Vaccines and Global Health: The Week in Review 26 September 2015

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_26 September 2015

blog edition: comprised of the approx. 35+ entries posted below on 13 September 2015..

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

Vaccines and Global Health: The Week in Review 19 September 2015

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_19 September 2015

blog edition: comprised of the approx. 35+ entries posted below on 13 September 2015..

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

EBOLA/EVD [to 19 September 2015]

EBOLA/EVD [to 19 September 2015]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

Ebola Situation Report – 16 September 2015
[Excerpts]
SUMMARY
:: There were 5 confirmed cases of Ebola virus disease (EVD) reported in the week to 13 September, all of which were in Sierra Leone. Guinea recorded its first EVD-free week in over 12 months. All but one of the cases in Sierra Leone were registered contacts associated with the Kambia chain of transmission. A new confirmed case was also reported from the central Sierra Leonean district of Bombali, which has not reported a case for over 5 months. The case, a 16-year-old girl, had severe symptoms in the community for several days before being admitted to an Ebola treatment centre (ETC). There is considered to be a high-risk of further transmission associated with this case, and over 600 contacts have been identified so far. A rapid-response team has been deployed in order to minimise the risk of further transmission and establish the origin of infection. The total number of contacts under observation in Guinea and Sierra Leone has increased from approximately 1300 on 6 September to 1800 on 13 September. The vast majority of these contacts are located in the Sierra Leonean districts of Bombali and Kambia. Approximately 60 contacts are considered to be high-risk.

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Ebola response phase 3: Framework for achieving and sustaining a resilient zero
WHO
September 2015 :: 17 pages
Downloads: Ebola response phase 3: Framework for achieving and sustaining a resilient zero pdf, 1.46
Overview
The purpose of the Ebola response Phase 3 framework is to incorporate new knowledge and tools into the ongoing Ebola response and recovery work to achieve and sustain a “resilient zero”. Phase 3 of the response builds upon the rapid scale-up of treatment beds, safe and dignified burial teams, and behaviour change capacities during Phase 1 (August-December 2014); and the enhanced capacities for case finding, contract tracing, and community engagement during Phase 2 (January-July 2015). This framework incorporates new developments and breakthroughs in Ebola control, from vaccines, diagnostics and response operations to survivor counselling and care.
Phase 3 objectives: Objective 1 – To accurately define and rapidly interrupt all remaining chains of Ebola transmission. Objective 2 – To identify, manage and respond to the consequences of residual Ebola risks.
The chapters include:
:: Context for the outbreak and descriptions of Objectives 1 and 2
:: Risks to the implementation of Phase 3
:: Priorities to operationalize Phase 3
:: Phase 3 and early recovery
:: Key timelines & milestones for Phase 3.

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Rapid response to new Ebola infection in Bombali, Sierra Leone
16 September 2015

Johnson & Johnson Announces BARDA Funding Award to Accelerate Ebola Vaccine Program

Johnson & Johnson Announces BARDA Funding Award to Accelerate Ebola Vaccine Program
Prime-boost vaccine regimen in development at the Janssen Pharmaceutical Companies currently in Phase I and II clinical studies in Europe, U.S. and Africa

NEW BRUNSWICK, N.J., – September 14, 2015 – Johnson & Johnson (NYSE: JNJ) announced today that Crucell Holland B.V., one of its Janssen Pharmaceutical Companies, has been awarded $28.5 million from The Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services, to help accelerate the development of its investigational Ebola prime-boost vaccine regimen. The regimen, which is currently being tested in clinical studies, uses a combination of two components based on AdVac technology from Crucell Holland B.V. and MVA-BN® technology from Bavarian Nordic.

The agreement involves a 5-year commitment, with options for an additional $40.5 million funding, to optimize manufacturing systems and capacity for the vaccine regimen, including technology transfers to large-scale production facilities, heat-stability studies to verify that the regimen is optimized for use in African countries, and final product manufacturing and quality control activities.

“We are committed to finding a way to support the fight to get to and stay at zero Ebola cases worldwide,” said Paul Stoffels, M.D., Chief Scientific Officer and Worldwide Chairman, Pharmaceuticals, Johnson & Johnson. “Future outbreaks are a real danger, and we need to be prepared for them. This BARDA investment in our prime-boost vaccine approach will help us to further develop and potentially deliver a vaccine with both short and long-term protection.”

Phase I clinical studies of the prime-boost vaccine regimen began in the United Kingdom and United States in December 2014, followed by several sites in Africa. A Phase II study, to be carried out in the U.K. and France, started in July 2015, and plans are well advanced for the commencement of a safety and immunogenicity study in Sierra Leone and additional phase II studies outside the outbreak area in Africa. While clinical studies continue, BARDA will focus on supporting manufacturing development of the regimen’s prime and boost components.

Prime-boost vaccine regimens involve an initial dose that primes the immune system to develop disease-specific antibodies, followed by a booster dose at a later date that can strengthen and optimize the duration of the immune response. A number of widely used vaccines use a multi-dose approach to create stronger and longer-lasting immunity, including some for polio, rotavirus and HPV.

Janssen, in partnership with Bavarian Nordic, has produced drug supply for more than 800,000 regimens and is set-up to be able to produce a total of 2 million regimens of the Ebola vaccine regimen during the course of 2015.

To date, there is no licensed vaccine, treatment or cure for the Ebola virus. The Ebola outbreak in West Africa has put the health care systems of Liberia, Sierra Leone and Guinea under tremendous pressure. As of September 2015, after more than one year of this sustained Ebola outbreak, over 28,100 people have been infected with the virus across the three countries, and over 11,300 have died – including more than 500 healthcare workers. Although the outbreak has been brought under control in recent months, it could easily resurge and preparedness for future outbreaks is essential.

POLIO [to 19 September 2015]

POLIO [to 19 September 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 16 September 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
:: Pakistan launched a nationwide polio campaign this week to vaccinate more than 35 million children in 163 districts of the country. Approximately 200,000 polio workers are participating in the polio campaign, during which Vitamin A will also be distributed. More
:: As progress continues to be made towards polio eradication, surveillance is increasingly one of the most important things the programme can do to protect children against every last poliovirus. Read more about how surveillance works here.
:: The Global Polio Eradication Initiative is proud to partner with the Global Citizen Festival on 26 September, featuring Beyonce, Ed Sheeran, Pearl Jam and other headliners to help fight extreme poverty and inequality around the world, and support approaches that will make life more sustainable for people and the planet.

Selected Country Report Content
Pakistan
:: Two new wild poliovirus type 1 (WPV1) cases were confirmed in the past week in Khyber Agency in the Federally Administered Tribal Areas. The most recent case had onset of paralysis on 22 August. The total number of WPV1 cases for 2015 is now 32, compared to 145 at this time last year.

WHO & Regionals [to 19 September 2015]

WHO & Regionals [to 19 September 2015]
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Addressing noncommunicable diseases in emergencies
16 September 2015 — Due to ongoing humanitarian crisis in Ukraine people struggle to receive treatment for noncommunicable diseases (NCDs) such as cancer, lung and heart disease and diabetes. Working closely with the Ukrainian Ministry of Health and partners, WHO provides emergency kits with training materials to treat these diseases in the field.

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The Weekly Epidemiological Record (WER) 18 September 2015, vol. 90, 38 (pp. 489–504) includes:
:: Global programme to eliminate lymphatic filariasis: progress report, 2014

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Global Alert and Response (GAR) – Disease Outbreak News (DONs)
:: 18 September 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Jordan
:: 17 September 2015 – Chikungunya – Spain (update)
:: 17 September 2015 – West Nile virus – Portugal
:: 17 September 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia
:: 14 September 2015 – Chikungunya – Senegal

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:: WHO Regional Offices
WHO African Region AFRO
No new digest content identified.

WHO Region of the Americas PAHO
:: PAHO/WHO and U.S. National Park Service partner to connect people to parks for better health (09/18/2015)
Countries of the Americas agree to step up action toward rabies elimination (09/17/2015)
Wellness Week in the Americas, Sept. 12-19, will focus on “Healthy Parks, Healthy People” (09/14/2015)

WHO South-East Asia Region SEARO
:: Regional Committee adopts resolution on cancer prevention, control
WHO Regional Committee meeting, which ended on 11 September, adopted six resolutions on priority areas. The countries resolved to strengthen cancer prevention and control programme, tobacco control, preparedness to respond to emergencies and outbreaks, anti-microbial resistance, community based health services and patient safety for sustainable Universal Health Coverage. Press Release

WHO European Region EURO
:: Day 4 highlights: RC65 adopts new tuberculosis action plan and closes 17-09-2015
:: Refugee crisis in Europe: update on the situation and WHO response 17-09-2015
Vilnius and Copenhagen, 14 September 2015
In response to the growing numbers of refugees and migrants arriving in the European Region, WHO supports countries by offering medical supplies, assessing national preparedness to assist people in need, training personnel at points of entry in public health and migration matters, and providing information materials.
Senior government officials of the 53 Member States in the WHO European Region discussed the public health impact of large-scale migration during the 65th session of the Regional Committee for Europe in Vilnius, Lithuania. They called for continued involvement and support from WHO to respond adequately to the public health implications of large influxes of people by conducting additional assessments in countries and by providing policy advice on contingency planning, training of health personnel and delivery of supplies. It was decided that a high-level WHO conference would be organized as soon as possible to agree on a common public health approach to large-scale migration in the Region.
“As refugee and migration movements escalate and the migratory routes change, more European countries face this challenge,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “Today more than ever, this situation calls for a regional, comprehensive and systematic public health response. As refugees and migrants move, intercountry coordination must be strengthened across the European Region, as well as with the countries of origin and transit.”…
:: Day 3 highlights: adoption of strategy on physical activity and roadmap for tobacco control 16-09-2015
:: WHO European Region Member States commit to denormalizing tobacco 16-09-2015
:: European ministers of health adopt strategy to tackle physical inactivity in 53 WHO Member States 16-09-2015
:: European countries review progress and synergize efforts for control of vaccine-preventable diseases
14-09-2015
Three days of discussion and sharing of experience among national immunization programme managers, WHO, partners and international experts on 1–3 September 2015 brought into full focus the challenges facing the European Region in the area of immunization and progress towards implementation of the European Vaccine Action Plan at national level. Over 130 delegates from 47 Member States of the European Region gathered in Antwerp, Belgium, to discuss remaining barriers to full immunization in Europe and the actions needed to achieve regional goals, such as elimination of measles and rubella and maintenance of the Region’s polio-free status.
“The European Vaccine Action Plan (EVAP) embodies regional commitment to immunization, and this meeting offers immunization programme managers the chance to voice their opinions and experience, interact with each other and WHO staff and work together to translate EVAP strategies into national priorities and actions,” said Dr Pierre van Damme, Professor of Vaccinology at the University of Antwerp and chair of the European Technical Advisory Group of Experts on Immunizaton (ETAGE), with reference to the interactive approach taken at the meeting. The format included included panels, small group discussion and question-and-answer sessions….

WHO Eastern Mediterranean Region EMRO
:: Malaria MDG target achieved amid sharp drop in cases and mortality, but 3 billion people remain at risk 17 September 2015
:: Improving the health of women, children and adolescents 14 September

WHO Western Pacific Region
:: UN: Progress made but more to be done to ensure all children are born free of HIV & syphilis in Asia-Pacific
BANGKOK, 14 September 2015 – The Asia–Pacific region has made significant progress in efforts to eliminate the transmission of HIV and syphilis, but thousands of mothers and children have yet to feel the benefits. Addressing this gap will be a key area for discussion at the 10th Asia-Pacific United Nations Parent-to-Child Transmission of HIV and Syphilis Task Force meeting in Beijing, China, this week. Read the joint news release

CDC/MMWR/ACIP Watch [to 19 September 2015]

CDC/MMWR/ACIP Watch [to 19 September 2015]
http://www.cdc.gov/media/index.html

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Enhanced Airport Entry Screening To End for Travelers from Liberia to the United States
FRIDAY, SEPTEMBER 18, 2015
On September 21, 2015, the Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security (DHS) will remove Liberia from the list of nations affected by Ebola…

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MMWR September 18, 2015 / Vol. 64 / No. 36
:: Influenza Vaccination Coverage Among Health Care Personnel — United States, 2014–15 Influenza Season
The Advisory Committee on Immunization Practices recommends annual influenza vaccination for all health care personnel (HCP) to reduce influenza-related morbidity and mortality among both HCP and their patients and to decrease absenteeism among HCP (1–5). To estimate influenza vaccination coverage among U.S. HCP for the 2014–15 influenza season, CDC conducted an opt-in Internet panel survey of 1,914 HCP during March 31–April 15, 2015. Overall, 77.3% of HCP survey participants reported receiving an influenza vaccination during the 2014–15 season, similar to the 75.2% coverage among HCP reported for the 2013–14 season (6). Vaccination coverage was highest among HCP working in hospitals (90.4%) and lowest among HCP working in long-term care (LTC) settings (63.9%). By occupation, coverage was highest among pharmacists (95.3%) and lowest among assistants and aides (64.4%). Influenza vaccination coverage was highest among HCP who were required by their employer to be vaccinated (96.0%). Among HCP without an employer requirement for vaccination, coverage was higher for HCP working in settings where vaccination was offered on-site at no cost for 1 day (73.6%) or multiple days (83.9%) and lowest among HCP working in settings where vaccine was neither required, promoted, nor offered on-site (44.0%). Comprehensive vaccination strategies that include making vaccine available at no cost at the workplace along with active promotion of vaccination might help increase vaccination coverage among HCP and reduce the risk for influenza to HCP and their patients (1,6,7).

:: Influenza Vaccination Coverage Among Pregnant Women — United States, 2014–15 Influenza Season
:: Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children — United States, July 9, 2014–January 4, 2015
:: Update: Influenza Activity — United States and Worldwide, May 24–September 5, 2015
:: Announcement: Available Online: Final 2014–15 Influenza Vaccination Coverage Estimates for Selected Local Areas, States, and the United States

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ACIP Meeting – October 21, 2015 [one-day meeting]
October 21, 2015[2 pages] Draft Agenda – September 9, 2015