for Biologicals and the Fraunhofer USA Center for Molecular
Biotechnology) https://www.regonline.com/builder/site/Default.aspx?
EventID=868054

Meeting: Strategic Advisory Group of Experts (SAGE) Meeting 9-11

November 2010, Geneva, Switzerland (Sponsor/Host: WHO)

Journal Watch
[Editor’s Note]
Vaccines: The Week in Review continues its weekly scanning of key journals
to identify and cite articles, commentary and editorials, books reviews and
other content supporting our focus on vaccine ethics and policy. Journal
Watch is not intended to be exhaustive, but indicative of themes and
issues the Center is actively tracking. We selectively provide full text of
some editorial and comment articles that are specifically relevant to our
work. Successful access to some of the links provided may require
subscription or other access arrangement unique to the publisher. Our initial
scan list includes the journals below. If you would like to suggest other titles,
please write to David Curry at
david.r.curry@centerforvaccineethicsandpolicy.org

Clinical Infectious Diseases

1 November 2010 Volume 51, Number 9
http://www.journals.uchicago.edu/toc/cid/current
Editorial Commentary:
Cell Culture–Derived Influenza Vaccines: Has Their Time Come?
David I. Bernstein
Articles and Commentaries
Clinical Efficacy of Cell Culture–Derived and Egg‐Derived Inactivated
Subunit Influenza Vaccines in Healthy Adults
Sharon Frey, Timo Vesikari, Agnieszka Szymczakiewicz-Multanowska,
Maria Lattanzi, Allen Izu, Nicola Groth, and Sandra Holmes
This trial evaluated the efficacy of cell culture– and egg‐derived influenza
vaccines versus placebo. The high overall vaccine efficacies, 83.8% and
78.4% against vaccine-like and 69.5% and 63.0% against all circulating
influenza virus strains, support use of both vaccines for seasonal influenza
vaccination.

Emerging Infectious Diseases

Volume 16, Number 10–October 2010
http://www.cdc.gov/ncidod/EID/index.htm
[Reviewed earlier]

Human Vaccines
Volume 6, Issue 10 October 2010
http://www.landesbioscience.com/journals/vaccines/toc/volume/6/issue/10/
[Reviewed last week]

JAMA
Vol. 304 No. 13, pp. 1413-1514, October 6, 2010
http://jama.ama-assn.org/current.dtl
Special Communications
Evaluating the Risks of Clinical Research
Annette Rid; Ezekiel J. Emanuel; David Wendle
Abstract
The ethical appropriateness of clinical research depends on protecting
participants from excessive risks. Yet no systematic framework has been
developed to assess research risks, and as a result, investigators, funders,
and review boards rely only on their intuitive judgments. Because intuitive
judgments of risk are subject to well-documented cognitive biases, this
approach raises concern that research participants are not being adequately
protected. To address this situation, we delineate a method called the
systematic evaluation of research risks (SERR), which evaluates the risks of
research interventions by comparing these interventions with the risks of
comparator activities that have been deemed acceptable. This method
involves a 4-step process: (1) identify the potential harms posed by the
proposed research intervention; (2) categorize the magnitude of the potential
harms into 1 of 7 harm levels on a harm scale; (3) quantify or estimate the
likelihood of each potential harm; and (4) compare the likelihood of each
potential harm from the research intervention with the likelihood of harms of
the same magnitude occurring as a result of an appropriate comparator
activity. By explicitly delineating, quantifying, and comparing the risks of
research interventions with the risks posed by appropriate comparator
activities, SERR offers a way to minimize the influence of cognitive biases on
the evaluation of research risks and thereby better protect research
participants from excessive risks.

Journal of Infectious Diseases

1 November 2010 Volume 202, Number 9
http://www.journals.uchicago.edu/toc/jid/current
[Reviewed last week]

The Lancet
Oct 09, 2010 Volume 376 Number 9748 Pages 1195 - 1272
http://www.thelancet.com/journals/lancet/issue/current
Comment
Academic medicine must take its global role: the M8 Alliance of
Academic Health Centers and Medical Universities
Mazda Adli, Sabine Kleinert, Stephen K Smith, Detlev Ganten
Preview
At the inaugural World Health Summit in 2009, the M8 Alliance of Academic
Health Centers and Medical Universities was formed to lead intensified
international debate about research and education in global health
challenges. The idea was to create an international forum that seeks
discussions with governmental representatives, policy makers, non-
governmental organisations, civil society, and the health-related industry to
initiate cross-sectoral solutions for the most pressing global health
challenges.
Global health governance—the response to infectious diseases
Rose Gana Fomban Leke
Preview
The burden of disease that affects the developing world has grown from a
high prevalence of communicable infectious diseases1 to new additions of
emerging infections plus an increasing problem of non-communicable
diseases.2,3 Most infectious diseases are largely specific to the world's
poorest regions, and sub-Saharan Africa bears a great burden of these
diseases.4 Bilateral and multilateral institutions, followed by organisations
and many new initiatives including advocates for health, make up the
multiple actors that are responding to the increasing threats of such a crisis
in infectious disease.
Review
Financing of HIV/AIDS programme scale-up in low-income and
middle-income countries, 2009–31
Robert Hecht, John Stover, Lori Bollinger, Farzana Muhib, Kelsey Case, David
de Ferranti
Summary
As the global HIV/AIDS pandemic nears the end of its third decade, the
challenges of efficient mobilisation of funds and management of resources
are increasingly prominent. The aids2031 project modelled long-term funding
needs for HIV/AIDS in developing countries with a range of scenarios and
substantial variation in costs: ranging from US$397 to $722 billion globally
between 2009 and 2031, depending on policy choices adopted by
governments and donors. We examine what these figures mean for individual
developing countries, and estimate the proportion of HIV/AIDS funding that
they and donors will provide. Scenarios for expanded HIV/AIDS prevention,
treatment, and mitigation were analysed for 15 representative countries. We
suggest that countries will move in increasingly divergent directions over the
next 20 years; middle-income countries with a low burden of HIV/AIDS will
gradually be able to take on the modest costs of their HIV/AIDS response,
whereas low-income countries with a high burden of disease will remain
reliant upon external support for their rapidly expanding costs. A small but
important group of middle-income countries with a high prevalence of
HIV/AIDS (eg, South Africa) form a third category, in which rapid scale-up in
the short term, matched by outside funds, could be phased down within 10
years assuming strategic investments are made for prevention and efficiency
gains are made in treatment.

The Lancet Infectious Disease

Oct 2010 Volume 10 Number 10 Pages 653 - 736
http://www.thelancet.com/journals/laninf/issue/current
[Reviewed last week]

Nature
Volume 467 Number 7316 pp633-738 7 October 2010
http://www.nature.com/nature/current_issue.html
[No relevant content]

Nature Medicine
October 2010, Volume 16 No 10
http://www.nature.com/nm/index.html
[No relevant content]
New England Journal of Medicine
October 7, 2010 Vol. 363 No. 15
http://content.nejm.org/current.shtml
[No relevant content]

The Pediatric Infectious Disease Journal

October 2010 - Volume 29 - Issue 10
http://journals.lww.com/pidj/pages/currenttoc.aspx
[Reviewed last week]

Pediatrics
October 2010 / VOLUME 126 / ISSUE 4
http://pediatrics.aappublications.org/current.shtml
Articles
Prenatal and Infant Exposure to Thimerosal From Vaccines and
Immunoglobulins and Risk of Autism
Cristofer S. Price, William W. Thompson, Barbara Goodson, Eric S. Weintraub,
Lisa A. Croen, Virginia L. Hinrichsen, Michael Marcy, Anne Robertson, Eileen
Eriksen, Edwin Lewis, Pilar Bernal, David Shay, Robert L. Davis, and Frank
DeStefano
OBJECTIVE Exposure to thimerosal, a mercury-containing preservative that
is used in vaccines and immunoglobulin preparations, has been hypothesized
to be associated with increased risk of autism spectrum disorder (ASD). This
study was designed to examine relationships between prenatal and infant
ethylmercury exposure from thimerosal-containing vaccines and/or
immunoglobulin preparations and ASD and 2 ASD subcategories: autistic
disorder (AD) and ASD with regression.
METHODS A case-control study was conducted in 3 managed care
organizations (MCOs) of 256 children with ASD and 752 controls matched by
birth year, gender, and MCO. ASD diagnoses were validated through
standardized in-person evaluations. Exposure to thimerosal in vaccines and
immunoglobulin preparations was determined from electronic immunization
registries, medical charts, and parent interviews. Information on potential
confounding factors was obtained from the interviews and medical charts. We
used conditional logistic regression to assess associations between ASD, AD,
and ASD with regression and exposure to ethylmercury during prenatal, birth-
to-1 month, birth-to-7-month, and birth-to-20-month periods.
RESULTS There were no findings of increased risk for any of the 3 ASD
outcomes. The adjusted odds ratios (95% confidence intervals) for ASD
associated with a 2-SD increase in ethylmercury exposure were 1.12 (0.83–
1.51) for prenatal exposure, 0.88 (0.62–1.26) for exposure from birth to 1
month, 0.60 (0.36–0.99) for exposure from birth to 7 months, and 0.60 (0.32–
0.97) for exposure from birth to 20 months.
CONCLUSIONS In our study of MCO members, prenatal and early-life
exposure to ethylmercury from thimerosal-containing vaccines and
immunoglobulin preparations was not related to increased risk of ASDs.
PLoS Medicine
(Accessed 10 October 2010)
http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-
1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1
&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1
c2a2501181c#results
Reflections on Pandemic (H1N1) 2009 and the International
Response
Gabriel M. Leung, Angus Nicoll
Summary Points
- Many of the initial responses to the 2009 H1N1 pandemic went well but
there are many lessons to learn for future pandemic planning.
- Clear communication of public health messages is crucial, and should not
confuse what could happen (and should be prepared for) with what is most
likely to happen.
- Decisions regarding pandemic response during the exigencies of a public
health emergency must be judged according to the best evidence available
at the time.
- Revising pandemic plans—to be more flexible and more detailed—should
wait for WHO leadership if national plans are not to diverge. Surveillance
beyond influenza should be stepped up, and contingencies drawn up for the
emergence or re-emergence of other novel and known pathogens.
- Data collection and sharing are paramount, and include epidemiological and
immunological data. Clinical management of severe influenza disease should
not be limited to the current antiviral regimen, and include the development
of other therapeutics (e.g., novel antivirals and immunotherapy).
- Greater and more timely access to antivirals and influenza vaccines
worldwide remains an ongoing challenge.

Science
8 October 2010 Vol 330, Issue 6001, Pages 137-280
http://www.sciencemag.org/current.dtl
[No relevant content]

Science Translational Medicine

6 October 2010 vol 2, issue 52
http://stm.sciencemag.org/content/current
[No relevant content]

Vaccine
http://www.sciencedirect.com/science/journal/0264410X

Volume 28, Issue 45 pp. 7241-7344 (21 October 2010)

[No relevant content]

Volume 28, Issue 44 pp. 7137-7240 (18 October 2010)

Editorial
A global prescription for adult immunization: Time is catching up
with us
Pages 7137-7139
Gregory A. Poland, Joël Belmin, Joanne Langley, Jean-pierre Michel, Pierre Van
Damme, Sabine Wicker
Regular Articles
Design of a robust infrastructure to monitor the safety of the
pandemic A(H1N1) 2009 vaccination program in Taiwan
Original Research Article
Pages 7161-7166
Wan-Ting Huang, Wen-Wen Chen, Hsu-Wen Yang, Wan-Chin Chen, Yen-Nan
Chao, Yu-Wen Huang, Jen-Hsiang Chuang, Hsu-Sung Kuo
Abstract
On November 1, 2009, Taiwan began a nationwide pandemic A(H1N1) 2009
vaccine (“H1N1 vaccine”) program to control the influenza pandemic. Timely
assessment of immunization safety during this mass vaccination campaign
was a public health priority. Therefore, the government developed a national
postlicensure safety surveillance strategy to identify and evaluate new,
unexpected, or prioritized adverse events in recipients of H1N1 vaccine in
near real-time. We describe the design and methodology of this new safety
assessment infrastructure, address challenges encountered, and its potential
future use for routine vaccine pharmacovigilance in Taiwan.
Middle- and high-school health education regarding adolescent
vaccines and human papillomavirus
Original Research Article
Pages 7179-7183
Amanda F. Dempsey, Sarah Schaffer
Abstract
We performed a mail-based survey of health education teachers in 6 states
with diverse health education environments to better understand health
education curricula in secondary schools related to adolescent vaccination
and human papillomavirus (HPV) infection. Of the 198 respondents (response
rate 68%), 66% and 71% reported teaching adolescents about recommended
vaccines and HPV, respectively. Middle schools were significantly less likely
to include these topics in their health curriculum than high schools even
though middle schools are generally the school type attended by 11–12 year
olds, the preferred target age for adolescent vaccination and HPV prevention
activities.
Knowledge and attitudes regarding influenza vaccination among
nurses: A research review
Original Research Article
Pages 7207-7214
Jing Zhang, Alison E. While, Ian J. Norman
Abstract
Introduction
Influenza vaccination rates among nurses remain suboptimal despite health
authority recommendations in many countries and several vaccination
campaign programmes to encourage nurses to be vaccinated in many
institutions. We reviewed published studies investigating nurses’ knowledge
and attitudes towards influenza vaccination to establish what is known about
the determinants of nurses’ influenza vaccination practices.
Methods
Relevant articles published up to July 2010 were identified through multiple
databases (CINAHL, MEDLINE, PubMed, EMBASE, BNI, HMIC, PsycINFO, CMAC,
and CNJ) using predetermined search strategies. Review of the titles and
abstracts revealed 182 of 254 references were not relevant. Of 45 full papers
reviewed, 32 did not report nurse data separately and one was a duplicate
report of a study.
Results
We included 12 research studies which had investigated the relationship
between knowledge and attitudes towards influenza vaccination and nurses’
vaccination practices published between 2003 and 2010. All the studies were
descriptive and relied upon self-report data. The findings of this review
indicate a relationship between knowledge, attitudes and vaccination
practices of nurses. There were three main findings: first, there was a strong
association between nurses’ knowledge of influenza and vaccination and their
vaccination status; second, the surveys showed a positive relationship
between perceptions of influenza as a serious illness and vaccination as
effective and safe and a positive vaccination status; and third, there was a
relationship between nurses’ vaccination status and their reported promotion
of vaccination to their patients.
Conclusion
This review indicates that higher knowledge and positive attitudes towards
influenza vaccination have a significantly positive association with
vaccination coverage among nurses. Further studies are needed to identify
influences on nurses’ attitudes and practices regarding influenza vaccination
and the personal, organizational, and situational factors that influence the
uptake of influenza vaccine by nurses.

Volume 28, Issue 43 pp. 6943-7136 (8 October 2010)

Meeting Report
Polio vaccines and polio immunization in the pre-eradication era:
WHO position paper—Recommendations
Pages 6943-6944
World Health Organization Department of Immunization Vaccines and
Biologicals 20, Avenue Appia 1211 Geneva 27 Switzerland WHO Publication
Abstract
This article presents the WHO recommendations on the use of polio vaccines
excerpted from the recently published Polio vaccines and polio immunization
in the pre-eradication era: WHO position paper. This document replaces the
WHO position paper entitled Introduction of inactivated poliovirus vaccine
into oral poliovirus vaccine-using countries published in the Weekly
Epidemiological Record in July 2003. Footnotes to this paper provide a limited
number of core references; their abstracts as well as a more comprehensive
list of references may be found at
http://www.who.int/immunization/documents/positionpapers/en/index.html.
Grading tables which assess the quality of scientific evidence for key
conclusions are also available through this link and are referenced in the
position paper.
Global use of Haemophilus influenzae type b conjugate vaccine
Original Research Article
Pages 7117-7122
Linda R. Ojo, Rosalyn E. O’Loughlin, Adam L. Cohen, Jennifer D. Loo, Karen M.
Edmond, Sharmila S. Shetty, Allyson P. Bear, Lois Privor-Dumm, Ulla K.
Griffiths, Rana Hajjeh
Abstract
Haemophilus influenzae type b (Hib) conjugate vaccines have been
underutilized globally. We report progress in global use of Hib vaccines
included in national immunization schedules. The number of countries using
Hib vaccine increased from 89/193 (46%) in 2004 to 158/193 (82%) by the
end of 2009. The increase was greatest among low-income countries eligible
for financial support from the GAVI Alliance [13/75 (17%) in 2004, 60/72
(83%) by the end of 2009], and can be attributed to various factors.
Additional efforts are still needed to increase vaccine adoption in lower
middle income countries [20/31 (65%) by the end of 2009].
Supporting new vaccine introduction decisions: Lessons learned
from the Hib Initiative experience
Original Research Article
Pages 7123-7129
R.A. Hajjeh, L. Privor-Dumm, K. Edmond, R. O’Loughlin, S. Shetty, U.K.
Griffiths, A.P. Bear, A.L. Cohen, A. Chandran, A. Schuchat, E.K. Mulholland, M.
Santosham
Abstract
The introduction of Haemophilus influenzae type b (Hib) vaccine in
developing countries has suffered from a long delay. Between 2005 and
2009, a surge in Hib vaccine adoption took place, particularly among GAVI-
eligible countries. Several factors contributed to the increase in Hib vaccine
adoption, including support provided by the Hib Initiative, a project funded by
the GAVI Alliance in 2005 to accelerate evidence-informed decisions for use
of Hib vaccine. This paper reviews the strategy adopted by the Hib Initiative
and the lessons learned in the process, which provide a useful model to
accelerate uptake of other new vaccines.