The Lancet Infectious Diseases
Mar 2015 Volume 15 Number 3 p249-360
http://www.thelancet.com/journals/laninf/issue/current

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Editorial
Global harmonisation in vaccine price
The Lancet Infectious Diseases
Summary
On Jan 20, 2015, Médecins Sans Frontières published the second edition of the report The right shot: bringing down barriers to affordable and adapted vaccines. The report highlighted the lack of a rational pricing system for vaccines that serves all countries and populations, and, as a consequence, private and public health providers struggle to sustain the costs of immunisation campaigns in many settings. Several factors, such as limited information on vaccine prices, introduction of costly new vaccines, absence of competition in vaccine production, and a paucity of vaccine products suited for low-resource settings, have created a market in which children in many countries are unprotected against life-threatening—but preventable—diseases.

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Comment
Novel observational study designs with new influenza vaccines
Eelko Hak
Published Online: 08 February 2015
Summary
In The Lancet Infectious Diseases, Hector Izurieta and colleagues1 presented results of a cohort study in 929 730 older people (65 years and older) who received a high-dose influenza vaccine (high-dose Fluzone, Sanofi Pasteur, PA, USA, 60 μg per strain) and compared rates of influenza-related visits and hospital admissions with 1 615 545 older people who received a standard dose of the same vaccine (15 μg per strain). The high-dose vaccine seemed to be 22% more effective than the standard-dose vaccine.

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Comparative effectiveness of high-dose versus standard-dose influenza vaccines in US residents aged 65 years and older from 2012 to 2013 using Medicare data: a retrospective cohort analysis
Hector S Izurieta, Nicole Thadani, David K Shay, Yun Lu, Aaron Maurer, Ivo M Foppa, Riley Franks, Douglas Pratt, Richard A Forshee, Thomas MaCurdy, Chris Worrall, Andrew E Howery, Jeffrey Kelman
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Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the USA: analysis of multisite, population-based surveillance
Matthew R Moore, Ruth Link-Gelles, William Schaffner, Ruth Lynfield, Catherine Lexau, Nancy M Bennett, Susan Petit, Shelley M Zansky, Lee H Harrison, Arthur Reingold, Lisa Miller, Karen Scherzinger, Ann Thomas, Monica M Farley, Elizabeth R Zell, Thomas H Taylor, Tracy Pondo, Loren Rodgers, Lesley McGee, Bernard Beall, James H Jorgensen, Cynthia G Whitney

Chains of transmission and control of Ebola virus disease in Conakry, Guinea, in 2014: an observational study
Ousmane Faye, Pierre-Yves Boëlle, Emmanuel Heleze, Oumar Faye, Cheikh Loucoubar, N’Faly Magassouba, Barré Soropogui, Sakoba Keita, Tata Gakou, El Hadji Ibrahima Bah, Lamine Koivogui, Amadou Alpha Sall, Simon Cauchemez

Review
The development of global vaccine stockpiles
Dr Catherine Yen, MD, Terri B Hyde, MD, Alejandro J Costa, MSc, Katya Fernandez, MSc, John S Tam, PhD, Stéphane Hugonnet, MD, Anne M Huvos, JD, Philippe Duclos, PhD, Vance J Dietz, MD, Brenton T Burkholder, MD
Published Online: 05 February 2015
Summary
Global vaccine stockpiles, in which vaccines are reserved for use when needed for emergencies or supply shortages, have effectively provided countries with the capacity for rapid response to emergency situations, such as outbreaks of yellow fever and meningococcal meningitis. The high cost and insufficient supply of many vaccines, including oral cholera vaccine and pandemic influenza vaccine, have prompted discussion on expansion of the use of vaccine stockpiles to address a wider range of emerging and re-emerging diseases. However, the decision to establish and maintain a vaccine stockpile is complex and must take account of disease and vaccine characteristics, stockpile management, funding, and ethical concerns, such as equity. Past experience with global vaccine stockpiles provide valuable information about the processes for their establishment and maintenance. In this Review we explored existing literature and stockpile data to discuss the lessons learned and to inform the development of future vaccine stockpiles.

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Personal View
Emergency Ebola response: a new approach to the rapid design and development of vaccines against emerging diseases
Claire M Tully, BA[Mod], Teresa Lambe, PhD, Prof Sarah C Gilbert, PhD, Prof Adrian V S Hill, DM
Published Online: 13 January 2015
Summary
The epidemic of Ebola virus disease has spread at an alarming rate despite containment efforts. As a result, unprecedented large-scale international response efforts have been made in an attempt to gain control of the outbreak and reduce transmission. Several international consortia have been formed in a remarkable worldwide collaborative effort to expedite trials of two candidate Ebola virus vaccines: cAd3-EBOZ and rVSV-EBOV. In parallel, both vaccines are being manufactured in large amounts to enable future rapid deployment for management of the crisis.