Clinical use of current polygenic risk scores may exacerbate health disparities

Nature Genetics
Volume 51 Issue 4, April 2019
https://www.nature.com/ng/volumes/51/issues/4

Perspective | 29 March 2019
Clinical use of current polygenic risk scores may exacerbate health disparities
This Perspective discusses scientific and ethical considerations regarding the clinical use of polygenic risk scores, highlighting the pressing need to diversify cohorts for genetic studies beyond European-ancestry populations.
Alicia R. Martin, Masahiro Kanai […]  & Mark J. Daly

Adaptive immune responses to primary and secondary dengue virus infections

Nature Reviews Immunology
Volume 19 Issue 4, April 2019
https://www.nature.com/nri/volumes/19/issues/4

Review Article | 24 January 2019
Adaptive immune responses to primary and secondary dengue virus infections
The existence of four different serotypes of dengue virus poses a challenge to vaccine development, as pre-existing immunity can lead to severe disease during infection with a heterologous serotype. This Review analyses the mechanisms of protective and pathological adaptive immune responses in primary and secondary dengue infection.
Ashley L. St. John  & Abhay P. S. Rathore

Abstract
Dengue is the leading mosquito-borne viral illness infecting humans. Owing to the circulation of multiple serotypes, global expansion of the disease and recent gains in vaccination coverage, pre-existing immunity to dengue virus is abundant in the human population, and secondary dengue infections are common. Here, we contrast the mechanisms initiating and sustaining adaptive immune responses during primary infection with the immune pathways that are pre-existing and reactivated during secondary dengue. We also discuss new developments in our understanding of the contributions of CD4+ T cells, CD8+ T cells and antibodies to immunity and memory recall. Memory recall may lead to protective or pathological outcomes, and understanding of these processes will be key to developing or refining dengue vaccines to be safe and effective.

Social Media in the Age of the “New Polio”

New England Journal of Medicine
March 28, 2019   Vol. 380 No. 13
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Social Media in the Age of the “New Polio”
Riley Bove, M.D.
When her son developed acute flaccid myelitis, a neurologist turned to a parent support group on Facebook, where she found recommended rehabilitation experts, information on electrical stimulation devices, templates for letters to insurers, and other key information.
 

A whole-health–economy approach to antimicrobial stewardship: Analysis of current models and future direction

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 30 Mar 2019)

Policy Forum
A whole-health–economy approach to antimicrobial stewardship: Analysis of current models and future direction
Monsey McLeod, Raheelah Ahmad, Nada Atef Shebl, Christianne Micallef, Fiona Sim, Alison Holmes
| published 29 Mar 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002774
Summary points
:: Antimicrobial stewardship (AMS) strategies are widely implemented in single healthcare sectors and organisations; however, the extent and impact of integrated AMS initiatives across the whole health economy are unknown.
:: Assessing degree of integration of AMS across the whole health economy and its impact is essential if we are to achieve a ‘One Health’ approach to addressing antimicrobial resistance (AMR), and therefore we searched systematically for and analysed published examples of integrated AMS initiatives to address this gap.
:: Application of a system-level framework to analyse integration of AMS initiatives across and within healthcare sectors shows that integration is emerging but needs strengthening.
:: Findings from a small number of evaluations in high-income countries suggest that antimicrobial prescribing and healthcare-associated infections can be reduced using a multisectoral integrated AMS approach.
:: More robust research designs to evaluate and understand the impact of multisectoral integrated AMS are needed, particularly with respect to differing health systems in different countries and local organisational contexts.
:: Our analysis highlights a number of challenges and ways forward for enhancing the delivery of AMS through an integrated approach.

Measles vaccination: A matter of confidence and commitment

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 30 Mar 2019)

Editorial
Measles vaccination: A matter of confidence and commitment
Richard Turner, on behalf of the PLOS Medicine Editors
| published 26 Mar 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002770
Prominent among the anxieties of our times are those regarding health and disease. Not only are ageing populations expected to suffer an increased burden of noncommunicable diseases in the future, but risks of and harms from existing and emerging infectious diseases could also increase, owing to population growth, migration, climate change, and other factors. At the population level, it is clear that the hard-won gains in medicine and public health brought about by vaccination, antimicrobial and other treatments, and improved sanitation will need to be sustained, broadened, and intensified to protect and provide for an increasing proportion of the human population. Global aspirations, including those set out in the Sustainable Development Goals, are unambiguous in setting out an anticipated future trajectory of improved health, well-being, and prosperity.

Measles, a highly contagious viral infection, is in various respects the perfect example of a threat to health that respects neither aspirations nor boundaries between developed and developing countries. Complications of measles infection include pneumonia (the most common cause of death in children with measles), encephalitis, ear infections that can lead to permanent deafness, and diarrhoea. Although a safe and very effective two-dose vaccination schedule has been available and widely deployed since the 1960s, the need for very high and consistent vaccination coverage to elicit herd immunity means that the disease burden and harms of measles remain substantial. WHO reports that globally, in an apparent uptrend of cases occurring in 2017, measles led to an estimated 110,000 deaths, most in children aged under 5 years [1]. Tragically, these deaths were unavoidable, given the estimated 20.8 million children in low- and middle-income countries who had not received a single dose of measles vaccine through routine programmes in that year.

In the 53 high- and middle-income countries that make up its European region, WHO has indicated that around 82,500 cases of measles were reported in 2018, an alarmingly high number even among a population in excess of 900 million people, and a greater than 3-fold increase since 2017 [2]. There were 72 reported deaths in children and adults. Here, the European Vaccine Action Plan 2015–2020 recognizes the need for high and consistent levels of vaccine coverage yet acknowledges the difficulties in meeting the challenges of achieving high and equitable coverage, owing to the existing pronounced variations in national and regional coverage with measles vaccination.

In the United States, despite the declared elimination of measles in 2000, outbreaks have been well documented in recent years—the outbreak in Southern California during December 2014–February 2015 involved at least 125 cases [3]. Among these cases, a substantial proportion were in people known not to have been vaccinated, including infants who were too young to have been protected and individuals who had chosen not to receive measles vaccination (i.e., 49 people were unvaccinated among the 110 cases identified in California). More recently, an outbreak in Clark County, Washington State has been widely reported in the past few weeks, and at the time of writing there had been 65 confirmed measles cases in this area [4]. In 2018, writing in PLOS Medicine, Jacqueline Olive and colleagues highlighted clusters of people claiming nonmedical exemptions from measles vaccination in states where this is permitted by law [5]. The authors noted that ‘new foci of antivaccine activities are being established in major metropolitan areas, rendering select cities vulnerable for vaccination-preventable diseases.’ It is difficult to imagine a future scenario without repeated and serious measles outbreaks in the US and elsewhere, given the gaps in protection against the disease. A cautionary indication of the extent to which the dangers of so-called ‘vaccine hesitancy’ can escalate is in the Philippines, where there are reported to have been thousands of measles cases and at least 189 deaths since the beginning of 2019, mainly in children [6].

The reasons for people not accepting vaccination against measles and other potentially fatal and readily preventable infections are, unfortunately, all too well known. Fears about potential harms of the combined measles, mumps, and rubella vaccination were raised by a discredited study published in The Lancet in 1998 and are continuing to circulate. As Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine, Houston, Texas, commented to PLOS Medicine, ‘the “anti-Vax” movement began as a fringe group but has now become a media empire in its own right, producing hundreds of websites, books, and videos. Even if a concerted effort were mounted against this movement, it could take years to be effective.’ Despite the volumes of scientific research and debate published in the intervening 20 years, supporting beyond reasonable doubt the overwhelmingly favourable benefit:risk assessment for vaccination against measles and other infectious diseases, levels of scepticism clearly persist and are being propagated in susceptible populations worldwide. It seems that the growth of social media has facilitated the development of geographically widespread communities with fixed yet indefensible opinions, where hearsay is spread intensively while robust medical evidence and guidance hold little sway.

It would probably be unwise to expect a single approach or constituency to be able to change minds opposed to vaccination. In the case of measles, high-quality surveillance activities alongside well-supported and planned vaccination programmes are essential to bring about progressive reductions in the high burden of morbidity and deaths in developing countries. In settings where limited public acceptance of measles vaccination is a danger, imaginative governmental and, where viable, civil society- or NGO-led information campaigns are needed to drive uptake of vaccination, alongside the essential underpinnings of culturally appropriate incentives and legal provisions. Healthcare professionals, who in many countries are generally trusted and enjoy a high level of confidence from the public, are likely to be an underused resource in conveying accurate information and advice on vaccines and vaccination through formal and informal routes. Ultimately, the question is one of altruism: everyone who has experienced the silent but long-lasting protection afforded by vaccination has the responsibility to promote understanding and acceptance of the benefits to others. Our neighbours and, most of all, their children, deserve nothing less.

[references at title link above]

Global expansion and redistribution of Aedes-borne virus transmission risk with climate change

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 30 Mar 2019)

Research Article
Global expansion and redistribution of Aedes-borne virus transmission risk with climate change
Sadie J. Ryan, Colin J. Carlson, Erin A. Mordecai, Leah R. Johnson
| published 28 Mar 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007213
Author summary
The established scientific consensus indicates that climate change will severely exacerbate the risk and burden of Aedes-transmitted viruses, including dengue, chikungunya, Zika, and other significant threats to global health security. Here, we show more subtle impacts of climate change on transmission, caused primarily by differences between the more heat-tolerant Aedes aegypti and the more heat-limited Ae. albopictus. Within the next century, nearly a billion people could face their first exposure to viral transmission from either mosquito in the worst-case scenario, mainly in Europe and high-elevation tropical and subtropical regions. However, while year-round transmission potential from Ae. aegypti is likely to expand (particularly in south Asia and sub-Saharan Africa), Ae. albopictus transmission potential is likely to decline substantially in the tropics, marking a global shift towards seasonal risk as the tropics eventually become too hot for transmission by Ae. albopictus. Complete mitigation of climate change to a pre-industrial baseline may protect almost a billion people from arbovirus range expansions; however, middle-of-the-road mitigation could produce the greatest expansion in the potential for viral transmission by Ae. albopictus. In any scenario, mitigating climate change would shift the projected burden of both dengue and chikungunya (and potentially other Aedes transmitted viruses) from higher-income regions back onto the tropics, where transmission might otherwise begin to decline due to rising temperatures.

A systematic review of interventions to improve uptake of pertussis vaccination in pregnancy

PLoS One
http://www.plosone.org/
[Accessed 30 Mar 2019]

Research Article
A systematic review of interventions to improve uptake of pertussis vaccination in pregnancy
Hassen Mohammed, Mark McMillan, Claire T. Roberts, Helen S. Marshall
Research Article | published 28 Mar 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0214538
Abstract
Background
Maternal pertussis vaccination has been introduced in several countries to prevent pertussis morbidity and mortality in infants too young to be vaccinated. Our review aimed to systematically collect and summarize the available evidence on the effectiveness of interventions used to improve pertussis vaccination uptake in pregnant women.
Methods
We conducted a systematic search of MEDLINE/PubMed, PMC and CINAHL. Before and after studies and those with a concurrent control group were considered for inclusion. Standardized effect sizes were described as the ratio of the odds to be vaccinated in the intervention group compared with the standard care group and absolute benefit increase (ABI) were calculated.
Results
Six studies were included in the review, of which three were randomized controlled trials (RCTs). Strategies to improve uptake were focused on healthcare providers, pregnant women, or enhancing vaccine access. Healthcare provider interventions included provider reminder, education, feedback and standing orders. Interventions directed at pregnant women focused solely on education. Observational studies showed: (1) the provision of maternal pertussis vaccination by midwives at the place of antenatal care has improved uptake of pertussis vaccine during pregnancy from 20% to 90%; (2) introduction of an automated reminder within the electronic medical record was associated with an improvement in the pertussis immunization rate from 48% to 97%; (3) an increase in prenatal pertussis vaccine uptake from 36% to 61% after strategies to increase provider awareness of recommendations were introduced. In contrast to these findings, interventions in all three RCTs (2 involved education of pregnant women, 1 had multi-component interventions) did not demonstrate improved vaccination uptake.
Conclusions
Based on the existing research, we recommend incorporating midwife delivered maternal immunization programs at antenatal clinics, use of a provider reminder system to target unvaccinated pregnant women and include maternal pertussis immunization as part of standard antenatal care.
 

“We are Muslims and these diseases don’t happen to us”: A qualitative study of the views of young Somali men and women concerning HPV immunization

Vaccine
Volume 37, Issue 15   Pages 2043-2166 (3 April 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/15

Research article Abstract only
“We are Muslims and these diseases don’t happen to us”: A qualitative study of the views of young Somali men and women concerning HPV immunization
Minnesota is home to the largest Somali immigrant population in the United States. Despite high rates of cervical cancer in this population, immunization rates for the human papillomavirus (HPV) are among the lowest in the nation. Targeting Somali young adults for catch-up vaccinations may be an important strategy for addressing these low rates. This study sought to understand the views of Somali young adults regarding HPV immunization.
Rebekah Pratt, Sharon W. Njau, Channelle Ndagire, Nicole Chaisson, … Jay Dirks
Pages 2043-2050

Assessing optimal use of the standard dose adjuvanted trivalent seasonal influenza vaccine in the elderly

Vaccine
Volume 37, Issue 15   Pages 2043-2166 (3 April 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/15

Research article Abstract only
Assessing optimal use of the standard dose adjuvanted trivalent seasonal influenza vaccine in the elderly
Dominic Thorrington, Edwin van Leeuwen, Mary Ramsay, Richard Pebody, Marc Baguelin
Pages 2051-2056

Simulated vaccine efficacy trials to estimate HIV incidence for actual vaccine clinical trials in key populations in Uganda

Vaccine
Volume 37, Issue 15   Pages 2043-2166 (3 April 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/15

Research article  Open access
Simulated vaccine efficacy trials to estimate HIV incidence for actual vaccine clinical trials in key populations in Uganda
Andrew Abaasa, Stephen Nash, Yunia Mayanja, Matt Price, … Jim Todd
Pages 2065-2072

Vaccine non-receipt and refusal in Ethiopia: The expanded program on immunization coverage survey, 2012

Vaccine
Volume 37, Issue 15   Pages 2043-2166 (3 April 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/15

Research article Abstract only
Vaccine non-receipt and refusal in Ethiopia: The expanded program on immunization coverage survey, 2012
Julia M. Porth, Abram L. Wagner, Habtamu Teklie, Yemesrach Abeje, … Matthew L. Boulton
Pages 2106-2121

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

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

Journal of Epidemiology and Global Health
Vol. 9(1); March (2019), pp. 11–18
Research Paper
Indonesian Hajj Cohorts and Mortality in Saudi Arabia from 2004 to 2011
M Pane, FYM Kong, TB Purnama, K Glass, S Imari… – Journal of Epidemiology …, 2019
ABSTRACT
The Hajj is an annual pilgrimage that 1–2 million Muslims undertake in the Kingdom of Saudi Arabia (KSA), which is the largest mass gathering event in the world, as the world’s most populous Muslim nation, Indonesia holds the largest visa quota for the Hajj. All Hajj pilgrims under the quota system are registered in the Indonesian government’s Hajj surveillance database to ensure adherence to the KSA authorities’ health requirements. Performance of the Hajj and its rites are physically demanding, which may present health risks. This report provides a descriptive overview of mortality in Indonesian pilgrims from 2004 to 2011. The mortality rate from 2004 to 2011 ranged from 149 to 337 per 100,000 Hajj pilgrims, equivalent to the actual number of deaths ranging between 501 and 531 cases. The top two mortality causes were attributable to diseases of the circulatory and respiratory systems. Older pilgrims or pilgrims with comorbidities should be encouraged to take a less physically demanding route in the Hajj. All pilgrims should be educated on health risks and seek early health advice from the mobile medical teams provided.
 
 
Journal of American College Health
Received 16 Nov 2018, Accepted 07 Feb 2019, Published online: 25 Mar 2019
Major Article
Family factors associated with emerging adults’ human papillomavirus vaccine behavior
DA Quinn, A Lewin
Abstract
Objective: The current study examined the role of family influences on the vaccine behavior of emerging adults.
Participants: In Spring 2017, we conducted anonymous online surveys of undergraduate students (n=608) at a large, public university in the mid-Atlantic.
Methods: Logistic regression was used to examine associations between family factors and students’ awareness of the HPV vaccine, vaccine receipt, and vaccine intentions. Family factors included sex communication, religiosity, parental monitoring, family structure, and parents’ birthplace. Results: More comprehensive family sex communication is associated with less uncertainty regarding HPV vaccine receipt and greater likelihood of being already vaccinated. More frequent family religiosity and more parental monitoring are associated with greater likelihood of having decided against vaccination rather than already being vaccinated. Significant gender and racial disparities exist.
Conclusion: Further research, policy, and programmatic intervention are needed to reduce disparities and to improve emerging adults’ compliance with HPV vaccine recommendations.

  
Journal of American College Health
Received 30 Aug 2018, Accepted 08 Feb 2019, Published online: 25 Mar 2019
Major Article
Understanding vaccine knowledge, attitudes, and decision-making through college student interviews
K Sandler, T Srivastava, OA Fawole, C Fasano… – Journal of American College …, 2019
Abstract
Objective: We aimed to explore knowledge, attitudes, and beliefs about vaccines required for college-entry and vaccine-related behaviors among college students.
Participants: Thirty-three full-time undergraduate students, ≥ 18 years old, enrolled at public (2) and private (3) colleges and universities in metropolitan Philadelphia in fall 2016.
Methods: We conducted semistructured interviews, which were double-coded with 5,015 comments overall and 99.3% intercoder reliability (κ = 0.779) using NVivo 11 software.
Results: Six key themes emerged: (1) low knowledge about vaccines and requirements; (2) mixed attitudes about required vs. recommended vaccines; (3) high trust in medical professionals; (4) low perceived risk for vaccine-preventable disease outbreaks; (5) substantial parental influence on students’ decision-making; and (6) low utilization of Student Health Services.
Conclusions: This study revealed lack of knowledge about and low prioritization of vaccination despite overall positive attitudes towards vaccines. Prematriculation education of college students is critical to increasing vaccine knowledge and use.

Journal of the International Association of Providers of AIDS Care
Volume 18: 1-9, 2019
Original Article
HIV Vaccine Preparedness among Men Who Have Sex with Men in Taiwan: Sociocultural and Behavioral Factors
DM Chuang, PA Newman, J Weaver – Journal of the International Association of …, 2019
Abstract
In Taiwan, men who have sex with men (MSM) are at disproportionate risk of HIV infection. We examined awareness and acceptability of future HIV vaccines. From July to August 2014, we conducted a cross-sectional survey with MSM recruited through community-based organizations (CBOs) in 2 cities. Among 200 participants (mean age, 27.6 years), half reported multiple partners and one-third condomless anal sex (past 3 months); 12% were HIV-positive. Traditional Chinese medicine (TCM) usewas reported by 42.7%. Over two-thirds (69.0%) were aware of HIV vaccine research, but less than half (43.8%) would accept an HIV vaccine if available. In multivariable analysis, higher educational attainment, >5 sex partners, and TCM use were positively associated with HIV vaccine awareness. Culturally informed HIV vaccine preparedness in Taiwan may be supported by a complementary approach to TCM and HIV prevention technologies, tailoring information for MSM with lower education and targeting those at high risk through gay-identified CBOs.

 

Wiadomosci Lekarskie
[01 Jan 2019, 72(2):255-260] (Warsaw, Poland : 1960)
Vaccination coverage rates and the incidence of vaccine preventable diseases among children in sumy region of Ukraine.
VA Smiianov, HS Zaitseva, VA Kurganskaya… – … lekarskie (Warsaw, Poland …, 2019
Abstract
OBJECTIVE: Introduction: Routine immunization contributes immensely to decline the incidence of vaccine preventable diseases among children. Statistical data shown the sharply decrease the vaccination coverage rates in Sumy region of Ukraine. The aim: Assess routine immunization uptake and its effect on the incidence of vaccine preventable diseases among children in Sumy region of Ukraine.
RESULTS: Review: During some years, only 50-60 % of Sumy region children had received all recommended vaccines, which is far below World Health Organization target of 80 %. This has led to an increase of morbidity associated with some infectious diseases. Outbreaks of measles were registered in 2006 and 2012, when were ill 9346 and 7931 children respectively. Massive measles outbreak ongoing nowadays. Total number infected have already exceeded 35,000 cases.
CONCLUSION: Conclusions: RI uptake in Ukraine is still below World Health Organization target. The main reason for the ongoing measles outbreak was low vaccination coverage for routine immunization antigens as a result of which collective immunity decreased to a critical level. Strict monitoring of the implementation of the immunization schedule by medical institutions at all levels are recommended to improve vaccination status of Ukrainian children.

 

Media/Policy Watch

Media/Policy Watch

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

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.
 
 
The Associated Press
https://apnews.com/
Accessed 30 Mar 2019
Lawmaker seeks legal opinion on scrapping vaccine exemption
By SUSAN HAIGH  29 March 2019

HARTFORD, Conn. (AP) — A senior lawmaker asked Connecticut’s attorney general on Friday to determine whether it would be constitutional to eliminate a religious exemption to the requirement that schoolchildren be vaccinated.

Democratic House Majority Leader Matt Ritter believes the exemption is being abused and should be scrapped in light of the uptick in measles and other outbreaks across the U.S. But he asked Attorney General William Tong for a formal opinion regarding any potential state or federal constitutional impediments in a letter obtained by The Associated Press.

“As you may know, three states — California, Mississippi and West Virginia — currently do not have a religious or philosophical exemption for required school immunizations,” he wrote. “In addition, the lack of either exemption has been challenged and upheld under federal constitutional principles.”…
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 30 Mar 2019
[No new, unique, relevant content]
 
 
BBC
http://www.bbc.co.uk/
Accessed 30 Mar 2019
26 Mar 2019
Brexit: Flu vaccine ‘could be airlifted into UK’
Drugs company Sanofi has plans to fly supplies of flu vaccine into the UK if other transport routes are disrupted after the country leaves the EU.
 
 
The Economist
http://www.economist.com/
Accessed 30 Mar 2019
Sharp exchanges – Hanging with the anti-vaxxers
Scientists and public-health officials could learn something from them
Mar 28th 2019 | EVANSTON, ILLINOIS
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 30 Mar 2019
The world must wake up to the threat of latest Ebola outbreak
 
 
Forbes
http://www.forbes.com/
Accessed 30 Mar 2019
Mar 28, 2019
What Rights Do Teens Have When It Comes To Their Health?
The laws regarding teen minors being able to decide to forego or proceed with medical care vary from state to state. In the setting of multiple outbreaks of vaccine-preventable illnesses, teens are opting to go against their parents and get vaccinated.
By Nina Shapiro  Contributor
 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 30 Mar 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 30 Mar 2019
[No new, unique, relevant content]
 
 
The Guardian
http://www.guardiannews.com/
Accessed 30 Mar 2019
Forget Trump – anti-vaxxers are the clear and present danger 
The measles outbreak in New York is an entirely predictable emergency. Those responsible should be publicly shamed
@emmabrockes
Thu 28 Mar 2019 09.09 EDT Last modified on Thu 28 Mar 2019 15.15 EDT
 
 
New Yorker
http://www.newyorker.com/
Accessed 30 Mar 2019
[No new, unique, relevant content]
 
 
New York Times
http://www.nytimes.com/
Accessed 30 Mar 2019
Africa
Mozambique Says Cholera Cases Up to 271 in Cyclone-Hit City
Cholera cases among cyclone survivors in Mozambique have jumped to 271, authorities said, a figure that nearly doubled from the previous day.
March 30
 
 
U.S.
With Guns Drawn, Officers Raided Home to Get Feverish Child
The police burst into an Arizona home to take custody of a toddler, raising questions about when parents can be stripped of control over their children’s health care.
March 29
 
 
Europe
Congo Registers Record 15 New Ebola Cases in One Day
Democratic Republic of Congo on Friday recorded 15 new confirmed cases of Ebola, the biggest one-day rise since the current outbreak was declared last August, the health ministry said.
March 29
New York
An Outbreak Spreads Fear: Of Measles, of Ultra-Orthodox Jews, of Anti-Semitism
A measles outbreak in a New York suburb has sickened scores of people and stoked long-smoldering tensions between the ultra-Orthodox Jewish community and the secular world at large.
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 30 Mar 2019
New York
Measles Outbreak Grows to 214 Cases in New York City
By Leslie Brody
March 28, 2019 3:56 pm ET
The measles outbreak in the Orthodox Jewish community in New York City continues to grow in areas where some families have resisted vaccinating their children, health officials said.
 
 
New York
County in New York Facing Measles Outbreak Bans Unvaccinated Minors From Public Spots
By Katie Honan
March 27, 2019 12:01 am ET
A New York county has declared a state of emergency over one of the worst measles outbreaks in the state in decades, banning unvaccinated minors from public places to help curb the spread of the disease
 
 
Washington Post
http://www.washingtonpost.com/
[No new, unique, relevant content]

Think Tanks et al

Think Tanks et al

 

Brookings
http://www.brookings.edu/
Accessed 30 Mar 2019
[No new relevant content]
 
 
Center for Global Development  
http://www.cgdev.org/page/press-center
March 26, 2019
What’s the Latest Economics Research on Africa? A Round-up from the Center for the Study of African Economies 2019 Conference
Last week’s annual Center for the Study of African Economies (CSAE) conference brought together researchers from the African continent and around the world for the presentation of nearly 300 papers about nearly every aspect of African societies, from agriculture to education to firms to health to trade. Here I provide a micro-summary of almost every paper presented at the conference.
David Evans
 
CSIS
https://www.csis.org/
Accessed 30 Mar 2019
[No new relevant content]
 
 
Council on Foreign Relations
http://www.cfr.org/
Accessed 30 Mar 2019
[No new relevant content]
 
 
Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 30 Mar 2019
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 23 March 2019

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

 pdf version A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_23 Mar 2019

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

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

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

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

WHO – SAGE [Strategic Advisory Group of Experts] Meeting

Milestones :: Perspectives
 

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

WHO – SAGE [Strategic Advisory Group of Experts] Meeting
The next SAGE meeting will take place in Geneva from the 2-4 April 2019.
Draft agenda for SAGE April 2019 meeting pdf, 124kb [As of 11 March 2019]
Selected Agenda Items
:: Quality and Use of Immunization and Surveillance Data
:: Report from the Global Advisory Committee on Vaccine Safety (GACVS) meeting 5-6 December 2018
:: Update on the development of a Post-2020 Immunization Strategy
:: Malaria Vaccine
:: Polio the last mile
:: Meningococcal vaccines: Global Strategy
:: Ebola vaccines
:: Update on the SAGE Evaluation

Launch of forum with partners to discuss the future decade of immunization

Milestones :: Perspectives

Launch of forum with partners to discuss the future decade of immunization

WHO

19 March 2019 – Global health partners are in Geneva this week, at a 3-day meeting co-organized by WHO to co-develop a new vision and strategy for vaccines and immunization covering the period 2021-2030.

“WHO is very pleased to be leading this effort in partnership with all stakeholders, working towards creating a new vision and strategy for immunization,” said Dr Peter Salama, Executive Director, Universal Health Coverage/Life Course. “And with the end goal of having a clear operational and resource plan for health impact in countries.”

The keynote speakers at the launch event were:
:: H.E. Maria Farani Azevêdo, Ambassador of Brazil at the United Nations in Geneva
:: Kate Gilmore, United Nations Deputy High Commissioner for Human Rights
:: Bernhard Kowatsch, Head of Innovation Accelerator, UN World Food Programme

The meeting participants included representatives from academia, global immunization and broader health partnerships, Civil Society Organizations (CSOs), donor agencies, Ministries of Health, industry, private sector, research institutes, and multilateral organizations.

The new plan aims to provide a unified vision and approach for vaccines and immunization, with clear strategies and tactics that sets a new compelling country-centric vision and provides direction for the global immunization community in the coming decade.

The plan will address new and emerging issues and harness new solutions in vaccines and immunization to re-ignite the importance of immunization in achieving the broader health agendas such as the Sustainable Development Goals (SDGs), Universal Health Coverage (UHC) and Primary Health Care (PHC).

“As you start your discussions on developing a new vaccines and immunization plan, my ask is that you take into account the experience of the BRICS countries – Brazil, Russia, India, China and South Africa – and the countries in the WHO Region of the Americas that have delivered good practices with access to and production of vaccines,” said Ambassador Farani Azevêdo, Ambassador of Brazil at the UN Mission in Geneva.

Six principles will guide the development of the new vaccines and immunization plan:
:: Country impact is at the centre of plan development;
:: Integrate novel ways of thinking and ensure broad engagement of stakeholders;
:: Collaboration is key while staying focused and practical;
: Incorporate lessons learned from previous plans and strategies;
:: Build on existing global health initiatives and partnerships; and
:: Showcase how next-generation immunization systems will contribute to and align with broader health agendas like SDGs, UHC and PHC.

“People must be at the centre of healthcare and their free and equal rights to essential healthcare services such as vaccinations must be observed throughout their life-course, without discrimination,” said Ms Kate Gilmore, Deputy High Commissioner for Human Rights, United Nations. “There is no such thing as a right to refuse vaccines when the consequences of doing so is to be borne by others and undermine the rights of others to health, as recognized in the International Human Rights Framework.”

“It is critical to bring innovation and accelerators to vaccines and immunization, as you move forward in developing your plan,” said Bernhard Kowatsch, Head of Innovation Accelerator of the United Nations World Food Programme. Mr Kowatsch shared a case study which tackled information gaps and inefficiencies in analysing data via a technological tool that has been piloted in El Salvador and adopted in South Sudan, Tajikistan and Uganda.

Following this co-creation forum, a comprehensive plan will be developed through a highly collaborative process, incorporating inputs from partners and stakeholders and guidance from relevant advisory groups over the coming months.

The final plan will be submitted to the World Health Assembly for discussion and endorsement by all WHO Member States in May 2020 and for implementation shortly thereafter.

Meeting agenda png, 439kb

Background information pdf, 3.75Mb

DRC – Ebola

Milestones :: Perspectives

DRC – Ebola

DONS – Ebola virus disease – Democratic Republic of the Congo  
21 March 2019
[Excerpts; Editor’s text bolding]
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces has recently shown an increase in the number of cases reported by week, after many weeks of overall decline… This rise is not unexpected and, in part, likely a result of the increased security challenges, including the recent direct attacks on treatment centers, and pockets of community mistrust, which slowed some response activities in affected areas for a few days…

… Since the beginning of the outbreak to 19 March 2019, 980 EVD cases1 (915 confirmed and 65 probable) have been reported, of which 57% (554) were female and 30% (293) were children aged less than 18 years. Cumulatively, cases have been reported from 130 of 339 health areas across 21 health zones of the North Kivu and Ituri provinces (Table 1). Overall, 610 deaths (case fatality ratio: 62%) have been reported, and 317 patients have been discharged after treatment in ETCs….

WHO risk assessment
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Attacks on ETCs in Katwa and Butembo represented the first large-scale and organized attacks targeted directly at the Ebola response, and were of a different order of magnitude to episodes of mistrust in communities or dangers of being caught in crossfire between fighting parties. In addition, the persistence of pockets of community resistance and mistrust, exacerbated by political tensions and insecurity, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas; reducing the overall effectiveness of interventions. The high proportion of community deaths reported among confirmed cases, persistent delays in detection and isolation in ETCs, challenges in the timely reporting and response to probable cases, collectively increase the likelihood of further chains of transmission in affected communities and increased risk of geographical spread within the Democratic Republic of the Congo and to neighbouring countries. As do the risk of increased population movement anticipated during periods of heightened insecurity…

 

Emergencies

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 20 March 2019
:: Following cyclone Idai’s landfall in Mozambique, accessibility in many areas remains a challenge, particularly Beira City. However, outside of Beira, polio outbreak response is ongoing in Zambezia.

Summary of new viruses this week:
:: Afghanistan—five wild poliovirus type 1 (WPV1)-positive environmental samples;
:: Pakistan – seven WPV1-positive environmental samples;
:: Nigeria— one circulating vaccine-derived poliovirus type 2 (cVDPV2) case and seven cVDPV2-positive environmental samples;
:: Niger—five cVDPV2-positive community contact samples;
:: Indonesia—one cVDPV1-positive isolate from a healthy community contact

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

 

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 Mar 2019]
Democratic Republic of the Congo
:: DONS – Ebola virus disease – Democratic Republic of the Congo  21 March 2019

Syrian Arab Republic
:: Health situation – Al-Hol camp  16 March 2019

South Sudan
::  WHO and partners assess and respond to the health needs of over 5000 internally displaced population in Dulamaya, South Sudan  18 March 2019

Bangladesh – Rohingya crisis – No new digest announcements identified  
Myanmar – No new digest announcements identified  
Nigeria – No new digest announcements identified  
Somalia – No new digest announcements identified
Yemen – No new digest announcements identified  

::::::

WHO Grade 2 Emergencies  [to 23 Mar 2019]

Ethiopia
:: Ethiopia sets to strengthen its capacity to detect, prevent and respond to public health emergencies
Addis Ababa, 15 March 2019 | The Federal Ministry of Health of Ethiopia launched the National Action Plan for Health Security (NAPHS) 2019 – 2023…

occupied Palestinian territory 
:: WHO appeals for US$ 5.3 million to respond to trauma and emergency care needs in Gaza
18 March 2019

Sudan
:: Sudan set to protect over 8 million people with its largest ever yellow fever vaccination drive  20 March 2019

Zimbabwe
:: WHO sending urgent health assistance after Cyclone Idai displaces thousands of people in Southern Africa
Brazzaville, 20 March 2019 – The World Health Organization (WHO) is providing urgent assistance to meet the health needs of thousands of people impacted by flooding in Malawi, Mozambique and Zimbabwe. The floods were triggered by Tropical Cyclone Idai, which swept through the region last week…

Brazil (in Portugese) – No new digest announcements identified
Cameroon  – No new digest announcements identified
Central African Republic  – 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
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Ukraine – No new digest announcements identified

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

::::::

 
WHO AFRO – Outbreaks and Emergencies Bulletin – Week 10/2019
Week 11: 11- 17 March 2019
The WHO Health Emergencies Programme is currently monitoring 65 events in the region. This week’s edition covers key new and ongoing events, including:
:: Flooding in Malawi, Mozambique and Zimbabwe
“” Ebola virus disease in the Democratic Republic of the Congo
:: Measles in Chad
:: Humanitarian crisis in Democratic Republic of the Congo.

 

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

 
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   – No new digest announcements identified
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 #5 | 4-17 March 2019

Somalia  – No new digest announcements identified
 

 

WHO & Regional Offices [to 23 Mar 2019]

WHO & Regional Offices [to 23 Mar 2019]

20 March 2019   News Release
New WHO recommendations to accelerate progress on TB
WHO has issued new guidance to improve treatment of multidrug resistant TB (MDR-TB). WHO is recommending shifting to fully oral regimens to treat people with MDR-TB. This new treatment course is more effective and is less likely to provoke adverse side effects. WHO recommends backing up treatment with active monitoring of drug safety and providing counselling support to help patients complete their course of treatment.
The recommendations are part of a larger package of actions designed to help countries increase the pace of progress to end tuberculosis (TB) and released in advance of World TB Day…

19 March 2019
Launch of forum with partners to discuss the future decade of immunization  
Global health partners are in Geneva this week, at a 3-day meeting co-organized by WHO to co-develop a new vision and strategy for vaccines and immunization covering the period 2021-2030.
“WHO is very pleased to be leading this effort in partnership with all stakeholders, working towards creating a new vision and strategy for immunization,” said Dr Peter Salama, Executive Director, Universal Health Coverage/Life Course.
[See Milestones above for detail]

 

19 March 2019  News Release
WHO expert panel paves way for strong international governance on human genome editing
The World Health Organization’s new advisory committee on developing global standards for governance and oversight of human genome editing has agreed to work towards a strong international governance framework in this area.

“Gene editing holds incredible promise for health, but it also poses some risks, both ethically and medically. This committee is a perfect example of WHO’s leadership, by bringing together some of the world’s leading experts to provide guidance on this complex issue. I am grateful to each member of the Expert Advisory Committee for their time and expertise.” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

Over the past two days, the committee of experts reviewed the current state of science and technology. They also agreed core principles of transparency, inclusivity and responsibility that underpin the Committee’s current recommendations. The committee agreed that it is irresponsible at this time for anyone to proceed with clinical applications of human germline genome editing…

::::::

 
Weekly Epidemiological Record, 22 March 2019, vol. 94, 12 (pp. 141–160)
:: Recommended composition of influenza virus vaccines for use in the 2019–2020 northern hemisphere influenza season
:: Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO engages over 12,000 community informants fast-track efforts in finding ‘missing TB cases’ in Nigeria
23 March 2019
:: Immunization experts agree on ways to reach more children with life-saving vaccines
22 March 2019  Immunization experts from East and Southern African countries concluded their annual EPI Managers Meeting on Wednesday here in Asmara, with participants agreeing on 20 recommendations aimed at reaching more children with life-saving vaccines and accelerating implementation of the Addis Declaration on Immunization to attain universal health coverage.
:: Nigeria consolidates efforts to curtail vaccine hesitancy  21 March 2019
:: WHO sending urgent health assistance after Cyclone Idai displaces thousands of people in Southern Africa  20 March 2019
:: Ethiopia sets to strengthen its capacity to detect, prevent and respond to public health emergencies  19 March 2019
:: WHO and partners assess and respond to the health needs of over 5000 internally displaced population in Dulamaya, South Sudan  19 March 2019
:: AFRO Regional Director Dr Moeti urges EPI managers to strengthen immunization through accelerated implementation of Addis Declaration on Immunization in ESA countries  18 March 2019

WHO Region of the Americas PAHO
:: Countries of the Americas can end tuberculosis by 2030 if actions to achieve this goal are accelerated (03/21/2019)

WHO South-East Asia Region SEARO
– No new digest announcements identified.

WHO European Region EURO
:: Drug resistant strains could become the dominant form of TB in Europe: it’s time to end TB
:: Marking World Down Syndrome Day in Azerbaijan with an inspiring story 21-03-2019
:: Ensuring safe drinking-water – highlighting water safety plans in Tajikistan on World Water Day 21-03-2019
:: WHO Europe/ECDC joint press release: Every hour 30 people are diagnosed with tuberculosis (TB) in the European Region. It’s time to make TB a disease of the past 19-03-2019

WHO Eastern Mediterranean Region EMRO
:: Aynaa’s story: treating severe acute malnutrition in Syria  21 March 2019
:: Sudan set to protect over 8 million people with its largest ever yellow fever vaccination drive
20 March 2019
:: WHO appeals for US$ 5.3 million to respond to trauma and emergency care needs in Gaza
18 March 2019

WHO Western Pacific Region
– No new digest announcements identified.

 

CDC/ACIP [to 23 Mar 2019]

CDC/ACIP [to 23 Mar 2019]

http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Latest News
Leading HIV Experts Convene 2019 National HIV Prevention Conference
Monday, March 18, 2019

Gaps in HIV Testing and Treatment Hinder Efforts to Stop New Infections
Monday, March 18, 2019
The vast majority (about 80 percent) of new HIV infections in the U.S. in 2016 were transmitted from the nearly 40 percent of people with HIV who either did not know they had HIV, or who received a diagnosis but were not receiving HIV care.
Published on the first day of CDC’s 2019 National HIV Prevention Conference, a new CDC Vital Signs report provides the latest data on the impact of undiagnosed and untreated HIV in the nation and underscores the critical need to expand HIV testing and treatment in the U.S…

MMWR News Synopsis for Friday, March 22, 2019
Tuberculosis — United States, 2018
Achieving the goal of tuberculosis elimination in the U.S. will require expanded efforts to control both active TB disease and latent TB infection. According to preliminary 2018 surveillance data, the U.S. has the lowest number of TB cases ever reported. However, the data show slowed progress toward the goal of TB elimination. At the current rate of progress, TB will not be eliminated in the U.S. this century. Data from CDC’s National TB Surveillance System show a total of 9,029 TB cases in 2018 (down from 9,094 in 2017), indicating slight declines in TB cases (down 0.7 percent) and TB rates (down 1.3 percent) compared to the previous year. This leaves the TB rate 28 times higher than the goal for TB elimination. Achieving our national goal to eliminate TB will require expanding detection and treatment of TB disease and latent TB infection and maximizing all available tools such as short course regimens for latent TB infection treatment.

Global Epidemiology of Tuberculosis and Progress Toward Achieving Global Targets — 2017
Despite the availability of effective treatments for tuberculosis for 70 years, estimates demonstrate only modest progress in reducing TB to meet global TB 2020 targets. Globally, TB is the leading cause of death by an infectious disease. The Sustainable Development Goals and the End TB Strategy set ambitious targets for reducing the global TB burden. In 2017, there were an estimated 10 million cases of TB worldwide, with an estimated 1.57 million deaths. These numbers demonstrate only modest progress in reducing TB as measured by the number of cases of disease, death, and drug resistance. The rate of decline of these measures must improve to meet global TB 2020 targets. Intensified efforts to improve TB case finding, treatment, and prevention are necessary to decrease the global burden of TB.

Vital Signs:
Vital Signs: HIV Transmission Along the Continuum of Care — United States, 2016

Announcements

Announcements

 
Paul G. Allen Frontiers Group    [to 23 Mar 2019]
https://www.alleninstitute.org/news-press/
News
How immune cells detect different threat levels from salmonella
March 20, 2019
Detailed findings of how immune cells detect subtle changes in infection could point to targets for better antibiotics
 
 
BMGF – Gates Foundation  [to 23 Mar 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 23 Mar 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 Mar 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 Mar 2019]
http://cepi.net/
No new digest content identified.
 
 
EDCTP    [to 23 Mar 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
22 March 2019
World TB Day: EDCTP investments in TB research rise to EUR 127 million
World Tuberculosis Day on 24 March 2019 is themed ‘It’s time’. As the World Health Organisation (WHO) explains, the theme underlines “the urgency to act” on the commitments made by global leaders in September 2018. At the United Nations TB…
 
 
Emory Vaccine Center    [to 23 Mar 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 
European Medicines Agency  [to 23 Mar 2019]
http://www.ema.europa.eu/ema/
News and press releases
EMA Management Board: highlights of March 2019 meeting
Press release 22/03/2019
EMA’s Management Board has re-elected Christa Wirthumer-Hoche as its chair for a three-year mandate. Dr Wirthumer-Hoche is Head of the Austrian Medicines and Medical Devices Agency, a post she has held since October 2013….
 
 
 
European Vaccine Initiative  [to 23 Mar 2019]
http://www.euvaccine.eu/news-events
Latest news
EVI-supported study published describing the preclinical immunogenicity and safety of placental malaria vaccine PRIMVAC
21 March 2019
This work -supported by the Bundesministerium für Bildung und Forschung (BMBF), Germany, and through funding from Irish Aid,…
 
 
FDA [to 23 Mar 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.
 
 
Fondation Merieux  [to 23 Mar 2019]
http://www.fondation-merieux.org/
No new digest content identified.
 
 
Gavi [to 23 Mar 2019]
https://www.gavi.org/
Latest News
No new digest content identified.
 
 
GHIT Fund   [to 23 Mar 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 Mar 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.
 
 
Hilleman Laboratories   [to 23 Mar 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 23 Mar 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 23 Mar 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.
 
 
IFRC   [to 23 Mar 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Mozambique
Emergency water and sanitation units deployed to disaster-struck Mozambique
Two major emergency response units are being deployed to Beira in Mozambique as the world’s largest humanitarian network continues to scale up its response to Cyclone Idai.
21 March 2019

Africa, Democratic Republic of the Congo
Understanding and working with communities is essential to end Ebola, says IFRC Secretary General
Kinshasa/Nairobi/Geneva, 20 March 2019 – The Secretary General of the world’s largest humanitarian network has called on organizations responding to Ebola in the Democratic Republic of the Congo (DRC) to place more emphasis on deepening understanding o …
20 March 2019
 
 
IVAC  [to 23 Mar 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 23 Mar 2019]
http://www.ivi.int/
IVI News & Announcements
No new digest content identified.
 
 
JEE Alliance  [to 23 Mar 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 23 Mar 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Cyclone Idai & Malawi flooding Crisis update
Crisis Update
22 Mar 2019

Tuberculosis
Video innovation helps TB patients comply with their treatment
Voices from the Field22 Mar 2019

Somalia
Addressing health needs of women and children in Baidoa
Project Update21 Mar 2019

Libya
Alarming rates of malnutrition and inhumane conditions …
Press Release20 Mar 2019

Cyclone Idai & Malawi flooding
“A lot of water” – on the ground after Cyclone Idai in Mozambique
Voices from the Field20 Mar 2019

Afghanistan
The long struggle of displaced families to survive winter in Herat
Project Update20 Mar 2019

Cyclone Idai & Malawi flooding
Humanitarian response in wake of devastating Cyclone Idai
Project Update19 Mar 2019

Refugees, IDPs and people on the move
EU-Turkey deal continues cycle of containment and despair
Press Release18 Mar 2019
 
 
NIH  [to 23 Mar 2019]
http://www.nih.gov/news-events/news-releases
No new digest content identified.
 
 
PATH  [to 23 Mar 2019]
https://www.path.org/media-center/
No new digest content identified.
 
 
Sabin Vaccine Institute  [to 23 Mar 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 23 Mar 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
22 March 2019
A vision of a reformed United Nations

22 March 2019
The road to NAIIS: UNAIDS’ role in better understanding Nigeria’s HIV epidemic

20 March 2019
Nigeria adapts strategy to end the AIDS epidemic

18 March 2019
People who use drugs: still being left behind
 
 
UNICEF  [to 23 Mar 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Press release
Geneva Palais Briefing Note: The situation of children affected by Cyclone Idai in Malawi, Mozambique and Zimbabwe
22/03/2019

Press release
Children living in protracted conflicts are three times more likely to die from water-related diseases than from violence – UNICEF
21/03/2019

Press release
Urgent funding needed to meet massive humanitarian needs in Democratic Republic of Congo, UN humanitarian chief and UNICEF Executive Director urge at end of country visit
Nearly 13 million people, including 4 million malnourished children, need assistance and protection
21/03/2019

Press release
UNICEF supplies arrive in flood-affected areas of Malawi, bringing relief to displaced families
19/03/2019

Press release
Thousands of children in need of urgent humanitarian assistance amid severe flooding as Cyclone Idai hits Mozambique, Malawi and Zimbabwe – UNICEF
17/03/2019
 
 
 
Vaccine Confidence Project  [to 23 Mar 2019]
http://www.vaccineconfidence.org/
17 Mar, 2019
Confidence Commentary:
American Medical Assoc appeals to Social Media Platforms
The American Medical Association has followed Member of Congress  in appealing to technology company heads to ensure accurate information on vaccines(full letter below).  While I fully support an appeal to address some of amplifying algorithms and other technical mechanisms that inflate and cluster misleading information, is it not neglect of our responsibility as public health professionals to be instructing technology experts to “ensure that users have access to scientifically valid information on vaccination”? Doesn’t this issue instead call for a collaborative effort, bringing together relevant expertise?  It is time for public health professionals, technology experts, and some members of the public to sit around the same table to bring the best information, through  honest, rather than manipulated media, in a sensitive rather than seeming censored manner. Democracy matters. This approach may only harden the views of those who already feel they have no voice.
-Heidi Larson

Vaccine Education Center – Children’s Hospital of Philadelphia  [to 23 Mar 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

Wellcome Trust  [to 23 Mar 2019]
https://wellcome.ac.uk/news
Opinion | 21 March 2019
A new method for ethical data science
by Danil Mikhailov
Wellcome Data Labs is applying a new method to solving data science problems so that potential negative consequences of algorithms are identified earlier in the development process.

The Wistar Institute [to 23 Mar 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE) [to 23 Mar 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.

::::::

 
BIO    [to 23 Mar 2019]
https://www.bio.org/insights/press-release
Mar 22 2019
PFDD: BIO Comments on FDA Draft Guidance Developing and Submitting Proposed Draft Guidance Relating to Patient Experience Data
… BIO believes that strong trilateral communication between the FDA, patients and patient organizations, and Sponsors around patient experience data will result in incorporation of patient experience data throughout the product lifecycle, including drug development and review. BIO appreciates that the Agency included Table 1 (beginning on line 423) in the Draft Guidance as it provides examples for all stakeholders regarding how patient experience data may play a role in the drug development lifecycle; however, as presented, the key stakeholders appear to function in isolation of each other rather than showing how the trilateral communication between patient stakeholders, medical product developers/researchers, and regulators results in effective collection and use of patient experience data. To better support trilateral communication, BIO requests that the FDA clearly outline a process by which the FDA will communicate and provide feedback to stakeholders that submit draft guidance or other patient experience data…

DCVMN – Developing Country Vaccine Manufacturers Network [to 23 Mar 2019]
http://www.dcvmn.org/
No new digest content identified.

IFPMA [to 23 Mar 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 23 Mar 2019]
http://www.phrma.org/press-room
No new digest content identified.

Journal Watch

Journal Watch

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

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

 

A Cost-Effectiveness Analysis of Vaccination for Prevention of Herpes Zoster and Related Complications: Input for National Recommendations

Annals of Internal Medicine
19 March 2019 Vol: 170, Issue 6
http://annals.org/aim/issue

Original Research
A Cost-Effectiveness Analysis of Vaccination for Prevention of Herpes Zoster and Related Complications: Input for National Recommendations
Lisa A. Prosser, PhD; Rafael Harpaz, MD, MPH; Angela M. Rose, MPH; Acham Gebremariam, MS; Angela Guo, MPH; Ismael R. Ortega-Sanchez, PhD; Fangjun Zhou, PhD; Kathleen Dooling, MD, MPH
Supplemental Content
Abstract
Background:
The U.S. Advisory Committee on Immunization Practices recently developed recommendations for use of a new recombinant zoster vaccine (RZV).
Objective:
To evaluate the cost-effectiveness of vaccination with RZV compared with zoster vaccine live (ZVL) and no vaccination, the cost-effectiveness of vaccination with RZV for persons who have previously received ZVL, and the cost-effectiveness of preferential vaccination with RZV over ZVL.
Design: Simulation (state-transition) model using U.S. epidemiologic, clinical, and cost data.
Data Sources: Published data.
Target Population:
Hypothetical cohort of immunocompetent U.S. adults aged 50 years or older.
Time Horizon: Lifetime.
Perspective: Societal and health care sector.
Intervention: Vaccination with RZV (recommended 2-dose regimen), vaccination with ZVL, and no vaccination.
Outcome Measures: The primary outcome measure was the incremental cost-effectiveness ratio (ICER).
Results of Base-Case Analysis:
For vaccination with RZV compared with no vaccination, ICERs ranged by age from $10 000 to $47 000 per quality-adjusted life-year (QALY), using a societal perspective and assuming 100% completion of the 2-dose RZV regimen. For persons aged 60 years or older, ICERs were less than $60 000 per QALY. Vaccination with ZVL was dominated by vaccination with RZV for all age groups 60 years or older.
Results of Sensitivity Analysis:
Results were most sensitive to changes in vaccine effectiveness, duration of protection, herpes zoster incidence, and probability of postherpetic neuralgia. Vaccination with RZV after previous administration of ZVL yielded an ICER of less than $60 000 per QALY for persons aged 60 years or older. In probabilistic sensitivity analyses, RZV remained the preferred strategy in at least 95% of simulations, including those with 50% completion of the second dose.
Limitation:
Few data were available on risk for serious adverse events, adherence to the recommended 2-dose regimen, and probability of recurrent zoster.
Conclusion:
Vaccination with RZV yields cost-effectiveness ratios lower than those for many recommended adult vaccines, including ZVL. Results are robust over a wide range of plausible values.

 

A one stop shop for cost-effectiveness evidence? Recommendations for improving Disease Control Priorities

BMC Cost Effectiveness and Resource Allocation
http://resource-allocation.biomedcentral.com/
(Accessed 23 Mar 2019)

Commentary
A one stop shop for cost-effectiveness evidence? Recommendations for improving Disease Control Priorities
Setting out a health benefits package (HBP) of interventions to be prioritised for funding is an important step towards achieving universal health coverage in low and middle income countries.
Authors: Matthias Arnold, Susan Griffin, Jessica Ochalek, Paul Revill and Simon Walker
Citation: Cost Effectiveness and Resource Allocation 2019 17:7
Published on: 20 March 2019

A new model for pharmacies? Insights from a quantitative study regarding the public’s perceptions

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 23 Mar 2019)

Research article
A new model for pharmacies? Insights from a quantitative study regarding the public’s perceptions
Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction with pharmacy services were found in prev…
Authors: Verónica Policarpo, Sónia Romano, João H. C. António, Tânia Sofia Correia and Suzete Costa
Citation: BMC Health Services Research 2019 19:186
Published on: 21 March 2019

Repeated clinical malaria episodes are associated with modification of the immune system in children

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

Research article
Repeated clinical malaria episodes are associated with modification of the immune system in children
There are over 200 million reported cases of malaria each year, and most children living in endemic areas will experience multiple episodes of clinical disease before puberty. We set out to understand how freq…
Authors: Yaw Bediako, Rhys Adams, Adam J. Reid, John Joseph Valletta, Francis M. Ndungu, Jan Sodenkamp, Jedidah Mwacharo, Joyce Mwongeli Ngoi, Domtila Kimani, Oscar Kai, Juliana Wambua, George Nyangweso, Etienne P. de Villiers, Mandy Sanders, Magda Ewa Lotkowska, Jing-Wen Lin…
Citation: BMC Medicine 2019 17:60
Published on: 13 March 2019

Evaluation of a phased pneumococcal conjugate vaccine introduction in Mongolia using enhanced pneumonia surveillance and community carriage surveys: a study protocol for a prospective observational study and lessons learned

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 23 Mar 2019)

Evaluation of a phased pneumococcal conjugate vaccine introduction in Mongolia using enhanced pneumonia surveillance and community carriage surveys: a study protocol for a prospective observational study and lessons learned
Streptococcus pneumoniae causes substantial morbidity and mortality among children. The introduction of pneumococcal conjugate vaccines (PCV) has the potential to dramatically reduce disease burden. As with any v…
Authors: S. F. La Vincente, C. von Mollendorf, M. Ulziibayar, C. Satzke, L. Dashtseren, K. K. Fox, E. M. Dunne, C. D. Nguyen, J. de Campo, M. de Campo, H. Thomson, G. Surenkhand, S. Demberelsuren, S. Bujinlkham, L. A. H. Do, D. Narangerel…
Citation: BMC Public Health 2019 19:333
Published on: 21 March 2019

Epidemiology and timing of seasonal influenza epidemics in the Asia-Pacific region, 2010–2017: implications for influenza vaccination programs

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 23 Mar 2019)

Research article
Epidemiology and timing of seasonal influenza epidemics in the Asia-Pacific region, 2010–2017: implications for influenza vaccination programs
Description of the epidemiology of influenza is needed to inform influenza vaccination policy. Here we examined influenza virus circulation in countries in the Asia-Pacific region and compared the timing of se…
Authors: Clotilde El Guerche-Séblain, Saverio Caini, John Paget, Philippe Vanhems and François Schellevis
Citation: BMC Public Health 2019 19:331
Published on: 21 March 2019

30 years of fatal dengue cases in Brazil: a review

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 23 Mar 2019)

Research article
30 years of fatal dengue cases in Brazil: a review
Over the last 30 years, extensive dengue epidemics have occurred in Brazil, characterized by emergences and re-emergences of different serotypes, a change in the epidemiological profile and an increase in the …
Authors: Priscila Conrado Guerra Nunes, Regina Paiva Daumas, Juan Camilo Sánchez-Arcila, Rita Maria Ribeiro Nogueira, Marco Aurélio Pereira Horta and Flávia Barreto dos Santos
Citation: BMC Public Health 2019 19:329
Published on: 21 March 2019
 
 

Seroprevalence of mumps before the introduction of mumps-containing vaccine in Lao PDR: results from a nationwide cross-sectional population-based survey

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 23 Mar 2019)

Research note
Seroprevalence of mumps before the introduction of mumps-containing vaccine in Lao PDR: results from a nationwide cross-sectional population-based survey
Mumps-containing vaccine is currently not a component of the national immunization schedule in Lao People’s Democratic Republic (PDR). Mumps itself is not a notifiable disease in the country and the seropreval…
Authors: Hironori Okabayashi, Kenichi Komada, Minoru Kidokoro, Tomomi Kitamura, Shinsuke Miyano, Tomoo Ito, Kongxay Phounphenghak, Chansay Pathammavong, Keiko Murano, Misato Nagai, Yoshio Mori, Katsuhiro Komase, Anonh Xeuatvongsa, Makoto Takeda and Masahiko Hachiya
Citation: BMC Research Notes 2019 12:155
Published on: 19 March 2019

 

It is an entrustment’: Broad consent for genomic research and biobanks in sub‐Saharan Africa

Developing World Bioethics
Volume 19, Issue 1  Pages: 1-60  March 2019
https://onlinelibrary.wiley.com/toc/14718847/current

ARTICLES
Open Access
It is an entrustment’: Broad consent for genomic research and biobanks in sub‐Saharan Africa
Paulina Tindana, Sassy Molyneux, Susan Bull, Michael Parker
Pages: 9-17
First Published: 23 October 2017

 

Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas PDF Version[PDF – 1.57 MB – 8 pages]

Emerging Infectious Diseases
Volume 25, Number 4—April 2019
http://wwwnc.cdc.gov/eid/

Perspective
Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas PDF Version[PDF – 1.57 MB – 8 pages]

  1. E. Paniz-Mondolfi et al.

Abstract
Venezuela’s tumbling economy and authoritarian rule have precipitated an unprecedented humanitarian crisis. Hyperinflation rates now exceed 45,000%, and Venezuela’s health system is in free fall. The country is experiencing a massive exodus of biomedical scientists and qualified healthcare professionals. Reemergence of arthropod-borne and vaccine-preventable diseases has sparked serious epidemics that also affect neighboring countries. In this article, we discuss the ongoing epidemics of measles and diphtheria in Venezuela and their disproportionate impact on indigenous populations. We also discuss the potential for reemergence of poliomyelitis and conclude that action to halt the spread of vaccine-preventable diseases within Venezuela is a matter of urgency for the country and the region. We further provide specific recommendations for addressing this crisis.

Prior Vaccination and Effectiveness of Communication Strategies Used to Describe Infectious Diseases PDF Version[PDF – 318 KB – 3 pages]

Emerging Infectious Diseases
Volume 25, Number 4—April 2019
http://wwwnc.cdc.gov/eid/

Research Letters
Prior Vaccination and Effectiveness of Communication Strategies Used to Describe Infectious Diseases PDF Version[PDF – 318 KB – 3 pages]

  1. S. Valley et al.

We tested the effect of prior vaccination on response to communication strategies in a hypothetical news article about an influenza pandemic. Vaccinated were more likely than nonvaccinated participants to plan future vaccination, and future vaccination intent was greater with certain communication strategies. Using these findings to target communication may increase vaccination rates.

Effects of Political Instability in Venezuela on Malaria Resurgence at Ecuador–Peru Border, 2018 PDF Version[PDF – 500 KB – 3 pages]

Emerging Infectious Diseases
Volume 25, Number 4—April 2019
http://wwwnc.cdc.gov/eid/

Effects of Political Instability in Venezuela on Malaria Resurgence at Ecuador–Peru Border, 2018 PDF Version[PDF – 500 KB – 3 pages]

  1. Jaramillo-Ochoa et al.

Mass migration from Venezuela has increased malaria resurgence risk across South America. During 2018, migrants from Venezuela constituted 96% of imported malaria cases along the Ecuador–Peru border. Plasmodium vivax predominated (96%). Autochthonous malaria cases emerged in areas previously malaria-free. Heightened malaria control and a response to this humanitarian crisis are imperative.

 

 

SPECIAL ISSUE: Frontiers of Health Policy Research

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…

Assessment of timely immunization in an urbanized agglomeration of East Delhi, India

International Journal of Community Medicine and Public Health
Vol 6, No 3 (2019)  March 2019
https://www.ijcmph.com/index.php/ijcmph/issue/view/48

Original Research Articles
Assessment of timely immunization in an urbanized agglomeration of East Delhi, India
Vinu Cherian, Narinder Kumar Saini, Arun Kumar Sharma
DOI: 10.18203/2394-6040.ijcmph20190603

A glance on public private partnership: an opportunity for developing nations to achieve universal health coverage

International Journal of Community Medicine and Public Health
Vol 6, No 3 (2019)  March 2019
https://www.ijcmph.com/index.php/ijcmph/issue/view/48

Review Articles
A glance on public private partnership: an opportunity for developing nations to achieve universal health coverage
Reena Titoria, Anu Mohandas
DOI: 10.18203/2394-6040.ijcmph20190640

Multistate Hepatitis A Outbreak: Vaccination of Food Service Workers as Part of the Kentucky Outbreak Response

Journal of Refugee & Global Health
Volume 2, Issue 1 (2019)

https://ir.library.louisville.edu/rgh/
Original Research
Multistate Hepatitis A Outbreak: Vaccination of Food Service Workers as Part of the Kentucky Outbreak Response
Ruth M. Carrico, Dawn Balcom, Delanor Mason, Audria G. Denker, Alyson Holland, Kimberley A. Buckner, Stephen P. Furmanek, and Wesley Trail