PNAS – Proceedings of the National Academy of Sciences of the United States
of America
http://www.pnas.org/content/early/
[Accessed 3 March 2018]

Transparency in authors’ contributions and responsibilities to promote integrity in scientific publication
Marcia K. McNutt, Monica Bradford, Jeffrey M. Drazen, Brooks Hanson, Bob Howard, Kathleen Hall Jamieson, Véronique Kiermer, Emilie Marcus, Barbara Kline Pope, Randy Schekman, Sowmya Swaminathan, Peter J. Stang and Inder M. Verma
PNAS 2018; published ahead of print February 27, 2018, https://doi.org/10.1073/pnas.1715374115

Public Health
March 2018 Volume 156, p1-152
http://www.publichealthjrnl.com/current

Reviews
Factors influencing seasonal influenza vaccination behaviour among elderly people: a systematic review
Kan, J. Zhang
p67–78
Published online: February 11, 2018

Qualitative Health Research
Volume 28, Issue 4, March 2018
http://qhr.sagepub.com/content/current

Research Articles
Researcher Self-Care in Emotionally Demanding Research: A Proposed Conceptual Framework
Smita Kumar, Liz Cavallaro
First Published December 9, 2017; pp. 648–658
Preview
Researchers are emotionally and psychologically affected by emotionally demanding research that demands a tremendous amount of mental, emotional, or physical energy and potentially affects or depletes the researcher’s well-being. Little attention has been given to preparing doctoral students and novice researchers engaged in such studies. Four possible types of emotionally demanding research experiences are presented: sensitive issues, personal trauma previously experienced, experience of traumatic life events during research, and unexpected events that arise during research in what was previously not identified as a sensitive issue. The need for self-care is highly relevant to each type, despite their different impacts on researcher well-being. This conceptual article furthers conversation in the field about how researchers and educators can address the need for self-care to prepare novice researchers and proposes a conceptual framework for researcher self-care in emotionally demanding research, with an aim for future empirical study.

Science Translational Medicine
28 February 2018  Vol 10, Issue 430
http://stm.sciencemag.org/

Perspective
Toward achieving precision health
By Sanjiv Sam Gambhir, T. Jessie Ge, Ophir Vermesh, Ryan Spitler
Science Translational Medicine28 Feb 2018 Restricted Access
Precision health can help to prevent disease occurrence, detect disease earlier, and advance human health through the use of integrated diagnostics.
Abstract
Health care systems primarily focus on patients after they present with disease, not before. The emerging field of precision health encourages disease prevention and earlier detection by monitoring health and disease based on an individual’s risk. Active participation in health care can be encouraged with continuous health-monitoring devices, providing a higher-resolution picture of human health and disease. However, the development of monitoring technologies must prioritize the collection of actionable data and long-term user engagement.

Travel Medicine and Infectious Diseases
January-February, 2018  Volume 21
http://www.travelmedicinejournal.com/

Editorial
Influenza risk at Muslim pilgrimages in Iraq and Saudi Arabia
Philippe Gautret
Vol. 21, p1–2
Published online: October 26, 2017

Vaccine
Volume 36, Issue 11   Pages 1323-1520 (7 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/11

Commentary
French mandatory vaccine policy
Pages 1323-1325
Tony Yang, Dorit Rubinstein Reiss

Vaccine
Volume 36, Issue 11   Pages 1323-1520 (7 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/11

Review
The National Vaccine Advisory Committee at 30: Impact and opportunity
Review article
Pages 1330-1344
Kimberly M. Thompson, Bruce G. Gellin, Alan R. Hinman, Walter A. Orenstein
Abstract
Thirty years after passage of legislation that created the National Vaccine Advisory Committee (NVAC) “to achieve optimal prevention of human infectious diseases through immunization and to achieve optimal prevention against adverse reactions to vaccines,” this review reflects NVAC’s role and impact on the U.S. vaccine and immunization enterprise as an external advisor to the Department of Health and Human Services. We reviewed the history of NVAC in the context of the principles of its establishment, with a focus on its reports and recommendations. We performed a systematic literature review to identify NVAC reports published in widely-accessible public health journals, and we reviewed the available archives to identify other reports and resolutions approved by the committee not published in journals. We characterized key issues considered by NVAC according to the five goals of the 2010 National Vaccine Plan. The predominance of NVAC activities to date related to the implementation of immunization across the lifespan and the many aspects of the system needed to foster the goal of full immunization. Reflecting on the impacts of NVAC to date, this review identified 30 NVAC approved reports published in journals, 22 stand-alone resolutions, and 26 unique unpublished reports. The development of new and improved vaccines continues to represent a significant priority for NVAC, and we identified several challenges related to future vaccine innovation. Given the many factors that impact on policy changes in the vaccine and immunization enterprise, we encountered challenges associated with demonstrating attribution of specific policy changes to NVAC recommendations. Although difficult to quantify, this review suggests that NVAC played an important role in the improvements in the U.S. immunization enterprise over the past 30 years and that NVAC can and will continue to play an important role supporting U.S. immunization going forward.

Vaccine
Volume 36, Issue 11   Pages 1323-1520 (7 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/11

Vaccination timeliness and co-administration among Kenyan children
Original research article
Pages 1353-1360
Nina B. Masters, Abram L. Wagner, Bradley F. Carlson, Matthew L. Boulton
Abstract
Background
Timely administration of recommended vaccines requires children to have multiple vaccines co-administered in the first year of life. The objectives of this study were to estimate the proportion of timely vaccinations and the proportion of co-administered vaccines, and to assess the relationship between vaccine co-administration and vaccine timeliness in Kenyan children.
Methods
Using the 2014 Kenyan Demographic and Health Survey (DHS), we calculated the proportion of children who received co-administered and timely vaccine doses. Co-administration was defined as doses administered on the same day with dates recorded on vaccination cards. Vaccines were considered timely if given within four days before to four weeks after the recommended interval for administration.
Results
10,385 children aged 1–4 years in the Kenyan 2014 DHS dataset had vaccination cards which comprised the study sample. Analysis revealed wide a range for receipt of timely doses, from 90.2% for OPV0 to 56.0% for Measles. Co-administration of the 6-week dose was associated with 2.81 times higher odds of a timely Penta dose 1 (95% CI: 2.28, 3.46) and birth-dose co-administration was associated with a substantial increase in timely BCG vaccination: AOR 7.43 (95% CI: 6.31, 8.75).
Conclusions
Though vaccine coverage in Kenya was high, timely vaccination was markedly low, with resultant implications for population immunity and potential spread of communicable diseases in unvaccinated infants. Co-administration of vaccines, place of residence, wealth index, and child age were consistently related to the odds of timely vaccine receipt. These relationships reinforce the importance of dedicating resources to programs that educate low socio-economic groups about the importance of vaccine co-administration.

Vaccine
Volume 36, Issue 11   Pages 1323-1520 (7 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/11

Improving human papilloma virus vaccination rates throughout military treatment facilities
Original research article
Pages 1361-1367
Rachel Dawson, Keith Lemmon, Nidhi J. Trivedi, Shana Hansen
Abstract
Objectives
The four objectives of this study were to (1) educate military healthcare providers on HPV disease and vaccine, (2) assess short term recall of information presented at educational sessions, (3) assess provider comfort level with the vaccine, and (4) assess improvement in HPV vaccination rates.
Methods
Standardized interactive educational sessions were conducted at military primary care clinics with pre- and post-educational quizzes administered before and immediately following the sessions. Provider attitudes were assessed using Likert scale questionnaires. Vaccination rates in children and young adolescents ages 11-18 at one of the participating regions that had a champion and started a Quality Improvement (QI) project were assessed at baseline, at 3-months and at 6-months post sessions.
Results
200 providers were reached at 48 primary care clinics during May 2014 through October 2015 with 200 quizzes and Likert scale questionnaires returned. There was increase in knowledge following the educational sessions as revealed in the pre- and post- test scores [t(57)=-5.04, p< 0.001]. There was a significant overall increase in comfort in answering patients’ and parents’ questions about HPV vaccine [p= 0.003]. There was a significant increase in the number of vaccines given at all the clinics 3-months after the educational sessions at the region who had a champion dedicated to monitoring vaccine rates and ensuring implementation efforts [p=0.01] and started a QI project. This increase was not sustained at 6-months [p=0.324].
Conclusions
Improvement in provider short term knowledge recall and comfort level in answering parents’ questions was seen. We found that educational sessions can improve HPV vaccination rates in military clinics that have a vaccine champion for up to 3-months. Further research into the effects of having clinic vaccine champions is critical.

Vaccine
Volume 36, Issue 11   Pages 1323-1520 (7 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/11

The impact of immunization programs on 10 vaccine preventable diseases in Italy: 1900–2015
Original research article
Pages 1435-1443
Patrizio Pezzotti, Stefania Bellino, Francesca Prestinaci, Simone Iacchini, … Giovanni Rezza
Abstract
Background
Vaccination has determined a dramatic decline in morbidity and mortality from infectious diseases over the last century. However, low perceived risk of the infectious threat and increased concern about vaccines’ safety led to a reduction in vaccine coverage, with increased risk of disease outbreaks.
Methods
Annual surveillance data of nationally communicable infectious diseases in Italy between 1900 and 2015 were used to derive trends in morbidity and mortality rates before and after vaccine introduction, focusing particularly on the effect of vaccination programs. Autoregressive integrated moving average models were applied to ten vaccine-preventable diseases: diphtheria, tetanus, poliomyelitis, hepatitis B, pertussis, measles, mumps, rubella, chickenpox, and invasive meningococcal disease. Results of these models referring to data before the immunization programs were projected on the vaccination period to estimate expected cases. The difference between observed and projected cases provided estimates of cases avoided by vaccination.
Results
The temporal trend for each disease started with high incidence rates, followed by a period of persisting reduction. After vaccine introduction, and particularly after the recommendation for universal use among children, the current rates were much lower than those forecasted without vaccination, both in the whole population and among the 0-to-4 year olds, which is, generally, the most susceptible age class. Assuming that the difference between incidence rates before and after vaccination programs was attributable only to vaccine, more than 4 million cases were prevented, and nearly 35% of them among children in the early years of life. Diphtheria was the disease with the highest number of prevented cases, followed by mumps, chickenpox and measles.
Conclusions
Universal vaccination programs represent the most effective prevention tool against infectious diseases, having a major impact on human health. Health authorities should make any effort to strengthen public confidence in vaccines, highlighting scientific evidence of vaccination benefits.

Vaccine
Volume 36, Issue 11   Pages 1323-1520 (7 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/11

The WHO Tailoring Immunization Programmes (TIP) approach: Review of implementation to date
Open access – Original research article
Pages 1509-1515
Eve Dubé, Julie Leask, Brent Wolff, Benjamin Hickler, … Katrine Habersaat
Abstract
Introduction
The WHO Regional Office for Europe developed the Guide to tailoring immunization programmes (TIP), offering countries a process through which to diagnose barriers and motivators to vaccination in susceptible low vaccination coverage and design tailored interventions. A review of TIP implementation was conducted in the European Region.
Material and methods
The review was conducted during June to December 2016 by an external review committee and was based on visits in Bulgaria, Lithuania, Sweden and the United Kingdom that had conducted a TIP project; review of national and regional TIP documents and an online survey of the Member States in the WHO European Region that had not conducted a TIP project. A review committee workshop was held to formulate conclusions and recommendations.
Results
The review found the most commonly cited strengths of the TIP approach to be the social science research as well as the interdisciplinary approach and community engagement, enhancing the ability of programmes to “listen” and learn, to gain an understanding of community and individual perspectives. National immunization managers in the Region are generally aware that TIP exists and that there is strong demand for the type of research it addresses. Further work is needed to assist countries move towards implementable strategies based on the TIP findings, supported by an emphasis on enhanced local ownership; integrated diagnostic and intervention design; and follow-up meetings, advocacy and incentives for decision-makers to implement and invest in strategies.
Conclusions
Understanding the perspectives of susceptible and low-coverage populations is crucial to improving immunization programmes. TIP provides a framework that facilitated this in four countries. In the future, the purpose of TIP should go beyond identification of susceptible groups and diagnosis of challenges and ensure a stronger focus on the design of strategies and appropriate and effective interventions to ensure long-term change.

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 3 March 2018)

Open Access Review
Meningococcal Vaccines: Current Status and Emerging Strategies
by Pumtiwitt C. McCarthy, Abeer Sharyan and Laleh Sheikhi Moghaddam
Vaccines 2018, 6(1), 12; doi:10.3390/vaccines6010012 – 25 February 2018
Abstract
Neisseria meningitidis causes most cases of bacterial meningitis. Meningococcal meningitis is a public health burden to both developed and developing countries throughout the world. There are a number of vaccines (polysaccharide-based, glycoconjugate, protein-based and combined conjugate vaccines) that are approved to target five of the six disease-causing serogroups of the pathogen. Immunization strategies have been effective at helping to decrease the global incidence of meningococcal meningitis. Researchers continue to enhance these efforts through discovery of new antigen targets that may lead to a broadly protective vaccine and development of new methods of homogenous vaccine production. This review describes current meningococcal vaccines and discusses some recent research discoveries that may transform vaccine development against N. meningitidis in the future

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

  
Scandinavian Journal of Public Health
Epub ahead of print
Vaccine hesitancy and trust.: Ethical aspects of risk communication
J Nihlén Fahlquist
Abstract [en]
Aim: This paper analyses vaccination policy from an ethical perspective, against the background of the growing hesitancy towards e.g. the measles vaccine.
Methods: The paper is normative and analyses ethical aspects of risk communication in the context of vaccination. It is argued that ethical analysis of risk communication should be done at the level of the message, the procedure and the effects. The paper takes examples from the Swedish context, linking the current lack of trust in experts to the 2009 vaccination policy and communication promoting the H1N1 vaccine Pandemrix.
Results: During the Swedish H1N1 vaccination policy in 2009, the message was that the vaccine is safe. However, a group of adolescents developed narcolepsy as a side effect of the vaccine. Taking this into account, it becomes clear that the government should communicate risks and benefits responsibly and take responsibility for individuals affected negatively by populational health interventions.
Conclusion: To communicate respectfully entails not treating vaccine sceptics as ill-informed or less educated, but instead taking the concerns of the vaccine hesitant, who potentially could change their minds, as a starting-point of a respectful discussion. There will inevitably be individuals who suffer from side effects of justifiable population-based health promotion activities. However, the public should be able to trust the message and count on the government to take responsibility for individuals affected by side effects. This is important for normative reasons, but is additionally likely to contribute to restored and maintained trust.

Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.
We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

BBC
http://www.bbc.co.uk/
Accessed 3 March 2018
Government publishes key vaccine report [U.K.]
27 February 2018
A long-awaited report into how the government makes decisions about which vaccines to fund has been published.
It follows calls for greater transparency about why a vaccine to protect children against meningitis B was not made more widely available.
Two-year-old Faye Burdett died in 2016 – she was too old to have the vaccine.
An 820,000-signature petition calling for all children to be vaccinated was then submitted, – but the idea was rejected as “not cost effective”.
One of the recommendations in the report is lowering the cost-effectiveness threshold for immunisation, potentially making it harder for new vaccines to be approved at current prices.
Health Minister Steven Brine was due to face questions from MPs on Tuesday over why the report into the cost-effectiveness of immunisations – promised by the end of 2016 – still had not been published…
[See Milestones/Perspectives above for more detail]
 
Financial Times
http://www.ft.com/home/uk
Accessed 3 March 2018
To wipe out measles, governments must regain social trust
28 February 2018
Heidi Larson
[See Research, Reports above for full text]
 
Forbes
http://www.forbes.com/
Accessed 3 March 2018
This Company Is Testing A Flu Vaccine Made In Tobacco — And Philip Morris Is On Board
Arlene Weintraub, Contributor
As the FDA meets to plan next year’s flu vaccine, companies like Medicago are testing innovative technologies designed to minimize the risk of another devastating outbreak.
“Heard Immunity” — In An Age Of Vaccine Skepticism, It Is Critical To Understand Herd Immunity
Geoffrey Kabat, Contributor
The low vaccination rates for seasonal flu among Americans signal the need for better education of the public regarding the benefits of vaccines and the possibly dire consequences of of vaccine avoidance.
 
The Guardian
http://www.guardiannews.com/
Accessed 3 March 2018
Disgraced anti-vaxxer Andrew Wakefield aims to advance his agenda in Texas election
26 February 2018
Anti-vaccine campaigners have found a growing political voice for their debunked ideas in Texas, the adopted home of discredited British researcher Andrew Wakefield, and now hope to unseat a moderate Republican in the heart of Houston.
Texas has seen rates of children opting out of vaccines for philosophical reasons skyrocket after Wakefield – the man behind the UK’s MMR vaccine controversy in the early 2000s – moved to the state’s capital, Austin, more than a decade ago.
Since the early 2000s, when he arrived, the rate of Texas children exempted from at least one vaccine has shot up by 1,900% according to one analysis, while Houston has become a battleground for anti-vaccine activists of growing clout.
Now, Wakefield sees the upcoming Republican primary in Houston on 6 March as an “an extremely important time” to advance his anti-vaccine agenda….
 
 
New York Times
http://www.nytimes.com/
Accessed 3 March 2018
Opinion

All Children Should Have to Get the Flu Shot
The law requires vaccination for measles and mumps. Why not for this deadly virus?
March 1, 2018 By Ezekiel J. Emanuel and Justin Bernstein

They’re Hosting Parasitic Worms in Their Bodies to Help Treat a Neglected Disease
1 March 2018
Seventeen volunteers in the Netherlands have agreed to host parasitic worms in their bodies for 12 weeks in order to help advance research toward a vaccine for schistosomiasis, a chronic disease that afflicts more than 200 million people a year, killing thousands, primarily in sub-Saharan Africa and South America.

Middle East
Yemen’s Cholera Epidemic Likely to Intensify in Coming Months: WHO
The World Health Organization warned on Monday that a cholera epidemic in Yemen that killed more than 2,000 people could flare up again in the rainy season.
Feb. 26, 2018

Italy’s Vaccine Debate Shows Anti-Establishment Sway
26 February 2018
In Italy, the fight against measles has moved from the doctor’s office to the political battleground. The nation is facing one of its worst epidemics of measles in recent years, reporting a six-fold increase in cases last year that accounted for a quarter of all the cases in Europe. And yet the government’s response — a new law requiring parents to vaccinate their kids against measles and nine other childhood diseases — has become one of the most divisive issues going into March 4 general elections.

Washington Post
http://www.washingtonpost.com/
Accessed 3 March 2018
Five myths about outbreaks
No, closing borders can’t stop the spread of disease.
1 March 2018
By Seth Berkley

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

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

– pdf version:  A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_24 Feb 2018

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

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

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

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

Milestones :: Perspectives

Every Child Alive: The urgent need to end newborn deaths
UNICEF
February 2018 :: 44 pages
https://www.unicef.org/publications/index_102640.html
Overiew
Every year, 2.6 million babies die before turning one month old. One million of them take their first and last breaths on the day they are born. However, millions of these young lives could be saved every year if every mother and every baby had access to affordable, quality health care, good nutrition and clean water. This report addresses the challenges of keeping every child alive, and calls for strong cooperation among governments, businesses, health-care providers, communities and families to give every newborn a fair chance to survive, and to collectively work towards the achievement of universal health coverage, and a world where no newborn dies of a preventable cause.

Excerpts [Editor’s text bolding]
p.19
…After birth, breastmilk is a baby’s first vaccine – the first and best protection against illness and disease. It is critical that health workers provide adequate nutritional counselling to mothers during pregnancy…
 
p.22
The 10 most critical products for newborn survival
:: Ambu-bags, used to manually resuscitate newborns who fail to breathe after birth
:: Antibiotics to treat mothers and newborns who have infections
:: Blankets and cloth to keep the baby warm and support skin-to-skin contact, including during breastfeeding
:: Chlorhexidine, a broad-spectrum antiseptic used to prevent infection of the umbilical cord, which can lead to sepsis
:: Continuous positive airway pressure (CPAP) machines for premature babies whose underdeveloped lungs make it difficult for them to breathe
:: Oxygen concentrator equipment, used to help very low-birthweight babies breathe
:: Phototherapy machines to reduce jaundice in newborns
:: Micronutrient supplements, especially iron and folic acid to prevent iron deficiency anaemia in pregnant women and reduce the risk of low-birthweight babies and complications at birth
:: Tetanus toxoid vaccine to prevent tetanus infection, which can result from unhygienic birth conditions
:: Thermometers, used to closely monitor the temperature of sick newborns

Press Release
World is failing newborn babies, says UNICEF
NEW YORK, 20 February 2018 – Global deaths of newborn babies remain alarmingly high, particularly among the world’s poorest countries, UNICEF said today in a new report on newborn mortality. Babies born in Japan, Iceland and Singapore have the best chance at survival, while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds.

“While we have more than halved the number of deaths among children under the age of five in the last quarter century, we have not made similar progress in ending deaths among children less than one month old,” said Henrietta H. Fore, UNICEF’s Executive Director. “Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies.”
Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.

The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.

Unequal shots at life
Highest newborn mortality rates
1. Pakistan: 1 in 22
2. Central African Republic: 1 in 24
3. Afghanistan: 1 in 25
4. Somalia: 1 in 26
5. Lesotho: 1 in 26
6. Guinea-Bissau: 1 in 26
7. South Sudan: 1 in 26
8. Côte d’Ivoire: 1 in 27
9. Mali: 1 in 28
10. Chad: 1 in 28

Lowest newborn mortality rates
1. Japan: 1 in 1,111
2. Iceland: 1 in 1,000
3. Singapore: 1 in 909
4. Finland: 1 in 833
5. Estonia: 1 in 769
5. Slovenia: 1 in 769
7. Cyprus: 1 in 714
8. Belarus: 1 in 667
8. Luxembourg: 1 in 667
8. Norway: 1 in 667
8. Republic of Korea: 1 in 667

More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. However, a shortage of well-trained health workers and midwives means that thousands don’t receive the life-saving support they need to survive. For example, while in Norway there are 218 doctors, nurses and midwives to serve 10,000 people, that ratio is 1 per 10,000 in Somalia.

This month, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns. Through the campaign, UNICEF is issuing an urgent appeal to governments, health care providers, donors, the private sector, families and businesses to keep every child alive by:
:: Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;
:: Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;
:: Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and
:: Empowering adolescent girls, mothers and families to demand and receive quality care.

“Every year, 2.6 million newborns around the world do not survive their first month of life. One million of them die the day they are born,” said Ms. Fore. “We know we can save the vast majority of these babies with affordable, quality health care solutions for every mother and every newborn. Just a few small steps from all of us can help ensure the first small steps of each of these young lives.”

Milestones :: Perspectives

Urgent need to scale up health services in Cox’s Bazar: WHO
SEAR/PR/1680
Cox’s Bazar, Bangladesh, 20 February 2018: Calling for continued efforts to further scale up health services for nearly 1.3 million people in Cox’s Bazar, Rohingyas and their surrounding host communities, the World Health Organization today said six months after the start of the refugee crisis, the vulnerable populations remain at risk of several diseases and in need of critical services for survival.

“Commendable efforts have been made by the Government of Bangladesh and partner agencies to provide health services; prevent diseases such as cholera; and rapidly control outbreaks of measles and diphtheria. However, the challenges are huge, multiple and evolving. The magnitude of the crisis requires continued efforts and generous contributions by all partners to scale up health services for the vulnerable population,” said Dr Poonam Khetrapal Singh, Regional Director for WHO South-East Asia.

An estimated 688,000 Rohingyas crossed over to Cox’s Bazar from Myanmar beginning 25 August 2017, joining nearly 212,500 others who had arrived in earlier waves, in one of the largest population movement in the shortest span.

While majority of the refugees are living in Kutapalong and Balukhali mega camps and 11 other clusters of small and big settlements, about 79 000 are living with the host population.
The mega camps are currently one of the world’s biggest refugee settlement areas and also one of the world’s most densely populated areas.

The health needs of this population continue to be immense. Women and young mothers need reproductive health services. An estimated 60 000 children are expected to be born in the camps in the next one year. Besides newborns, pregnant and young mothers; children, adults and the elderly need basic health services and that for injuries, trauma and various non-communicable diseases such as heart disease, diabetes, and importantly, psychosocial support.

“Water and sanitation, and shelter continues to be far from optimum, increasing the risk of rapid spread of several communicable and water borne diseases,” the Regional Director said, stressing the need to accelerate efforts to address the key determinants of health on a priority.
The upcoming rainy season and the risk of cyclone and floods, increase the vulnerability of these people to waterborne diseases such as diarrhea and hepatitis, and vector borne diseases such as malaria, dengue and chikungunya.

For keeping a close watch on the situation, WHO established the Early Warning and Response System (EWARS), early as the crisis started, to rapidly detect and respond to disease outbreak to minimize death and disease. Additionally, WHO has been periodically carrying out risk assessments to enable Ministry of Health and partners take measures to detect potential health risks and take timely and appropriate measures.

The EWARS and risk assessments helped Bangladesh’s decision to carry out large scale vaccination campaigns with cholera, measles and rubella, polio and diphtheria vaccines. WHO has been working with the Ministry of Health and partners to plan, roll out and monitor vaccination campaigns to ensure all children are protected.

WHO continues to lead and coordinate efforts of over 100 partners managing more than 270 health facilities – health posts, hospitals, treatment centers and mobile clinics – while also providing medicines and medical equipment, diagnostics, guidelines and trainings and building laboratory capacity.

Despite efforts by government and partners, challenges are many. The affected population has distinct and unique culture and language, a major barrier in impacting health seeking and hygiene behavior.

But the most impending challenge is finding a safe space to relocate the refugees in case of floods and cyclone during the upcoming rainy season, which may further impact their health.
“The Government of Bangladesh has been extremely generous and forthcoming in hosting and providing for the Rohingyas. However, the health sector is grossly under-funded and grappling to meet the needs of the affected population,” Dr Khetrapal Singh said, appealing to international community to contribute generously and commit to support what clearly is set to be a protracted emergency.

Reiterating WHO’s committed to work with the Ministry of Health and Family Welfare and partners to address health issues of the vulnerable population, the Regional Director said concerted efforts by both national and international community is the need of the hour to strengthen and reinforce health services for both the Rohingyas and the their host population in Cox’s Bazar.

Emergencies

 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 21 February 2018 [GPEI]
:: New on http://polioeradication.org/: Ending polio and yellow fever in Nigeria, and why the polio vaccine must be delivered multiple times.
::  Our brand new animation on the two polio vaccines has been released, available in English, French, and Arabic.
:: In response to recent cases, the government of the Democratic Republic of the Congo (DRC) has announced the circulating vaccine-derived poliovirus 2 (cVDPV2) outbreak ongoing in the country as a Public Health Emergency of National Concern. Since the outbreak began, the Ministry of Health, supported by WHO and partners of the Global Polio Eradication Initiative, has implemented four monovalent oral polio vaccine 2 (mOPV2) supplementary immunization campaigns and one mop-up campaign to prevent virus spread. They have worked hard to strengthen surveillance and routine immunization in the outbreak zones and across the country, and are fully committed to ending the outbreak. The total number of officially reported cVDPV2 cases in the DRC in 2017 is 21. No cases of cVDPV2 with onset in 2018 have so far been reported.
:: Summary of newly-reported viruses this week: No new viruses reported.

::::::
::::::
 
Syria cVDPV2 outbreak situation report 35, 20 February 2018
Situation update 20 February 2018
[Editor’ text bolding]
:: No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 74. The most recent case (by date of onset of paralysis) is 21 September 2017 from Boukamal district, Deir Ez-Zor governorate.
:: An inactivated polio vaccine (IPV) immunization round has successfully concluded in Damascus, Hasakah, parts of Aleppo governorates, and Jurmana district of rural Damascus as part of the second phase of the outbreak response. IPV vaccination is continuing in accessible parts of Aleppo governorate.
:: Reportedly, a total of 233 518 children aged 2–23 months received IPV, representing 71% of the estimated target.
:: Post campaign monitoring of the IPV campaign has concluded in Damascus, Hasakah and parts of Aleppo governorate that completed the implementation. Overall, post campaign monitoring indicates 81% vaccination rates by parental/caregiver recall and 77% by finger marking.
:: Post campaign monitoring particularly focused on the internally displaced persons (IDP) camps; the data indicates 91% vaccination rates by parental/caregiver recall and 89% by finger marking.
:: A nationwide immunization round utilizing bivalent OPV (bOPV) is planned for March. The campaign will target all children aged less than 5 years.

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WHO Grade 3 Emergencies  [to 24 February 2018]
The Syrian Arab Republic
:: Syria cVDPV2 outbreak situation report 35, 20 February 2018
[See Polio above for detail]

Yemen 
Weekly cholera bulletins
:: Weekly epidemiology bulletin, 5–11 February 2018
Cumulative figures
-The cumulative total from 27 April 2017 to 11 Feb 2018 is 1,059,970 suspected cholera cases and 2,258 associated deaths, (CFR 0.21%), 1104 have been confirmed by culture.
– 59.3 % of death were severe cases at admission
– The total proportion of severe cases among the suspected cases is 16%
– The national attack rate is 382.7 per 10,000. The five governorates with the highest cumulative attack rates per 10,000 remain Amran (894), Al Mahwit (857), Al Dhale’e (644), Hajjah (520) and Sana’a (515).
– Children under 5 years old represent 28.8% of total suspected cases.
– In total, 29,629 rapid diagnostic tests (RDT) have been performed which represents 28 % coverage.
– 2,732 cultures have been performed which represents 22.3% coverage.
– The last positive culture was on 4 Feb 2018 in Al Harith district in Amant Al Asimah
– 182 districts are still reporting suspected cholera cases since last 3 weeks
– 123 districts (out of 305 affected districts) did not report any suspected cases for the last three consecutive weeks
Governorate and District level
– At governorate level, the trend from W4 –W6 decrease or was stable in all governorates except (Aden governorate)
(+13%).
Trends
– The weekly number of cases is decreasing for the 22 consecutive weeks.
– The weekly proportion of severe cases has significantly decreased representing now 9% of the admitted cases.
Week 6 2018
– 3,886 suspected cases and 3 associated deaths were reported
– 9 % are severe cases
– 589 RDTs were performed, 131 were positive
– No culture test was performed this week

::::::
 
WHO Grade 2 Emergencies  [to 24 February 2018]
Bangladesh/Myanmar: Rakhine Conflict 2017
[See WHO announcement in Milestones/Perspectives above]

Democratic Republic of the Congo 
:: Read the health situation report in French pdf, 4.28Mb, February 2018

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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
:: 23 Feb 2018   UN chiefs call for stepped-up support for vulnerable Syrians, refugees and host communities, amid escalating violence inside Syria

Yemen 
:: 20 Feb 2018  Yemen Humanitarian Update Covering 12 – 18 February 2018

WHO & Regional Offices [to 24 February 2018]

Latest news
Europe observes a 4-fold increase in measles cases in 2017 compared to previous year
Copenhagen, 19 February 2018
Measles has rebounded in the WHO European Region. The disease affected 21 315 people and caused 35 deaths in 2017, following a record low of 5273 cases in 2016. The WHO Regional Office for Europe has released new data for 2017 one day ahead of a health ministerial meeting on immunization in Montenegro on 20 February 2018.
“Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated. Over 20 000 cases of measles, and 35 lives lost in 2017 alone, are a tragedy we simply cannot accept,” says Dr Zsuzsanna Jakab, WHO Regional Director for Europe.
“Elimination of both measles and rubella is a priority goal that all European countries have firmly committed to, and a cornerstone for achieving the health-related Sustainable Development Goals,” Dr Jakab continues. “This short-term setback cannot deter us from our commitment to be the generation that frees our children from these diseases once and for all.”..

::::::

Highlights
Recommended composition of influenza virus vaccines for use in the 2018-2019
February 2018- A periodic replacement of viruses contained in influenza vaccines is necessary in order for the vaccines to be effective due to the constant evolving nature of influenza viruses. Twice a year, WHO organizes consultations, and issues recommendations on the composition of the influenza vaccines for the following influenza season.

::::::
 
Weekly Epidemiological Record, 23 February 2018, vol. 93, 08 (pp. 73–96)
:: BCG vaccines: WHO position paper – February 2018
 
::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: WHO strategizes to address the worsening challenge of the malaria burden in South Sudan
24 February 2018
:: Sierra Leone maximizes protection against polio with Inactivated Polio Vaccine launch
23 February 2018
Today Sierra Leone officially introduced injectable polio vaccine (or…
:: WHO and GAVI Alliance Partners along with the Ministry of Health strategizes to vaccinate over 485 000 children under one year of age in 2018  22 February 2018
Despite widespread conflict and insecurity, South Sudan has witnessed…
:: Experts agree on guidelines to boost vaccine uptake through improved communication
20 February 2018  Health experts from over 15 countries have begun a two-day meeting in…

WHO Region of the Americas PAHO
:: PAHO reminds international travelers to get vaccinated before traveling to areas with yellow fever (02/23/2018)
 
WHO European Region EURO
::  12 European countries commit to greater efforts to protect people from vaccine-preventable diseases 23-02-2018
:: European Region countries convene to boost emergency preparedness and response 20-02-2018
:: Portraits from Ukraine’s conflict line, where humanitarian assistance is most needed 20-02-2018
:: South-eastern European countries meet to develop regional action plan 19-02-2018

WHO Western Pacific Region
:: Questions and answers on avian influenza
21 February 2018 — Avian influenza viruses normally spread between birds. However, some viruses have been found to infect humans. The primary risk factor for humans is exposure to infected live or dead poultry or contaminated environments, such as live bird markets. Read our Q&A to learn more.

CDC/ACIP [to 24 February 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

 
MMWR News Synopsis for February 22, 2018 / No. 5
https://www.cdc.gov/mmwr/index2018.html
:: HIV Diagnoses Among Persons Aged 13–29 Years — United States, 2010‒2014
A new analysis provides a clearer picture of the remarkable escalations in HIV diagnosis rates among adolescents as age increases between 13-21 years. Between 2010 and 2014, there were large differences in diagnosis rates among adolescents and young adults as age increased (between 13 and 21 years). An analysis of data from the National HIV Surveillance System revealed large differences in HIV diagnosis rates per 100,000 between adolescents ages 13-15 years (0.7); 16-17 years (4.5); and 18-19 years (16.5). The analysis also found that while diagnosis rates were higher among young adults than adolescents, they were less variable among age groups: 20-21 years (28.6 per 100,000); 22-23 years (34.0); 24-25 years (33.8); 26-27 years (31.3); and 28-29 years (28.7). The findings demonstrate the importance of targeting primary prevention efforts to people younger than 18 years and continuing through the period of elevated risk in the mid-20s.

ECDC – European Centre for Disease Prevention and Control  [to 24 February 2018]

https://ecdc.europa.eu/en/home
19 Feb 2018
Africa CDC Director Dr Nkengasong visits ECDC

Announcements

 
AERAS  [to 24 February 2018]
http://www.aeras.org/pressreleases
February 19, 2018
Results from Innovative Phase 2 Tuberculosis Vaccine Trial Offer Potential for New BCG Revaccination Strategies, Hope For Subunit Vaccines
Study is the First “Prevention of Infection” Trial Conducted for Tuberculosis, the World’s Leading Infectious Disease Killer
Results to Be Presented at the 5th Global Forum on TB Vaccines
NEW DELHI (February 19, 2018) –Aeras, a nonprofit organization dedicated to developing vaccines against tuberculosis (TB), today announced results from an innovative clinical trial that provides encouraging new evidence that TB vaccines could prevent sustained infections in high-risk adolescents. In a prevention-of-infection Phase 2 trial conducted in South Africa, revaccination with the Bacille Calmette-Guerin (BCG) vaccine significantly reduced sustained TB infections in adolescents.  An experimental vaccine candidate, H4:IC31, also reduced sustained infections, although not at statistically significant levels. However, the trend observed for H4:IC31 is the first time a subunit vaccine has shown any indication of ability to protect against TB infection or disease in humans.
TB infections that developed during the study were determined using a QuantiFERON®-TB Gold in Tube (QFT-GIT) test, a commercially available blood test that helps diagnose TB infections. In the trial, individuals who tested negative for QFT-GIT were considered to not have a TB infection. The trial measured the rate by which individuals converted to QFT-GIT positive, implying evidence of TB infection.  Those individuals who tested QFT-GIT positive consecutively over 6 months were considered to have a sustained infection.,,

Aeras Highlights Commitment to Eradicating the World’s Leading Infectious Disease Killer at the 5th Global Forum on Tuberculosis
Aeras will highlight the progress being made in TB vaccine research at the 5th Global Forum on TB Vaccines in New Delhi, India, February 20-23, 2018. Presentations will include new data from Aeras’s advancing portfolio of TB vaccines, including data from four clinical-stage candidates. Keep reading for all presentation details.

European Medicines Agency  [to 24 February 2018]
http://www.ema.europa.eu/ema/
23/02/2018
Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 19-22 February 2018
Five medicines recommended for approval, including two orphans
 
 
IFFIm
http://www.iffim.org/library/news/press-releases/
22 February 2018
Financial engineering for global development
New IFFIm Board Chair Cyrus Ardalan reflects on IFFIm’s pioneering role in the growth of socially responsible investing.
Excerpt
…Q. IFFIm has been frequently singled out as an example of a successful socially responsible investment. Indeed, the landmark Third International Conference on Financing for Development, in 2015 in Addis Ababa, Ethiopia, stated that IFFIm should “be replicated to address broader development needs.” What can others in the global development sector learn from IFFIm’s example that they might adopt for their own financing needs?
CA: First, IFFIm Vaccine Bonds are as pure an example of socially responsible financing as you can get.
They have a clear social benefit, the results are measurable, and we can readily see the impact these funds are having. That’s a model that many others can emulate readily, though it may need to be adapted to different development needs.
Second, others might want to look at the institutional structure underpinning IFFIm, not just the bonds it issues. It’s a unique and, we think, replicable form of financial engineering. It enables us to accelerate for the short-term value that donor governments provide over the long run. It also gives Gavi much more flexibility to provide solutions when the need is greatest. That’s why IFFIm-generated funding initially made up more than 50% percent of Gavi’s expenditures.
On a less formal basis, we’re also offering advice and information to leaders in other development sectors who are exploring ways to improve the volume and flow of financing. We’ve done so, for example, with The International Commission on Financing Global Education Opportunity, which is contemplating an International Financing Facility for Education, or IFFEd.    Their goal is to mobilise by 2020 an additional $10 billion annually for investment into education in developing countries.

1. Can you describe potential new strategic initiatives IFFIm is currently exploring?

CA: Over the past couple of years we’ve looked at ways IFFIm can expand its role to help Gavi where there are emerging needs. That would include, first of all, doing more with what IFFIm has traditionally done through Vaccine Bond issuances.
Second, IFFIm could also be called on to more directly support Gavi’s impact on reducing the cost and increasing the availability of vaccines through its market shaping role. Market shaping is really one of Gavi’s core functions and achievements, and it has dramatically increased the supply of vaccines that low income countries can afford.
IFFIm has contributed to market shaping activities in the past by frontloading more than 90% of initial vaccines for Gavi’s pentavalent programme.  Pentavalent vaccine is effective in eradicating five diseases: diphtheria, tetantus, pertussis, hepatitis B and Haemophilus influenzae type b.  This investment encouraged manufacturers to increase vaccine production and decrease the price.  Gavi is now able to procure pentavalent vaccine for as low as $1.68 a dose – a price reduction of more than 50% since 2006.
Additionally, Gavi supported the introduction of pentavalent vaccine in 73 countries., By leveraging IFFIm’s unused capacity, it could play a greater role in supporting Gavi’s market shaping activities.
Third, IFFIm might provide additional financing to help countries install modern cold chain equipment that enables vaccines to be delivered unspoiled to the children whose lives depend on them – especially in remote areas. The goal is to increase access to more children and allow for the wider use of energy efficient, solar-powered equipment, especially in places that don’t have access to electricity.
Finally, we’re also looking into ways in which IFFIm can help with a new mechanism that will allow for the rapid deployment of financing in the event of infectious disease outbreaks, should Gavi decide to play an active role in this area.

IVAC  [to 24 February 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
[Undated]
IVAC Executive Director Dr. Kate O’Brien is featured in the Spring 2018 issue of the Hopkins Bloomberg Public Health magazine
 
Read the latest VIEW-hub report (December 2017)
 
 
MSF/Médecins Sans Frontières  [to 24 February 2018]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
Press release
Syria: Mass Casualties in Eastern Ghouta as 13 Medical Facilities are Hit and Lifesaving Supplies are Blocked by Siege
February 21, 2018
BRUSSELS/NEW YORK—Thirteen hospitals and clinics that receive support from Doctors Without Borders/Médecins Sans Frontières (MSF) have been damaged or destroyed over the past three days amid an extraordinary increase in bombing and shelling over the Syrian enclave of Eastern Ghouta, MSF said today. Meanwhile, lifesaving medical supplies urgently needed to treat mass casualties are being restricted by the ongoing siege on the area.

 
NIH  [to 24 February 2018]
http://www.nih.gov/news-events/news-releases
February 23, 2018
U.S. hospitals testing experimental therapies to prevent two common bacterial infections
February 23, 2018 — NIH-funded sites join large, international clinical trials.

NIH program to accelerate therapies for arthritis, lupus releases first datasets
February 21, 2018 — Collaborative effort provides important clues about potential research targets.
 

UNAIDS [to 24 February 2018]
http://www.unaids.org/en
23 February 2018
UNAIDS’ Deputy Executive Director, Programme, not to seek renewal of his position
GENEVA, 23 February 2018—UNAIDS’ Deputy Executive Director, Programme, Luiz Loures, has communicated his wish to the UNAIDS Executive Director not to seek the renewal of his position as Assistant Secretary-General of the United Nations and Deputy Executive Director of UNAIDS. Dr Loures will end his term as Deputy Executive Director at the end of March 2018.
The Executive Director of UNAIDS, Michel Sidibé, has accepted the decision and conveyed the decision to the Secretary-General of the United Nations. Mr Sidibé also thanked Dr Loures for his 22 years of dedicated service to UNAIDS…

UNICEF  [to 24 February 2018]
https://www.unicef.org/media/
23 February 2018
Cyclone season and threat of violence loom over 720,000 Rohingya children in Myanmar and Bangladesh – UNICEF
GENEVA/NEW YORK, 23 February 2018 – Urgent efforts are needed to help more than 720,000 Rohingya children who are threatened either by the approaching cyclone season in Bangladesh or by ongoing violence and denial of their basic rights in Myanmar, UNICEF said today.

UNICEF Executive Director Henrietta H. Fore gives remarks at the #EveryChildALIVE launch
NEW YORK, 20 February 2018 – “Thank you for joining us as we launch “Every Child Alive” — our new campaign to end the tragedy of preventable child deaths. Thanks to many of the people in this room, more children are surviving to their fifth birthdays than at any time in history. But as we celebrate the progress achieved for the young citizens of the world, we must do more for the youngest of all: newborns.”

The war on children in Syria: Reports of mass casualties among children in Eastern Ghouta and Damascus
AMMAN, 20 February 2018- “No words will do justice to the children killed, their mothers, their fathers and their loved ones”[1].

World is failing newborn babies, says UNICEF
NEW YORK, 20 February 2018 – Global deaths of newborn babies remain alarmingly high, particularly among the world’s poorest countries, UNICEF said today in a new report on newborn mortality. Babies born in Japan, Iceland and Singapore have the best chance at survival, while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds.
[See Reports/Research below for more detail]

Wellcome Trust  [to 24 February 2018]
https://wellcome.ac.uk/news
News / Published: 21 February 2018
Bolster European Research Area to boost science post-Brexit
The European Research Area (ERA) should be strengthened and broadened to increase scientific collaboration between member states and associated countries including the UK, according to a new report from Wellcome.
The Future Partnership Project report, Building a Strong Future for European Science: Brexit and Beyond [PDF 641KB], based on consultations with more than 200 UK and European scientists and policy makers, makes recommendations about how greater scientific collaboration could be achieved after Brexit.

4 projects reveal history of health experiences in LGBTQI+ community
Published: 19 February 2018
To mark this year’s LGBT History Month, Charli Colegate from our Humanities and Social Science team highlights four grants that are exploring the health-related histories of LGBTQI+ people.

The Wistar Institute   [to 24 February 2018]
https://www.wistar.org/news/press-releases
Press Release 
Variant of the p53 Gene Increased Tumor Cell Metabolism
PHILADELPHIA — (Feb. 22, 2018) — Scientists at The Wistar Institute have found a novel mechanism through which mutant p53 enhances metastasis by controlling tumor metabolism.

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Industry Watch   [to 24 February 2018]
:: GSK presents new efficacy data for FLUARIX® QUADRIVALENT (Influenza Vaccine) in children 6 months through 35 months of age
PHILADELPHIA, Feb. 21, 2018 /PRNewswire/ — GSK presented today at the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices meeting that FLUARIX® QUADRIVALENT demonstrated 63.2% efficacy against moderate to severe influenza and 49.8% efficacy against influenza of any severity in children 6 months through 35 months of age.
These results are based on a randomized, observer-blind, non-influenza vaccine-controlled trial that enrolled 12,018 children in five independent cohorts in 13 countries in Asia, Europe, and Central America from 2011 through the end of 2014.
“Children 6 months through 35 months of age are particularly vulnerable to the flu, and the efficacy results from this trial are promising,” said Dr. Leonard Friedland, Vice President, Scientific Affairs and Public Health, GSK Vaccines, who presented the data to the ACIP.    “FLUARIX® QUADRIVALENT can help ensure health care provider and parents have the ability to help protect young children against the flu.”…

Journal Watch

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

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

American Journal of Public Health
March 2018  108(3)
http://ajph.aphapublications.org/toc/ajph/current

AJPH PERSPECTIVES
OUTBREAKS
Delays in Global Disease Outbreak Responses: Lessons from H1N1, Ebola, and Zika
Steven J. Hoffman and Sarah L. Silverberg
108(3), pp. 329–333
Abstract
In global disease outbreaks, there are significant time delays between the source of an outbreak and collective action. Some delay is necessary, but recent delays have been extended by insufficient surveillance capacity and time-consuming efforts to mobilize action.
Three public health emergencies of international concern (PHEICs)—H1N1, Ebola, and Zika—allow us to identify and compare sources of delays and consider seven hypotheses about what influences the length of delays. These hypotheses can then motivate further research that empirically tests them. The three PHEICs suggest that deferred global mobilization is a greater source of delay than is poor surveillance capacity. These case study outbreaks support hypotheses that we see quicker responses for novel diseases when outbreaks do not coincide with holidays and when US citizens are infected. They do not support hypotheses that we see quicker responses for more severe outbreaks or those that threaten larger numbers of people.
Better understanding the reason for delays can help target policy interventions and identify the kind of global institutional changes needed to reduce the spread and severity of future PHEICs.

American Journal of Public Health
March 2018  108(3)
http://ajph.aphapublications.org/toc/ajph/current

AJPH PRACTICE
VACCINES
Fostering Interprofessional Education Through a Multidisciplinary, Community-Based Pandemic Mass Vaccination Exercise
Annette Hays, Christopher Schriever, John Rudzinski, Janet L. Lynch, Ellen Genrich and Allison Schriever
108(3), pp. 358–360
Abstract
We expanded health care services to economically disadvantaged individuals in an interprofessional, student-driven vaccination effort that also served as a pandemic planning drill. Health care professional students from colleges in and around Rockford, Illinois participated in implementing a mass vaccination event from 2011 to 2014 that targeted the underserved population. There was a 459% increase in total vaccinations administered to at-risk patients from year 1 to year 4. This interprofessional health care student–driven effort expanded medical service to disadvantaged individuals.

Annals of Internal Medicine
20 February 2018 Vol: 168, Issue 4
http://annals.org/aim/issue

Original Research
Low Prevalence of Hepatitis B Vaccination Among Patients Receiving Medical Care for HIV Infection in the United States, 2009 to 2012
John Weiser, MD, MPH; Alejandro Perez, MPH; Heather Bradley, PhD; Hope King, PhD, MSPH; R. Luke Shouse, MD, MPH
Abstract
Background: Persons with HIV infection are at increased risk for hepatitis B virus infection. In 2016, the World Health Organization resolved to eliminate hepatitis B as a public health threat by 2030.
Objective: To estimate the prevalence of hepatitis B vaccination among U.S. patients receiving medical care for HIV infection (“HIV patients”).
Design: Nationally representative cross-sectional survey.
Setting: United States.
Participants: 18 089 adults receiving HIV medical care who participated in the Medical Monitoring Project during 2009 to 2012.
Measurements: Primary outcomes were prevalence of 1) no documentation of hepatitis B vaccination or laboratory evidence of immunity or infection (candidates to initiate vaccination), and 2) initiation of vaccination among candidates, defined as documentation of at least 1 vaccine dose in a 1-year surveillance period during which patients received ongoing HIV medical care.
Results: At the beginning of the surveillance period, 44.2% (95% CI, 42.2% to 46.2%) of U.S. HIV patients were candidates to initiate vaccination. By the end of the surveillance period, 9.6% (CI, 8.4% to 10.8%) of candidates were vaccinated, 7.5% (CI, 6.4% to 8.6%) had no documented vaccination but had documented infection or immunity, and 82.9% (CI, 81.1% to 84.7%) remained candidates. Among patients at facilities funded by the Ryan White HIV/AIDS Program (RWHAP), 12.5% (CI, 11.1% to 13.9%) were vaccinated during the surveillance period versus 3.7% (CI, 2.6% to 4.7%) at facilities not funded by RWHAP. At the end of surveillance, 36.7% (CI, 34.4% to 38.9%) of HIV patients were candidates to initiate vaccination.
Limitation: The study was not designed to describe vaccine series completion or actual prevalence of immunity.
Conclusion: More than one third of U.S. HIV patients had missed opportunities to initiate hepatitis B vaccination. Meeting goals for hepatitis B elimination will require increased vaccination of HIV patients in all practice settings, particularly at facilities not funded by RWHAP.
Primary Funding Source: Centers for Disease Control and Prevention.

BMC Cost Effectiveness and Resource Allocation
http://resource-allocation.biomedcentral.com/
(Accessed 24 February 2018)

Methodology
20 February 2018
Incorporating economies of scale in the cost estimation in economic evaluation of PCV and HPV vaccination programmes in the Philippines: a game changer?
Authors: Thanthima Suwanthawornkul, Naiyana Praditsitthikorn, Wantanee Kulpeng, Manuel Alexander Haasis, Anna Melissa Guerrero and Yot Teerawattananon
Abstract
Background
Many economic evaluations ignore economies of scale in their cost estimation, which means that cost parameters are assumed to have a linear relationship with the level of production. Economies of scale is the situation when the average total cost of producing a product decreases with increasing volume caused by reducing the variable costs due to more efficient operation. This study investigates the significance of applying the economies of scale concept: the saving in costs gained by an increased level of production in economic evaluation of pneumococcal conjugate vaccines (PCV) and human papillomavirus (HPV) vaccinations.
Methods
The fixed and variable costs of providing partial (20% coverage) and universal (100% coverage) vaccination programs in the Philippines were estimated using various methods, including costs of conducting questionnaire survey, focus-group discussion, and analysis of secondary data. Costing parameters were utilised as inputs for the two economic evaluation models for PCV and HPV. Incremental cost-effectiveness ratios (ICERs) and 5-year budget impacts with and without applying economies of scale to the costing parameters for partial and universal coverage were compared in order to determine the effect of these different costing approaches.
Results
The program costs of the partial coverage for the two immunisation programs were not very different when applying and not applying the economies of scale concept. Nevertheless, the program costs for universal coverage were 0.26 and 0.32 times lower when applying economies of scale compared to not applying economies of scale for the pneumococcal and human papillomavirus vaccinations, respectively. ICERs varied by up to 98% for pneumococcal vaccinations, whereas the change in ICERs in the human papillomavirus vaccination depended on both the costs of cervical cancer screening and the vaccination program. This results in a significant difference in the 5-year budget impact, accounting for 30 and 40% of reduction in the 5-year budget impact for the pneumococcal and human papillomavirus vaccination programs.
Conclusions
This study demonstrated the feasibility and importance of applying economies of scale in the cost estimation in economic evaluation, which would lead to different conclusions in terms of value for money regarding the interventions, particularly with population-wide interventions such as vaccination programs. The economies of scale approach to costing is recommended for the creation of methodological guidelines for conducting economic evaluations.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 24 February 2018)

Research article
Efficacy of a bivalent killed whole-cell cholera vaccine over five years: a re-analysis of a cluster-randomized trial
Oral cholera vaccine (OCV) is a feasible tool to prevent or mitigate cholera outbreaks. A better understanding of the vaccine’s efficacy among different age groups and how rapidly its protection wanes could he…
Authors: Youyi Fong, M. Elizabeth Halloran, Jin Kyung Park, Florian Marks, John D. Clemens and Dennis L. Chao
Citation: BMC Infectious Diseases 2018 18:84
Published on: 20 February 2018

Global Public Health
Volume 13, 2017   Issue 4
http://www.tandfonline.com/toc/rgph20/current

Article
Geneva–Seattle collaboration in support of developing country vaccine manufacturing
Michael A. Stevenson
Pages: 426-441
Published online: 19 Oct 2016
ABSTRACT
Vaccines were once produced almost exclusively by state-supported entities. While they remain essential tools for public health protection, the majority of the world’s governments have allowed industry to assume responsibility for this function. This is significant because while the international harmonisation of quality assurance standards have effectively increased vaccine safety, they have also reduced the number of developing country vaccine producers, and Northern multinational pharmaceutical companies have shown little interest in offering the range of low-priced products needed in low and middle-income-country contexts. This article examines how public–private collaboration is relevant to contemporary efforts aimed at strengthening developing country manufacturers’ capacity to produce high-quality, low-priced vaccines. Specifically, it casts light on the important and largely complimentary roles of the World Health Organization, The Bill and Melinda Gates Foundation, and the Seattle-based non-profit PATH, in this process. The take away message is that external support remains critical to ensuring that developing country vaccine manufacturers have the tools needed to produce for both domestic and global markets, and the United Nations supply chain, and collaboration at the public–private interface is driving organisational innovation focused on meeting these goals.

International Health
Volume 10, Issue suppl_1, 1 March 2018
http://inthealth.oxfordjournals.org/content/current
Special Issue: Onchocerciasis: The Beginning of the End

INTRODUCTION
Onchocerciasis: the beginning of the end
Joni Lawrence; Yao K Sodahlon
International Health, Volume 10, Issue suppl_1, 1 March 2018, Pages i1–i2, https://doi.org/10.1093/inthealth/ihx070
Extract
Thirty years ago, the concept that onchocerciasis could be eliminated worldwide was unthinkable. Today, we’re on the road to seeing the end of this debilitating disease. Thanks to the efforts of a global partnership consisting of MSD, also known as Merck & Co., Inc., Kenilworth, NJ USA, the Mectizan Donation Program (MDP), endemic countries, bilateral funding agencies and the donor community, the World Health Organization (WHO), non-governmental organizations (NGOs) and researchers, the disease is on the decline. In areas that have been under treatment the longest, the blindness, visual impairment, skin disease and itching caused by onchocerciasis is now increasingly rare.

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 1, 19 February 2018
https://academic.oup.com/jpids/issue
SPECIAL ARTICLE

A Time to Save
Carol J Baker
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, 19 February 2018, Pages 1–5, https://doi.org/10.1093/jpids/piw080
Abstract
Group B Streptococcus (GBS), characterized by Lancefield in 1933, was not recognized as a human pathogen until the early 1970s when it emerged and replaced Escherichia coli as the most common cause of sepsis and meningitis among neonates and young infants. This article briefly gives a personnel account of the discovery of clinical syndromes of GBS distinguished by age at onset, vertical mode of transmission for early-onset disease, meningeal tropism for GBS capsular (CPS) type III strains, and protective CPS epitopes. It also reviews the difficult evolution of the now routine program for antenatal GBS culture screening and intrapartum antibiotic prophylaxis, development of the first GBS candidate vaccines, clinical trials documenting the immunogenicity and safety of CPS tetanus toxoid conjugate vaccines, ongoing need to prevent morbidity and mortality in neonates and young infants, and critical need for commercial vaccines for routine use in pregnant women.

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 1, 19 February 2018
https://academic.oup.com/jpids/issue
SPECIAL ARTICLE

Editor’s Choice
Rapid Decrease in Rates of Hospitalization Resulting From Invasive Pneumococcal Disease and Community-Acquired Pneumonia in Children Aged <60 Months After 13-Valent Pneumococcal Conjugate Vaccine Introduction in Argentina
Eduardo L López; Eduardo Glatstein; Gustavo C Ezcurra; Marisa Iacono; Eduardo Teplitz …
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, 19 February 2018, Pages 30–35, https://doi.org/10.1093/jpids/piw089

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 1, 19 February 2018
https://academic.oup.com/jpids/issue
SPECIAL ARTICLE

Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico
Minesh P Shah; Benjamin A Lopman; Jacqueline E Tate; John Harris; Marcelino Esparza-Aguilar
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, 19 February 2018, Pages 56–63, https://doi.org/10.1093/jpids/pix004
Internet searches for “rotavirus,” as measured by Google Trends, correlated well with laboratory-confirmed rotavirus disease and hospitalizations for acute gastroenteritis in the United States, United Kingdom, and Mexico. Internet searches declined after the introduction of national rotavirus vaccination programs, mirroring rotavirus disease activity.

Lancet Global Health
Mar 2018 Volume 6 Number 3 e229-e350
http://www.thelancet.com/journals/langlo/issue/current

Editorial
Local research in Africa: a glimpse at possibilities in Niger
The Lancet Global Health
At the core of the conclusions reached by the Lancet Commission on the future of health in sub-Saharan Africa published last September is a sense of possibility for what Africans can and must accomplish to level their populations’ health with the rest of the world’s by 2030. Among the key requirements are the home-bred, tailored solutions that a greater local research capacity and leadership would produce to respond to the challenges ahead. At the first Epicentre Niger Scientific Day held in Niamey on January 25, there were signs that the message is on point and the optimism justified.

Epicentre, an offshoot of Médecins Sans Frontières (MSF) created in 1988, conducts field epidemiology, research, and training activities that encompass the span of MSF’s areas of intervention. This connection to the medical humanitarian organisation makes it a unique research institution, with solid operational know-how, deep roots in the field, and strong ties to local communities. While its nerve centre is located in Paris, France, its heart clearly beats to the rhythm of two research facilities located in Maradi, Niger, and Mbarara, Uganda. Both are the scene for locally-led innovative research on issues ranging from infectious diseases and malnutrition to antimicrobial resistance, mental health, and child development. In Niger, the local staff of around 250 researchers, communicators, laboratory technicians, and administrators, run projects under the careful mentorship of international experts with knowledge of the realities of the field and a keen understanding of the importance of local knowledge and talent development.

Scientific days showcasing Epicentre’s research have been held in Paris for the last 27 years and for the first time in Kampala in 2017. But the day in Niamey, organised with the support of the Elsevier Foundation, carries some particular significance. A vast, landlocked country mostly covered by desert, Niger is by traditional indicators one of the poorest and least developed countries in the world. It is prone to chronic food insecurity, natural disasters, and infectious disease outbreaks, which included hepatitis E and meningitis in 2017. Diarrhoea is still a leading cause of death in children, as is malaria. Against such a backdrop, the research presented during the conference stands out: studies on malaria treatments highlighting the challenges of seasonal malaria chemoprevention, nutritional interventions underlining the difficulties in preventing severe acute malnutrition, and work around the heat stable and therefore highly adapted Rotasiil rotavirus vaccine, with impact beyond Niger, to only name a few. A francophone forum for these presentations is to be valued. As for many French-speaking countries, Niger faces challenges of another order that need to be acknowledged: the predominance of English as the language of communication in science undeniably represents a limiting factor for many francophone African researchers, adding significant hurdles to the exchange of knowledge and dissemination of research generated locally, as well as hindering the rise of local talent able to champion the country on the international scene.

But there was no shortage of talent present in Niamey, both on stage and in the audience. It is fair to say that the rigour of the research, clarity of the presentations, and depth of the discussions on topics of direct importance to the local context made an impression. Familiar difficulties were evoked during a plenary session expanding beyond Epicentre’s work, on the priorities for research in Niger: the pressing need for locally-adapted tools, the shortage of researchers, and the obstacles encountered in research activities—including accessing information—because of infrastructural limitations. Participants to a round table on how to move from research to policy also identified the misalignment of the donor-researcher-policymaker triad and the need for a stronger link between the protagonists of research and policy. These are all quasi-universal issues and they must be addressed. Yet opportunities seem to exist, many driven by the researcher’s knowledge and membership of the local context: the proximity to the Ministry of Health as a natural and close partner, the understanding of the local oral tradition to overcome research dissemination barriers, or even the inherent trust of the local population in the conduct of research. A sense of possibility was definitely glimpsed at in Niger, and with collaborations between Epicentre, local universities and research institutes such as CERMES, NGOs and other partners, Nigeriens involved in local research can play their part in leading Africa towards her health goals.

Lancet Global Health
Mar 2018 Volume 6 Number 3 e229-e350
http://www.thelancet.com/journals/langlo/issue/current

Articles
Global disability-adjusted life-year estimates of long-term health burden and undernutrition attributable to diarrhoeal diseases in children younger than 5 years
Christopher Troeger, Danny V Colombara, Puja C Rao, Ibrahim A Khalil, Alexandria Brown, Thomas G Brewer, Richard L Guerrant, Eric R Houpt, Karen L Kotloff, Kavita Misra, William A Petri Jr, James Platts-Mills, Mark S Riddle, Scott J Swartz, Mohammad H Forouzanfar, Robert C Reiner Jr, Simon I Hay, Ali H Mokdad

Lancet Global Health
Mar 2018 Volume 6 Number 3 e229-e350
http://www.thelancet.com/journals/langlo/issue/current

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis
Freya M Shearer, Joshua Longbottom, Annie J Browne, David M Pigott, Oliver J Brady, Moritz U G Kraemer, Fatima Marinho, Sergio Yactayo, Valdelaine E M de Araújo, Aglaêr A da Nóbrega, Nancy Fullman, Sarah E Ray, Jonathan F Mosser, Jeffrey D Stanaway, Stephen S Lim, Robert C Reiner Jr, Catherine L Moyes, Simon I Hay, Nick Golding

Lancet Infectious Diseases
Mar 2018 Volume 18 Number 3 p227-356  e64-e106
http://www.thelancet.com/journals/laninf/issue/current

Comment
Tuberculosis eradication: renewed commitment and global investment required
Helen Cox, Mark P Nicol

Lancet Infectious Diseases
Mar 2018 Volume 18 Number 3 p227-356  e64-e106
http://www.thelancet.com/journals/laninf/issue/current

Correspondence
Dengvaxia: age as surrogate for serostatus
Maíra Aguiar [Centre for Mathematics and Applications, Faculty of Sciences and Technology, Nova University of Lisbon, 2829-516 Caparica, Portugal mafsantos@fc.ul.pt ]
Nico Stollenwerk [Centro de Matemática, Aplicações Fundamentais e Investigação Operacional, Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal]
Published: 21 December 2017
DOI: https://doi.org/10.1016/S1473-3099(17)30752-1

Since April, 2016, Dengvaxia—a dengue vaccine produced by Sanofi Pasteur (Lyon, France)—has been licensed for use in 19 countries. Dengvaxia was recommended by the WHO Strategic Advisory Group of Experts (SAGE) on immunisation to be used in regions with high endemicity, as defined by a prevalence of dengue antibodies of more than 50% in the targeted age group of people aged 9–45 years.1 We have previously discussed the risks behind this vaccine recommendation,2, 3 and by analysing an age-structured model4 using the available vaccine trial data1 predicted a significant reduction in dengue virus infection-related hospital admissions if Dengvaxia is given only to individuals who are seropositive for dengue antibodies. We also predicted a significant increase in the number of dengue-related admissions, over 5 years, if the vaccine is administered without previous population screening for serostatus.4 More recently, our analysis of trial data has indicated that serostatus (and not age) is statistically discriminative with regard to the relative risk (RR) of hospital admission after vaccination, and of efficacy5—ie, the RR is similar across age classes but significantly different across serostatus groups.5

After rigorous statistical analysis of study data (taken from Martínez-Vega and colleagues’ analysis6), here we present further evidence showing that serostatus (and not age) is statistically discriminative with regard to the RR of hospital admission after Dengvaxia vaccination, and efficacy. By using the risk of dengue-related admission to hospital estimated from dengue antibody-seronegative children aged 2–8 years and infectivity measured from control groups of seropositive children younger than 9 years or seronegative individuals aged 9–16 years,6 we calculated the probability of specific numbers of individuals requiring dengue-related hospital admission in either seropositive children aged 2–8 years or seronegative children aged 9–16 years. The distribution of the number of expected admissions to hospital for younger seropositive children and older seronegative children and adolescents, and the actual number of hospital admissions for each group as reported in Martínez-Vega and colleagues’ analysis6 are shown in the appendix, showing the differences in the risk of hospital admissions between seronegative and seropositive individuals in the same age group.

The relative risk measured from seronegative individuals aged 2–8 years—the group for which Dengvaxia is not recommended—can explain and correctly estimate the observed increase of dengue-related admissions to hospital for all seronegative children enrolled during the vaccine trials, independent of age (appendix). However, it cannot explain statistically the observed number of seropositive individuals admitted to hospital of the same age (appendix).

Despite all our efforts in communicating the risks behind the Dengvaxia recommendation and its implementation without serostatus testing before vaccination,2, 3, 4, 5 an individual’s age, as a risk factor, was (until November) the only restriction for vaccine recommendation in countries with high endemicity. More than 800,000 children in the Philippines and around 300,000 individuals in Brazil were vaccinated against dengue virus in mass vaccination programmes, and many of those were possibly seronegative individuals. Communications from Sanofi in November,7 stating that vaccinated seronegative individuals are at risk of a vaccine-induced increase in the severity of a subsequent dengue virus infection, and by WHO advising that Dengvaxia be used only in people previously infected with dengue,8 are inexcusably late, since the vaccine-induced risk in seronegative individuals was already observed in the phase 3 trial data, published more than a year ago.1 Even with controversial modelling results indicating that the use of Dengvaxia in highly endemic settings could be beneficial at the population level,9 ethically no one should have been put under risk by receiving this vaccine.
We declare no competing interests.

Lancet Infectious Diseases
Mar 2018 Volume 18 Number 3 p227-356  e64-e106
http://www.thelancet.com/journals/laninf/issue/current

Articles
The global burden of tuberculosis: results from the Global Burden of Disease Study 2015
GBD Tuberculosis Collaborators

Lancet Infectious Diseases
Mar 2018 Volume 18 Number 3 p227-356  e64-e106
http://www.thelancet.com/journals/laninf/issue/current

Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis
Evelina Tacconelli, Elena Carrara, Alessia Savoldi, Stephan Harbarth, Marc Mendelson, Dominique L Monnet, Céline Pulcini, Gunnar Kahlmeter, Jan Kluytmans, Yehuda Carmeli, Marc Ouellette, Kevin Outterson, Jean Patel, Marco Cavaleri, Edward M Cox, Chris R Houchens, M Lindsay Grayson, Paul Hansen, Nalini Singh, Ursula Theuretzbacher, Nicola Magrini and the WHO Pathogens Priority List Working Group

Lancet Infectious Diseases
Mar 2018 Volume 18 Number 3 p227-356  e64-e106
http://www.thelancet.com/journals/laninf/issue/current

Review
Genetics of human susceptibility to active and latent tuberculosis: present knowledge and future perspectives
Laurent Abel, Jacques Fellay, David W Haas, Erwin Schurr, Geetha Srikrishna, Michael Urbanowski, Nimisha Chaturvedi, Sudha Srinivasan, Daniel H Johnson, William R Bishai

Lancet Infectious Diseases
Mar 2018 Volume 18 Number 3 p227-356  e64-e106
http://www.thelancet.com/journals/laninf/issue/current

The WHO public health approach to HIV treatment and care: looking back and looking ahead
Nathan Ford, Andrew Ball, Rachel Baggaley, Marco Vitoria, Daniel Low-Beer, Martina Penazzato, Lara Vojnov, Silvia Bertagnolio, Vincent Habiyambere, Meg Doherty, Gottfried Hirnschall

Nature 
Volume 554 Number 7693 pp403-554  22 February 2018
http://www.nature.com/nature/current_issue.html

Editorials
Adolescence research must grow up
Young people get a raw deal from society. Targeted study and approaches as part of a new global effort are urgently needed to help them.

Nature 
Volume 554 Number 7693 pp403-554  22 February 2018
http://www.nature.com/nature/current_issue.html

Perspectives
Importance of investing in adolescence from a developmental science perspective
Ronald E. Dahl, Nicholas B. Allen, Linda Wilbrecht & Ahna Ballonoff Suleiman
Insights into windows of opportunity that will have strong positive impacts on the trajectories of health, education, social and economic success of adolescents are reviewed.

Nature 
Volume 554 Number 7693 pp403-554  22 February 2018
http://www.nature.com/nature/current_issue.html

Analysis
Adolescence and the next generation
Open
George C. Patton, Craig A. Olsson, Vegard Skirbekk, Richard Saffery, Mary E. Wlodek+ et al.
Investing in adolescents as the parents of the next generation is important for the wellbeing of current and future generations.

New England Journal of Medicine
February 22, 2018  Vol. 378 No. 8
http://www.nejm.org/toc/nejm/medical-journal

Human Neonatal Rotavirus Vaccine (RV3-BB) to Target Rotavirus from Birth
Julie E. Bines, M.D., Jarir At Thobari, Ph.D., Cahya Dewi Satria, M.D., Amanda Handley, M.P.H.,
Emma Watts, B.Sci., Daniel Cowley, Ph.D., Hera Nirwati, M.D., Ph.D., James Ackland, B.Sci.,
Jane Standish, M.B., B.S., Frances Justice, B.Sci., Gabrielle Byars, M.Bio.Med.Sci., Katherine J. Lee, Ph.D., Graeme L. Barnes, M.D., Novilia S. Bachtiar, Dr.M.Kes., Ajeng Viska Icanervilia, .D.,
Karen Boniface, B.Sci., Nada Bogdanovic-Sakran, B.Sci., Daniel Pavlic, B.Sci., Ruth F. Bishop, A.O., D.Sc., Carl D. Kirkwood, Ph.D., Jim P. Buttery, M.D., and Yati Soenarto, M.D., Ph.D.
Conclusions
RV3-BB was efficacious in preventing severe rotavirus gastroenteritis when administered according to a neonatal or an infant schedule in Indonesia. (Funded by the Bill and Melinda Gates Foundation and others; Australian New Zealand Clinical Trials Registry number, ACTRN12612001282875.)

New England Journal of Medicine
February 22, 2018  Vol. 378 No. 8
http://www.nejm.org/toc/nejm/medical-journal

Sounding Board
A Framework for Ethical Payment to Research Participants
Luke Gelinas, Ph.D., Emily A. Largent, J.D., Ph.D., R.N., I. Glenn Cohen, J.D., Susan Kornetsky, M.P.H., Barbara E. Bierer, M.D., and Holly Fernandez Lynch, J.D.
The authors propose a framework for evaluating the appropriateness of payments to research participants. They distinguish three acceptable rationales for payment: out-of-pocket expenses, time and burdens of participation, and incentive to participate.

PLoS One
http://www.plosone.org/
[Accessed 24 February 2018]

Research Article
Cross-sectional associations between psychological traits, and HPV vaccine uptake and intentions in young adults from the United States
Aaron M. Scherer, Heather Schacht Reisinger, Marin L. Schweizer, Natoshia M. Askelson, Angela Fagerlin, Charles F. Lynch
Research Article | published 23 Feb 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0193363

PLoS One
http://www.plosone.org/
[Accessed 24 February 2018]

Development of improved therapeutic mesothelin-based vaccines for pancreatic cancer
Michael White, Andrew Freistaedter, Gwendolyn J. B. Jones, Emmanuel Zervos, Rachel L. Roper
Research Article | published 23 Feb 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0193131

PLoS One
http://www.plosone.org/
[Accessed 24 February 2018]

Global influenza seasonality to inform country-level vaccine programs: An analysis of WHO FluNet influenza surveillance data between 2011 and 2016
Laura P. Newman, Niranjan Bhat, Jessica A. Fleming, Kathleen M. Neuzil
Research Article | published 21 Feb 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0193263