The Lancet
May 17, 2014 Volume 383 Number 9930 p1693 – 1780
http://www.thelancet.com/journals/lancet/issue/current

Comment
Mandatory polio vaccination for travellers: protecting global public health
Paul D Rutter, Liam J Donaldson
Full Text
The goal of following smallpox eradication with another programme to eliminate a disease from the planet was too compelling to resist and, in 1988, the World Health Assembly set its sights on polio.1 26 years later, the dream is not yet a reality. On May 5, 2014, WHO issued strong recommendations that Pakistan, Syria, and Cameroon should ensure that their residents and long-term visitors have up-to-date vaccination against polio before they travel internationally, and that each individual is issued with an International Certificate of Vaccination or Prophylaxis as proof of this.

Beyond expectations: 40 years of EPI
Margaret Chan

Use of vaccines as probes to define disease burden
Dr Daniel R Feikin MD a b, Prof J Anthony G Scott c d, Bradford D Gessner MD e
Summary
Vaccine probe studies have emerged in the past 15 years as a useful way to characterise disease. By contrast, traditional studies of vaccines focus on defining the vaccine effectiveness or efficacy. The underlying basis for the vaccine probe approach is that the difference in disease burden between vaccinated and unvaccinated individuals can be ascribed to the vaccine-specific pathogen. Vaccine probe studies can increase understanding of a vaccine’s public health value. For instance, even when a vaccine has a seemingly low efficacy, a high baseline disease incidence can lead to a large vaccine-preventable disease burden and thus that population-based vaccine introduction would be justified. So far, vaccines have been used as probes to characterise disease syndromes caused by Haemophilus influenzae type b, pneumococcus, rotavirus, and early infant influenza. However, vaccine probe studies have enormous potential and could be used more widely in epidemiology, for example, to define the vaccine-preventable burden of malaria, typhoid, paediatric influenza, and dengue, and to identify causal interactions between different pathogens.