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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Media/Policy Watch

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

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

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

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

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

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

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

.– 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_30 September 2017

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

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

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

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

Milestones :: Perspectives

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Featured Journal Content

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

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

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

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

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

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

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

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

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

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

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

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

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

::::::
::::::
 
UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Iraq
:: OCHA Iraq | Hawiga Flash Update #2: Hawiga Humanitarian Response, 29 September 2017
 
Syrian Arab Republic
:: 29 Sep 2017  Children in Homs vaccinated against measles thanks to UNICEF
With World Health Organization and the Ministry of Health, UNICEF launched a two-week vaccination campaign against measles. The campaign aims to reach over 260,000 children, aged 5-12 years old, in Homs with the necessary vaccines, focusing on children in hard to reach areas and shelters for internally displaced families…

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

::::::
UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
DRC
:: DRC: More than 1 million people uprooted from their homes by lingering violence in Kasai
Published on 25 Sep 2017

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

Somalia 
:: Humanitarian Bulletin Somalia, September 2017 | Issued on 26 September 2017
HIGHLIGHTS
…Displaced persons among worst affected by drought.
…Over 100,000 displaced people evicted from settlements in 2017, according to the Norwegian Refuge Council.
…AWD/Cholera cases have declined from a peak of over 5,300 cases in June to 93 cases in August.
…Strengthening localization of humanitarian response
 
::::::
::::::
 
Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

MERS-CoV [to 30 September 2017]
http://www.who.int/emergencies/mers-cov/en/
27 September 2017
Countries agree next steps to combat global health threat by MERS-CoV
Critical next steps to accelerate the response to the global public health threat posed by Middle-East respiratory syndrome coronavirus (MERS-CoV) have been agreed by representatives from the Ministries of Health and Ministries of Agriculture of affected and at-risk countries, and experts. The virus, which circulates in dromedary camels without causing visible disease, can be fatal for humans.

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

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

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

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

WHO & Regional Offices [to 30 September 2017]

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

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

::::::

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Journal Watch

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 30 September 2017)

Research Article
Possible explanations for why some countries were harder hit by the pandemic influenza virus in 2009 – a global mortality impact modeling study
A global pandemic mortality study found prominent regional mortality variations in 2009 for Influenza A(H1N1)pdm09. Our study attempts to identify factors that explain why the pandemic mortality burden was hig…
Kathleen F. Morales, John Paget and Peter Spreeuwenberg
BMC Infectious Diseases 2017 17:642
Published on: 25 September 2017

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 30 September 2017)

Research article
Assessment of the HBV vaccine response in a group of HIV-infected children in Morocco
Since its development in the early 1980s, Hepatitis B virus (HBV) vaccine has been proven to be highly protective. However, its immunogenicity may be ineffective among HIV-infected children. In Morocco, HBV va…
Houda Haban, Soumia Benchekroun, Mina Sadeq, Abdelaziz Benjouad, Said Amzazi, Hicham Oumzil and Elmir Elharti
BMC Public Health 2017 17:752
Published on: 29 September 2017

Global Health: Science and Practice (GHSP)
September 2017 | Volume 5 | Number 3
http://www.ghspjournal.org/content/current

COMMENTARIES
Open Access
Seeking Synchrony Between Family Planning and Immunization: A Week-10 DMPA Start Option for Breastfeeding Mothers
John Stanback
Global Health: Science and Practice September 2017, 5(3):341-344; https://doi.org/10.9745/GHSP-D-17-00063
Many mothers initiate DMPA injectables at 6 weeks postpartum, at the time of their baby’s first immunization visit. Offering an optional delayed DMPA start at the next (10-week) immunization visit has potential advantages including a reduced follow-up schedule with DMPA visits synchronized with other immunization visits, and, possibly, improved contraceptive and immunization outcomes.

Health Policy and Planning
Volume 32, Issue 8   October 2017
http://heapol.oxfordjournals.org/content/current

The cost structure of routine infant immunization services: a systematic analysis of six countries
Fangli Geng; Christian Suharlim; Logan Brenzel; Stephen C Resch; Nicolas A Menzies
Health Policy and Planning, Volume 32, Issue 8, 1 October 2017, Pages 1174–1184, https://doi.org/10.1093/heapol/czx067

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 30 September 2017]

Research
The cost structure of routine infant immunization services: a systematic analysis of six countries
Fangli Geng; Christian Suharlim; Logan Brenzel; Stephen C Resch; Nicolas A Menzies
Health Policy and Planning, Volume 32, Issue 8, 1 October 2017, Pages 1174–1184, https://doi.org/10.1093/heapol/czx067
Abstract
Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 13, Issue 9 2017
http://www.tandfonline.com/toc/khvi20/current

Article
A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions
Vittal Mogasale, Enusa Ramani, Il Yeon Park & Jung Seok Lee
Pages: 2017-2024
Published online: 12 Jun 2017
ABSTRACT
A Typhoid Conjugate Vaccine (TCV) is expected to acquire WHO prequalification soon, which will pave the way for its use in many low- and middle-income countries where typhoid fever is endemic. Thus it is critical to forecast future vaccine demand to ensure supply meets demand, and to facilitate vaccine policy and introduction planning. We forecasted introduction dates for countries based on specific criteria and estimated vaccine demand by year for defined vaccination strategies in 2 scenarios: rapid vaccine introduction and slow vaccine introduction. In the rapid introduction scenario, we forecasted 17 countries and India introducing TCV in the first 5 y of the vaccine’s availability while in the slow introduction scenario we forecasted 4 countries and India introducing TCV in the same time period. If the vaccine is targeting infants in high-risk populations as a routine single dose, the vaccine demand peaks around 40 million doses per year under the rapid introduction scenario. Similarly, if the vaccine is targeting infants in the general population as a routine single dose, the vaccine demand increases to 160 million doses per year under the rapid introduction scenario. The demand forecast projected here is an upper bound estimate of vaccine demand, where actual demand depends on various factors such as country priorities, actual vaccine introduction, vaccination strategies, Gavi financing, costs, and overall product profile. Considering the potential role of TCV in typhoid control globally; manufacturers, policymakers, donors and financing bodies should work together to ensure vaccine access through sufficient production capacity, early WHO prequalification of the vaccine, continued Gavi financing and supportive policy.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 13, Issue 9 2017
http://www.tandfonline.com/toc/khvi20/current

Article
Age-appropriate versus up-to-date coverage of routine childhood vaccinations among young children in Israel
Chen Stein-Zamir & Avi Israeli
Pages: 2102-2110
Published online: 11 Jul 2017

Brief Report
Relationship between maternal experiences and adolescent HPV vaccination
Abbey B. Berenson, V. Gnaukita Brown, Erika L. Fuchs, Jacqueline M. Hirth & Mihyun Chang
Pages: 2150-2154
Published online: 12 Jun 2017

Review
Standard of care in immunotherapy trials: Challenges and considerations
Gareth Rivalland, Andrew M. Scott & Thomas John
Pages: 2164-2178
Published online: 01 Mar 2017
This review addresses the most important challenges in the selection of SOC in immunotherapeutic trials and the current and future challenges in trial design.

Article Commentary
Immunotherapy is different: Implications for vaccine clinical trial design
Richard Simon
Pages: 2179-2184
Published online: 12 May 2017

Article
Recall and decay of consent information among parents of infants participating in a randomized controlled clinical trial using an audio-visual tool in The Gambia
Robert B. Mboizi, Muhammed O. Afolabi, Michael Okoye, Beate Kampmann, Anna Roca & Olubukola T. Idoko
Pages: 2185-2191
Published online: 09 Jun 2017

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 13, Issue 9 2017
http://www.tandfonline.com/toc/khvi20/current

Review
Vaccine development and trials in low and lower-middle income countries: Key issues, advances and future opportunities
Amy Grenham & Tonya Villafana
Pages: 2192-2199
Published online: 31 Jul 2017
ABSTRACT
Over the past 10 years there has been an increase in the number of vaccine clinical studies conducted in resource limited countries. These include vaccine trials for diseases such as malaria and dengue fever which are endemic to many low and lower-middle income countries. Concurrent with the increase in the number of trials, has been the increase and improvement in local infrastructure to enable the appropriate conduct and oversight of trials in these settings, including strengthening of local scientific capabilities, ethical and regulatory oversight. While significant advances have been made, there remain gaps to be addressed including strengthening pharmacovigilance in these regions. There are also opportunities to establish novel collaborations to address diseases specific to these populations including strengthening local manufacturers, new ways to engage established large pharmaceutical companies and leveraging established global infrastructure and pathways to develop innovative products beyond vaccines.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 30 September 2017]

Opinion
Neglected tropical diseases: exploring long term practical approaches to achieve sustainable disease elimination and beyond
Giuseppina Ortu and Oliver Williams
Published on: 27 September 2017
Abstract
Background
Remarkable progress has been made in the fight against neglected tropical diseases, but new challenges have emerged. Innovative diagnostics, better drugs and new insecticides are often identified as the priority; however, access to these new tools may not be sufficient to achieve and sustain disease elimination, if certain challenges and priorities are not considered.
Main body
The authors summarise key operational challenges, and based on these, identify two major priorities: strengthening the capacity of the primary health care health system in correctly diagnosing and managing neglected tropical diseases; and establishing an effective disease surveillance process.
Five steps are proposed as concrete actions to build an effective primary health care service for neglected tropical diseases, and a health management information system capable of accurately reporting these diseases. Community engagement and formalization of community health workers role are proposed as essential components of these steps.
Shift of financial support from disease oriented programmes to disease integrated interventions, improved access to international guidelines for primary health care staff, and availability of donated drugs in health care structures are also suggested as key elements of the proposed process.
Conclusion
The authors conclude that failure to address these priorities now may lead to further challenges on the long path towards neglected tropical disease elimination and beyond.

International Journal of Community Medicine and Public Health
Vol 4, No 10 (2017)  October 2017
http://www.ijcmph.com/index.php/ijcmph/issue/view/31

Original Research Articles
Assessment of immunization services at immunization sessions under Ghatnandur PHC area in Beed district
Shashikant Shivajirao Salunke, Poonam Vijay Sancheti
DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20174228

Awareness and attitudes of mothers towards new vaccines in the childhood vaccination programme in delhi state: a cross sectional study
Reema Mukherjee, Manisha Arora, Atul Kotwal, Poonam Hooda
DOI: 10.18203/2394-6040.ijcmph20174264

International Journal of Infectious Diseases
October 2017 Volume 63, p1-100
http://www.ijidonline.com/issue/S1201-9712(17)X0010-6

Reviews
Utility and potential of rapid epidemic intelligence from internet-based sources
S.J. Yan, A.A. Chughtai, C.R. Macintyre
p77–87
Published online: July 29, 2017

JAMA
September 26, 2017, Vol 318, No. 12, Pages 1083-1198
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Addressing Antimicrobial Resistance and Stewardship: The Priority Antimicrobial Value and Entry (PAVE) Award
Gregory W. Daniel, PhD, MPH; Monika Schneider, PhD; Mark B. McClellan, MD, PhD
JAMA. 2017;318(12):1103-1104. doi:10.1001/jama.2017.10164
This Viewpoint describes the Priority Antimicrobial Value and Entry (PAVE) award, which has been proposed to address the problem of antimicrobial-resistant infections using limited public funds to shift to value-based payment for new, high-priority antimicrobial drugs.

Journal of Epidemiology & Community Health
October 2017 – Volume 71 – 10
http://jech.bmj.com/content/current

Cancer Risk
The impact of bivalent HPV vaccine on cervical intraepithelial neoplasia by deprivation in Scotland: reducing the gap
Ross L Cameron, Kimberley Kavanagh, D Cameron Watt, Chris Robertson, Kate Cuschieri, Syed Ahmed, Kevin G Pollock

Journal of Medical Ethics
October 2017 – Volume 43 – 10
http://jme.bmj.com/content/current

Editorials
Antimicrobial resistance and antimicrobial stewardship programmes: benefiting the patient or the population?
Alberto Giubilini

Why health services research needs bioethics
Lucy Frith
 
Commentaries
Vulnerability of pregnant women in clinical research Free
Indira S E van der Zande, Rieke van der Graaf, Martijn A Oudijk, Johannes J M van Delden

Pregnant women should not be categorised as a ‘vulnerable population’ in biomedical research studies: ending a vicious cycle of ‘vulnerability’
Carleigh B Krubiner, Ruth R Faden

Journal of Virology
October 2017, volume 91, issue 20
http://jvi.asm.org/content/current

Gem
Monoclonal Antibodies against Zika Virus: Therapeutics and Their Implications for Vaccine Design
Qihui Wang, Jinghua Yan, and George Fu Gao

The Lancet
Sep 30, 2017 Volume 390 Number 10102 p1563-1622  e23
http://www.thelancet.com/journals/lancet/issue/current

Articles
Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study
Helen Petousis-Harris, Janine Paynter, Jane Morgan, Peter Saxton, Barbara McArdle, Felicity Goodyear-Smith, Steven Black
…Interpretation
Exposure to MeNZB was associated with reduced rates of gonorrhoea diagnosis, the first time a vaccine has shown any protection against gonorrhoea. These results provide a proof of principle that can inform prospective vaccine development not only for gonorrhoea but also for meningococcal vaccines.

Lancet Global Health
Oct 2017 Volume 5 Number 10 e948-e1046
http://www.thelancet.com/journals/langlo/issue/current

Articles
Effect of counselling on health-care-seeking behaviours and rabies vaccination adherence after dog bites in Haiti, 2014–15: a retrospective follow-up survey
Melissa Dominique Etheart, Maxwell Kligerman, Pierre Dilius Augustin, Jesse D Blanton, Benjamin Monroe, Ludder Fleurinord, Max Millien, Kelly Crowdis, Natael Fenelon, Ryan MacLaren Wallace

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

Editorial
Vaccine against Zika virus must remain a priority
The Lancet Infectious Diseases

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

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

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

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

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

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

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

Nature 
Volume 549 Number 7673 pp432-558  28 September 2017
http://www.nature.com/nature/current_issue.html

Editorials
Steps towards transparency in research publishing
As research and editorial processes become increasingly open, scientists and editors need to be proactive but also alert to risks.

New England Journal of Medicine
September 28, 2017  Vol. 377 No. 13
http://www.nejm.org/toc/nejm/medical-journal

Special Report
Investing in Global Health for Our Future
Victor Dzau, M.D., Valentin Fuster, M.D., Ph.D., Jendayi Frazer, Ph.D., and Megan Snair, M.P.H.
N Engl J Med 2017; 377:1292-1296 September 28, 2017 DOI: 10.1056/NEJMsr1707974
[Initial text]
With connectedness among countries increasing, the United States exists in a highly interdependent world. All countries are now vulnerable to the ever-present threats of infectious disease outbreaks and epidemics, as well as the continuous challenges of malaria, tuberculosis, and human immunodeficiency virus–acquired immunodeficiency syndrome (HIV–AIDS). Furthermore, the increasing prevalence of chronic noncommunicable diseases (NCDs) has negatively affected global health and economies, compromising societal gains in life expectancy, productivity, and overall quality of life.1 In addition to resulting in the loss of lives, these disease burdens can stall the progress of a country’s development and significantly affect its ability to become a strong trading partner or a business or travel destination. Human capital clearly contributes substantially to economic growth, and it follows that having a healthy population is critical for economic prosperity. For all these reasons, the health of other countries has a great influence on the health, security, economy, and well-being of the United States. At the same time, interdependency brings opportunities for shared innovation and universal purpose in response to similar disease burdens across countries…

Prehospital & Disaster Medicine
Volume 32 – Issue 5 – October 2017
https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/latest-issue

Editorial
The Revised International Guidelines for Ethical Health-Related Human Research
Samuel J. Stratton
https://doi.org/10.1017/S1049023X17006938
Published online: 28 September 2017, pp. 471-472

Original Research
Categorization and Analysis of Disaster Health Publications: An Inventory
Marvin L. Birnbaum, Sowmya Adibhatla, Olivia Dudek, Jessica Ramsel-Miller
https://doi.org/10.1017/S1049023X17006525
Published online: 31 May 2017, pp. 473-482

Disaster Metrics: A Comprehensive Framework for Disaster Evaluation Typologies
Diana F. Wong, Caroline Spencer, Lee Boyd, Frederick M. Burkle, Frank Archer
https://doi.org/10.1017/S1049023X17006471
Published online: 08 May 2017, pp. 501-514

Preventive Medicine
Volume 101, Pages 1-238 (August 2017)
http://www.sciencedirect.com/science/journal/00917435/101?sdc=1

Review Article
A systematic review of peer-supported interventions for health promotion and disease prevention
Pages 156-170
Rajeev Ramchand, Sangeeta C. Ahluwalia, Lea Xenakis, Eric Apaydin, Laura Raaen, Geoffrey Grimm

Regular Articles
Seasonal influenza vaccine uptake among people with disabilities: A nationwide population study of disparities by type of disability and socioeconomic status in France
Original Research Article
Pages 1-7
Aurélie Bocquier, Lisa Fressard, Alain Paraponaris, Bérengère Davin, Pierre Verger

Science         
29 September 2017  Vol 357, Issue 6358
http://www.sciencemag.org/current.dtl

Feature
The preprint dilemma
By Jocelyn Kaiser
Science29 Sep 2017 : 1344-1349 Full Access
Biologists are posting unreviewed papers in record numbers. Here’s a survival guide.

Policy Forum
Reducing antimicrobial use in food animals
By Thomas P. Van Boeckel, Emma E. Glennon, Dora Chen, Marius Gilbert, Timothy P. Robinson, Bryan T Grenfell, Simon A. Levin, Sebastian Bonhoeffer, Ramanan Laxminarayan
Science29 Sep 2017 : 1350-1352 Open Access CCBY
Consider user fees and regulatory caps on veterinary use