Vaccines_The Week in Review_1 June 2013

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Vaccines: The Week in Review1 June 2013Center for Vaccine Ethics & Policy (CVEP)This weekly summary targets news, events, announcements, articles and research in the globalvaccine ethics and policy space and is aggregated from key governmental, NGO, internationalorganization and industry sources, key peer-reviewed journals, and other media channels. Thissummary proceeds from the broad base of themes and issues monitored by the Center for VaccineEthics & Policy in its work: it is not intended to be exhaustive in its coverage. Vaccines: The Week inReview is also posted in pdf form and as a set of blog posts athttp://centerforvaccineethicsandpolicy.wordpress.com/. This blog allows full-text searching of over3,500 entries.

Comments and suggestions should be directed toDavid R. Curry, MSEditor andExecutive DirectorCenter for Vaccine Ethics & Policy

[email protected]

WHO Director-General praises the World Health Assembly for its workDr Margaret Chan, Director-General of the World Health OrganizationClosing remarks at the Sixty-sixth World Health AssemblyGeneva, Switzerland

27 May 2013http://www.who.int/dg/speeches/2013/world_health_assembly_20130527/en/index.htmlExcerpt; Editors text bolding

Looking at the overall world health situation, my greatest concernright now is the novel coronavirus.

We understand too little about this virus when viewed against the magnitude ofits potential threat.

Any new disease that is emerging faster than our understanding is never undercontrol.We do not know where the virus hides in nature. We do not know how people aregetting infected. Until we answer these question, we are empty-handed when it

comes to prevention.These are alarm bells. And we must respond.The novel coronavirus is not a problem that any single affected country can keep

to itself or manage all by itself. The novel coronavirus is a threat to the entire world.As the Chair of committee A succinctly stated: this virus is something that can killus.
http://centerforvaccineethicsandpolicy.wordpress.com/http://centerforvaccineethicsandpolicy.wordpress.com/mailto:[email protected]://www.who.int/dg/speeches/2013/world_health_assembly_20130527/en/index.htmlhttp://www.who.int/dg/speeches/2013/world_health_assembly_20130527/en/index.htmlmailto:[email protected]://www.who.int/dg/speeches/2013/world_health_assembly_20130527/en/index.htmlhttp://www.who.int/dg/speeches/2013/world_health_assembly_20130527/en/index.htmlhttp://centerforvaccineethicsandpolicy.wordpress.com/


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Through WHO and the International Health Regulations, we need to bring togetherthe assets of the entire world in order to adequately address this threat. We needmore information, and we need it quickly, urgently.

As I have announced, joint WHO missions with the Kingdom of Saudi Arabia andTunisia will take place just as soon as possible. The purpose is to gather all the factsneeded to conduct a proper risk assessment. I thank these countries for their

cooperation and collaboration.I thank Member States for supporting my views on the seriousness of this

situation.

WHO: Global Alert and Response (GAR) Disease Outbreak Newshttp://www.who.int/csr/don/2013_03_12/en/index.htmlMiddle East respiratory syndromecoronavirus update 31 May 2013

31 May 2013 - The Ministry of Health in Saudi Arabia has notified WHO of anadditional laboratory-confirmed case with Middle East respiratory syndromecoronavirus (MERS-CoV).The patient is a 61-year-old man with underlying medical conditions who became

ill on 20 May 2013. The patient is from Al-Ahsa. Additionally, three patients earlierreported from Al-Ahsa have died.

The government is continuing to investigate the outbreaks in the country.Globally, from September 2012 to date, WHO has been informed of a total of 50laboratory-confirmed cases of infection with MERS-CoV, including 30 deaths.Yellow fever in Ethiopia update 31 May 2013

31 May 2013 - The Ministry of Health of Ethiopia is launching an emergency mass-vaccination campaign against yellow fever from 10 June 2013. This is in response tolaboratory confirmation of six cases in the country on 7 May 2013.

The campaign aims to cover more than 527, 000 people in the following sixdistricts: South Ari, North Ari, Benatsemay, Selamago, Hammer, and Gnangatomand one administrative town (Jinka) in South Omo Zone of the Southern Nations,Nationalities and Peoples region (SNNPR) of Ethiopia.

The International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG11) will provide over 585,800 doses of yellow fever vaccine for the massvaccination campaign run by the Ministry of Health in Ethiopia, with support fromthe GAVI Alliance and other partners. WHO is closely supporting the outbreakinvestigation, capacity building for case management, resource mobilization foroutbreak management, and monitoring preventive and control activities in thefieldHuman infection with avian influenza A(H7N9) virus update 29 May 2013

29 May 2013 - The National Health and Family Planning Commission, Chinanotified WHO of an additional laboratory confirmed case of human infection withAvian Influenza A(H7N9) virus.

The patient is a six-year-old boy reported from Beijing who became ill on 21 May2013 and is in stable condition.To date, WHO has been informed of a total of 132 laboratory-confirmed cases,

including 37 deaths.Authorities in affected locations continue to maintain surveillance, epidemiological

investigations, close contact tracing, clinical management, laboratory testing andsharing of samples as well as prevention and control measures. City and provincial
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governments have started to normalize their emergency operations into theirroutine surveillance and response activities.

So far, there is no evidence of sustained human-to-human transmission

Update: Polio this week -As of 29 May 2013

Global Polio Eradication Initiativehttp://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx[Editors extract and bolded text]. At last weeks World Health Assembly (WHA) in Geneva, Switzerland, healthministers from around the world acknowledged the progress achieved in the pastyear in bringing polio to its lowest ever levels, thanks to actions of Member States inplacing polio eradication on an emergency footing. Delegates endorsed the newPolio Eradication and Endgame Strategic Plan 2013-2018 to secure a lasting polio-free world and urged for its full implementation and financing. For more, pleaseclick here.. In the Horn of Africa, four new wild poliovirus (WPV) cases were reported in thepast week (one in Kenya and three in Somalia). Outbreak response is continuing.

See Horn of Africa section for more.Nigeria. Two new WPV cases were reported in the past week (WPV1s from Borno), bringingthe total number of WPV cases for 2013 to 24. One of the new cases is the mostrecent WPV case in the country, with onset of paralysis on 25 April.Pakistan. One new WPV case was reported in the past week (WPV1 from KhyberPakhtunkhwa KP), bringing the total number of WPV cases for 2013 to nine. It isthe most recent WPV case in the country, and had onset of paralysis on 3 May.Horn of Africa. Four new WPV cases were reported in the past week (one WPV1 from Dadaab,north-eastern Kenya, and three WPV1s from Somalia), bringing the total number ofWPV1 cases in the region to six (two from Kenya and four from Somalia). Theselatest cases had onset of paralysis between 26 April and 14 May.. Outbreak response activities are continuing in both countries this week. In Kenya,immunization activities began on 26 May, to reach nearly 440,000 children agedless than 15 years across Dadaab. Further SNIDs are planned for a wider area,including parts of Nairobi, on 9 June, followed by large-scale subnationalimmunization days (SNIDs) in late June.In Somalia, SNIDs are ongoing (26-29 May), including in Banadir region (whichincludes Mogadishu).. Immunization campaigns are also planned and being conducted in other areas ofthe Horn of Africa, notably Ethiopia and Yemen, to urgently boost populationimmunity levels and minimize the risk of spread of the outbreak. In Ethiopia, inborder areas with Kenya and Somalia, an immunization activity is planned to starton 31 May (targeting children aged less than 15 years). Focus will be particularly onreaching children in refugee camps. Broader activities are planned for late June.. Yemen is planning two activities in early and late June.Wall Street Journal: ASIA NEWSUpdated May 28, 2013, 5:21 p.m. ETPolio Team Pulled From Pakistan City
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World Health Organization Acts in Peshawar After Two Members of Vaccine TeamAre Shothttp://online.wsj.com/article/SB10001424127887323855804578511413280432932.html?mod=wsj_streaming_stream#articleTabs%3Darticle

The Weekly Epidemiological Record (WER) for 31 May 2013, vol. 88, 22(pp. 225232) includes:. Review of the 20122013 winter influenza season, northern hemispherehttp://www.who.int/entity/wer/2013/wer8822.pdf

WHO - Humanitarian Health Actionhttp://www.who.int/hac/en/index.html-No new relevant updates published

UN Watch to 1 June 2013Selected meetings, press releases, and press conferences relevant to immunization,vaccines, infectious diseases, global health, etc. http://www.un.org/en/unpress/. Secretary-General Says Findings of Report on Post-2015 Agenda Fill KeyGaps in Millennium Development Goals (30 May 2013)SG/SM/15065-DEV/2991. Secretary-General Commends High-level Panel Reports Call to PlaceSustainability at Centre of Post-2015 Development Agenda (30 May 2013)SG/SM/15064-DEV/2990. Press Conference on Launch of Report on Post-2015 DevelopmentAgenda (30 May 2013)

Reports/Research/Analysis/ Conferences/Meetings/Book WatchVaccines: The Week in Review has expanded its coverage of new reports, books,research and analysis published independent of the journal channel covered inJournal Watch below. Our interests span immunization and vaccines, as well asglobal public health, health governance, and associated themes. If you would like tosuggest content to be included in this service, please contact David Curry at:[email protected]

Report: A New Global Partnership: Eradicate Poverty and TransformEconomies through Sustainable Development The Report of the High-LevelPanel of Eminent Persons on the Post-2015 Development AgendaUNMay 2013, 81 pageshttp://www.post2015hlp.org/wp-content/uploads/2013/05/UN-Report.pdf

The High Level Panel on the Post-2015 Development Agenda released a reportwhich sets out a universal agenda to eradicate extreme poverty from the face ofthe earth by 2030, and deliver on the promise of sustainable development. Thereport calls upon the world to rally around a new Global Partnership that offers hope
http://online.wsj.com/article/SB10001424127887323855804578511413280432932.html?mod=wsj_streaming_stream#articleTabs%3Darticlehttp://online.wsj.com/article/SB10001424127887323855804578511413280432932.html?mod=wsj_streaming_stream#articleTabs%3Darticlehttp://www.who.int/entity/wer/2013/wer8822.pdfhttp://www.who.int/hac/en/index.htmlhttp://www.un.org/en/unpress/http://www.un.org/News/Press/docs/2013/sgsm15065.doc.htmhttp://www.un.org/News/Press/docs/2013/sgsm15065.doc.htmhttp://www.un.org/News/Press/docs/2013/sgsm15064.doc.htmhttp://www.un.org/News/Press/docs/2013/sgsm15064.doc.htmhttp://www.un.org/News/briefings/docs/2013/130530_Development.doc.htmhttp://www.un.org/News/briefings/docs/2013/130530_Development.doc.htmmailto:[email protected]://www.post2015hlp.org/wp-content/uploads/2013/05/UN-Report.pdfhttp://online.wsj.com/article/SB10001424127887323855804578511413280432932.html?mod=wsj_streaming_stream#articleTabs%3Darticlehttp://online.wsj.com/article/SB10001424127887323855804578511413280432932.html?mod=wsj_streaming_stream#articleTabs%3Darticlehttp://www.who.int/entity/wer/2013/wer8822.pdfhttp://www.who.int/hac/en/index.htmlhttp://www.un.org/en/unpress/http://www.un.org/News/Press/docs/2013/sgsm15065.doc.htmhttp://www.un.org/News/Press/docs/2013/sgsm15065.doc.htmhttp://www.un.org/News/Press/docs/2013/sgsm15064.doc.htmhttp://www.un.org/News/Press/docs/2013/sgsm15064.doc.htmhttp://www.un.org/News/briefings/docs/2013/130530_Development.doc.htmhttp://www.un.org/News/briefings/docs/2013/130530_Development.doc.htmmailto:[email protected]://www.post2015hlp.org/wp-content/uploads/2013/05/UN-Report.pdf


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and a role to every person in the world. The Panel was established by UnitedNations Secretary-General Ban Ki-moon and co-chaired by Indonesian PresidentSusilo Bambang Yudhoyono, Liberian President Ellen Johnson Sirleaf and UnitedKingdom Prime Minister David Cameron.http://www.post2015hlp.org/featured/high-level-panel-releases-recommendations-for-worlds-next-development-agenda/

GAVI Alliance welcomes priority given to health and immunisation in High LevelPanel ReportStatement from Dr Seth Berkley, CEO of the GAVI Alliance, following the publicationof the report of the UN High Level Panel of Eminent Persons on the Post-2015Development Agenda.

Report: Accountability for Maternal, Newborn and Child SurvivalCountdown to 201527 May 2013Summary report:

http://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_noprofiles.pdfFull report:http://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_withprofiles.pdf

The new Countdown report has been produced by a global collaboration ofacademics and health professionals from Johns Hopkins University, Aga KhanUniversity, Federal University of Pelotas in Brazil, Harvard University, London Schoolof Hygiene and Tropical Medicine, UNICEF, the World Health Organization, UNFPA,Family Care International, Save the Children, and other institutions from around theworld. The secretariat of the Countdown to 2015 initiative(www.countdown2015mnch.org) is based at The Partnership for Maternal, Newborn& Child Health.

Countdown to 2015 assesses progress in the 75 countries that together accountfor more than 95% of all maternal and child deaths. This evidence is intended tosupport greater progress towards achieving UN Millennium Development Goals(MDGs) 4 and 5 by 2015. These MDGs call for reducing maternal deaths by three-quarters and the deaths of children under 5 years of age by two-thirds compared to1990 levels.

Accountability for Maternal, Newborn and Child Survival reports on the extent towhich women and children have access to key life-saving services in these 75countries, including family planning, antenatal care, skilled birth attendance, post-natal care, vaccinations, and treatment for diarrhea, pneumonia and other leadingkillers of young children

The report also highlights areas where more progress is needed, including:. Infectious Diseases. Malaria, pneumonia, diarrhea, sepsis, measles, AIDS, andother infectious diseases account for at least half of all young child deaths. Many ofthese deaths can be prevented with cost-effective interventions. These priorities arehighlighted by several recent efforts to scale up action to reduce child mortality,including the Global Action Plan for the Prevention and Control of Pneumonia andDiarrhoea, launched last month by WHO and UNICEF; the Global Vaccine ActionPlan, endorsed by the 194 member-states of the WHO in 2012; and Committing to
http://www.post2015hlp.org/featured/high-level-panel-releases-recommendations-for-worlds-next-development-agenda/http://www.post2015hlp.org/featured/high-level-panel-releases-recommendations-for-worlds-next-development-agenda/http://www.gavialliance.org/library/news/statements/2013/gavi-alliance-welcomes-priority-given-to-health-and-immunisation-in-high-level-panel-report/http://www.gavialliance.org/library/news/statements/2013/gavi-alliance-welcomes-priority-given-to-health-and-immunisation-in-high-level-panel-report/http://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_noprofiles.pdfhttp://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_noprofiles.pdfhttp://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_withprofiles.pdfhttp://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_withprofiles.pdfhttp://www.countdown2015mnch.org/http://www.post2015hlp.org/featured/high-level-panel-releases-recommendations-for-worlds-next-development-agenda/http://www.post2015hlp.org/featured/high-level-panel-releases-recommendations-for-worlds-next-development-agenda/http://www.gavialliance.org/library/news/statements/2013/gavi-alliance-welcomes-priority-given-to-health-and-immunisation-in-high-level-panel-report/http://www.gavialliance.org/library/news/statements/2013/gavi-alliance-welcomes-priority-given-to-health-and-immunisation-in-high-level-panel-report/http://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_noprofiles.pdfhttp://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_noprofiles.pdfhttp://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_withprofiles.pdfhttp://countdown2015mnch.org/documents/2013Report/Countdown_2013-Update_withprofiles.pdfhttp://www.countdown2015mnch.org/


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Child Survival: A Promise Renewed, led by the governments of India, Ethiopia andthe US, supported by UNICEF

Report: Replenishing the Global Fund in 2013 Options for U.S. DiplomaticSupport

Katherine E. BlissCSIS, May 2013, 8 pages

Hopes are high for a successful outcome of the 2013 replenishment process,through which the Global Fund to Fight AIDS, Tuberculosis and Malaria seekspledges of $15 billion to support planned activities for 20142016. The Fund is at acritical juncture. Established in 2002 to be an innovative multilateral organization,the Fund was designed as a partnership of the corporate, nonprofit, andgovernment sectors and intended to be more flexible and attuned to country needsthan traditional United Nations agencies in distributing donor monies. Followingreports of grant mismanagement in some key recipient countries in 2011, the Fundwent through an extensive, and at times difficult, yearlong reform process that hasput new leadership in place, overhauled grant administration and accounting

procedures, and positioned the organization to reengage with donors in securingfinancial support for its activities. Yet at a time when some experts argue it is finallypossible to turn the tide on HIV/AIDS, malaria, and tuberculosis,2 it is an openquestion whether countries and other donors will pledge adequate funding to meetthe revitalized Funds replenishment goalhttp://smartglobalhealth.org/page/m/c780604/35488746/11f3ad/2614f53b/2136232856/VEsE/

Meeting: The 8th Global Conference on Health PromotionFinlandia Hall, Helsinki, Finland1014 June 2013

This conference is co-hosted by WHO and the Ministry of Social Affairs and Health,Finland. The main theme of the conference is Health in All Policies (HiAP) and itsfocus is on implementation, the how-to. It is structured around six themes.

The conference aims to:- facilitate the exchange of experiences and lessons learnt and give guidance

on effective mechanisms for promoting intersectoral action;- review approaches to address barriers and build capacity for implementing

Health in All Policies;- identify opportunities to implement the recommendations of the Commission

on Social Determinants of Health through Health in All Policies;- establish and review economic, developmental and social case for investing

in HiAP;- address the contribution of health promotion in the renewal and reform of

primary health care; and- review progress, impact and achievements of health promotion since the

Ottawa Conference.http://www.who.int/mediacentre/events/meetings/2013/health_promotion/en/index.html
http://smartglobalhealth.org/page/m/c780604/35488746/11f3ad/2614f53b/2136232856/VEsE/http://smartglobalhealth.org/page/m/c780604/35488746/11f3ad/2614f53b/2136232856/VEsE/http://www.who.int/mediacentre/events/meetings/2013/health_promotion/en/index.htmlhttp://www.who.int/mediacentre/events/meetings/2013/health_promotion/en/index.htmlhttp://smartglobalhealth.org/page/m/c780604/35488746/11f3ad/2614f53b/2136232856/VEsE/http://smartglobalhealth.org/page/m/c780604/35488746/11f3ad/2614f53b/2136232856/VEsE/http://www.who.int/mediacentre/events/meetings/2013/health_promotion/en/index.htmlhttp://www.who.int/mediacentre/events/meetings/2013/health_promotion/en/index.html


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WHO: Emergency Response Framework (ERF)May 2013, 51 pageshttp://www.who.int/entity/hac/about/erf_.pdfERF is to clarify WHOs roles and responsibilities and to provide a commonapproach for its work in emergenciesExecutive Summary

WHOs Member States face a broad range of emergencies resulting from varioushazards and differing in scale, complexity and international consequences. Theseemergencies can have extensive political, economic, social and public healthimpacts, with potential long-term consequences sometimes persisting for yearsafter the emergency. They may be caused by natural disasters, conflict, diseaseoutbreaks, food contamination, or chemical or radio-nuclear spills, among otherhazards. They can undermine decades of social development and hard-earnedhealth gains, damage hospitals and other health infrastructure, weaken healthsystems and slow progress towards the Millennium Development Goals (MDGs).Preparing for and responding effectively to such emergencies are among the mostpressing challenges facing the international community.

WHO has an essential role to play in supporting Member States to prepare for,

respond to and recover from emergencies with public health consequences. WHOalso has obligations to the Inter-Agency Standing Committee (IASC) as HealthCluster Lead Agency, to the international Health Regulations (2005) and to otherinternational bodies and agreements related to emergency response.

The purpose of this Emergency Response Framework (ERF) is to clarify WHOsroles and responsibilities in this regard and to provide a common approach for itswork in emergencies. Ultimately, the ERF requires WHO to act with urgency andpredictability to best serve and be accountable to populations affected byemergencies.

First, the ERF sets out WHOs core commitments in emergency response whichare those actions that WHO is committed to delivering in emergencies with publichealth consequences to minimize mortality and life-threatening morbidity byleading a coordinated and effective health sector response.

Second, the ERF elaborates the steps WHO will take between the initial alert of anevent and its eventual emergency classification, including event verification andevent risk assessment.

Third, the ERF describes WHOs internal grading process for emergenciesincluding the purpose of grading, the definitions of the various grades, the criteriafor grading, and the steps to remove a grade.

Fourth, this paper describes WHOs Performance Standards for emergencyresponse: specific deliverables with timelines for completion that are used by WHOto measure its performance.

Fifth, the ERF outlines WHOs four critical functions during emergency response:leadership, information, technical expertise and core services.

Sixth, the ERF states the role of WHOs Global Emergency Management Team(GEMT) during emergency response, particularly related to the optimal use ofOrganization-wide resources, the monitoring of the implementation of relevantprocedures and policies, and the management of WHOs internal and externalcommunications.

Seventh, the ERF outlines WHOs Emergency Response Procedures (ERPs) thatspecify roles and responsibilities across the Organization to deliver on the fourcritical functions and the Performance Standards.
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Finally, three essential emergency policies which will optimize WHOs responseare detailed: the surge policy, the Health Emergency Leader policy and the no-regrets policy.

At the end of the document there are six complementary annexes. Annex 1provides a flow chart of the grading process and Annex 2 a country-level timelineduring emergency response. Annex 3 states WHOs obligations under an Inter-

Agency Standing Committee Level 3 emergency; Annex 4 sets out WHOsPerformance Standards in protracted emergencies; Annex 5 defines WHOscommitment to institutional readiness; and Annex 6 defines WHOs commitment toemergency risk management.

Journal WatchVaccines: The Week in Review continues its weekly scanning of key peer-reviewed

journals to identify and cite articles, commentary and editorials, books reviews andother content supporting our focus on vaccine ethics and policy.Journal Watch isnot intended to be exhaustive, but indicative of themes and issues the

Center is actively tracking. We selectively provide full text of some editorial andcomment articles that are specifically relevant to our work. Successful access tosome of the links provided may require subscription or other access arrangementunique to the publisher.

If you would like to suggest other journal titles to include in this service, pleasecontact David Curry at: [email protected]

American Journal of Infection ControlVol 41 | No. 6 | June 2013 | Pages 481-574http://www.ajicjournal.org/currentParent willingness to remind health care workers to perform hand hygiene20 December 2012Genevieve L. Buser, MDCM, MSHP, Brian T. Fisher, DO, MSCE, Judy A. Shea, PhD,Susan E. Coffin, MD, MPHBackgroundHealth care worker (HCW) hand hygiene (HH) is the core strategy to prevent healthcare-associated infections (HAI). Suboptimal HCW HH rates continue despitehospital efforts to increase compliance.Objectives

To determine whether parents of hospitalized children perceive they have a role inpreventing HAI and whether they are willing to remind HCW to perform HH, with andwithout an invitation.MethodsWe conducted structured interviews of parents of children admitted to a pediatrichospital. Questions assessed knowledge, attitudes, and behaviors about HAI andHH. The primary outcome was willingness to remind a HCW to do HH (5-point Likertscale).ResultsWe interviewed 115 parents, of whom 84% were aware of HAI. Most parents (78%)perceived HH as the most important practice to prevent HAI. However, only 67%would definitely remind a HCW to perform HH. Importantly, 92% said that an
mailto:[email protected]://www.ajicjournal.org/currenthttp://www.ajicjournal.org/article/S0196-6553(12)01159-5/abstractmailto:[email protected]://www.ajicjournal.org/currenthttp://www.ajicjournal.org/article/S0196-6553(12)01159-5/abstract


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invitation from a HCW would make them more likely to remind a HCW to do HH inthe future.ConclusionOur results suggest that parents of hospitalized children are willing to help preventHAI; however one-third are still reluctant to remind HCW to perform HH. Aninvitation by HCW to parents to remind HCW to perform HH might effectively

engage parents as partners in HAI prevention.Twitter as a source of vaccination information: Content drivers and whatthey are sayingBrad Love, PhD, Itai Himelboim, PhD, Avery Holton, MA, Kristin Stewart, MBAhttp://www.ajicjournal.org/article/S0196-6553%2812%2901371-5/abstractAbstractTwitter is a popular source of health information. This study reports a contentanalysis of posts about vaccinations, documenting sources, tone, and medicalaccuracy. Results can help explain patient knowledge and directions for educationalcampaigns. A set of 6,827 tweets indicates professional sources were shared mostand treated positively. Two-thirds of shared medical content were substantiated.One-third of messages were positive, counter to other research and suggesting that

users apply critical thinking when evaluating content.

American Journal of Public HealthVolume 103, Issue 6 (June 2013)http://ajph.aphapublications.org/toc/ajph/current[Reviewed earlier]

Annals of Internal Medicine21 May 2013, Vol. 158. No. 10http://www.annals.org/content/current[Reviewed earlier; No relevant content]

BMC Public Health(Accessed 1 June 2013)http://www.biomedcentral.com/bmcpublichealth/contentResearch articleThe role of religious leaders in promoting acceptance of vaccinationwithin a minority group: a qualitative studyWilhelmina LM Ruijs1,2*, Jeannine LA Hautvast1, Said Kerrar1, Koos van derVelden1 and Marlies EJL Hulscher3

http://www.biomedcentral.com/1471-2458/13/511/abstractAbstractBackgroundAlthough childhood vaccination programs have been very successful, vaccinationcoverage in minority groups may be considerably lower than in the generalpopulation. In order to increase vaccination coverage in such minority groupsinvolvement of faith-based organizations and religious leaders has been advocated.We assessed the role of religious leaders in promoting acceptance or refusal of
http://www.ajicjournal.org/article/S0196-6553(12)01371-5/abstracthttp://ajph.aphapublications.org/toc/ajph/currenthttp://www.annals.org/content/currenthttp://www.biomedcentral.com/bmcpublichealth/contenthttp://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins2http://www.biomedcentral.com/1471-2458/13/511/#ins2http://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins3http://www.biomedcentral.com/1471-2458/13/511/abstracthttp://www.ajicjournal.org/article/S0196-6553(12)01371-5/abstracthttp://ajph.aphapublications.org/toc/ajph/currenthttp://www.annals.org/content/currenthttp://www.biomedcentral.com/bmcpublichealth/contenthttp://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins2http://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins1http://www.biomedcentral.com/1471-2458/13/511/#ins3http://www.biomedcentral.com/1471-2458/13/511/abstract


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vaccination within an orthodox Protestant minority group with low vaccinationcoverage in The Netherlands.MethodsSemi-structured interviews were conducted with orthodox Protestant religiousleaders from various denominations, who were selected via purposeful sampling.

Transcripts of the interviews were thematically analyzed, and emerging concepts

were assessed for consistency using the constant comparative method fromgrounded theory.ResultsData saturation was reached after 12 interviews. Three subgroups of religiousleaders stood out: those who fully accepted vaccination and did not address thesubject, those who had religious objections to vaccination but focused on adeliberate choice, and those who had religious objections to vaccination andpreached against vaccination. The various approaches of the religious leadersseemed to be determined by the acceptance of vaccination in their congregation aswell as by their personal point of view. All religious leaders emphasized theimportance of voluntary vaccination programs and religious exemptions fromvaccination requirements. In case of an epidemic of a vaccine preventable disease,

they would appreciate a dialogue with the authorities. However, they were notwilling to promote vaccination on behalf of authorities.ConclusionReligious leaders attitudes towards vaccination vary from full acceptance to clearrefusal. According to orthodox Protestant church order, local congregation membersappoint their religious leaders themselves. Obviously they choose leaders whoseviews are compatible with the views of the congregation members. Moreover, thepositions of orthodox Protestant religious leaders on vaccination will not changeeasily, as their objections to vaccination are rooted in religious doctrine and theyowe their authority to their interpretation and application of this doctrine. Althoughthe dialogue with religious leaders that is pursued by the Dutch government may behelpful in controlling epidemics by other means than vaccination, it is unlikely toincrease vaccination coverage.

British Medical BulletinVolume 105 Issue 1 March 2013http://bmb.oxfordjournals.org/content/current[Reviewed earlier]

British Medical Journal01 June 2013 (Vol 346, Issue 7910)http://www.bmj.com/content/346/7910[No relevant content]

Bulletin of the World Health OrganizationVolume 91, Number 6, June 2013, 389-464http://www.who.int/bulletin/volumes/91/6/en/index.html[No relevant content]
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Clinical TherapeuticsVol 35 | No. 5 | May 2013 | Pages 541-744http://www.clinicaltherapeutics.com/current[Reviewed earlier; No relevant content]

Cost Effectiveness and Resource Allocation(Accessed 1 June 2013)http://www.resource-allocation.com/[No new relevant content]

Current Opinion in Infectious Diseases.June 2013 - Volume 26 - Issue 3 pp: v-v,213-293http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspx[Reviewed earlier]

Development in PracticeVolume 23, Issue 3, 2013http://www.tandfonline.com/toc/cdip20/current[Reviewed earlier; No relevant content]

Emerging Infectious DiseasesVolume 19, Number 6June 2013http://www.cdc.gov/ncidod/EID/index.htm[Reviewed earlier]

EurosurveillanceVolume 18, Issue 22, 30 May 2013http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678[No relevant content]

Forum for Development StudiesVolume 40, Issue 2, 2013http://www.tandfonline.com/toc/sfds20/current[Reviewed earlier; No relevant content]

Global Health GovernanceVolume VI, Issue 1: Fall 2012 December 31, 2012[Reviewed earlier]

Globalization and Health
http://www.clinicaltherapeutics.com/currenthttp://www.resource-allocation.com/http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspxhttp://www.tandfonline.com/toc/cdip20/currenthttp://www.cdc.gov/ncidod/EID/index.htmhttp://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678http://www.tandfonline.com/toc/sfds20/currenthttp://blogs.shu.edu/ghg/2012/12/31/volume-vi-issue-1-fall-2012/http://www.clinicaltherapeutics.com/currenthttp://www.resource-allocation.com/http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspxhttp://www.tandfonline.com/toc/cdip20/currenthttp://www.cdc.gov/ncidod/EID/index.htmhttp://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678http://www.tandfonline.com/toc/sfds20/currenthttp://blogs.shu.edu/ghg/2012/12/31/volume-vi-issue-1-fall-2012/


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[Accessed 1 June 2013]http://www.globalizationandhealth.com/[No new relevant content]

Health Affairs

May 2013; Volume 32, Issue 5http://content.healthaffairs.org/content/currentTheme: Tackling The Cost Conundrum[No specific relevant content on vaccines/immunization]

Health and Human RightsVol 14, No 2 (2012)http://hhrjournal.org/index.php/hhr[Reviewed earlier]

Health Economics, Policy and LawVolume 8 - Issue 02 - April 2013http://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissue[Reviewed earlier]

Health Policy and PlanningVolume 28 Issue 3 May 2013http://heapol.oxfordjournals.org/content/current[Reviewed earlier]

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)Volume 9, Issue 5 May 2013http://www.landesbioscience.com/journals/vaccines/toc/volume/9/issue/5/[Reviewed earlier]

Infectious Diseases of Povertyhttp://www.idpjournal.com/content[Accessed 1 June 2013][No new relevant content]

International Journal of EpidemiologyVolume 42 Issue 2 April 2013http://ije.oxfordjournals.org/content/current[Reviewed earlier]

International Journal of Infectious DiseasesVol 17 | No. 7 | July 2013
http://www.globalizationandhealth.com/http://content.healthaffairs.org/content/currenthttp://hhrjournal.org/index.php/hhrhttp://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissuehttp://heapol.oxfordjournals.org/content/currenthttp://www.landesbioscience.com/journals/vaccines/toc/volume/9/issue/5/http://www.idpjournal.com/contenthttp://ije.oxfordjournals.org/content/currenthttp://www.globalizationandhealth.com/http://content.healthaffairs.org/content/currenthttp://hhrjournal.org/index.php/hhrhttp://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissuehttp://heapol.oxfordjournals.org/content/currenthttp://www.landesbioscience.com/journals/vaccines/toc/volume/9/issue/5/http://www.idpjournal.com/contenthttp://ije.oxfordjournals.org/content/current


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http://www.ijidonline.com/current[Reviewed earlier]

JAMAMay 22, 2013, Vol 309, No. 20

http://jama.ama-assn.org/current.dtl[No relevant content]

JAMA PediatricsMay 2013, Vol 167, No. 5http://archpedi.jamanetwork.com/issue.aspx[Reviewed earlier; No relevant content]

Journal of Community HealthVolume 38, Issue 3, June 2013

http://link.springer.com/journal/10900/38/3/page/1[Reviewed earlier]

Journal of Health Organization and ManagementVolume 27 issue 3http://www.emeraldinsight.com/journals.htm?issn=1477-7266&show=latest[Reviewed earlier; No relevant content]

Journal of Infectious DiseasesVolume 208 Issue 1 July 1, 2013http://jid.oxfordjournals.org/content/currentEDITORIAL COMMENTARIESEditor's choice: Loss of Passively Acquired Maternal Antibodies in HighlyVaccinated Populations: An Emerging Need to Define the Ontogeny ofInfant Immune ResponsesHayley A. Gans and Yvonne A. Maldonado

J Infect Dis. (2013) 208(1): 1-3 doi:10.1093/infdis/jit144http://jid.oxfordjournals.org/content/208/1/1.extractExtract

Protection against infectious diseases is provided to young infants by passiveimmunity through the transplacental transfer of immunoglobulin G duringpregnancy and through immunoglobulin A in breast milk [17]. Despite the obviousbenefits of these antibodies to the youngest infants, their levels wane over time,necessitating the development of active immunity through vaccination. The timingof primary vaccination is complex, driven by the need to provide protection prior toa time when the infant is likely to be exposed to disease, by the possibility ofinterference with vaccine-induced immunity by passively acquired maternalantibodies, and, finally, by considerations of the developing infant immune system[79].
http://www.ijidonline.com/currenthttp://jama.ama-assn.org/current.dtlhttp://archpedi.jamanetwork.com/issue.aspxhttp://link.springer.com/journal/10900/38/3/page/1http://www.emeraldinsight.com/journals.htm?issn=1477-7266&show=latesthttp://jid.oxfordjournals.org/content/currenthttp://jid.oxfordjournals.org/content/208/1/1.extracthttp://www.ijidonline.com/currenthttp://jama.ama-assn.org/current.dtlhttp://archpedi.jamanetwork.com/issue.aspxhttp://link.springer.com/journal/10900/38/3/page/1http://www.emeraldinsight.com/journals.htm?issn=1477-7266&show=latesthttp://jid.oxfordjournals.org/content/currenthttp://jid.oxfordjournals.org/content/208/1/1.extract


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The titers of transplacentally transferred passive antibodies (PA) provided toinfants are, in part, determined by antibody titers present in the mother duringpregnancy. These maternal titers are affected by her nutritional and immune status,and evidence demonstrates that antibody titers induced by vaccination are typicallylower than titers induced by natural disease [3, 5, 6, 10]. After decades ofvaccination against childhood diseases, it is clear that successful vaccine programs

have resulted in dramatic decreases in morbidity and mortality. However, theincreasing prevalence of vaccine-derived maternal antibodies has also led tounexpected outcomes. This is most evident in the emergence of measlessusceptibility in young infants living in highly vaccinated populations where themeasles vaccine has been in use for decades [1114]. Historically, in developednations protection against measles among infants


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[Reviewed earlier; No relevant content]

Journal of Medical EthicsJune 2013, Volume 39, Issue 6http://jme.bmj.com/content/current

[Reviewed earlier]

Journal of Medical MicrobiologyJune 2013; 62 (Pt 6)http://jmm.sgmjournals.org/content/current[Reviewed earlier; No relevant content]

Journal of the Pediatric Infectious Diseases Society (JPIDS)Volume 2 Issue 2 June 2013http://jpids.oxfordjournals.org/content/current

[Reviewed earlier]

Journal of PediatricsVol 162 | No. 6 | June 2013 | Pages 1087-1298http://www.jpeds.com/[Reviewed earlier]

Journal of VirologyJune 2013, volume 87, issue 11http://jvi.asm.org/content/current[Reviewed earlier; No relevant content]

The LancetJun 01, 2013 Volume 381 Number 9881 p1877 1958 e16 - 17http://www.thelancet.com/journals/lancet/issue/currentEditorialImproving the health response to humanitarian crises

The LancetPreviewEarthquake in Haiti. Tsunami in Japan. Floods in Pakistan. When humanitarian criseshappen, the natural response is to get help to those affected as quickly as possible.But when governments, agencies, and charities respond to a crisis, are theyresponding in the best way possible? In 2011, the UK's Humanitarian EmergencyResponse Review, chaired by Paddy Ashdown, found that the evidence base foraction in these settings was weak.CommentAvian influenza A H7N9 in Zhejiang, ChinaMarion Koopmans, Menno D de JongPreview
http://jme.bmj.com/content/currenthttp://jmm.sgmjournals.org/content/currenthttp://jpids.oxfordjournals.org/content/currenthttp://www.jpeds.com/http://jvi.asm.org/content/currenthttp://www.thelancet.com/journals/lancet/issue/currenthttp://jme.bmj.com/content/currenthttp://jmm.sgmjournals.org/content/currenthttp://jpids.oxfordjournals.org/content/currenthttp://www.jpeds.com/http://jvi.asm.org/content/currenthttp://www.thelancet.com/journals/lancet/issue/current


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On March 31, 2013, the China Health and Planning Commission notified WHO ofthree human infections in Shanghai and Anhui with a novel influenza viruscharacterised as avian influenza A H7N9 (illness onset between Feb 19 and March15, 2013).1 Genetic characterisation2 showed that this virus resulted fromrecombination of genes between three parent viruses noted in Asia in poultry andwild birds. The severity of disease was remarkable, as was the fact that patients

were from towns located 400 km apart, and had no epidemiological connection.CommentGenesis of avian-origin H7N9 influenza A virusesMarc Van Ranst, Philippe LemeyPreviewSince March, 2013, 126 laboratory-confirmed cases of avian influenza A H7N9 havebeen detected in ten provinces or municipalities in east and southeast China (as ofApril 30, 2013).1 Most H7N9-infected patients are older (approximate median age62 years) urban men who reported exposure to chickens or captive-bred pigeonseither professionally or through visits to live poultry markets.2,3 Patients rapidlydevelop progressive pneumonia leading to acute respiratory distress syndrome andmultiorgan failure.

World ReportRevising the Declaration of HelsinkiKelly MorrisPreview |

The Declaration of Helsinki is undergoing its seventh revision. Reaction to the firstdraft, out for public consultation until June 15, has been polarised. Kelly Morrisinvestigates.Human infections with the emerging avian influenza A H7N9 virus fromwet market poultry: clinical analysis and characterisation of viral genome

Yu Chen, Weifeng Liang, Shigui Yang, Nanping Wu, Hainv Gao, Jifang Sheng,Hangping Yao, Jianer Wo, Qiang Fang, Dawei Cui, Yongcheng Li, Xing Yao, YuntaoZhang, Haibo Wu, Shufa Zheng, Hongyan Diao, Shichang Xia, Yanjun Zhang, Kwok-Hung Chan, Hoi-Wah Tsoi, Jade Lee-Lee Teng, Wenjun Song, Pui Wang, Siu-Ying Lau,Min Zheng, Jasper Fuk-Woo Chan, Kelvin Kai-Wang To, Honglin Chen, Lanjuan Li,Kwok-Yung Yuenhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2960903-4/abstractPreview |Cross species poultry-to-person transmission of this new reassortant H7N9 virus isassociated with severe pneumonia and multiorgan dysfunction in human beings.Monitoring of the viral evolution and further study of disease pathogenesis willimprove disease management, epidemic control, and pandemic preparedness.Origin and diversity of novel avian influenza A H7N9 viruses causinghuman infection: phylogenetic, structural, and coalescent analysesDi Liu, Weifeng Shi, Yi Shi, Dayan Wang, Haixia Xiao, Wei Li, Yuhai Bi, Ying Wu,Xianbin Li, Jinghua Yan, Wenjun Liu, Guoping Zhao, Weizhong Yang, Yu Wang, JuncaiMa, Yuelong Shu, Fumin Lei, George F Gaohttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2960938-1/abstractPreview |

The novel avian influenza A H7N9 virus might have evolved from at least fourorigins. Diversity among isolates implies that the H7N9 virus has evolved into at
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least two different lineages. Unknown intermediate hosts involved might beimplicated, extensive global surveillance is needed, and domestic-poultry-to-persontransmission should be closely watched in the future.

The Lancet Infectious Diseases

Jun 2013 Volume 13 Number 6 p465 - 558http://www.thelancet.com/journals/laninf/issue/current[Reviewed earlier]

Medical Decision Making (MDM)May 2013; 33 (4)http://mdm.sagepub.com/content/current[Reviewed earlier]

The Milbank Quarterly

A Multidisciplinary Journal of Population Health and Health PolicyMarch 2013 Volume 91, Issue 1 Pages 1218http://onlinelibrary.wiley.com/doi/10.1111/milq.2013.91.issue-1/issuetoc[Reviewed earlier]

NatureVolume 497 Number 7450 pp409-530 23 May 2013http://www.nature.com/nature/current_issue.html[No relevant content]

Nature ImmunologyJune 2013, Volume 14 No 6 pp523-643http://www.nature.com/ni/journal/v14/n6/index.html[No relevant content]

Nature MedicineMay 2013, Volume 19 No 5 pp507-651http://www.nature.com/nm/journal/v19/n5/index.html[Reviewed earlier; No relevant content]

Nature Reviews ImmunologyJune 2013 Vol 13 No 6http://www.nature.com/nri/journal/v13/n6/index.html[No relevant content]

New England Journal of MedicineMay 30, 2013 Vol. 368 No. 22
http://www.thelancet.com/journals/laninf/issue/currenthttp://mdm.sagepub.com/content/currenthttp://onlinelibrary.wiley.com/doi/10.1111/milq.2013.91.issue-1/issuetochttp://www.nature.com/nature/current_issue.htmlhttp://www.nature.com/ni/journal/v14/n6/index.htmlhttp://www.nature.com/nm/journal/v19/n5/index.htmlhttp://www.nature.com/nri/journal/v13/n6/index.htmlhttp://www.thelancet.com/journals/laninf/issue/currenthttp://mdm.sagepub.com/content/currenthttp://onlinelibrary.wiley.com/doi/10.1111/milq.2013.91.issue-1/issuetochttp://www.nature.com/nature/current_issue.htmlhttp://www.nature.com/ni/journal/v14/n6/index.htmlhttp://www.nature.com/nm/journal/v19/n5/index.htmlhttp://www.nature.com/nri/journal/v13/n6/index.html


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http://www.nejm.org/toc/nejm/medical-journal[No relevant content]

OMICS: A Journal of Integrative BiologyJune 2013, 17(6)

http://online.liebertpub.com/toc/omi/17/6[No relevant content]

Revista Panamericana de Salud Pblica/Pan American Journal of PublicHealth (RPSP/PAJPH)May 2013 Vol. 33, No. 5http://www.paho.org/journal/index.php?option=com_content&task=view&id=125&Itemid=224[No relevant content]

The Pediatric Infectious Disease JournalJune 2013 - Volume 32 - Issue 6 pp: A15-A16,585-707,e227-e264http://journals.lww.com/pidj/pages/currenttoc.aspx[No relevant content]

PediatricsJune 2013, VOLUME 131 / ISSUE 6http://pediatrics.aappublications.org/current.shtml

ArticleComparative Effectiveness of Acellular Versus Whole-Cell PertussisVaccines in TeenagersNicola P. Klein, MD, PhD, Joan Bartlett, MPH, MPP, Bruce Fireman, MA, Ali Rowhani-Rahbar, MD, MPH, PhD, and Roger Baxter, MDhttp://pediatrics.aappublications.org/content/131/6/e1716.abstractAbstractBACKGROUND: During the 1990s, the United States switched from combineddiphtheria, tetanus toxoids, whole-cell pertussis (DTwP) vaccines to combinedacellular pertussis (DTaP) vaccines because of safety concerns. After a 20102011pertussis outbreak, we sought to evaluate whether disease risk in 10 to 17 year oldsdiffered between those who previously received DTwP from those who receivedDTaP.METHODS: A case-control study among individuals born from 1994 to 1999 whoreceived 4 pertussis-containing vaccines during the first 2 years of life at KaiserPermanente Northern California (KPNC). We separately compared pertussispolymerase chain reaction (PCR)-positive cases with PCR-negative and KPNC-matched controls. We assessed risk of pertussis relative to vaccine type in earlychildhood (4 DTwPs, mixed DTwP/DTaP, or 4 DTaPs) by using conditional logisticregression stratified for calendar time and adjusted for gender, race, medical clinic,and receipt of reduced antigen content acellular pertussis (Tdap) vaccine.RESULTS: We compared 138 PCR-positive cases with 899 PCR-negative and 54 339KPNC-matched controls. Teenagers who had received 4 DTwPs were much less
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likely to be pertussis PCR-positive than those who had received 4 DTaPs (odds ratio5.63, 95% confidence interval 2.5512.46) or mixed DTwP/DTaP vaccines (odds ratio3.77, 95% confidence interval 1.579.07). Decreasing number of DTwP doses wassignificantly associated with increased pertussis risk (P < .0001).CONCLUSIONS: Teenagers who received DTwP vaccines in childhood were moreprotected during a pertussis outbreak than were those who received DTaP vaccines.

ArticlePregnancy Dose Tdap and Postpartum Cocooning to Prevent InfantPertussis: A Decision AnalysisAndrew Terranella, MD, MPH, Garrett R. Beeler Asay, PhD, Mark L. Messonnier, PhD,

Thomas A. Clark, MD, MPH, and Jennifer L. Liang, DVM, MPVMhttp://pediatrics.aappublications.org/content/131/6/e1748.abstractAbstractBACKGROUND: Infants


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BACKGROUND: In 2006 and 2008, 2 new rotavirus vaccines (RotaTeq [RV5] andRotarix [RV1]) were introduced in the United States.METHODS: We assessed intussusception events reported to the Vaccine AdverseEvent Reporting System from February 2006 through April 2012 for RV5 and fromApril 2008 through April 2012 for RV1. For RV5, we conducted a self-controlled riskinterval analysis using Poisson regression to estimate the daily reporting ratio (DRR)

of intussusception comparing average daily reports 3 to 6 versus 0 to 2 days aftervaccination. We calculated reporting rate differences based on DRRs andbackground rates of intussusception. Sensitivity analyses were conducted to assesseffects of differential reporting completeness and inaccuracy of baseline rates. Fewreports were submitted after RV1, allowing only a descriptive analysis.RESULTS: The Vaccine Adverse Event Reporting System received 584 confirmedintussusception reports after RV5 and 52 after RV1, with clustering 3 to 6 days afterboth vaccines. The DRR comparing the 3- to 6-day and the 0- to 2-day periods afterRV5 dose 1 was 3.75 (95% confidence interval = 1.90 to 7.39). There was nosignificant increase in reporting after dose 2 or dose 3. Over all 3 doses, the excessrisk of intussusception was 0.79 events (95% confidence interval = 0.04 to 1.62)per 100 000 vaccinations. From the sensitivity analyses, we conclude that under a

worst-case scenario, the DRR could be 5.00 and excess risk per 100 000 doses couldbe 1.36.CONCLUSIONS: We observed a persistent clustering of reported intussusceptionevents 3 to 6 days after the first dose of RV5 vaccination. This clustering couldtranslate to a small increased risk of intussusception, which is outweighed by thebenefits of rotavirus vaccination.

ArticleEffectiveness of Decision Support for Families, Clinicians, or Both on HPVVaccine ReceiptAlexander G. Fiks, MD, MSCE; Robert W. Grundmeier, MD; Lihai Song, MS; KristenFeemster, MD, MPH, MSHP; Dean Karavite, MSI; Cayce C. Hughes, MPH; JamesMassey, RN; Ron Keren, MD, MPH; Louis M. Bell, MD; Richard Wasserman, MD, andA. Russell Localio, PhDhttp://pediatrics.aappublications.org/content/131/6/1114.abstractAbstractOBJECTIVE: To improve human papillomavirus (HPV) vaccination rates, we studiedthe effectiveness of targeting automated decision support to families, clinicians, orboth.METHODS: Twenty-two primary care practices were cluster-randomized to receive a3-part clinician-focused intervention (education, electronic health record-basedalerts, and audit and feedback) or none. Overall, 22 486 girls aged 11 to 17 yearsdue for HPV vaccine dose 1, 2, or 3 were randomly assigned within each practice toreceive family-focused decision support with educational telephone calls.Randomization established 4 groups: family-focused, clinician-focused, combined,and no intervention. We measured decision support effectiveness by finalvaccination rates and time to vaccine receipt, standardized for covariates andlimited to those having received the previous dose for HPV #2 and 3. The 1-yearstudy began in May 2010.RESULTS: Final vaccination rates for HPV #1, 2, and 3 were 16%, 65%, and 63%among controls. The combined intervention increased vaccination rates by 9, 8, and13 percentage points, respectively. The control group achieved 15% vaccination forHPV #1 and 50% vaccination for HPV #2 and 3 after 318, 178, and 215 days. The
http://pediatrics.aappublications.org/content/131/6/1114.abstracthttp://pediatrics.aappublications.org/content/131/6/1114.abstract


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combined intervention significantly accelerated vaccination by 151, 68, and 93days. The clinician-focused intervention was more effective than the family-focusedintervention for HPV #1, but less effective for HPV #2 and 3.CONCLUSIONS: A clinician-focused intervention was most effective for initiating theHPV vaccination series, whereas a family-focused intervention promotedcompletion. Decision support directed at both clinicians and families most

effectively promotes HPV vaccine series receipt.

PharmaceuticsVolume 5, Issue 2 (June 2013), Pages 220-http://www.mdpi.com/1999-4923/5/2[Reviewed earlier; No relevant content]

PharmacoeconomicsVolume 31, Issue 5, May 2013http://link.springer.com/journal/40273/31/5/page/1

[No relevant content]

PLoS One[Accessed 1 June 2013]http://www.plosone.org/Meningococcal Serogroup A, C, W135 and Y Conjugated Vaccine: A Cost-Effectiveness Analysis in the NetherlandsHiltsje Hepkema, Koen B. Pouwels, Arie van der Ende, Tjalke A. Westra, Maarten J.Postmahttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0065036AbstractBackgroundIn 2002, vaccination with a serogroup C meningococcal conjugate vaccine (MenC)was introduced in the Netherlands for all children aged 14 months. Despite itssuccess, herd immunity may wane over time. Recently, a serogroup A,C,W135,Ymeningococcal conjugate vaccine (MenACWY) was licensed for use in subjects of 12months of age and above.Objectives

To evaluate the cost-effectiveness of meningococcal vaccination at 14 months andan additional vaccination at the age of 12 years, both with the MenACWY vaccine.MethodsA decision analysis cohort model, with 185,000 Dutch newborns, was used toevaluate the cost-effectiveness of different immunization strategies. For strategiesincluding a vaccination at 12 years of age, an additional cohort with adolescentsaged 12 years was followed. The incremental cost-effectiveness ratio (ICER) wasestimated for the current disease incidence and for a scenario when herd immunityis lost.ResultsVaccination with MenACWY at 14 months is cost-saving. Vaccinating with MenACWYat 14 months and at 12 years would prevent 7 additional cases of meningococcalserogroup A,C,W135,Y disease in the birth cohort and adolescent cohort followed for
http://www.mdpi.com/1999-4923/5/2http://link.springer.com/journal/40273/31/5/page/1http://www.plosone.org/http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0065036http://www.mdpi.com/1999-4923/5/2http://link.springer.com/journal/40273/31/5/page/1http://www.plosone.org/http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0065036


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99 years compared to the current vaccine schedule of a single vaccination withMenC at 14 months. With the current incidence, this strategy resulted in an ICER of635,334 per quality adjusted life year. When serogroup C disease incidencereturns to pre-vaccination levels due to a loss of vaccine-induced herd-immunity,vaccination with MenACWY at 14 months and at 12 years would be cost-saving.Conclusions

Routine vaccination with MenACWY is cost-saving. With the current epidemiology, abooster-dose with MenACWY is not likely cost-effective. When herd immunity is lost,a booster-dose has the potential of being cost-effective. A dynamic model should bedeveloped for more precise estimation of the cost-effectiveness of the prevention ofdisappearance of herd immunity.

PLoS Medicine(Accessed 1 June 2013)http://www.plosmedicine.org/[No new relevant content]

PLoS Neglected Tropical DiseasesMay 2013http://www.plosntds.org/article/browseIssue.action[No new relevant content]

PNAS - Proceedings of the National Academy of Sciences of the UnitedStatesof America(Accessed 1 June 2013)http://www.pnas.org/content/early/recent[No new relevant content]

Public Health EthicsVolume 6 Issue 1 April 2013http://phe.oxfordjournals.org/content/current[Reviewed earlier]

Qualitative Health ResearchJuly 2013; 23 (7)http://qhr.sagepub.com/content/current[Reviewed earlier; No relevant content]

Risk AnalysisMay 2013 Volume 33, Issue 5 Pages 751944http://onlinelibrary.wiley.com/doi/10.1111/risa.2013.33.issue-5/issuetoc[Reviewed earlier; No relevant content]
http://www.plosmedicine.org/http://www.plosntds.org/article/browseIssue.actionhttp://www.pnas.org/content/early/recenthttp://phe.oxfordjournals.org/content/currenthttp://qhr.sagepub.com/content/currenthttp://onlinelibrary.wiley.com/doi/10.1111/risa.2013.33.issue-5/issuetochttp://www.plosmedicine.org/http://www.plosntds.org/article/browseIssue.actionhttp://www.pnas.org/content/early/recenthttp://phe.oxfordjournals.org/content/currenthttp://qhr.sagepub.com/content/currenthttp://onlinelibrary.wiley.com/doi/10.1111/risa.2013.33.issue-5/issuetoc


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Science31 May 2013 vol 340, issue 6136, pages 1005-1132http://www.sciencemag.org/current.dtlReviewAccelerating Next-Generation Vaccine Development for Global Disease

PreventionWayne C. Koff, Dennis R. Burton, Philip R. Johnson, Bruce D. Walker, Charles R.

King, Gary J. Nabel, Rafi Ahmed, Maharaj K. Bhan, Stanley A. PlotkinAbstractBackground

Vaccines have provided some of the greatest successes in the history ofmedicine, including the eradication of smallpox, the near eradication of polio, andthe prevention of considerable morbidity and mortality from numerous infectiousdiseases each year. However, past strategies for vaccine development are unlikelyto succeed in the future against major global diseases such as AIDS, tuberculosis,and malaria. For such diseases, the correlates of protection are poorly defined, andthe pathogens evade immune detection and/or exhibit extensive genetic variability.

Limitations of animal models to predict human immune responses to vaccines,coupled with low success rates for vaccine development compared withbiopharmaceuticals, suggest that new paradigms must be implemented foraccelerating vaccine development.Advances

Recent technological advances in molecular genetics, molecular and cellularimmunology, structural biology, bioinformatics, computational biology,nanotechnology, formulation methods, and systems biology are ushering in a newera of vaccine discovery. For example, genomic-based antigen discovery is beingexploited for the design of vaccines against multiple bacterial pathogens. Similarly,interrogation of the memory B cell and antibody repertoires from virus-infectedsubjects has led to the identification of broadly neutralizing antibodies against HIV,influenza, and other viruses, which are now being exploited as tools to design highlyconserved epitope-based vaccines. Advances in adjuvant and vector deliverytechnologies are providing novel approaches for immune potentiation of vaccines,offering new strategies for improving vaccine response rates in neonates and theelderly. However, translation of these advances into vaccines remains impeded bymajor gaps in our knowledge of human immune responses, including methods tofocus immune responses on subdominant protective epitopes, to elicit long-termmemory responses, and to drive antibody maturation processes. These gaps cannow be addressed given the technological advances described, including thedevelopment of approaches to analyze immune responses at the single-cell andsystems levels.Outlook

Successful development of vaccines against the major global diseases for whichvaccines do not currently exist would be transformational for public health, withhuge benefits across society. To accelerate next-generation vaccine development,we propose that new human immunologybased clinical research initiatives beestablished, with the goal of elucidating and more effectively generating vaccine-induced protective immune responses. Collectively, such a "Human VaccinesProject" holds the potential to greatly accelerate the development of next-generation vaccines against major global killers such as AIDS, tuberculosis, malaria,
http://www.sciencemag.org/current.dtlhttp://www.sciencemag.org/current.dtl


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and other infectious diseases; enable more successful vaccine development againstallergies, autoimmune diseases, and cancers; and provide a foundation for vaccinedevelopment against new and emerging diseases.http://www.sciencemag.org/content/340/6136/1232910.abstract

Science Translational Medicine29 May 2013 vol 5, issue 187http://stm.sciencemag.org/content/current[No relevant content]

Social Science & Medicinehttp://www.sciencedirect.com/science/journal/02779536/85Volume 86, Pages 1-112 (June 2013)[No relevant content]Volume 87, Pages 1-194 (June 2013)[No relevant content]

Volume 88, Pages 1-116 (July 2013)[No relevant content]Volume 89, Pages 1-62 (July 2013)[No relevant content]Volume 90, In Progress (August 2013)[No relevant content]

Vaccinehttp://www.sciencedirect.com/science/journal/0264410X

Volume 31, Issue 22, Pages 2539-2598 (24 May 2013)

Teenagers understandings of and attitudes towards vaccines and vaccine-preventable diseases: A qualitative studyOriginal Research ArticlePages 2543-2550S. Hilton, C. Patterson, E. Smith, H. Bedford, K. HAbstractBackground

To examine immunisation information needs of teenagers we exploredunderstandings of vaccination and vaccine-preventable diseases, attitudes towardsimmunisation and experiences of immunisation. Diseases discussed included ninefor which vaccines are currently offered in the UK (human papillomavirus,meningitis, tetanus, diphtheria, polio, whooping cough, measles, mumps andrubella), and two not currently included in the routine UK schedule (hepatitis B andchickenpox).Methods

Twelve focus groups conducted between November 2010 and March 2011 with 59teenagers (29 girls and 30 boys) living in various parts of Scotland.Results

Teenagers exhibited limited knowledge and experience of the diseases, excludingchickenpox. Measles, mumps and rubella were perceived as severe forms of
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chickenpox-like illness, and rubella was not associated with foetal damage. Boyscommonly believed that human papillomavirus only affects girls, and both gendersexhibited confusion about its relationship with cancer. Participants considered twokey factors when assessing the threat of diseases: their prevalence in the UK, andtheir potential to cause fatal or long-term harm. Meningitis was seen as a threat,but primarily to babies. Participants explained their limited knowledge as a result of

mass immunisation making once-common diseases rare in the UK, andacknowledged immunisation's role in reducing disease prevalence.ConclusionsWhile it is welcome that fewer teenagers have experienced vaccine-preventablediseases, this presents public health advocates with the challenge ofcommunicating benefits of immunisation when advantages are less visible. Thefindings are timely in view of the Joint Committee on Vaccination andImmunisation's recommendation that a booster of meningitis C vaccine should beoffered to teenagers; that teenagers did not perceive meningitis C as a significantthreat should be a key concern of promotional information. While teenagersexperiences of immunisation in school were not always positive, they seemedenthusiastic at the prospect of introducing more vaccines for their age group.

Costbenefit analysis of hospital based postpartum vaccination withcombined tetanus toxoid, reduced diphtheria toxoid, and acellularpertussis vaccine (Tdap)Original Research ArticlePages 2558-2564

Yao Ding, Sylvia H. Yeh, Chris Anna M. Mink, Kenneth M. Zangwill, Norma J. Allred,Joel W. HaAbstractObjective

To assess the economic benefits associated with hospital-based postpartum Tdap(combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis)vaccination.MethodsA decision tree model was constructed to calculate the potential costbenefit of thisstrategy from both a health care system and a societal perspective. Probabilitiesand costs were derived from published literature, data reported to Centers forDisease Control and Prevention, and recommendations from expert panels. Thematernal vaccination protection period for infants was defined as 7 months, and 10years of waning immunity following Tdap for birth mothers was estimated in themodel. All cost estimates were inflated to year 2012 US dollars and discounted at a3% annual discount rate.ResultsIn the base case from a societal perspective, the expected costs per vaccinated andunvaccinated mother were estimated at $129.27 and $187.97, respectively,suggesting an expected net benefit of $58.70 per vaccinated mother. The overallsocietal benefits in the cohort of 3.6 million U.S. birth mothers ranged from $52.8126.8 million, depending on the vaccination coverage level. If including directmedical costs only, the strategy would not generate net savings from a health caresystem perspective. Annual incidence of pertussis in birth mothers and Tdapefficacy exhibited substantial impact on the model as shown in one-way and two-way sensitivity analyses.Conclusions
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Although postpartum Tdap vaccination is not cost-beneficial from a health caresystem perspective in the base case, this strategy is likely to generate net benefitsfrom a societal perspectivePostlicensure surveillance for pre-specified adverse events following the13-valent pneumococcal conjugate vaccine in childrenOriginal Research Article

Pages 2578-2583Hung Fu Tseng, Lina S. Sy, In-Lu Amy Liu, Lei Qian, S. Michael Marcy, EricWeintraub, Katherine Yih, Roger Baxter, Jason M. Glanz, James Donahue, AllisonNaleway, James Nordin, Steven J. JacobsenAbstractAlthough no increased risk was detected for serious adverse events in theprelicensure trials for the 13-valent pneumococcal vaccine, Prevnar 13 (PCV13),continued monitoring of rare but serious adverse events is necessary. A surveillancesystem using cohort study design was set up to monitor safety of PCV13immediately after it was included in the childhood immunization program in theUnited States. The exposed population included children of 1 month to 2 years oldwho received PCV13 from April, 2010 to January, 2012 from the eight managed care

organizations participating in the Vaccine Safety Datalink Project in the UnitedStates. The historical unexposed population was children of the same age whoreceived the 7-valent pneumococcal conjugate vaccine Prevnar 7 (PCV7) in 2007(or 2005 depending on the outcome of interest) to 2009. The risk of pre-specifiedadverse events in the risk window following PCV13 was repeatedly compared to thatin the historical comparison group. The number of doses included in the study was599,229. No increased risk was found for febrile seizures, urticaria or angioneuroticedema, asthma, thrombocytopenia, or anaphylaxis. An increased risk forencephalopathy was not confirmed following the medical record review. The relativerisk for Kawasaki disease in 028 days following vaccination was 1.94 (95%confidence interval: 0.794.86), comparing PCV13 to PCV7. Comparing to PCV7vaccine, we identified no significant increased risk of pre-specified adverse eventsin the Vaccine Safety Datalink study cohort. The possible association betweenPCV13 and Kawasaki disease may deserve further investigation.

VaccineVolume 31, Issue 23, Pages 2599-2658 (28 May 2013)Long-term safety assessment of live attenuated tetravalent denguevaccines: Deliberations from a WHO technical consultationOriginal Research ArticlePages 2603-2609Live Dengue Vaccines Technical Consultation Reporting Group, Adwoa D. Bentsi-Enchill, Julia Schmitz, Robert Edelman, Anna Durbin, John T. Roehrig, Peter G. Smith,

Joachim Hombach, Jeremy FarrarAbstractDengue is a rapidly growing public health threat with approximately 2.5 billionpeople estimated to be at risk. Several vaccine candidates are at various stages ofpre-clinical and clinical development. Thus far, live dengue vaccine candidates havebeen administered to several thousands of volunteers and were well-tolerated, withminimal short-term safety effects reported in Phase I and Phase II clinical trials.Based on the natural history of dengue, a theoretical possibility of an increased riskof severe dengue as a consequence of vaccination has been hypothesized but not
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yet observed. In October 2011, the World Health Organization (WHO) convened aconsultation of experts in dengue, vaccine regulation and vaccine safety to reviewthe current scientific evidence regarding safety concerns associated with liveattenuated dengue vaccines and, in particular, to consider methodologicalapproaches for their long-term evaluation. In this paper we summarize the scientificbackground and methodological considerations relevant to the safety assessment of

these vaccines. Careful planning and a coordinated approach to safety assessmentare recommended to ensure adequate long-term evaluation of dengue vaccinesthat will support their introduction and continued use.Introducing vaccination against serogroup B meningococcal disease: Aneconomic and mathematical modelling study of potential impactOriginal Research ArticlePages 2638-2646Hannah Christensen, Matthew Hickman, W. John Edmunds, Caroline L. TrotterAbstractBackgroundMeningococcal disease remains an important cause of morbidity and mortalityworldwide. The first broadly effective vaccine against group B disease (which

causes considerable meningococcal disease in Europe, the Americas andAustralasia) was licensed in the EU in January 2013; our objective was to estimatethe potential impact of introducing such a vaccine in England.MethodsWe developed two models to estimate the impact of introducing a new MenBvaccine. The cohort model assumes the vaccine protects against disease only; thetransmission dynamic model also allows the vaccine to protect against carriage(accounting for herd effects). We used these, and economic models, to estimate thecase reduction and cost-effectiveness of a number of different vaccine strategies.ResultsWe estimate 27% of meningococcal disease cases could be prevented over thelifetime of an English birth cohort by vaccinating infants at 2,3,4 and 12 months ofage with a vaccine that prevents disease only; this strategy could be cost-effectiveat 9 per vaccine dose. Substantial reductions in disease (71%) can be producedafter 10 years by routinely vaccinating infants in combination with a large-scalecatch-up campaign, using a vaccine which protects against carriage as well asdisease; this could be cost-effective at 17 per vaccine dose.ConclusionsNew MenB vaccines could substantially reduce disease in England and be cost-effective if competitively priced, particularly if the vaccines can prevent carriage aswell as disease. These results are relevant to other countries, with a similarepidemiology to England, considering the introduction of a new MenB vaccine.Indicators to assess National Immunization Technical Advisory Groups(NITAGs)Original Research ArticlePages 2653-2657

Julia Blau, Nahad Sadr-Azodi, Marine Clementz, Nihal Abeysinghe, Niyazi Cakmak,Philippe Duclos, Cara Janusz, Barbara Jauregui, Richard Mihigo, Liudmila Mosina,

Yoshihiro Takashima, Kamel SenouciAbstractA National Immunization Technical Advisory Group (NITAG) is an expert advisorycommittee that provides evidence-based recommendations to the Ministry of Health


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(MoH) to guide immunization programs and policies. The World Health Organization(WHO), the Initiative for Supporting National Independent Immunization and VaccineAdvisory Committees (SIVAC) at Agence de Mdecine Prventive (AMP) and the USCenters for Disease Control and Prevention (US CDC) engaged NITAG stakeholdersand technical partners in the development of indicators to assess the effectivenessof NITAGs. A list of 17 process, output and outcome indicators was developed and

tested in 14 countries to determine whether they were understandable, feasible tocollect, and useful for the countries. Based on the findings, a revised version of theindicators is proposed for self-assessment in the countries, as well as for globalmonitoring of the NITAGs.

VaccineVolume 31, Issue 24, Pages 2659-2722 (31 May 2013)Economic analysis of measles elimination program in the Republic ofKorea, 2001: A cost benefit analysis studyOriginal Research ArticlePages 2661-2666Geun-Ryang Bae, Young June Choe, Un Yeong Go, Yong-Ik Kim, Jong-Koo Lee

AbstractBackgroundIn this study, we modeled the cost benefit analysis for three different measlesvaccination strategies based upon three different measles-containing vaccines inKorea, 2001. We employed an economic analysis model using vaccination coveragedata and population-based measles surveillance data, along with availableestimates of the costs for the different strategies. In addition, we have includedanalysis on benefit of reduction of complication by mumps and rubella.MethodsWe evaluated four different strategies: strategy 1, keep-up program with a seconddose measles-mumps-rubella (MMR) vaccine at 46 years without catch-upcampaign; strategy 2, additional catch-up campaign with measles (M) vaccine;strategy 3, catch-up campaign with measles-rubella (MR) vaccine; and strategy 4,catch-up campaign with MMR vaccine. The cost of vaccination included cost forvaccines, vaccination practices and other administrative expenses. The directbenefit of estimated using data from National Health Insurance Company, agovernment-operated system that reimburses all medical costs spent on designatedillness in Korea.ResultsWith the routine one-dose MMR vaccination program, we estimated a baseline of178,560 measles cases over the 20 years; when the catch-up campaign with M, MRor MMR vaccines was conducted, we estimated the measles cases would decreaseto 5936 cases. Among all strategies, the two-dose MMR keep-up program with MRcatch-up campaign showed the highest benefit-cost ratio of 1.27 with a net benefitof 51.6 billion KRW.ConclusionAcross different vaccination strategies, our finding suggest that MR catch-upcampaign in conjunction with two-dose MMR keep-up program was the mostappropriate option in terms of economic costs and public health effects associatedwith measles elimination strategy in Korea.Who is unlikely to report adverse events after vaccinations to the VaccineAdverse Event Reporting System (VAERS)?


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Original Research ArticlePages 2673-2679Michael M. McNeil, Rongxia Li, Susanne Pickering, Theresa M. Real, Philip J. Smith,Michael R. PembertonAbstractBackground

Healthcare provider (HCP) reporting to the Vaccine Adverse Event Reporting System(VAERS) is important to assuring the safety of U.S. licensed vaccines. HCPawareness of and practices regarding reporting of adverse events followingimmunization (AEFI) is understudied.MethodsA large, nationally representative sample of U.S. office-based HCP across threeoccupational groups (physicians, mid-level providers [physician assistants,advanced practice nurses] and nurses) and three primary care practice areas(pediatrics, family medicine, internal medicine) were surveyed utilizing standardizedmethodology. We assessed HCP familiarity with VAERS, the situations under whichthey were likely to report an AEFI, and the methods they used and preferred forreporting. We used logistic regression to determine factors associated with HCP not

reporting AEFI to VAERS.ResultsOur survey response rate was 54.9%. The percentage of HCP aware of VAERS (71%)varied by occupation and primary care practice area. About 37% of HCP hadidentified at least one AEFI with only 17% of these indicating that they had everreported to VAERS. More serious events were more likely to be reported. Factorsassociated with HCP not reporting AEFI included: HCP not familiar versus veryfamiliar with filing a paper VAERS report (OR = 12.84; p < 0.0001), primary carepractice area of internal medicine versus pediatrics (OR = 4.22; p = 0.0005), andHCP not familiar versus very familiar with when it was required to file a VAERSreport (OR = 5.52; p = 0.0013).ConclusionsSpecific educational interventions targeted to HCP likely to see AEFI but notcurrently reporting may improve vaccine safety reporting practices.Have changing pneumococcal vaccination programmes impacted diseasein Ontario?Original Research ArticlePages 2680-2685Gillian H. Lim, Anne E. Wormsbecker, Allison McGeer, Dylan R. Pillai, Jonathan B.Gubbay, Wallis Rudnick, Don E. Low, Karen Green, Natasha S. Crowcroft, Shelley L.DeeksAbstractBackgroundPublicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) wasintroduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valentvaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Amongadults 65 years, a 23-valent polysaccharide vaccine (PPV23) has been universallyavailable since 1996. In January 2012, PCV13 was approved for adults 50 years.

This study examines the impact of publicly funded vaccination programmes oninvasive pneumococcal disease (IPD).Methods
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Laboratory data from population-based surveillance for IPD conducted at theToronto Invasive Bacterial Disease Network and from Public Health OntarioLaboratories between January 1, 2008 and December 31, 2010 were analyzed.ResultsBetween 2008 and 2010 there were 3259 cases of IPD; overall incidence was7.4/9.3/8.3 per 100,000 in 2008/9/10, respectively. Incidence increased significantly

among adults 65+ years during the period; this group had the highest incidence(21.525.6/100,000). The second highest incidence in 2008 and 2009 was in infants


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Review ArticlePages 2731-2737

T. Jacob John, Sunil Gupta, A.J. Chitkara, Ashok Kumar Dutta, Ray BorrowAbstractThe Global Meningococcal Initiative (GMI) consists of an international group ofscientists and clinicians, with expertise in meningococcal immunology,

epidemiology, public health and vaccinology that aims to prevent meningococcaldisease worldwide through education, research, cooperation and vaccination. InIndia, there is no national policy on routine meningococcal vaccination to controlthe disease. The GMI convened a meeting in India, with local medical leaders andpublic policy personnel, to gain insight into meningococcal disease burden andcurrent surveillance and vaccination practices in the country. Neisseria meningitidisis the third most common cause of sporadic bacterial meningitis in children


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Base-case B (assumed PCV-13 has additional protection against AOM compared toPCV-7), 343,830 (US$4298) per QALY or more QALY is gained by saving moneywithout or with caregiver's productivity loss, respectively.

We also find that, in Base-case B if cost per PCV-13 shot is equal to or less thanthat 17,000, then a PCV-13 vaccination programme offered to the birth cohort in

Japan is likely to be a socially acceptable option compared to the current PCV-7

vaccination programme. Furthermore, if cost per PCV-13 shot is equal to or lessthan 12,000, replacing PCV-7 with PCV-13 will save money and gain more QALYs.While in Base-case A, the replacement can only be socially acceptable if cost perPCV-13 shot is equal to or less than 11,000.Reducing children's pain and distress towards flu vaccinations: A noveland effective application of humanoid roboticsOriginal Research ArticlePages 2772-2777

Tanya N. Beran, Alex Ramirez-Serrano, Otto G. Vanderkooi, Susan KuhnAbstractObjectiveMillions of children in North America receive an annual flu vaccination, many of

whom are at risk of experiencing severe distress. Millions of children also usetechnologically advanced devices such as computers and cell phones. Based on thisfamiliarity, we introduced another sophisticated device a humanoid robot tointeract with children during their vaccination. We hypothesized that these childrenwould experience less pain and distress than children who did not have thisinteraction.Method

This was a randomized controlled study in which 57 children (30 male; age, mean SD: 6.87 1.34 years) were randomly assigned to a vaccination session with anurse who used standard administration procedures, or with a robot who wasprogrammed to use cognitive-behavioral strategies with them while a nurseadministered the vacc

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Vaccines_The Week in Review_1 June 2013