Vaccine
Volume 32, Issue 50, Pages 6725-6866 (28 November 2014)
http://www.sciencedirect.com/science/journal/0264410X/32/50

Integration of vaccine supply chains with other health commodity supply chains: A framework for decision making
Review Article
Pages 6725-6732
Prashant Yadav, Patrick Lydon, Julianna Oswald, Modibo Dicko, Michel Zaffran
Abstract
One of the primary objectives of National Immunization Programs is to strengthen and optimize immunization supply chains so that vaccines are delivered to the end recipients effectively, efficiently and sustainably. As a result of larger investments in global health and a wider portfolio of vaccines, global agencies are recognizing the need for vaccine supply chains to operate at their most optimal levels. Integration with other supply chains is often presented as a strategy to improve efficiency. However, it remains unclear if the proposed benefits from integration of vaccine supply chains with other supply chains will outweigh the costs. This paper provides a framework for deciding where such integration offers the most significant benefits. It also cautions about the pitfalls of integration as a one size fits all strategy. It also highlights the need for systematic collection of cost and efficiency data in order to understand the value of integration and other such initiatives.

Parental attitudes and decision-making regarding MMR vaccination in an anthroposophic community in Sweden – A qualitative study
Original Research Article
Pages 6752-6757
Emma Byström, Ann Lindstrand, Nathalie Likhite, Robb Butler, Maria Emmelin
Abstract
Measles outbreaks occur regularly throughout Europe, up to 31 500 cases in the previous year, particularly where there are pockets of populations with lower vaccination coverage than the recommended ≥95%. Anthroposophic communities in Europe are one of several groups with relatively low vaccination coverage. In Sweden, outbreaks of measles and rubella were reported from an anthroposophic community. Thus the aim of this qualitative study was to explore facilitators and barriers to MMR vaccination among parents living in anthroposophic communities in Sweden. Twenty parents living in an anthroposophic community were interviewed, focusing on their views and decisions on MMR vaccination. The interviews were analyzed using qualitative content analysis. Two overarching views of health emerged, differentiating broadly parents who vaccinate vs. parents who do not vaccinate. Four themes describing parental attitudes toward measles vaccination were developed and three of these, the conformers, the pragmatists and the attentive delayers describe different approaches toward vaccinations among those who actually vaccinate. The last theme, promoters of natural immunity, represents those postponing or refusing vaccination beyond childhood. This study suggests that there is a spectrum of parental beliefs regarding MMR vaccination in this anthroposophic community. Interventions specifically targeted to the anthroposophic community and strengthening health workers capacity for a constructive dialog on vaccine’s benefit and risks may contribute to higher vaccination coverage. This is believed to minimize the risk of future epidemics and contribute to the WHO European Region’s goal of eliminating measles.

History of Vaccinology
Interwoven support: An historical survey of US federal programs enabling immunization
Original Research Article
Pages 6855-6866
Dack W. Dalrymple, John D. Grabenstein
Abstract
Highlights
:: US Government involvement with immunization begins with events in 1777 and 1813.
:: Involvement accelerated upon licensing of manufacturing quality in 1903.
:: Military and civilian programs help discover and develop new vaccines.
:: USG programs funded vaccine purchases and delivered and supported vaccinations.
:: USG programs help assess safety, compensate after injury, and protect workers.