Heterogeneity in coverage for measles and varicella vaccination in toddlers – analysis of factors influencing parental acceptance

BMC Public Health
(Accessed 23 September 2017)

Research article
Heterogeneity in coverage for measles and varicella vaccination in toddlers – analysis of factors influencing parental acceptance
In 2004, routine varicella vaccination was introduced in Germany for children aged 11–14 months. Routine measles vaccination had already been introduced in 1973 for the same age group, but coverage is still to… Vaccination rates differed between regions, with rates constantly higher in Würzburg. Within each region, vaccination rates were lower for varicella than for measles. Measles vaccination status was mainly dependent upon socio-demographic factors (attendance at a childcare unit, parental school education), whereas for the more recently introduced varicella vaccination recommendation by the physician had the strongest impact. Hence, different strategies are needed to further improve vaccination rates for both diseases.
Christine Hagemann, Andrea Streng, Alexander Kraemer and Johannes G. Liese
BMC Public Health 2017 17:724
Published on: 19 September 2017

Global Health Action – Volume 10, 2017 – Issue 1 [In Progress]

Global Health Action
Volume 10, 2017 – Issue 1 [In Progress]

Capacity Building Article
Power, potential, and pitfalls in global health academic partnerships: review and reflections on an approach in Nepal
David Citrin, Stephen Mehanni, Bibhav Acharya, Lena Wong, Isha Nirola, Rekha Sherchan, Bikash Gauchan, Khem Bahadur Karki, Dipendra Raman Singh, Sriram Shamasunder, Phuoc Le, Dan Schwarz, Ryan Schwarz, Binod Dangal, Santosh Kumar Dhungana, Sheela Maru, Ramesh Mahar, Poshan Thapa, Anant Raut, Mukesh Adhikari, Indira Basnett, Shankar Prasad Kaluanee, Grace Deukmedjian, Scott Halliday & Duncan Maru

Article: 1367161
Published online: 15 Sep 2017
Mobile instant messaging for rural community health workers: a case from Malawi
Christoph Pimmer, Susan Mhango, Alfred Mzumara & Francis Mbvundula
Article: 1368236
Published online: 15 Sep 2017

Requirements of health policy and services journals for authors to disclose financial and non-financial conflicts of interest: a cross-sectional study

Health Research Policy and Systems
[Accessed 23 September 2017]

Requirements of health policy and services journals for authors to disclose financial and non-financial conflicts of interest: a cross-sectional study
A majority of health policy and services journal policies required the disclosure of authors’ financial and non-financial COIs, but few required details on disclosed COIs. Health policy journals should provide specific definitions and instructions for disclosing non-financial COIs. A framework providing clear typology and operational definitions of the different types of COIs will facilitate both their disclosure by authors and reviewers and their assessment and management by the editorial team and the readers.
Assem M. Khamis, Maram B. Hakoum, Lama Bou-Karroum, Joseph R. Habib, Ahmed Ali, Gordon Guyatt, Fadi El-Jardali and Elie A. Akl
Published on: 19 September 2017

Effects of improved sanitation on diarrheal reduction for children under five in Idiofa, DR Congo: a cluster randomized trial

Infectious Diseases of Poverty
[Accessed 23 September 2017]

Study Protocol
Effects of improved sanitation on diarrheal reduction for children under five in Idiofa, DR Congo: a cluster randomized trial
Seungman Cha, JaeEun Lee, DongSik Seo, Byoung Mann Park, Paul Mansiangi, Kabore Bernard, Guy Jerome Nkay Mulakub-Yazho and Honore Minka Famasulu
Published on: 19 September 2017

Drug Development at the Portfolio Level Is Important for Policy, Care Decisions and Human Protections

September 19, 2017, Vol 318, No. 11, Pages 979-1080

Drug Development at the Portfolio Level Is Important for Policy, Care Decisions and Human Protections
Jonathan Kimmelman, PhD; Benjamin Carlisle, MA; Mithat Gönen, PhD
JAMA. 2017;318(11):1003-1004. doi:10.1001/jama.2017.11502
This Viewpoint discusses the drug development portfolio—a family of trials assessing a drug for different indications or in different combinations with other drugs—and summarizes some of the challenges drug portfolios pose for policy, care, and human protections.

The Impact of Hepatitis B Vaccine Failure on Long-term Natural Course of Chronic Hepatitis B Virus Infection in Hepatitis B e Antigen–Seropositive Children

Journal of Infectious Diseases
Volume 216, Issue 6   15 September 2017

The Impact of Hepatitis B Vaccine Failure on Long-term Natural Course of Chronic Hepatitis B Virus Infection in Hepatitis B e Antigen–Seropositive Children
Chi-San Tai; Jia-Feng Wu; Huey-Ling Chen; Yen-Hsuan Ni; Hong-Yuan Hsu
The Journal of Infectious Diseases, Volume 216, Issue 6, 15 September 2017, Pages 662–669, https://doi.org/10.1093/infdis/jix339
Vaccine failure with chronic hepatitis B virus (HBV) infection still develops in children after universal hepatitis B immunization. Vaccine failure HBV-carrier children were associated with delayed hepatitis B e antigen seroconversion, and more HBV genotype C infection.

Safety and immunogenicity of a mRNA rabies vaccine in healthy adults: an open-label, non-randomised, prospective, first-in-human phase 1 clinical trial

The Lancet
Sep 23, 2017 Volume 390 Number 10101 p1465-1562

Safety and immunogenicity of a mRNA rabies vaccine in healthy adults: an open-label, non-randomised, prospective, first-in-human phase 1 clinical trial
Martin Alberer, Ulrike Gnad-Vogt, Henoch Sangjoon Hong, Keyvan Tadjalli Mehr, Linus Backert, Greg Finak, Raphael Gottardo, Mihai Alexandru Bica, Aurelio Garofano, Sven Dominik Koch, Mariola Fotin-Mleczek, Ingmar Hoerr, Ralf Clemens, Frank von Sonnenburg
Vaccines based on mRNA coding for antigens have been shown to be safe and immunogenic in preclinical models. We aimed to report results of the first-in-human proof-of-concept clinical trial in healthy adults of a prophylactic mRNA-based vaccine encoding rabies virus glycoprotein (CV7201).
We did an open-label, uncontrolled, prospective, phase 1 clinical trial at one centre in Munich, Germany. Healthy male and female volunteers (aged 18–40 years) with no history of rabies vaccination were sequentially enrolled. They received three doses of CV7201 intradermally or intramuscularly by needle-syringe or one of three needle-free devices. Escalating doses were given to subsequent cohorts, and one cohort received a booster dose after 1 year. The primary endpoint was safety and tolerability. The secondary endpoint was to determine the lowest dose of CV7201 to elicit rabies virus neutralising titres equal to or greater than the WHO-specified protective antibody titre of 0·5 IU/mL. The study is continuing for long-term safety and immunogenicity follow-up. This trial is registered with ClinicalTrials.gov, number NCT02241135.
Between Oct 21, 2013, and Jan 11, 2016, we enrolled and vaccinated 101 participants with 306 doses of mRNA (80–640 μg) by needle-syringe (18 intradermally and 24 intramuscularly) or needle-free devices (46 intradermally and 13 intramuscularly). In the 7 days post vaccination, 60 (94%) of 64 intradermally vaccinated participants and 36 (97%) of 37 intramuscularly vaccinated participants reported solicited injection site reactions, and 50 (78%) of 64 intradermally vaccinated participants and 29 (78%) of 37 intramuscularly vaccinated participants reported solicited systemic adverse events, including ten grade 3 events. One unexpected, possibly related, serious adverse reaction that occurred 7 days after a 640 μg intramuscular dose resolved without sequelae. mRNA vaccination by needle-free intradermal or intramuscular device injection induced virus neutralising antibody titres of 0·5 IU/mL or more across dose levels and schedules in 32 (71%) of 45 participants given 80 μg or 160 μg CV7201 doses intradermally and six (46%) of 13 participants given 200 μg or 400 μg CV7201 doses intramuscularly. 1 year later, eight (57%) of 14 participants boosted with an 80 μg needle-free intradermal dose of CV7201 achieved titres of 0·5 IU/mL or more. Conversely, intradermal or intramuscular needle-syringe injection was ineffective, with only one participant (who received 320 μg intradermally) showing a detectable immune response.
This first-ever demonstration in human beings shows that a prophylactic mRNA-based candidate vaccine can induce boostable functional antibodies against a viral antigen when administered with a needle-free device, although not when injected by a needle-syringe. The vaccine was generally safe with a reasonable tolerability profile.



The Lancet
Sep 23, 2017 Volume 390 Number 10101 p1465-1562

John D Clemens, G Balakrish Nair, Tahmeed Ahmed, Firdausi Qadri, Jan Holmgren
Cholera is an acute, watery diarrhoeal disease caused by Vibrio cholerae of the O1 or O139 serogroups. In the past two centuries, cholera has emerged and spread from the Ganges Delta six times and from Indonesia once to cause global pandemics. Rational approaches to the case management of cholera with oral and intravenous rehydration therapy have reduced the case fatality of cholera from more than 50% to much less than 1%. Despite improvements in water quality, sanitation, and hygiene, as well as in the clinical treatment of cholera, the disease is still estimated to cause about 100 000 deaths every year. Most deaths occur in cholera-endemic settings, and virtually all deaths occur in developing countries. Contemporary understanding of immune protection against cholera, which results from local intestinal immunity, has yielded safe and protective orally administered cholera vaccines that are now globally stockpiled for use in the control of both epidemic and endemic cholera.

New England Journal of Medicine – September 21, 2017  Vol. 377 No. 12

New England Journal of Medicine
September 21, 2017  Vol. 377 No. 12

Tuberculosis Elimination in the United States — The Need for Renewed Action
Bayer and K.G. Castro
Free Full Text

The Fate of FDA Postapproval Studies
Woloshin, L.M. Schwartz, B. White, and T.J. Moore
The Food and Drug Administration often requires postapproval studies to address issues such as optimal dosing, potential long-term side effects, and use in children or to confirm a drug’s clinical benefit. But many of these studies aren’t completed on time, if at all.

Updated estimation of the impact of a Japanese encephalitis immunization program with live, attenuated SA 14-14-2 vaccine in Nepal

PLoS Neglected Tropical Diseases
(Accessed 23 September 2017)

Research Article
Updated estimation of the impact of a Japanese encephalitis immunization program with live, attenuated SA 14-14-2 vaccine in Nepal
Shyam Raj Upreti, Nicole P. Lindsey, Rajendra Bohara, Ganga Ram Choudhary, Sushil Shakya, Mukunda Gautam, Jagat Narain Giri, Marc Fischer, Susan L. Hills
Research Article | published 21 Sep 2017 PLO
Author summary
In 2006, the Ministry of Health and Population in Nepal commenced a Japanese encephalitis (JE) immunization program using SA 14-14-2 JE vaccine, with mass campaigns conducted in selected districts, followed by introduction of JE vaccine into the routine childhood immunization program. JE and acute encephalitis syndrome data gathered through Nepal’s routine surveillance system from 2004 through 2014 were analyzed to assess the impact of this immunization program. Expected and observed JE and acute encephalitis syndrome cases and incidence rates were compared. Considerable impact on JE incidence was demonstrated and the results also suggested that a large proportion of acute encephalitis syndrome cases without laboratory confirmation are due to JE. The results support the belief that a JE immunization program will result in sizable reductions in the incidence of both laboratory-confirmed JE and clinical acute encephalitis syndrome cases. JE is a severe disease, and the program’s impact likely extended to reduction of rates of JE-related mortality and long-term disability.

Science 22 September 2017  Vol 357, Issue 6357     

22 September 2017  Vol 357, Issue 6357

In Depth
Why is the flu vaccine so mediocre?
By Jon Cohen
Science22 Sep 2017 : 1222-1223 Restricted Access
The complex factors behind failure are coming into sharper focus.

Books et al.
The legacy of the Spanish flu
By Suzanne Shablovsky
Science22 Sep 2017 : 1245 Restricted Access
Nearly a century after it killed millions, a journalist reflects on how a pandemic changed the world

Vaccine exemptions and the kindergarten vaccination coverage gap

Volume 35, Issue 40, Pages 5309-5434 (25 September 2017)

Original Research Article
Vaccine exemptions and the kindergarten vaccination coverage gap
Original Research Article
Pages 5346-5351
Philip J. Smith, Jana Shaw, Ranee Seither, Adriana Lopez, Holly A. Hill, Mike Underwood, Cynthia Knighton, Zhen Zhao, Megha Shah Ravanam, Stacie Greby, Walter A. Orenstein
Vaccination requirements for kindergarten entry vary by state, but all states require 2 doses of measles containing vaccine (MCV) at kindergarten entry.
To assess (i) national MCV vaccination coverage for children who had attended kindergarten; (ii) the extent to which undervaccination after kindergarten entry is attributable to parents’ requests for an exemption; (iii) the extent to which undervaccinated children had missed opportunities to be administered missing vaccine doses among children whose parent did not request an exemption; and (iv) the vaccination coverage gap between the “highest achievable” MCV coverage and actual MCV coverage among children who had attended kindergarten.
A national survey of 1465 parents of 5–7 year-old children was conducted during October 2013 through March 2014. Vaccination coverage estimates are based provider-reported vaccination histories. Children have a “missed opportunity” for MCV if they were not up-to-date and if there were dates on which other vaccines were administered but not MCV. The “highest achievable” MCV vaccination coverage rate is 100% minus the sum of the percentages of (i) undervaccinated children with parents who requested an exemption; and (ii) undervaccinated children with parents who did not request an exemption and whose vaccination statuses were assessed during a kindergarten grace period or period when they were provisionally enrolled in kindergarten.
Among all children undervaccinated for MCV, 2.7% were attributable to having a parent who requested an exemption. Among children who were undervaccinated for MCV and whose parent did not request an exemption, 41.6% had a missed opportunity for MCV. The highest achievable MCV coverage was 98.6%, actual MCV coverage was 90.9%, and the kindergarten vaccination gap was 7.7%.
Vaccination coverage may be increased by schools fully implementing state kindergarten vaccination laws, and by providers assessing children’s vaccination status at every clinic visit, and administering missed vaccine doses.

Intention to accept pertussis vaccine among pregnant women in Karachi, Pakistan

Volume 35, Issue 40, Pages 5309-5434 (25 September 2017)

Intention to accept pertussis vaccine among pregnant women in Karachi, Pakistan
Original Research Article
Pages 5352-5359
Mariam Siddiqui, Afshin Alaf Khan, Aiden Kennedy Varan, Alejandra Esteves-Jaramillo, Shazia Sultana, Asad S. Ali, Anita K.M. Zaidi, Saad B. Omer
Maternal immunization against pertussis is a potential strategy to protect young infants from severe disease. We assessed factors associated with intention to accept pertussis vaccination among pregnant women in Karachi, Pakistan.
We conducted a cross-sectional survey between May and August 2013 in pregnant women who visited healthcare centers in urban slums of Karachi city. Women completed a survey examining socio-demographic factors, vaccination history, knowledge on pertussis disease, perception of vaccine recommendation sources, and potential influences on vaccine decision-making.
Of the 283 participants, 259 (92%) provided their intention to either accept or decline pertussis vaccination. Eighty-three percent women were willing to accept the pertussis vaccine if offered during pregnancy. About half (53%) of the participants had ever heard of pertussis disease. Perceptions of pertussis vaccine efficacy, safety, and disease susceptibility were strongly associated with intention to accept pertussis vaccine (p < 0.01). Healthcare providers, Ministry of Health, and mass media were considered as highly reliable sources of vaccine recommendation and associated with intention to accept antenatal pertussis vaccination (p < 0.001). Healthcare provider recommendation was a common reason cited by respondents for pregnant women to accept antenatal pertussis vaccination (p = 0.0005). However, opinion of primary decision-makers in the family (husbands and in-laws) was a crucial reason cited by respondents for pregnant women to reject pertussis vaccination in pregnancy (p = 0.003).
Antenatal pertussis vaccination initiatives in South Asia should strongly consider inclusion of family members, healthcare providers, national health ministries, and mass media to help implement new vaccination programs.

Advancing new vaccines against pandemic influenza in low-resource countries

Volume 35, Issue 40, Pages 5309-5434 (25 September 2017)

Special Section on “World Vaccine Congress Series Papers”; Edited by T. Kaser
Advancing new vaccines against pandemic influenza in low-resource countries
Original Research Article
Pages 5397-5402
Francesco Berlanda Scorza

Developing and financing neglected disease vaccines in our new era of “blue marble health” and the anthropocene epoch

Volume 35, Issue 40, Pages 5309-5434 (25 September 2017)

Developing and financing neglected disease vaccines in our new era of “blue marble health” and the anthropocene epoch
Pages 5403-5405
Peter J. Hotez
New findings of widespread neglected diseases among the poor living in wealthy group of 20 (G20) economies and the concept of “blue marble health” offer innovative mechanisms for financing urgently new vaccines, especially for vector-borne neglected tropical diseases (NTDs). This approach could complement or parallel a recently suggested global vaccine development fund for pandemic threats.

Current Status of Rift Valley Fever Vaccine Development

Vaccines — Open Access Journal
(Accessed 23 September 2017)

Current Status of Rift Valley Fever Vaccine Development
by Bonto Faburay, Angelle Desiree LaBeaud, D. Scott McVey, William C. Wilson and Juergen A. Richt
Vaccines 2017, 5(3), 29; doi:10.3390/vaccines5030029 – 19 September 2017
Rift Valley Fever (RVF) is a mosquito-borne zoonotic disease that presents a substantial threat to human and public health. It is caused by Rift Valley fever phlebovirus (RVFV), which belongs to the genus Phlebovirus and the family Phenuiviridae within the order Bunyavirales. The wide distribution of competent vectors in non-endemic areas coupled with global climate change poses a significant threat of the transboundary spread of RVFV. In the last decade, an improved understanding of the molecular biology of RVFV has facilitated significant progress in the development of novel vaccines, including DIVA (differentiating infected from vaccinated animals) vaccines. Despite these advances, there is no fully licensed vaccine for veterinary or human use available in non-endemic countries, whereas in endemic countries, there is no clear policy or practice of routine/strategic livestock vaccinations as a preventive or mitigating strategy against potential RVF disease outbreaks. The purpose of this review was to provide an update on the status of RVF vaccine development and provide perspectives on the best strategies for disease control. Herein, we argue that the routine or strategic vaccination of livestock could be the best control approach for preventing the outbreak and spread of future disease

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

Current Topics in Microbiology and Immunology
Springer, Berlin, Heidelberg  2017
Accelerating Vaccine Development During the 2013–2016 West African Ebola Virus Disease Outbreak
Elizabeth S. Higgs, Sheri A. Dubey, Beth A. G. Coller, Jakub K. Simon, Laura Bollinger, Robert A. Sorenson, Barthalomew Wilson, Martha C. Nason, Lisa E. Hensley
First Online: 17 September 2017
The Ebola virus disease outbreak that began in Western Africa in December 2013 was unprecedented in both scope and spread, and the global response was slower and less coherent than was optimal given the scale and pace of the epidemic. Past experience with limited localized outbreaks, lack of licensed medical countermeasures, reluctance by first responders to direct scarce resources to clinical research, community resistance to outside interventions, and lack of local infrastructure were among the factors delaying clinical research during the outbreak. Despite these hurdles, the global health community succeeded in accelerating Ebola virus vaccine development, in a 5-month interval initiating phase I trials in humans in September 2014 and initiating phase II/III trails in February 2015. Each of the three Ebola virus disease-affected countries, Sierra Leone, Guinea, and Liberia, conducted a phase II/III Ebola virus vaccine trial. Only one of these trials evaluating recombinant vesicular stomatitis virus expressing Ebola virus glycoprotein demonstrated vaccine efficacy using an innovative mobile ring vaccination trial design based on a ring vaccination strategy responsible for eradicating smallpox that reached areas of new outbreaks. Thoughtful and intensive community engagement in each country enabled the critical community partnership and acceptance of the phase II/III in each country. Due to the delayed clinical trial initiation, relative to the epidemiologic peak of the outbreak in the three countries, vaccine interventions may or may not have played a major role in bringing the epidemic under control. Having demonstrated that clinical trials can be performed during a large outbreak, the global research community can now build on the experience to implement trials more rapidly and efficiently in future outbreaks. Incorporating clinical research needs into planning for future health emergencies and understanding what kind of trial designs is needed for reliable results in an epidemic of limited duration should improve global response to future infectious disease outbreaks.
Gynecologic Oncology
Volume 147, Issue 1, October 2017, Pages 209-210
Racial Differences in Reasons for Lack of HPV Vaccine Initiation in Adolescent Girls in the US, 2015
A Beavis, M Krakow, K Levinson, A Rositch – Gynecologic Oncology, 2017
Objectives: While cervical cancer rates are higher in black compared to white women, HPV vaccine initiation is lower in white teens compared to black teens. We sought to characterize differences in reasons for non-initiation of the HPV vaccine between parents of black and white adolescent females in 2015.

Awareness of HPV Vaccinations and Barriers to Vaccination Administration Among Underserved Women
R Guerra, A Bhalwal, C Ibarra, N Jooya, SC Robazetti… – Gynecologic Oncology, 2017
Objectives: To delineate awareness and knowledge of HPV vaccinations among medically underserved women who attend health fairs and identify barriers to vaccine administration.

Brain, Behavior, and Immunity
Available online 17 September 2017
Positive Mood on the Day of Influenza Vaccination Predicts Vaccine Effectiveness: A Prospective Observational Cohort Study
K Ayling, L Fairclough, P Tighe, I Todd, V Halliday…
Influenza vaccination is estimated to only be effective in 17–53% of older adults. Multiple patient behaviors and psychological factors have been shown to act as ‘immune modulators’ sufficient to influence vaccination outcomes. However, the relative importance of such factors is unknown as they have typically been examined in isolation. The objective of the present study was to explore the effects of multiple behavioral (physical activity, nutrition, sleep) and psychological influences (stress, positive mood, negative mood) on the effectiveness of the immune response to influenza vaccination in the elderly. A prospective, diary-based longitudinal observational cohort study was conducted. One hundred and thirty-eight community-dwelling older adults (65–85 years) who received the 2014/15 influenza vaccination completed repeated psycho-behavioral measures over the two weeks prior, and four weeks following influenza vaccination. IgG responses to vaccination were measured via antigen microarray and seroprotection via hemagglutination inhibition assays at 4 and 16 weeks post-vaccination. High pre-vaccination seroprotection levels were observed for H3N2 and B viral strains. Positive mood on the day of vaccination was a significant predictor of H1N1 seroprotection at 16 weeks post-vaccination and IgG responses to vaccination at 4 and 16 weeks post-vaccination, controlling for age and gender. Positive mood across the 6-week observation period was also significantly associated with post-vaccination H1N1 seroprotection and IgG responses to vaccination at 16 weeks post-vaccination, but in regression models the proportion of variance explained was lower than for positive mood on the day of vaccination alone. No other factors were found to significantly predict antibody responses to vaccination. Greater positive mood in older adults, particularly on the day of vaccination, is associated with enhanced responses to vaccination.

Media/Policy Watch

Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

New York Times
Accessed 23 September 2017
The HPV Vaccine Gains Ground Among U.S. Teenagers
Sixty percent of adolescents received the vaccine in 2016. A decade ago, less than 30 percent did.
September 22, 2017 – By ANERI PATTANI

Superbug’s Spread to Vietnam Threatens Malaria Control
Vietnam’s main malaria treatment is failing at an alarming rate because of a highly drug-resistant superbug that has spread into the southern part of the country from western Cambodia, scientists said Thursday.
September 21, 2017 – By THE ASSOCIATED PRESS

Washington Post
Accessed 23 September 2017
Greece makes measles vaccination appeal amid European spike
By Associated Press September 22
ATHENS, Greece — Health authorities in Greece have issued a public appeal to participate in vaccination and booster shot programs following a spike in measles cases in the country amid an outbreak in Europe.
The Greek Center for Disease Control and Prevention said Friday that 166 cases had been reported in the country in 2016-17, with an increase in recent days.
More than 17,000 measles cases have been reported in that period in 30 European countries monitored by the European Center for Disease Prevention and Control, resulting in 40 deaths.
The European agency said the highest concentration of cases was reported in Romania.

Vaccines and Global Health: The Week in Review 16 September 2017

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_16 September 2017

– blog edition: comprised of the approx. 35+ entries posted below.

– 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.

Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Milestones :: Perspectives

Milestones :: Perspectives
The Mérieux Fondation is celebrating 50 years of fighting infectious diseases in developing countries
Les Pensiéres Center for Global Health, Veyrier-du-Lac (France)
September 14, 2017
Calling for all public and private stakeholders worldwide to rally together and international health diplomacy, it reasserts France’s central role.
To mark its 50th anniversary, the Foundation is organizing an International Meeting at the Les Pensières Center for Global Health on the shores of Lake Annecy. The aim of this day is to highlight new collaborative international approaches for fighting the increased risk of epidemics.

The threat of infectious disease is ever present, accounting for nearly 17 million victims each year, most of whom are children in developing countries. This threat is now taking on a new dimension in light of an increasing number of conflicts, demographic explosion, massive migrations of populations, accelerating global exchanges of all kinds and climate change – a context for which humans are largely responsible.

Traditional top-down approaches have demonstrated their limited efficacy in combating infectious diseases. They must now give way to new, local initiatives, conducted with and for the residents of those communities. Multidisciplinary approaches to global health go beyond merely treating patients, encompassing everything in the environment that impacts patients.

France has a role to play in this global fight, due to its expertise in infectious disease, Pasteurian tradition and the historical global influence of French medicine. As such, it needs to reassert its position and ensure it is an integral part of the wider framework of international health diplomacy, which is yet to be formed. The Foundation is ready to commit to this cause and provide its expertise in biology in the field.

To this end, over 150 scientists, researchers, doctors, biologists, humanitarian players and representatives from international organizations, hailing from West Africa, Asia, Latin America, Madagascar, Haiti and the Middle East are meeting together today to share their experiences at three round tables dedicated to key challenges:
:: Epidemic risks in developing countries, chaired by Professor Christian Bréchot, President of Institut Pasteur
:: New dynamics in health capacity building: leveraging local resources, chaired by Professor Ogobara Doumbo, Director of the Malaria Research and Training Centre, Faculty of Medicine, University of Bamako, Mali
:: The global health approach: bringing vulnerable populations more than medical care, chaired by Dr. Jean William Pape, Founder and Director of the GHESKIO Centers, Haiti

A single model for action to combat infectious diseases
For the past 50 years, the Mérieux Foundation has been committed to fighting infectious diseases affecting developing countries by strengthening their clinical biology capabilities.

Without diagnostics, medicine is blind. The Mérieux Foundation has therefore made its commitment to diagnostics the driving force behind its work. Diagnostics are an essential part of the healthcare chain and an invaluable tool for identifying pathogens responsible for disease and prescribing suitable treatment. They are therefore key to fighting bacterial resistance and, more globally, indispensable for disease surveillance and control.

The Foundation is focusing its actions on:
:: Creating and equipping laboratories of excellence, the Rodolphe Mérieux Laboratories;
:: Around these reference laboratories, renovating clinical laboratories in the field to give local populations access to quality diagnostics;
:: On-site training of new generations of healthcare players in these countries;
:: Rolling out international applied research programs, coordinated by its GABRIEL research network;
:: Building international research and diagnostic networks worldwide;
:: Developing global health programs to treat the most vulnerable, namely mothers and children.

Presided by Alain Mérieux, the Mérieux Foundation has public interest status and carries out its actions in concert with Fondation Christophe et Rodolphe Mérieux, an independent family foundation created in 2001 under the aegis of the Institut de France. Fondation Christophe et Rodolphe Mérieux is a 30% shareholder of the Institut Mérieux and is the sole beneficiary of the dividends paid out by the Institut.

The Mérieux Foundation employs over 100 people working in France and in developing countries and dedicates an annual budget of nearly €25 million to its actions in the field. Close to half this budget is provided by the family…
PATH announces new collaboration to advance maternal immunization in low- and middle-income countries
Announcement | September 11, 2017
The Advancing Maternal Immunization collaboration will create a roadmap to help infants survive and thrive by making immunization available to pregnant mothers
A newly launched collaboration is bringing together stakeholders from around the world to improve infant health and survival through maternal immunization, particularly in low- and middle-income countries (LMICs). The newly assembled Advancing Maternal Immunization (AMI) collaboration is meeting an urgent need for pregnant mothers in LMICs to be able to protect their babies from infectious diseases by getting vaccinated themselves—an option not used to its full potential in many parts of the world, especially in resource-limited settings where it is not widely available.
With a current focus on respiratory syncytial virus (RSV)—which is estimated to cause more than a quarter of global respiratory deaths (nearly 120,000) among children younger than five years of age annually—AMI aims to ensure that a successful RSV vaccine is made available to women in LMICs without delay. No licensed vaccine exists to prevent RSV, but a number of vaccine candidates are advancing, including a maternal vaccine in late-stage development that may be available in the next few years.
Coordinated by PATH in collaboration with the World Health Organization (WHO) and funded by the Bill & Melinda Gates Foundation, AMI will start by developing a roadmap to facilitate informed global, regional, and country decisions around RSV maternal vaccines. It will also identify requirements to enable rapid launch and uptake in LMICs…
New Gates Foundation Report Highlights Remarkable Progress Against Global Poverty and Disease, Warns Future Progress in Jeopardy
Bill and Melinda Gates Call for Strong Leadership to Address “Solvable Human Misery”
SEATTLE, Sept. 13, 2017 – The Bill & Melinda Gates Foundation today launched an inaugural annual report showcasing the remarkable progress that has been made in reducing extreme poverty and disease in recent decades, but issuing a stern warning to the world that future progress is in jeopardy.

Goalkeepers: The Stories Behind the Data, co-authored and edited by Bill and Melinda Gates and produced in partnership with the Institute for Health Metrics and Evaluation at the University of Washington, highlights past progress against some of the most devastating issues facing poor countries and uses breakthrough data projections to forecast good and bad future scenarios – with millions of lives hanging in the balance.

In all, the report tracks 18 data points from the UN Sustainable Development Goals, or Global Goals, including child and maternal deaths, stunting, access to contraceptives, HIV, malaria, extreme poverty, financial inclusion and sanitation. The report looks beneath the numbers to pinpoint the leaders, approaches and innovations that made a difference.

Through the data and first-person accounts from six contributors, the report showcases the stunning progress the world has made in the past generation: cutting extreme poverty and child deaths in half and reducing HIV deaths and maternal deaths by nearly half, among many other accomplishments. But as the report shows, serious challenges remain – including deep disparities between countries – and future progress is not inevitable.

The projections are showcased in charts and explore three potential 2030 scenarios for each indicator. The first is what could happen if we continue along the current path, based on past trends – without significant changes to approaches or current spending levels. Two additional scenarios provide a glimpse at a better and worse future: what could happen with strong leadership, innovation and investment and, starkly, what could happen if attention and funding waned. For example, a mere 10 percent cut in global donor funding for HIV treatment could result in more than 5 million more deaths by 2030…

Goalkeepers: The Stories Behind the Data 2017
Bill & Melinda Gates Foundation, 2017 :: 44 pages
PDF: http://www.globalgoals.org/goalkeepers/datareport/assets/downloads/Stories_behind_the_data_2017.pdf
[Excerpt p. 35]
Proportion of the target population covered by eight vaccines, conditional on inclusion in national vaccine schedules
Vaccines are one of the most impressive success stories in global health. More people are being immunized and protected against more diseases than ever before. The next steps for immunization programs are to battle stagnation by finding the pockets of inequity that exist within countries—even those with high average rates—and reach all children with a full set of lifesaving vaccinations. We’ve grouped countries and plotted the groups separately to show the gap between more and less developed countries.
Target: Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries and provide access to affordable essential medicines and vaccines. Socio-demographic index (SDI) is a measure based on average income per capita, education attainment, and total fertility rate.
WHO – The 72nd Session of the United Nations General Assembly (UNGA 72)
12 – 25 September 2017
The 72nd Regular Session of the UN General Assembly (UNGA 72) will convene at UN Headquarters on Tuesday, 12 September 2017. The General Debate will open on Tuesday, 19 September 2017, with the theme, ‘Focusing on People: Striving for Peace and a Decent Life for All on a Sustainable Plan
The WHO Delegation to UNGA will be led by Dr Tedros, who will focus on raising awareness and building political commitment to his priority issues of universal health coverage; health security; women’s, children’s and adolescents’ health; and environmental health, including the health impacts of climate change. Dr Tedros, together with Deputy Head of Delegation Dr Flavia Bustreo and other senior officials, will organize and participate to many high-level events, including the flagship WHO event on Universal Health Coverage.
 [Details of major and side events at link above]


Public Health Emergency of International Concern (PHEIC)
Polio this week as of 13 September 2017 [GPEI]
:: Following flooding in Benue, Nigeria, the World Health Organization has deployed its polio infrastructure across the state to strengthen disease prevention efforts.
:: Pakistan and Afghanistan plan to implement National Immunization Days during the second half of September.
:: Summary of newly-reported viruses this week: two new wild poliovirus type 1 (WPV1) positive environmental samples were confirmed this week, one located in Karachi, Pakistan, and the other in Rawalpindi, Pakistan
Situation reports on the polio outbreak in Syria [WHO]
Situation update 12 September 2017
:: No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 39. All confirmed cases to date have had onset of paralysis before 14 July 2017.
:: Final lab results are pending for an additional 4 poliovirus type-2 (PV2) isolates (2 from Mayadeen and 1 from Boukamal districts, Deir Ez-Zor governorate, and 1 from Thawra district, Raqqa governorate).
:: The second round for Deir Ez-Zor concluded 28 August. Third party independent monitoring reported coverage of 77% (gauged by caregiver recall).
:: Preparations for the second Raqqa round continue.
:: The Ministry of Health has established healthy children stool sampling in all governorates receiving IDPs from Deir Ez-Zor and Raqqa.
:: IPV is being administered to unvaccinated children under five from Deir Ez-Zor and Raqqa at border checkpoints and entrances in all governorates.
:: The total number of AFP cases detected in Deir Ez-Zor governorate since the beginning of 2017 is 134 (99 from Mayadeen, 10 from Deir Ez-Zor, and 25 from Boukamal districts). Raqqa governorate has reported 16 AFP cases (5 from Raqqa, 10 from Tell Abyad, and 1 from Thawra districts). Homs governorate has reported 30 AFP cases (14 from Homs city, 13 from Rastan, 1 from Tadmour and 2 from Talkalakh districts).
WHO Grade 3 Emergencies  [to 16 September 2017]
:: WHO Intensifies Efforts to Contain Cholera Outbreak in Borno State
Maiduguri, 08 September 2017-With more than 1000 suspected and confirmed cases of cholera including 30 deaths in Borno state as of 07 Sept 2017, World Health Organization (WHO) has intensified its response efforts to contain the outbreak in Muna internally displaced persons (IDPs)camp in Maiduguri, Jere, Monguno and Dikwa local government areas (LGAs)…
The Syrian Arab Republic
:: Situation reports on the polio outbreak in Syria [WHO]  Situation update 12 September 2017
[See Polio above]
UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: 15 Sep 2017  After three year siege, UNHCR aid convoy reaches Deir Ez-Zor in eastern Syria
:: Iraq: Humanitarian Bulletin, September 2017 | Issued on 15 September
…Humanitarian partners prepare for up to 85,000 displaced from Hawiga and surrounding areas.
…Iraq inter-agency toll-free call centre one of a kind in existence.
…Cash Working Group develops joint approach for assistance programmes.
…Iraq Humanitarian Fund prepares new allocation.
…Military operations in Hawiga may affect 85,000
Yemen  No new announcements identified.
UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
:: UN Aid Chief: Humanitarian response saves lives in Nigeria’s north-east, civilian safety must be prioritized
(Abuja, 12 September 2017): At the end of a two-day mission to Nigeria, the United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Mark Lowcock, said that the Government and humanitarians had made important progress in delivering life-saving relief to millions of people in north-east Nigeria. However, the complex Lake Chad Basin crisis will require sustained international support over the coming years…
:: Nigeria: Five ways to contain the cholera outbreak
:: Nigeria – North-East Flash Update No. 3 – Cholera Outbreak, 9 September 2017
:: Somalia: Drought Response – Situation Report No. 16  Published on 14 Sep 2017
[Highlights excerpts]
…There is progress on containment of the AWD/cholera outbreak with a significant decline in cases in August.
…Case numbers of measles remain high. A nationwide measles vaccination campaign is scheduled for November/December 2017.Health partners highlight the need for further funding for this campaign.
:: 7 Sep 2017  Somalia Civil-Military Working Group Report – August 2017
Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.
MERS-CoV [to 16 September 2017]
Middle East respiratory syndrome coronavirus (MERS-CoV) – Oman
12 September 2017
Emergency cholera vaccination campaign kicks off in Sierra Leone
FREETOWN, 15 September 2017 – Sierra Leone’s first ever Oral Cholera Vaccination (OCV) campaign kicked off today, September 15th 2017. The emergency campaign targets communities affected by Western Area’s severe floods and landslides, which left over 6,000 people displaced and caused over 500 confirmed deaths.
“The cholera vaccine is safe and available free of cost for everyone living in the affected communities who is over 1 year of age,” said Dr. Brima Kargbo, Chief Medical Officer of the Ministry of Health and Sanitation. “We encourage people in these areas to take the two required doses of the vaccine, which will significantly increase protection against this life-threatening disease.”
Two doses of the vaccine are needed to maximize protection against cholera. The first dose will be administered from 15th to 20th September and the second from 5th to 10th October.  It will be available at health facilities and from health workers who will be going house-to-house in the affected communities and camps.
“Risks of cholera can increase after severe flooding and Sierra Leone has experienced severe outbreaks in the past,” said Alexander Chimbaru, Officer in-Charge of the World Health Organization in Sierra Leone. “In such situations, the cholera vaccine can be a valuable tool to reduce risks, alongside ongoing efforts to improve access to safe water, good hygiene practices and sanitation.”…

 WHO & Regional Offices [to 16 September 2017]

 WHO & Regional Offices [to 16 September 2017]

World hunger again on the rise, driven by conflict and climate change, new UN report says
   15 September 2017 – After steadily declining for over a decade, global hunger is on the rise again, affecting 815 million people in 2016, or 11 per cent of the global population, says a new edition of the annual United Nations report on world food security and nutrition released today.

World Sepsis Day 2017
September 2017 – Sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs. For World Sepsis Day 2017, WHO and partners are hosting a free online congress to shine a spotlight on neglected aspects of sepsis.


Weekly Epidemiological Record, 15 September 2017, vol. 92, 37 (pp. 537–556)
:: Meeting of the International Task Force for Disease Eradication, June 2017
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Swaziland conducts Post MR and IPV vaccine Introduction Evaluation 15 September 2017
:: Emergency cholera vaccination campaign kicks off in Sierra Leone  15 September 2017
:: Cameroon investigates yaws outbreak among indigenous populations  15 September 2017
:: Uganda conducts preventative Polio immunization campaign  14 September 2017
:: WHO scales-up accountability processes as workshop on Key Performance Indicators integration opens in Abuja 14 September 2017
:: Mental health is a critical component in disaster response and recovery  13 September 2017
:: Nigeria collaborates with journalists on high quality measles vaccination campaign.
13 September 2017
:: Botswana embarks on a joint review of five health programmes! 13 September 2017
:: WHO supports Government of Uganda to develop a National Action Plan for Health Security (NAPHS)  12 September 2017
:: One year into emergency response, WHO evaluates operations in Northeastern Nigeria.
12 September 2017
:: Integrated Measles and EOS campaign protects 2.6 million children in Ethiopia’s Somali Region  11 September 2017

WHO Region of the Americas PAHO
:: Countries scale up mosquito control efforts for Mosquito Awareness Week (09/13/2017)
:: Wellness Week in the Americas promotes mental well-being (09/11/2017)

WHO South-East Asia Region SEARO
:: Bangladesh/Myanmar: Rakhine Conflict 2017   Situation Report: 01   Date: 15 September 2017
:: Since 25 August more than 379,000 people are estimated to have crossed from Myanmar to Bangladesh following violence in Rakhine state, Myanmar
:: 156,000 are located in makeshift settlement/camps, 35 000 in host communities and 188 000 in new spontaneous settlements
:: 26,747 people have been displaced in Myanmar…
:: WHO and UNICEF to support MOH on routine EPI and mass vaccination…
Public health concerns  [excerpt]
:: Routine vaccination rates are reported to be very low in northern Rakhine state (e.g. <70% coverage against measles 1 or 2), a reflection of a higher risk of outbreaks from expanded program on immunization-associated diseases…

WHO European Region EURO
:: Day 4 highlights: partnerships essential in our “multisectoral, multidimensional world” 14-09-2017
:: Day 3 highlights: “The health workforce is the beating heart of any health system” 13-09-2017
:: Day 2 highlights: Director-General outlines key health priorities 12-09-2017
:: Day 1 highlights: RC67 opens 11-09-2017
:: 67th session of WHO Regional Committee for Europe opens in Budapest 10-09-2017

WHO Eastern Mediterranean Region EMRO
:: WHO trains 2800 health care providers to respond to gender-based violence
13 September 2017 – WHO estimates that globally around 1 in 3 women have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence. In Afghanistan, WHO, with the support of USAID and the Italian Development Cooperation, has trained over 2800 nurses, doctors and midwives on the gender-based violence protocol, which was developed by the Ministry of Public Health and WHO, with the support of UN Women in 2014. A further 6500 health care providers in all provinces are currently being trained on how to properly manage cases of gender-based violence, including physical, sexual and psychological violence…

CDC/ACIP [to 16 September 2017]

CDC/ACIP [to 16 September 2017]

MMWR News Synopsis for September 14, 2017
:: Use of Unannounced Mystery Patient Drills to Assess Hospital Emergency Department Preparedness for Communicable Diseases of Public Health Concern — New York City, 2016
:: Rates and Trends of Pediatric Acute Lymphoblastic Leukemia — United States, 2001–2014
:: Occupational Animal Exposure Among Persons with Campylobacteriosis and Cryptosporidiosis Nebraska, 2005–2015
:: Updated Dosing Instructions for Immune Globulin (Human) GamaSTAN S/D for Hepatitis A Virus Prophylaxis


State Health Officials Strongly Encourage Influenza Vaccinations Among Pregnant Women
Association of State and Territorial Health Officials [U.S.]
ARLINGTON, Va., Sept. 14, 2017 /PRNewswire-USNewswire/ — Jay Butler, MD, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services, released the following statement today regarding the importance of influenza vaccinations for pregnant women:
“As we enter flu season, state and territorial health officials strongly encourage all individuals six months or older to receive an annual influenza vaccination, including pregnant women and older adults. Each year, millions of Americans are affected by the flu and influenza vaccines are vital to reduce the chances of getting sick. Illness from influenza infection can be particularly dangerous for pregnant women and their developing babies.

A recent report from the ongoing Vaccine Safety Datalink project found that there may be a possible link between miscarriage early in pregnancy and the flu vaccine in women who received a certain version of the vaccine two years in a row. ASTHO and its members are concerned about this potential risk when weighed against other risks, including the risks posed by influenza during pregnancy, and continue to work with national healthcare organizations, including the American College of Obstetricians and Gynecologists and CDC, to determine whether these new findings should lead to any changes in national recommendations. Given the large volume of data indicating the safety of influenza vaccination during pregnancy, ASTHO and its members support current recommendations for use of vaccines during pregnancy.

This study raises an important question about risk, and an ongoing investigation to study this issue further is recommended. It is also important to note that this study does not prove that flu vaccine was the cause of the miscarriage. Earlier studies have not found a link between flu vaccination and miscarriage. CDC continues to recommend that pregnant women get an influenza vaccine during any trimester of their pregnancy because flu poses a danger to pregnant women, and a flu vaccine can prevent influenza in pregnant women which also protects their baby after birth.

State and territorial health departments continue to encourage pregnant women to get vaccinated to be protected from influenza during pregnancy. Immunizations are a vital public health tool and one of the most cost-effective means of public health promotion and disease prevention. Vaccines prevent disease, disability, and death in children and adults.”


 BMGF – Gates Foundation  [to 16 September 2017]
SEPTEMBER 13, 2017
New Gates Foundation Report Highlights Remarkable Progress Against Global Poverty and Disease, Warns Future Progress in Jeopardy
Bill and Melinda Gates Call for Strong Leadership to Address “Solvable Human Misery”
[See Week in Review above for more detail]
CEPI – Coalition for Epidemic Preparedness Innovations  [to 16 September 2017]
Board member advert
CEPI is now looking for visionary leaders to serve on its new permanent Board and help guide the coalition through its next phase of growth, maximising the positive impact that CEPI can make in the years ahead.
To express your interest in being a member of CEPI’s board, or to nominate an individual you believe to be an exceptional candidate, please email board@cepi.net by October 1, 2017, providing a CV where possible.
PDF FORMAT – 50KB  Download

European Medicines Agency  [to 16 September 2017]
Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 11 to 14 September 2017
Thirteen medicines recommended for approval, including one orphan medicine

Raising awareness of the perils of antimicrobial resistance
EMA to host a meeting with key stakeholders on the work of international health authorities and how to optimise collaboration …
FDA [to 16 September 2017]
What’s New in Biologics
Influenza Virus Vaccine for the 2017-2018 Season
Updated: 9/14/2017
Fondation Merieux  [to 16 September 2017]
September 14, 2017
The Mérieux Fondation is celebrating 50 years of fighting infectious diseases in developing countries
Les Pensiéres Center for Global Health, Veyrier-du-Lac (France)
[See Milestones above for more detail
Global Fund [to 16 September 2017]
22 Million Lives Saved
13 September 2017
Programs supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria have saved 22 million lives, according to a report released today. The report also shows significant increases in the number of people receiving treatment for HIV, diagnosis and treatment for TB and having an insecticide treated net to prevent malaria…
The Global Fund Results Report 2017, with cumulative results through the end of 2016, shows a decline of one-third in the number of people dying from AIDS, TB and malaria in the countries where the Global Fund invests…
Programs supported by the Global Fund, which are designed and implemented by local experts and communities affected by the diseases, provided 11 million people with antiretroviral therapy for HIV – more than half the total number of people on treatment worldwide.
Global Fund-supported programs have provided 17.4 million people with testing and treatment for TB, and 795 million mosquito nets to prevent malaria. As a result of prevention and control interventions in more than 100 countries, the Global Fund’s target of averting 140-180 million infections by the end of 2016 was met in 2015…
Report pdf [52 pages]:
NIH  [to 16 September 2017]
September 12, 2017
NIH awards $15 million to support development of 3-D human tissue models
“Tissue chips” to be engineered to model disease and test drug efficacy prior to clinical trials.

Dr. James Ostell named Director of the National Center for Biotechnology Information
September 11, 2017 — NCBI maintains biomedical databases, including PubMed, GenBank, BLAST, Entrez, RefSeq, dbSNP, PubMed Central and dbGaP.
PATH  [to 16 September 2017]
Announcement | September 14, 2017
PATH joins world leaders in New York City this week to advocate for innovation to create a healthier, more secure world

Announcement | September 11, 2017
PATH announces new collaboration to advance maternal immunization in low- and middle-income countries
[See Milestones above for more details]

UNAIDS [to 16 September 2017]
Thailand launches new national strategy to end the AIDS epidemic by 2030
15 September 2017
The Ministry of Public Health of Thailand has launched its new 2017–2030 National AIDS Strategy, which provides a road map for ending the AIDS epidemic as a public health threat in Thailand by 2030. Narong Pipatanasai, Deputy Prime Minister and Chair of the National AIDS Committee, led the launch at the Government Complex in Bangkok, Thailand, on 13 September.
The 13-year plan adapts the latest global commitments to Thailand, ensuring an effective, cost-efficient and high-impact HIV response. A recent UNAIDS report on the global AIDS epidemic finds that annual new HIV infections dropped by 50% in Thailand between 2010 and 2016, the steepest decline for any country in the Asia and the Pacific region…

UNAIDS and Malaysia launch joint data web platform
14 September 2017
UNAIDS and the Ministry of Health of Malaysia have launched a joint web platform that aims to strengthen the generation of strategic information and the use of national, subnational and key population data for evidence-informed programming.
The platform, which is hosted and supported by the UNAIDS regional data hub, was launched by Noor Hisham Abdullah, Director-General of Malaysia’s Ministry of Health, and Eamonn Murphy, Director of the UNAIDS Regional Support Team for Asia and the Pacific, at the 5th Asia Pacific Conference on Public Health, which ended on 13 September in Kuching, Malaysia…

Metro Manila city leaders commit to intensifying HIV response
11 September 2017
Mayors and other city leaders from the 17 cities that make up the National Capital Region in the Philippines pledged to make the HIV epidemic a public health emergency requiring multisectoral strategies and a full provision of resources. The city representatives recently signed a city HIV resolution during a dinner meeting in Manila hosted by the Secretary of the Department of Health, Paulyn Jean Rosell-Ubial…
Wellcome Trust  [to 16 September 2017]
News / Published: 12 September 2017
European foundations unite to tackle global challenges
Three of Europe’s biggest philanthropic foundations have joined together to award €5m to tackle some of the most pressing global challenges of our time.
Wellcome Trust, Volkswagen Stiftung and Riksbankens Jubileumsfond have funded six research groups as part of the Europe and Global Challenges Initiative. The projects range from understanding how to best protect and integrate Syrian refugees, to strengthening climate action in the global south. Each partner will fund two projects directly.
DCVMN – Developing Country Vaccine Manufacturers Network  [to 16 September 2017]
25 September 2017 to 28 September 2017
DCVMN Annual General Meeting
Seoul / Korea
Download the Agenda
Industry Watch
:: FDA Advisory Committee votes unanimously for Shingrix (HZ/su) in the US for prevention of herpes zoster (shingles) in adults ages 50 and over
LONDON, Sept. 13, 2017 /PRNewswire/ — GlaxoSmithKline plc announced today that the Vaccines and Related Biological Products Advisory Committee (VRBPAC) of the US Food and Drug Administration (FDA) voted unanimously that the data support the efficacy and safety of Shingrix, for the prevention of herpes zoster (shingles) in adults ages 50 and over. FDA Advisory Committees provide non-binding recommendations for consideration by the FDA, with the final decision on approval made by the FDA.
Dr. Emmanuel Hanon, Senior Vice President and Head of Vaccines R&D for GSK said: “Shingles is a painful and potentially serious condition. The risk of developing shingles increases with age and it is estimated that up to one in three people in the United States will develop shingles. Today’s vote brings us one step closer to approval of Shingrix, which is specifically designed to overcome age-related weakening of the immune system.”
The Biologics License Application (BLA) was submitted to the FDA in October 2016…

Journal Watch

Journal Watch

   Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

The relationship between burden of childhood disease and foreign aid for child health

BMC Health Services Research
(Accessed 16 September 2017)

Research article
The relationship between burden of childhood disease and foreign aid for child health
We sought to examine the relationship between child specific health aid (CHA) and burden of disease. Based on existing evidence, we hypothesized that foreign aid for child health would not be proportional to burden of disease….CHA has grown significantly over the last two decades. There is no clear relationship between CHA and burden of disease. This report provides a description of foreign aid for child health, and hopes to inform policy and decision-making regarding foreign aid.
Clay Bavinger, Paul Wise and Eran Bendavid

BMC Health Services Research 2017 17:655
Published on: 15 September 2017

A review of Grey and academic literature of evaluation guidance relevant to public health interventions

BMC Health Services Research
(Accessed 16 September 2017)

Research article
A review of Grey and academic literature of evaluation guidance relevant to public health interventions
Sarah Denford, Charles Abraham, Margaret Callaghan, Peter Aighton, Frank De Vocht and Steven Arris
BMC Health Services Research 2017 17:643
Published on: 12 September 2017
Public Health evaluation is essential to understanding what does and does not work, and robust demonstration of effectiveness may be crucial to securing future funding. Despite this, programs are often implemented with poor, incomplete or no evaluation. Public health practitioners are frequently required to provide evidence for the effectiveness of their services; thus, there is a growing need for evaluation guidance on how to evaluate public health programs. The aim of this study is to identify accessible high-quality, evaluation guidance, available to researchers and practitioners and to catalogue, summarise and categorise the content of a subset of accessible, quality guides to evaluation.
We systematically reviewed grey and academic literature for documents providing support for evaluation of complex health interventions. Searches were conducted January to March 2015, and included academic databases, internet search engines, and consultations with academic and practicing public health experts. Data were extracted by two authors and sent to the authors of the guidance documents for comments.
Our initial search identified 402 unique documents that were screened to identify those that were (1) developed by or for a national or international organization (2) freely available to all (3) published during or after 2000 (4) specific to public health. This yielded 98 documents from 43 organisations. Of these, 48 were reviewed in detail. This generated a detailed catalogue of quality evaluation guidance. The content included in documents covers 37 facets of evaluation.
A wide range of guidance on evaluation of public health initiatives is available. Time and knowledge constraints may mean that busy practitioners find it challenging to access the most, up-to-date, relevant and useful guidance. This review presents links to and reviews of 48 quality guides to evaluation as well as categorising their content. This facilitates quick and each access to multiple selected sources of specific guidance.

Lessons from a decade of individual-based models for infectious disease transmission: a systematic review (2006-2015)

BMC Infectious Diseases
(Accessed 16 September 2017)

Research Article
Lessons from a decade of individual-based models for infectious disease transmission: a systematic review (2006-2015)
Individual-based models (IBMs) are useful to simulate events subject to stochasticity and/or heterogeneity, and have become well established to model the potential (re)emergence of pathogens (e.g., pandemic influenza, bioterrorism). Individual heterogeneity at the host and pathogen level is increasingly documented to influence transmission of endemic diseases and it is well understood that the final stages of elimination strategies for vaccine-preventable childhood diseases (e.g., polio, measles) are subject to stochasticity. Even so it appears IBMs for both these phenomena are not well established. We review a decade of IBM publications aiming to obtain insights in their advantages, pitfalls and rationale for use and to make recommendations facilitating knowledge transfer within and across disciplines.
Lander Willem, Frederik Verelst, Joke Bilcke, Niel Hens and Philippe Beutels
BMC Infectious Diseases 2017 17:612
Published on: 11 September 2017

Informed consent and registry-based research – the case of the Danish circumcision registry

BMC Medical Ethics
(Accessed 16 September 2017)

Informed consent and registry-based research – the case of the Danish circumcision registry
Research into personal health data holds great potential not only for improved treatment but also for economic growth. In these years many countries are developing policies aimed at facilitating such research often under the banner of ‘big data’. A central point of debate is whether the secondary use of health data requires informed consent if the data is anonymised. In 2013 the Danish Minister of Health established a new register collecting data about all ritual male childhood circumcisions in Denmark. The main purpose of the register was to enable future research into the consequences of ritual circumcision.
Thomas Ploug and Søren Holm
BMC Medical Ethics 2017 18:53
Published on: 15 September 2017

BMC Public Health (Accessed 16 September 2017)

BMC Public Health
(Accessed 16 September 2017)

Research article
A socio-ecological analysis of barriers to the adoption, sustainablity and consistent use of sanitation facilities in rural Ethiopia
Despite evidence showing that access to and use of improved sanitation is associated with healthier households and communities, barriers influencing the adoption and sustainablity of sanitation facilities rema…
Fikralem Alemu, Abera Kumie, Girmay Medhin, Teshome Gebre and Phoebe Godfrey
BMC Public Health 2017 17:706
Published on: 13 September 2017

Research article
Modelling the effects of booster dose vaccination schedules and recommendations for public health immunization programs: the case of Haemophilus influenzae serotype b
Haemophilus influenzae serotype b (Hib) has yet to be eliminated despite the implementation of routine infant immunization programs. There is no consensus regarding the number of primary vaccine doses and an optimal schedule for the booster dose. We sought to evaluate the effect of a booster dose after receiving the primary series on the long-term disease incidence.
Nadia A. Charania and Seyed M. Moghadas
BMC Public Health 2017 17:705
Published on: 13 September 2017

Research article
Associations between media use and health information-seeking behavior on vaccinations in South Korea
Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population.
Jiyeon Kim and Minsoo Jung
BMC Public Health 2017 17:700
Published on: 11 September 2017

Global Public Health Volume 12, 2017 Issue 11

Global Public Health
Volume 12, 2017   Issue 11

Gender counts: A systematic review of evaluations of gender-integrated health interventions in low- and middle-income countries
Brittany Schriver, Mahua Mandal, Arundati Muralidharan, Anthony Nwosu, Radhika Dayal, Madhumita Das & Jessica Fehringer
Pages: 1335-1350
Published online: 07 Mar 2016

A systematic review of microfinance and women’s health literature: Directions for future research
L. O’Malley & J. G. Burke

Pages: 1433-1460
Published online: 15 Apr 2016

Access to medicines and hepatitis C in Africa: can tiered pricing and voluntary licencing assure universal access, health equity and fairness?

Globalization and Health
[Accessed 16 September 2017]

Access to medicines and hepatitis C in Africa: can tiered pricing and voluntary licencing assure universal access, health equity and fairness?
The recent introduction of Direct Acting Antivirals (DAAs) for treating Hepatitis C Virus (HCV) can significantly assist in the world reaching the international target of elimination by 2030. Yet, the challenge facing many individuals and countries today lies with their ability to access these treatments due to their relatively high prices. Gilead Sciences applies differential pricing and licensing strategies arguing that this provides fairer and more equitable access to these life-saving medicines. This paper analyses the implications of Gilead’s tiered pricing and voluntary licencing strategy for access to the DAAs.
Yibeltal Assefa, Peter S. Hill, Anar Ulikpan and Owain D. Williams
Globalization and Health 2017 13:73
Published on: 13 September 2017

Systems thinking in combating infectious diseases

Infectious Diseases of Poverty
[Accessed 16 September 2017]

Systems thinking in combating infectious diseases
Shang Xia, Xiao-Nong Zhou and Jiming Liu
Published on: 11 September 2017
The transmission of infectious diseases is a dynamic process determined by multiple factors originating from disease pathogens and/or parasites, vector species, and human populations. These factors interact with each other and demonstrate the intrinsic mechanisms of the disease transmission temporally, spatially, and socially. In this article, we provide a comprehensive perspective, named as systems thinking, for investigating disease dynamics and associated impact factors, by means of emphasizing the entirety of a system’s components and the complexity of their interrelated behaviors. We further develop the general steps for performing systems approach to tackling infectious diseases in the real-world settings, so as to expand our abilities to understand, predict, and mitigate infectious diseases.

Preventing Cancer and Other Diseases Caused by Human Papillomavirus Infection 2017 Lasker-DeBakey Clinical Research Award

September 12, 2017, Vol 318, No. 10, Pages 883-974

Preventing Cancer and Other Diseases Caused by Human Papillomavirus Infection 2017 Lasker-DeBakey Clinical Research Award
Douglas R. Lowy, MD; John T. Schiller, PhD
JAMA. 2017;318(10):901-902. doi:10.1001/jama.2017.11706
In this Viewpoint, 2017 Lasker-DeBakey Clinical Medical Research Award winners Douglas Lowy and John Schiller discuss the development of the virus-like particle technology that was used to create the human papillomavirus vaccine to prevent cervical cancer and other diseases.

Navigating a new narrative for developing countries: rising strong

JBI Database of Systematic Review and Implementation Reports
September 2017 – Volume 15 – Issue 9

Navigating a new narrative for developing countries: rising strong
Jordan, Zoe
JBI Database of Systematic Reviews and Implementation Reports . 15(9):2223-2224, September 2017.
…This issue of the JBI Database of Systematic Reviews and Implementation Reports includes    three editorials that highlight both the potential impact and real challenge that implementation of evidence in policy and practice can have in African settings. Okwen refers to the “complex symphony of an evidence ecosystem that requires innovative approaches from evidence generation to evidence implementation”.4(p.2227) This beautifully crafted sentiment is echoed by Bayuo in his editorial related to evidence utilization in Ghana as he describes the parallel “worlds” within which the desire and practice of evidence based healthcare live, given the significant contextual challenges faced by those working in the African context.5
These insightful editorials are accompanied by a range of pragmatic articles6-10 related to the synthesis and implementation of a range of evidence that once again highlight the unique needs and challenges of health professionals in Africa and other low income countries, and the inimitable contexts within which it needs to be considered and utilized.
Despite these challenges I believe that, internationally, we are rising strong. Increasingly we are finding new and creative ways to work collaboratively, cooperatively, collectively, and with common vision and commitment to drive the evidence based healthcare agenda forward in developing regions. I am confident that the narrative is indeed changing and changing for the better.

Journal of Community Health – Volume 42, Issue 5, October 2017

Journal of Community Health
Volume 42, Issue 5, October 2017

Original Paper
State of HIV in the US Deep South
Susan Reif, Donna Safley, Carolyn McAllaster, Elena Wilson… Pages 844-853

Original Paper
Practices and Attitudes of Missouri School Nurses Regarding Immunization Records and Select Immunizations of Graduating High School Seniors
Darson L. Rhodes, Michele Draper, Kendra Woolman, Carol Cox Pages 872-87

Original Paper
Adolescent Participation in HPV Vaccine Clinical Trials: Are Parents Willing?
Jennifer Cunningham Erves, Tilicia L. Mayo-Gamble

Original Paper
Improving HPV Vaccination Through a Diverse Multi-state Coalition
Echo L. Warner, Brynn Fowler, Laura Martel, Deanna Kepka

Gray literature: An important resource in systematic reviews (pages 233–240)

Journal of Evidence-Based Medicine
August 2017  Volume 10, Issue 3  Pages 153–240

Gray literature: An important resource in systematic reviews (pages 233–240)
Arsenio Paez
Version of Record online: 31 AUG 2017 | DOI: 10.1111/jebm.12266
Systematic reviews aide the analysis and dissemination of evidence, using rigorous and transparent methods to generate empirically attained answers to focused research questions. Identifying all evidence relevant to the research questions is an essential component, and challenge, of systematic reviews. Gray literature, or evidence not published in commercial publications, can make important contributions to a systematic review. Gray literature can include academic papers, including theses and dissertations, research and committee reports, government reports, conference papers, and ongoing research, among others. It may provide data not found within commercially published literature, providing an important forum for disseminating studies with null or negative results that might not otherwise be disseminated. Gray literature may thusly reduce publication bias, increase reviews’ comprehensiveness and timeliness, and foster a balanced picture of available evidence.

Single visit rabies pre-exposure priming induces a robust anamnestic antibody response after simulated post-exposure vaccination: results of a dose-finding study

Journal of Travel Medicine
Volume 24, Issue 5, 1 September 2017

Original Article
Single visit rabies pre-exposure priming induces a robust anamnestic antibody response after simulated post-exposure vaccination: results of a dose-finding study
This dose finding study demonstrates that priming with a single dose of rabies vaccine was sufficient to induce an adequate anamnestic antibody response to rabies PEP in all subjects 1 year later, even in those in whom the RVNA threshold of 0.5 IU/ml was not reached after priming.
Emile F.F. Jonker, MD; Leonardus G. Visser, MD, PhD
Journal of Travel Medicine, Volume 24, Issue 5, 1 September 2017, tax033,

The Lancet – Sep 16, 2017 Volume 390 Number 10100 p1083-1464

The Lancet
Sep 16, 2017 Volume 390 Number 10100 p1083-1464

Global Health Metrics
Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016
GBD 2016 SDG Collaborators  –  Open Access

Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016
GBD 2016 SDG Collaborators  –  Open Access

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
GBD 2016 SDG Collaborators  –  Open Access

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
GBD 2016 SDG Collaborators  –  Open Access

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
GBD 2016 SDG Collaborators  –  Open Access

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

The Lancet
Sep 16, 2017 Volume 390 Number 10100 p1083-1464

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016
GBD 2016 SDG Collaborators  –  Open Access
The UN’s Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today’s gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030.
We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0–100, with 0 as the 2·5th percentile estimated between 1990 and 2030, and 100 as the 97·5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment.
Globally, the median health-related SDG index was 56·7 (IQR 31·9–66·8) in 2016 and country-level performance markedly varied, with Singapore (86·8, 95% uncertainty interval 84·6–88·9), Iceland (86·0, 84·1–87·6), and Sweden (85·6, 81·8–87·8) having the highest levels in 2016 and Afghanistan (10·9, 9·6–11·9), the Central African Republic (11·0, 8·8–13·8), and Somalia (11·3, 9·5–13·1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2–8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past.
GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs’ broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.
Bill & Melinda Gates Foundation.

Measuring global health: motivation and evolution of the Global Burden of Disease Study

The Lancet
Sep 16, 2017 Volume 390 Number 10100 p1083-1464

Measuring global health: motivation and evolution of the Global Burden of Disease Study
Christopher J L Murray, Alan D Lopez
People everywhere, but particularly those charged with improving the health of populations, want to know whether human beings are living longer and getting healthier. There is an inherent fascination with quantification of levels and patterns of disease, the emergence of new threats to health, and the comparative importance of various risk factors for the health of populations. Before the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) was initiated, no comprehensive assessments of human health were done.


PLoS Neglected Tropical Diseases (Accessed 16 September 2017)

PLoS Neglected Tropical Diseases
(Accessed 16 September 2017)

Global health policy and neglected tropical diseases: Then, now, and in the years to come
Thomas Fürst, Paola Salari, Laura Monzón Llamas, Peter Steinmann, Christopher Fitzpatrick, Fabrizio Tediosi
Viewpoints | published 14 Sep 2017 PLOS Neglected Tropical Diseases

Research Article
Cost-effectiveness of a national enterovirus 71 vaccination program in China
Within the price range of current routine vaccines paid by the government, a national EV71 vaccination program would be cost-saving or highly cost-effective to prevent EV71 related morbidity, mortality, and use of health service among children younger than five years in China. Policy makers should consider including EV71 vaccination as part of China’s routine childhood immunization schedule.
Wenjun Wang, Jianwen Song, Jingjing Wang, Yaping Li, Huiling Deng, Mei Li, Ning Gao, Song Zhai, Shuangsuo Dang, Xin Zhang, Xiaoli Jia
| published 11 Sep 2017 PLOS Neglected Tropical Diseases

Rapid qualitative research methods during complex health emergencies: A systematic review of the literature

Social Science & Medicine
Volume 189, Pages 1-170 (September 2017)
Review article
Rapid qualitative research methods during complex health emergencies: A systematic review of the literature
Review Article
Pages 63-75
Ginger A. Johnson, Cecilia Vindrola-Padros
The 2013–2016 Ebola outbreak in West Africa highlighted both the successes and limitations of social science contributions to emergency response operations. An important limitation was the rapid and effective communication of study findings. A systematic review was carried out to explore how rapid qualitative methods have been used during global heath emergencies to understand which methods are commonly used, how they are applied, and the difficulties faced by social science researchers in the field. We also asses their value and benefit for health emergencies. The review findings are used to propose recommendations for qualitative research in this context. Peer-reviewed articles and grey literature were identified through six online databases. An initial search was carried out in July 2016 and updated in February 2017. The PRISMA checklist was used to guide the reporting of methods and findings. The articles were assessed for quality using the MMAT and AACODS checklist. From an initial search yielding 1444 articles, 22 articles met the criteria for inclusion. Thirteen of the articles were qualitative studies and nine used a mixed-methods design. The purpose of the rapid studies included: the identification of causes of the outbreak, and assessment of infrastructure, control strategies, health needs and health facility use. The studies varied in duration (from 4 days to 1 month). The main limitations identified by the authors were: the low quality of the collected data, small sample sizes, and little time for cross-checking facts with other data sources to reduce bias. Rapid qualitative methods were seen as beneficial in highlighting context-specific issues that need to be addressed locally, population-level behaviors influencing health service use, and organizational challenges in response planning and implementation. Recommendations for carrying out rapid qualitative research in this context included the early designation of community leaders as a point of contact, early and continuous sharing of findings, and development of recommendations with local policy makers and practitioners.

Communicable and non-communicable disease risks at the Grand Magal of Touba: The largest mass gathering in Senegal

Travel Medicine and Infectious Diseases
July-August, 2017 Volume 18

Articles in Press
Communicable and non-communicable disease risks at the Grand Magal of Touba: The largest mass gathering in Senegal
Cheikh Sokhna, Balla Mbacké Mboup, Papa Gallo Sow, Gaoussou Camara, Mamadou Dieng, Mbaké Sylla, Lamine Gueye, Doudou Sow, Aldiouma Diallo, Philippe Parola, Didier Raoult, Philippe Gautret
Publication stage: In Press Corrected Proo
An estimated 4–5 million individuals gather each year in the holy city of Touba, Senegal during the Grand Magal religious pilgrimage. Pilgrims come from across Senegal and the surrounding countries, as well as from countries outside Africa. It is the largest mass gathering (MG) of the Mouride community and the largest Muslim religious MG in West Africa.

Pneumococcal vaccination: Direct and herd effect on carriage of vaccine types and antibiotic resistance in Icelandic children

Volume 35, Issue 39, Pages 5225-5308 (18 September 2017)

Original Research Article
Pneumococcal vaccination: Direct and herd effect on carriage of vaccine types and antibiotic resistance in Icelandic children
Pages 5242-5248
Samuel Sigurdsson et al…
Since the introduction of pneumococcal conjugate vaccines, vaccine type pneumococcal carriage and disease has decreased world-wide. The aim was to monitor changes in the nasopharyngeal carriage of pneumococci, the distribution of serotypes and antimicrobial resistance in children before and after initiation of the 10-valent pneumococcal vaccination in 2011, in a previously unvaccinated population.
Repeated cross-sectional study at 15 day-care centres in greater Reykjavik area. Nasopharyngeal swabs were collected yearly in March from 2009 to 2015. The swabs were selectively cultured for pneumococci, which were serotyped using latex agglutination and/or PCR and antimicrobial susceptibility determined. Two independent studies were conducted.
In study 1, on total impact, isolates from children aged <4 years were included. The vaccine-eligible-cohort (birth-years: 2011–2013, sampled in 2013–2015) was compared with children at the same age born in 2005–2010 and sampled in 2009–2012. In study 2 on herd effect, isolates from older non-vaccine-eligible children (3.5–6.3 years) were compared for the periods before and after the vaccination (2009–2011 vs 2013–2015. Vaccine impact was determined using 1-odds-ratio.
Following vaccination, the vaccine impact on vaccine type acquisition was 94% (95% CI: 91–96%) in study 1 and 56% (95% CI: 44–65%) in study 2. The impact on serotype 6 A was 33% (95% CI: −9%; 59%) in study 1 and 42% (95% CI: 10–63%) in study 2 with minimal effect on 19A. The non-vaccine serotypes/groups 6C, 11, 15 and 23B were the most common serotypes/groups after vaccination. Isolates from the vaccine-eligible-cohort had lower penicillin MICs, less resistance to erythromycin and co-trimoxazole and less multi resistance than isolates from the control-group.
The efficacy of the vaccination on vaccine serotypes was high, and a milder effect on vaccine-associated-serotype 6A was observed for the vaccine-eligible-cohort. There was a significant herd effect on vaccine types in older non-vaccine-eligible children. Overall antimicrobial non-susceptibility was reduced.

Vaccination coverage among social and healthcare workers in ten countries of Samu-social international sites

Volume 35, Issue 39, Pages 5225-5308 (18 September 2017)

Vaccination coverage among social and healthcare workers in ten countries of Samu-social international sites
Original Research Article
Pages 5291-5296
Esaie Marshall, Dominique Salmon, Nadia Bousfiha, Yacouba Togola, François Ouedraogo, Maud Santantonio, Coumba Khadidja Dieng, Suzanne Tartière, Xavier Emmanuelli
We aim to determine the vaccination coverage of social and healthcare workers in International sites of Samusocial, providing emergency care to homeless people, and to assess factors associated with having received necessary doses at adulthood.
Data on immunization coverage of social and healthcare workers were provided by a cross-sectional survey, conducted from February to April 2015 among 252 Samusocial workers in 10 countries. Vaccination status and characteristics of participants were collected through a self-administered questionnaire. Prevalence rate ratio (PRR) of vaccination status was calculated using Poisson regression models.
Among 252 Samusocial social and health workers who felt a questionnaire, median age was 39 years, 42.1% were female, 88.9% were in contact with homeless beneficiaries (19.1% health workers). Overall, 90.1% of Samusocial staff felt adult vaccinations was useful and 70.2% wished to receive booster doses in future. Vaccination coverage at adulthood was satisfactory for diphtheria and poliomyelitis (96%), but low for influenza (20.8%), meningococcus (50.5%), hepatitis B (56.3%), yellow fever (58.1%), measles (81.3%) and pertussis (90.7%). The main reasons for not having received vaccination booster doses were forgetting the dates of booster doses (38.4%) and not having received the information (13.5%). In adjusted analysis, prevalence of up-to-date for vaccination schedule was 35% higher among health workers than among social workers (aPRR=1.35, 95%CI: 1.01–1.82, P=0.05) and was 56% higher among workers who had a documentary evidence of vaccination than in those who did not (aPRR=1.56, 95%CI: 1.19–2.02, P=0.001).
The Samusocial International workers vaccine coverage at adulthood was insufficient and disparate by region. It is necessary to strengthen the outreach of this staff and increase immunization policy for hepatitis B, diphtheria, tetanus, and measles, as well as for yellow fever, rabies and meningococcal ACYW135 vaccines in at risk regions.