Milestones :: Perspectives

Yemen
 
Nationwide measles and rubella immunization campaign reaches 11.6 million children in Yemen

21 February 2019 – In collaboration with local health authorities, WHO and UNICEF have concluded a nationwide measles and rubella vaccination campaign in Yemen reaching more than 11.6 million (90%) children aged 6 months–16 years across the country.

WHO, with the support of Saudi Arabia, United Arab Emirates, Kuwait and Gavi, the Vaccine Alliance, contributed to the campaign through the provision of vaccines, fuel, training, deployment of health workers and supervisors, as well as raising awareness among communities about ways to protect themselves against these diseases.

Dhamar, Mareb and Sana’a governorates have reported over 100% coverage due to a large number of internally displaced persons coming from other governorates. The campaign continued for an additional 3 days in districts where low coverage was reported.

Despite the challenging conditions, WHO teams and health workers were able to reach high-risk areas, IDP camps and marginalized communities with awareness-raising activities and vaccination.

Milestones :: Perspectives
Vaccine “Hesitancy”
 

The Guardian
http://www.guardiannews.com/
Accessed 23 Feb 2019
Vaccines and immunisation

Opinion
The Guardian view on vaccination: a duty of public health
Editorial
The anti-vaxx movement arises from mistrust but threatens the physical health of society
Sun 17 Feb 2019
The latest World Health Organization report on measles epidemics shows that cases jumped by 50% last year. In one of the poorest and least connected countries in the world, Madagascar, nearly a thousand children are reported to have died after a measles outbreak in the countryside. The real figure is likely to be much higher, because of difficulties of reporting. An emergency programme of vaccination seems to have contained that epidemic for the moment but it is a reminder of how devastating the disease can be against unprepared populations. In the rich world, meanwhile, previously prepared populations are having their defences dismantled from the inside.

The discovery of ad campaigns against vaccination on Facebook that are carefully targeted at pregnant women is unusually worrying. It shows how the widespread availability of sophisticated advertising techniques is going to give considerable power to people who previously had no way of getting their message across to large numbers. In the most recent US campaigns against vaccination, 147 different advertisements have been used and some viewed more than 5m times. There is an arms race under way, whether we like it or not.

Facebook and YouTube/Google must take some responsibility for the consequences of their profit-seeking algorithms. Neither company should be profiting from an activity so detrimental to public health as anti-vaccination propaganda. Both ban tobacco advertising but permit propagandising against vaccination, even from people with a commercial interest in quack remedies. Yet the withholding of children from vaccination might be considered even more anti-social than tobacco smoking. The teenager who smokes puts their own body at risk more than that of anyone else, whereas the parent who refuses a child vaccination is unlikely to harm their own health at all: only that of their offspring. If this were just a decision to allow their own children to run a small risk, it might be defended. But it is not. Because of the way that herd immunity works, such parents are threatening other people’s children too, some of whom cannot for medical reasons be vaccinated.

In some western countries threatened by campaigns against vaccination there are rules in place to stop unvaccinated children from attending school. This protects communities and sends a powerful signal to the wider world, but it is a drastic step. It risks punishing children twice for their parents’ faults.

If parents trusted the state, the medical profession, or the gatekeepers of the media, this problem would not arise. The roots of the protests against vaccination lie for a large part in the inarticulate but powerful sense that modern life is dehumanising, and that powerful forces are conspiring to turn us into obedient robots and to squeeze out our humanity. When power is no longer trusted, it does not matter that it telling the truth. Yet the distrust of anti-vaxxer parents is a threat to everyone’s children and not just their own.

One step is obviously a campaign of public education by figures who are trusted by the target audience in the way that their friends on social media are. If public health campaigns were run with half the ruthless ingenuity displayed by betting companies, we might be better off. But not everything can be left to governments and large companies. Parents who care about their own children’s health must be prepared to take the argument to the playgrounds and on to social media as well.

Milestones :: Perspectives

Science         
22 February 2019  Vol 363, Issue 6429
http://www.sciencemag.org/current.dtl

Editorial
The law and vaccine resistance
By Dorit Rubinstein Reiss
Science22 Feb 2019 : 795
Last week, the Centers for Disease Control and Prevention announced that more than 100 cases of measles, spanning 10 states, had been reported in the United States since the beginning of the year. This news came on the heels of the World Health Organization’s estimate of over 200,000 cases of measles in 2018. These numbers signal the reemergence of a preventable, deadly disease, attributed in significant part to vaccine hesitancy. Communities and nations must seriously consider leveraging the law to protect against the spread of this highly contagious disease.

In the United States, measles was deemed “eliminated” in 2000 because of vaccination success. Since then, its reemergence has been associated with a resistance to vaccination. This also reflects the fact that unvaccinated U.S. residents visit countries that have seen large measles outbreaks (such as Ukraine, the Philippines, and Israel), become infected, and bring the disease back home.

Outbreaks in the United States are still fewer than in, say, Europe because of unique U.S. policies and laws that maintain high vaccination coverage. All 50 states and the District of Columbia have laws requiring vaccinations for school and daycare attendance. School mandates have proven very effective: The stronger they are, the higher the vaccination rate, and the lower the risk of outbreaks. The Vaccines for Children Program is a broad federal initiative that funds vaccines for children whose families cannot otherwise afford them. There is, however, more that the United States can do. There are “hotspots” where vaccination rates are low, and these are where outbreaks appear. Recent measles outbreaks—including those in Washington state and New York—occurred when an unvaccinated individual, after visiting an area where measles is endemic, returned to a U.S. community with low vaccination rates and infected others (primarily unvaccinated children).

What can be done? States have extensive leeway to protect public health, and courts have consistently upheld strong school immunization mandates. Thus, states could tighten nonmedical exemptions (for example, by requiring consultation with a doctor) or remove these exemptions completely from school mandates. Valid medical exemptions are important, but it is less clear whether nonmedical exemptions are appropriate. Some scholars are concerned that eliminating nonmedical exemptions may generate resentment among parents and interfere with parental autonomy. Others—including professional medical associations—disagree, because mandates protect children, and a parent’s freedom to send an unvaccinated child to school places classmates at risk of dangerous diseases. There is a strong argument for removing nonmedical exemptions, and at the least, they should be hard to get, to further incentivize parents to vaccinate. In many states, however, getting an exemption is as easy as checking a box. States and localities could also require schools to provide their immunization rates to parents at the start of the school year.

Beyond school mandates, states can consider other legal tools that have not yet been used. States could implement workplace mandates for those working with vulnerable populations, such as health care workers, teachers in schools, and providers of daycare. States could impose tort liability (civil law damages for harm) when unexcused refusal to vaccinate leads to individuals becoming infected unnecessarily or worse, to a large outbreak. States could permit teenagers to consent to vaccinations without parental approval. And states could mandate vaccinations to enroll in institutions of higher education.

Vaccine hesitancy is a problem with many components. In handling it, societies should improve public understanding of vaccinations but also not hesitate to use the law to prevent deadly diseases from spreading.

Milestones :: Perspectives

 DRC – Ebola

29: Situation report on the Ebola outbreak in North Kivu  19 February 2019

Situation Update

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo, continues to prove challenging to contain as ongoing security incidents and pockets of community mistrust hamper response efforts. Following our last report on 12 February 2019, 24 new EVD cases have been reported, including 20 confirmed and four probable cases. The four probable cases were all deaths that occurred in November and December 2018 in Komanda Health Zone, with a clinical history consistent with EVD but without the opportunity to be tested…
…Case management

On 24 November 2018, MoH announced the launch of a randomized control trial (RCT) for Ebola therapeutics. The RCT is now enrolling and treating patients at ETC sites in Katwa, Beni and Butembo. This is ongoing, with all confirmed cases in ETCs receiving therapy under the compassionate use protocol, together with supportive care. To date, 66 patients have been enrolled in the RCT and 334 patients have received therapy under the compassion use protocol.

An Ebola transit (TC) centre was opened in Katwa in the last week.

…Implementation of ring vaccination protocol

As of 17 February 2019, a cumulative total of 80,989 people have been vaccinated since the start of the outbreak.

Vaccination of HCWs and FLsWS are underway in bordering areas of Uganda and South Sudan. Advanced preparations are ongoing in Rwanda.

::::::

STRATEGIC RESPONSE PLAN FOR THE EBOLA VIRUS DISEASE OUTBREAK IN THE PROVINCES OF NORTH KIVU AND ITURI

February – July 2019

13 February 2019

[Excerpts’ full plan at title link qbove]]

Introduction

The tenth epidemic of Ebola virus disease (EVD) in the Democratic Republic of the Congo, affecting the provinces of North Kivu and Ituri, was declared by the Ministry of Health on 1 August 2018. The initial strategic response plan (SRP-1) covering the period up to in October 2018 and then the second strategic response plan (SRP-2) for the period from October 2018 to January 2019 facilitated deployment of the important resources of the Congolese Government and its partners.

Despite the complexity of this epidemic (dense and mobile population, insecurity, community resistance and risk of spread at the national and regional levels), the implementation of the interventions made it possible to significantly reduce the spread of the outbreak in the initial epicentres of Mangina / Mandima and Beni and stopped transmission in some secondary focal points like Tchomia, Masereka and Mutwanga.

Nevertheless, since the beginning of December a significant increase in the incidence of new cases has been observed particularly along the corridor towards the large urban center of Butembo (health zones of Butembo and Katwa) and beyond in the zone of Kayna health center located about 150 km from Goma. In addition, active outbreaks have emerged to the north, particularly in the health zones of Komanda and Oicha.

The third strategic response plan (SRP-3), which covers February through end July 2019, considers the salient points and recommendations made during the operational review of the implementation of the SRP-2 and other guidance based on lessons learned and risk analysis.

…6.9 Vaccination of at-risk groups

Despite the context and challenges, as of January 27, 2019, in North Kivu and Ituri Provinces 695 rings (3 February) were defined in the community and 2 targeted geographical areas. A total of 73,298 contacts and contacts of contacts were listed. Of those vaccinated, 18,895 are contacts, 22,441 are health and front-line staff and 16,855 are children aged 1 to 18 years.

As the number of cases reported from unknown contacts remains high, efforts have been made to improve the identification of contacts and contact of contacts, particularly in all locations where the symptomatic case visited a high-risk health facility before being isolated or dying.

It is important to emphasize that the investigational vaccine will continue to be used according to WHO recommendations in compliance with Good Clinical Practice (GCP) and that sustained attention be paid to the quality of the processes, procedures and management of clinical trials data in accordance with international standards.

However, there is a shortage of national staff trained in GCP, low involvement of HZMTs and the community in the organization of vaccination and an increase in the number of ineligible people (pregnant women, breastfeeding women and infants).

Other measures to establish and continue to prevent the spread of transmission include:

:: Further improve the listing of the “satellites” of the rings (i.e. outside the place of residence of the case, these are all places that the symptomatic person visited before being isolated or dying) to identify and offer vaccination to all people at risk.

:: Organize vaccination teams performing “sweeping” operations to review how rings were defined for cases with onset of symptoms in the last 7 days and to verify if contacts at the place of residence and in the satellites have been fully enumerated and vaccinated.

::  Organize teams that primarily vaccinate all health personnel and front-line staff in priority-identified facilities because they have seen or treated a case of EVD within the previous 21 days.

::  Modify the protocol for the use of the rVSV vaccine to include vaccination of pregnant women after the 1st trimester of pregnancy and vaccination of infants including new-borns, as recommended by the National Ethics Committee. Arrangements will be made for the follow-up of pregnant women who were vaccinated through the end of their pregnancies.

::  The supply of infrared thermometers and handwashing facilities, drinking water, soap and capacity building on hygiene behaviour in schools.

:: The construction of isolation rooms for suspected cases at school.

::  Providing specific documentation and protocol for the prevention, guidance and management of suspected cases at school to provide key messages on family-based Ebola prevention.

:: Strengthen the technical capacity of national PCB teams to be able to deploy an experimental vaccine for this epidemic and in the future and consider appropriate study options for the evaluation of other vaccines against GCPs…

Emergencies
 
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 20 February 2019
:: On 19 February, the 20th IHR Emergency Committee including members, advisers, and invited Member States convened to discuss the status of international spread of poliovirus. The Committee unanimously agreed that the risk of polio spread continues to be a Public Health Emergency of International Concern (PHEIC) and proposed an extension of Temporary Recommendations for an additional three months. The recommendations come amid outbreak notification of cVDPV1 and cVDPV2 in Indonesia and Mozambique respectively. The official WHO Statement and the Temporary Recommendations will be issued shortly. [Full statement not yet posted]

:: The GPEI has developed the Global Polio Surveillance Action Plan 2018-2020, incorporating newer strategies and innovations to help endemic, outbreak and high-risk countries measure and enhance sensitivity of their surveillance systems. Read more here.

:: WHO is seeking input on draft guidance for managing human exposure to live polioviruses in facilities such as labs and vaccine plants. The document is open for public comment and WHO is particularly seeking feedback from national authorities for containment and others working in public health.
 
 
Summary of new viruses this week:
:: Afghanistan — one case of wild poliovirus type 1 (WPV1) and four WPV1-positive environmental samples;

:: Pakistan – two cases of WPV1 and four WPV1-positive environmental samples.

::::::
::::::
 
 
Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.

WHO Grade 3 Emergencies  [to 23 Feb 2019]
Democratic Republic of the Congo
:: :: 29: Situation report on the Ebola outbreak in North Kivu  19 February 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   21 February 2019

Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 3 – 14 February 2019
…Immunization
Vaccination at Registration Post: Three vaccination posts have been established in camp 7, camp 17 and 26 with the support of UNHCR to provide immunization service to newborn eligible for birth registration under family head count. The activity started in Teknaf in Sep 2018 and in Ukhia (camp 7 and 17) in Feb 2019. Immunization activities are offered for 5 days a week.
Health worker immunization: Two vaccinations post are providing immunization to health care workers on weekly basis to humanitarian workers in camps. To-date 1,753 Td doses have been administered to health workers.
VPD Surveillance: 3 AFP cases have been investigated in 2019 with result still pending. Out of 88 suspected measles cases in 2019, 53 patients (42%) have been investigated through Case Report Form.

South Sudan
::  WHO provides lifesaving health care services to displaced populations and host communities in 22 locations in South Sudan  18 February 2019

Myanmar – No new digest announcements identified  
Nigeria – No new digest announcements identified  
Somalia – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified  
Yemen – No new digest announcements identified

::::::

WHO Grade 2 Emergencies  [to 23 Feb 2019]
Brazil (in Portugese) – No new digest announcements identified
Cameroon  – No new digest announcements identified
Central African Republic  – No new digest announcements identified
Ethiopia – No new digest announcements identified
Hurricane Irma and Maria in the Caribbean – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory  – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies  [to 23 Feb 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania

 
::::::
::::::

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic   
:: Humanitarian Update Syrian Arab Republic – Issue 01 | 19 February 2019

  FIGURES
. People in need of humanitarian assistance 13M
. People in acute need of humanitarian assistance 5.2M
. Internally displaced people (as of August) 6.2M
. Returnees (January – December 2018) 1.4 M
. People in need in UN-declared hardto-reach areas 1.1M
HRP 2018 FUNDING
. 3.36 billion requested (US$)
. 64.9% funded

Yemen – No new digest announcements identified

::::::

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Ethiopia 
:: Ethiopia Humanitarian Bulletin Issue #3 | 04-17 February 2019

HIGHLIGHTS
. Over 45,000 IDPs in need of urgent humanitarian assistance in Central Gondar.
. The level of humanitarian needs in 2019 expected to remain similar to 2018.
. UNHCR notes spontaneous movement of South Sudanese refugees in Ethiopia.

Somalia  – No new digest announcements identified

::::::
::::::

Editor’s Note:</strong
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

EBOLA/EVD  [to 23 Feb 2019]
http://www.who.int/ebola/en/
:: 29: Situation report on the Ebola outbreak in North Kivu  19 February 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   21 February 2019
 
 
MERS-CoV [to 23 Feb 2019]
http://who.int/emergencies/mers-cov/en/
– No new digest announcements identified.
 
 
Yellow Fever  [to 23 Feb 2019]
http://www.who.int/csr/disease/yellowfev/en/
– No new digest announcements identified.
 
 
Zika virus  [to 23 Feb 2019]
http://www.who.int/csr/disease/zika/en/
– No new digest announcements identified.

WHO & Regional Offices [to 23 Feb 2019]

21 February 2019
Nationwide measles and rubella immunization campaign reaches 11.6 million children in Yemen

20 February 2019
News Release
Countries are spending more on health, but people are still paying too much out of their own pockets

::::::

 
Weekly Epidemiological Record, 22 February 2019, vol. 94, 08 (pp. 85–104)
:: Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper – February 2019

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Kenya now eliminates maternal and neonatal tetanus  22 February 2019
:: Zambian Government commits to ending cholera by 2025   22 February 2019
:: Community informants yield results in surveillance for suspected polio in hard-to-reach areas
22 February 2019
:: WHO and Uganda Red Cross society sign agreement to strengthen Ebola screening at Points of Entry between Uganda and DRC  21 February 2019
:: New Minister of Health recommits government to end Hepatitis E Outbreak  20 February 2019
 
 
WHO Region of the Americas PAHO
– No new digest announcements identified.
 
 
WHO South-East Asia Region SEARO
– No new digest announcements identified.
 
 
WHO European Region EURO
:: Summits give citizens a voice in creating sustainable health policy 22-02-2019
 
 
WHO Eastern Mediterranean Region EMRO
:: Improving access to health care in Yemen  19 February 2019
 
 
WHO Western Pacific Region
– No new digest announcements identified.

CDC/ACIP [to 23 Feb 2019]

http://www.cdc.gov/media/index.html

https://www.cdc.gov/vaccines/acip/index.html

– No new digest announcements identified.

Africa CDC   [to 23 Feb 2019]

https://au.int/en/africacdc

– No new digest announcements identified.

China CDC 

http://www.chinacdc.cn/en/

New website launched…no “news” or “announcements” page identified. Link to National Health Commission of the People’s Republic of China not responding at inquiry [23 Feb 2019]

Announcements

 
Paul G. Allen Frontiers Group    [to 23 Feb 2019]
https://www.alleninstitute.org/news-press/
News
2 million-cell experiment traces how a mammal grows, cell by single cell
February 20, 2019
Largest single-cell database of its kind sheds light on early mouse development, lays groundwork for understanding developmental diseases
 
 
BMGF – Gates Foundation  [to 23 Feb 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 23 Feb 2019]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.
 
 
CARB-X   [to 23 Feb 2019]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.
 
 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 23 Feb 2019]
http://cepi.net/
11 Feb 2019
CEPI partners with IVI to accelerate development of vaccines against emerging global health threats
Oslo, Norway; Seoul, Republic of Korea 11 February 2019—The Coalition for Epidemic Preparedness Innovations (CEPI) and the Republic of Korea-based International Vaccine Institute (IVI), an international organisation devoted to vaccines for global health, today announced a collaboration to accelerate the development of vaccines against emerging infectious diseases.
Under the terms of the CEPI–IVI Master Implementing Partner Services Agreement, IVI will provide technical services for CEPI-funded projects, executing specific activities as needs arise on behalf of CEPI in the course of advancing new vaccines against emerging pathogens. To this end, IVI will receive funding and support from CEPI to implement the necessary technical services per service orders for vaccine development by engaging local scientists in Korea, and by mobilising IVI’s expertise and capabilities, which include: laboratory and vaccine process research and development, epidemiological studies, and clinical trial and regulatory support…
 
 
EDCTP    [to 23 Feb 2019]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Latest news
No new digest content identified.
 
 
Emory Vaccine Center    [to 23 Feb 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 European Medicines Agency  [to 23 Feb 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.
 
 
 
European Vaccine Initiative  [to 23 Feb 2019]
http://www.euvaccine.eu/news-events
Latest news
5th Call for TRANSVAC Vaccine Development Services
18 February 2019
TRANSVAC2  project offers high-quality technical services to support the development of prophylactic and therapeutic vaccines…
 
 
FDA [to 23 Feb 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
February 22, 2019 –
Statement from FDA Commissioner Scott Gottlieb, M.D., and Director of FDA’s Center for Drug Evaluation and Research Janet Woodcock, M.D., on the FDA’s continuing efforts to maintain its strong oversight of generic drug quality issues domestically and abroad
 
 
Fondation Merieux  [to 23 Feb 2019]
http://www.fondation-merieux.org/
No new digest content identified.
 
 
Gavi [to 23 Feb 2019]
https://www.gavi.org/
22 February 2019
Typhoid vaccination campaign to tackle outbreak in Zimbabwe
Geneva, 22 February 2019 – A major typhoid vaccination campaign begins today in Harare to tackle a drug-resistant outbreak of the disease.
The campaign aims to vaccinate 325,000 people in nine suburbs of Zimbabwe’s capital. It will be the first campaign in Africa to use a new typhoid conjugate vaccine (TCV) which, unlike other typhoid vaccines, can be administered to young children and has long-lasting immunity.
This is the second wave of a major typhoid outbreak in Harare which first began in October 2017. This second wave began in September 2018 and has so far resulted in 1,810 cases and two deaths.
Around one in five cases in Harare are estimated to be resistant to the antibiotic ciprofloxacin – the first line of defence against the disease – with an alarming 73% resistance reported in certain areas. With drug resistant genes circulating, there is a risk that resistance could grow.
“While typhoid vaccines have existed for over a century, previously they could only offer short term protection and couldn’t be used to protect those most vulnerable to this severe disease: young children,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “These new conjugate vaccines will be a game-changer, not only in the battle against typhoid but also in the global effort to tackle drug resistance. The fact that they are now ready to be used to contain this devastating outbreak in Zimbabwe is fantastic news.”…
 
 
GHIT Fund   [to 23 Feb 2019]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical
No new digest content identified.
 
 
Global Fund  [to 23 Feb 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.
 
 
Hilleman Laboratories   [to 23 Feb 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 23 Feb 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 23 Feb 2019]
https://www.iavi.org/newsroom
No new digest content identified.
 
 
IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.
 
 
IVAC  [to 23 Feb 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 23 Feb 2019]
http://www.ivi.int/
IVI News & Announcements
Typhoid conjugate vaccine from Indonesia found to be safe, immunogenic in phase 1 clinical trial
SEOUL, Korea, JAKARTA, Indonesia, February 22, 2019 — Scientists from Bio Farma, the University of Indonesia, and the International Vaccine Institute (IVI), recently published the results of a phase I clinical trial study of a novel typhoid conjugate vaccine involving Indonesian adults and children, showing that the vaccine was safe and generated potentially protective immune responses…
Researchers at IVI and Indonesian partners aimed to define the safety and immunogenicity of a new S. typhi Vi-DT conjugate vaccine. The latest study, published recently in the journal PLoS ONE, suggests that the new vaccine is safe and immunogenic in adults and children over 2 years of age, with a single dose inducing strong immune responses regardless of age.
“This study is an important step towards the development of Vi-DT typhoid vaccine that can safeguard the world’s most vulnerable -especially young children, against typhoid fever,” said Dr. Sushant Sahastrabuddhe, Director of the Typhoid Program at IVI…
 
 
JEE Alliance  [to 23 Feb 2019]
https://www.jeealliance.org/
Selected News and Events
Mali – A Multi-sectoral and Multi-stakeholder Cooperation Success Story
8.2.2019
Article
Disease outbreaks continue to occur in Mali and the ongoing security crisis highlights the importance of a comprehensive national framework for health security. Recognizing the need for cooperation…
 
 
MSF/Médecins Sans Frontières  [to 23 Feb 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Nauru
Nauru | Concerns over reopening Christmas Island detention centre
MSF Australia. 21 Feb 2019
 
 
Central African Republic
Unprotected: Report on violence and lack of protection for civili…
Report 19 Feb 2019
 
 
NIH  [to 23 Feb 2019]
http://www.nih.gov/news-events/news-releases
February 19, 2019
New protocol could ease diagnosis of bacterial infections in infants
— Findings promise to reduce need for spinal tap, antibiotics, and hospitalizations.
 
 
PATH  [to 23 Feb 2019]
https://www.path.org/media-center/
No new digest content identified.
 
 
Sabin Vaccine Institute  [to 23 Feb 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 23 Feb 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
22 February 2019
Faith-based organizations: essential partners in the AIDS response for migrants

20 February 2019
Tanzanian and South African experts exchange expertise

19 February 2019
HIV testing campaign brings the community together in Bangui

18 February 2019
We need action on human rights
 
 
UNICEF  [to 23 Feb 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Press release
Increasing number of people face severe food shortages in South Sudan
Joint UNFAO, UNICEF, WFP Press Release
22/02/2019

Statement
Redeployment agreement from Hudaydah welcome – calls to bring positive change for children
Statement by Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa
20/02/2019

Statement
Central African Republic peace agreement brings hope to millions of children
Statement attributable to UNICEF Executive Director Henrietta Fore
18/02/2019

Statement
UNICEF Executive Director Henrietta Fore’s remarks at Munich Security Conference: Town Hall Event: “Update on Ebola in the DRC & Beyond”
Munich, Germany, 16 February 2019 –
“Once again, we’re facing an outbreak of Ebola — the 10th in the DRC.
“And once again, we face familiar challenges — and more. An unforgiving disease that requires 100 per cent of cases to be controlled and isolated. A high-density, mobile population.    A lingering mistrust of aid. More children and women among those infected and dying of the disease. And a new, unexpected threat: security concerns and direct attacks that impede access.
“In some ways, we’re in a better place than 2014. Building on what we’ve learned from previous outbreaks, we’re now working as a tightly co-ordinated team, using a common Strategic Response Plan.
“Since the beginning of the epidemic, UNICEF and our partners have deployed more than 650 staff members to the effort. All under the excellent leadership of the Ministry of Health, which is well-trained and experienced from previous outbreaks.
“Together, we’re providing drinking water to more than 1.3 million people. We’re providing sanitation and hygiene kits — and emergency nutritional care for Ebola patients. We’re directly assisting 950 affected families. We’re supporting orphans and unaccompanied children. And we’ve reached more than 10 million people with information on preventing this disease and reducing transmission — including in schools.
“We’re also deploying innovative approaches — isolation cubes for treatment, new vaccines, experimental therapeutics, and big-data analysis to track the spread of the outbreak.
“Our protection teams are doing intense-contact follow-up work, to ensure well-being within communities and to prevent spread to non-affected areas.
“We’re putting a renewed emphasis on risk communication and community engagement, to improve trust in — and uptake of — vital health and prevention services.
“And the UN peacekeeping force is providing a welcome security umbrella for all that we’re doing.
“Thanks to this work, we’ve controlled the outbreak in Equateur, and in many spots in North Kivu, including Beni. We’ve also succeeded in preventing the outbreak from spreading to other regions and countries.
“But the outbreak remains active. There is a serious risk of it reaching major urban centres, like Goma.
“Our staff members — across all of our organizations — are stretched thin. They’re facing continued community resistance — and new security threats.
“In this uncertain environment, we will be strained to control new outbreaks in DRC — or even respond to other health emergencies like cholera or polio that might emerge in neighbouring countries.
“We must find ways to stay one step ahead of Ebola.
“And we can do it. The excellent work of Uganda and Rwanda to prepare has made all the difference in preventing an outbreak.
“Which is why — in addition to our immediate response — UNICEF is working with our partners with a new urgency to strengthen health systems and local response capabilities over the long-term.
“This includes bolstering immunization stocks and capacity.
“It includes scaling-up surveillance and isolation capabilities, especially in urban areas — so important in controlling the Lagos outbreak in 2014.
“And it includes investing in stronger communication efforts with communities, and new prevention and control efforts in health facilities and schools. This includes a new team of anthropologists and communication for development specialists to improve our research and assessment efforts.
“In the meantime, we must make the most of a key window of opportunity, before the Strategic Response Plan ends in July 2019. We must continue raising the alarm on this emergency to summon more funds, recruit more staff, and be strategic about where — and when — we deploy current staff.
“Throughout, we must work closely with the new government to reduce security threats, strengthen health systems for the future, and gain access to every child and community affected.
“Ebola is unforgiving — but it’s not unbeatable.
“Let’s draw inspiration — and learn lessons — from our successes so far, and act now, before the outbreak spreads to Goma or crosses the border.
Thank you.”
 
 
Vaccine Confidence Project  [to 23 Feb 2019]
http://www.vaccineconfidence.org/
No new digest content identified.
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia  [to 23 Feb 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 23 Feb 2019]
https://wellcome.ac.uk/news
Opinion | 19 February 2019
Open access and Plan S: how Wellcome is tackling four key concerns
by Robert Kiley, David Carr
There has been lots of reaction to the changes we’re making to Wellcome’s open access policy to ensure that no research is behind a paywall. This is how we are working to address them.
 
 
The Wistar Institute   [to 23 Feb 2019]
https://www.wistar.org/news/press-releases
Press Release    Feb. 21, 2019
The Wistar Institute and Anixa Biosciences Extend Collaborative Research Agreement
Philadelphia and San Jose, Calif. – (Feb. 21, 2019) – The Wistar Institute has extended its collaboration with Anixa Biosciences, Inc. (NASDAQ: ANIX), a biotechnology company focused on using the body’s immune system to fight cancer. The project is focused on understanding the role of myeloid-derived suppressor cells (MDSCs) and how they can be used in diagnostic and therapeutic applications…
 
 
World Organisation for Animal Health (OIE)   [to 23 Feb 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.
 
::::::
 
 
BIO    [to 23 Feb 2019]
https://www.bio.org/insights/press-release
No new digest content identified.
 
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 23 Feb 2019]
http://www.dcvmn.org/
No new digest content identified.
 
 
IFPMA   [to 23 Feb 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
 
 
PhRMA    [to 23 Feb 2019]
http://www.phrma.org/press-room
No new digest content identified.
 
 
Industry Watch  [to 23 Feb 2019]

:: Bharat Biotech Acquires Chiron Behring Vaccines
Hyderabad, India, February 15 th 2019:

Bharat Biotech announces the forthcoming acquisition of Chiron Beh-ring Vaccines Pvt Ltd, located in Ankleshwar, Gujarat from GlaxoSmithKline Asia. Bharat Biotech will acquire 100% equity stake in Chiron Behring Vaccines in an all cash transaction, subject to a number of closing condi-tions which Bharat Biotech and GSK intend to complete in the coming weeks.

Chiron Behring Vaccines was formed as a result of the purchase of the vaccines business of Hoechst AG by Chiron Corporation USA. It is one of the largest manufacturers of high quality rabies vaccines in the world. Chiron Behring Vaccines is a WHO Pre-qualified manufacturer of rabies vaccines, eligible for supplies to UN agencies and has product registrations in more than 20 countries. The rabies vaccine manufactured at An-kleshwar is a result of decades of research & product development..

Bharat Biotech has a wide portfolio of vaccines, with market access to more than 70 countries. The addition of this rabies vaccine will establish Bharat Biotech as a global leader in rabies vaccines manufacturing. Bharat Biotech plans to enhance upon the manufacturing capabilities at Chiron Behring Vaccines and expand mar-ket access through product registrations in additional high demand countries.

Announcing the deal, Dr. Krishna Ella, Chairman and Managing Director of Bharat Biotech, said:

“This acquisition is strategic in helping us enhance our opportunities to achieve greater scale in tackling pub-lic health problems. Bharat Biotech will strengthen its product portfolio and substantially increase product availability in response to the growing demand for this vaccine. With the significant disease burden of rabies in India and other countries, I appreciate GSK’s vision in this transition to Bharat Biotech, to continue to meet the needs of the patients…

Philippines revokes Sanofi’s product license for dengue vaccine
February 19, 2019,  MANILA (Reuters) – The Philippines has permanently halted the sale, distribution and marketing of Sanofi’s dengue vaccine in the country after the French drug maker failed to meet the directives of regulators.

Food and Drug Administration (FDA) Director General Nela Charade Puno said on Tuesday registration certificates for Dengvaxia products have been revoked because of Sanofi’s “brazen defiance” of the agency’s directives.

The FDA said Sanofi failed to comply with post marketing authorization requirements as of December last year.

Sanofi said it disagreed with the FDA’s findings.

“Sanofi Pasteur respectfully disagrees with the conclusions stated in the order and considers that the Philippines FDA has taken this decision despite our diligence, including the submission of documents from completed post-approval commitments and regular updates on the status of post-marketing studies,” the company said in a statement.

Sanofi, which filed a motion for reconsideration, said the agency had not questioned the safety and efficacy of Dengvaxia…

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

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content

(Accessed 23 Feb 2019)
Research article
Advancing towards contemporary practice: a systematic review of organisational performance measures for non-acute health charities
The study concluded that (1) demonstration of organisational performance is relevant to non-acute health charities; (2) organisational performance measurement is feasible in this sector; (3) an evidence-based organisational performance measurement framework for the sector has not yet been developed nor has an existing organisational performance measurement framework been adapted for the sector, although the Balanced Scorecard is likely to be an effective option and (4) five leading measures – Quality of Service; Finance; Stakeholders (Customers and Clients); People and Culture; and Governance and Business Management; could be used to determine organisational performance in these sectors. Finally, ‘Mission and Purpose’ could be explored as a potential measure. Further research to understand why there is such limited published organisational performance evidence for the sector could be useful. Case studies of organisational measurement strategies of successful non-acute healthcare charities and research into important factors for organisational performance implementation in the sector may contribute to greater uptake and knowledge dissemination.
Authors: Richard Colbran, Robyn Ramsden, Karen Stagnitti and John W. Toumbourou
Citation: BMC Health Services Research 2019 19:132
Published on: 22 February 2019
 
 

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 23 Feb 2019)

Research article
Effects of the rotavirus vaccine program across age groups in the United States: analysis of national claims data, 2001–2016
The direct effectiveness of infant rotavirus vaccination implemented in 2006 in the United States has been evaluated extensively, however, understanding of population-level vaccine effectiveness (VE) is still …
Authors: Julia M. Baker, Rebecca M. Dahl, Justin Cubilo, Umesh D. Parashar and Benjamin A. Lopman
Citation: BMC Infectious Diseases 2019 19:186
Published on: 22 February 2019
 
 

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 23 Feb 2019)

Research article
HBV vaccination and PMTCT as elimination tools in the presence of HIV: insights from a clinical cohort and dynamic model
Sustainable Development Goals set a challenge for the elimination of hepatitis B virus (HBV) infection as a public health concern by the year 2030. Deployment of a robust prophylactic vaccine and enhanced inte…
Authors: Anna L. McNaughton, José Lourenço, Louise Hattingh, Emily Adland, Samantha Daniels, Anriette Van Zyl, Connie S. Akiror, Susan Wareing, Katie Jeffery, M. Azim Ansari, Paul Klenerman, Philip J. R. Goulder, Sunetra Gupta, Pieter Jooste and Philippa C. Matthews
Citation: BMC Medicine 2019 17:43
Published on: 21 February 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles

(Accessed 23 Feb 2019)
Research article
Administrative cases: an effective alternative to lawsuits in assuring access to medicines?
Although public policy in Brazil supports access to essential medicines, the health system cannot meet all demand. Increasingly, the population has used legal demands to seek access to medicines, an approach that can undermine equitable access by creating policy inconsistencies (e.g., granting access to medicines outside the SUS formulary). In response, the Executive Branch has signed institutional agreements to create an administrative case for submitting requests for medicines directly to the Executive Branch. The objective of this study was to assess the degree to which the administrative cases for requests are in accordance with public policies and guidelines, e.g., if administrative cases results in fewer decisions to purchase outside the SUS formulary.

Authors: Virginia Oliveira Chagas, Mércia Pandolfo Provin and Rita Goreti Amaral

Citation: BMC Public Health 2019 19:212

Published on: 20 February 2019

Ethics & Human Research
Volume 41, Issue 1  January-February 2019
https://onlinelibrary.wiley.com/journal/25782363

New Challenges and Unresolved Issues
The inaugural issue of Ethics & Human Research (E&HR) marks an exciting milestone in The Hastings Centers’ 40‐year history of publishing a journal that focuses on the ethical, regulatory, and policy issues related to research with humans. Like its predecessor, IRB: Ethics & Human Research, E&HR will publish conceptual and empirical analyses on a wide range of topics related to the human research enterprise.
The journal’s name change conveys to the global community of authors and readers that E&HR is not solely about issues related to institutional review boards (IRBs) in the United States. The title shift provides an opportunity to identify new ethical, policy, and regulatory challenges that rapid developments in science, medicine, and regulatory frameworks bring to the conduct and oversight of human subjects research in the United States and elsewhere. Along with publishing work that investigates new challenges, E&HR aims not only to draw attention to unresolved issues but also to broaden the scope of issues for investigation and analysis in the field of human research ethics. The pieces in this inaugural issue identify several new challenges and hint at some of the unresolved issues and broader topics that merit further attention.

Genome Medicine
https://genomemedicine.biomedcentral.com/articles
[Accessed 24 Nov 2018]

Comment
Translating genomic medicine to the clinic: challenges and opportunities
Genomic medicine has considerable potential to provide novel diagnostic and therapeutic solutions for patients who have molecularly complex diseases and who are not responding to existing therapies…The huge medical, economic, and societal problems arising from the large number of patients who do not respond to therapy emphasize the need for novel diagnostic and therapeutic solutions for the management of patients. Genomic medicine has considerable potential, but also presents significant challenges that are likely to be addressed by joint international initiatives.
Authors: Huan Zhang, Lars Klareskog, Andreas Matussek, Stefan M. Pfister and Mikael Benson
Citation: Genome Medicine 2019 11:9
Published on: 22 February 2019

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 23 Feb 2019]

Review
In search of Pan-American indigenous health and harmony
The objective of this article is to describe the state of North, Central, South American and Caribbean (Pan-American) indigenous health. The second objective is to identify recommendations for optimal healthca…
Authors: Julie Babyar
Citation: Globalization and Health 2019 15:16
Published on: 20 February 2019

Health Economics, Policy and Law 
Volume 14 – Special Issue 2 – April 2019
https://www.cambridge.org/core/journals/health-economics-policy-and-law/latest-issue

SPECIAL ISSUE: Frontiers of Health Policy Research
If the enhancement of human freedom is both the main object and the primary means to development (Sen, 1999), then good individual and population health are both ends and means to development and freedom in all countries, regardless of their current ranking on the Human Development Index or other indexes on wealth, prosperity and well-being…

This special issue on the ‘frontiers in health policy research’ focuses attention on three distinct areas of inquiry. One set of papers analyses efforts to improve the quality of care and increase the value of care that health systems purchase. A second set of articles focuses on issues of health behaviour and social determinants of health. Finally, the third set of articles presents differing views on how to predict the adequacy of supply of medical professionals. The range of these articles illustrates, not only the exciting breadth of health policy research, but the degree to which scholars within this field are addressing issues of high importance to policy makers around the world. We think it is fair to claim that all of the articles address issues that are on the ‘frontier’ of health policy in the sense that they attempt to provide answers to questions that policy makers around the world are currently grappling with…

Humanitarian Exchange Magazine
Number 74,  February 2019
https://odihpn.org/magazine/communication-community-engagement-humanitarian-response/

Communication and community engagement in humanitarian response
This edition of Humanitarian Exchange, co-edited with Charles-Antoine Hofmann from the UN Children’s Fund (UNICEF), focuses on communication and community engagement. Despite promising progress, coherent and coordinated information is still not provided systematically to affected communities, and humanitarian responses take insufficient account of the views and feedback of affected people. In 2017, UNICEF, the International Federation of Red Cross and Red Crescent Societies (IFRC), the UN Office for the Coordination of Humanitarian Affairs (OCHA) and other partners came together under the auspices of the Communicating with Disaster Affected Communities (CDAC) Network to establish the Communication and Community Engagement (CCE) initiative, which aims to organise a collective service for communications and community engagement. The articles in this edition take stock of efforts to implement this initiative.

Drawing on lessons from 23 Peer 2 Peer Support missions, Alice Chatelet and Meg Sattler look at what’s needed to integrate CCE into the humanitarian architecture. Viviane Lucia Fluck and Dustin Barter discuss the institutional and practical barriers to implementing community feedback mechanisms. Bronwyn Russel analyses the performance of the Nepal inter-agency common feedback project; Justus Olielo and Charles-Antoine Hofmann outline the challenges of establishing common services in Yemen; and Gil Francis Arevalo reports on community engagement in preparedness and response in the Philippines. Ian McClelland and Frances Hill discuss emerging findings from a strategic partnership in the Philippines between the Humanitarian Innovation Fund and the Asian Disaster Reduction and Response Network.

Charlotte Lancaster describes how call centres in Afghanistan and Iraq are enhancing two-way communication with crisis-affected people. Mia Marzotto from Translators without Borders reflects on the importance of language and translation in communication and community engagement, and Ombretta Baggio and colleagues report on efforts to bring community perspectives into decision-making during an Ebola outbreak in the Democratic Republic of Congo. Ayo Degett highlights emerging findings from a Danish Refugee Council project on participation in humanitarian settings, and Jeff Carmel and Nick van Praag report on the Listen Learn Act (LLA) project. Geneviève Cyvoct and Alexandra T. Warner write on an innovative common platform to track the views of affected people in Chad. The edition ends with an article by Stewart Davies on collective accountability in the response to the Central Sulawesi earthquake.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 2, 2019
http://www.tandfonline.com/toc/khvi20/current

Article Commentary
Maternal vaccine knowledge in low- and middle-income countries—and why it matters
Anna Larson Williams, Rachel Mitrovich, Lawrence Mwananyanda & Chris Gill
Pages: 283-286
Published online: 10 Oct 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 2, 2019
http://www.tandfonline.com/toc/khvi20/current

Article
Measuring childhood vaccination acceptance of mother in Zhejiang province, East China
Yu Hu, Yaping Chen, Ying Wang & Hui Liang
Pages: 287-294
Published online: 05 Oct 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 2, 2019
http://www.tandfonline.com/toc/khvi20/current

Article
The impact of Measles-Rubella vaccination on the morbidity and mortality from Congenital Rubella Syndrome in 92 countries
Emilia Vynnycky, Timoleon Papadopoulos & Konstantinos Angelis
Pages: 309-316
Published online: 25 Oct 2018

Journal of Evidence-Based Medicine
Volume 12, Issue S1  Pages: 1-34  January 2019
https://onlinelibrary.wiley.com/toc/17565391/current

7th Meeting of the COMET Initiative (VII), Thursday 15th and Friday 16th November 2018, De Rode Hoed, Amsterdam
On the 15^th and 16^th November 2018, the Core Outcome Measures in Effectiveness Trials (COMET) Initiative held its seventh international meeting. After success at COMET VI, the COMET meeting returned to De Rode Hoed (The Red Hat) in Amsterdam for their second consecutive meeting. One‐hundred and fifteen participants gathered from around the world, coming from five continents and 18 countries.

The Lancet
Feb 23, 2019  Volume 393  Number 10173  p717-846, e30-e32
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Fetal medicine: past, present, and future
The Lancet

Maternal and Child Health Journal
Volume 23, Issue 2, February 2019
https://link.springer.com/journal/10995/23/2

Original Paper
Disparities in Tdap Vaccination and Vaccine Information Needs Among Pregnant Women in the United States
Jennifer L. Kriss, Alison P. Albert…

Nature 
Volume 566 Issue 7744, 21 February 2019
http://www.nature.com/nature/current_issue.html

Editorial | 20 February 2019
A new model for disease research in Africa
Locally led studies on public health are good for the continent and the globe. Scientists, politicians and funders should support it.

PLoS One
http://www.plosone.org/
[Accessed 23 Feb 2019]

Research Article
Vaccination timeliness among newborns and infants in Ethiopia
Matthew L. Boulton, Bradley F. Carlson, Abram L. Wagner, Julia M. Porth, Berhanu Gebremeskel, Yemesrach Abeje
Research Article | published 19 Feb 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0212408

PLoS One
http://www.plosone.org/
[Accessed 23 Feb 2019]

Research Article
Effectiveness of pneumococcal conjugate vaccines against invasive pneumococcal disease among children under five years of age in Africa: A systematic review
James Samwel Ngocho, Best Magoma, Gaudencia Alois Olomi, Michael Johnson Mahande, Sia Emmanueli Msuya, Marien Isaäk de Jonge, Blandina Theophil Mmbaga
Research Article | published 19 Feb 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0212295

Public Health  
Volume 167  Pages 1-160, A1-A2 (February 2019)
http://www.publichealthjrnl.com/current

Review article  Abstract only
A systematic review of the prevalence of limited health literacy in Southeast Asian countries

1. Rajah, M.A.A. Hassali, M.K. Murugiah

Pages 8-15

Public Health  
Volume 167  Pages 1-160, A1-A2 (February 2019)
http://www.publichealthjrnl.com/current

Research article  Abstract only
Neighbourhood influence on the fourth dose of diphtheria-tetanus-pertussis vaccination
S.T. Hegde, A.L. Wagner, P.J. Clarke, R.C. Potter, … M.L. Boulton
Pages 41-49

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Control and management strategies in multidrug-resistant tuberculosis: literature review
Review | Portuguese |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Co-management of tuberculosis and diabetes: an integrative review
Review | Portuguese |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Human papillomavirus vaccine receptivity: a systematic review
Review | Portuguese |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Legal framework for electronic medical records in the Region of the Americas: definition of domains to legislate and situation analysis
Original research | Spanish |

Science         
22 February 2019  Vol 363, Issue 6429
http://www.sciencemag.org/current.dtl

Editorial
The law and vaccine resistance
By Dorit Rubinstein Reiss
Science22 Feb 2019 : 795
[See Milestones/Perspectives above for full text]

Science         
22 February 2019  Vol 363, Issue 6429
http://www.sciencemag.org/current.dtl

South African law may impede human health research
By Linda Nordling
Science22 Feb 2019 : 802 Restricted Access
Data protection measure may block reuse of data in biobanks.
Summary
South Africa’s varied population makes it a magnet for research on public health and human diversity. But a new privacy law called The Protection of Personal Information Act, scheduled to go into effect in 2020, could upend such research. The law aims to protect South Africans from abuse of their personal data and says that such information, including genetic data, must be collected for a specific purpose—and that data subjects need to be “aware of the purpose.” But giant sample and data repositories called biobanks are transforming health research around the world by allowing multiple researchers to ask new questions of the same data. At a meeting in Cape Town on 4–5 February, lawyers, ethicists, and researchers discussed how the new South African rule could limit such secondary use of data and hamstring international collaborations.

Science         
22 February 2019  Vol 363, Issue 6429
http://www.sciencemag.org/current.dtl

Policy Forum
Regulation of predictive analytics in medicine
By Ravi B. Parikh, Ziad Obermeyer, Amol S. Navathe
Science22 Feb 2019 : 810-812 Restricted Access
Algorithms must meet regulatory standards of clinical benefit
Summary
Artificial intelligence (AI) and increased computing power have long held the promise of improving prediction and prognostication in health care (1). Now, use of predictive analytics and AI in medicine, though with fits and starts, is transitioning from hype to reality: Several commercial algorithms have received regulatory approval for broad clinical use. But the barrier for entry of new advanced algorithms has been low. To unlock the potential of advanced analytics while protecting patient safety, regulatory and professional bodies should ensure that advanced algorithms meet accepted standards of clinical benefit, just as they do for clinical therapeutics and predictive biomarkers. External validation and prospective testing of advanced algorithms are clearly needed (2), but recent regulatory clearances raise concerns over the rigor of this process. Given these concerns, we propose five standards to guide regulation of devices based on predictive analytics and AI. Although well-established research standards, such as the TRIPOD Checklist, exist for developing and validating multivariable prediction models in medicine (3), our standards provide regulatory guidance for such algorithms prior to implementation in clinical settings.

Science Translational Medicine
20 February 2019  Vol 11, Issue 480
http://stm.sciencemag.org/

Research Articles
Estimating cholera incidence with cross-sectional serology
By Andrew S. Azman, Justin Lessler, Francisco J. Luquero, Taufiqur Rahman Bhuiyan, Ashraful Islam Khan, Fahima Chowdhury, Alamgir Kabir, Marc Gurwith, Ana A. Weil, Jason B. Harris, Stephen B. Calderwood, Edward T. Ryan, Firdausi Qadri, Daniel T. Leung
Science Translational Medicine20 Feb 2019 Open Access CCBY
Cross-sectional Vibrio cholerae–related antibody measures can be used to estimate cholera incidence in a population.
Estimating the true prevalence of cholera
Successful development of anti-cholera measures requires accurate estimates of infection incidence. Reporting of cholera cases, however, typically relies on clinical assessment at the time of patient presentation and can be problematized by lack of access to health care and variable, nonspecific symptomatology. Combining a small number of serological markers with machine learning methods, Azman et al. were able to accurately detect individuals who had had cholera infections within the previous year. Simulated serosurveys showed that this simple antibody-based approach could potentially be used as an alternative method to estimate cholera incidence in a population.
Abstract
The development of new approaches to cholera control relies on an accurate understanding of cholera epidemiology. However, most information on cholera incidence lacks laboratory confirmation and instead relies on surveillance systems reporting medically attended acute watery diarrhea. If recent infections could be identified using serological markers, cross-sectional serosurveys would offer an alternative approach to measuring incidence. Here, we used 1569 serologic samples from a cohort of cholera cases and their uninfected contacts in Bangladesh to train machine learning models to identify recent Vibrio cholerae O1 infections. We found that an individual’s antibody profile contains information on the timing of V. cholerae O1 infections in the previous year. Our models using six serological markers accurately identified individuals in the Bangladesh cohort infected within the last year [cross-validated area under the curve (AUC), 93.4%; 95% confidence interval (CI), 92.1 to 94.7%], with a marginal performance decrease using models based on two markers (cross-validated AUC, 91.0%; 95% CI, 89.2 to 92.7%). We validated the performance of the two-marker model on data from a cohort of North American volunteers challenged with V. cholerae O1 (AUC range, 88.4 to 98.4%). In simulated serosurveys, our models accurately estimated annual incidence in both endemic and epidemic settings, even with sample sizes as small as 500 and annual incidence as low as two infections per 1000 individuals. Cross-sectional serosurveys may be a viable approach to estimating cholera incidence.

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Short communication  Open access
POLICI: A web application for visualising and extracting yellow fever vaccination coverage in Africa
Arran Hamlet, Kévin Jean, Sergio Yactayo, Justus Benzler, … Tini Garske
Pages 1384-1388

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Open access
Age-related immunogenicity and reactogenicity of live oral cholera vaccine CVD 103-HgR in a randomized, controlled clinical trial
James M. McCarty, Michael D. Lock, Sean Bennett, Kristin M. Hunt, … Marc Gurwith
Pages 1389-1397

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
Community acceptance and willingness-to-pay for a hypothetical Zika vaccine: A cross-sectional study in Indonesia
Harapan Harapan, Mudatsir Mudatsir, Amanda Yufika, Yusuf Nawawi, … Allison Imrie
Pages 1398-1406

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Open access
Developing standardized competencies to strengthen immunization systems and workforce
Denise Traicoff, Alice Pope, Peter Bloland, Dharmesh Lal, … Hardeep Sandhu
Pages 1428-1435

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
Factors affecting parental intention to vaccinate kindergarten children against influenza: A cross-sectional survey in China
Yanbing Zeng, Zhipeng Yuan, Jiahui Yin, Yaofeng Han, … Ya Fang
Pages 1449-1456

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
The anti-vaccine movement in Poland: The socio-cultural conditions of the opposition to vaccination and threats to public health
Piotr Żuk, Paweł Żuk, Justyna Lisiewicz-Jakubaszko
Pages 1491-1494

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
Perceptions and acceptability of an experimental Ebola vaccine among health care workers, frontline staff, and the general public during the 2014–2015 Ebola outbreak in Sierra Leone
Mohamed F. Jalloh, Mohammad B. Jalloh, Alison Albert, Brent Wolff, … Helena Nordenstedt
Pages 1495-1502
 
 

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

Global Health Action
[01 Jan 2019, 12(1):1574544]
Article
Organization and implementation of an oral cholera vaccination campaign in an endemic urban setting in Dhaka, Bangladesh.
IA Khan, AI Khan, A Rahman, SA Siddique, MT Islam… –
Abstract
Bangladesh has historically been cholera endemic, with seasonal cholera outbreaks occurring each year. In collaboration with the government of Bangladesh, the Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) initiated operational research to test strategies to reach the high-risk urban population with an affordable oral cholera vaccine (OCV) “ShancholTM” and examine its effectiveness in reducing diarrhea due to cholera. Here we report a sub-analysis focusing on the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. We described how the vaccination program was planned, prepared and implemented using different strategies to deliver oral cholera vaccine to a high-risk urban population in Dhaka, Bangladesh based on administrative data and observations made during the program. The objective of this study is to evaluate the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. OCV administration by trained local volunteers through outreach sites and mop-up activities yielded high coverage of 82% and 72% of 172,754 targeted individuals for the first and second dose respectively, using national Expanded Program on Immunization (EPI) campaign mechanisms without disrupting routine immunization activities. The cost of delivery was low. Safety and cold chain requirements were adequately managed. The adopted strategies were technically and programmatically feasible. Current evidence on implementation strategies in different settings together with available OCV stockpiles should encourage at-risk countries to use OCV along with other preventive and control measures.
 
 

Family & Community Health
April/June 2019 – Volume 42 – Issue 2 – p 161–169
https://journals.lww.com/familyandcommunityhealth/pages/default.aspx
Original Articles
Toward a Model of HPV Vaccine Series Completion in Adolescent Hispanic Males: Identifying Mothers’ Salient Behavioral, Normative, and Control Beliefs
AM Roncancio, CC Carmack, KK Ward, SW Vernon…
Abstract
Human papillomavirus (HPV) vaccine series completion among adolescent Hispanic males (35%) is lower than the Healthy People 2020 80% goal. This directed qualitative content analysis identified mothers’ beliefs about their sons completing the series. We found that mothers (N = 19) (1) express positive feelings; (2) believe the vaccine has positive effects; (3) identify the father and doctors as supporters and friends as nonsupporters; (4) list health insurance, transportation, and clinic reminders as facilitators; and (5) mention affordability as a barrier to vaccine completion. Results provide guidance for interventions. Increasing HPV vaccination among boys will decrease the overall incidence of HPV in this population.
 
 

Journal of Adolescent Health
Available online 15 February 2019
Original article
Predictors of Human Papillomavirus Vaccine Completion Among Low-Income Latina/o Adolescents
MA Gerend, YP Stephens, MM Kazmer, EH Slate… – Journal of Adolescent …, 2019
The purpose of this longitudinal study was to identify individual and interpersonal factors associated with human papillomavirus (HPV) vaccine series completion in a sample of low-income Latina/o adolescent girls and boys.
American Journal of Preventive Medicine
Available online 15 February 2019
Review Article
Human Papillomavirus Vaccine Interventions in the US: A Systematic Review and Meta-analysis
AM Rodriguez, TQN Do, M Goodman, KM Schmeler… – American Journal of …, 2019
Despite current recommendations, human papillomavirus vaccine uptake remains low. A systematic review and meta-analysis assessed the effectiveness of interventions targeting human papillomavirus vaccine initiation and completion among children, adolescents, and young adults aged 9–26 years.
 
Deutsche Medizinische Wochenschrift (1946)
[13 Feb 2019, 144(4):244-253]
Journal Article
Gaps in Vaccine Coverage and Adverse Effects of Vaccines-An Overview
C Bogdan – Deutsche medizinische Wochenschrift (1946), 2019
Abstract
The success of vaccination programs is jeopardized by gaps in vaccine coverage of the target population. These are frequently due to a lack of awareness, but also result from misconceptions of adverse effects of vaccines. Subject of this article are the current vaccination rates of children, adolescents and adults as well as of medical personnel in Germany, the reporting and surveillance system for adverse effects of vaccines, the magnitude of registered permanent vaccine-induced damages and the possible immunological mechanisms underlying vaccine-triggered autoimmune diseases.
 

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.

 
 
The Associated Press
https://apnews.com/
Accessed 23 Feb 2019
More than 900 dead in Madagascar measles outbreak
February 21, 2019
JOHANNESBURG (AP) — The World Health Organization says that an epidemic of measles in Madagascar has caused more than 900 deaths.
According to WHO figures, there have been more than 68,000 cases of the disease in which 553 deaths were confirmed and another 373 suspected from measles since the outbreak began in September.
Those most at risk are infants from nine to 11 months old.
The epidemic is blamed on a low immunization rate for measles across the island nation over a period of many years, according to WHO spokesman Tarik Jasarevic. The vaccination rate is estimated to be less than 60 percent, according to figures from WHO and UNICEF figures, he said.
Madagascar has launched a nationwide campaign to try to bring the outbreak under control, through mass vaccination campaigns and surveillance.
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
BBC
http://www.bbc.co.uk/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
The Economist
http://www.economist.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Forbes
http://www.forbes.com/
Accessed 23 Feb 2019
5 Cognitive Biases That Explain Why People Still Don’t Vaccinate
Parents who refuse to vaccinate their children often fall prey to several common cognitive biases, experts say.
By  Sarah Watts  Contributor
…The subject of vaccines involves complex medical science, so the mechanism of how they work and what’s in them can be hard for a layperson to understand. Additionally, because public safety is involved (particularly the safety of children, who are more vulnerable to disease), strong emotions abound. As a result, people are likely to fall prey to a number of cognitive biases when deciding whether or not to vaccinate. Here are just five examples.
1. Cognitive dissonance. “Cognitive dissonance occurs when an individual has conflicting thoughts or behavior. To ease the discomfort, the individual either needs to change the behavior or change the belief,” says Smith. For a parent who hears about the efficacy of vaccines but also worries they may harm their child, they may decide that vaccines don’t work in order to eliminate the dissonance. “Though these conclusions are incorrect, choosing to believe them makes parents feel better about their choices to not vaccinate,” says Smith.

2) Omission bias. “One interesting bias I’ve come upon is the omission bias,” says Dr. Nidhi Ghildayal, researcher and PhD in Public Health at the University of Minnesota. In regard to vaccines, the omission bias occurs when “parents believe that the act of vaccinating, which they may have heard has a small chance of [side effects], is worse than simply not committing any action, even if the potential consequences of this non-action pose a significantly higher risk.” In other words, not vaccinating can feel safer because it’s an inaction – even though the risks involved in that inaction are greater.

3) Confirmation bias. Parents who choose not to vaccinate may also rely on confirmation bias to justify their decision, says Smith. “Confirmation bias is the tendency to interpret or focus on information which supports our existing beliefs,” she says. Although everyone falls victim to confirmation bias some of the time, parents who choose not to vaccinate “frequently turn a blind eye to the copious research and evidence that shows the necessity of vaccines, and instead focus on any evidence that supports what they believe in order to feel better about their decision,” Smith says.

4) Availability heuristic. “The availability heuristic is another common cognitive bias in which individuals tend towards remembering or rehashing rare or distant instances in which vaccines have failed, as opposed to understanding and retaining all the instances in which vaccines have worked and prevented illness,” Ghildayal says. “Media and social circles are much more likely to bring up these rare occurrences, so an individual is much more likely to have those cases in the front of their mind.”

5) Illusory correlation. The illusory correlation is a belief that a relationship exists between two variables when in reality, it probably doesn’t. “Parents may choose to believe that children who show symptoms of autism have been influenced by vaccinations, since the symptoms and the vaccinations tend to occur around the same time,” says Smith, even though the connection between autism and vaccinations has been debunked. “A preconceived belief about the connection between vaccination and autism leads parents to use any incidence where autism and vaccination co-occur to confirm their bias and to support their choice to not vaccinate.”

 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
The Guardian
http://www.guardiannews.com/
Accessed 23 Feb 2019
Vaccines and immunisation
Opinion
The Guardian view on vaccination: a duty of public health
Editorial
The anti-vaxx movement arises from mistrust but threatens the physical health of society
Sun 17 Feb 2019
[See Milestones/Perspectives above for full text]
 
 
New Yorker
http://www.newyorker.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
New York Times
http://www.nytimes.com/
Accessed 23 Feb 2019
Health
Feb 23, 2019
Pinterest Restricts Vaccine Search Results to Curb Spread of Misinformation
Pinterest, a digital platform popular with parents, took an unusual step to crack down on the proliferation of anti-vaccination propaganda: It purposefully hobbled its search box.
Type “vaccine” into its search bar and nothing pops up. “Vaccination” or “anti-vax”? Also nothing.
Pinterest, which allows people to save pictures on virtual pinboards, is often used to find recipes for picky toddlers, baby shower décor or fashion trends, but it has also become a platform for anti-vaccination activists who spread misinformation on social media.
It is an especially effective way to reach parents: 80 percent of mothers and 38 percent of fathers in the United States are on Pinterest, according to 2017 data from comScore. The company has more than 250 million monthly active users and is expected to go public this year.
Other platforms like Facebook and YouTube have also been infiltrated with misinformation about vaccines, and are taking steps to combat it. One of YouTube’s policies is to demonetize anti-vaccine videos.
But only Pinterest, as first reported by The Wall Street Journal, has chosen to banish results associated with certain vaccine-related searches, regardless of whether the results might have been reputable.
“Right now, blocking results in search is a temporary solution to prevent people from encountering harmful misinformation,” said Jamie Favazza, a spokeswoman. The company said it was working with experts to develop a more tailored long-term approach.
The changes, which were not publicly announced, started in September and October.
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Washington Post
http://www.washingtonpost.com/
Accessed 23 Feb 2019
Some anti-vaccination parents cite religious exemptions. Measles outbreaks could change that.
Sarah Pulliam Bailey · Feb 21, 2019

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 23 Feb 2019
[No new relevant content]

Center for Global Development
http://www.cgdev.org/page/press-center
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 23 Feb 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 23 Feb 2019
[No new relevant content]

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 23 Feb 2019
[No new relevant content]