Postmarketing Safety of Vaccines Approved by the U.S. Food and Drug Administration – A Cohort Study

Annals of Internal Medicine
15 September 2020 Volume 173, Issue 6
http://annals.org/aim/issue

 

Original Research
Postmarketing Safety of Vaccines Approved by the U.S. Food and Drug Administration – A Cohort Study
Noam Tau, MD, Dafna Yahav, MD, and Daniel Shepshelovich, MD
Vaccinations are an important public health strategy that has reduced morbidity and mortality from many infectious diseases. Postmarketing surveillance helps to detect vaccine-related adverse events or long-term complications. This cohort study describes the prevalence and types of safety issues reported for vaccines approved by the U.S. Food and Drug Administration between 1996 and 2015.
Conclusion:
Over a 20-year period, vaccines were found to be remarkably safe. A large proportion of safety issues were identified through existing postmarketing surveillance programs and were of limited clinical significance. These findings confirm the robustness of the vaccine approval system and postmarketing surveillance.

Maternal vaccinations coverage and reasons for non-compliance – a cross-sectional observational study

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 19 Sep 2020)

 

Maternal vaccinations coverage and reasons for non-compliance – a cross-sectional observational study
Maternal influenza and pertussis vaccinations have been proven safe and effective in reducing maternal and infant morbidity and mortality. Though recommended, not all pregnant women receive these important vac… [Israel]
Authors: David Drezner, Michal Youngster, Hodaya Klainer and Ilan Youngster
Citation: BMC Pregnancy and Childbirth 2020 20:541
Content type: Research article
Published on: 16 September 2020

Spatial access inequities and childhood immunisation uptake in Kenya

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 19 Sep 2020)

 

Spatial access inequities and childhood immunisation uptake in Kenya
Poor access to immunisation services remains a major barrier to achieving equity and expanding vaccination coverage in many sub-Saharan African countries. In Kenya, the extent to which spatial access affects i…
Authors: Noel K. Joseph, Peter M. Macharia, Paul O. Ouma, Jeremiah Mumo, Rose Jalang’o, Peter W. Wagacha, Victor O. Achieng, Eunice Ndung’u, Peter Okoth, Maria Muñiz, Yaniss Guigoz, Rocco Panciera, Nicolas Ray and Emelda A. Okiro
Citation: BMC Public Health 2020 20:1407
Content type: Research article
Published on: 15 September 2020

Big Data, Biomedical Research, and Ethics Review: New Challenges for IRBs

Ethics & Human Research
Volume 42, Issue 5 Pages: 1-40 September–October 2020
https://onlinelibrary.wiley.com/toc/25782363/current

 

Participants with autism • Big data and pragmatic trials • Covid‐19 research
Articles
Big Data, Biomedical Research, and Ethics Review: New Challenges for IRBs
Agata Ferretti, Marcello Ienca, Samia Hurst, Effy Vayena
Pages: 17-28
First Published: 16 September 2020
ABSTRACT
The increased use of big data in the medical field has shifted the way in which biomedical research is designed and carried out. The novelty of techniques and methods brought by big data research brings new challenges to institutional review boards (IRBs). Yet it is unclear if IRBs should be the responsible oversight bodies for big data research and, if so, which criteria they should use. A large but heterogenous set of ethics guidelines and normative responses have emerged to address these issues. In this study, we conducted a scoping review of soft‐law documents and guidelines with the aim of assessing ongoing normative efforts that are proliferating in this domain. We also synthesize a set of recurrent guidelines that could work as a baseline to create a harmonized process for big data research ethics.

HIV/AIDS research in Africa and the Middle East: participation and equity in North-South collaborations and relationships

Globalization and Health
http://www.globalizationandhealth.com/

 

Articles
HIV/AIDS research in Africa and the Middle East: participation and equity in North-South collaborations and relationships
HIV/AIDS has attracted considerable research attention since the 1980s. In the current context of globalization and the predominance of cooperative work, it is crucial to analyze the participation of the countries and regions where the infection is most prevalent. This study assesses the participation of African countries in publications on the topic, as well as the degree of equity or influence existing in North-South relations.
Authors: Gregorio González-Alcaide, Marouane Menchi-Elanzi, Edy Nacarapa and José-Manuel Ramos-Rincón
Content type: Research
17 September 2020

Budget line items for immunization in 33 African countries

Health Policy and Planning
Volume 35, Issue 7, August 2020
https://academic.oup.com/heapol/issue/35/6

 

Original Articles
Budget line items for immunization in 33 African countries
Ulla K Griffiths, Jennifer Asman, Alex Adjagba, Marina Yo, James O Oguta
Health Policy and Planning, Volume 35, Issue 7, August 2020, Pages 753–764, https://doi.org/10.1093/heapol/czaa040
Abstract
The Global Strategy for Women’s Children’s and Adolescents’ Health emphasizes accountability as essential to ensure that decision-makers have the information required to meet the health needs of their populations and stresses the importance of tracking resources, results, and rights to see ‘what works, what needs improvement and what requires increased attention’. However, results from accountability initiatives are mixed and there is a lack of broadly applicable, validated tools for planning, monitoring and evaluating accountability interventions. This article documents an effort to transform accountability markers—including political will, leadership and the monitor–review–act cycle—into a measurement tool that can be used prospectively or retrospectively to plan, monitor and evaluate accountability initiatives. It describes the development process behind the tool including the literature review, framework development and subsequent building of the measurement tool itself. It also examines feedback on the tool from a panel of global experts and the results of a pilot test conducted in Bauchi and Gombe states in Nigeria. The results demonstrate that the tool is an effective aid for accountability initiatives to reflect on their own progress and provides a useful structure for future planning, monitoring and evaluation. The tool can be applied and adapted to other accountability mechanisms working in global health.

The development of a new accountability measurement framework and tool for global health initiatives

Health Policy and Planning
Volume 35, Issue 7, August 2020
https://academic.oup.com/heapol/issue/35/6

 

The development of a new accountability measurement framework and tool for global health initiatives
Adriane Martin Hilber, Patricia Doherty, Andrea Nove, Rachel Cullen, Tunde Segun
Health Policy and Planning, Volume 35, Issue 7, August 2020, Pages 765–774, https://doi.org/10.1093/heapol/czz170

An analysis of the strategic plan development processes of major public organisations funding health research in nine high-income countries worldwide

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 19 Sep 2020]

 

Research
An analysis of the strategic plan development processes of major public organisations funding health research in nine high-income countries worldwide
There have been claims that health research is not satisfactorily addressing healthcare challenges. A specific area of concern is the adequacy of the mechanisms used to plan investments in health research. How…
Authors: Cristina Morciano, Maria Cristina Errico, Carla Faralli and Luisa Minghetti
Citation: Health Research Policy and Systems 2020 18:106
Published on: 18 September 2020

Transforming the practice of medicine through team science

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 19 Sep 2020]

Transforming the practice of medicine through team science
The translation of biomedical research discoveries into clinical practice is marked by extended timelines (averaging 17 years) and multiple sequential process steps. However, even after a drug, device, diagnostic tool or unique therapeutic procedure successfully navigates through clinical testing to approval, real barriers remain in applying and scaling the innovation in practice.

 

Authors: Jason H. Pitzen, Heidi L. Dieter, Darren L. Gronseth, Amber K. Dahl, Venessa L. Boyle, Tharana Maran, C. Michel Harper Jr and Gregory J. Gores
Citation: Health Research Policy and Systems 2020 18:104
Content type: Study Protocol
Published on: 17 September 2020

Reverse vaccinology assisted designing of multiepitope-based subunit vaccine against SARS-CoV-2

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 19 Sep 2020]

 

Reverse vaccinology assisted designing of multiepitope-based subunit vaccine against SARS-CoV-2
Authors: Muhammad Tahir ul Qamar, Farah Shahid, Sadia Aslam, Usman Ali Ashfaq, Sidra Aslam, Israr Fatima, Muhammad Mazhar Fareed, Ali Zohaib and Ling-Ling Chen
Content type: Research Article
16 September 2020

COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve

International Journal of Infectious Diseases
September 2020 Volume 98, p1-502
https://www.ijidonline.com/issue/S1201-9712(20)X0010-5

 

COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance
Abdu A. Adamu, Rabiu I. Jalo, Desire Habonimana, Charles S. Wiysonge
p161–165
Published online: June 24, 2020

Advancing COVID-19 vaccines – avoiding different regulatory standards for different vaccines and need for open and transparent data sharing

International Journal of Infectious Diseases
September 2020 Volume 98, p1-502
https://www.ijidonline.com/issue/S1201-9712(20)X0010-5

 

Advancing COVID-19 vaccines – avoiding different regulatory standards for different vaccines and need for open and transparent data sharing
Eskild Petersen, Christian Wejse, Alimuddin Zumla
p501–502
Published online: August 18, 2020
[See COVID above for abstracts]

Association of Routine Infant Vaccinations With Antibody Levels Among Preterm Infants

JAMA
September 15, 2020, Vol 324, No. 11, Pages 1019-1116
https://jamanetwork.com/journals/jama/currentissue

 

Original Investigation
Association of Routine Infant Vaccinations With Antibody Levels Among Preterm Infants
Elsbeth D. M. Rouers, MD; Patricia C. J. Bruijning-Verhagen, MD, PhD; Pieter G. M. van Gageldonk, BSc; et al.
has active quiz
JAMA. 2020;324(11):1068-1077. doi:10.1001/jama.2020.12316
This cohort study evaluates IgG antibody concentrations in preterm infants after administration of combination diphtheria–tetanus toxoids–acellular pertussis–inactivated poliomyelitis–Haemophilus influenza type b–and hepatitis B (DTaP-IPV-Hib-HepB) and pneumococcal conjugate vaccines.

Policies Among US Pediatricians for Dismissing Patients for Delaying or Refusing Vaccination

JAMA
September 15, 2020, Vol 324, No. 11, Pages 1019-1116
https://jamanetwork.com/journals/jama/currentissue

 

Research Letter
Policies Among US Pediatricians for Dismissing Patients for Delaying or Refusing Vaccination
Sean T. O’Leary, MD, MPH; Jessica R. Cataldi, MD, MSCS; Megan C. Lindley, MPH; et al.
JAMA. 2020;324(11):1105-1107. doi:10.1001/jama.2020.10658
This survey study assesses US pediatrician practices and office policies in response to parents who either refuse primary vaccinations or request to spread out individual vaccines in the primary series.

Addressing Influenza Vaccination Disparities During the COVID-19 Pandemic

JAMA
September 15, 2020, Vol 324, No. 11, Pages 1019-1116
https://jamanetwork.com/journals/jama/currentissue

 

Viewpoint
Addressing Influenza Vaccination Disparities During the COVID-19 Pandemic
Lisa A. Grohskopf, MD, MPH; Leandris C. Liburd, PhD, MPH; Robert R. Redfield, MD
free access has active quiz has multimedia has audio
JAMA. 2020;324(11):1029-1030. doi:10.1001/jama.2020.15845
In this Viewpoint, CDC scientists discuss the public health urgency of increasing influenza vaccination uptake early in the 2020-2021 season to ameliorate the threat to patients and hospitals of overlapping outbreaks, and urges clinicians to strongly recommend the vaccine and administer it to patients whenever and wherever possible.
Conversations with Dr Bauchner: Coronavirus Update From the CDC – August 20, 2020

Ethical Considerations for COVID-19 Vaccine Trials in Correctional Facilities

JAMA
September 15, 2020, Vol 324, No. 11, Pages 1019-1116
https://jamanetwork.com/journals/jama/currentissue

 

Ethical Considerations for COVID-19 Vaccine Trials in Correctional Facilities
Emily A. Wang, MD, MAS; Jonathan Zenilman, MD, PhD; Lauren Brinkley-Rubinstein, PhD
free access has active quiz
JAMA. 2020;324(11):1031-1032. doi:10.1001/jama.2020.15589
This Viewpoint discusses the importance of studying coronavirus disease 2019 (COVID-19) vaccine candidates in prisoners, and proposes a framework for considering how to include them safely, ethically, and without coercion in future phase 3 vaccine trials.

Inflow restrictions can prevent epidemics when contact tracing efforts are effective but have limited capacity

Journal of the Royal Society – Interface
September 2020 Volume 17 Issue 170
https://royalsocietypublishing.org/toc/rsif/current

 

Life Sciences–Mathematics interface
Report
Inflow restrictions can prevent epidemics when contact tracing efforts are effective but have limited capacity
Hannes Malmberg and Tom Britton
Published:09 September 2020Article ID:20200351
https://doi.org/10.1098/rsif.2020.0351

Consent to Trainee Involvement in Pediatric Care

New England Journal of Medicine
September 17, 2020 Vol. 383 No. 12
http://www.nejm.org/toc/nejm/medical-journal

 

Perspective
Consent to Trainee Involvement in Pediatric Care
Emily A. Largent, J.D., Ph.D., R.N.
Consent to the involvement of students, interns, and residents in the care of children has received scant attention as compared with consent for either care or research. But there are compelling reasons for routinely obtaining children’s assent to trainee involvement.

Tolerance in the Age of Immunotherapy

New England Journal of Medicine
September 17, 2020 Vol. 383 No. 12
http://www.nejm.org/toc/nejm/medical-journal

 

Review Article
Tolerance in the Age of Immunotherapy
Jeffrey A. Bluestone, Ph.D., and Mark Anderson, M.D., Ph.D.
The immune system distinguishes between “self” and “nonself” and remembers dangerous exposures. Elaborate mechanisms control immune responses, but in some cases, the response either does not recognize the danger or causes unwanted autoinflammation. The authors review advances in developing durable immune tolerance

Trump lied about science

Science
18 September 2020 Vol 369, Issue 6510
http://www.sciencemag.org/current.dtl

 

Editorial
Trump lied about science
By H. Holden Thorp
Summary
When President Donald Trump began talking to the public about coronavirus disease 2019 (COVID-19) in February and March, scientists were stunned at his seeming lack of understanding of the threat. We assumed that he either refused to listen to the White House briefings that must have been occurring or that he was being deliberately sheltered from information to create plausible deniability for federal inaction. Now, because famed Washington Post journalist Bob Woodward recorded him, we can hear Trump’s own voice saying that he understood precisely that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was deadly and spread through the air. As he was playing down the virus to the public, Trump was not confused or inadequately briefed: He flat-out lied, repeatedly, about science to the American people. These lies demoralized the scientific community and cost countless lives in the United States.

Global citizen deliberation on genome editing

Science
18 September 2020 Vol 369, Issue 6510
http://www.sciencemag.org/current.dtl

 

Policy Forum
Global citizen deliberation on genome editing
By John S. Dryzek, Dianne Nicol, Simon Niemeyer, Sonya Pemberton, Nicole Curato, André Bächtiger, Philip Batterham, Bjørn Bedsted, Simon Burall, Michael Burgess, Gaetan Burgio, Yurij Castelfranchi, Hervé Chneiweiss, George Church, Merlin Crossley, Jantina de Vries, Mahmud Farooque, Marit Hammond, Baogang He, Ricardo Mendonça, Jennifer Merchant, Anna Middleton, John E. J. Rasko, Ine Van Hoyweghen, Antoine Vergne
Science18 Sep 2020 : 1435-1437
Global governance can be informed by a deliberative assembly composed of lay citizens
Summary
Genome editing technologies provide vast possibilities for societal benefit, but also substantial risks and ethical challenges. Governance and regulation of such technologies have not kept pace in a systematic or internationally consistent manner, leaving a complex, uneven, and incomplete web of national and international regulation (1). How countries choose to regulate these emergent technologies matters not just locally, but globally, because the implications of technological developments do not stop at national boundaries. Practices deemed unacceptable in one country may find a more permissive home in another: not necessarily through national policy choice, but owing to a persistent national legal and regulatory void that enables “ethics dumping” (2)—for example, if those wanting to edit genes to “perfect” humans seek countries with little governance capacity. Just as human rights are generally recognized as a matter of global concern, so too should technologies that may impinge on the question of what it means to be human. Here we show how, as the global governance vacuum is filled, deliberation by a global citizens’ assembly should play a role, for legitimate and effective governance.

Influenza vaccination coverage among adults with diabetes, United States, 2007–08 through 2017–18 seasons

Vaccine
Volume 38, Issue 42 Pages 6485-6658 (29 September 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/42

 

Research article Abstract only
Influenza vaccination coverage among adults with diabetes, United States, 2007–08 through 2017–18 seasons
Mei-Chuan Hung, Peng-jun Lu, Anup Srivastav, Yiling J. Cheng, Walter W. Williams

Self-reported immunity and opinions on vaccination of hospital personnel among paediatric healthcare workers in Denmark

Vaccine
Volume 38, Issue 42 Pages 6485-6658 (29 September 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/42

 

Research article Full text access
Self-reported immunity and opinions on vaccination of hospital personnel among paediatric healthcare workers in Denmark
Marie-Louise von Linstow, Thilde Nordmann Winther, Anna Eltvedt, Allan Bybeck Nielsen, … Anja Poulsen

A prospective cohort study of immunogenicity of quadrivalent human papillomavirus vaccination among Alaska Native Children, Alaska, United States

Vaccine
Volume 38, Issue 42 Pages 6485-6658 (29 September 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/42

 

Research article Abstract only
A prospective cohort study of immunogenicity of quadrivalent human papillomavirus vaccination among Alaska Native Children, Alaska, United States
Michael G. Bruce, Elissa Meites, Lisa Bulkow, Gitika Panicker, … Lauri E. Markowitz

Cost-effectiveness of SMS appointment reminders in increasing vaccination uptake in Lagos, Nigeria: A multi-centered randomized controlled trial

Vaccine
Volume 38, Issue 42 Pages 6485-6658 (29 September 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/42

 

Research article Abstract only
Cost-effectiveness of SMS appointment reminders in increasing vaccination uptake in Lagos, Nigeria: A multi-centered randomized controlled trial
Yoshito Kawakatsu, Adefunke Oyeniyi Adesina, Nobuhiro Kadoi, Hirotsugu Aiga

Cost-effectiveness of SMS appointment reminders in increasing vaccination uptake in Lagos, Nigeria: A multi-centered randomized controlled trial

Vaccine
Volume 38, Issue 42 Pages 6485-6658 (29 September 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/42

 

Research article Abstract only
Cost-effectiveness of SMS appointment reminders in increasing vaccination uptake in Lagos, Nigeria: A multi-centered randomized controlled trial
Yoshito Kawakatsu, Adefunke Oyeniyi Adesina, Nobuhiro Kadoi, Hirotsugu Aiga

Vaccination and Vaccine Effectiveness: A Commentary of Special Issue Editors

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 19 Sep 2020)

 

Open Access Editorial
Vaccination and Vaccine Effectiveness: A Commentary of Special Issue Editors
by Claudio Costantino , Alessandra Casuccio and Vincenzo Restivo
Vaccines 2020, 8(3), 545; https://doi.org/10.3390/vaccines8030545 – 18 Sep 2020
Abstract
The Special Issue “Vaccination and Vaccine Effectiveness”, published in the journal Vaccines, has the main aim to increase international literature data on vaccine effectiveness and safety and on vaccination strategies in order to reduce vaccine hesitancy and improve vaccination coverage rates. The main topics included in the call for papers were vaccines administered to infants, adolescents, adults, elderly people, at-risk populations (due to comorbidities and personal risk factors) and healthcare workers and strategies adopted to promote vaccination adherence among these categories. This Special Issue started from the assumption that, despite vaccination being universally recognized as one of the best strategies to increase duration and quality of life during the last centuries, vaccination coverage rates are often under the levels recommended to reduce circulation and to extinguish vaccine-preventable diseases. Vaccine hesitancy involves at least 15% of the general population, and healthcare workers also sometimes demonstrate doubts on vaccination effectiveness and safety. At the end of the six-month submission period, 16 articles (15 research article and one review) were accepted after the peer-review processes and published online.

A Review of Methodological Considerations for Economic Evaluations of Gene Therapies and Their Application in Literature

Value in Health
September 2020 Volume 23, Issue 9, p1119-1280
https://www.valueinhealthjournal.com/issue/S1098-3015(20)X0011-8

 

SYSTEMATIC LITERATURE REVIEW
A Review of Methodological Considerations for Economic Evaluations of Gene Therapies and Their Application in Literature
Renske M.T. ten Ham, Olaf H. Klungel, Hubert G.M. Leufkens, Geert W.J. Frederix
p1268–1280
Published online: August 18, 2020
Results
The first literature search yielded 13 articles discussing methodological considerations. The second search provided 12 EEs. Considerations identified were payment models, definition of perspectives, addressing uncertainty, data extrapolation, discount rates, novel value elements, and use of indirect and surrogate endpoints. All EEs scored satisfactory to good according to Consolidated Health Economic Evaluation Reporting Standards. Regarding methodological application, we found 1 methodological element (payment models) was applied in 2 base cases. Scenarios explored alternative perspectives, survival assumptions, and extrapolation methods in 10 EEs.
Conclusions
Although EE quality of reporting was considered good, their informativeness for health technology assessment and decision makers seemed limited owing to many uncertainties. We suggest accepted EE methods can broadly be applied to GTs, but few elements may need adjustment. Further research and multi-stakeholder consensus is needed to determine appropriateness and application of individual methodological considerations. For now, we recommend including scenario analyses to explore impact of methodological choices and (clinical) uncertainties. This study contributes to better understanding of perceived appropriate evaluation of GTs and informs best modeling practices.

Media/Policy Watch

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

 

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 19 Sep 2020
[No new, unique, relevant content]

 

BBC
http://www.bbc.co.uk/
Accessed 19 Sep 2020
[No new, unique, relevant content]

 

The Economist
http://www.economist.com/
Accessed 19 Sep 2020
[No new, unique, relevant content]

 

Forbes
http://www.forbes.com/
Accessed 19 Sep 2020
Sep 18, 2020
Why We Can’t Rely On Natural Immunity To Protect Us From Covid-19
A new study, compounded with recent reports of reinfection, shows why building immunity to Covid-19 is trickier than we’d like to believe.
By William A. Haseltine Contributor

Sep 17, 2020
Trump Says His Only Failure In ‘Phenomenal’ Coronavirus Response Was ‘Public Relations’
The president has argued people should trust a vaccine ‘because of the great job we’ve done,’ but polls show the majority of Americans disagree.
By Andrew Solender Forbes Staff

Sep 17, 2020
Nearly Half Of All Americans, Including Most Republicans, Say They Would Not Get Covid-19 Vaccine
56% of Republicans said definitely or probably would not get vaccinated.
By Tommy Beer Forbes Staff

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 19 Sep 2020
September 16, 2020
America Needs to Lock Down Again
To get the novel coronavirus under control, the United States must impose stringent lockdowns across the country for roughly two months.
Michael T. Osterholm and Mark Olshaker

 

Foreign Policy
http://foreignpolicy.com/
Accessed 19 Sep 2020
The World Is Winning—and Losing—the Vaccine Race
Immunization to COVID-19 is supposed to solve our problems—but it’s starting to trigger even bigger ones.
By Adam Tooze
September 19, 2020, 6:00 AM

 

The Guardian
http://www.guardiannews.com/
[No new, unique, relevant content]

 

New Yorker
http://www.newyorker.com/
[No new, unique, relevant content]

 

New York Times
http://www.nytimes.com/
Accessed 19 Sep 2020
Health
AstraZeneca, Under Fire for Vaccine Safety, Releases Trial Blueprints
Experts are concerned that the company has not been more forthcoming about two participants who became seriously ill after getting its experimental vaccine.
By Denise Grady, Katherine J. Wu and Sharon LaFraniere
PRINT EDITIONSeptember 21, 2020

Health
In ‘Power Grab,’ Health Secretary Azar Asserts Authority Over F.D.A.
Experts said the memo would make it more difficult for the F.D.A. to issue new rules, but it’s unclear how it would affect the vetting of coronavirus vaccines.
By Sheila Kaplan

Health
C.D.C. Testing Guidance Was Published Against Scientists’ Objections
A controversial guideline saying people without Covid-19 symptoms didn’t need to get tested for the virus came from H.H.S. officials and skipped the C.D.C.’s scientific review process.
By Apoorva Mandavilli
Sept. 17

 

Washington Post
https://www.washingtonpost.com/
Accessed 19 Sep 2020
Democrats face quandary on vaccine support as election nears
Sep 19, 2020

China and Russia are ahead in the global coronavirus vaccine race, bending long-standing rules
Eva Dou and Isabelle Khurshudyan · Sep 18, 2020

Vaccine companies reveal their study designs, even as Trump sows confusion
Carolyn Y. Johnson · Health · Sep 17, 2020

Think Tanks et al

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 19 Sep 2020
Up Front
Politics is wrecking America’s pandemic response
Jonathan Rothwell and Christos Makridis
Thursday, September 17, 2020

Center for Global Development [to 19 Sep 2020]
http://www.cgdev.org/page/press-center
Accessed 19 Sep 2020
September 15, 2020
Using Machine Learning for Healthcare Resource Allocation in COVID-19: Opportunities and Challenges for LMICs
One of the greatest challenges for any health system facing COVID-19 is the equitable and efficient allocation of scarce resources. With health systems stretched, and concerns about COVID-19 vaccine nationalism, machine learning presents a valuable opportunity to help guide decisions on the allocation of scarce resources like hospital beds, staff, and vaccines, in low- and middle-income countries (LMICs).
Anukrat Bhansali and Vageesh Jain

Chatham House [to 19 Sep 2020]
https://www.chathamhouse.org/
[No new relevant content]

 

CSIS
https://www.csis.org/
Accessed 19 Sep 2020
Commentary
Advice to the Independent Panel on Pandemic Preparedness and Response
September 17, 2020 | By J. Stephen Morrison, Carolyn Reynolds

On Demand Event
Online Event: CSIS Book Launch with Heidi J. Larson – Stuck
September 16, 202

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 19 Sep 2020
September 14, 2020
Cybersecurity
The Cyber Side of Vaccine Nationalism
Vaccine nationalism has given rise to a new wave of cyber espionage targeting COVID-19 vaccine research.
Blog Post by David P. Fidler Digital and Cyberspace Policy Program
In the COVID-19 pandemic, vaccine nationalism has become an important and controversial phenomenon. Rather than cooperate through global mechanisms to develop, manufacture, and distribute a vaccine against the coronavirus, countries with the means to do so have prioritized national access to a vaccine. Despite warnings about its adverse consequences for global health and international cooperation, vaccine nationalism is not abating. The political momentum of vaccine nationalism can be found in not only the pharmaceutical realm but also cyberspace…

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 19 Sep 2020
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 12 September 2020

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: 

– 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

Global collaboration for health: rhetoric versus reality

Featured Journal Content

 

The Lancet
Sep 12, 2020 Volume 396 Number 10253 p735-798, e25-e29
https://www.thelancet.com/journals/lancet/issue/current
Editorial
Global collaboration for health: rhetoric versus reality
The Lancet
The 75th session of the UN General Assembly (UNGA) opens on Sept 15, 2020. Being held remotely for the first time, the meeting will inevitably be dominated by the COVID-19 pandemic, but other issues on the agenda that have resonance for global health include the climate crisis, peace, disarmament, and humanitarian assistance. Underpinning this year’s agenda is the UN theme of multilateralism, under the banner ”The future we want, the United Nations we need: reaffirming our collective commitment to multilateralism”. Yet the meeting comes at a time when global collaboration and cooperation are in disarray.

The UNGA is traditionally built on bold rhetoric of global collaboration and exhaustive debate over some of the world’s most intractable problems. But rather than expressing a shared vision for a common future, countries are now undermining global cooperation through rising nationalism, open hostility towards multilateral institutions, and a growing tendency to look after their own interests—eg, rushing to secure supplies of potential COVID-19 vaccines. Health is precariously caught in the middle of these tensions. Science has become increasingly politicised, with multiple and conflicted interests at play, and often little sense of solidarity within or between nations.

 

An immediate casualty of these opposing forces is the global effort towards vaccines for COVID-19. COVAX, the COVID-19 Global Access Facility, is led by WHO; Gavi, The Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations, and aims to rapidly develop and equitably distribute effective vaccines. Variable commitment to COVAX reflects the tension between nationalism and collaboration. 170 countries plan to participate, but the USA, for one, is opting not to join COVAX. Instead, the USA has secured bilateral deals with several pharmaceutical companies for millions of doses of promising COVID-19 vaccines. Similar deals have been struck by Australia, the EU, and the UK. In July, Médecins Sans Frontières warned that “These bilateral deals will reduce the initial global vaccine stocks available for vulnerable groups in poorer countries and undermine global efforts to ensure fair allocation”.

Insufficient collaboration is also jeopardising the Pan American Health Organization, with many member states, including Brazil, Venezuela, and Mexico, withholding essential funding at a time when Latin America is under mounting pressure from COVID-19. Meanwhile, the USA continues its deeply disappointing withdrawal from WHO.

The climate emergency is another subject on which rhetoric has fallen flat in the face of nationalistic inaction. The global response to COVID-19 depends heavily on the idea of creating a better future for human and planetary health, and commitment to this approach is non-negotiable for sustainable recovery. It is disappointing that the UNGA’s formal general agenda does not more extensively cover climate change beyond the item “Protection of global climate for present and future generations of humankind”, although there is a Summit on Biodiversity on Sept 30, as well as activities across New York City.

Hopefully, the summit will also return the UNGA’s focus to the Sustainable Development Goals, which must still be met by 2030, and to defining a post-2020 biodiversity framework. An early indication that nations might work to protect health in the face of climate change as laid out in this year’s WHO manifesto for a healthy and green recovery from COVID-19 is seen in the commitment to the Resilient Recovery Platform. Launched in Japan on Sept 3, 2020, the platform is a global sharing of policy and actions to address the response to COVID-19 coupled with the response to the climate emergency, with stakeholders such as governments, businesses, non-governmental organisations, and civil society. The participation of 80 countries shows a willingness to engage in overhauling socioeconomic models towards a sustainable future. But will it be translated into action?

Global solidarity cannot be garnered through rhetoric alone. COVID-19 has brought into clear view that every person’s health is interconnected, and the UNGA is a platform with the power to reorientate global interests in such a way as to protect the health and lives of all people in every nation. The need for global cooperation has never been more visible or more crucial. Unfortunately, the UN has so far in 2020 not been able to transform rhetoric into reality. This should give pause for serious reflection. Global crises call for global responses, and we have yet to see them.

COVID-19 Vaccines, Therapeutics, Diagnostics

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COVID-19 Vaccines, Therapeutics, Diagnostics

Statement from the first ACT-Accelerator Facilitation Council meeting
10 September 2020 WHO
As Members and Partners of the Facilitation Council of the ‘Access to COVID-19 Tools Accelerator’ (ACT- Accelerator), on the occasion of the Council’s launch meeting;

We share the vision of the ACT-Accelerator as a unique international collaboration to fast-track the development and equitable deployment of COVID-19 vaccines, therapeutics and diagnostics globally while strengthening related health systems;

We thank the World Health Organization and the European Commission for their leadership in co- convening this first meeting of the Facilitation Council at this crucial time, as the COVID-19 pandemic continues to have a devastating impact on the health, societies and economies of all countries, the consequences of which have disproportionately affected poor and vulnerable populations;

We welcome South Africa and Norway as the Council’s co-chairs;

We recognize that the fastest and most effective solution to the COVID-19 crisis, and the full mitigation of its health, social and economic consequences, is through global multilateral collaboration and international solidarity that supports all countries and populations, including the world’s poorest and at-risk populations such as women and children;

We fully align with the ACT-Accelerator goal of rapidly reducing the risk of severe COVID-19 disease globally, which will in turn bolster the capacity of health systems to safely and effectively manage COVID- 19 and restore the global confidence needed to resume economic and societal activity;

We appreciate the leadership and work of the ACT-Accelerator Pillar co-conveners and their partners for the substantial achievements to date, while recognizing the considerable challenges they face to realize the full potential of this unprecedented global collaboration;

We consider the ACT-Accelerator an integral part of the implementation of the World Health Assembly Resolution (WHA73.1(3)) and that it responds fully to the G20 Leaders’ Commitment of 26 March 2020, as both highlighted the need for end-to-end solutions to accelerate the development and equitable, universal deployment of life saving COVID-19 vaccines, therapeutics and diagnostics;

 

We acknowledge the urgency of catalysing a step-change in political support and financing for the ACT- Accelerator in order to enable it to deliver on its mission of accelerating the discovery and deployment of new COVID-19 tools to all people, everywhere;

Accordingly, we will:
[1] Provide sustained political leadership to galvanize and harness broad international support for the ACT-Accelerator, including in key upcoming fora such as the UN General Assembly, the G20 and G7 processes, the Paris Peace Forum and IMF/World Bank Group meetings and through our respective regional cooperation groups and national processes;

[2] Advocate in support of the ACT-Accelerator Investment Case in order to secure as a matter of urgency the financial resources required to scale-up for impact and change the course of the pandemic;

[3] Honour and realize our shared commitment to leave no one behind in this crisis, by working to ensure that all countries and populations have early, affordable and equitable access to the new vaccines, therapeutics and diagnostics that the ACT-Accelerator is pursuing.

COVID-19 Vaccines – Development Standards/Regulatory Review/Commitments

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COVID-19 Vaccines – Development Standards/Regulatory Review/Commitments

Press Release
Biopharma Leaders Unite to Stand with Science
Nine CEOs sign historic pledge to continue to make the safety and well-being of vaccinated individuals the top priority in development of the first COVID-19 vaccines

NEW YORK–(BUSINESS WIRE)– Sep. 8, 2020 The CEOs of AstraZeneca, BioNTech, GlaxoSmithKline plc), Johnson & Johnson, Merck, known as MSD outside the United States and Canada, Moderna, Inc., Novavax, Inc., Pfizer Inc., and Sanofi today announced a historic pledge, outlining a united commitment to uphold the integrity of the scientific process as they work towards potential global regulatory filings and approvals of the first COVID-19 vaccines. All nine CEOs signed the following pledge:

“We, the undersigned biopharmaceutical companies, want to make clear our on-going commitment to developing and testing potential vaccines for COVID-19 in accordance with high ethical standards and sound scientific principles.

“The safety and efficacy of vaccines, including any potential vaccine for COVID-19, is reviewed and determined by expert regulatory agencies around the world, such as the United States Food and Drug Administration (FDA). FDA has established clear guidance for the development of COVID-19 vaccines and clear criteria for their potential authorization or approval in the US. FDA’s guidance and criteria are based on the scientific and medical principles necessary to clearly demonstrate the safety and efficacy of potential COVID-19 vaccines. More specifically, the agency requires that scientific evidence for regulatory approval must come from large, high quality clinical trials that are randomized and observer-blinded, with an expectation of appropriately designed studies with significant numbers of participants across diverse populations.

“ Following guidance from expert regulatory authorities such as FDA regarding the development of COVID-19 vaccines, consistent with existing standards and practices, and in the interest of public health, we pledge to:
:: Always make the safety and well-being of vaccinated individuals our top priority.
:: Continue to adhere to high scientific and ethical standards regarding the conduct of clinical trials and the rigor of manufacturing processes.
:: Only submit for approval or emergency use authorization after demonstrating safety and efficacy through a Phase 3 clinical study that is designed and conducted to meet requirements of expert regulatory authorities such as FDA.
:: Work to ensure a sufficient supply and range of vaccine options, including those suitable for global access.

“We believe this pledge will help ensure public confidence in the rigorous scientific and regulatory process by which COVID-19 vaccines are evaluated and may ultimately be approved.”

Together, these nine companies have collectively developed more than 70 novel vaccines that have helped to eradicate some of the world’s most complex and deadly public health threats, underscoring their experience in clinical development and regulatory rigor, as well as their longstanding commitments to patient safety and public health.

::::::

FDA Voices 09/11/2020
The FDA’s Scientific and Regulatory Oversight of Vaccines is Vital to Public Health
By: Stephen M. Hahn, M.D., Commissioner of Food and Drugs and Peter Marks, M.D., Ph.D., Director, Center for Biologics Evaluation and Research
[Excerpt]
…The FDA’s career scientists and physicians are helping to facilitate the development and evaluation of safe and effective COVID-19 vaccines. These professionals have globally recognized expertise in the complexity of vaccine development and in evaluating the safety and effectiveness of vaccines intended to prevent infectious diseases. They are experts in clinical trial design and analysis and synthesizing and evaluating tremendous amounts of data to determine whether a vaccine has been shown to be safe and effective. These experts are responsible for assessing the adequacy of manufacturing and the facilities where vaccines are made, which are critical to producing high-quality vaccines, and for post-marketing safety surveillance, using a wide variety of surveillance systems and data mining to continually review safety after a vaccine is approved.

The FDA is often held up as the “gold standard” of regulatory agencies around the globe. What’s at the core of these standards are the agency’s regulatory independence and science-based decision-making.  As with all products we regulate, we will follow the science and data in our decision making regarding COVID-19 vaccines. It is because the FDA is a science-based agency that we say this with the clarity of conviction. The dedicated career public health professionals who will be involved in evaluating the data submitted to the FDA in requests for Emergency Use Authorization (EUA) and in Biologics License Applications (BLAs) for COVID-19 vaccines are committed to decision making based on science and data. They are fathers, mothers, sisters, brothers, grandparents and more – and they (and their families) are directly impacted by the work they do. They are exactly who you want making decisions regarding vaccine safety and effectiveness.

No time in recent memory has shone as bright a light on the work of FDA review staff as the COVID-19 pandemic. We understand that a lot of people may not have information about vaccine development or how the FDA determines whether or not to approve a vaccine – and may not have given it much thought – at least until now.

With so much at stake, we understand the importance of being as transparent as possible about the work we do, including how we will make decisions regarding COVID-19 vaccines. The publication of our guidance was an important step – we firmly believe that transparency regarding the FDA’s thinking about the scientific data needed to support approval of safe and effective vaccines will help build public confidence in the FDA’s evaluation process, which will be critical in ensuring the use of COVID-19 vaccines once available.

An upcoming key milestone is the meeting of our Vaccines and Related Biological Products Advisory Committee on October 22, at which the committee will discuss publicly the general development of COVID-19 vaccines. While this meeting is not intended to discuss any particular vaccine candidates, the agency is also prepared to rapidly schedule additional meetings of this Committee upon submission of any BLAs or requests for EUAs to further ensure transparency.

The FDA has been asked what regulatory path will be used to make COVID-19 vaccines available (i.e., will there be an EUA, or will the FDA approve a BLA?). The short answer is, taking into consideration input from the FDA, manufacturers decide whether and when to submit an EUA request or BLA to the FDA. The agency will review EUA requests and BLAs received and make appropriate determinations by looking at the totality of the available scientific evidence. For a vaccine for which there is adequate manufacturing information, issuance of an EUA may be appropriate once studies have demonstrated the safety and effectiveness of the vaccine, but before the manufacturer has submitted all of the various data elements normally required and/or the FDA has completed its formal review of the BLA.

As we have said, these decisions will be firmly rooted in science. We are committed to expediting the development of COVID-19 vaccines, but not at the expense of sound science and decision making. We will not jeopardize the public’s trust in our science-based, independent review of these or any vaccines. There’s too much at stake….