Science
19 July 2019 Vol 365, Issue 6450
http://www.sciencemag.org/current.dtl

Special Issue Apollo Anniversary
Introduction to special issue
Shooting for the Moon
By Keith T. Smith
Science19 Jul 2019 : 232-233

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Discussion No access
Mandatory vaccinations for children in Italy: The need for a stable frame
Helena C. Maltezou, Caterina Ledda, Venerando Rapisarda
Pages 4419-4420

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Discussion No access
Mandatory vaccinations for children in Italy: The need for a stable frame
Helena C. Maltezou, Caterina Ledda, Venerando Rapisarda
Pages 4419-4420

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Review article Open access
Potential use of microarray patches for vaccine delivery in low- and middle- income countries
Nicolas Peyraud, Darin Zehrung, Courtney Jarrahian, Collrane Frivold, … Birgitte Giersing
Pages 4427-4434

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Abstract only
Perceptions of influenza and pneumococcal vaccine uptake by older persons in Australia
Lynne Briggs, Patricia Fronek, Val Quinn, Tracy Wilde
Pages 4454-4459

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Abstract only
Differences between coverage of yellow fever vaccine and the first dose of measles-containing vaccine: A desk review of global data sources
Nedghie Adrien, Terri B. Hyde, Marta Gacic-Dobo, Joachim Hombach, … Philipp Lambach
Pages 4511-4517

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Abstract only
The privilege paradox: Geographic areas with highest socio-economic advantage have the lowest rates of vaccination
Gabrielle M. Bryden, Matthew Browne, Matthew Rockloff, Carolyn Unsworth
Pages 4525-4532

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Open access
Maternal immunization in Malawi: A mixed methods study of community perceptions, programmatic considerations, and recommendations for future planning
Jessica A. Fleming, Alister Munthali, Bagrey Ngwira, John Kadzandira, … Niranjan Bhat
Pages 4568-4575

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Abstract only
Smartphone app uses loyalty point incentives and push notifications to encourage influenza vaccine uptake
Leila Pfaeffli Dale, Lauren White, Marc Mitchell, Guy Faulkner
Pages 4594-4600

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Open access
National immunization strategies targeting migrants in six European countries
Cristina Giambi, Martina Del Manso, Teresa Dalla Zuanna, Flavia Riccardo, … Silvia Declich
Pages 4610-4617

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

Research article Abstract only
Compliance to timely vaccination in an Expanded Program on Immunization center of Pakistan
Umair Qazi, Sidra Malik, Usman A. Raza, Maryam Saad, … Saeed Anwar
Pages 4618-4622

Vaccine
Volume 37, Issue 32 Pages 4419-4658 (26 July 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/32

History of Vaccinology papers
Research article Open access
Chile’s National Advisory Committee on Immunization (CAVEI): Evidence-based recommendations for public policy decision-making on vaccines and immunization
Jeannette Dabanch, Cecilia González, Jaime Cerda, Johanna Acevedo, … Magdalena Bastías
Pages 4646-4650

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 20 Jul 2019)

Open Access Protocol
Pertussis Vaccination Failure in the New Zealand Pediatric Population: Study Protocol
by Hannah Chisholm, Anna Howe, Emma Best and Helen Petousis-Harris
Vaccines 2019, 7(3), 65; https://doi.org/10.3390/vaccines7030065 – 16 July 2019
Abstract
Pertussis vaccines have been effective at reducing pertussis-associated morbidity and mortality. However, they have a complex array of limitations, particularly associated with the duration of protection against clinical disease and imperfect immunity (carriage and transmission). Little is known about risk factors for pertussis vaccination failure. Understanding pertussis vaccination failure risk is most important in the paediatric population. This study aims to investigate risk factors for pertussis vaccination failure in (1) infants between birth and six weeks of age born to mothers who received pertussis booster vaccinations during pregnancy and (2) infants after the completion of the primary series (approximately five months old) to four years old. This will be achieved in a two-step process for each study group. Pertussis vaccination failure cases will first be described using a case series study design, relevant case characteristics will be sourced from six national administrative datasets. The case series study results will help select candidate risk factors (hypothesis generating step) to be tested in the retrospective cohort study (hypothesis testing step). Pattern analysis will be used to investigate risk factor patterns in the cohort study. The identification of higher risk groups enables targeting strategies, such as additional doses, to better prevent pertussis disease

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

The Journal of Law, Medicine & Ethics
First Published July 12, 2019
Research Article
Legal and Policy Responses to Vaccine-Preventable Disease Outbreaks
L Barraza, D Reiss, P Freeman –
Abstract
Laws and policies are vital tools in preventing outbreaks and limiting the further spread of disease, but they can vary in content and implementation. This manuscript provides insight into challenges in responding to recent vaccine-preventable disease outbreaks by examining legislative changes in California, policy changes on certain university campuses, and the laws implicated in a measles outbreak in Minnesota.

First Published July 12, 2019
Research Article
Emergency Declarations for Public Health Issues: Expanding Our Definition of Emergency
G Sunshine, N Barrera, AJ Corcoran, M Penn
Abstract
Emergency declarations are a vital legal authority that can activate funds, personnel, and material and change the legal landscape to aid in the response to a public health threat. Traditionally, declarations have been used against immediate and unforeseen threats such as hurricanes, tornadoes, wildfires, and pandemic influenza. Recently, however, states have used emergency declarations to address public health issues that have existed in communities for months and years and have risk factors such as poverty and substance misuse. Leaders in these states have chosen to use emergency powers that are normally reserved for sudden catastrophes to address these enduring public health issues. This article will explore emergency declarations as a legal mechanism for response; describe recent declarations to address hepatitis A and the opioid overdose epidemic; and seek to answer the question of whether it is appropriate to use emergency powers to address public health issues that are not traditionally the basis for an emergency declaration.

Cancer
First published: 10 July 2019
https://doi.org/10.1002/cncr.32379
Original Article
Intent and subsequent initiation of human papillomavirus vaccine among young cancer survivors
B Cherven, SM Castellino, Y Chen, FL Wong, JM York… –
Background
Despite an increased risk of subsequent human papillomavirus (HPV)–related malignancies, HPV vaccine initiation rates among cancer survivors remain critically low. The purpose of this study was to determine the relationship between HPV vaccine intent and subsequent vaccine initiation among cancer survivors by linking data from a cross‐sectional survey with state‐based immunization registry records.

Frontiers in Public Health
Received: 08 Jan 2019; Accepted: 16 Jul 2019.
Methods ARTICLE
Assessing vaccine herd protection by killed whole-cell oral cholera vaccines using different study designs
M Ali, JD Clemens –
Abstract
The population level effectiveness of a vaccine may arise as the result of direct protection of vaccinees and vaccine herd protection, which may protect non-vaccinees, vaccinees, or both. Indirect, total, enhanced and overall vaccine protection are measures of vaccine herd protection. The level of population level effectiveness induced by a vaccine depends on many factors, including the level of vaccine protective efficacy, the magnitude and distribution of vaccine coverage at a point in time and the extent to which different groups mix with one another in the community. Data on vaccine herd protection are important in the assessment of the public health importance and cost-effectiveness of many vaccines. Killed whole-cell (WC) oral cholera vaccines (OCVs) have been evaluated for herd protection in various study settings, leveraging geographic information system (GIS) tools for the analyses. This article provides a brief description of the herd protective effects of killed WC OCVs measured using various study deigns that include a) individually randomized, controlled clinical trials, b) cluster randomized clinical trials, c) observational cohort studies, and d) observational case-control studies. In all of the study designs, significant herd protection was observed in unvaccinated persons as well as in the community as a whole. The findings of these studies suggest that using killed WC OCV as a public health tool for controlling cholera is impactful and cost-effective.

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 20 Jul 2019
[No new, unique, relevant content]

BBC
http://www.bbc.co.uk/
Accessed 20 Jul 2019
[No new, unique, relevant content]

The Economist
http://www.economist.com/
Accessed 20 Jul 2019
[No new, unique, relevant content]

Financial Times
http://www.ft.com/home/uk
Accessed 20 Jul 2019
July 15, 2019
Tedros Adhanom Ghebreyesus
Anti-vaxxers distract from a more serious threat

Forbes
http://www.forbes.com/
Accessed 20 Jul 2019
[No new, unique, relevant content]

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 20 Jul 2019
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 20 Jul 2019
[No new, unique, relevant content]

The Guardian
http://www.guardiannews.com/
Accessed 20 Jul 2019
Opinion
Ebola
The Guardian view on Ebola in the DRC: help needed – and dialogue too
Editorial
The second largest outbreak of the disease has already sickened thousands. WHO’s declaration of an emergency of international concern should prompt more and better support
Thu 18 Jul 2019 13.27 EDT Last modified on Fri 19 Jul 2019 05.48 EDT

New Yorker
http://www.newyorker.com/
Accessed 20 Jul 2019
[No new, unique, relevant content]

New York Times
http://www.nytimes.com/
Accessed 20 Jul 2019
Africa
Congo Soldiers, Police to Enforce Ebola Emergency Measures
Congolese soldiers and police will enforce hand-washing and fever checks now that the deadly Ebola outbreak has been declared an international health emergency , authorities said Thursday.
July 18 By The Associated Press

Europe
Britain Tells Canada and France to Pull Their Weight on Ebola
Britain’s international development minister Rory Stewart called on France and Canada on Monday to offer more help in tackling the Ebola outbreak in Democratic Republic of Congo.
By Reuters
July 15

Health
Polio Cases Surge in Pakistan and Afghanistan
False rumors that children are fainting or dying have led parents to turn away vaccinators, threatening the campaign to eradicate the disease.
By Donald G. McNeil Jr.

Washington Post
http://www.washingtonpost.com/
Accessed 20 Jul 2019
Editorial Board · Editorial-Opinion ·
The vaccine challenge isn’t just about getting shots
Jul 19, 2019

Foreign
Germany introducing mandatory measles vaccination for kids
Associated Press · · Jul 17, 2019

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 20 Jul 2019
[No new relevant content]

Center for Global Development
http://www.cgdev.org/page/press-center
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 20 Jul 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 20 Jul 2019
July 18, 2019
Democratic Republic of Congo
Ebola Reaches DRC Border City of Two Million, WHO Responds
The recent designation of Ebola as a “public health emergency of international concern” by the World Health Organization (WHO) is a positive development in efforts to contain the disease. The decision highlights the importance of containing the disease to an international audience; the WHO’s designation is being widely carried by the international media.
Blog Post by John Campbell Africa in Transition

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 20 Jul 2019
[No new relevant content]

Milestones :: Perspectives :: Research

DRC – Ebola/Cholera/Polio/Measles

Disease Outbreak News (DONs}
Ebola virus disease – Democratic Republic of the Congo
11 July 2019
The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continues this past week with a similar transmission intensity to the previous week. While the number of new cases continues to ease in former hotspots, such as Butembo, Katwa and Mandima health zones, there has been an increase in cases in Beni, and a high incidence of cases continues in parts of Mabalako Health Zone. In addition to these re-emerging hotspots, there are a large number of people with confirmed and probable infections moving to other health zones, with the greatest number coming from Beni Health Zone. The movement of cases causes the outbreak to spread to new health zones and re-emerge in health zones with previously controlled infections. Overall, this underscores the importance of robust mechanisms for listing and following up contacts and understanding the motivations for peoples’ decisions to move…

::::::

CDC Lab Research Shows Two Treatments Effective Against DRC Ebola Strain
Tuesday, July 9, 2019
New research by the Centers for Disease Control and Prevention (CDC) shows two investigational Ebola treatments being used in the ongoing outbreak in eastern Democratic Republic of the Congo (DRC) are effective in laboratory studies.

The treatments – the antiviral remdesivir and antibodies in the ZMapp treatment – blocked growth of the virus strain causing the outbreak in human cells in the laboratory. The research suggests these treatments hold promise for allowing patients to recover from the deadly illness. The research will be published Tuesday, July 9, in Lancet Infectious Diseases.

Importantly, the study also shows that the lab test most often used in DRC and neighboring countries to diagnose Ebola – which was developed during the 2014-2016 West Africa outbreak for use against a different strain of Ebola virus – appears to be accurate for the outbreak strain now circulating in DRC, which researchers are calling the Ituri strain. The Ituri strain and the strain that caused the West Africa outbreak are both strains of Ebola virus (formerly called Ebola Zaire).

“All of the treatments being tested in the current DRC outbreak were developed to fight Ebola viruses from previous outbreaks,” said Laura McMullan, Ph.D., CDC microbiologist and the paper’s lead author. “RNA viruses are always mutating – and because Ebola is an RNA virus it’s vitally important to make sure existing treatments work against the virus that’s making people sick now.”

How and Why This Research Was Done
Lacking samples from patients infected with the Ebola virus strain causing the current outbreak, CDC laboratory scientists reconstructed the Ituri strain of Ebola virus using reverse genetics in the CDC Biosafety Level 4 laboratory, under the highest level of biosecurity and safety. They based this work on virus sequence data generated from recent patient samples by the DRC National Institute of Biomedical Research (INRB) and the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) and published in GenBank, an open-access database for pathogen sequences.

By having access to the virus strain, CDC laboratory experts can learn more about the Ituri strain and how it fits into the Ebola virus family tree, which may provide clues to finding additional promising treatments. The scientists will also be able to test new therapies as they are developed to see if they can effectively fight against the actual virus making people sick. They will also be able to compare it to future Ebola strains to explore how the virus changes over time.

“This work has benefits beyond the current study. Having access to this virus will allow us to explore whether other compounds or potential therapies affect the virus in the lab,” said Inger Damon, M.D., PhD, chief strategy officer for the CDC’s 2018 Ebola response and director of CDC’s Division of High-Consequence Pathogens and Pathology. “We hope the knowledge gained from this work can be translated into safe and effective therapies to help cure Ebola patients.”

Laboratory experts within CDC’s Viral Special Pathogens Branch have been testing compounds and antivirals since 2007 to look for potential treatments for viral hemorrhagic fevers – some of the world’s deadliest diseases, including Ebola and Marburg. In addition to assessing the effectiveness of remdesivir and the antibodies in the ZMapp cocktail against the Ituri strain, CDC researchers also encourage the future testing of the investigational vaccine being used in DRC and of other investigational therapies – such as mAb114 and Regeneron’s REGN-3EB against the current Ebola Ituri virus.

The current DRC outbreak is the second-largest ever recorded and DRC’s tenth Ebola outbreak since 1976. To date, more than 2,400 people have become infected and more than 1,600 have died. Uganda also has reported three travel-associated deaths tied to a DRC Ebola patient. Armed conflicts and public mistrust in the area have complicated public health response efforts. Despite efforts from the DRC Ministry of Health and international health partners, including CDC, the current outbreak has continued for 10 months.

The research will be available on the Lancet Infectious Diseases websiteexternal icon at 6:30 p.m. EST Tuesday, July 9. For more information on Ebola and the current DRC outbreak, please visit www.cdc.gov/ebola.

::::::

Press release
Vaccination to contain severe measles outbreak underway in the Democratic Republic of the Congo amidst Ebola and mass displacement
Campaign led by the Ministry of Health with support from UNICEF and MSF

ITURI, Democratic Republic of the Congo/DAKAR/GENEVA/NEW YORK, 11 July 2019 – Health workers are urgently rolling out a complex measles vaccination campaign targeting 67,000 children in Ituri, northeast Democratic Republic of the Congo (DRC), a region ravaged by armed conflict that is now also the hub of the second-deadliest Ebola outbreak on record.

At least 1,981 deaths due to measles have been reported across the DRC this year, over two-thirds of them among children below 5 years old. As of 23 June, nearly 115,000 cases of suspected measles had been reported, far more than the 65,000 recorded in all of 2018.
Ituri, one of the two provinces (the other is North Kivu) struck by Ebola since the outbreak began nearly a year ago, has recorded over 5,400 cases and 50 deaths.

“The combined threat of Ebola and measles for the thousands of families living in overcrowded and unsanitary displacement camps is unprecedented,” said UNICEF DRC Representative Edouard Beigbeder. “We have a small window to prevent a potentially massive loss of life.”

The first sites targeted for measles vaccinations are four displacement camps in Bunia, Ituri, that have seen a huge influx of families forcibly uprooted by fighting in recent weeks. The boundary of one camp, located alongside Bunia’s General Hospital, is less than 100 metres away from an Ebola treatment center. It is also less than 3 kilometres away from parts of Bunia that have seen 5 Ebola cases since the start of the outbreak, 2 of them in the past three weeks.

The Ebola outbreak means the measles vaccination campaign must incorporate extra measures to protect against infection and meticulous triage. Health workers will need to wear gowns to prevent contact with blood or other body fluids. Teams will include an additional health worker who will evaluate and refer suspected Ebola cases, check temperatures and oversee handwashing and other safety measures.

An additional layer of complexity is that some of the early symptoms of Ebola – fever, redness around the eyes, diarrhoea – are virtually indistinguishable from those of measles, malaria or cholera – all of which are prevalent, especially in severely congested displacement sites.

Up to 400,000 people are thought to be internally displaced across Ituri, the vast majority of them women and children. Many live in about 35 camps scattered throughout the province, in territory that is virtually inaccessible due to insecurity. Fighting among various armed groups has damaged or destroyed up to half the health facilities and schools in the province.

“The northeastern part of DRC is home to one of the worst humanitarian crises today. Whether it is from measles, Ebola, or the reality of living in a displacement camp, children are at grave risk. We must do everything we can to protect them,” Beigbeder said.

Measles campaigns are also being planned for Tchomia and Nyankunde health zones.

As of 8 July, there were 2,428 cases of Ebola, with 1,641 deaths. Almost 30 per cent of cases are among children.

Featured Journal Content

Nature Medicine
Volume 25 Issue 7, July 2019
https://www.nature.com/nm/volumes/25/issues/7
Editorial | 03 July 2019
Time to vaccinate against hesitancy
Recent measles outbreaks worldwide highlight the urgency of tracking and countering vaccine hesitancy to ensure the continued success of immunization programs.

In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan, whose goals included eliminating measles in at least five out of the six World Health Organization (WHO) regions by 2020. This goal seemed attainable, given the gains in measles vaccine coverage in low-income countries during the previous decade. And yet, in 2019, measles has surged worldwide. According to the World Health Organization (WHO), three times as many cases were reported in January through March of 2019 than during the same period in 2018. The United States, which had declared that locally transmitted measles was eliminated within its borders in 2000, has already reported the largest number of cases in any year since 1992 (https://www.cdc.gov/measles/cases-outbreaks.html).

Vaccine hesitancy, defined as a delay in vaccination or a refusal to vaccinate in spite of vaccine availability, has played a major role in driving outbreaks in all regions. At the beginning of 2019, the WHO declared vaccine hesitancy one of the top ten threats to global health. Routine and supplemental immunizations are a cornerstone of preventive health and wellness, but are threatened by gaps in coverage. The ongoing measles outbreaks, although tragic, provide an opportunity for health authorities to rebuild and preserve trust in immunization programs by promoting the uptake of tools to measure vaccine hesitancy, thus better supporting health care providers as they engage with patients and field-test new messaging approaches in communities that have different reasons for delaying or refusing vaccines.

Measles vaccines are the poster child for successful vaccine design and potential disease control, but a mix of complacency, fear and challenges to vaccine access have stymied vaccine coverage efforts. Although there are now a number of published tools to measure attitudes toward vaccination, in an analysis of data collected from 2014 to 2016, only 30% of WHO member countries reported performing assessments of vaccine hesitancy in the previous 5 years (S. Lane, N. E. MacDonald, M. Marti and L. Dumolard, Vaccine 36, 3861–3867; 2018). In the future, it will be important for more countries to routinely measure vaccine hesitancy and dissect which distinct factors are contributing on per-country and even more localized bases, a strategy that might help better anticipate gaps in vaccine coverage.

In the same analysis, one of the top three cited reasons for vaccine hesitancy was concerns related to the safety and side effects of vaccines. The detrimental effects of anti-vaccine messaging have thus far proven challenging to overcome. Primary health care providers already have an important influence in the decision to vaccinate and are therefore well placed to discuss the monitoring systems that ensure vaccine safety. However, to communicate this message even more effectively, providers themselves must have a strong grasp of the principles underpinning vaccine development, scheduling and surveillance, because such an understanding has been shown to increase providers’ confidence in promoting immunization (Paterson, P. et al., Vaccine 34, 6700–6706; 2016). In addition, some public health researchers feel that if vaccine counseling were better reimbursed by insurance companies, more health care providers in countries with healthcare systems such as that in the United States might be motivated to take on the time commitment of having these dialogues.

More information is still needed about which approaches best convey the benefits of immunization and address the concerns of parents who delay or refuse vaccines. One study has found that common fear-based messages might actually backfire (B. Nyhan, J. Reifler, S. Richey and G. L. Freed, Pediatrics 133, e835–e842; 2014). In that study, parents randomly received one of four interventions designed to provide information about the safety of the measles–mumps–rubella vaccine or the risks of contracting these diseases. Those who were given images of children sick with measles, mumps or rubella were actually more likely to believe in the discredited link between vaccines and autism. New studies are needed to test the efficacy of more refined motivational or empathetic communication, with the caveat that there will be no one-size-fits-all strategy in light of the varied contextual factors that contribute to the lack of vaccine confidence. In addition to addressing the needs of caregivers, approaches designed to enhance preventive-care education of young adults, including those in college, could mitigate gaps in vaccine knowledge and confidence later in life. Social media has been rightly lambasted for its role in perpetuating irresponsible and dangerous beliefs about vaccine safety and efficacy, but attention has mostly focused on how to block the spread of spurious misinformation on online platforms. Immunization programs should also better leverage social media to respond to determinants of vaccine hesitancy in different communities.

If measles continues to circulate in the United States through the fall, the country is at danger of losing its elimination status. Importantly, the effects of vaccine hesitancy extend beyond measles vaccines. If elimination of measles, a relatively simple disease to control, cannot be achieved, the possibility of elimination of other vaccine-preventable diseases with more complex dynamics and variable vaccine efficacy seems less likely. Restricting allowable exemptions from vaccination for school-age children, although a welcome development in response to the outbreaks in regions of the United States, would provide only part of the solution. To be truly effective, immunization programs must improve both education and outreach by incorporating strategies to measure and respond to vaccine hesitancy. Unless this epidemic is used to galvanize these changes, the United States will be no better prepared to prevent the next outbreak.

Featured Journal Content

World Health Organization model list of essential medicines: 21st list – 2019
WHO/MVP/EMP/IAU/2019.06 : 60 pages
PDF: WHO-MVP-EMP-IAU-2019.06-eng.pdf (‎951.1Kb)‎
19.3 Vaccines [p.44]

News release
WHO updates global guidance on medicines and diagnostic tests to address health challenges, prioritize highly effective therapeutics, and improve affordable access
New essential medicines and diagnostics lists published today
9 July 2019 Geneva
WHO’s Essential Medicines List and List of Essential Diagnostics are core guidance documents that help countries prioritize critical health products that should be widely available and affordable throughout health systems.

Published today, the two lists focus on cancer and other global health challenges, with an emphasis on effective solutions, smart prioritization, and optimal access for patients.

“Around the world, more than 150 countries use WHO’s Essential Medicines List to guide decisions about which medicines represent the best value for money, based on evidence and health impact,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The inclusion in this list of some of the newest and most advanced cancer drugs is a strong statement that everyone deserves access to these life-saving medicines, not just those who can afford them.”

The Essential Medicines List (2019)
Cancer treatments: While several new cancer treatments have been marketed in recent years, only a few deliver sufficient therapeutic benefits to be considered essential. The 12 medicines WHO added to the new Medicines List for five cancer therapies are regarded as the best in terms of survival rates to treat melanoma, lung, prostate, multiple myeloma and leukemias cancers.

For example, two recently developed immunotherapies (nivolumab and pembrolizumab) have delivered up to 50% survival rates for advanced melanoma, a cancer that until recently was incurable.

Antibiotics: The Essential Medicines Committee strengthened advice on antibiotic use by updating the AWARE categories, which indicate which antibiotics to use for the most common and serious infections to achieve better treatment outcomes and reduce the risk of antimicrobial resistance.  The committee recommended that three new antibiotics for the treatment of multi-drug resistant infections be added as essential…

Featured Journal Content

Bioethics International’s Good Pharma Scorecard Improved the Data-Sharing Practices of Large Pharmaceutical Companies
NEW HAVEN, Conn., July 10, 2019 /PRNewswire/ — Bioethics International (BEI), a not-for-profit organization dedicated to raising the bar on ethics, trustworthiness and patient-centricity in the pharmaceutical industry, today announced the third publication of its Good Pharma Scorecard (GPS) in The BMJ. The GPS is an annual ranking of new drugs and the associated pharmaceutical companies on their ethics performance. This year’s rankings focus on clinical transparency and data-sharing practices in large pharmaceutical companies, specifically on trial registration, results reporting, publication and data-sharing practices.  BEI, in collaboration with Yale School of Medicine and Stanford Law School, developed new data sharing measures, which were informed by a multi-stakeholder advisory team.

Two companies, Novo Nordisk and Roche, tied for the top rank in overall trial transparency, each with scores of 100%. Novo Nordisk, Roche, Novartis and Janssen/Johnson & Johnson all achieved scores of 100% on the data-sharing measure.

In addition to measuring companies’ data-sharing practices, the study tested whether the GPS ranking tool could improve companies’ practices. BEI provided companies a 30-day window to amend their policies to meet the new data-sharing measure. At the end of the window, three companies improved their policies.  Additionally, since the first GPS published rankings in 2015, the industry’s overall median transparency scores have gone up year after year.

“A goal of the GPS is to help set ethics and social responsibility measures in the pharma industry and provide an independent tracking tool to both recognize best practices and catalyze reform, where needed, in companies,” said Jennifer E. Miller, Ph.D., founder of Bioethics International, assistant professor at the Yale School of Medicine and lead author on the paper.

“We are encouraged by the efforts of some large companies to share patient-level trial data and a willingness to improve policies and practices, where needed. However, there is substantial room for improvement. Providing companies with a consistent, fair and achievable set of measures is important to encouraging and tracking further progress toward routine data sharing.”…

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 10 July 2019
:: A circulating vaccine-derived poliovirus type 2 (cVDPV2) has been confirmed in China. It is genetically linked to a VDPV2 isolated from an environmental sample from Xinjiang province, collected on 18 April 2018.  WHO is continuing to evaluate the situation and stands ready to support the ongoing investigation and risk assessment by national authorities.

Summary of new viruses this week:
:: Pakistan — nine wild poliovirus type 1 (WPV1) cases and 3 WPV1-positive environmental samples;
:: Angola —  one circulating vaccine-derived poliovirus  (cVDPV2) case;
:: China – one cVDPV2 case. See country sections below for more details.

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

Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.
WHO Grade 3 Emergencies [to 13 Jul 2019]

Democratic Republic of the Congo
:: 49: Situation report on the Ebola outbreak in North Kivu 9 July 2019
:: Disease Outbreak News (DONs} Ebola virus disease – Democratic Republic of the Congo
11 July 2019
[See DRC Ebola+ above for detail]

Yemen
:: Outbreak update – Cholera in Yemen, 30 June 2019
8 July 2019 – The Ministry of Public Health and Population of Yemen reported 21,865 suspected cases of cholera with 13 associated deaths during epidemiological week 26 (24 to 30 June) of 2019. Thirteen percent of cases were severe. The cumulative total number of suspected cholera cases from 1 January 2018 to 30 June 2019 is 823,221, with 1210 associated deaths (CFR 0.13%). Children under five represent 23.0% of total suspected cases during 2019. The outbreak has affected 22 of 23 governorates and 299 of 333 districts in Yemen…

Nigeria
:: Nigeria intensifies cross border immunization, with special focus on nomadic populations 
Kano, 8 July, 2019 – In renewed efforts to vaccinate children traversing in and out of Nigeria, the World Health Organization (WHO) is supporting the government in an initiative to improve supplemental and routine immunization activities in the North Western region, which has a significant nomadic population.
Nomadic pastoralists live beyond the reach of established health care programs that are designed to serve sedentary populations. As a result, these groups are often under-immunized and out of the reach of existing disease surveillance activities.
Speaking on the intervention, Mallam Gwanda Mairakuma of Maiadua local government in Niger Republic said that, “with this intensified commitment, vaccination activities have reduced the number of complications associated with Measles infection on our children”…

Mozambique floods – No new digest announcements identified
Myanmar – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 13 Jul 2019]

Libya
:: Medical aid accelerated as Libya crisis intensifies 6 July 2019

MERS-CoV
:: Worldwide reduction in MERS cases and deaths since 2016 8 July 2019
The World Health Organization and colleagues from the University of Oxford, Imperial College London and Institut Pasteur* have estimated that, since 2016, 1 465 cases of Middle East Respiratory syndrome coronavirus (MERS-CoV) and between 300 and 500 deaths may have been averted due to accelerated global efforts to detect infections early and reduce transmission.
In 2012, a novel virus that had not previously been seen in humans was identified for the first time in a resident from Saudi Arabia. The virus, now known as MERS-CoV, has, as of 31 May 2019, infected more than 2 442 people worldwide. MERS-CoV is a respiratory virus that can cause severe disease and has been fatal in approximately 35% of patients to date. MERS is zoonotic and people are infected from direct or indirect contact with dromedary camels. While the virus has demonstrated limited ability to transmit between people outside of hospitals, it has repeatedly caused large scale outbreaks in health care facilities with severe health, security and economic impacts, most notably in Saudi Arabia in 2014-2016 and the Republic of Korea in 2015. The outbreak in the Republic of Korea in 2015 involved 186 cases and 38 deaths, and had an estimated economic impact of US$12 billion.
In a research letter published in the journal Emerging Infectious Diseases on 8 July 2019, the researchers analyze case-based data on laboratory-confirmed MERS-CoV infections reported to WHO since 2012…

Afghanistan – No new digest announcements identified
Bangladesh – Rakhine conflict – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Cyclone Idai – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Malawi floods – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies [to 13 Jul 2019]

Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syrian Arab Republic: Recent Developments in Northwestern Syria Situation Report No. 7 – as of 12 July 2019
HIGHLIGHTS
:: …Humanitarian response is ongoing with hundreds of thousands of people receiving critical assistance essential for their survival. Violence in areas directly affected by conflict is driving displacement into denselypopulated areas, putting a strain on service delivery for humanitarian actors. A joint assessment is currently being finalized that will provide an overview of needs in the most affected areas.
:: Civilian infrastructure, including humanitarian facilities, continues to be damaged or destroyed in the violence. In the last two weeks, at least four medical facilities have been impacted by the violence, with several other unconfirmed reports, as well as a water station serving over 80,000 people, and several schools, IDP settlements, markets and bakeries.

Yemen – No new digest announcements identified

::::::

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth
:: Southern Africa: Cyclones Idai and Kenneth Snapshot, as of 10 July 2019.

EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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

WHO & Regional Offices [to 13 Jul 2019]
WHO updates global guidance on medicines and diagnostic tests to address health challenges, prioritize highly effective therapeutics, and improve affordable access
New essential medicines and diagnostics lists published today
9 July 2019 News release Geneva
[See Milestones above for detail]

::::::

Calls for consultants / proposals
8 July 2019
Consultancy – Support for WHO’s work on advancing vaccine development and vaccination against yellow fever, Zika, and dengue
Deadline for applications: 25 July 2019

::::::

Weekly Epidemiological Record, 12 July 2019, vol. 94, 28 (pp. 309–316)
:: Global Advisory Committee on Vaccine Safety, 5–6 June 2019

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Marginalised and mistrustful: listening to people who have few reasons to trust outsiders [DRC] 13 July 2019
:: Uganda Village joins forces to Fight Ebola 11 July 2019

WHO Region of the Americas PAHO
:: PAHO/WHO urges northern hemisphere countries to prepare for heatwaves  (07/12/2019)
:: CDB, PAHO launch “Stronger Together” campaign, raising awareness about mental health and psychosocial support in disasters (07/10/2019)

WHO South-East Asia Region SEARO
:: Sri Lanka eliminates measles SEAR/PR/1712
New Delhi, 9 July 2019: The World Health Organization today announced Sri Lanka has eliminated measles, interrupting transmission of the indigenous virus that causes the killer childhood disease.
“Sri Lanka’s achievement comes at a time when globally measles cases are increasing. The country’s success demonstrates its commitment, and the determination of its health workforce and parents to protect children against measles,” said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia, congratulating the island nation…

WHO European Region EURO
– No new digest announcements identified

WHO Eastern Mediterranean Region EMRO
– No new digest announcements identified

WHO Western Pacific Region
– No new digest announcements identified

CDC/ACIP [to 13 Jul 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Thursday, July 11, 2019
TRANSCRIPT of July 9, 2019, CDC Vital Signs: Nationwide Outbreak of Acute Flaccid Myelitis—United States, 2018

CDC Lab Research Shows Two Treatments Effective Against DRC Ebola Strain
Tuesday, July 9, 2019
[See DRC – Ebola above for detail]

CDC Telebriefing-New Vital Signs Report – CDC reports on largest acute flaccid myelitis (AFM) outbreak: doctors should recognize symptoms early and report all suspected cases
Tuesday, July 9, 2019

CDC Urges Doctors to Rapidly Recognize and Report AFM Cases
Tuesday, July 9, 2019

MMWR News Synopsis for July 12, 2019
Changes in HIV Preexposure Prophylaxis (PrEP) Awareness and Use Among Men Who Have Sex with Men — 20 Urban Areas, 2014 and 2017
Use of a daily pill for HIV prevention – HIV preexposure prophylaxis or PrEP – has increased but remains too low, particularly among gay and bisexual African American and Latino men. More gay and bisexual men at high risk for HIV are using PrEP. CDC analyzed data from more than 7,800 interviews with gay and bisexual men at high risk for HIV in 20 U.S. cities. The analysis found that reported PrEP use increased from 6% to 35% — and that reported awareness of PrEP increased from 60% to 90% — among the survey participants between 2014 and 2019. Despite those increases, PrEP use remains too low. African American and Latino gay and bisexual men reported lower PrEP awareness and use than white gay and bisexual men. To end the HIV epidemic in the United States, healthcare providers should routinely test their patients for HIV, assess HIV-negative patients for indications of HIV risk, and appropriately prescribe PrEP.

Vital Signs: Surveillance for Acute Flaccid Myelitis — United States, 2018

Africa CDC [to 13 Jul 2019]
http://www.africacdc.org/
27-06-2019
AUC and Government of China Sign Exchange of Letters of Agreement for the Construction of Africa CDC Headquarters Building
…The signing of the Exchange of Letters of Agreement is an important step towards actualization of the construction project. It paves the way for the signing of an Agreement on the Economic and Technical Cooperation for the provision of the grant aid for the construction, commencement of the project design, and subsequent laying of the foundation.

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/
2019-07-12
All children with leukemia included in national centralized treatment and management system
China’s program of leukemia centralized treatment and management has covered all children in the country, and already benefited 35,000 kids, according to the National Health Commission.

Chinese hospital publishes brain tumor database
2019-07-10
China’s leading neurosurgery hospital has published a database of 2,000 gene samples from Chinese patients with glioma, a type of brain tumor.

All poor rural areas to get basic healthcare access
2019-07-10
All residents in impoverished rural areas are expected to have access to basic healthcare services provided by certified doctors by the end of the year.

Announcements

Paul G. Allen Frontiers Group [to 13 Jul 2019]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
Press Release
Advancing Leading Edge Cancer Research in a $4.5 Million Collaboration
July 11, 2019
LLS, The Mark Foundation for Cancer Research and The Paul G. Allen Frontiers Group Join Forces to Advance Leading Edge Cancer Research

BMGF – Gates Foundation [to 13 Jul 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 13 Jul 2019]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.

CARB-X [to 13 Jul 2019]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.

CEPI – Coalition for Epidemic Preparedness Innovations [to 13 Jul 2019]
http://cepi.net/
10 July 2019
CEPI awards contract worth up to US$12.5 million to consortium led by Wageningen Bioveterinary Research to develop a human vaccine against Rift Valley fever
With support from the EU’s Horizon 2020 programme, CEPI will provide funding for vaccine manufacturing, preclinical research, and a phase 1 study to assess a single-dose vaccine candidate.

Clinton Health Access Initiative, Inc. (CHAI) [to 13 Jul 2019]
https://clintonhealthaccess.org/about/
No new digest content identified.

EDCTP [to 13 Jul 2019]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Latest news
12 July 2019
Director General Jean-Eric Paquet visits EDCTP-funded CHAPS adolescent study in Cape Town
On 8 July 2019, the European Commission Director-General for Research and Innovation, Jean-Eric Paquet, visited the Emavulandleni Research Centre in Cape Town, South Africa, together with colleagues from the European Commission, the Department of Science and Technology of South Africa, the South African Medical Research Council and EDCTP. This research centre is one of the sites for the EDCTP-funded ‘Combined HIV Adolescent Prevention Study’ (CHAPS), led by Professor Linda Gail-Bekker and conducted South Africa, Uganda and Zimbabwe.

Emory Vaccine Center [to 13 Jul 2019]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency [to 13 Jul 2019]
http://www.ema.europa.eu/ema/
News and press releases
Press release: EU and US reach a milestone in mutual recognition of inspections of medicines manufacturers
Last updated: 12/07/2019

Press release: Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 8-11 July 2019
PRAC, Last updated: 11/07/2019

News: Guido Rasi elected chair of International Coalition of Medicines Regulatory Authorities (ICMRA)
Last updated: 08/07/2019

European Vaccine Initiative [to 13 Jul 2019]
http://www.euvaccine.eu/news-events
No new digest content identified.

FDA [to 13 Jul 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.

Fondation Merieux [to 13 Jul 2019]
http://www.fondation-merieux.org/
No new digest content identified.

Gavi [to 13 Jul 2019]
https://www.gavi.org/
No new digest content identified.

GHIT Fund [to 13 Jul 2019]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical
No new digest content identified.

Global Fund [to 13 Jul 2019]
https://www.theglobalfund.org/en/news/
No new digest content identified.

Hilleman Laboratories [to 13 Jul 2019]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 13 Jul 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.

IAVI [to 13 Jul 2019]
https://www.iavi.org/newsroom
No new digest content identified.

International Coalition of Medicines Regulatory Authorities (ICMRA)
http://www.icmra.info/drupal/en/news
Monday 8 July 2019
Election of New Chair and Vice Chairs of ICMRA (July 2019)
…ICMRA brings together the leaders of regulatory authorities around the world to provide
strategic direction for enhanced cooperation on common scientific, regulatory or safety
challenges, improved communication and information sharing and effective global crisis
response mechanisms…

IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.

IFRC [to 13 Jul 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Asia Pacific, Bangladesh
Cox’s Bazar: Heavy rains trigger landslides in camps, Red Crescent response efforts underway
Cox’s Bazar/Kuala Lumpur/Geneva, 11 July 2019 – Heavy rains triggered landslides in camps in Cox’s Bazar housing more than 900,000 people from Rakhine state, Myanmar. Bangladesh Red Crescent Society response operations are underway in seven camps where …
11 July 2019

IVAC [to 13 Jul 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.

IVI [to 13 Jul 2019]
http://www.ivi.int/
IVI News & Announcements
IVI exchanged a memorandum of understanding with the Armed Forces Medical Research Institute (AFMRI)
July 12, 2019 – SEOUL, South Korea. Today IVI exchanged a memorandum of understanding with the Armed Forces Medical Research Institute (AFMRI), the Korean military’s only institution dedicated to medical research and development, prevention of diseases, and promotion of health of military personnel.
Through this partnership, IVI and AFMRI will seek the exchange of research resources and close cooperation for the development of a vaccine against human adenovirus type 55, which is reported to cause outbreaks of acute respiratory diseases among military trainees and in school populations around the world. Both parties will also aim to facilitate discussions to explore and conduct joint research projects, and to support the vaccination of the Armed Forces…

JEE Alliance [to 13 Jul 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 13 Jul 2019]
http://www.msf.org/
Selected News; Project Updates, Reports
Ethiopia
The constant cycle of displacement
Project Update 12 Jul 2019

Iraq
Supporting people in Qayyarah
Project Update 12 Jul 2019

Democratic Republic of Congo
Six years on, still no news of our colleagues held hostage by armed group…
Statement 11 Jul 2019

Annual Report
International Activity Report 2018
10 Jul 2019

Pakistan
The only option for cutaneous leishmaniasis treatment in Khyber Pa…
Project Update 9 Jul 2019

Myanmar
Clinic closure marks milestone for HIV treatment in Myanmar
Project Update 8 Jul 2019

NIH [to 13 Jul 2019]
http://www.nih.gov/news-events/news-releases
Friday, July 5, 2019
Novel Method Identifies Patients at Risk for HIV Who May Benefit From Prevention Strategies
NIH-funded studies demonstrate the value of automated prediction algorithms that could be used to prevent new HIV infections

PATH [to 13 Jul 2019]
https://www.path.org/media-center/
July 9, 2019 by PATH
PATH applauds recognition for frontline treatment of childhood diarrheal disease by the World Health Organization
New listing for co-packaged ORS-zinc in the WHO essential medicines list could improve access and save lives
Seattle, Washington, USA, July 9, 2019 – PATH applauds a landmark decision this week by the World Health Organization (WHO) to include a new listing for co-packaged oral rehydration salts (ORS) and zinc sulfate in its Model List of Essential Medicines (EML) and Model List of Essential Medicines for Children (EMLc), reinforcing the lifesaving benefits of using ORS and zinc together for pediatric diarrhea management, and achieving alignment with the long-standing recommendation for the use of both therapies as frontline practice. It is estimated that more than 60 percent of childhood diarrheal deaths could be prevented with full coverage of ORS and zinc alongside other community interventions…

Sabin Vaccine Institute [to 13 Jul 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.

UNAIDS [to 13 Jul 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
12 July 2019
Charting progress against discrimination
Laws discriminate in many ways, but the criminalization of people is one of the most devastating forms of discrimination. Despite calls for reform and the commitments under the 2030 Agenda for Sustainable Development to remove discriminatory laws and reduce inequalities:

:: Sixty-nine countries still criminalize same-sex sexual relationships.
:: More than 100 countries criminalize drug use or the personal possession of drugs and 98 countries criminalize some form of sex work.
:: One in five people in prison are there because of drug-related crimes and 80% of those are there for personal possession or use.
:: Nineteen countries deport non-nationals on the grounds of their HIV status.

A high-level political forum is meeting in New York, United States of America, from 9 to 18 July to review the progress made against the commitments of Member States towards achieving the Sustainable Development Goals, including those on inequality and on peace, justice and strong institutions…

10 July 2019
Youth networks are saving lives
A study undertaken by Watipa and commissioned by UNAIDS and the PACT as part of its #uproot agenda found that young people play an essential role in demand creation, linkages to care and uptake of services for HIV and sexual and reproductive health and rights.
The report showcasing the results, titled Young people’s participation in community-based responses to HIV: from passive beneficiaries to active agents of change, showed that young people, particularly role models and leaders who are living with HIV, play a critical part in enabling access to HIV treatment and retention in care. The results showed that the support provided by young people to their peers has a positive effect on antiretroviral therapy adherence, navigating disclosure and living positively with HIV. Details of the types of support show that young people are actively involved in peer psychosocial support, peer-to-peer consultations, policy engagement processes, peer mobilization around specific campaigns and projects, and peer-supported hospital and care access…

UNICEF [to 13 Jul 2019]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports
Statement
Attack in Afrin, Syria, kills three children and causes significant damage to school
Statement from Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa
12/07/2019

Press release
Vaccination to contain severe measles outbreak underway in the Democratic Republic of the Congo amidst Ebola and mass displacement
Campaign led by the Ministry of Health with support from UNICEF and MSF
11/07/2019
[See Milestones above for detail]

Press release
Rohingya refugee children in Cox’s Bazar at risk from flooding and landslides as monsoon rains continue
Education for over 60,000 children in camps and host community is disrupted because of damage to learning centres
09/07/2019

Statement
At least seven children killed in yet another attack on civilians in northwest Syria
Statement by UNICEF Executive Director Henrietta Fore

Vaccine Confidence Project [to 13 Jul 2019]
http://www.vaccineconfidence.org/
No new digest content identified.

Vaccine Education Center – Children’s Hospital of Philadelphia [to 13 Jul 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

Wellcome Trust [to 13 Jul 2019]
https://wellcome.ac.uk/news
Opinion | 11 July 2019
Public health funding: a new approach to address conditions like obesity and cancer
by Sophie Hawkesworth, Portfolio Manager Population Health, Wellcome

The Wistar Institute [to 13 Jul 2019]
https://www.wistar.org/news/press-releases
Press Release
Jul. 9, 2019
Consortium of HIV Researchers Puts Philadelphia at Global Center of Research Advances Toward a Cure for HIV/AIDS
Wistar and partners unveil educational videos focused on taking part in a cure-directed clinical trial.

World Organisation for Animal Health (OIE) [to 13 Jul 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.

::::::

BIO [to 13 Jul 2019]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 13 Jul 2019]
http://www.dcvmn.org/
No new digest content ide
ntified.

IFPMA [to 13 Jul 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 13 Jul 2019]
http://www.phrma.org/press-room
No new digest content identified.

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

American Journal of Tropical Medicine and Hygiene
Volume 101, Issue 1, 2019
http://www.ajtmh.org/content/journals/14761645/101/1

Perspective Piece
Emerging Trends in Clinical Tropical Medicine Research
Mark K. Huntington, Joe P. Bryan, Troy D. Moon, Pascal J. Imperato, Susan L. F. McLellan, Walter R. Taylor and John S. Schieffelin
https://doi.org/10.4269/ajtmh.19-0043
The American Society for Tropical Medicine and Hygiene recently inaugurated an award for the best clinical research article published in the society’s journal in the previous year. This article summarizes both the process of selecting the winner and several themes that stood out in those articles which rose to the top for consideration. Themes of note included the importance of doing clinical research outside of referral centers, the complexity that must be considered when implementing interventions, incorporation of both ends of the age spectrum into studies, and considering cost-effectiveness and opportunity cost of interventions.

American Journal of Tropical Medicine and Hygiene
Volume 101, Issue 1, 2019
http://www.ajtmh.org/content/journals/14761645/101/1

Articles
High Rates of Exposures to Waterborne Pathogens in Indigenous Communities in the Amazon Region of Ecuador
Natalia Romero-Sandoval, Lizeth Cifuentes, Gabriela León, Paola Lecaro, Claudia Ortiz-Rico, Philip Cooper and Miguel Martín
https://doi.org/10.4269/ajtmh.18-0970
Waterborne pathogens, associated with poverty and poor sanitary conditions, are a major cause of morbidity and mortality worldwide. There are limited data on the epidemiology of waterborne pathogens in indigenous populations living in the Amazon region. We did a cross-sectional survey in two indigenous Shuar communities in the Amazon region of Ecuador in which we documented the presence of pathogens representing different sources of environmental contamination of water. We detected protozoa and soil-transmitted helminths by microscopy of fecal samples and the presence of IgG antibodies to hepatitis A and Leptospira spp. in blood samples from individuals older than 2 years and collected data by questionnaire on sociodemographic factors and knowledge of infectious diseases. Seroprevalence for hepatitis A and Leptospira spp. were 98.1% (95% CI: 97.0–99.8) and 50.0% (95% CI: 43.3–56.6), respectively, whereas 62.6% (95% CI: 55.8–69.4) had enteric parasites in stool samples. In participants older than 6 years, eight of 10 had evidence of infection with or exposure to at least one of the pathogens studied. Although prevalence of pathogens varied by age, it did not vary significantly by gender, temporal migration, illiteracy, perceived morbidity, receipt of conditional cash transfers, water boiling practices, poor housing conditions, and anthropometric status. These findings indicate a high level of contamination of drinking water by human pathogens in these indigenous communities and the need for interventions to improve access to and use of clean drinking water in these marginalized communities.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 13 Jul 2019)

Research article
Impact of a guideline-based best practice alert on pneumococcal vaccination rates in adults in a primary care setting [U.S.]
Despite the high burden of pneumococcal disease, pneumococcal vaccine coverage continues to fall short of Healthy People 2020 goals. A quasi-experimental design was used to investigate the impact of pneumococc…
Authors: Carrie McAdam-Marx, Casey Tak, Tanaz Petigara, Nathan W. Jones, Minkyoung Yoo, Melissa Struwe Briley, Karen Gunning and Lisa Gren
Citation: BMC Health Services Research 2019 19:474
Published on: 10 July 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 13 Jul 2019)

Research article
Implementation of the World’s largest measles-rubella mass vaccination campaign in Bangladesh: a process evaluation
Gavi, the Vaccine Alliance, supported a mass vaccination Measles-Rubella Campaign (MRC) in Bangladesh during January–February 2014.
Authors: Haribondhu Sarma, Ashwin Budden, Sharmin Khan Luies, Stephen S. Lim, Md. Shamsuzzaman, Tahmina Sultana, Julie K. Rajaratnam, Laura Craw, Cathy Banwell, Md. Wazed Ali and Md. Jasim Uddin
Citation: BMC Public Health 2019 19:925
Published on: 10 July 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 13 Jul 2019)

Research article
Trajectories of seasonal influenza vaccine uptake among French people with diabetes: a nationwide retrospective cohort study, 2006–2015
Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but their SIV rates remain far below public health targets. We aimed to identify temporal trajectories of SIV uptake over a …
Authors: Aurélie Bocquier, Sébastien Cortaredona, Lisa Fressard, Pierre Loulergue, Jocelyn Raude, Ariane Sultan, Florence Galtier and Pierre Verger
Citation: BMC Public Health 2019 19:918
Published on: 9 July 2019

Clinical Therapeutics
July 2019 Volume 41, Issue 7, p1227-1400
http://www.clinicaltherapeutics.com/current

PREVENTION OF RHEUMATOID ARTHRITIS: Challenges and Opportunities to Change the Paradigm of Disease Management
Edited by Kevin Dale Deane, Tsang Tommy Cheung

Health Affairs
Vol. 38, No. 7 July 2019
https://www.healthaffairs.org/toc/hlthaff/current

Physicians, Nurses, Disparities & More
Research Article Global Health Policy
Twenty Years Of Antiretroviral Therapy For People Living With HIV: Global Costs, Health Achievements, Economic Benefits
Steven S. Forsythe , William McGreevey , Alan Whiteside , Maunank Shah , …

JAMA
July 9, 2019, Vol 322, No. 2, Pages 95-180
http://jama.jamanetwork.com/issue.aspx

Original Investigation
Effect of Recombinant Zoster Vaccine on Incidence of Herpes Zoster After Autologous Stem Cell Transplantation – A Randomized Clinical Trial
Adriana Bastidas, MD; Javier de la Serna, MD; Mohamed El Idrissi, MSc; et al.
JAMA. 2019;322(2):123-133. doi:10.1001/jama.2019.9053
This randomized trial compares the effects of 2 doses of nonlive adjuvanted recombinant zoster vaccine vs placebo on incidence of herpes zoster in adults who had undergone autologous hematopoietic stem cell transplantation.

JAMA
July 9, 2019, Vol 322, No. 2, Pages 95-180
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Trust in Health Care
Trust Between Health Care and Community Organizations
Somava Saha Stout, MD, MS; Lisa A. Simpson, MB, BCh, MPH; Prabhjot Singh, MD, PhD
JAMA. 2019;322(2):109-110. doi:10.1001/jama.2019.1211
This Viewpoint discusses the importance of trust in partnerships between health care and community-based organizations for achieving better health outcomes and proposes principles and strategies for building and nurturing trustworthy collaborations.

JAMA
July 9, 2019, Vol 322, No. 2, Pages 95-180
http://jama.jamanetwork.com/issue.aspx

Editorial
Trust in Health Care
Howard Bauchner, MD

JAMA
July 9, 2019, Vol 322, No. 2, Pages 95-180
http://jama.jamanetwork.com/issue.aspx

Trust in Health Care
Building Trust in Health Systems to Eliminate Health Disparities
Donald E. Wesson, MD, MBA; Catherine R. Lucey, MD; Lisa A. Cooper, MD, MPH
JAMA. 2019;322(2):111-112. doi:10.1001/jama.2019.1924
This Viewpoint discusses the historic lack of trust between health systems and underserved communities and suggests evidence-based strategies to build the trusting relationships needed to address this complex social problem.

Journal of Travel Medicine
Volume 26, Issue 5, 2019,
https://academic.oup.com/jtm/issue/26/5

Perspectives
Ebola vaccines: ready to use for humanitarian health workers?
Blaise Genton, MD, PhD
Journal of Travel Medicine, Volume 26, Issue 5, 2019, tay152, https://doi.org/10.1093/jtm/tay152
Humanitarian health workers are likely to benefit from immunization with an Ebola vaccine when deployed in epidemic zones. However implementation is difficult since there is yet not licensed vaccine that can be administered before they reach the field. Also several uncertainties remain (safety, cross-protection between species, duration of protection etc.).

Journal of Travel Medicine
Volume 26, Issue 5, 2019,
https://academic.oup.com/jtm/issue/26/5

Editor’s Choice
Japanese encephalitis vaccine for travelers: risk-benefit reconsidered
Bradley A Connor, MD; Davidson H Hamer, MD; Phyllis Kozarsky, MD; Elaine Jong, MD; Scott B Halstead, MD …
Journal of Travel Medicine, Volume 26, Issue 5, 2019, taz037, https://doi.org/10.1093/jtm/taz037

Journal of Travel Medicine
Volume 26, Issue 5, 2019,
https://academic.oup.com/jtm/issue/26/5

Editor’s Choice
Japanese encephalitis vaccine for travelers: risk-benefit reconsidered
Bradley A Connor, MD; Davidson H Hamer, MD; Phyllis Kozarsky, MD; Elaine Jong, MD; Scott B Halstead, MD …
Journal of Travel Medicine, Volume 26, Issue 5, 2019, taz037, https://doi.org/10.1093/jtm/taz037

Journal of Travel Medicine
Volume 26, Issue 5, 2019,
https://academic.oup.com/jtm/issue/26/5

Rapid Communication
Meningitis vaccine shortage and the 2019 Hajj mass gathering: market dynamics and epidemic control
Shahul H Ebrahim, MD, MSc, PhD; Abdullah M Assiri, MD, FACP; Ziad A Memish, MD, FRCPC, FRCPL, FRCPE, FACP, FFPH
Journal of Travel Medicine, Volume 26, Issue 5, 2019, taz039, https://doi.org/10.1093/jtm/taz039
Extract
Saudi Arabia implements two meningococcal meningitis epidemic control strategies for Hajj pilgrims. Visa-linked meningococcal vaccination certification (A, C, Y, W-135) is mandatory for all pilgrims. In addition, for those arriving from the `meningitis belt countries’, a single dose of oral ciprofloxacin is administered at arrival ports prior to the immigration process to eliminate meningococcal nasopharyngeal carriage (1). Hajj and Umrah constitute the largest annual mass gathering of pilgrims from over 180 countries with a projected growth from current 3 million to 30 million by 2030 (2). With these dual approaches, meningococcal carriage rates have been…

Journal of Travel Medicine
Volume 26, Issue 5, 2019,
https://academic.oup.com/jtm/issue/26/5

Rapid Communication
Meningitis vaccine shortage and the 2019 Hajj mass gathering: market dynamics and epidemic control
Shahul H Ebrahim, MD, MSc, PhD; Abdullah M Assiri, MD, FACP; Ziad A Memish, MD, FRCPC, FRCPL, FRCPE, FACP, FFPH
Journal of Travel Medicine, Volume 26, Issue 5, 2019, taz039, https://doi.org/10.1093/jtm/taz039
Extract
Saudi Arabia implements two meningococcal meningitis epidemic control strategies for Hajj pilgrims. Visa-linked meningococcal vaccination certification (A, C, Y, W-135) is mandatory for all pilgrims. In addition, for those arriving from the `meningitis belt countries’, a single dose of oral ciprofloxacin is administered at arrival ports prior to the immigration process to eliminate meningococcal nasopharyngeal carriage (1). Hajj and Umrah constitute the largest annual mass gathering of pilgrims from over 180 countries with a projected growth from current 3 million to 30 million by 2030 (2). With these dual approaches, meningococcal carriage rates have been…

The Lancet
Jul 13, 2019 Volume 394Number 10193p93-186
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Research integrity: recognising the responsibilities of authors
The Lancet

The Lancet
Jul 13, 2019 Volume 394Number 10193p93-186
https://www.thelancet.com/journals/lancet/issue/current

Comment
Polio endgame options: will we have the vaccines needed?
Kimberly M Thompson

The Lancet
Jul 13, 2019 Volume 394Number 10193p93-186
https://www.thelancet.com/journals/lancet/issue/current

International failure in northwest Syria: humanitarian health catastrophe demands action
Miriam Orcutt, et al

The Lancet
Jul 13, 2019 Volume 394Number 10193p93-186
https://www.thelancet.com/journals/lancet/issue/current

Articles
The safety and immunogenicity of two novel live attenuated monovalent (serotype 2) oral poliovirus vaccines in healthy adults: a double-blind, single-centre phase 1 study
We found that the novel OPV2 candidates were safe and immunogenic in IPV-immunised adults, and our data support the further development of these vaccines to potentially be used for maintaining global eradication of neurovirulent type-2 polioviruses.
Pierre Van Damme, et al
Open Access

The Lancet
Jul 13, 2019 Volume 394Number 10193p93-186
https://www.thelancet.com/journals/lancet/issue/current

Health Policy
The G20 and development assistance for health: historical trends and crucial questions to inform a new era
Joseph L Dieleman, et al
Summary
One of the most important gatherings of the world’s economic leaders, the G20 Summit and ministerial meetings, takes place in June, 2019. The Summit presents a valuable opportunity to reflect on the provision and receipt of development assistance for health (DAH) and the role the G20 can have in shaping the future of health financing. The participants at the G20 Summit (ie, the world’s largest providers of DAH, emerging donors, and DAH recipients) and this Summit’s particular focus on global health and the Sustainable Development Goals offers a unique forum to consider the changing DAH context and its pressing questions. In this Health Policy perspective, we examined trends in DAH and its evolution over time, with a particular focus on G20 countries; pointed to persistent and emerging challenges for discussion at the G20 Summit; and highlighted key questions for G20 leaders to address to put the future of DAH on course to meet the expansive Sustainable Development Goals. Key questions include how to best focus DAH for equitable health gains, how to deliver DAH to strengthen health systems, and how to support domestic resource mobilisation and transformative partnerships for sustainable impact. These issues are discussed in the context of the growing effects of climate change, demographic and epidemiological transitions, and a global political shift towards increasing prioritisation of national interests. Although not all these questions are new, novel approaches to allocating DAH that prioritise equity, efficiency, and sustainability, particularly through domestic resource use and mobilisation are needed. Wrestling with difficult questions in a changing landscape is essential to develop a DAH financing system capable of supporting and sustaining crucial global health goals.

The Lancet
Jul 13, 2019 Volume 394Number 10193p93-186
https://www.thelancet.com/journals/lancet/issue/current

Viewpoint
When ethics and politics collide in donor-funded global health research
Katerini T Storeng,
Jennifer Palmer
In this Viewpoint, we share our experience of censorship in evaluation research for global health. Our experience shows a broader trend of donors and implementing partners who deliberately use ethical and methodological arguments to undermine essential research. In a context of chronic underfunding of universities and their growing dependence on donor-driven research grants, we propose several structural and cultural changes to prevent manipulation of research governance systems and to safeguard the independence of research…