Germline Genome Editing Research: What Are Gamete Donors (Not) Informed About in Consent Forms?

The CRISPR Journal
Volume 3, Issue 1 / February 2020
https://www.liebertpub.com/toc/crispr/3/1

 

Research Articlen Open Access
Germline Genome Editing Research: What Are Gamete Donors (Not) Informed About in Consent Forms?
Emilia Niemiec and Heidi Carmen Howard
Pages:52–63
Published Online:17 February 2020
https://doi.org/10.1089/crispr.2019.0043

Large-scale public data reuse to model immunotherapy response and resistance

Genome Medicine
https://genomemedicine.biomedcentral.com/articles
[Accessed 29 Feb 2020]

 

Large-scale public data reuse to model immunotherapy response and resistance
Authors: Jingxin Fu, Karen Li, Wubing Zhang, Changxin Wan, Jing Zhang, Peng Jiang and X. Shirley Liu
Citation: Genome Medicine 2020 12:21
Content type: Database
Published on: 26 February 2020
Abstract
Despite growing numbers of immune checkpoint blockade (ICB) trials with available omics data, it remains challenging to evaluate the robustness of ICB response and immune evasion mechanisms comprehensively. To address these challenges, we integrated large-scale omics data and biomarkers on published ICB trials, non-immunotherapy tumor profiles, and CRISPR screens on a web platform TIDE (http://tide.dfci.harvard.edu). We processed the omics data for over 33K samples in 188 tumor cohorts from public databases, 998 tumors from 12 ICB clinical studies, and eight CRISPR screens that identified gene modulators of the anticancer immune response. Integrating these data on the TIDE web platform with three interactive analysis modules, we demonstrate the utility of public data reuse in hypothesis generation, biomarker optimization, and patient stratification.

Medical populism and immunisation programmes: Illustrative examples and consequences for public health

Global Public Health
Volume 15, 2020 Issue 3
http://www.tandfonline.com/toc/rgph20/current

 

Article
Medical populism and immunisation programmes: Illustrative examples and consequences for public health
Gideon Lasco & Heidi J. Larson
Pages: 334-344
Published online: 20 Oct 2019
ABSTRACT
Various factors have been implicated in vaccine hesitancy and loss of vaccine confidence, but the specific ways and particular moments in which immunisation programmes and vaccine scares are politicised, exacerbating negative attitudes about vaccines and leading to retrogressive policies, have been relatively under-examined. This paper applies the concept of ‘medical populism’ [Lasco, G., & Curato, N. (2019). Medical populism. Social Science & Medicine, 221(1), 1–8. doi:10.1016/j.socscimed.2018.12.006] to examine these under-studied dynamics, looking at political actors and how they ‘construct antagonistic relations between “the people” whose lives have been put at risk by “the establishment”’ in the performance of vaccine-related crises. Four illustrative cases – from Nigeria, Italy, Ukraine, and the Philippines – are presented to demonstrate the descriptive and analytic value of medical populism beyond the framing and characterisation of the politics of health. The study underscores the need to understand people’s perceptions and ‘explanatory models’ of vaccines and vaccine failures, to look at the political milieux that underpin immunisation programmes, and to anticipate and address knowledge claims made by political actors.

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 29 Feb 2020]

 

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage
Authors: Yibeltal Assefa, Peter S. Hill, Wim Van Damme, Judith Dean and Charles F. Gilks
Content type: Research
24 February 2020

Not covered enough: inadequate age appropriate immunisation in urban slums of Delhi: a community based cross sectional survey

International Journal of Community Medicine and Public Health
Vol 7, No 3 (2020) March 2020
https://www.ijcmph.com/index.php/ijcmph/issue/view/60

 

Original Research Articles
Not covered enough: inadequate age appropriate immunisation in urban slums of Delhi: a community based cross sectional survey
Sonali Randhawa, Shomik Ray

Assessment of immunization among newborns: comparison between children delivered vaginally and by cesarean section

International Journal of Community Medicine and Public Health
Vol 7, No 3 (2020) March 2020
https://www.ijcmph.com/index.php/ijcmph/issue/view/60

 

Assessment of immunization among newborns: comparison between children delivered vaginally and by cesarean section
Arvinder Pal Singh Narula, Prakash Prabhakarrao Doke, Varsha Mahesh Vaidya, Archana Vasantrao Patil, Tushar Madhavrao Panchanadikar, Girija Narendrakumar Wagh

Coronavirus Infections—More Than Just the Common Cold

JAMA
February 25, 2020, Vol 323, No. 8, Pages 691-800
http://jama.jamanetwork.com/issue.aspx

 

Viewpoint
Coronavirus Infections—More Than Just the Common Cold
Catharine I. Paules, MD; Hilary D. Marston, MD, MPH; Anthony S. Fauci, MD
free access has active quiz has multimedia has audio
JAMA. 2020;323(8):707-708. doi:10.1001/jama.2020.0757
In this Viewpoint Anthony Fauci and colleagues review the emergence of pathogenic human coronaviruses (SARS-Cov and MERS-CoV) as background for discussing a rapidly spreading novel coronavirus (2019-nCoV) identified in 2019 in China and the public health strategies necessary to contain the threat.
Audio Interview: Coronavirus Infections—More Than Just the Common Cold
Clinical Review Audio: Dr Anthony Fauci: What Clinicians Need to Know About Coronavirus (CME)
Audio Interview: The 2019 Novel Coronavirus Outbreak – Update From NIAID’s Anthony Fauci, MD
Audio Interview: COVID-19 Update From China

The Novel Coronavirus Originating in Wuhan, ChinaChallenges for Global Health Governance

JAMA
February 25, 2020, Vol 323, No. 8, Pages 691-800
http://jama.jamanetwork.com/issue.aspx

 

The Novel Coronavirus Originating in Wuhan, ChinaChallenges for Global Health Governance
Alexandra L. Phelan, SJD, LLM; Rebecca Katz, PhD, MPH; Lawrence O. Gostin, JD
free access has active quiz has multimedia has audio
JAMA. 2020;323(8):709-710. doi:10.1001/jama.2020.1097
In this Viewpoint, Gostin and colleagues review the emerging novel coronavirus (2019-nCoV) outbreak, discuss the public health benefits and risks of the Chinese government’s large city quarantines, and call for WHO leadership to coordinate a global coordinated response that could contain this and prevent similar future outbreaks.
Clinical Review Audio: Dr Anthony Fauci: What Clinicians Need to Know About Coronavirus (CME)
Audio Interview: COVID-19 Update From China

Ethical Considerations in Using Social Media to Engage Research Participants: Perspectives of Australian Researchers and Ethics Committee Members

Journal of Empirical Research on Human Research Ethics
Volume 15 Issue 1-2, February-April 2020
http://journals.sagepub.com/toc/jre/current
Special Issue: Ethical Issues in Social Media Research
Ethics Review of Social Media Research
Ethical Considerations in Using Social Media to Engage Research Participants: Perspectives of Australian Researchers and Ethics Committee Members
Stacey Hokke, Naomi J. Hackworth, Shannon K. Bennetts, Jan M. Nicholson, Patrick Keyzer, Jayne Lucke, Lawrie Zion, Sharinne B. Crawford
First Published June 14, 2019; pp. 12–27

Reasoning “Uncharted Territory”: Notions of Expertise Within Ethics Review Panels Assessing Research Use of Social Media

Journal of Empirical Research on Human Research Ethics
Volume 15 Issue 1-2, February-April 2020
http://journals.sagepub.com/toc/jre/current
Special Issue: Ethical Issues in Social Media Research
Ethics Review of Social Media Research

Reasoning “Uncharted Territory”: Notions of Expertise Within Ethics Review Panels Assessing Research Use of Social Media
Chelsea Sellers, Gabrielle Samuel, Gemma Derrick

 

First Published December 12, 2019; pp. 28–39

 

Linking Survey and Twitter Data: Informed Consent, Disclosure, Security, and Archiving

Journal of Empirical Research on Human Research Ethics
Volume 15 Issue 1-2, February-April 2020
http://journals.sagepub.com/toc/jre/current
Special Issue: Ethical Issues in Social Media Research
Ethics Review of Social Media Research

Linking Survey and Twitter Data: Informed Consent, Disclosure, Security, and Archiving
Luke Sloan, Curtis Jessop, Tarek Al Baghal, Matthew Williams

 

First Published June 21, 2019; pp. 63–76

 

Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study

The Lancet
Feb 29, 2020 Volume 395 Number 10225 p659-754, e41
https://www.thelancet.com/journals/lancet/issue/current

 

Articles
Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study
Joseph T Wu, Kathy Leung, Gabriel M Leung

Transforming Global Health with AI

New England Journal of Medicine
February 27, 2020 Vol. 382 No. 9
http://www.nejm.org/toc/nejm/medical-journal

 

Perspective
Transforming Global Health with AI
M.C. Mehta, I.T. Katz, and A.K. Jha
Artificial intelligence could revolutionize health and health care in low- and middle-income countries by addressing the large knowledge and judgment gaps that make care delivery poor. But for AI to fulfill this promise, some key challenges will need to be addressed.

Benefits and harms of the human papillomavirus (HPV) vaccines: systematic review with meta-analyses of trial data from clinical study reports

Systematic Reviews
https://systematicreviewsjournal.biomedcentral.com/articles
[Accessed 29 Feb 2020]

 

Benefits and harms of the human papillomavirus (HPV) vaccines: systematic review with meta-analyses of trial data from clinical study reports
To assess the benefits and harms of the human papillomavirus (HPV) vaccines.
Authors: Lars Jørgensen, Peter C. Gøtzsche and Tom Jefferson
Citation: Systematic Reviews 2020 9:43
Content type: Research
Published on: 28 February 2020

Benefits and harms of the human papillomavirus (HPV) vaccines: comparison of trial data from clinical study reports with corresponding trial register entries and journal publications

Systematic Reviews
https://systematicreviewsjournal.biomedcentral.com/articles
[Accessed 29 Feb 2020]

 

Benefits and harms of the human papillomavirus (HPV) vaccines: comparison of trial data from clinical study reports with corresponding trial register entries and journal publications
No study has looked at differences of pooled estimates—such as meta-analyses—of corresponding study documents of the same intervention. In this study, we compared meta-analyses of human papillomavirus (HPV) va…
Authors: Lars Jørgensen, Peter C. Gøtzsche and Tom Jefferson
Citation: Systematic Reviews 2020 9:42
Content type: Research
Published on: 28 February 2020

What the systematic review of HPV vaccine clinical study reports does, and does not, reveal: commentary on Jørgensen et al.

Systematic Reviews
https://systematicreviewsjournal.biomedcentral.com/articles
[Accessed 29 Feb 2020]

 

What the systematic review of HPV vaccine clinical study reports does, and does not, reveal: commentary on Jørgensen et al.
Authors: Hilda Bastian
Citation: Systematic Reviews 2020 9:41
Content type: Commentary
Published on: 28 February 2020

Finding equipoise: CEPI revises its equitable access policy

Vaccine
Volume 38, Issue 9 Pages 2115-2272 (24 February 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/9

 

Review article Open access
Finding equipoise: CEPI revises its equitable access policy
Brenda Huneycutt, Nicole Lurie, Sara Rotenberg, Richard Wilder, Richard Hatchett
Pages 2144-2148
Abstract
Launched at Davos in January 2017 with funding from sovereign investors and philanthropic institutions, the Coalition for Epidemic Preparedness Innovations (CEPI) is an innovative partnership between public, private, philanthropic, and civil organisations whose mission is to stimulate, finance and co-ordinate vaccine development against diseases with epidemic potential in cases where market incentives fail. As of December 2019, CEPI has committed to investing up to $706 million in vaccine development. This includes 19 vaccine candidates against its priority pathogens (Lassa fever virus, Middle East respiratory syndrome coronavirus, Nipah virus, Chikungunya, Rift Valley fever) and three vaccine platforms to develop vaccines against Disease X, a novel or unanticipated pathogen.
As an entity largely supported by public funds, ensuring equitable access to vaccines whose development it supports in low- and middle-income countries is CEPI’s primary focus. CEPI developed an initial equitable access policy shortly after its formation, with key stakeholders expressing strong views about its content and prescriptive nature. The CEPI board instructed that it be revisited after a year. This paper describes the process of revising the policy, and how key issues were resolved. CEPI will continue to take an iterative, rather than prescriptive, approach to its policy—one that reflects the needs of multiple stakeholders and ensures it can meet its equitable access goals.

Men having sex with men and the HPV vaccine in France: A low vaccine coverage that may be due to its infrequent proposal by physicians

Vaccine
Volume 38, Issue 9 Pages 2115-2272 (24 February 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/9

 

Research article Abstract only
Men having sex with men and the HPV vaccine in France: A low vaccine coverage that may be due to its infrequent proposal by physicians
Benoit Petit, Olivier Epaulard
Pages 2160-2165

Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia

Vaccine
Volume 38, Issue 9 Pages 2115-2272 (24 February 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/9

 

Research article Abstract only
Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia
Aida Kalok, Sweet Yi Esther Loh, Kah Teik Chew, Nor Haslinda Abdul Aziz, … Zaleha Abdullah Mahdy
Pages 2183-2189

Survey of influenza vaccine knowledge, attitudes, and beliefs among pregnant women in the 2016–17 season

Vaccine
Volume 38, Issue 9 Pages 2115-2272 (24 February 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/9

 

Research article Abstract only
Survey of influenza vaccine knowledge, attitudes, and beliefs among pregnant women in the 2016–17 season
Jennifer P. King, Kayla E. Hanson, James G. Donahue, Jason M. Glanz, … Edward A. Belongia
Pages 2202-2208

Will We Have a Cohort of Healthcare Workers Full Vaccinated against Measles, Mumps, and Rubella?

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 29 Feb 2020)

 

Open Access Article
Will We Have a Cohort of Healthcare Workers Full Vaccinated against Measles, Mumps, and Rubella?
by Andrea Trevisan , Chiara Bertoncello , Elisa Artuso , Clara Frasson , Laura Lago , Davide De Nuzzo , Annamaria Nicolli and Stefano Maso
Vaccines 2020, 8(1), 104; https://doi.org/10.3390/vaccines8010104 – 27 Feb 2020
Abstract
Healthcare workers are a population exposed to several infectious diseases, and an immunization programme is essential for the maintenance of good vaccination coverage to protect workers and patients. A population of 10,653 students attending degree courses at Padua Medical School (medicine and surgery, dentistry and health professions) was screened for vaccination coverage and antibody titres against rubella, mumps, and measles. The students were subdivided into five age classes according to their date of birth: those born before 1980, between 1980 and 1985, between 1986 and 1990, between 1991 and 1995, and after 1995. Vaccination coverage was very low in students born before 1980, but the rate of positive antibody titre was high due to infection in infancy. Increasing date of birth showed increased vaccination coverage. In contrast, immune coverage was high for rubella (more than 90%) but not for mumps and measles (approximately 80%). An “anomaly” was observed for mumps and measles in the cohort born between 1991 and 1995, probably due to the trivalent vaccine formulation. Students born after 1990 showed vaccination coverage that exceeded 90%. It is therefore very likely that we will have a future generation of healthcare workers with optimal vaccination coverage.

Value-Based Pharmaceutical Contracts: Value for Whom?

Value in Health
February 2020 Volume 23, Issue 2, p139-276
https://www.valueinhealthjournal.com/issue/S1098-3015(20)X0003-9

 

Commentary
Value-Based Pharmaceutical Contracts: Value for Whom?
Joseph T. Kannarkat, Chester B. Good, Natasha Parekh
p154–156
Published online: December 5, 2019
Highlights
:: The nature of who benefits from value-based pharmaceutical contracts (VBPCs) is unclear.
:: VBPCs are reimbursement agreements between healthcare payers and pharmaceutical manufacturers that tie price, amount, or nature of drug reimbursements to value-based outcomes.
:: We discuss how VBPCs compare with value-based payer–provider arrangements in terms of performance-based reimbursements and alignment of incentives.
:: We examine how VBPCs can affect costs, clinical outcomes, and access to medications.
:: We recommend a patient-outcome centered approach for developing VBPCs and tying VBPCs to overarching drug cost reduction strategies.
Abstract
Value-based pharmaceutical contracts (VBPCs) are performance-based reimbursement agreements between healthcare payers and pharmaceutical manufacturers in which the price, amount, or nature of reimbursement is tied to value-based outcomes. VBPCs are often complex, and the nature of who benefits and in what ways can be unclear. We discuss how VBPCs compare with value-based payer–provider arrangements in terms of performance-based reimbursements and alignment of incentives. In addition, we examine how VBPCs can affect costs, clinical outcomes, and access to medications. Because these contracts are unlikely to reduce costs in isolation, we recommend taking a patient-centered approach when developing VBPCs and tying VBPCs to more overarching payer drug cost reduction strategies.

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 29 Feb 2020
Ideas
Democracies Are Better at Fighting Outbreaks
China’s harsh response to the coronavirus has influential admirers, but Western nations recognize that public health fundamentally depends on public trust.
February 24, 2020
Ariana A. Berengaut
Penn Biden Center’s director of programs, partnerships, and strategic planning

Health
You’re Likely to Get the Coronavirus
Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain.
James Hamblin
February 24, 2020

 

BBC
http://www.bbc.co.uk/
Accessed 29 Feb 2020
Health
Coronavirus: Where are we with a vaccine?
By James Gallagher Health and science correspondent
27 February 2020

 

The Economist
http://www.economist.com/
Accessed 29 Feb 2020
[No new, unique, relevant content]

 

Financial Times
http://www.ft.com/home/uk
Accessed 29 Feb 2020
Lunch with the FT
Ebola co-discoverer Peter Piot on how to respond to the coronavirus
February 28 2020

 

Forbes
http://www.forbes.com/
Feb 28, 2020
Bill Gates: Governments Should Invest Billions To Battle ‘Once-In-A-Century’ Pathogen
“That’s the scale of investment required to solve the problem.”
By Lisette Voytko Forbes Staff

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 29 Feb 2020
[No new, unique, relevant content]

 

Foreign Policy
http://foreignpolicy.com/
Accessed 29 Feb 2020
How Hackers and Spies Could Sabotage the Coronavirus Fight
Intelligence services have a long history of manipulating information on health issues, and an epidemic is especially tempting for interference. Why aren’t we better prepared?
Argument | Bruce Schneier, Margaret Bourdeaux

 

The West Is About to Fail the Coronavirus Test
China made huge mistakes managing the outbreak. The rest of the world may not do any better.
Argument | Melissa Chan, Ethan Guillén

 

Virus Travel Bans Are Inevitable But Ineffective
Experts can’t stop restrictions, but they can mitigate them.
Argument | Mara Pillinger

 

The Guardian
http://www.guardiannews.com/
Accessed 29 Feb 2020
[No new, unique, relevant content]

 

New Yorker
http://www.newyorker.com/
Accessed 29 Feb 2020
[No new, unique, relevant content]

 

New York Times
http://www.nytimes.com/
Accessed 29 Feb 2020
Health
Who’s on the U.S. Coronavirus Task Force
Several of the nation’s top health officials are among those sitting on an advisory panel formed by President Trump.
29 Feb 2020

Sunday Review
We’ve Ignored the Warnings About Global Pandemics
Now, after many fire drills, the world may be facing a real fire.
By The Editorial Board

Business
Japan’s Leader Announces $2.5B Package to Help Fight Virus
Japanese Prime Minister Shinzo Abe on Saturday announced a 270 billion yen ($2.5 billion) emergency economic package to help fight the coronavirus as he sought the public’s support for his government’s fight against the outbreak.
By The Associated Press

 

Washington Post
https://www.washingtonpost.com/
Accessed 29 Feb 2020
Azar Says U.S.-Funded Drug, Vaccine Must Be Accessible (Feb 29, 202012:30 p.m. NY)
Any drug or vaccine developed by companies with help from the government must be financially accessible for people, Health and Human Services Secretary Alex Azar told Congress Thursday.
“I have directed my teams that if we do any joint venture with a private enterprise that we’re cofunding the research and development program that we would ensure there’s access to the fruits of that, whether vaccine or therapeutics,” Azar said at a congressional hearing. The U.S. government is collaborating with pharmaceutical and biotechnology firms to develop vaccines and drugs for the coronavirus.
Azar’s comments are a shift from remarks Wednesday, when he said, “we would want to ensure that we work to make it affordable, but we can’t control that price, because we need the private sector to invest. Price controls won’t get us there.”…

Think Tanks et al

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 29 Feb 2020
[No new relevant content]

Center for Global Development [to 29 Feb 2020]
http://www.cgdev.org/page/press-center
Selected Publications, News and Events
February 28, 2020
The Impact of Coronavirus on China’s SMEs: Findings from the Enterprise Survey for Innovation and Entrepreneurship in China
Since the coronavirus outbreak began in January, Chinese business activity has been severely slowed, affecting China’s position in the global industrial supply chain. The Enterprise Survey for Innovation and Entrepreneurship in China (ESIEC) launched a survey on the “condition of micro, small and medium-sized enterprises (SMEs) amidst the coronavirus outbreak.”
Rouchen Dai , Junpeng Hu and Xiaobo Zhang

February 28, 2020
Reconciling SME Production in China with Coronavirus Control
With the steady decline in new confirmed cases of coronavirus in China beyond Hubei Province, public scrutiny has increasingly shifted to the economy affected by the outbreak, particularly the impact on the plethora of small and medium enterprises (SMEs). An earlier CGD note explored the impact of coronavirus on SMEs using data from the Enterprise Survey for Innovation and Entrepreneurship in China (ESIEC) and follow-up interviews. In this accompanying note, we consider how SMEs can resume production without compromising epidemic control.
Xiaobo Zhang and Ruixin Wang

February 26, 2020
China’s “Counterpart Assistance” Approach to Coronavirus: Lessons from the Wenchuan Earthquake Response
In early 2020, a new type of coronavirus epidemic (COVID-19) emerged suddenly and spread steadily from China’s Wuhan City, Hubei Province, disrupting China’s social order. The epicenter of the epidemic, Hubei Province lacked medical personnel and epidemic prevention supplies; assistance was urgently needed. This note identifies the Chinese government’s “counterpart aid” strategy in response to the epidemic and explores the strategy’s utility, drawing on earlier experiences with disaster response.
Xiaobo Zhang and Lihe Xu

 

CSIS
https://www.csis.org/
Accessed 29 Feb 2020
Podcast Episode
COVID-19: New Reality
February 26, 2020 | H. Andrew Schwartz, J. Stephen Morrison, Jude Blanchette, Stephanie Segal
In this episode, Andrew invites CSIS’s Steve Morrison, Jude Blanchette, and Stephanie Segal to discuss how the coronavirus outbreak, also known as COVID-19, is directly affecting the global…

Transcript
COVID-19: New Reality
February 27, 2020

Report
Sustaining U.S. Support for Gavi: A Critical Global Health Security and Development Partner
February 24, 2020 | Katherine Bliss As Gavi, the Vaccine Alliance, seeks funding to support its ambitious new 2021-2025 work plan, the United States should take steps to reinforce its longstanding support of the Alliance and help ensure continued progress on critical health security and development goals.

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 29 Feb 2020
February 27, 2020
Coronavirus
What You Need to Know About the Coronavirus Outbreak
A new coronavirus that originated in China has sparked fears of a potential pandemic, as health experts seek to answer questions about how it spreads.
Backgrounder by Claire Felter and Lindsay Maizland

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 29 Feb 2020
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 22 Feb 2020

.– 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_22 Feb 2020

– 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

EMERGENCIES

Emergencies

Editor’s Note:
While we have concentrated the most current key reports just below, COVID-19 announcements, analysis and commentary will be found throughout this issue, in all sections.
Beyond the considerable continuing coverage in the global general media:
Daily WHO situation reports here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
WHO Coronavirus disease (COVID-2019) daily press briefings here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)
Situation report – 33 [WHO]

Novel Coronavirus (COVID-19)
22 February 2020
[Excerpts]
SITUATION IN NUMBERS
Globally :: 77,794 laboratory-confirmed [599 new]
[Week ago: 49,053 laboratory-confirmed [2056 new]]
China :: 76,392 laboratory-confirmed [397 new]
:: 2,348 deaths [109 new]
Outside of China
:: 1,402 laboratory-confirmed [58 new]
:: 28 countries
:: 11 deaths [1 new]

WHO RISK ASSESSMENT
China – Very High
Regional Level – High
Global Level – High

HIGHLIGHTS
:: Two new countries (Lebanon and Israel) reported cases of COVID-19 in the past 24 hours.
:: The role of environmental contamination in the transmission of COVID-19 is not yet clear. On 18 February, a new protocol entitled “Surface sampling of coronavirus disease (COVID-19): A practical “how to” protocol for health care and public health professionals” was published. This protocol was designed to determine viable virus presence and persistence on fomites in various locations where a COVID-19 patient is receiving care or isolated, and to understand how fomites may play a role in the transmission of the virus.
:: The WHO Director-General briefed the emergency ministerial meeting on COVID-19 organized by the African Union and the Africa Centres for Disease Control and Prevention. Details can be found here.

::::::

National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
Selected News & Announcements
Feb 22: Daily briefing on novel coronavirus cases in China
On Feb 21, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps reported 397 new cases of confirmed infections, 1,361 new cases of suspected infections, and 109 deaths.
[See Emergencies above for detail]

China races to develop vaccines against coronavirus
2020-02-21
BEIJING — Chinese scientists are racing to develop vaccines against the novel coronavirus by adopting five technological approaches, a senior National Health Commission official said on Feb 21.
“Some projects have entered the stage of animal testing,” Zeng Yixin, deputy director of the commission, told a news conference on China’s fight against the novel coronavirus outbreak.
“Under the premise of ensuring safety, effectiveness and accessibility (of vaccines), (we) foresee that as soon as from April to May this year some vaccines could enter clinical trials, or under specific conditions, could be applied for emergency use,” he said.
“Our goal is that if required by the outbreak situation, the emergency use of vaccines, as well as the emergency review and approval process, can be activated in accordance with laws,” the official said.

 

::::::

Johnson & Johnson to Expand Partnership with U.S. Department of Health & Human Services to Accelerate the Discovery of Potential COVID-19 Treatments
NEW BRUNSWICK, N.J., Feb. 18, 2020 /PRNewswire/ — Johnson & Johnson (NYSE: JNJ) today announced that its Janssen Pharmaceutical Companies will expand its existing partnership with the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health & Human Services, to seek treatment solutions for COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2 (also known as 2019-nCoV). This latest collaboration will enhance Janssen’s ongoing work with global partners to screen a library of existing antiviral molecules, with the aim of identifying compounds with promising antiviral activity against SARS-CoV-2.
The expanded partnership with BARDA builds on Johnson & Johnson’s multipronged response to the COVID-19 outbreak. These efforts, in addition to the ongoing development of a potential vaccine candidate, bring hope of finding a solution against COVID-19 for communities in greatest need in China and around the world…

 

::::::
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WHO Director General – Speeches Emergency Ministerial meeting on COVID-19 organized by the African Union and the Africa Centres for Disease Control and Prevention

Milestones :: Perspectives :: Research

 

WHO Director General – Speeches

Emergency Ministerial meeting on COVID-19 organized by the African Union and the Africa Centres for Disease Control and Prevention
22 February 2020
Your Excellency Mr Moussa Faki Mahamat, Chairperson of the African Union Commission, Commissioner Amira El Fadil, WHO Regional Director Dr Matshidiso Moeti and Director John Nkengasong,
[Excerpts]
Excellencies, dear colleagues and friends,
…It’s hard to believe that only 52 days ago, WHO’s country office in China was notified of a cluster of cases of pneumonia of unknown cause in Wuhan city.

 

In just seven weeks, this outbreak has captured the world’s attention, and rightly so, because it has the potential to cause severe political, social and economic upheaval.  

…The data from China continue to show a decline in new cases. This is welcome news, but it must be interpreted very cautiously. It’s far too early to make predictions about this outbreak.
Outside China, there are now 1200 cases in 26 countries, with 8 deaths. As you know, there is one confirmed case on the African continent, in Egypt.

Several African countries have tested suspected cases of COVID-19, but fortunately they have been found negative.

Although the total number of cases outside China remains relatively small, we are concerned about the number of cases with no clear epidemiological link, such as travel history to China or contact with a confirmed case.

We are especially concerned about the increase in cases in the Islamic Republic of Iran, where there are now 18 cases and four deaths in just the past two days. WHO has supplied testing kits to Iran, and we will continue to provide further support in the coming days and weeks. What has been reported from South Korea and Italy yesterday is also a matter of concern and how the virus is now spreading to other parts of the world. But in addition to that, as I said earlier in my press conference, the window of opportunity is narrowing. This meeting, I hope, will help us come together as a continent in attacking this virus.

 

As you know, a WHO-led international team of experts – including a representative from the Nigerian CDC, our colleague Chikwe Ihekweazu, has been on the ground in China for the past week, visiting three provinces, and is today traveling to the epicenter in Wuhan.

With every day that passes, we know a little bit more about this virus, and the disease it causes.

We know that more than 80% of patients have mild disease and will recover. But the other 20% of patients have severe or critical disease, ranging from shortness of breath to septic shock and multi-organ failure. These patients require intensive care, using equipment such as respiratory support machines that are, as you know, in short supply in many African countries. And that’s a cause for concern.

In 2% of reported cases, the virus is fatal, and the risk of death increases the older a patient is, and with underlying health conditions. We see relatively few cases among children. More research, of course, is needed to understand why.

Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems. And I said earlier, our Africa regional office in partnership with the Africa CDC — we’re working hard to prepare countries in Africa for the potential arrival of the virus.

WHO has identified 13 priority countries in Africa because of their direct links to China or their high volume of travel with China. As my sister Tshidi said, an increasing number of African countries are now able to test for COVID-19 with laboratory test kits supplied by WHO, compared with only one just a couple of weeks ago.

Some countries in Africa, including DRC, are also leveraging the capacity they have built up to test for Ebola, to test for COVID-19. This is a great example of how investing in health systems can pay dividends for health security.

 

We have also shipped more than 30,000 sets of personal protective equipment to several countries in Africa, and we’re ready to ship almost 60,000 more sets to 19 countries in the coming weeks.

We’re working with manufacturers of personal protective equipment to address the severe disruption in the market for masks, gloves, gowns and other PPE, to ensure we can protect health workers.

 

During the past month about 11,000 African health workers have been trained using WHO’s online courses on COVID-19, which are available free of charge in English, French and other languages at OpenWHO.org.

We’re also providing advice to countries on how to do screening, testing, contact tracing and treatment.

Last week we brought the international research community together to identify research priorities, especially in the areas of diagnostics, therapeutics and vaccines.

 

Two weeks ago, I briefed the UN Secretary-General Antonio Guterres, and we agreed to activate the United Nations Crisis Management Team, led by Dr Mike Ryan, to enable WHO to focus on the health response while other agencies bring their expertise to bear on the social, economic and developmental implications of the outbreak.

We have also held two calls with UN resident coordinators all over the world, to brief them on the actions they can take to prepare their countries and ensure the United Nations system is working as one. And I hope, your excellencies, ministers, that you will work with our resident coordinators and WHO representatives to respond in a very coordinated fashion at country level.

 

The increasing signs of transmission outside China show that the window of opportunity we have for containing this virus is narrowing.

We are calling on all countries to invest urgently in preparedness. We have to take advantage of the window of opportunity we have, to attack  the virus outbreak with a sense of urgency.

Thank you all for your attention to this issue. I assure you that WHO is committed to working with all African countries to do everything we can to prevent transmission and detect and treat cases as early as possible.

Emergencies – Ebola

Emergencies

Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Ebola Outbreak in DRC 80: 16 February 2020
[Excerpts]
Situation Update
This week, the incidence of Ebola virus disease (EVD) cases continued to be low (Figure 1). From 10 to 16 February 2020, one new confirmed case was reported in Beni Health Zone, North Kivu Province in Democratic Republic of the Congo. The case was reported on 11 February 2020, and was listed and followed as a contact at the time of detection, with known epidemiological links. Early detection of cases reduces the probability of transmission of EVD in the community and significantly improves the clinical outcome for the patients…

While we are cautiously optimistic about the overall trend and reduced geographic spread of the outbreak, the security situation in several EVD-affected health areas remain volatile, and the risk of spread within Democratic Republic of the Congo and neighbouring countries remains high. Given delays in isolation of some cases in recent weeks and continued reports of nosocomial transmission, we expect to see additional cases in the coming weeks. It is critical that response teams rapidly detect, investigate and follow-up all cases and their contracts…

…Conclusion
While there is room for cautious optimism around the low number of new confirmed cases reported in recent weeks, the situation remains fragile and further cases should be expected. It is important to ensure continued access and heightened vigilance for response activities, including early case identification, contact tracing, and improving infection prevention and control measures in healthcare facilities.

 

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WHO & Regional Offices [to 22 Feb 2020]

WHO & Regional Offices [to 22 Feb 2020]
19 February 2020 News release
World failing to provide children with a healthy life and a climate fit for their future: WHO-UNICEF-Lancet

 

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Weekly Epidemiological Record, 21 February 2020, vol. 95, 08 (pp. 69–76)
:: Progress towards measles elimination – China, January 2013–June 2019
:: COVID-19 update

 

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO pledges to support African countries on joint coronavirus disease preparedness a…
22 February 2020
:: Polio-Nigeria leaves no stone unturned, targets over 55 million children in house-to…
20 February 2020

WHO Region of the Americas PAHO
:: Update on COVID-19 in the Region of the Americas
Washington, DC, February 20, 2020 (PAHO) – The Pan American Health Organization (PAHO) has announced a total of 23 confirmed cases of coronavirus 2019 (COVID-19) in the Region of the Americas. As of 18 February, all cases were reported in the United States (15) and Canada (8)…

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

WHO European Region EURO
:: Towards an agreement for improving access to high-cost medicines 21-02-2020

WHO Eastern Mediterranean Region EMRO
:: Polio eradication on United Nations Secretary General’s agenda during Pakistan visit
18 February 2020

WHO Western Pacific Region
No new digest content identified.

CDC/ACIP [to 22 Feb 2020]

CDC/ACIP [to 22 Feb 2020]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
ACIP Meetings
Next ACIP Meeting: February 26-27, 2020
Agenda (Draft) pdf icon[2 pages]

Latest News Releases
:: Transcript for CDC Telebriefing: Update on COVID-19 Friday, February 21, 2020

MMWR News Synopsis Friday, February 21, 2020
Interim Estimates of 2019–20 Seasonal Influenza Vaccine Effectiveness — United States, February 2020
CDC preliminary vaccine effectiveness estimates indicate that the 2019-20 flu vaccine is providing substantial protective benefit, particularly among children, who were hard hit by flu this season. Flu vaccines are reducing doctor visits associated with flu illness by 45% overall and 55% in children. CDC’s interim flu vaccine effectiveness (VE) estimates show that the flu vaccine has reduced doctor visits associated with flu illness by almost half (VE = 45%) so far this season. This is consistent with estimates of flu vaccine effectiveness from previous seasons that ranged from 40%-60% when flu vaccine viruses were similar to circulating flu viruses. Vaccination is providing substantial protection (VE = 55%) for children, who have been particularly hard hit by flu this season.

Africa CDC [to 22 Feb 2020]

Africa CDC [to 22 Feb 2020]
http://www.africacdc.org/
News
Eighty experts participate in training on enhanced surveillance at points of entry
ADDIS ABABA, ETHIOPIA, 17 FEBRUARY 2020. Eighty participants from 18 African countries are participating in a training on enhanced surveillance at points of entry currently holding in Narobi, Kenya, for points of entry surveillance officers, national surveillance officers, airport authority officers, and representatives of airlines.   The training is organized by the Africa Centres for Disease Control and Prevention in…
Actions taken include training representatives of Member States in laboratory testing of coronavirus, infection prevention and control, risk communication, and surveillance. Africa CDC is also supporting countries to source for and obtain reagents needed to rapidly test for the virus.
This training is to strengthen capacity in the continent and ensure standardization of points of entry surveillance by the different countries so they can quickly detect and contain the outbreak while at its lowest magnitude in the continent…

 

China CDC

China CDC
http://www.chinacdc.cn/en/
No new digest content identified.

 

National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
News
Feb 22: Daily briefing on novel coronavirus cases in China
On Feb 21, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps reported 397 new cases of confirmed infections, 1,361 new cases of suspected infections, and 109 deaths.
[See Emergencies above for detail]

China races to develop vaccines against coronavirus
2020-02-21
BEIJING — Chinese scientists are racing to develop vaccines against the novel coronavirus by adopting five technological approaches, a senior National Health Commission official said on Feb 21.
“Some projects have entered the stage of animal testing,” Zeng Yixin, deputy director of the commission, told a news conference on China’s fight against the novel coronavirus outbreak.
“Under the premise of ensuring safety, effectiveness and accessibility (of vaccines), (we) foresee that as soon as from April to May this year some vaccines could enter clinical trials, or under specific conditions, could be applied for emergency use,” he said.
“Our goal is that if required by the outbreak situation, the emergency use of vaccines, as well as the emergency review and approval process, can be activated in accordance with laws,” the official said.

Announcements

Announcements

Sabin Vaccine Institute Launches Vaccine Acceptance and Demand Program — Now recruiting for a number of positions
Senior Manager, Vaccine Acceptance
Reports to: Vice President, Vaccine Acceptance and Demand Location: Washington, DC
Vice President, Vaccine Acceptance and Demand
Reports to: President, Global Immunization Location: Washington, DC
Senior Manager, Social Media Research
Reports to: Vice President, Vaccine Acceptance and Demand Location: Washington, DC
Senior Manager, Immunization Advocates
Reports to: Vice President, Vaccine Acceptance and Demand Location: Washington, DC

 

Vaccine Confidence Project [to 22 Feb 2020]
http://www.vaccineconfidence.org/
Latest News & Archive
World must fight anti-vaccine drive, says Women in Science winner from Bangladesh
18 February 2020

 

Vaccine Education Center – Children’s Hospital of Philadelphia [to 22 Feb 2020]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

 

Wellcome Trust [to 22 Feb 2020]
https://wellcome.ac.uk/news
Opinion | 20 February 2020
Ideas to reimagine research culture: what we’ve heard at our university town halls
by Ben Bleasdale

Opinion | 19 February 2020
COVID-19: how researchers around the world are racing to understand the virus and prevent future outbreaks
by Josie Golding
As the outbreak of COVID-19 continues to spread in China and countries around the world, a global community of researchers are working to find out more about the virus and assess what research needs to be done to stop it.

 

The Wistar Institute [to 22 Feb 2020]
https://www.wistar.org/news/press-releases
Press Releases
Feb. 19, 2020
New Molecular Mechanism Involved in Cellular Senescence That Modulates Inflammation and Response to Cancer Immunotherapy
The newly identified pathway may be modulated during chemotherapy to enable response to immune checkpoint blockade.

 

World Organisation for Animal Health (OIE) [to 22 Feb 2020]
https://www.oie.int/en/for-the-media/press-releases/2020/
Press Releases
2nd OIE Rinderpest Challenge: the winners
Today, the World Organisation for Animal Health (OIE) announces the winners of the 2nd OIE Rinderpest Challenge. For four weeks, players across the globe competitively diagnosed livestock and helped laboratories manage at-risk materials in order to find the virtual outbreak of Rinderpest. The challenge is now closed, yet players can continue to train!
Paris, 12 February 2020 – Over 12,300 participants from 121 countries participated in the 2nd OIE Rinderpest Challenge between 15 January and 12 February 2020. An exciting opportunity which gathered ten times more participants than the first edition held in 2019. For the past four weeks, participants have been playing the serious game to collect points for their countries. Meanwhile, they learned how to diagnose Rinderpest among several other diseases with similar clinical signs, as well as how to cautiously handle materials that potentially contain the rinderpest virus in laboratories.
According to the points displayed on the leaderboard at the close of the challenge, Uzbekistan is the winning country. With a total of 4,129,060 points, a new record has been set…

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ARM [Alliance for Regenerative Medicine] [to 22 Feb 2020]
https://alliancerm.org/press-releases/
Press Releases
No new digest content identified.

 

BIO [to 22 Feb 2020]
https://www.bio.org/press-releases
Press Releases
BIO Asia Conference in Tokyo Cancelled Amid
COVID-19 Outbreak

Washington, DC – February 21, 2020 – The Biotechnology Innovation Organization (BIO) announced today, it is canceling the annual BIO Asia conference in Tokyo scheduled for March 10-11. The decision was based on the global impact of COVID-19 and Japanese government recommendations.
“Our attendees’ health and safety are our utmost priority,” said Jim Greenwood, BIO President & CEO. “We offer our support and sympathy to all of those who’ve been impacted by the virus around the world.”…

 

DCVMN – Developing Country Vaccine Manufacturers Network [to 22 Feb 2020]
http://www.dcvmn.org/
News
Advanced Pharmacovigilance workshop and WG meeting
16 March 2020 to 19 March 2020, Shanghai / China

 

IFPMA [to 22 Feb 2020]
http://www.ifpma.org/resources/news-releases/
Selected Press Releases, Statements, Publications
No new digest content identified.
PhRMA [to 22 Feb 2020]
http://www.phrma.org/
Selected Press Releases, Statements
Helping those affected by the coronavirus
Stephen J. Ubl   |     February 20, 2020
America’s biopharmaceutical companies are committed to developing solutions to help diagnose and treat those with COVID-19, a novel strain of coronavirus that originated in Wuhan, China. In addition to applying their scientific expertise to find ways to diagnose, treat and prevent infections from the virus, the biopharmaceutical industry is providing financial support and in-kind donations to organizations and collaborating with U.S., Chinese and global health authorities to combat this global public health emergency.
More than half of PhRMA members have R&D efforts under way or are providing donations of medicines and critical medical supplies as well as providing financial donations to support patients and first responders in addressing this evolving crisis…

Journal Watch

Journal Watch
Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focu-s 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

Maximizing the impact of, and sustaining standing orders protocols for adult immunization in outpatient clinics

American Journal of Infection Control
March 2020 Volume 48, Issue 3, p239-354
http://www.ajicjournal.org/current

 

Major Articles
Maximizing the impact of, and sustaining standing orders protocols for adult immunization in outpatient clinics
L.J. Tan, Robin VanOss, Cori L. Ofstead, Harry P. Wetzler
p290–296
Published online: October 18, 2019
Open Access

The Potential Economic Value of a Zika Vaccine for a Woman of Childbearing Age

American Journal of Preventive Medicine
March 2020 Volume 58, Issue 3, p313-472
http://www.ajpmonline.org/current

 

Research Articles
The Potential Economic Value of a Zika Vaccine for a Woman of Childbearing Age
Sarah M. Bartsch, Lindsey Asti, Owen J. Stokes-Cawley, So Yoon Sim, Maria Elena Bottazzi, Peter J. Hotez, Bruce Y. Lee
p370–377
Published online: January 20, 2020

Human Papillomavirus Vaccination Schedule: Adherence Among Commercially Insured Adolescents and Young Adults in the United States, 2011–2017

American Journal of Public Health
March 2020 110(33)
http://ajph.aphapublications.org/toc/ajph/current

 

HUMAN PAPILLOMAVIRUS VACCINE
Human Papillomavirus Vaccination Schedule: Adherence Among Commercially Insured Adolescents and Young Adults in the United States, 2011–2017
Demetria Hubbard, Sadeep Shrestha, Emily B. Levitan and Huifeng Yun
110(3), pp. 385–390

Legal Uncertainty—The Gray Area around Substandard Medicines: Where Public Health Meets Law

American Journal of Tropical Medicine and Hygiene
Volume 102, Issue 2, February 2020
http://www.ajtmh.org/content/journals/14761645/102/2

 

Perspective Pieces
Legal Uncertainty—The Gray Area around Substandard Medicines: Where Public Health Meets Law
Eugenia Olliaro, Piero Olliaro, Calvin W. L. Ho and Raffaella Ravinetto
Pages: 262–267
https://doi.org/10.4269/ajtmh.19-0645

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 22 Feb 2020)

 

Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis
Although vaccination coverage in Eritrea has improved in recent years, some children are still missing out, and it’s important to identify risk factors for lower coverage in order to target campaigns and inter…
Authors: Fitsum Kibreab, Sonia Lewycka and Andebrhan Tewelde
Citation: BMC Public Health 2020 20:267
Content type: Research article
Published on: 22 February 2020