Emerging Infectious Diseases
Volume 23, Number 10—October 2017
http://wwwnc.cdc.gov/eid/

Research
Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India PDF Version [PDF – 1.19 MB – 7 pages]
Mohanty et al.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 7 October 2017]

Research
A scoping review of mentorship of health personnel to improve the quality of health care in low and middle-income countries
This review identifies a paucity of evidence of mentorship in this context however, current evidence supports the assertion that effective mentorship contributes to the improvement of certain quality of care outcomes. The features of successful mentorship interventions are outlined and the implications are discussed in the context of existing evidence.
Patricia Schwerdtle, Julia Morphet and Helen Hall
Published on: 3 October 2017

Health Policy and Planning
Volume 32, Issue 9   November 2017
http://heapol.oxfordjournals.org/content/current

Original Articles
Institutionalizing and sustaining social change in health systems: the case of Uganda
Jerald Hage; Joseph J Valadez
Health Policy and Planning, Volume 32, Issue 9, 1 November 2017, Pages 1248–1255, https://doi.org/10.1093/heapol/czx066

Large-scale delivery of seasonal malaria chemoprevention to children under 10 in Senegal: an economic analysis
Catherine Pitt; Mouhamed Ndiaye; Lesong Conteh; Ousmane Sy; El Hadj Ba …
Health Policy and Planning, Volume 32, Issue 9, 1 November 2017, Pages 1256–1266, https://doi.org/10.1093/heapol/czx084

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 7 October 2017]

Research
Generating demand for and use of evaluation evidence in government health ministries: lessons from a pilot programme in Uganda and Zambia
The Demand-Driven Evaluations for Decisions (3DE) programme was piloted in Zambia and Uganda in 2012–2015. It aimed to answer evaluative questions raised by policymakers in Ministries of Health, rapidly and wi…
Sophie Witter, Andrew Kardan, Molly Scott, Lucie Moore and Louise Shaxson
Health Research Policy and Systems 2017 15:86
Published on: 2 October 2017

Opinion
Knowledge mobilisation for policy development: implementing systems approaches through participatory dynamic simulation modelling
Evidence-based decision-making is an important foundation for health policy and service planning decisions, yet there remain challenges in ensuring that the many forms of available evidence are considered when…
Louise Freebairn, Lucie Rychetnik, Jo-An Atkinson, Paul Kelly, Geoff McDonnell, Nick Roberts, Christine Whittall and Sally Redman
Health Research Policy and Systems 2017 15:83
Published on: 2 October 2017

Review
How do we define the policy impact of public health research? A systematic review
In order to understand and measure the policy impact of research we need a definition of research impact that is suited to the task. This article systematically reviewed both peer-reviewed and grey literature …
Kristel Alla, Wayne D. Hall, Harvey A. Whiteford, Brian W. Head and Carla S. Meurk
Health Research Policy and Systems 2017 15:84
Published on: 2 October 2017
 

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 7 October 2017]

Study Protocol
Study roadmap for high-throughput development of easy to use and affordable biomarkers as diagnostics for tropical diseases: a focus on malaria and schistosomiasis
Kokouvi Kassegne, Ting Zhang, Shen-Bo Chen, Bin Xu, Zhi-Sheng Dang, Wang-Ping Deng, Eniola Michael Abe, Hai-Mo Shen, Wei Hu, Takele Geressu Guyo, Solomon Nwaka, Jun-Hu Chen and Xiao-Nong Zhou
Published on: 2 October 2017

International Journal of Human Rights in Healthcare
Vol. 10 Issue: 4  2017
http://www.emeraldinsight.com/toc/ijhrh/10/4

Papers
Medical translation: the neglected human right
Bradley Dalton-Oates (pp. 228 – 238)
Originality/value
This paper fulfills a need to examine medical translation in the context of other types of translation under International Law. This paper fulfills a need to study how the lack of specific International Legislation guaranteeing the right to medical translation has implications for national/regional legislators, medical providers, and patients alike. This paper fulfills a need to discuss the legal remedies available to patients who have suffered adverse medical events after not being able to communicate with their medical provider.

Evolution of opportunities for early childhood development in Arab countries
Vladimir Hlasny (pp. 256 – 276)
Purpose
The purpose of this paper is to evaluate opportunities for early childhood development (ECD) regarding children’s prenatal care, access to nutrition, health, parental care and cognitive-developmental activities, in 33 surveys from 13 countries. A total of 15 indicators for children’s opportunities are assessed including their typical level, inequality across demographic groups, and factors responsible.

JAMA
October 3, 2017, Vol 318, No. 13, Pages 1201-1294
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Research Integrity, Academic Promotion, and Attribution of Authorship and Nonauthor Contributions
Spyros D. Mentzelopoulos, MD, PhD; Spyros G. Zakynthinos, MD, PhD
JAMA. 2017;318(13):1221-1222. doi:10.1001/jama.2017.11790
This Viewpoint discusses the importance of research authorship for academic promotion and proposes revision of research integrity codes to define nonauthor contributions and distinguish nonauthor from author contributions to discourage awarding of authorship to nonauthor collaborators.

Editorial
Trying to Improve Sepsis Care in Low-Resource Settings
Flavia R. Machado, MD, PhD; Derek C. Angus, MD, MPH
Abstract
Earlier this year, the World Health Organization recognized sepsis as a global health problem, responsible for millions of preventable deaths every year, and adopted a resolution targeting the prevention, diagnosis, and treatment of sepsis, especially in low- and middle-income countries.1 Although most sepsis cases are assumed to occur in low- and middle-income countries, nearly all research on both the epidemiology of sepsis and optimal treatment comes from high-income countries.

Research Letter
Incidence of Measles in the United States, 2001-2015
Nakia S. Clemmons, MPH; Gregory S. Wallace, MD, MPH; Manisha Patel, MD, MS; et al.
JAMA. 2017;318(13):1279-1281. doi:10.1001/jama.2017.9984
This study uses Centers for Disease Control and Prevention data to characterize trends in the incidence of measles among US residents from 2001 to 2015.

JAMA Pediatrics
October 2017, Vol 171, No. 10, Pages 927-1024
http://archpedi.jamanetwork.com/issue.aspx

Viewpoint
Communicating About Vaccines in a Fact-Resistant World
Saad B. Omer, MBBS, MPH, PhD; Avnika B. Amin, MSPH; Rupali J. Limaye, PhD
JAMA Pediatr. 2017;171(10):929-930. doi:10.1001/jamapediatrics.2017.2219
This Viewpoint discusses ways to guide productive vaccine discussions in the clinic.

Editorial
Using Disease Epidemiology to Optimize Immunization Schedules
Cindy M. Weinbaum, MD, MPH; Walter A. Orenstein, MD
JAMA Pediatr. 2017;171(10):944-945. doi:10.1001/jamapediatrics.2017.2375
Abstract
Macartney et al1 report in this issue of JAMA Pediatrics on the safety of using combination measles-mumps-rubella-varicella (MMRV) vaccine as the second dose of measles-mumps-rubella (MMR) vaccine and sole dose of varicella vaccine in Australia, and the effect of this policy on national vaccine coverage. They found that there was no increase in febrile seizures when MMRV is administered in the second year of life approximately 6 months after a first dose of MMR and that on-time vaccination increased with use of MMRV. Are these findings an indication that the timing and use of combination MMRV vaccine should be reconsidered for the United States?

Original Investigation
Evaluation of Combination Measles-Mumps-Rubella-Varicella Vaccine Introduction in Australia
Kristine Macartney, MD; Heather F. Gidding, PhD; Lieu Trinh, PhD; et al.
JAMA Pediatr. 2017;171(10):992-998. doi:10.1001/jamapediatrics.2017.1965
This population-based study examines the incidence of febrile seizures associated with combination measles-mumps-rubella-varicella vaccine in toddlers.
 

Journal of Medical Internet Research
Vol 19, No 10 (2017): October
http://www.jmir.org/2017/10

mHealth
Using Mobile Phones to Improve Vaccination Uptake in 21 Low- and Middle-Income Countries: Systematic Review
JMIR Mhealth Uhealth 2017 (Oct 04); 5(10):e148
Clare Oliver-Williams, Elizabeth Brown, Sara Devereux, Cassandra Fairhead, Isaac Holeman
ABSTRACT
Background: The benefits of vaccination have been comprehensively proven; however, disparities in coverage persist because of poor health system management, limited resources, and parental knowledge and attitudes. Evidence suggests that health interventions that engage local parties in communication strategies improve vaccination uptake. As mobile technology is widely used to improve health communication, mobile health (mHealth) interventions might be used to increase coverage.
Objective: The aim of this study was to conduct a systematic review of the available literature on the use of mHealth to improve vaccination in low- and middle-income countries with large numbers of unvaccinated children.
Methods: In February 2017, MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, and Web of Science, as well as three health organization websites—Communication Initiative Network, TechNet-21, and PATH—were searched to identify mHealth intervention studies on vaccination uptake in 21 countries.
Results: Ten peer-reviewed studies and 11 studies from white or gray literature were included. Nine took place in India, three in Pakistan, two each in Malawi and Nigeria, and one each in Bangladesh, Zambia, Zimbabwe, and Kenya. Ten peer-reviewed studies and 7 white or gray studies demonstrated improved vaccination uptake after interventions, including appointment reminders, mobile phone apps, and prerecorded messages.
Conclusions: Although the potential for mHealth interventions to improve vaccination coverage seems clear, the evidence for such interventions is not. The dearth of studies in countries facing the greatest barriers to immunization impedes the prospects for evidence-based policy and practice in these settings.

The Lancet
Oct 07, 2017 Volume 390 Number 10103 p1623-1714   e24
http://www.thelancet.com/journals/lancet/issue/current

Editorial
Cholera: ending a 50-year pandemic
The Lancet
Published: 07 October 2017
[See Cholera above for full text]

Comment
In search of global governance for research in epidemics
David H Peters, Gerald T Keusch, Janice Cooper, Sheila Davis, Jens Lundgren, Michelle M Mello, Olayemi Omatade, Fred Wabwire-Mangen, Keith P W J McAdam
Siummary
The west African epidemic of Ebola virus disease in 2014–15 became a major tragedy because the global system under the International Health Regulations and the governance of research related to epidemics both failed to function as needed. Research started too late and yielded only one vaccine candidate with probable effectiveness.1 Today, the international framework for epidemic preparedness and response still does not include a role for research.2 Future cross-national epidemics and Public Health Emergencies of International Concern are likely to involve pathogens that have no proven effective vaccines or specific therapeutics.

Nature 
Volume 550 Number 7674 pp7-150  5 October 2017
http://www.nature.com/nature/current_issue.html

World View
Make plans to eliminate cholera outbreaks
Governments must stop denying the occurrence of cholera and unite in long-term prevention strategies, says Anita Zaidi.

Comment
Scientists have most impact when they’re free to move
An analysis of researchers’ global mobility reveals that limiting the circulation of scholars will damage the scientific system, say Cassidy R. Sugimoto and colleagues.

Open countries have strong science
Caroline S. Wagner and Koen Jonkers find a clear correlation between a nation’s scientific influence and the links it fosters with foreign researchers.

Review
Expanding and reprogramming the genetic code
Jason W. Chin
A review of the recent developments in reprogramming the genetic code of cells and organisms to include non-canonical amino acids in precisely engineered proteins.

Articles
Massively parallel de novo protein design for targeted therapeutics
Aaron Chevalier,
Daniel-Adriano Silva, Gabriel J. Rocklin, errick R. Hicks, Renan Vergara+ et al.
A massively parallel computational and experimental approach for de novo designing and screening small hyperstable proteins targeting influenza haemagglutinin and botulinum neurotoxin B identifies new therapeutic candidates more robust than traditional antibody therapies.

New England Journal of Medicine
October 5, 2017  Vol. 377 No. 14
http://www.nejm.org/toc/nejm/medical-journal

Review Articles
The Changing Face of Clinical Trials: Challenges in the Design and Interpretation of Noninferiority Trials
Mauri and R.B. D’Agostino, Sr.,
[Initial text]
Noninferiority clinical trials have become a major tool for the evaluation of drugs, devices, biologics, and other medical treatments. Treatment with placebo or with a no-treatment control in a study is not ethical when an effective treatment has already been established. Effective medical treatments exist for many medical conditions and are the relevant bar to be surpassed by a new treatment. Although some new treatments offer greater efficacy, others may promise greater safety or convenience, or less expense, while providing similar efficacy. The concept of a good substitute was the original rationale for the design of noninferiority trials (i.e., to evaluate a new treatment for efficacy similar to that of an established treatment). Recently, noninferiority trial methods have also been applied in evaluating whether an effective treatment is safe enough. The number of randomized trials assessing noninferiority increased by a factor of 6 in a decade — in 2005, just under 100 trials were listed in MEDLINE under the general rubric of “noninferiority,” whereas in 2015, there were almost 600 such trials. These trials span multiple medical and surgical disciplines and diverse treatment strategies.
In this article, we provide a framework for considering the features, including pitfalls, of noninferiority studies. We use cardiovascular treatment trials as examples, although noninferiority trials can be conducted in many fields. These trials include studies designed for regulatory approval of new therapies and trials designed to compare established treatments. In addition, we consider the application of noninferiority concepts and design to emerging areas of clinical investigation. The term “placebo” is used to denote either a true placebo or a no-treatment control in situations in which a true placebo is not available…

Pediatrics
October 2017, VOLUME 140 / ISSUE 4
http://pediatrics.aappublications.org/content/140/4?current-issue=y

State-of-the-Art Review Article
Partnerships for Global Child Health
Andrew P. Steenhoff, Heather L. Crouse, Heather Lukolyo, Charles P. Larson, Cynthia Howard, Loeto Mazhani, Suzinne Pak-Gorstein, Michelle L. Niescierenko, Philippa Musoke, Roseda Marshall, Miguel A. Soto, Sabrina M. Butteris, Maneesh Batra, on behalf of the GH Task Force of the American Board of Pediatrics
Pediatrics Oct 2017, 140 (4) e20163823; DOI: 10.1542/peds.2016-3823
This literature-based expert consensus review presents the definition, scope, genesis, evolution, and models of GCH partnerships, including benefits and challenges, guiding principles and core practices.
Abstract
Child mortality remains a global health challenge and has resulted in demand for expanding the global child health (GCH) workforce over the last 3 decades. Institutional partnerships are the cornerstone of sustainable education, research, clinical service, and advocacy for GCH. When successful, partnerships can become self-sustaining and support development of much-needed training programs in resource-constrained settings. Conversely, poorly conceptualized, constructed, or maintained partnerships may inadvertently contribute to the deterioration of health systems. In this comprehensive, literature-based, expert consensus review we present a definition of partnerships for GCH, review their genesis, evolution, and scope, describe participating organizations, and highlight benefits and challenges associated with GCH partnerships. Additionally, we suggest a framework for applying sound ethical and public health principles for GCH that includes 7 guiding principles and 4 core practices along with a structure for evaluating GCH partnerships. Finally, we highlight current knowledge gaps to stimulate further work in these areas. With awareness of the potential benefits and challenges of GCH partnerships, as well as shared dedication to guiding principles and core practices, GCH partnerships hold vast potential to positively impact child health.

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 7 October 2017]

The Effect of Armed Conflict on the Utilization of Maternal Health Services in Uganda: A Population-based Study
October 3, 2017 · Research Article
Introduction: Maternal mortality rates can be adversely affected by armed conflict, implying a greater level of vulnerability among women, and is often linked to the lack of or limited access to maternal healthcare during conflict. Previous research in Uganda has shown that armed conflict negatively impacts women’s utilization of maternal healthcare services for a multitude of reasons at the individual, health-system and political levels.
Methods: This study compared aggregated Demographic and Health Surveys data from 13 districts in Northern Uganda, a conflict-affected region, with data from the rest of the country, for the use of maternal healthcare services for the years 1988, 1995, 2000, 2006 and 2011, using statistical analyses and logistic regression. Specific indicators for maternal healthcare utilization included contraceptive use, antenatal care, skilled assistance at birth and institutional delivery.
Results: Use of contraception and institutional deliveries among women in Northern Uganda was significantly lower compared to the rest of the country. However, skilled assistance at birth among women in Northern Uganda was significantly higher.
Conclusions: The findings in this study show that armed conflict can have a negative impact on aspects of maternal healthcare such as contraceptive use and institutional deliveries; however, other indicators such as skilled assistance at birth were seen to be better among conflict-affected populations. This reiterates the complex nature of armed conflict and the interplay of different factors such as conflict intensity, existing health systems and services, and humanitarian interventions that could influence maternal healthcare utilization.

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
[Accessed 7 October 2017]

Assessing the Prevalence of Risk Factors for Neglected Tropical Diseases in Brazos County, Texas
October 4, 2017 · Research Article
Introduction: Although more than one billion people live at risk of neglected tropical diseases (NTDs) in areas of Asia, sub-Saharan Africa, and Latin America, the degree to which they burden countries like the U.S. is unclear. Even though many NTDs such as dengue, leishmaniasis, and Chagas disease are typically not endemic to the U.S., the possibility of their emergence is noteworthy, especially in states like Texas with high levels of poverty, large immigrant populations, geographic proximity to endemic areas, and a climate amenable to the vectors for these diseases. Despite the health threat that emerging NTDs may pose, little is known about the prevalence of risk factors for NTDs in the U.S.
Methods: We tested the Community Assessment for Public Health Emergency Response (CASPER) method to assess the prevalence of risk factors for NTDs in Brazos County, Texas.
Results: We found relatively low prevalence of risk factors related to travel (5.2% of respondents visited an endemic area in the previous 3 months); however, few respondents reported adherence to mosquito prevention, such as wearing long sleeves and long pants (14.1%, 95% CI: 13.9,14.4) and repellant containing DEET (13.5%, 95% CI: 13.2,13.7). Between 5.4% and 35.8% of respondents had a visible container (e.g., pet water dishes, flower pots, bird baths) that could support mosquito breeding.
Discussion: CASPER findings present public health authorities with potential avenues for implementing health education and other interventions aimed at reducing exposure to risk factors for NTDs among Texas residents.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 7 October 2017)

Safety and immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccine in adults and children in Lambaréné, Gabon: A phase I randomised trial
Selidji T. Agnandji, José F. Fernandes, Emmanuel B. Bache, Régis M. Obiang Mba, Jessica S. Brosnahan, Lumeka Kabwende, Paul Pitzinger, Pieter Staarink, Marguerite Massinga-Loembe, Verena Krähling, Nadine Biedenkopf, Sarah Katharina Fehling, Thomas Strecker, David J. Clark, Henry M. Staines, Jay W. Hooper, Peter Silvera, Vasee Moorthy, Marie-Paule Kieny, Akim A. Adegnika, Martin P. Grobusch, Stephan Becker, Michael Ramharter, Benjamin Mordmüller, Bertrand Lell, VEBCON Consortium , Sanjeev Krishna, Peter G. Kremsner
Research Article | published 06 Oct 2017 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002402
Author summary
Why was this study done?
:: The worst Ebola outbreak in history ended in 2016 after killing about 11,323 individuals and infecting 28,650 individuals worldwide.
:: This public health emergency accelerated efforts to develop a vaccine as part of the strategy to contain the outbreak.
:: Two vaccine candidates with preclinical safety and efficacy data obtained from non-human primates entered human trials.
:: The one used in our study is the rVSVΔG-ZEBOV-GP vaccine, containing a non-infectious portion of a gene from the Zaire Ebola virus introduced into a recombinant vesicular stomatitis virus (rVSV), which itself is unlikely to cause disease in humans.
:: To generate data for deployment of the vaccine, several dose-ranging phase I trials were initiated across centres in the United States, Europe, and Africa.

What did the researchers do and find?
:: We allocated 115 adults aged 18–50 years to receive 1 of the 5 doses used in the trial. A single intramuscular dose ranging from 3 × 103 to 2 × 107 plaque-forming units (PFU) was given, and participants were followed up until 6 months post-injection for safety and immunogenicity.
: Preliminary results led to the selection of the 2 × 107 PFU dose for further development.
We also included 20 adolescents (13–17 years) and 20 children (6–12 years), who received the 2 × 107 PFU dose and were followed-up in a similar way as the adults.
:: No vaccine-related serious or severe adverse event was reported by any participant.
:: A high proportion of our population—even though residing in an area with no history of Ebola outbreak—had pre-vaccination antibodies specific to the Zaire Ebola virus.
:: In adults, antibodies persisted up to 6 months post-injection at doses of 3 × 105 to 2 × 107 PFU.
:: In participants with baseline antibodies, a dose as low as 3 × 104 PFU could induce high antibody titres up to day 56 post-injection.
: Higher vaccine replication, leading to shedding of the vaccine in saliva and urine, occurred in children and adolescents.

What do these findings mean?
:: Our results and other findings show that this vaccine is safe and immunogenic.
:: Lower vaccine doses may be needed in paediatric populations as well as for boosting after primary vaccination or naturally acquired immunity.

When cost-effective interventions are unaffordable: Integrating cost-effectiveness and budget impact in priority setting for global health programs
Alyssa Bilinski, Peter Neumann, Joshua Cohen, Teja Thorat, Katherine McDaniel, Joshua A. Salomon
Essay | published 02 Oct 2017 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002397
Summary points
:: Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue.
:: Budget impact analysis (BIA) describes an intervention’s short-term costs and savings from the payer’s perspective.
:: Researchers should report BIA alongside cost-effectiveness analysis (CEA). When CEA and BIA lead to different conclusions, researchers should explain why.
:: Policymakers should recognize that not all cost-effective interventions are affordable and interpret information about cost-effectiveness in the context of their budget and other available funding sources.
:: Both cost-effectiveness and affordability should be reflected in the design of essential health service packages.
 
 

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 7 October 2017)

The cost-effectiveness of an eradication programme in the end game: Evidence from guinea worm disease
Christopher Fitzpatrick, Dieudonné P. Sankara, Junerlyn Farah Agua, Lakshmi Jonnalagedda, Filippo Rumi, Adam Weiss, Matthew Braden, Ernesto Ruiz-Tiben, Nicole Kruse, Kate Braband, Gautam Biswas
Research Article | published 05 Oct 2017 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0005922

Hepatitis B virus infection as a neglected tropical disease
Geraldine A. O’Hara, Anna L. McNaughton, Tongai Maponga, Pieter Jooste, Ponsiano Ocama, Roma Chilengi, Jolynne Mokaya, Mitchell I. Liyayi, Tabitha Wachira, David M. Gikungi, Lela Burbridge, Denise O’Donnell, Connie S. Akiror, Derek Sloan, Judith Torimiro, Louis Marie Yindom, Robert Walton, Monique Andersson, Kevin Marsh, Robert Newton, Philippa C. Matthews
Viewpoints | published 05 Oct 2017 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0005842

PLoS One
http://www.plosone.org/

Research Article
Examining word association networks: A cross-country comparison of women’s perceptions of HPV testing and vaccination
Bernd C. Schmid, Jamie Carlson, Günther A. Rezniczek, Jessica Wyllie, Kenneth Jaaback, Filip Vencovsky
| published 05 Oct 2017 PLOS ONE
https://doi.org/10.1371/journal.pone.0185669

Comparison of rubella immunization rates in immigrant and Italian women of childbearing age: Results from the Italian behavioral surveillance system PASSI (2011-2015)
Massimo Fabiani, Gianluigi Ferrante, Valentina Minardi, Cristina Giambi, Flavia Riccardo, Silvia Declich, Maria Masocco
Research Article | published 02 Oct 2017 PLOS ONE
https://doi.org/10.1371/journal.pone.0178122

Risk Analysis
October 2017   Volume 37, Issue 10  Pages 1799–2022
http://onlinelibrary.wiley.com/doi/10.1111/risa.2017.37.issue-9/issuetoc

Perspectives
Bridging the Gap between Social Acceptance and Ethical Acceptability (pages 1817–1827)
Behnam Taebi
Version of Record online: 10 NOV 2016 | DOI: 10.1111/risa.12734

Science         
06 October 2017  Vol 358, Issue 6359
http://www.sciencemag.org/current.dtl

Special Issue: Single-Cell Genomics
Reviews
Single-cell transcriptomics to explore the immune system in health and disease
By Michael J. T. Stubbington, Orit Rozenblatt-Rosen, Aviv Regev, Sarah A. Teichmann
Science06 Oct 2017 : 58-63
Abstract
The immune system varies in cell types, states, and locations. The complex networks, interactions, and responses of immune cells produce diverse cellular ecosystems composed of multiple cell types, accompanied by genetic diversity in antigen receptors. Within this ecosystem, innate and adaptive immune cells maintain and protect tissue function, integrity, and homeostasis upon changes in functional demands and diverse insults. Characterizing this inherent complexity requires studies at single-cell resolution. Recent advances such as massively parallel single-cell RNA sequencing and sophisticated computational methods are catalyzing a revolution in our understanding of immunology. Here we provide an overview of the state of single-cell genomics methods and an outlook on the use of single-cell techniques to decipher the adaptive and innate components of immunity.

Science Translational Medicine
04 October 2017  Vol 9, Issue 410
http://stm.sciencemag.org/

Report
Neutralizing human monoclonal antibodies prevent Zika virus infection in macaques
By Diogo M. Magnani, Thomas F. Rogers, Nathan Beutler, Michael J. Ricciardi, Varian K. Bailey, Lucas Gonzalez-Nieto, Bryan Briney, Devin Sok, Khoa Le, Alexander Strubel, Martin J. Gutman, Núria Pedreño-Lopez, Nathan D. Grubaugh, Cassia G. T. Silveira, Helen S. Maxwell, Aline Domingues, Mauricio A. Martins, David E. Lee, Erica E. Okwuazi, Sherrie Jean, Elizabeth A. Strobert, Ann Chahroudi, Guido Silvestri, Thomas H. Vanderford, Esper G. Kallas, Ronald C. Desrosiers, Myrna C. Bonaldo, Stephen S. Whitehead, Dennis R. Burton, David I. Watkins
Science Translational Medicine04 Oct 2017 Full Access
Neutralizing antibodies prevent Zika infection in nonhuman primates.

Social Science & Medicine
Volume 190, Pages 1-278 (October 2017)
http://www.sciencedirect.com/science/journal/02779536/190?sdc=1

Original Research Article
The Islamification of antiretroviral therapy: Reconciling HIV treatment and religion in northern Nigeria
Original Research Article
Pages 75-82
Jack Ume Tocco
Abstract
Access and adherence to antiretroviral therapy (ART) are essential to HIV treatment success and epidemic control. This article is about how HIV-positive Muslims and providers balance ART with religious tenets and obligations. I conducted 17 months of multi-site ethnographic research between 2007 and 2010, including participant-observation in an urban HIV clinic in Kano, Nigeria and a support group for people living with HIV, as well as in-depth interviews with 30 HIV-positive men and 30 key informants with caregiving, clinical, or policy roles related to HIV/AIDS. Patients migrated from Islamic prophetic medicine to ART when it became more widely available in the mid-2000s through the U.S. PEPFAR program. At the same time, a conceptual shift occurred away from considering HIV immediately curable through spiritual and herbal-based Islamic prophetic medicine toward considering HIV as a chronic infection that requires adherence to daily pill regimens. Hope for a complete cure and encouragement from some Islamic prophetic healers resulted in some patients forgoing ART. Patients and providers adapted biomedical treatment guidelines to minimize disruption to religious practices also considered essential to Muslims’ wellbeing, irrespective of HIV status. Providers discouraged patients on second-line ART from fasting because such patients had fewer treatment options and, often, poorer health. However, patients’ medication adherence was affected by the desire to fulfill fasting obligations and to avoid questions from family and friends unaware of their HIV-positive status. This study is one of few ethnographic accounts of HIV treatment in a Muslim-majority society and contributes to understanding the significance of religion for HIV treatment in northern Nigeria. It has implications for public health programming and clinical approaches to HIV treatment in medically pluralistic Muslim societies.

Tropical Medicine & International Health
October 2017   Volume 22, Issue 10  Pages 1205–1360
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2017.22.issue-10/issuetoc

Reviews
Critical interpretive synthesis of barriers and facilitators to TB treatment in immigrant populations (pages 1206–1222)
Lin and G. J. Melendez-Torres
Version of Record online: 7 SEP 2017 | DOI: 10.1111/tmi.12938
Abstract
Objective
To systematically review studies of TB treatment experiences in immigrant populations, using Critical Interpretive Synthesis (CIS).
Methods
On 26 October 2014, MEDLINE, CINAHL, Embase, LILACS, and PsycINFO were systematically searched. Grey literature and reference lists were hand-searched. Initial papers included were restricted to studies of immigrant patient perspectives; after a model was developed, a second set of papers was included to test the emerging theory.
Results
Of 1761 studies identified in the search, a total of 29 were included in the synthesis. Using those studies, we developed a model that suggested treatment experiences were strongly related to the way both individuals and societies adjusted to immigration (‘acculturation strategies’). Relationships with healthcare workers and immigration policies played particularly significant roles in TB treatment.
Conclusions
This review emphasised the roles of repatriation policy and healthcare workers in forming experiences of TB treatment in immigrant populations.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Conference report
Reaching every child with rotavirus vaccine: Report from the 10th African rotavirus symposium held in Bamako, Mali
Pages 5511-5518
Samba O. Sow, A. Duncan Steele, Jason M. Mwenda, George E. Armah, Kathleen M. Neuzil
Abstract
The Center for Vaccine Development – Mali (CVD – Mali), the World Health Organization’s regional office in Africa (WHO/AFRO), and the CVD at the University of Maryland School of Medicine hosted the 10th African Rotavirus Symposium in Bamako, Mali on 1–2 June 2016. The symposium is coordinated by WHO/AFRO, the Regional Rotavirus Reference Laboratories, and the African Rotavirus Network (ARN), with support from the Bill & Melinda Gates Foundation. The event brings together leading rotavirus researchers, scientists, and policy-makers from across Africa and the world. Over 150 participants, from 31 countries, including 27 in Africa, joined forces to address the theme “Reaching Every Child in Africa with Rotavirus Vaccines.” This symposium, the first in francophone Africa, occurred at an unprecedented time when 33 African countries had introduced rotavirus vaccines into their national immunization programs. The symposium concluded with a Call to Action to introduce rotavirus vaccines in the 21 remaining African countries, to increase access in countries with existing vaccination programs, and to continue surveillance and research on rotavirus and other diarrheal diseases.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Commentary
The eradication of Polio: Have we succeeded?
Pages 5519-5521
Alan R. Hinman

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Reviews
Live-attenuated tetravalent dengue vaccines: The needs and challenges of post-licensure evaluation of vaccine safety and effectiveness
Review Article
Pages 5535-5542
Ole Wichmann, Kirsten Vannice, Edwin J. Asturias, Expedito José de Albuquerque Luna, Ira Longini, Anna Lena Lopez, Peter G. Smith, Hasitha Tissera, In-Kyu Yoon, Joachim Hombach
Abstract
Since December 2015, the first dengue vaccine has been licensed in several Asian and Latin American countries for protection against disease from all four dengue virus serotypes. While the vaccine demonstrated an overall good safety and efficacy profile in clinical trials, some key research questions remain which make risk-benefit-assessment for some populations difficult. As for any new vaccine, several questions, such as very rare adverse events following immunization, duration of vaccine-induced protection and effectiveness when used in public health programs, will be addressed by post-licensure studies and by data from national surveillance systems after the vaccine has been introduced. However, the complexity of dengue epidemiology, pathogenesis and population immunity, as well as some characteristics of the currently licensed vaccine, and potentially also future, live-attenuated dengue vaccines, poses a challenge for evaluation through existing monitoring systems, especially in low and middle-income countries. Most notable are the different efficacies of the currently licensed vaccine by dengue serostatus at time of first vaccination and by dengue virus serotype, as well as the increased risk of dengue hospitalization among young vaccinated children observed three years after the start of vaccination in one of the trials. Currently, it is unknown if the last phenomenon is restricted to younger ages or could affect also seronegative individuals aged 9 years and older, who are included in the group for whom the vaccine has been licensed. In this paper, we summarize scientific and methodological considerations for public health surveillance and targeted post-licensure studies to address some key research questions related to live-attenuated dengue vaccines. Countries intending to introduce a dengue vaccine should assess their capacities to monitor and evaluate the vaccine’s effectiveness and safety and, where appropriate and possible, enhance their surveillance systems accordingly. Targeted studies are needed, especially to better understand the effects of vaccinating seronegative individuals.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Using campaigns to improve perceptions of the value of adult vaccination in the United States: Health communication considerations and insights
Review Article
Pages 5543-5550
Glen J. Nowak, Angela K. Shen, Jason L. Schwartz
Abstract
Vaccines have much relevance and promise for improving adult health in the United States, but to date, overall use and uptake remain far below desired levels. Many adults have not received recommended vaccinations and many healthcare providers do not strongly and actively encourage their use with patients. This has led some public health and medical experts to conclude that adult vaccines are severely undervalued by the U.S. public and healthcare providers and to call for campaigns and communication-based efforts to foster increased appreciation, and in turn, higher adult immunization rates. A narrative integrative review that draws upon the vaccine valuation and health communication literatures is used to develop a framework to guide campaign and communication-based efforts to improve public, provider, and policymakers’ assessment of the value of adult vaccination. The review does this by: (1) distinguishing social psychological value from economic value; (2) identifying the implications of social psychological value considerations for adult vaccination-related communication campaigns; and (3) using five core health communication considerations to illustrate how social psychological notions of value can be integrated into campaigns or communication that are intended to improve adult vaccination value perceptions and assessments, and in turn, motivate greater support for and uptake of recommended adult vaccines.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Assessing care-givers’ satisfaction with child immunisation services in Zambia: Evidence from a national survey
Original Research Article
Pages 5597-5602
Chitalu Miriam Chama-Chiliba, Felix Masiye, Chrispin Mphuka
Abstract
Aim
The main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants.
Methods
This study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5. We used an ordered logistic regression model to analyse the significance of perceived quality of vaccination services, immunisation delivery mode and a range of individual characteristics in predicting care-giver satisfaction.
Results
Findings show that one in five care givers were unsatisfied with the vaccination services that they had received, with rural populations showing a significantly higher level of satisfaction. Poor quality of care, defined by long waiting times, poor quality of communication between health staff and care givers, long distance to vaccination sites, mode of delivery, and personal characteristics were among major factors driving care-giver satisfaction ratings. We also find that receiving a vaccination at outreach mode of delivery was associated with higher odds of greater satisfaction compared to on-facility vaccination services. The odds of satisfaction were lower for respondents living further away from a health facility, which emphasizes the importance of access in seeking vaccination services.
Conclusion
These findings suggest that major improvements in quality of vaccination and service organisation will be needed to increase client satisfaction and service utilisation.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Impact of five years of rotavirus vaccination in Finland – And the associated cost savings in secondary healthcare
Original Research Article
Pages 5611-5617
Tuija Leino, Ulrike Baum, Peter Scott, Jukka Ollgren, Heini Salo
Abstract
Introduction
This study aimed to estimate the impact of the national rotavirus (RV) vaccination programme, starting 2009, on the total hospital-treated acute gastroenteritis (AGE) and severe RV disease burden in Finland during the first five years of the programme. This study also evaluated the costs saved in secondary healthcare by the RV vaccination programme.
Methods
The RV related outcome definitions were based on ICD10 diagnostic codes recorded in the Care Register for Health Care. Incidences of hospitalised and hospital outpatient cases of AGE (A00-A09, R11) and RVGE (A08.0) were compared prior (1999–2005) and after (2010–2014) the start of the programme among children less than five years of age.
Results
The reduction in disease burden in 2014, when all children under five years of age have been eligible for RV vaccination, was 92.9% (95%CI: 91.0%–94.5%) in hospitalised RVGE and 68.5% (66.6%–70.3%) in the total hospitalised AGE among children less than five years of age. For the corresponding hospital outpatient cases, there was a reduction of 91.4% (82.4%–96.6%) in the RVGE incidence, but an increase of 6.3% (2.7%–9.9%) in the AGE incidence. The RV vaccination programme prevented 2206 secondary healthcare AGE cases costing €4.5 million annually. As the RV immunisation costs were €2.3 million, the total net savings just in secondary healthcare costs were €2.2 million, i.e. €33 per vaccinated child.
Discussion
The RV vaccination programme clearly controlled the severe, hospital-treated forms of RVGE. The total disease burden is a more valuable end point than mere specifically diagnosed cases as laboratory confirmation practises usually change after vaccine introduction. The RV vaccination programme annually pays for itself at least two times over.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Evaluating cessation of the type 2 oral polio vaccine by modeling pre- and post-cessation detection rates
Original Research Article
Pages 5674-5681
Steve J. Kroiss, Michael Famulare, Hil Lyons, Kevin A. McCarthy, Laina D. Mercer, Guillaume Chabot-Couture
Abstract
The globally synchronized removal of the attenuated Sabin type 2 strain from the oral polio vaccine (OPV) in April 2016 marked a major change in polio vaccination policy. This change will provide a significant reduction in the burden of vaccine-associated paralytic polio (VAPP), but may increase the risk of circulating vaccine-derived poliovirus (cVDPV2) outbreaks during the transition period. This risk can be monitored by tracking the disappearance of Sabin-like type 2 (SL2) using data from the polio surveillance system. We studied SL2 prevalence in 17 countries in Africa and Asia, from 2010 to 2016 using acute flaccid paralysis surveillance data. We modeled the peak and decay of SL2 prevalence following mass vaccination events using a beta-binomial model for the detection rate, and a Ricker function for the temporal dependence. We found type 2 circulated the longest of all serotypes after a vaccination campaign, but that SL2 prevalence returned to baseline levels in approximately 50 days. Post-cessation model predictions identified 19 anomalous SL2 detections outside of model predictions in Afghanistan, India, Nigeria, Pakistan, and western Africa. Our models established benchmarks for the duration of SL2 detection after OPV2 cessation. As predicted, SL2 detection rates have plummeted, except in Nigeria where OPV2 use continued for some time in response to recent cVDPV2 detections. However, the anomalous SL2 detections suggest specific areas that merit enhanced monitoring for signs of cVDPV2 outbreaks.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Polio immunity and the impact of mass immunization campaigns in the Democratic Republic of the Congo
Original Research Article
Pages 5693-5699
Arend Voorman, Nicole A. Hoff, Reena H. Doshi, Vivian Alfonso, Patrick Mukadi, Jean-Jacques Muyembe-Tamfum, Emile Okitolonda Wemakoy, Ado Bwaka, William Weldon, Sue Gerber, Anne W. Rimoin
Abstract
Background
In order to prevent outbreaks from wild and vaccine-derived poliovirus, maintenance of population immunity in non-endemic countries is critical.
Methods
We estimated population seroprevalence using dried blood spots collected from 4893 children 6–59 months olds in the 2013–2014 Demographic and Health Survey in the Democratic Republic of the Congo (DRC).
Results
Population immunity was 81%, 90%, and 70% for poliovirus types 1, 2, and 3, respectively. Among 6–59-month-old children, 78% reported at least one dose of polio in routine immunization, while only 15% had three doses documented on vaccination cards. All children in the study had been eligible for at least two trivalent oral polio vaccine campaigns at the time of enrollment; additional immunization campaigns seroconverted 5.0%, 14%, and 5.5% of non-immune children per-campaign for types 1, 2, and 3, respectively, averaged over relevant campaigns for each serotype.
Conclusions
Overall polio immunity was high at the time of the study, though pockets of low immunity cannot be ruled out. The DRC still relies on supplementary immunization campaigns, and this report stresses the importance of the quality and coverage of those campaigns over their quantity, as well as the importance of routine immunization.

Vaccine
Volume 35, Issue 42, Pages 5511-5730 (9 October 2017)
www.sciencedirect.com/science/journal/0264410X/35/41?sdc=1

Canadian school-based HPV vaccine programs and policy considerations
Original Research Article
Pages 5700-5707
Gilla K. Shapiro, Juliet Guichon, Margaret Kelaher
Abstract
Background
The National Advisory Committee on Immunization in Canada recommends human papillomavirus (HPV) vaccination for females and males (ages 9–26). In Canada, the HPV vaccine is predominantly administered through publicly funded school-based programs in provinces and territories. This research provides an overview of Canadian provincial and territorial school-based HPV vaccination program administration and vaccination rates, and identifies foreseeable policy considerations.
Methods
We searched the academic and grey literature and contacted administrators of provincial and territorial vaccination programs to compile information regarding HPV vaccine program administration and vaccination rates in Canada’s 13 provincial and territorial jurisdictions.
Results
As of October 2016, all 13 Canadian jurisdictions vaccinate girls, and six jurisdictions include boys in school-based publicly funded HPV vaccination programs. Eleven jurisdictions administer the HPV vaccine in a two-dose schedule. The quadrivalent vaccine (HPV4) has been the vaccine predominantly used in Canada; however, the majority of provinces will likely adopt the nonavalent vaccine in the future. According to available data, vaccination uptake among females ranged between 46.7% and 93.9%, while vaccination uptake among males (in programs with available data to date) ranged between 75.0% and 87.4%.
Conclusions
Future research and innovation will beneficially inform Canadian jurisdictions when considering whether to administer the nonavalent vaccine, whether to implement a two or one-dose vaccination schedule, and how to improve uptake and rates of completion. The usefulness of standardizing methodologies for collecting and reporting HPV vaccination coverage and implementing a national registry were identified as important priorities.

Vaccine: Development and Therapy
https://www.dovepress.com/vaccine-development-and-therapy-archive111
(Accessed 7 October 2017)

Review
The new first-line defense: the potential of nasopharyngeal colonization in vaccine strategies
Chan WY, Cohen JM, Brown JS
Vaccine: Development and Therapy 2016, 6:47-57
Published Date: 17 October 2016

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 7 October 2017)

Open Access
Review
Approaches and Perspectives for Development of African Swine Fever Virus Vaccines
by Marisa Arias, Ana de la Torre, Linda Dixon, Carmina Gallardo, Ferran Jori, Alberto Laddomada, Carlos Martins, R. Michael Parkhouse, Yolanda Revilla, Fernando and Jose-Manuel Rodriguez and Sanchez-Vizcaino
Vaccines 2017, 5(4), 35; doi:10.3390/vaccines5040035 (registering DOI) – 7 October 2017
Abstract
African swine fever (ASF) is a complex disease of swine, caused by a large DNA virus belonging to the family Asfarviridae. The disease shows variable clinical signs, with high case fatality rates, up to 100%, in the acute forms. ASF is currently present in Africa and Europe where it circulates in different scenarios causing a high socio-economic impact. In most affected regions, control has not been effective in part due to lack of a vaccine. The availability of an effective and safe ASFV vaccines would support and enforce control–eradication strategies. Therefore, work leading to the rational development of protective ASF vaccines is a high priority. Several factors have hindered vaccine development, including the complexity of the ASF virus particle and the large number of proteins encoded by its genome. Many of these virus proteins inhibit the host’s immune system thus facilitating virus replication and persistence. We review previous work aimed at understanding ASFV–host interactions, including mechanisms of protective immunity, and approaches for vaccine development. These include live attenuated vaccines, and “subunit” vaccines, based on DNA, proteins, or virus vectors. In the shorter to medium term, live attenuated vaccines are the most promising and best positioned candidates. Gaps and future research directions are evaluated.

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

Journal of Child Health Care
First Published October 2, 2017
Research Article
Parental conceptions of the rotavirus vaccine during implementation in Stockholm: A phenomenographic study
E Sjogren, LS Ask, A Ortqvist, M Asp
Abstract
In 2014, Stockholm became the first Swedish county to introduce the rotavirus vaccine, which is given from as early as six weeks of age. The aim of this study was to describe parental conceptions of rotavirus infection and vaccination during its implementation as part of the child immunization program, as their support is vital for any new vaccine. The study followed a descriptive, qualitative design with a phenomenographic approach. Ten in-depth interviews with parents were conducted in Stockholm County, transcribed and analyzed to describe qualitatively different conceptions of rotavirus infection and vaccination. Four main categories were identified: to vaccinate without doubt, hesitant to vaccinate, risky to vaccinate, and unnecessary to vaccinate. All the parents had in common the desire to protect their children from suffering, either by vaccinating their child in order to avoid rotavirus infection or by not vaccinating their child because of concerns about the side effects. It is important that child health-care professionals understand the variations of conceptions that influence the parents’ decisions and that these conceptions may differ considerably. Individualized parental information about rotavirus infection and vaccination would help to achieve a successful implementation of the vaccination program.

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.
 

BBC
http://www.bbc.co.uk/
Accessed 7 October 2017
School vaccinations ‘cut cervical cancer alerts by 41%’
4 October 2017
The number of young women in Scotland showing early signs of potential cervical cancer has dropped by 41% since a school vaccination programme was introduced, researchers have said.
The University of Aberdeen study looked at women who had received the Human Papilloma Virus (HPV) vaccine.
It found 758 women were referred for further investigation in 2013-2014, down from 1,294 in 2008-2009…

 
 
The Guardian
http://www.guardiannews.com/
Accessed 7 October 2017
Global development
Trump policy set to hinder war on polio in Pakistan
Disease holding on in Pakistan, Afghanistan and Nigeria where there is mistrust of western governments who bankroll the vaccines
29 September 2017
…In Pakistan and Afghanistan, the big obstacle, experts say, is not lack of money to fight it, but mistrust of the western governments who bankroll the vaccines. Now Donald Trump could be about to deepen that mistrust. If the US president makes good on his bellicose threats to take a harder line on Pakistan, he will undoubtedly incite anti-US sentiments, which in the past have led to attacks on polio workers and prompted tribal leaders to ban vaccination campaigns…
 

New York Times
http://www.nytimes.com/
Accessed 7 October 2017
UN: More Should Have Been Done to Fight Cholera in Yemen
By THE ASSOCIATED PRESSOCT. 3, 2017, 1:18 P.M. E.D.T.
GENEVA — The World Health Organization’s emergencies chief says the agency could have acted faster and sent more vaccines to fight a massive, deadly surge of cholera cases in war-battered Yemen this year.
Dr. Peter Salama still expressed optimism that “we are turning (the) corner” on the preventable, water-borne disease that has topped 700,000 suspected cases and caused more than 2,000 deaths this year.
Salama spoke to reporters Tuesday as the U.N. agency and its partners laid out ambitious projects to reduce the number of annual cholera deaths by 90 percent by 2030…
In Yemen, the country’s 2-1/2 war has devastated the health system and public services and put the country on the brink of famine. Yemen had been set to receive a million doses of cholera vaccine over the summer but the government opted not to take them.
Salama said the Yemen government said it didn’t believe that would be enough.
“Could WHO and the cholera-specific partners have scaled up more quickly the case-management work, and could we have tried to mobilize more doses for cholera vaccine given the very limited supply globally of cholera vaccine? I think so — yes,” Salama said…

Washington Post
http://www.washingtonpost.com/
Accessed 7 October 2017
A mother refused to follow a court order to vaccinate her son. Now she’s going to jail.
By Kristine Phillips October 4, 2017
A Michigan woman will spend seven days in jail after she defied a judge’s order to have her 9-year-old son vaccinated.
Rebecca Bredow was sentenced for contempt of court Wednesday, nearly a year after an Oakland County judge ordered her to have her son vaccinated. Bredow had been given until Wednesday to get her son the medically allowed amount of vaccination, which would be up to eight vaccines. But the Detroit area mother, citing her religious beliefs, had refused to do so.
“I’m a passionate mother who cares deeply about my children, their health and their well-being. . . . If my child was forced to be vaccinated, I couldn’t bring myself to do it,” Bredow said during a court hearing, according to the Associated Press.
The jail sentence is the latest in an ongoing custody battle with her ex-husband, James Horne, who wants their son vaccinated and shares joint custody of the child…

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

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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.

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

Milestones :: Perspectives

 
Measles no longer endemic in 79% of the WHO European Region
Copenhagen, 26  September 2017
In the WHO European Region, 42 of 53 countries have interrupted endemic transmission of measles, and 37 countries have interrupted endemic transmission of rubella as of the end of 2016. This was determined by the European Regional Verification Commission for Measles and Rubella Elimination (RVC) at its 6th meeting in June 2017.
“I congratulate each country for fulfilling the commitment to protect its people from measles and rubella and collectively moving the European Region closer to its elimination goal,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “However, we cannot become complacent now. Outbreaks continue to cause unnecessary suffering and loss of life, and routine immunization coverage is decreasing. It is unacceptable that 1 in every 15 children still does not receive the first vaccination dose against measles and rubella on time. We will eliminate these diseases from our Region, but need to be ready to walk the hardest last mile.”…
 
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Serum Institute’s vaccine demonstrates significant efficacy against severe rotavirus gastroenteritis
Indian Government orders the vaccine for use in Universal Immunization Programme
Pune, India (26 September 2017)—Results from a Phase 3 efficacy study in India of the Serum Institute of India Pvt. Ltd.’s rotavirus vaccine BRV-PV (known as ROTASIIL®) were published in the journal Vaccine. The study showed the vaccine to be safe, well tolerated, and to provide significant efficacy against severe rotavirus gastroenteritis. In 2013, an estimated 47,100 rotavirus deaths occurred in India, 22 percent of all rotavirus deaths that occurred globally.

ROTASIIL reduced severe rotavirus diarrhea by more than a third – 39.5 percent over two years. Significantly, the vaccine efficacy was nearly 55 percent against the most severe and potentially life-threatening cases of rotavirus diarrhea, which represent the highest risk of dehydration, hospitalizations, and deaths. The results demonstrated by ROTASIIL in India appear generally comparable to the performance of RotaTeq® and Rotarix® in Bangladesh and in some African countries.

Dr. Rajeev Dhere, executive director of the Serum Institute, under whose leadership this vaccine has been developed, commented, “We are delighted with these results, which indicate that ROTASIIL could save the lives of tens of thousands of children each year in India and, potentially, around the world.”

The international nonprofit PATH partnered with Serum Institute on evaluating this vaccine in the Phase 3 efficacy study. Six study sites across India enrolled 7,500 infants in the trial. ROTASIIL is an oral vaccine administered to infants in a three-dose course at 6, 10, and 14 weeks of age, at the same time as routine vaccinations under India’s Universal Immunization Programme.

The office of the Drugs Controller General of India, through its subject expert committee, reviewed the Phase 3 safety and efficacy results and subsequently inspected Serum Institute’s manufacturing facilities leading to licensure of ROTASIIL in January 2017.

The Government of India has placed an order for 3.8 million doses of ROTASIIL to use in the Universal Immunization Programme, which serves 26 million children. Serum Institute has manufactured the vaccine doses and is awaiting instructions from the Ministry of Health and Family Welfare for their distribution. ROTASIIL will also be available for sale in India’s private market later this year.

Serum Institute is pursuing World Health Organization (WHO) prequalification to make this vaccine available for global procurement. PATH and Serum Institute partnered to conduct a separate Phase 3 study in India to gather additional data required for WHO prequalification; results from that study will be submitted for publication this year.

“This is great news for India,” noted Dr. David Kaslow, PATH’s vice president for Essential Medicines and global head of the Center for Vaccine Innovation and Access. “The results and successful licensure of this rotavirus vaccine is an exciting and encouraging milestone toward the public health goal of improving the supply of affordable rotavirus vaccines, both in India and worldwide.”

Médecins Sans Frontières and Epicentre are also evaluating the efficacy and safety of ROTASIIL in a separate Phase 3 study in Niger. That study is still ongoing, but results from the primary analysis (one year of data) also showed the vaccine to be highly efficacious for the prevention of severe rotavirus diarrhea and to have an excellent safety profile. The efficacy of the vaccine against severe and very severe rotavirus diarrhea in the Niger study was 66.7 percent and 78.8 percent, respectively. These results were published in the New England Journal of Medicine in March 2017.

The ROTASIIL used in the Niger study was stored at less than 25°C and transported for vaccination at ambient temperature, thus bypassing the typically challenging and costly cold-chain requirements that apply to most other vaccines. The ROTASIIL used in the India study was from the same lots of vaccine used in the Niger study.

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Towards a Rabies-Free World as Unparalleled Global Initiative Gets Underway
Global partners announce plan to end human deaths from dog-transmitted rabies by 2030
NEW YORK, Sept. 28, 2017 /PRNewswire/
…World Rabies Day marks the announcement of the biggest global anti-rabies initiative, as the World Health Organization (WHO), the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the UN (FAO) and the Global Alliance for Rabies Control (GARC) reveal an ambitious plan to end human deaths from dog-transmitted rabies by 2030.

The plan — ‘Zero by 30: The Strategic Plan’ — centres on a One Health approach and addresses the disease in a holistic and cross-sectoral manner while highlighting the important role veterinary, health and educational services play in rabies prevention and control.

“The plan ensures support to countries in developing national plans, and provides innovative training and education tools across regional rabies networks,” said Dr. Bernadette Abela-Ridder on behalf of the four partners. “Vaccines are a key component of the global plan and a trigger for national programmes. The United Against Rabies collaboration provides leadership and advocates for resources critical to reaching zero human rabies deaths by 2030.”

‘United against Rabies’ builds on more than ten years of global partnership, research and evidence- building to demonstrate the feasibility of eliminating dog-transmitted rabies. The plan places a magnifying glass on the problem of continued human deaths from rabies and helps to make this a priority disease for key international organizations and governments…
 
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New global initiative will connect the world for better health through digital technology
Digital Square, led by PATH, will align multi-sector investments into scalable solutions that strengthen national digital health systems
Washington, DC, September 28, 2017—Global Innovation Week, an annual gathering of the international development community, kicked off today with a series of institutional commitments to support innovation. This evening at USAID, Dr. David Fleming, PATH’s vice president for Public Health, delivered PATH’s pledge to advance a new type of funding model that maximizes the impact of every dollar spent on digital technology in the global health sector.

“For over a decade, PATH’s Digital Health program has been a leader in the application and use of scalable digital products and services globally and at the country level. We build on that legacy by pledging to encourage co-investment among partners and donors to support countries in seamlessly connecting their digital health systems, sharing better data, and reaching better health outcomes,” said Dr. Fleming.

As a part of this commitment, PATH is pleased to announce Digital Square. The new initiative, comprised of 40+ partner organizations, encourages more efficient investment in digital health technology solutions in low- and middle-income countries through an innovative co-investment model. “Co-investment is a simple but powerful concept. Development dollars are scarce; by coordinating them, we can maximize the impact of our financial investments,” said Dykki Settle, Director of Digital Health at PATH.

The initiative offers a platform for individuals and organizations to confidently coordinate their funding and technical expertise into a suite of proven, adaptable digital health technologies. These solutions can be scaled across an entire country, and even between countries. “This alignment of donors and partners to fund proven technology solutions – that we know can scale – is what sets us apart,” said Digital Square Director Lesley-Anne Long.

Digital Square also helps to support countries to develop the skills they need at all levels—from national government leaders to local healthcare workers—to bring these technologies to scale. Digital Square is a USAID program designed and funded in partnership with the Bill & Melinda Gates Foundation.

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Cholera
 
Yemen  eDEWS Cholera Response Daily Epidemiological Update [EN/AR] 29 Sep 2017
Suspected Cases:       753,098
Associated Deaths:      2,122
Case Fatality Rate        0.28%
Governates affected:      96%
Districts affected:           91%
 
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900,000 vaccines ‘en route’ to Cox’s Bazar to prevent cholera
Oral cholera vaccine will protect Rohingya refugees seeking shelter in Bangladesh as well as the resident population
Cox’s Bazar, Bangladesh, 29 September 2017 – The International Coordinating Group (ICG) on Vaccine Provision will release 900,000 doses of the Oral Cholera Vaccine (OCV) from the global stockpile to prevent the spread of cholera among recently arrived vulnerable populations and host communities in areas around Cox’s Bazar.
The Government of Bangladesh made the request to the ICG on 27 September, and the approval was granted in 24 hours by the coordinating mechanism that brings together WHO, UNICEF, Médecins Sans Frontières (MSF), and the International Federation of the Red Cross (IFRC).
ICG partners – with support from Gavi, the Vaccine Alliance – will deliver 900,000 doses of Oral Cholera Vaccine to Bangladesh within two weeks for an immunisation campaign due to start in October.
“This is a precautionary step to avoid a preventable cholera outbreak,” said Dr. Abul Kalam Azad, Director General of Health Services at the Bangladesh Ministry of Health and Family Welfare. “We appreciate the support and speed of partners in delivering on this urgent request, and we look forward to receiving and using the vaccines.”
More than half a million people have crossed from Myanmar to Bangladesh since 25 August following violence in Rakhine State.
Many are crowded into camps or temporary settlements with challenging access to clean water     and sanitation amid heavy rains; this increases the risk of vector and waterborne diseases such as cholera.
“We are doing everything we can to prevent an outbreak, including pre-positioning supplies, implementing disease surveillance and monitoring water quality,” said Dr. Navaratnasamy Paranietharan, WHO Representative in Bangladesh. “A vaccination campaign will help to keep this vulnerable population safe from cholera.”

Featured Journal Content

Lancet Infectious Diseases
Oct 2017 Volume 17 Number 10 p1003-1098  e306-e333
http://www.thelancet.com/journals/laninf/issue/current
Comment 

Oral cholera vaccines: exploring the farrago of evidence
Suman Kanungo, Pranab Chatterjee
1012
Open Access
Summary
The development of a cheap and effective oral cholera vaccine (OCV) is a remarkable achievement in the field of cholera prevention. A meta-analysis on the efficacy and effectiveness of OCVs by Qifang Bi and colleagues1 updates the estimates of the 2011 Cochrane review.2 Their analysis includes additional studies published since 2011, yet provides estimates that are almost the same.

The debate about the low efficacy of OCVs in children aged younger than 5 years has continued to dominate the policy discourse in endemic countries such as India, where children are the main target of immunisation programmes. Older estimates identified children younger than 5 years to be at a disproportionately higher risk of cholera than other age groups;3 however, updated estimates have shown that making robust assertions in the absence of accurate age-specific morbidity and mortality data is difficult.4 This uncertainty has further contributed to a policy-level hesitancy in adopting OCVs for widespread use in endemic countries. Crucially, more accurate estimates of cholera burden should be established to enable programmatic implementation of OCVs, and the reasons for poor immune responses to OCVs in children need to be understood. Furthermore, we propose that the extent of herd protection offered by OCVs should be established, especially in children, if a targeted vaccination policy covering all age groups is endorsed for highly endemic hotspots.5

Water, sanitation, and hygiene (WaSH) interventions are considered to be the best method of cholera control, but gaps have been shown in the knowledge about which interventions work best.6 In our experience, in-house contamination of water remains a major problem, which sometimes persists despite efficient programmatic implementation of WaSH strategies.7 Trials in India have shown similar problems, and a rural sanitation programme failed to show evidence of prevention of diarrhoea and soil-transmitted helminth infections or reduction in faecal contamination of water sources.8, 9, 10

Modelling studies have suggested that in areas with poor sanitation, isolated efforts for water quality improvement are likely to be met with low success.11 Further, considering the high endemicity of cholera in low-income and middle-income countries (LMICs), single-pathway interventions are likely to be inadequate in the control of diarrhoeal diseases, and cholera in particular because of environmental persistence of vibrios, which might not be eradicated even with stringent implementation of such interventions.11 Besides, deploying adequate WaSH interventions takes time because it involves significant investment in infrastructural improvements and behavioural changes. Keeping these issues in mind, cheap and effective OCVs emerge as a viable option to keep cholera at bay, reducing morbidity and mortality, while the definitive WaSH interventions are identified and rolled out. The successful expansion of the Swachh Bharat (Clean India) mission in India provides a governance-driven model of sanitation and hygiene promotion that can be replicated in other LMICs; however, its effectiveness in reducing numbers of cases and deaths from cholera or diarrhoeal diseases needs to be systematically studied.

Although cholera outbreaks in areas of political and civil unrest are a major concern, strategies to mitigate the risks have been poorly studied. Mortality and morbidity from cholera in complex emergencies remains high. A systematic review showed that the evidence on the effectiveness of WaSH interventions in times of humanitarian crises is scarce and of poor quality.12 Only point-of-use interventions and safe water storage were effective measures in reducing diarrhoea incidence.12 By contrast, a single-dose regimen was an effective strategy to combat a cholera outbreak in South Sudan and an endemic focus in Bangladesh.13, 14

The creation of an OCV stockpile, and the commitment of Gavi, the Vaccine Alliance, to support vaccination of emergency and endemic areas of cholera activity, provides a cost-effective method by which countries can access vaccines as they work towards universal deployment of adequate WaSH facilities. In our opinion, a balanced public health policy needs to be in place, in which OCVs are used as a synergistic tool for cholera control, while the most efficient, cost-effective, and locally feasible, acceptable, and relevant WaSH interventions are identified and deployed. Given that even in endemic countries, cholera is a public health menace only in specific regions, with multiple local factors contributing to disease epidemiology, health policies need to be customised to fit the local contexts, eschewing one-size-fits all approaches.
[References at article title link]

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 27 September 2017 [GPEI]
:: Summary of newly-reported viruses this week:
…Pakistan:  one new wild poliovirus type 1 (WPV1) case reported, in Lakki Marwat district, Khyber Pakhtoon province; four new WPV1-positive environmental samples, reported in Sindh and Balochistan provinces.
…Afghanistan: two new WPV1-positive environmental samples reported in Kandahar province.

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WHO Grade 3 Emergencies  [to 30 September 2017]
South Sudan
:: South Sudan completes the self-assessment for the implementation of the Joint External Evaluation of the International Health Regulations (2005)  25 September 2017
:: Read the latest health situation report pdf, 1.59Mb  22 September 2017
…General cholera trends
Cholera transmission has continued to decline countrywide. In the last four weeks [weeks
35-38], cholera cases dropped from at least 132 cases in week 35 of 2017 to at least 5 cases
In week 38 of 2017…
 
The Syrian Arab Republic
:: WHO online trainings help medical staff in Syria’s besieged areas save lives  28-09-2017

Yemen
:: [Cholera] Daily epidemiology bulletin, 27 September 2017
[See Cholera above for more detail]

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WHO Grade 2 Emergencies [to 30 September 2017]
Democratic Republic of the Congo
:: WHO is providing essential medicines for basic health care in response to the growing humanitarian needs of internally displaced people in Tanganyika and Greater Kasai
[French] 26 September 2017 — In this emergency project, WHO is providing medicines to about 100 health facilities in targeted health zones to reduce the impact of epidemics affecting IDPs and host communities.

Ethiopia
:: Integrated Measles and EOS campaign protects 2.6 million children in Ethiopia’s Somali Region
11 September 2017 –Measles is a highly infectious vaccine-preventable disease. While children that are not immunized are at risk, those that are also malnourished or are already affected by other diseases are especially susceptible to it. Children in countries and districts where there is an ongoing emergency such as the current drought which has led to water scarcity and food insecurity in the Horn of Africa are therefore more at risk of contracting the virus and developing complications that often lead to disability and even death…

::::::
::::::
 
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. 
Iraq
:: OCHA Iraq | Hawiga Flash Update #2: Hawiga Humanitarian Response, 29 September 2017
 
Syrian Arab Republic
:: 29 Sep 2017  Children in Homs vaccinated against measles thanks to UNICEF
With World Health Organization and the Ministry of Health, UNICEF launched a two-week vaccination campaign against measles. The campaign aims to reach over 260,000 children, aged 5-12 years old, in Homs with the necessary vaccines, focusing on children in hard to reach areas and shelters for internally displaced families…

Yemen  
:: eDEWS Cholera Response Daily Epidemiological Update [EN/AR]
[See Cholera above for more detail]

::::::
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.
DRC
:: DRC: More than 1 million people uprooted from their homes by lingering violence in Kasai
Published on 25 Sep 2017

Nigeria 
:: Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock : Opening remarks on Lake Chad Basin for the noon briefing – 28.09.17

Somalia 
:: Humanitarian Bulletin Somalia, September 2017 | Issued on 26 September 2017
HIGHLIGHTS
…Displaced persons among worst affected by drought.
…Over 100,000 displaced people evicted from settlements in 2017, according to the Norwegian Refuge Council.
…AWD/Cholera cases have declined from a peak of over 5,300 cases in June to 93 cases in August.
…Strengthening localization of humanitarian response
 
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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 30 September 2017]
http://www.who.int/emergencies/mers-cov/en/
27 September 2017
Countries agree next steps to combat global health threat by MERS-CoV
Critical next steps to accelerate the response to the global public health threat posed by Middle-East respiratory syndrome coronavirus (MERS-CoV) have been agreed by representatives from the Ministries of Health and Ministries of Agriculture of affected and at-risk countries, and experts. The virus, which circulates in dromedary camels without causing visible disease, can be fatal for humans.

At a meeting hosted by the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (OIE) in Geneva this week, more than 130 experts from 33 countries, organizations and research institutions met to share what is known about the virus, identify priority research needs, improve cross-collaboration between animal and human health sectors and agree on a plan to address crucial gaps.

“MERS is not only a regional threat. While the majority of human cases have been reported from the Middle-East, the outbreak in the Republic of Korea in 2015 showed MERS’ global reach and capacity to have significant public health and economic consequences,” said Dr Maria Van Kerkhove, MERS-CoV Technical Lead in WHO’s Health Emergencies programme. “We are at the stage where we have to confront the challenges in our ability to detect and respond to MERS outbreaks and improve our knowledge about this virus through collaborative research,” she said.

Since 2012, when the virus was first identified in Saudi Arabia, there have been 2081 laboratory-confirmed cases of MERS-CoV infection reported to WHO from 27 countries, with at least 722 deaths – a fatality rate of 35%. While progress has been made in research and surveillance, significant gaps remain in understanding the virus, including how it circulates in dromedary camels, the natural reservoir host, or how it spills over into the human population.

“MERS-CoV is a disease with a significant impact on public health, which requires further investigations in animal sources to better understand its epidemiology and improve its control in humans. OIE Member Countries are requested to notify any occurrences of MERS-CoV in animals. This crucial information will contribute to escalating a coordinated response from the animal and human health sectors”, said Dr Gounalan Pavade, Chargé de mission, OIE…
 
 
CDC Is Deactivating the Emergency Operations Center for the Zika Response
Press Release  September 29, 2017
CDC is deactivating its emergency response for Zika virus (Zika) to transition efforts to normal program operations on September 29, 2017. On January 22, 2016, CDC activated its Emergency Operations Center (EOC) in response to the devastating effects of Zika virus infection during pregnancy. A team of experts from across the agency, called the Zika Coordination and Operations Transition Team (ZCOTT), will lead the transition from EOC activation to routine, long-term activities and will ensure timely coordination and collaboration on scientific, communication, and policy activities..

WHO & Regional Offices [to 30 September 2017]

Health services must stop leaving older people behind
29 September 2017 – Ahead of the International Day of the Older Person – 1 October – WHO calls for a new approach to providing health services for older people. WHO highlights the role of primary care and the contribution community health workers can make to keeping older people healthier for longer. Older adults are more likely to experience chronic conditions and often multiple conditions at the same time. Yet today’s health systems generally focus on the detection and treatment of individual acute diseases.

Highlights
Antimalarial drug resistance in the Greater Mekong Subregion: How concerned should we be?
September 2017 – A recent letter published in The Lancet Infectious Diseases reported on the presence of a drug-resistant lineage (strain) of malaria parasites in south Viet Nam that is responsible for “alarming rates of failure” of dihydroartemisinin-piperaquine, a first-line antimalarial medicine.

::::::

Weekly Epidemiological Record, 29 September 2017, vol. 92, 39 (pp. 573–588)
:: Armenia, Maldives, Sri Lanka and Kyrgyzstan certified malaria-free
:: Malaria elimination: report from the inaugural global forum of countries with potential to eliminate malaria by 2020
:: Monthly report on dracunculiasis cases, January-August 2017
 
::::::
 
Request for proposals: Website administrator/developer for the TechNet-21 website
pdf, 254kb 29 September 2017 Application deadline: 3 November 2017
 
::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Uganda commits to scaling up collaboration between veterinary health and the public health sector  29 September 2017
:: WHO and partners meet to reflect on progress made in expanding access to medicines through the EC/ACP/WHO Renewed Partnership Project  28 September 2017
:: WHO’s emergency mobile medical teams provide lifesaving health services in famine-affected and hard-to-reach areas of South Sudan  27 September 2017
:: Sixth Meeting of African Ministers of Health of Small Island Developing States opens in Seychelles  27 September 2017
:: South Sudan completes the self-assessment for the implementation of the Joint External Evaluation of the International Health Regulations (2005)  27 September 2017
:: President Danny Faure calls on small island developing nations to continue to ‘Work together as One’  27 September 2017
: Uganda hosts Inter-agency meeting on Neonatal health for Eastern and Southern Africa
25 September 2017
:: Tackling the common health challenges of African Small Island Developing States 25 September 2017

WHO Region of the Americas PAHO
:: PAHO aims to reduce shortage of health workers in the Americas, improve distribution, and enhance skills to achieve SDGs (09/28/2017)
::  Agreements reached on new sustainable health agenda, tobacco control and maintenance of measles and rubella elimination (09/28/2017)
::  Region of the Americas aims to be smoke-free by 2022 (09/28/2017)
::  Dr. Carissa F. Etienne re-elected for second term as PAHO Director (09/27/2017)
:: The Americas adopt ambitious agenda to build sustainable and universal health by 2030 (09/27/2017)
::  Countries of the Americas pledge to improve the health of ethnic groups (09/26/2017)
::  Life expectancy in the Americas increases to 75 years (09/26/2017)
::  PAHO Director highlights regional health achievements and challenges during 2013-2017 (09/25/2017)
::  Health ministers’ meeting at PAHO opens with somber tone after recent disasters (09/25/2017)

WHO South-East Asia Region SEARO
:: 900,000 vaccines “en route” to Cox’s Bazar to prevent cholera  29 Sep 2017
[See Cholera above for more detail]

WHO European Region EURO
:: Living longer, healthier lives – working towards integrated, people-centred care for older persons 29-09-2017
::  Over 100 cases of Chikungunya confirmed in Italy 29-09-2017
::  WHO and Italy sign first country cooperation strategy 26-09-2017
::  Endemic measles interrupted in 42 out of 53 countries in the Region 26-09-2017
[See Milestones above for more detail]

CDC/ACIP [to 30 September 2017]
http://www.cdc.gov/media/index.html

Press Release  September 29, 2017
CDC Is Deactivating the Emergency Operations Center for the Zika Response
CDC is deactivating its emergency response for Zika virus (Zika) to transition efforts to normal program operations on September 29, 2017. On January 22, 2016, CDC activated its Emergency Operations Center (EOC) in response to the devastating effects of Zika virus infection during pregnancy. A team of experts from across the agency, called the Zika Coordination and Operations Transition Team (ZCOTT), will lead the transition from EOC activation to routine, long-term activities and will ensure timely coordination and collaboration on scientific, communication, and policy activities..
 
Press Release  September 28, 2017
New study shows Tdap vaccination during pregnancy can prevent whooping cough in babies
Less than half of pregnant women in the United States take advantage of vaccination
A new CDC study published today in Clinical Infectious Diseases reported that vaccination with whooping cough vaccine, Tdap, during the third trimester of pregnancy prevented more than three out of four (78 percent) cases of whooping cough (also known as pertussis) in babies younger than two months. However, only 49 percent of pregnant women who delivered between fall 2015 and spring 2016 received the vaccine. CDC recommends women get Tdap during each pregnancy to provide critical short-term protection to babies when they are most at risk for this life-threatening illness…

MMWR News Synopsis for September 28, 2017
:: Influenza Vaccination Coverage Among Health Care Personnel – United States, 2016-17 Influenza Season
CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. health care workers get vaccinated annually against influenza. CDC recommends that all health care personnel (HCP) receive an annual flu vaccination to reduce flu-related morbidity and mortality among HCP and their patients. We analyzed data from an internet panel survey to measure what proportion of HCP received the flu vaccine during the 2016-17 flu season. Based on the data:
:: 79 percent of survey respondents reported receiving vaccination, which is similar coverage during the past three flu seasons.
:: Vaccination coverage continued to be higher among HCP working in hospitals (92 percent) and lower among HCP working in ambulatory (76 percent) and long-term care settings (68 percent).
:: As in previous seasons, coverage was highest among HCP who were required by their employer to be vaccinated (97 percent) and lowest among HCP working in settings where vaccination was not required, promoted, or offered onsite (46 percent).
 
:: Influenza Vaccination Coverage Among Pregnant Women – United States, 2016-17 Influenza Season
CDC recommends that pregnant women get a flu shot during any trimester of their pregnancy to protect themselves and their newborn babies from flu. Pregnant women are at risk for severe flu-associated illness and, since 2004, CDC has recommended flu vaccination for all women who are or will be pregnant during the flu season. We analyzed data from an internet panel survey to measure what proportion of pregnant women received the flu vaccine during the 2016-17 flu season. Based on the data:
:: 54 percent of pregnant women reported being vaccinated before (16 percent) or during (37 percent) pregnancy, which is similar to coverage during the past four flu seasons.
:: 67 percent of women reported receiving a provider offer for influenza vaccination, 12 percent received a recommendation but no offer, and 21 percent received no recommendation; among these women, influenza vaccination coverage was 71 percent, 44 percent, and 15 percent, respectively.
 
:: Evaluation of the Impact of Mandating Health Care Providers to Offer Hepatitis C Virus Screening to All Persons Born During 1945-1965 – New York, 2014

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::::::

Announcements
 
FDA [to 30 September 2017]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
September 28, 2017 –
FDA improves access to reports of adverse drug reactions
The U.S. Food and Drug Administration today launched a new user-friendly search tool that improves access to data on adverse events associated with drug and biologic products through the FDA’s Adverse Event Reporting System (FAERS). The tool is designed to make it easier for consumers, providers, and researchers to access this information.

What’s New for Biologics
:: Important Information for Human Cell, Tissue, and Cellular and Tissue-Based Product (HCT/P) Establishments Regarding Zika Virus Transmission Risk in the World (PDF – 162KB)
Posted: 9/28/2017
:: Important Information for Blood Establishments Regarding Zika Virus Transmission Risk in the World (PDF – 143KB)
Posted: 9/28/2017
:: Influenza Virus Vaccine for the 2017-2018 Season
Updated: 9/28/2017
 
Gavi [to 30 September 2017]
http://www.gavi.org/library/news/press-releases/
29 September 2017
900,000 vaccines ‘en route’ to Cox’s Bazar to prevent cholera
Oral cholera vaccine will protect Rohingya refugees seeking shelter in Bangladesh as well as resident population.
 [See Cholera above for more detail]
 
Korea commits US$4 million to immunise children in world’s poorest countries
South Korea renews pledge to Gavi, the Vaccine Alliance for 2018
Geneva, 25 September 2017 – The Republic of Korea has committed US$4 million to Gavi, the Vaccine Alliance to fund its work over 2018, helping to reach hundreds of thousands of children across the developing world with lifesaving vaccines.
South Korea became the first East Asian donor to Gavi in 2010, and has since provided $15 million to the Vaccine Alliance. Today’s $4 million commitment, made at a signing ceremony at the Ministry of Foreign Affairs (MOFA) in Seoul, will be delivered in 2018 and will be funded through Korea’s Global Disease Eradication Fund…
 
Hilleman Laboratories   [to 30 September 2017]
http://www.hillemanlabs.org/
28/09/2017
Hilleman Laboratories receives Indo-Swedish grant for developing – Oral Cholera Vaccine (OCV)
New Delhi: Hilleman Laboratories, a joint-venture partnership between MSD and Wellcome Trust, received a 6 million krona Indo – Swedish grant for the project ‘Improved, affordable single strain whole cell-B subunit oral cholera vaccine’.
The proposed project carried out by Hilleman Laboratories, is being jointly funded by the Department of Biotechnology (DBT), Government of India and Vinnova, the Swedish Governmental Agency for Innovation Systems.
The project will fuel further Research & Development of the Oral Cholera Vaccine (OCV) with knowledge exchange and transfer of scientists across India and Sweden.
Speaking on the partnership, Dr. Davinder Gill, CEO Hilleman Laboratories said, “Cholera remains a threat to global public health and is a barometer of health inequity and lack of social development. Considering the urgent need for effective and affordable Cholera vaccines, both for use in Cholera outbreaks and in mass vaccination campaigns, we would like to accelerate development of our simplified Oral Cholera Vaccine, HILLCHOLTM.” …
 
Human Vaccines Project   [to 30 September 2017]
http://www.humanvaccinesproject.org/media/press-releases/
Sep 26, 2017, 09:04 ET
Dr. Marie-Paule Kieny Appointed To The Human Vaccines Project Board Of Directors
PRNewswire-USNewswire/ — The Human Vaccines Project, a nonprofit public-private partnership focused on decoding the immune system to improve human health, welcomes Dr. Marie-Paule Kieny to its Board of Directors. Dr. Kieny is currently Director of Research at Institut National de la Santé et de la Recherché Médicale (INSERM) where she connects INSERM with the international health research community, and has held several positions at the World Health Organization (WHO)….
 
IAVI  [to 30 September 2017]
https://www.iavi.org/
September 29, 2017
New IAVI Collaboration Seeks to Expand Evolutionary Data on Cancer and HIV
What do HIV and cancer have in common?
The scientific question gets a fresh start this month as IAVI’s Jonathan Hare and Charles Swanton of the Francis Crick Institute and Cancer Research UK (CRUK) initiate their CRUK Pioneer Award. The £200,000 grant over two years funds their search for immunological parallels between HIV/AIDS and Non-Small Cell Lung Cancer (NSCLC).
Jonathan Hare is senior manager of IAVI’s Human Immunology Lab in London and winner of a CRUK Pioneer Award to expand evolutionary data on HIV and cancer.“ Scientists have ruminated on the crossover between cancer and HIV for years,” said Hare, who is senior manager of IAVI’s Human Immunology Lab at Imperial College London. “Though some data exists to suggest a connection, we can now get started on a more systematic approach to identifying common ground.”…
 
MSF/Médecins Sans Frontières  [to 30 September 2017]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
Press release
Intensified Bombings Decimate Health Facilities Across Northwestern Syria
Brussels/New York, September 28, 2017—An escalation in the bombing of medical facilities since September 19 has forced the closure and evacuation of hospitals throughout northwestern Syria, leaving people trapped in a war zone without access to health care, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) in a statement today.

Press release
Yemen: Government Health Staff are Saving Lives Without Salaries in War-Torn Country
September 28, 2017
Yemen’s public health staff have not received their regular salaries in a year, bringing medical services to the edge of collapse, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) in a report released today.
 
NIH  [to 30 September 2017]
http://www.nih.gov/news-events/news-releases
September 28, 2017
Disease resistance successfully spread from modified to wild mosquitoes
— NIAID-funded group assesses mating of genetically modified species
 
PATH  [to 30 September 2017]
http://www.path.org/news/index.php
Press release | September 28, 2017
New global initiative will connect the world for better health through digital technology
Digital Square, led by PATH, will align multi-sector investments into scalable solutions that strengthen national digital health systems

Announcement | September 26, 2017
PATH welcomes $10.5 million grant to expand contraceptive choice and access
Subcutaneous DMPA Access Collaborative will provide coordination and technical assistance for product introduction and scale-up in family planning programs

Press release | September 26, 2017
Serum Institute’s vaccine demonstrates significant efficacy against severe rotavirus gastroenteritis
Indian Government orders the vaccine for use in Universal Immunization Programme

UNAIDS [to 30 September 2017]
http://www.unaids.org/en
Update
Governments of Belarus and the Netherlands exchange best practices
29 September 2017
During a two-day visit on 25 and 26 September to Belarus, UNAIDS Deputy Executive Director Luiz Loures and the Ambassador for Sexual and Reproductive Health and Rights & HIV/AIDS of the Netherlands, Lambert Grijns, met with civil society organizations and communities of people who inject drugs, women living with HIV, men who have sex with men and sex workers to hear their perspectives on the current needs and challenges of the AIDS response in the country.
 
Wellcome Trust  [to 30 September 2017]
https://wellcome.ac.uk/news
News / Published: 29 September 2017
New typhoid vaccine could halve infection rate
Researchers have shown that a new typhoid vaccine called Vi-TT is safe, well-tolerated and could be effective in tackling typhoid rates in affected areas.
 
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DCVMN – Developing Country Vaccine Manufacturers Network  [to 30 September 2017]
http://www.dcvmn.org/
25 September 2017 to 28 September 2017
DCVMN Annual General Meeting
Seoul / Korea
Download the Agenda
 
::::::
 
Industry Watch
:: Moderna Announces Publication in Molecular Therapy Characterizing Potent Immune Response Generated by Its mRNA Prophylactic Vaccines
–Research led by Karolinska Institutet describes how Moderna’s vaccines target key antigen-presenting cells, leading to both B cell and T cell responses–
September 26, 2017 08:00 AM Eastern Daylight Time
CAMBRIDGE, Mass.–(BUSINESS WIRE)–Moderna Therapeutics, a clinical stage biotechnology company that is pioneering messenger RNA (mRNA) therapeutics and vaccines to create a new generation of transformative medicines for patients, announced a new publication in Molecular Therapy that provides mechanistic insights about its mRNA prophylactic vaccines. The research, led by Professor Karin Loré, Ph.D., and her group at the Karolinska Institutet in Stockholm, Sweden, characterizes how Moderna’s vaccines target key antigen-presenting cells, leading to both B cell and T cell activation, which yields a potent immune response.
The study utilized a research version of Moderna’s influenza H10N8 vaccine, which encodes for the viral antigenic protein hemagglutinin (HA) encapsulated in lipid nanoparticles (LNPs). In the study, the H10N8 vaccine induced protective titers of HA antibody, as well as CD4+ T cell responses, after intramuscular or intradermal injection into non-human primates (NHPs)…
 
“Given the software-like nature of our medicines, these findings should translate across our vaccine platform. We look forward to publishing additional mechanism of action insights as we continue to advance our ambitious pipeline of prophylactic vaccines.”

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

American Journal of Infection Control
October 01, 2017 Volume 45, Issue 10, p1057-1174, e103-e118
http://www.ajicjournal.org/current

Message from APIC
International Infection Prevention Week: A time to celebrate infection preventionists and raise awareness of the profession
Published in issue: October 01, 2017

Brief Report
Psychosocial determinants of influenza vaccination intention: A cross-sectional study on inpatient nurses in Singapore
Highlights
:: Of the respondents, 71% intended to receive the influenza vaccination.
:: Vaccination benefits and nonsusceptibility best predict vaccination intention.
:: Impending threat of infectious diseases affects nurses’ decision for vaccination.
:: Vaccination promotion should address concerns on influenza vaccine adverse effects.
Dwee Wee Lim, Lay Tin Lee, Win Mar Kyaw, Angela Chow
Published online: April 24, 2017

American Journal of Preventive Medicine
October 2017 Volume 53, Issue 4, p405-566, e123-e154
http://www.ajpmonline.org/current

Brief Reports
Potential Consequences of Not Using Live Attenuated Influenza Vaccine
Kenneth J. Smith, Mary Patricia Nowalk, Angela Wateska, Shawn T. Brown, Jay V. DePasse, Jonathan M. Raviotta, Eunha Shim, Richard K. Zimmerman
Published online: April 18, 2017

Population Health
Tdap Vaccination Among Healthcare Personnel, Internet Panel Survey, 2012–2014
Anup Srivastav, Carla L. Black, Peng-Jun Lu, Jun Zhang, Jennifer L. Liang, Stacie M. Greby
Published online: May 23, 2017

American Journal of Public Health
October 2017 107(10)
http://ajph.aphapublications.org/toc/ajph/current

Editorials
PREEXPOSURE PROPHYLAXIS
Preexposure Prophylaxis: Adapting HIV Prevention Models to Achieve Worldwide Access
Stewart Landers and Farzana Kapadia
107(10), pp. 1534–1535

PREVENTION OPTIMISM
Individual Versus Community-Level Risk Compensation Following Preexposure Prophylaxis of HIV
Martin Holt and Dean A. Murphy
107(10), pp. 1568–1571

HIV Preexposure Prophylaxis and Condomless Sex: Disentangling Personal Values From Public Health Priorities
Sarah K. Calabrese, Kristen Underhill and Kenneth H. Mayer
107(10), pp. 1572–1576

WORLD HEALTH ORGANIZATION
The World Health Organization, Public Health Ethics, and Surveillance: Essential Architecture for Social Well-Being
Amy L. Fairchild, Angus Dawson, Ronald Bayer and Michael J. Selgelid
107(10), pp. 1596–1598

American Journal of Tropical Medicine and Hygiene
Volume 97, Issue 3, 2017 Suppl, 2017
http://www.ajtmh.org/content/current

Editorial
Assessing the Health Impact of Malaria Control Interventions in the MDG/Sustainable Development Goal Era: A New Generation of Impact Evaluations
Author: Alexander K. Rowe
https://doi.org/10.4269/ajtmh.17-0509

Articles
Framework for Evaluating the Health Impact of the Scale-Up of Malaria Control Interventions on All-Cause Child Mortality in Sub-Saharan Africa
Authors: Yazoume Yé, Thomas P. Eisele, Erin Eckert, Eline Korenromp, Jui A. Shah, Christine L. Hershey, Elizabeth Ivanovich, Holly Newby, Liliana Carvajal-Velez, Michael Lynch, Ryuichi Komatsu, Richard E. Cibulskis, Zhuzhi Moore and Achuyt Bhattarai
https://doi.org/10.4269/ajtmh.15-0363

Implementing Impact Evaluations of Malaria Control Interventions: Process, Lessons Learned, and Recommendations
Authors: Christine L. Hershey, Achuyt Bhattarai, Lia S. Florey, Peter D. McElroy, Carrie F. Nielsen, Yazoume Yé, Erin Eckert, Ana Cláudia Franca-Koh, Estifanos Shargie, Ryuichi Komatsu, Paul Smithson, Julie Thwing, Jules Mihigo, Samantha Herrera, Cameron Taylor, Jui Shah, Eric Mouzin, Steven S. Yoon and S. René Salgado
https://doi.org/10.4269/ajtmh.17-0064

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 30 September 2017)

Research article
Knowledge translation tools for parents on child health topics: a scoping review
An emerging field of knowledge translation (KT) research has begun to focus on health consumers, particularly in child health. KT tools provide health consumers with research knowledge to inform health decisio…
Lauren Albrecht, Shannon D. Scott and Lisa Hartling
BMC Health Services Research 2017 17:686
Published on: 29 September 2017

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 30 September 2017)

Research article
Determinants of effective vaccine coverage in low and middle-income countries: a systematic review and interpretive synthesis
David E. Phillips, Joseph L. Dieleman, Stephen S. Lim and Jessica Shearer
BMC Health Services Research 2017 17:681
Published on: 26 September 2017
Abstract
Background
Many children in low and middle-income countries remain unvaccinated, and vaccines do not always produce immunity. Extensive research has sought to understand why, but most studies have been limited in breadth and depth. This study documents existing evidence on determinants of vaccination and immunization and presents a conceptual framework of determinants.
Methods
We used systematic review, content analysis, thematic analysis and interpretive synthesis to document and analyze the existing evidence on determinants of childhood vaccination and immunization.
Results
We documented 1609 articles, including content analysis of 78 articles. Three major thematic models were described in the context of one another. Interpretive synthesis identified similarities and differences between studies, resulting in a conceptual framework with three principal vaccine utilization determinants: 1) Intent to Vaccinate, 2) Community Access and 3) Health Facility Readiness.
Conclusion
This study presents the most comprehensive systematic review of vaccine determinants to date. The conceptual framework represents a synthesis of multiple existing frameworks, is applicable in low and middle-income countries, and is quantitatively testable. Future researchers can use these results to develop competing conceptual frameworks, or to analyze data in a theoretically-grounded way. This review enables better research in the future, further understanding of immunization determinants, and greater progress against vaccine preventable diseases around the world.