Journal of Medical Internet Research
Viewpoint

The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks
Chih-Long Pan, Chih-Hao Lin, Yan-Ren Lin, Hsin-Yu Wen, Jet-Chau Wen
J Med Internet Res 2018 (Feb 02); 20(2):e39
ABSTRACT
Due to the increasing number of natural and man-made disasters, mass casualty incidents occur more often than ever before. As a result, health care providers need to adapt in order to cope with the overwhelming patient surge. To ensure quality and safety in health care, accurate information in pandemic disease control, death reduction, and health quality promotion should be highlighted. However, obtaining precise information in real time is an enormous challenge to all researchers of the field. In this paper, innovative strategies are presented to develop a sound information network using the concept of “witness sensors.” To overcome the reliability and quality limitations of information obtained through social media, researchers must focus on developing solutions that secure the authenticity of social media messages, especially for matters related to health. To address this challenge, we introduce a novel concept based on the two elements of “witness” and “sensor.” Witness sensors can be key players designated to minimize limitations to quality of information and to distinguish fact from fiction during critical events. In order to enhance health communication practices and deliver valid information to end users, the education and management of witness sensors should be further investigated, especially for implementation during mass casualty incidents and epidemic outbreaks.

The Lancet

Jan 27, 2018 Volume 391 Number 10118 p281-400  e2-e4
http://www.thelancet.com/journals/lancet/issue/current

Editorial
Yellow fever: a major threat to public health
The Lancet | 3 February 2018
The world’s largest fractional-dose vaccination campaign for yellow fever started on Jan 25 in Brazil, with the support of WHO. The campaign attempts to avoid the urban transmission cycle, not seen in the country since 1942. 33 people have died due to yellow fever between Jan 14 and 23, while the number of confirmed cases in the country has reached more than 130.

Although more cases of yellow fever were recorded in Brazil in 2016–17, the recent outbreak has extended into a much larger area, including highly populated cities, making it more threatening to public health. These large cities are infested by Aedes aegypti, the urban yellow fever vector, which can transmit the disease from person to person. The number of people at risk is also increasing in other tropical regions, such as South America and Africa.

Due to a global shortage of the vaccine, in outbreak emergencies WHO recommends fractional dosing to protect more people by using less antigen in each dose. Whereas studies have shown that a fifth of the standard dose can provide the same immunity as the standard full dose for at least 12 months, it is not clear how long the immunity ultimately lasts.

For routine immunisation, the standard full dose, recommended by WHO since 2013, is thought to confer lifelong protection, although supporting evidence for this view is not strong. Some Brazilian experts believe that a booster vaccine 10 years after the primary vaccination should be administered to guarantee lifetime protection.

As a zoonotic disease, with a reservoir in non-human primates, it is unlikely that yellow fever will be eradicated. However, epidemics can be prevented if populations are protected by routine immunisation and if mass vaccination campaigns are implemented quickly in response to an outbreak. A coalition of partners led by WHO, UNICEF, and Gavi, the Vaccine Alliance, aims to eliminate yellow fever epidemics worldwide by 2026. To achieve this goal, there is an urgent need for research to clarify the duration of protective levels of immunity provided by fractionated and full-dose yellow fever vaccines to support development of effective vaccination programmes.

The Lancet
Jan 27, 2018 Volume 391 Number 10118 p281-400  e2-e4
http://www.thelancet.com/journals/lancet/issue/current

The Lancet Commissions
The Lancet Commission on pollution and health
Philip J Landrigan, Richard Fuller, Nereus J R Acosta, Olusoji Adeyi, Robert Arnold, Niladri (Nil) Basu, Abdoulaye Bibi Baldé, Roberto Bertollini, Stephan Bose-O’Reilly, Jo Ivey Boufford, Patrick N Breysse, Thomas Chiles, Chulabhorn Mahidol, Awa M Coll-Seck, Maureen L Cropper, Julius Fobil, Valentin Fuster, Michael Greenstone, Andy Haines, David Hanrahan, David Hunter, Mukesh Khare, Alan Krupnick, Bruce Lanphear, Bindu Lohani, Keith Martin, Karen V Mathiasen, Maureen A McTeer, Christopher J L Murray, Johanita D Ndahimananjara, Frederica Perera, Janez Potočnik, Alexander S Preker, Jairam Ramesh, Johan Rockström, Carlos Salinas, Leona D Samson, Karti Sandilya, Peter D Sly, Kirk R Smith, Achim Steiner, Richard B Stewart, William A Suk, Onno C P van Schayck, Gautam N Yadama, Kandeh Yumkella, Ma Zhong
462
Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide—three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four.

Lancet Global Health
Feb 2018 Volume 6 Number 2 e121-e228
http://www.thelancet.com/journals/langlo/issue/current

Articles
Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services
Daniel R Hogan, Gretchen A Stevens, Ahmad Reza Hosseinpoor, Ties Boerma
Summary
Background
Achieving universal health coverage, including quality essential service coverage and financial protection for all, is target 3.8 of the Sustainable Development Goals (SDG). As a result, an index of essential health service coverage indicators was selected by the UN as SDG indicator 3.8.1. We have developed an index for measuring SDG 3.8.1, describe methods for compiling the index, and report baseline results for 2015.
Methods
16 tracer indicators were selected for the index, which included four from within each of the categories of reproductive, maternal, newborn, and child health; infectious disease; non-communicable diseases; and service capacity and access. Indicator data for 183 countries were taken from UN agency estimates or databases, supplemented with submissions from national focal points during a WHO country consultation. The index was computed using geometric means, and a subset of tracer indicators were used to summarise inequalities.
Findings
On average, countries had primary data since 2010 for 72% of the final set of indicators. The median national value for the service coverage index was 65 out of 100 (range 22–86). The index was highly correlated with other summary measures of health, and after controlling for gross national income and mean years of adult education, was associated with 21 additional years of life expectancy over the observed range of country values. Across 52 countries with sufficient data, coverage was 1% to 66% lower among the poorest quintile as compared with the national population. Sensitivity analyses suggested ranks implied by the index are fairly stable across alternative calculation methods.
Interpretation
Service coverage within universal health coverage can be measured with an index of tracer indicators. Our universal health coverage service coverage index is simple to compute by use of available country data and can be refined to incorporate relevant indicators as they become available through SDG monitoring.
Funding
Ministry of Health, Japan, and the Rockefeller Foundation.

Lancet Global Health
Feb 2018 Volume 6 Number 2 e121-e228
http://www.thelancet.com/journals/langlo/issue/current

Progress on catastrophic health spending in 133 countries: a retrospective observational study
Adam Wagstaff, Gabriela Flores, Justine Hsu, Marc-François Smitz, Kateryna Chepynoga, Leander R Buisman, Kim van Wilgenburg, Patrick Eozenou

Progress on impoverishing health spending in 122 countries: a retrospective observational study
Adam Wagstaff, Gabriela Flores, Marc-François Smitz, Justine Hsu, Kateryna Chepynoga, Patrick Eozenou

Prevalence of chronic obstructive pulmonary disease in the global population with HIV: a systematic review and meta-analysis
Jean Joel Bigna, Angeladine Malaha Kenne, Serra Lem Asangbeh, Aurelie T Sibetcheu
e193

Lancet Infectious Diseases
Feb 2018 Volume 18 Number 2 p123-226  e33-e63
http://www.thelancet.com/journals/laninf/issue/current

Editorial
The dengue vaccine dilemma
The Lancet Infectious Diseases

Lancet Infectious Diseases
Feb 2018 Volume 18 Number 2 p123-226  e33-e63
http://www.thelancet.com/journals/laninf/issue/current

Articles
Immunogenicity and safety of one versus two doses of tetravalent dengue vaccine in healthy children aged 2–17 years in Asia and Latin America: 18-month interim data from a phase 2, randomised, placebo-controlled study
Xavier Sáez-Llorens, Vianney Tricou, Delia Yu, Luis Rivera, José Jimeno, Ana Cecilia Villarreal, Epiphany Dato, Sonia Mazara, Maria Vargas, Manja Brose, Martina Rauscher, Suely Tuboi, Astrid Borkowski, Derek Wallace
Summary
Background
Development of vaccines that are effective against all four dengue virus serotypes (DENV-1–4) in all age groups is important. Here, we present 18-month interim data from an ongoing study undertaken to assess the immunogenicity and safety of Takeda’s tetravalent dengue vaccine (TDV) candidate over 48 months in children living in dengue-endemic countries.
Methods
We undertook a phase 2, multicentre, randomised, double-blind, placebo-controlled study at three sites in the Dominican Republic, Panama, and the Philippines. We randomly assigned children aged 2–17 years to receive either two TDV doses 3 months apart (group 1), one TDV dose (group 2), one TDV dose and a booster dose 1 year later (group 3), or placebo (group 4). We did the randomisation (1:2:5:1) using an interactive web response system stratified by age. The primary endpoint of this 18-month interim analysis was DENV serotype-specific antibody geometric mean titres (GMTs) in the per-protocol immunogenicity subset on days 1, 28, 91, 180, 365, 393, and 540. Secondary safety endpoints were the proportions of participants with serious adverse events and with virologically confirmed dengue in the safety set, and solicited and unsolicited adverse events in the immunogenicity subset. This trial is registered with ClinicalTrials.gov, number NCT02302066.
Findings
Between Dec 5, 2014, and Feb 13, 2015, 1800 children were randomly assigned to group 1 (n=201), group 2 (n=398), group 3 (n=1002), and group 4 (n=199). 1794 participants received at least one dose of TDV or placebo (safety set), of whom 562 participated in the immunogenicity subset and 509 were included in the per-protocol set. Antibody titres remained elevated 18 months after vaccination in all TDV groups. At day 540, in groups 1, 2, 3, and 4, respectively, DENV-1 GMTs were 476 (95% CI 286–791), 461 (329–647), 1056 (804–1388), and 92 (49–173); DENV-2 GMTs were 1212 (842–1744), 1242 (947–1628), 1457 (1182–1796), and 177 (93–337); DENV-3 GMTs were 286 (171–478), 298 (205–433), 548 (411–730), and 78 (44–137); and DENV-4 GMTs were 98 (65–150), 102 (75–139), 172 (133–222), and 33 (21–52). Limited differences in GMTs were observed between groups 1 and 2 (in which participants received one and two doses of TDV, respectively). In baseline-seronegative participants, a 1-year booster clearly increased GMTs. Vaccine-related unsolicited adverse events occurred in 14 (2%) of 562 participants, but no vaccine-related serious adverse events arose. Symptomatic, virologically confirmed dengue was recorded in 21 (1·3%) of 1596 participants vaccinated with TDV compared with nine (4·5%) of 198 placebo recipients.
Interpretation
TDV was well tolerated and immunogenic against all four dengue serotypes, irrespective of baseline dengue serostatus. These data provide proof of concept for TDV and support the ongoing phase 3 efficacy assessment of two doses 3 months apart.
Funding
Takeda Vaccines.

Lancet Infectious Diseases
Feb 2018 Volume 18 Number 2 p123-226  e33-e63
http://www.thelancet.com/journals/laninf/issue/current

Review
Antimicrobial resistance among children in sub-Saharan Africa
Phoebe C M Williams, David Isaacs, James A Berkley
Open Access
Summary
Antimicrobial resistance is an important threat to international health. Therapeutic guidelines for empirical treatment of common life-threatening infections depend on available information regarding microbial aetiology and antimicrobial susceptibility, but sub-Saharan Africa lacks diagnostic capacity and antimicrobial resistance surveillance. We systematically reviewed studies of antimicrobial resistance among children in sub-Saharan Africa since 2005. 18 of 1075 articles reviewed met inclusion criteria, providing data from 67,451 invasive bacterial isolates from inconsistently defined populations in predominantly urban tertiary settings. Among neonates, Gram-negative organisms were the predominant cause of early-onset neonatal sepsis, with a high prevalence of extended-spectrum β-lactamase-producing organisms. Gram-positive bacteria were responsible for a high proportion of infections among children beyond the neon atal period, with high reported prevalence of non-susceptibility to treatment advocated by the WHO therapeutic guidelines. There are few up-to-date or representative studies given the magnitude of the problem of antimicrobial resistance, especially regarding community-acquired infections. Research should focus on differentiating resistance in community-acquired versus hospital-acquired infections, implementation of standardised reporting systems, and pragmatic clinical trials to assess the efficacy of alternative treatment regimens.

Medical Decision Making (MDM)
Volume 38, Issue 2, February 2018
http://mdm.sagepub.com/content/current

Original Articles
Using Cluster Analysis to Group Countries for Cost-effectiveness Analysis: An Application to Sub-Saharan Africa
Louise B. Russell, Gyan Bhanot, Sun-Young Kim, Anushua Sinha
First Published August 19, 2017; pp. 139–149
Abstract
Objective. To explore the use of cluster analysis to define groups of similar countries for the purpose of evaluating the cost-effectiveness of a public health intervention—maternal immunization—within the constraints of a project budget originally meant for an overall regional analysis.
Methods. We used the most common cluster analysis algorithm, K-means, and the most common measure of distance, Euclidean distance, to group 37 low-income, sub-Saharan African countries on the basis of 24 measures of economic development, general health resources, and past success in public health programs. The groups were tested for robustness and reviewed by regional disease experts.
Results. We explored 2-, 3- and 4-group clustering. Public health performance was consistently important in determining the groups. For the 2-group clustering, for example, infant mortality in Group 1 was 81 per 1,000 live births compared with 51 per 1,000 in Group 2, and 67% of children in Group 1 received DPT immunization compared with 87% in Group 2. The experts preferred four groups to fewer, on the ground that national decision makers would more readily recognize their country among four groups.
Conclusions. Clusters defined by K-means clustering made sense to subject experts and allowed a more detailed evaluation of the cost-effectiveness of maternal immunization within the constraint of the project budget. The method may be useful for other evaluations that, without having the resources to conduct separate analyses for each unit, seek to inform decision makers in numerous countries or subdivisions within countries, such as states or counties.

New England Journal of Medicine
February 1, 2018  Vol. 378 No. 5
http://www.nejm.org/toc/nejm/medical-journal

Health Policy Report
The Challenging Quest to Improve Rural Health Care
John K. Iglehart
In the United States, rural populations have a lower life expectancy than urban populations and face shortages of health care providers. This report discusses the challenges facing rural health care systems and efforts to expand the rural health care workforce.

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 3 February 2018]

Research Article
Infectious Disease Risk and Vaccination in Northern Syria after 5 Years of Civil War: The MSF Experience
February 2, 2018 ·
Alan de Lima Pereira, Rosamund Southgate, Hikmet Ahmed, Penelope O’Connor, Vanessa Cramond, Annick Lenglet
Abstract
Introduction: In 2015, following an influx of population into Kobanê in northern Syria, Médecins Sans Frontières (MSF) in collaboration with the Kobanê Health Administration (KHA) initiated primary healthcare activities. A vaccination coverage survey and vaccine-preventable disease (VPD) risk analysis were undertaken to clarify the VPD risk and vaccination needs. This was followed by a measles Supplementary Immunization Activity (SIA). We describe the methods and results used for this prioritisation activity around vaccination in Kobanê in 2015.
Methods: We implemented a pre-SIA survey in 135 randomly-selected households in Kobanê using a vaccination history questionnaire for all children <5 years. We conducted a VPD Risk Analysis using MSF ‘Preventive Vaccination in Humanitarian Emergencies’ guidance to prioritize antigens with the highest public health threat for mass vaccination activities. A Measles SIA was then implemented and followed by vaccine coverage survey in 282 randomly-selected households targeting children <5 years.
Results: The pre-SIA survey showed that 168/212 children (79.3%; 95%CI=72.7-84.6%) had received one vaccine or more in their lifetime. Forty-three children (20.3%; 95%CI: 15.1-26.6%) had received all vaccines due by their age; only one was <12 months old and this child had received all vaccinations outside of Syria. The VPD Risk Analysis prioritised measles, Haemophilus Influenza type B (Hib) and Pneumococcus vaccinations. In the measles SIA, 3410 children aged 6-59 months were vaccinated. The use of multiple small vaccination sites to reduce risks associated with crowds in this active conflict setting was noted as a lesson learnt. The post-SIA survey estimated 82% (95%CI: 76.9-85.9%; n=229/280) measles vaccination coverage in children 6-59 months.
Discussion: As a result of the conflict in Syria, the progressive collapse of the health care system in Kobanê has resulted in low vaccine coverage rates, particularly in younger age groups. The repeated displacements of the population, attacks on health institutions and exodus of healthcare workers, challenge the resumption of routine immunization in this conflict setting and limit the use of SIAs to ensure sustainable immunity to VPDs. We have shown that the risk for several VPDs in Kobanê remains high.
Conclusion: We call on all health actors and the international community to work towards re-establishment of routine immunisation activities as a priority to ensure that children who have had no access to vaccination in the last five years are adequately protected for VPDs as soon as possible.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 3 February 2018)

Editorial
What’s coming for health science and policy in 2018? Global experts look ahead in their field
The PLOS Medicine Editors , Soumya Swaminathan, Robin S. Room, Louise C. Ivers, Graham Hillis, Rebecca F. Grais, Zulfiqar A. Bhutta, Peter Byass
| published 30 Jan 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002498

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

BBC
http://www.bbc.co.uk/
Accessed 3 February 2018
3 Feb 2018
Philippines gripped by dengue vaccine fears

Forbes
http://www.forbes.com/
Accessed 3 February 2018
Despite Doubters, Moderna Raises $500 Million, Is Now Worth $7 Billion
Matthew Herper, Forbes Staff
Moderna Therapeutics, a biotechnology firm that is developing drugs that work on a genetic messaging system that is essentially to all living cells, has raised $500 million from a group of new and current investors.

Huffington Post UK
http://www.huffingtonpost.co.uk/
Accessed 3 February 2018
Why It’s Our Duty To Get Immunised
| 29 January 2018
…The flu outbreak is just one example of a crisis which could have been averted if the public was more proactive in its approach to managing its own health. The flu vaccine is widely available, for the price of a cinema ticket and at multiple convenient locations on the high street, ranging from independent pharmacies to high street chains and even supermarkets.

New York Times
http://www.nytimes.com/
Accessed 3 February 2018
U.S. Flu Outbreak Worsens; Hospitalizations Highest in Nearly a Decade: CDC
The U.S. flu outbreak worsened over the past week as more people headed to doctors’ offices and emergency rooms, with hospitalizations at the highest in nearly 10 years, U.S. health officials said on Friday.
Feb. 2, 2018

India Wants to Give Half a Billion People Free Health Care
1 February 2018
India announced on Thursday a sweeping plan to give half a billion poor Indians free access to health care, as Prime Minister Narendra Modi seeks to address rising demands for greater economic and social protections before national elections next year….The health care plan, part of the government’s 2018-19 budget presented on Thursday, would offer 100 million families up to 500,000 rupees, or about $7,860, of coverage each year. That sum, while small by Western standards, would be enough to cover the equivalent of five heart surgeries in India. Officials did not outline eligibility requirements, and many details of the program have yet to be finalized.

Scientific American
https://www.scientificamerican.com/
Accessed 3 February 2018
Seth Berkley: A Completely Preventable Public Health Crisis
1 February 2018
An outbreak of diphtheria in a Rohingya refugee camp in Bangladesh makes it clear that these people were living in substandard conditions before they fled Myanmar
… This deadly respiratory disease is as preventable as it is infectious, thanks to one of the most widely available vaccines in the world. So, while the densely populated conditions may have facilitated the spread of the disease, the refugee camps are not the cause. The fact that there is a diphtheria outbreak in the first place is a clear indication that these people did not have access to even the most basic vaccines and brings into question the conditions they were living in before they arrived at the camp. This outbreak is not the product of conditions within the camps, but rather a deadly legacy of the conditions in which they had been living before they fled Myanmar.

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

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

– pdf version:  A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_27 Jan 2018

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

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

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

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

Milestones :: Perspectives

 142nd session of the WHO Executive Board
19 January 2018 – Next week the WHO Executive Board will set the agenda for the World Health Assembly, and determine how to best promote health, keep the world safe, and serve the vulnerable. The session takes place on 22–27 January 2018 in Geneva, Switzerland, and will be webcast live.
:: Provisional agenda
:: All documentation
[Selected Documentation]
Decisions [interim report]
In an effort to respond to Member States’ needs, the present texts have been made available as quickly as possible. The definitive versions of the resolutions and decisions adopted, edited for the Official Records, will be made available in due course.

EB142(1) – Implementation of International Health Regulations (2005): draft five-year global strategic plan to improve public health preparedness and response, 2018–2023

EB142(2) – Polio transition planning

EB142(3) – Addressing the global shortage of, and access to, medicines and vaccines

EB142(4) – Global strategy and plan of action on public health, innovation and intellectual property

EB142(5) – Health, environment and climate change

EB142(6) – Maternal, infant and young child nutrition

EB142(7) – Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits

EB142(8) – Evaluation of the election of the Director-General of the World Health Organization

EB142(9) – Engagement with non-State actors
 
::::::
 
Dr Carissa Etienne elected for a second term as WHO Regional Director for the Americas
WHO | 23 January 2018
The WHO Executive Board, currently holding its 142nd session in Geneva, has appointed Dr Carissa Etienne for a second term as WHO Regional Director for Americas….
“My vision for the Americas is of a society free from inequality where everyone, particularly the most vulnerable and disadvantaged people, can lead healthy, meaningful and productive lives,” said Dr Etienne. “One of my top priorities is ensuring that everyone has access to quality health services without fear of being impoverished.”
Under her leadership, during these past five years PAHO led preparedness and response efforts to the regional Zika and chikungunya epidemics as well as to yellow fever outbreaks in Brazil. The Americas became the first WHO Region to eliminate the endemic transmission of measles, rubella and congenital rubella syndrome…

Dengvaxia Update
We continue to monitor developments associated with Dengvaxia. We did not identify any new press releases or statements on the Sanofi website.
.
Sanofi agrees to pay for proven Dengvaxia adverse events in the Philippines
by Eric Sagonowsky | Fierce Pharma
Jan 23, 2018 11:41am
Sanofi had already agreed to refund the Philippines for unused Dengvaxia shots as part of an ongoing safety controversy there. Now an executive has told legislators the company will “shoulder the cost” of any adverse events that are scientifically linked to vaccination.

Speaking at a Senate hearing on Monday, Sanofi Pasteur Asia-Pacific head Thomas Triomphe said that “should there be any case related to vaccination, death or any other case, we will shoulder the cost, if there is a causality that has been demonstrated through scientific evidence,” according to The Inquirer.

The testimony came as a safety controversy for the vaccine intensified over the last week, with reports that preliminary autopsy results showed a common cause of death among children who died after vaccination, though experts said no causal link was found. At the same hearing, an expert panel from the Philippine General Hospital reported that there was “no evidence linking Dengvaxia to any deaths,” a Sanofi spokesperson told FiercePharma on Monday.

“This finding is consistent with the fact that Sanofi Pasteur has not had any reports of deaths due to vaccination in any of the clinical studies of the vaccine involving over 40,000 people nor in the public or private use of Dengvaxia where over 1 million dose of the vaccine have been administered in several endemic countries,” the spokesperson added…

.

The Lancet Infectious Diseases
February 2018
Editorial
The dengue vaccine dilemma 
Dengue is the most common mosquito-transmitted viral infectious disease. A 2016 study estimated nearly 60 million symptomatic dengue cases worldwide every year (estimates including asymptomatic cases are at least six times higher), resulting in about 10,000 deaths. 4 billion people are at-risk in 128 countries where aedes mosquito vectors are present. Efforts to develop a vaccine against dengue have been ongoing for decades. The first such vaccine to be used routinely is CYD-TDV (marketed as Dengvaxia), a live, attenuated tetravalent product developed by Sanofi Pasteur. Following two phase 3 clinical trials published in 2014, Dengvaxia was licenced in December, 2015, and approved in 19 countries. Subsequently, regional mass vaccination programmes were launched in the Philippines and Brazil, targeting 1 million people.

However, after reassessment of data from the clinical trials, Sanofi warned on Nov 29, 2017, that the vaccine can increase the risk of severe dengue in particular circumstances. The vaccination programme in the Philippines has been suspended, with information released to WHO by Sanofi raising questions about future use of Dengvaxia.

How any vaccine against dengue is used is complicated by the fact that virus occurs in four serotypes, and immunity against any one serotype does not generate lasting immunity against the other three, hence the need for a tetravalent vaccine. Furthermore, being infected with—and developing immunity to—one viral serotype seems to be the trigger that can lead to a patient having more severe disease manifestations when subsequently infected with a different serotype, a phenomenon known as antibody-dependent enhancement. Infections with the third and fourth serotypes, if they occur, usually result in milder disease.

Expert opinion and a position paper on Dengvaxia were issued by WHO in 2016. When licenced, the vaccine was approved for people aged 9–45 years, in which group the phase 3 trials at 2 years of follow-up showed a reduction in severe dengue of 93% and of hospital admissions due to dengue of 82%. The vaccine was not approved in younger children because of less favourable efficacy and safety; in particular, an increase in hospital admissions due to dengue among those aged 2–5 years. This finding, which might have been an effect of age or because of more dengue-unexposed (ie, seronegative) individuals in the younger age group, could not then be explained since serostatus before immunisation was unknown for most trial participants. However, some experts warned in 2016 that the increased risk of hospital admission was a serious safety concern, including Maíra Aguiar and colleagues in this journal, a point emphasised by Aguiar and Nico Stollenwerk in their Correspondence published online on Dec 21, 2017.

Sanofi’s statement in November came about because—prompted by WHO—the company developed an assay to estimate dengue serostatus before vaccination in trial participants. A supplemental statement from WHO on Dec 22, 2017, verifies that overall Dengvaxia reduces the risk of confirmed severe dengue and hospital admissions. Vaccine recipients presumed to be seropositive at immunisation had sustained protection during 5 years’ follow-up. However, among recipients seronegative before immunisation—and regardless of age at vaccination—there was a higher risk of severe dengue disease and hospital admission compared with unvaccinated controls. Thus, in seronegative individuals, the vaccine seems to enhance the severity of subsequent dengue infection.

Where then do these findings leave the status of Dengvaxia and other candidate vaccines against dengue? The Dec 22 WHO statement notes that in settings of high dengue seroprevalence, the vaccine is likely still beneficial at a population level. However, Aguiar and Stollenwerk state that “ethically no one should have been put under risk by receiving this vaccine”. Age was clearly used as a proxy for seropositive status in the original recommendations, a position that is no longer tenable. Indeed, the new WHO recommendation is for vaccination only in individuals with proven past dengue infection. But no point-of-care test for dengue serostatus exists. In a phase 2 trial of the Takeda TDV tetravalent dengue vaccine published in this issue, serostatus at the time of vaccination was measured, but follow-up is too short to detect risks associated with being seronegative. Phase 3 trials of the Takeda vaccine and another from the Instituto Butantan, Brazil, whose primary completion dates are later this year, might provide more answers. A new position paper from WHO is also expected later this year. In the meantime, a rapid assay of dengue serostatus is surely a priority.

Featured Journal Content

PLoS One
http://www.plosone.org/
[Accessed 27 January 2018]

Research Article
The influence of political ideology and trust on willingness to vaccinate
Bert Baumgaertner, Juliet E. Carlisle, Florian Justwan
Research Article | published 25 Jan 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0191728
Abstract
In light of the increasing refusal of some parents to vaccinate children, public health strategies have focused on increasing knowledge and awareness based on a “knowledge-deficit” approach. However, decisions about vaccination are based on more than mere knowledge of risks, costs, and benefits. Individual decision making about vaccinating involves many other factors including those related to emotion, culture, religion, and socio-political context. In this paper, we use a nationally representative internet survey in the U.S. to investigate socio-political characteristics to assess attitudes about vaccination. In particular, we consider how political ideology and trust affect opinions about vaccinations for flu, pertussis, and measles. Our findings demonstrate that ideology has a direct effect on vaccine attitudes. In particular, conservative respondents are less likely to express pro-vaccination beliefs than other individuals. Furthermore, ideology also has an indirect effect on immunization propensity. The ideology variable predicts an indicator capturing trust in government medical experts, which in turn helps to explain individual-level variation with regards to attitudes about vaccine choice.

Emergencies

 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 24 January 2018 [GPEI]
:: New on http://polioeradication.org/: In one of the final strongholds of the poliovirus, vaccination coverage is improving thanks to the women working to access children.
:: In Pakistan, we documented some of the high-risk mobile children that must be visited by vaccinators during the low transmission season.
::  By expanding environmental surveillance, Afghanistan hopes to track the movement of poliovirus with more accuracy than ever before.

:: Summary of newly-reported viruses this week:
…Afghanistan:  One new case of wild poliovirus type 1 (WPV1) has been reported in Nangarhar province. One new WPV1 positive environmental sample has been reported in Kandahar province.
… Pakistan: Two new WPV1 positive environmental samples have been reported, one collected from Sindh province, and one from Balochistan province.

::::::
 
Syria cVDPV2 outbreak situation report 31, 23 January 2018
Situation update 23 January 2018
:: No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 74. The most recent case (by date of onset of paralysis) is 21 September 2017 from Boukamal district, Deir Ez-Zor governorate.
:: The first round of the second phase of the outbreak response has been completed in all governorates (Deir Ez-Zor, Homs, Hasakah and Raqqa) with vaccination activities finishing on 21 January.
:: Administrative data has been received from all areas except eastern Deir Ez-Zor.
:: Post-campaign monitoring began 21 January in all governorates.
:: Preparation for the second round (IPV) continues. Global Polio Eradication Initiative (GPEI) partners continue to assist.

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

WHO Grade 3 Emergencies  [to 27 January 2018]
The Syrian Arab Republic
:: Syria cVDPV2 outbreak situation report 31, 23 January 2018
[See Polio above for detail]

Yemen
:: WHO airlifts 200 tonnes of health supplies to Yemen
SANA’A, 18 January 2018 — The World Health Organization has delivered 200 tonnes of life-saving medicines and health supplies to Yemen. Four United Nations planes carrying the cargo landed in Sana’a Airport this week.
The shipments include essential medicines, insulin vials, antibiotics, rabies vaccines, intravenous (IV) fluids, and other medical supplies and equipment…

Nigeria 
Nigeria set to vaccinate 25 million people, its biggest yellow fever campaign ever  24 January 2018
[See Yellow Fever below for more detail]
 
::::::
 
WHO Grade 2 Emergencies  [to 27 January 2018]
Ukraine
:: Ukraine’s efforts to stop measles outbreak continue as case total increases
16 January 2018 — Measles continues to spread in Ukraine, with new cases now being reported in all oblasts and Kyiv. These cases are the latest in an expanding outbreak that affected over 3000 people and claimed the lives of 5 children and adults in 2017, according to preliminary data. The latest information from other countries in the WHO European Region also indicates a rise in cases, including large measles outbreaks affecting Greece, Italy and Romania.

::::::
::::::
 
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
:: 26 Jan 2018 – Is the world becoming numb to the killing of children? – Statement by Fran Equiza, UNICEF Representative in Syria [EN/AR]

DRC  
:: Deteriorating humanitarian crisis in DR Congo demands largest ever appeal
(Kinshasa, 18 January 2018) The dramatic deterioration of the humanitarian situation in the Democratic Republic of the Congo in 2017 has forced humanitarian actors to launch an appeal for USD 1.68 billion for 2018, the largest ever funding appeal for the country where 13.1 million people require humanitarian assistance.
The funding is required to urgently assist some 10.5 million Congolese people in 2018. Geographical expansion of the humanitarian needs and worsening situations in existing crisis hotspots all require a step change of the response of the international community to address life-threatening humanitarian and protection needs…

Yemen 
:: 20 Jan 2018  US$ 2.96 billion needed to provide life-saving assistance to 13.1 million people in Yemen in 2018 [EN/AR]
 
::::::

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.
ROHINGYA REFUGEE CRISIS
:: ISCG Situation Update: Rohingya Refugee Crisis, Cox’s Bazar | 21 January 2018

Ethiopia  
:: 23 Jan 2018  Ethiopia Humanitarian Bulletin Issue 45 | 08 – 20 January 2018
HIGHLIGHTS
…Opening of Gaaluun bridge at Dawa river improves humanitarian access to Dawa zone.
…As part of the national plan to rehabilitate internally displaced persons in Oromia and Somali regions, the Oromia region is settling some 86,000 IDPs in 12 towns across the region.
…An ‘Alert’ released by Government and humanitarian partners estimated up to 7 million people in need of humanitarian assistance in the first half of 2018, requiring some US$895 milliON
 
::::::
::::::
 
Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

MERS-CoV [to 27 January 2018]
http://www.who.int/emergencies/mers-cov/en/
DONS
Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia  26 January 2018
Between 9 December 2017 and 17 January 2018, the National IHR Focal Point of The Kingdom of Saudi Arabia reported 20 additional cases of Middle East Respiratory Syndrome (MERS), including eight deaths. In addition, one death from a previously reported case was reported to WHO…
 
Yellow Fever  [to 27 January 2018]
http://www.who.int/csr/disease/yellowfev/en/
:: Brazil launches world’s largest campaign with fractional-dose yellow fever vaccine
Brasilia, January 25, 2018 (PAHO) – Brazil today launched a mass immunization campaign that will deliver fractional doses of yellow fever vaccine to residents of 69 municipalities in the states of Rio de Janeiro and São Paulo. The strategic plan for the campaign was developed with support from the Pan American Health Organization (PAHO) and the World Health Organization (WHO). It will be the world’s largest vaccination campaign, to date, using fractional doses of yellow fever vaccine.
Some 23.8 million people are expected to be vaccinated during the campaign, including 10.3 million in the state of São Paulo and 10 million in the state of Rio de Janeiro. The state of Bahia is expected to begin vaccinating on 19 February 2018 with an estimated target population of 3.3 million people to be reached with the vaccine..

:: Nigeria set to vaccinate 25 million people, its biggest yellow fever campaign ever
24 January 2018, Abuja – The Government of Nigeria will launch a mass vaccination campaign to prevent the spread of yellow fever on Thursday (January 25) with support from the World Health Organization (WHO) and partners. More than 25 million people will be vaccinated throughout 2018, in the largest yellow fever vaccination drive in the country’s history.
The immunization plan is part of efforts to eliminate yellow fever epidemics globally by 2026. The preventive campaign will use vaccines funded by Gavi, the Vaccine Alliance, and will be supported by UNICEF. It will begin on 25 January in Kogi, Kwara and Zamfara states, and then move to Borno state where the campaign will focus on camps for internally displaced persons and surrounding host communities. More than 8.6 million people will be vaccinated in the four states in the coming days.
“The goal of the Yellow Fever Preventive Mass Vaccination Campaign is to reduce yellow fever transmission by achieving 90% coverage in implementing States and Local Government Areas in line with the strategy for the Elimination of Yellow fever Epidemics by 2026,” said Dr Faisal Shuaib, Executive Director of National Primary Healthcare Development Agency…

WHO & Regional Offices [to 27 January 2018]

142nd session of the WHO Executive Board
19 January 2018 – Next week the WHO Executive Board will set the agenda for the World Health Assembly, and determine how to best promote health, keep the world safe, and serve the vulnerable. The session takes place on
22–27 January 2018 in Geneva, Switzerland, and will be webcast live.
:: Provisional agenda
:: All documentation
[See Milestones above for more detail]

World Leprosy Day: ending transmission among children
26 January 2018 – National programmes must boost active case-finding, strengthen surveillance, improve contact-tracing and focus more on early detection of leprosy cases among children to ensure achievement of the global target of zero child infections by 2020. This call comes as the world observers World Leprosy Day on Sunday, 28 January.
 
Weekly Epidemiological Record, 26 January 2018, vol. 93, 04/05 (pp. 33–44)
:: Meeting of the International Task Force for Disease Eradication, October 2017
:: Fact sheet on tuberculosis (updated January 2018)

::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO promotes one-health approach to enhance response to zoonoses in South Sudan
25 January 2018
:: Nigeria set to vaccinate 25 million people, its biggest yellow fever campaign ever – Copy
24 January 2018
:: WHO prioritizes water, sanitation and hygiene (WASH) services in health care facilities to achieve health goals in South Sudan  24 January 2018
:: Government of Uganda confirms outbreak of Crimean-Congo hemorrhagic and Rift Valley fevers  24 January 2018
:: Antimicrobial Consumption Monitoring in Mauritius  23 January 2018
:: Strengthening rational use of Medicines in Tanzania  23 January 2018
:: The United Nations in Zambia, CDC and DFID commend government’s initiative of setting up an efficient cholera treatment hospital and for scaling up preventive interventions in the community 22 January 2018

WHO Region of the Americas PAHO
:: 2017 in review: 10 key public health events in the Americas (12/20/2017)

WHO South-East Asia Region SEARO
:: Nearly half a million children being vaccinated against diphtheria in Cox’s Bazar  14 January 2018
 
WHO European Region EURO
::  Understanding and addressing the mental health needs of adolescents 26-01-2018
:: Cross-sectoral toolkit to guide Member States along SDG roadmap 25-01-2018

WHO Eastern Mediterranean Region EMRO
:: New tool supports systematic use of research evidence for public health decision-making
Cairo, 25 January 2018 – As a result of collaborative work between WHO and several academic institutions, a tool has been developed to streamline use of qualitative research evidence in public health decision-making. A series of academic papers published in the Implementation Science journal this week provides a scientific tool for assessing how much confidence to place in findings from qualitative evidence syntheses. The tool known as CERQual has been designed to help decision-makers use qualitative evidence for decisions and policies about health care and social welfare
:: WHO responds to humanitarian needs in Tripoli with the support of ECHO  22 January 2018

WHO Western Pacific Region
:: Healthy Islands: South Pacific Tourism Organisation and WHO forge new partnership
SUVA, Fiji, 17 January 2018 – The World Health Organization and the South Pacific Tourism Organisation join forces to promote healthy tourism in the Pacific. Through a new partnership, the organizations commit to promoting the health and well-being of tourists and the tourism workforce by establishing smoke-free public places, increasing access to healthy local food options and physical activities and improving accessibility for persons with disabilities in the tourism sector.
 

CDC/ACIP [to 27 January 2018]

http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Friday, January 26, 2018
CDC Update on Widespread Flu Activity – Transcript
… . It has been a tough flu season so far this year. And while flu activity is beginning to go down in parts of the country, it remains high for most the U.S., with some areas still rising. Most people with influenza are being infected with the H3N2 influenza virus. And in seasons where H3N2 is the main cause of influenza, we see more cases, more visits to the doctor, more hospitalizations, and more deaths, especially among older people. This season now looking like the 2014-15 season where H3N2 predominated. In that season, was categorized as a high severity season..

Thursday, January 25, 2018
More birth defects seen in parts of U.S. with local Zika spread – Press Release
Birth defects most strongly linked to Zika virus infection during pregnancy have increased in parts of the United States that have had local Zika virus transmission, according to a report in CDC’s Morbidity and Mortality Weekly Report (MMWR). Areas with local transmission of Zika – southern Florida, a portion of south Texas, and Puerto Rico – saw a 21 percent increase in births with outcomes most strongly linked to Zika virus in the last half of 2016 compared with births in the first half of that year…
 
MMWR News Synopsis for January 25, 2018
Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection – 15 States and U.S. Territories
Zika remains a threat to mothers and babies in the United States. Though the relationship between the increase in birth defects in certain areas and local Zika virus transmission has not been confirmed, this increase highlights the critical need for strong and rapid public health surveillance systems to identify babies with birth defects. About 3 out of every 1,000 babies born in 15 U.S. states and territories in 2016 had a birth defect meeting the case definition for birth defects potentially related to Zika virus infection during pregnancy. Areas with local Zika virus transmission in the U.S. had a 21 percent increase in the birth defects most strongly linked to Zika virus infection during pregnancy in the last half of 2016 compared with the first half. It is not known if this increase is due to local transmission of Zika virus alone, or if there are other contributing factors. These findings underscore the importance of surveillance for early identification of birth defects potentially related to Zika virus infection and the need for continued monitoring in areas at risk for Zika.

Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines
Vaccination is our best tool to prevent shingles, and Shingrix® is now the preferred shingles vaccine. Every year in the U.S., about 1 million people get shingles – and the vast majority are older than 50. On October 25, 2017, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted that the Shingrix® vaccine is the preferred vaccine to prevent shingles. This new vaccine is more than 90 percent effective, even among the elderly, and maintained high protection during the four years of clinical trials. Previously, Zostavax® had been the only vaccine for seniors to prevent shingles. For adults 60 years and older, Zostavax is about 51 percent effective in preventing shingles. Zostavax is less protective in the elderly and protection wanes over time. Shingrix is now recommended as the preferred vaccine to prevent shingles for adults 50 and older. Eligible adults should get Shingrix even if they previously received Zostavax.

Announcements
 
BMGF – Gates Foundation  [to 27 January 2018]
http://www.gatesfoundation.org/Media-Center/Press-Releases
JANUARY 26, 2018
Investing in Africa: the EU and Bill & Melinda Gates Foundation commit a further €100 million
BRUSSELS (25 January 2018) – The Bill & Melinda Gates Foundation today announced their commitment to contribute to the EU’s External Investment Plan.
The Gates Foundation will contribute $50 million (€40.9 million) in financing, as well as an additional $12.5 million (€10.2 million) in technical assistance, to investment projects in the health sector in Africa through the EU’s framework to improve sustainable investments in Africa.       This pooling of resources is designed to encourage additional private investment towards achieving the Sustainable Development Goals, and will allow successful projects to be scaled up more rapidly. The European Commission welcomes this strong support to its efforts towards sustainable development in Africa, and will match this contribution with another €50 million…

JANUARY 26, 2018
Initiative Announced to End Malaria in Central America and the Dominican Republic
Inter-American Development Bank, Bill & Melinda Gates Foundation and Carlos Slim Foundation to endorse five-year initiative
DAVOS, Switzerland – The Inter-American Development Bank (IDB), the Bill & Melinda Gates Foundation and the Carlos Slim Foundation today announced an initiative to support seven Central American countries and the Dominican Republic in taking the final steps necessary to eliminate malaria in their territories. The Regional Malaria Elimination Initiative (RMEI) will bring $83.6 million in new funds, and is expected to leverage over $100 million in domestic financing and $39 million of existing donor resources across the region by 2022 to ensure malaria remains a top health and development priority despite dwindling numbers of cases. The funding will serve to close the technical and financing gaps to support and execute country elimination plans in Belize, Costa Rica, the Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua and Panama…

European Medicines Agency  [to 27 January 2018]
http://www.ema.europa.eu/ema/
26/01/2018
Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 22-25 January 2018
…The Committee recommended granting a marketing authorisation for Shingrix (recombinant, adjuvanted Herpes zoster vaccine), a vaccine for the prevention of herpes zoster and post-herpetic neuralgia in adults 50 years of age or older….

23/01/2018
Human medicines: highlights of 2017
92 medicines recommended for approval, including 35 with a new active substance …
 
Gavi [to 27 January 2018]
http://www.gavi.org/library/news/press-releases/
25 January 2018
Orange, Gavi and Côte d’Ivoire Ministry of Health join forces to boost child immunisation
The mobile phone project “M-Vaccin Côte d’ Ivoire” will raise awareness of immunisation among parents and communities to increase vaccine coverage in regions with the lowest coverage.
Davos, 25 January 2018 – Orange SA and Gavi, the Vaccine Alliance, will enter into a partnership with the Côte d’Ivoire Ministry of Health to increase immunisation rates in the regions and districts with the lowest vaccine coverage, it was announced at the World Economic Forum today.
The “M-Vaccin Côte d’Ivoire” project uses Orange mobile technology to inform parents about the importance of vaccination by sending text and voice messages in the local language. Targeted messages will also help ensure parents don’t miss immunisation sessions by reminding them of their children’s schedule and dates.
“This new partnership is truly innovative and important for the children of Côte d’Ivoire,” explained Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Parents often do not receive enough information about the importance of immunisation because they live a long way from health centres or in hard-to-reach places. These voice and text messages should therefore have a significant impact and lead to an increase in vaccine coverage.”…

Global Fund [to 27 January 2018]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
Lombard Odier and the Global Fund Join Forces to Expand Private Investment In Global Health
26 January 2018
Lombard Odier and the Global Fund are pleased to announce a strategic partnership to rethink traditional approaches to investment and philanthropy to make it easier for more people to contribute to the fight against some of the world’s most pressing health challenges. Together they will create innovative solutions that allow investors to meet both their goals of doing well financially and doing good socially…
Lombard Odier and the Global Fund have come together in their belief that private sector investment is a vital resource that needs to be better employed to support the sustainable development agenda – particularly ending HIV, TB and malaria as epidemics, and building strong, resilient systems for health. The demand for capital is high. A funding gap of US$20 billion was identified for 2017-2019 to implement approved strategies to fight the three diseases in countries where the Global Fund invests, so every extra dollar can help to maximize the positive impact of the Global Fund partnership. Increased funding can also support innovative, evidence-based approaches that generate greater impact for communities affected by the diseases…

News
Global Fund and Partners Launch HER
24 January 2018
The Global Fund to Fight AIDS, Tuberculosis and Malaria and partners pledged support for HER – HIV Epidemic Response – an initiative to build private sector support for programs that address HIV in 13 African countries where adolescent girls and young women face disproportionate risk.
 
JEE Alliance  [to 27 January 2018]
https://www.jeealliance.org/
24.1.2018
Alliance successes in 2017 and an update on 2018
The year 2017 was the first full year of the work of the JEE Alliance. During the year, 15 new members joined the Alliance, contributing the wealth of expertise and experience. There are now 68 members…
 
NIH  [to 27 January 2018]
http://www.nih.gov/news-events/news-releases
January 24, 2018
15 years later, PEPFAR continues to save lives
— NIAID experts highlight federal program’s unprecedented impact on HIV pandemic.

Study links gut-homing protein levels with HIV infection risk, disease progression
January 24, 2018 — NIH clinical trial is testing antibody against the protein in people with HIV.

NIH begins large HIV treatment study in pregnant women
January 24, 2018 — Clinical trial will compare three antiretroviral drug regimens.

NIH to launch genome editing research program
January 23, 2018 — Somatic Cell Genome Editing aims to develop tools for safe and effective genome editing in humans.

Flu infection study increases understanding of natural immunity
January 23, 2018 — Findings illustrate role of specific antibodies.
 
 
PATH  [to 27 January 2018]
http://www.path.org/news/index.php
Press release | January 24, 2018
India-made rotavirus vaccine achieves World Health Organization prequalification
ROTAVAC® will now be available for procurement by United Nations agencies and Gavi, the Vaccine Alliance, for use in low-resource countries
New Delhi, January 24, 2018—PATH applauds Indian vaccine manufacturer Bharat Biotech for receiving prequalification from the World Health Organization (WHO) for their oral rotavirus vaccine, ROTAVAC. As a partner in the development of ROTAVAC, PATH worked with the Indian Department of Biotechnology, the Society for Applied Studies, and Bharat Biotech on the clinical trials that demonstrated the safety and efficacy of the vaccine…

UNAIDS [to 27 January 2018]
http://www.unaids.org/en
22 January 2018
Update
How do investment vehicles and innovations work together to deliver better health care?
UNAIDS, ICV, Johnson & Johnson, BD and the Center for Global Health and Diplomacy are hosting a forum entitled Transformational Aid for Development in order to create connections for scaling up innovations and investments for health and to reach vulnerable populations…

UNICEF  [to 27 January 2018]
https://www.unicef.org/media/
24 January 2018
More action needed to improve security and humanitarian access in Myanmar if Rohingya children are to return safely – UNICEF
COX’S BAZAR, Bangladesh, 24 January 2018 –  Improved security and unimpeded humanitarian access in Myanmar are essential before Rohingya children can be returned from Bangladesh, UNICEF Deputy Executive Director Justin Forsyth said today.

Statement by Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa, on Syrian children freezing to death while crossing from Syria to Lebanon
AMMAN, 20 January 2018- “It is tragic that at least 12 Syrians including two children died in Eastern Lebanon near the Masna’ border crossing with Syria.”

At least one in four children in Iraq impacted by conflict and poverty
BAGHDAD/AMMAN, 19 January 2018 – “Iraq today hosts one of UNICEF’s largest operations in the world, responding with humanitarian and development assistance to the needs of the most vulnerable girls and boys across the country.

Wellcome Trust  [to 27 January 2018]
https://wellcome.ac.uk/news
News / Published: 25 January 2018
What our new strategy means for the Public Engagement Fund
We’ve developed an ambitious new strategy for our public engagement work and, as a result, we are making some changes to the Public Engagement Fund.
When we launched the Public Engagement Fund in January 2017 we said that the fund would evolve – as we learned from its implementation, and to reflect Wellcome’s changing vision.
After the changes, funding will still be open to anyone with a great project for engaging the public in Wellcome’s mission of improving health…

News / Published: 22 January 2018
New Wellcome office in Berlin will bolster global partnerships
News / Published: 22 January 2018
Wellcome is planning to open a small office in the German capital later this year so that we can work more closely with our international partners on shared priorities…

The Wistar Institute   [to 27 January 2018]
https://www.wistar.org/news/press-releases
Press Releases
Wistar’s David Weiner, Ph.D., Named President of the International Society for Vaccines
PHILADELPHIA—(Jan. 25, 2018)—The Wistar Institute is pleased to announce David B. Weiner, Ph.D., executive vice president, director of the Vaccine & Immunotherapy Center at The Wistar Institute, and the W.W. Smith Charitable Trust Professor in Cancer Research, has been appointed President of the International Society for Vaccines (ISV), an organization that engages, supports, and sustains the professional goals of a diverse membership in all areas relevant to vaccines.
“As I begin my service as ISV President, it is important to keep in mind that our overarching goals and focus remains the same: serve all of our members and continue to build the society and ‘lift all boats’ in vaccine research around the globe,” Weiner said. “In this regard, we extend our hand and encourage all members to be engaged and energized, and to take an active role in this society-your society.”…

::::::
 
IFPMA   [to 27 January 2018]
http://www.ifpma.org/resources/news-releases/
24 January 2018
The African Global Health Leaders Fellowship launched to support the future of health in Africa
Geneva, 24 January 2018│ The Centre on Global Health Security at Chatham House, the Global Health Centre at the Graduate Institute and the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) announced yesterday the establishment of the 2018-2019 African Global Health Leaders Fellowship.
Sub-Saharan African countries have undergone unprecedented transformation and change in the last decade, including constant economic growth, a growing middle class, a healthier, more productive and increasingly more educated and skilled workforce and increased political stability. Although many challenges remain, recognition must be given to the huge advances that have been made.
To mark the occasion, the three signing partners invited emerging leaders and fellows of the West African Global Health Leaders Fellowship ─ the predecessor of the new fellowship, to discuss the achievements and challenges across the continent, including the most promising approaches for improving healthcare systems and the realisation of Universal Health Coverage (UHC).
The fellowship supports the development of the next generation of public health leaders in Africa. The objective is to help fellows from Africa develop the knowledge, insight and skills to work within their own countries to formulate and implement evidence-based policy and to serve as the next generation of leaders. It builds skills in leadership, policy analysis and formulation, as well as global health diplomacy…

Industry Watch   [to 27 January 2018]
:: World Health Organization Grants Prequalification to Bharat Biotech’s Rotavirus Vaccine, ROTAVAC®
NEW DELHI–(BUSINESS WIRE)–Bharat Biotech today announced that the World Health Organization (WHO Geneva) has awarded prequalification to the developing world’s first rotavirus vaccine, ROTAVAC®…

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org
 
2018 Antimicrobial Resistance Benchmark
Access to Medicine Foundation
January 2018 :: 185 pages
PDF: https://amrbenchmark.org/wp-content/uploads/2018/01/Antimicrobial-Resistance-Benchmark-2018.pdf
The Antimicrobial Resistance Benchmark provides the first independent assessment of how pharmaceutical companies are responding to AMR. The 30 companies in scope include those
with the largest R&D divisions, the largest market presence, and specific expertise in developing critically needed medicines and vaccines. The goal of the Antimicrobial Resistance Benchmark is
to guide and incentivise such companies to adopt and implement effective actions for tackling AMR. It highlights where good ideas for limiting AMR are being implemented and where action
is still required. The AMR Benchmark is independently funded by UK AID and the Dutch Ministry of Health, Welfare and Sport.

Key Findings
:: There are 28 antibiotics for high-priority pathogens in late stages of development. However, only two of these are supported by plans to ensure the successful candidate can be made accessible and used wisely once it reaches the market.

:: Nearly half of companies evaluated are involved in efforts to track patterns in antibiotic drug resistance, with AMR surveillance programmes running in 147 countries. Pneumonia is the most widely-tracked infection.

:: Eight companies are setting limits on the levels of antibiotics that can be released into the environment in wastewaters at their antibiotic manufacturing facilities. Yet no company publishes what is released in practice.
:: Four companies are taking steps to separate sales agents’ bonuses from the volume of antibiotics they sell. GSK and Shionogi have fully separated the two globally, Pfizer is piloting that approach in certain territories, and Novartis is taking steps toward adjusting its sales teams incentives.

Journal Watch

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

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

American Journal of Infection Control
February 2018 Volume 46, Issue 2, p123-244
http://www.ajicjournal.org/current

Major Articles
Systematic review of electronic surveillance of infectious diseases with emphasis on antimicrobial resistance surveillance in resource-limited settings
Pinyo Rattanaumpawan, Adhiratha Boonyasiri, Sirenda Vong, Visanu Thamlikitkul
p139–146
Published online: October 10, 2017
Abstract
Background
Electronic surveillance of infectious diseases involves rapidly collecting, collating, and analyzing vast amounts of data from interrelated multiple databases. Although many developed countries have invested in electronic surveillance for infectious diseases, the system still presents a challenge for resource-limited health care settings.
Methods
We conducted a systematic review by performing a comprehensive literature search on MEDLINE (January 2000-December 2015) to identify studies relevant to electronic surveillance of infectious diseases. Study characteristics and results were extracted and systematically reviewed by 3 infectious disease physicians.
Results
A total of 110 studies were included. Most surveillance systems were developed and implemented in high-income countries; less than one-quarter were conducted in low-or middle-income countries. Information technologies can be used to facilitate the process of obtaining laboratory, clinical, and pharmacologic data for the surveillance of infectious diseases, including antimicrobial resistance (AMR) infections. These novel systems require greater resources; however, we found that using electronic surveillance systems could result in shorter times to detect targeted infectious diseases and improvement of data collection.
Conclusions
This study highlights a lack of resources in areas where an effective, rapid surveillance system is most needed. The availability of information technology for the electronic surveillance of infectious diseases, including AMR infections, will facilitate the prevention and containment of such emerging infectious diseases.

American Journal of Infection Control
February 2018 Volume 46, Issue 2, p123-244
http://www.ajicjournal.org/current

Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control
Sarah H. Alfaraj, Jaffar A. Al-Tawfiq, Talal A. Altuwaijri, Marzouqa Alanazi, Nojoom Alzahrani, Ziad A. Memish
p165–168
Published online: September 25, 2017

American Journal of Preventive Medicine
February 2018 Volume 54, Issue 2, p157-324
http://www.ajpmonline.org/current

Research Articles
Immunization Practices of U.S. Obstetrician/Gynecologists for Pregnant Patients
Sean T. O’Leary, Laura E. Riley, Megan C. Lindley, Mandy A. Allison, Lori A. Crane, Laura P. Hurley, Brenda L. Beaty, Michaela Brtnikova, Margaret Collins, Alison P. Albert, Allison K. Fisher, Angela J. Jiles, Allison Kempe
p205–213
Published online: December 12, 2017

American Journal of Preventive Medicine
February 2018 Volume 54, Issue 2, p157-324
http://www.ajpmonline.org/current

Nativity Disparities in Human Papillomavirus Vaccination Among U.S. Adults
…few studies have explored whether vaccination differences exist by nativity status. Vaccination disparities have the potential to exacerbate HPV-related cancer disparities in the long term if left unaddressed. Therefore, the authors investigated whether there were significant differences in HPV vaccination initiation (one or more doses) and completion (three or more doses) between U.S.-born and foreign-born men and women.
Ashley E. Pérez, Madina Agénor, Kristi E. Gamarel, Don Operario
p248–258
Published online: December 11, 2017

American Journal of Preventive Medicine
February 2018 Volume 54, Issue 2, p157-324
http://www.ajpmonline.org/current

Review Articles
The Cost of Interventions to Increase Influenza Vaccination: A Systematic Review
Laura J. Anderson, Paul Shekelle, Emmett Keeler, Lori Uscher-Pines, Roberta Shanman, Sally Morton, Gursel Aliyev, Teryl K. Nuckols
p299–315
Published in issue: February 2018

American Journal of Public Health
February 2018   108(2)
http://ajph.aphapublications.org/toc/ajph/current

SOCIAL IMPACT BONDS
Social Impact Bonds as a Funding Method for Health and Social Programs: Potential Areas of Concern
Amy S. Katz, Benjamin Brisbois, Suzanne Zerger and Stephen W. Hwang
108(2), pp. 210–215
Abstract
Social Impact Bonds (SIBs) represent a new way to finance social service and health promotion programs whereby different types of investors provide an upfront investment of capital. If a given program meets predetermined criteria for a successful outcome, the government pays back investors with interest. Introduced in the United Kingdom in 2010, SIBs have since been implemented in the United States and across Europe, with some uptake in other jurisdictions.
We identify and explore selected areas of concern related to SIBs, drawing from literature examining market-based reforms to health and social services and the evolution of the SIB funding mechanism. These areas of concern include increased costs to governments, restricted program scope, fragmented policymaking, undermining of public-sector service provision, mischaracterization of the root causes of social problems, and entrenchment of systemically produced vulnerabilities.
We argue that it is essential to consider the long-term, aggregate, and contextualized effects of SIBs in order to evaluate their potential to contribute to public health. We conclude that such evaluations must explore the assumptions underlying the “common sense” arguments often used in support of SIBs.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 27 January 2018)

Research article
General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh
Service readiness of health facilities is an integral part of providing comprehensive quality healthcare to the community. Comprehensive assessment of general and service-specific (i.e. child immunization) rea…
Authors: Md. Shajedur Rahman Shawon, Gourab Adhikary, Md. Wazed Ali, Md. Shamsuzzaman, Shahabuddin Ahmed, Nurul Alam, Katya A. Shackelford, Alexander Woldeab, Stephen S. Lim, Aubrey Levine, Emmanuela Gakidou and Md. Jasim Uddin
Citation: BMC Health Services Research 2018 18:39
Published on: 25 January 2018

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 27 January 2018)

Research article
Cost-effectiveness of increasing vaccination in high-risk adults aged 18–64 Years: a model-based decision analysis
Adults aged 18–64 years with comorbid conditions are at high risk for complications of certain vaccine-preventable diseases, including influenza and pneumococcal disease. The 4 Pillars™ Practice Transformation…
Authors: Angela R. Wateska, Mary Patricia Nowalk, Richard K. Zimmerman, Kenneth J. Smith and Chyongchiou J. Lin
Citation: BMC Infectious Diseases 2018 18:52
Published on: 25 January 2018

 
BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 27 January 2018)

Research article
Evaluation of two health education interventions to improve the varicella vaccination: a randomized controlled trial from a province in the east China
We evaluated the effect of two Elaboration Likelihood Model (ELM)-based health educational interventions on varicella vaccine (VarV) vaccination among pregnant women in a province in the east China.
Authors: Yu Hu, Qian Li and Yaping Chen
Citation: BMC Public Health 2018 18:144
Published on: 16 January 2018

Humanitarian Exchange Magazine
http://odihpn.org/magazine/the-humanitarian-consequences-of-violence-in-central-america/
Number 70   October 2017
Special Feature: The Lake Chad Basin: an overlooked crisis?
by Humanitarian Practice Network October 2017
The 70th edition of Humanitarian Exchange, co-edited with Joe Read, focuses on the humanitarian crisis in Nigeria and the Lake Chad Basin. The violence perpetrated by Boko Haram and the counter-insurgency campaign in Nigeria, Cameroon, Chad and Niger has created a humanitarian crisis affecting some 17 million people. Some 2.4 million have been displaced, the vast majority of them in north-eastern Nigeria. Many are living in desperate conditions, without access to sufficient food or clean water. The Nigerian government’s focus on defeating Boko Haram militarily, its reluctance to acknowledge the scale and gravity of the humanitarian crisis and the corresponding reticence of humanitarian leaders to challenge that position have combined to undermine the timeliness and effectiveness of the response…
[Reviewed earlier]

JAMA
January 23/30, 2018, Vol 319, No. 4, Pages 319-418
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Improving Public Health Requires Inclusion of Underrepresented Populations in Research
Catherine Y. Spong, MD; Diana W. Bianchi, MD
JAMA. 2018;319(4):337-338. doi:10.1001/jama.2017.19138
Advances in genomics have ushered in promising therapies tailored to the individual. Personalized medicine is promoted and has begun to positively influence care. For example, medications such as trastuzumab for the 30% of breast cancers that overexpress ERBB2 and vemurafenib for patients with late-stage melanoma who carry the V600E variant have been beneficial.1 Despite these advances, for many sectors of the population—children, older adults, pregnant and lactating women, and individuals with physical and intellectual disabilities—limited evidence-based therapies optimized to their specific medical needs exist. Combined, these groups comprise as much as 58% of the US population (eTable in the Supplement). Research focusing on or at the very least includes members of these groups is critically needed.

Journal of Pediatrics
February 2018 Volume 193, p1-280
http://www.jpeds.com/current

Editor’s Choice
Smart use of vaccines
Sarah S. Long
Published in issue: February 2018
Abstract
The increasing complexities of the recommended immunization schedule and vaccine products available make it almost impossible for even the best informed and intentioned practitioners and staff to get it perfect. Mistakes are “costly,” leaving some children sub-optimally protected from vaccine-targeted diseases (and in some scenarios requiring extra doses), while other children may be over-immunized. In this volume of The Journal, Rodgers et al report a study of the frequency and cost of vaccinations administered outside minimum and maximum recommended ages despite using what currently is likely to be one of the “smartest” electronic systems that aims to prevent these errors. Data included examination and analysis of de-identified information throughout 2014 from 6 Centers for Disease Control and Prevention Sentinel Sites of Immunization Information Systems in 6 states, representing approximately 10% of the US population <19 years of age. The system possesses advanced functionality available at the point of clinical care.
In most regards, the findings are reassuring. Among roughly 3.4 million doses of vaccines with maximum age recommendations, only 0.3% of doses were given after the maximum age. Among roughly 7.5 million doses of vaccines with minimum age recommendations, only 0.1% of doses were administered before the minimum age. Monetary costs could accrue when an unnecessary dose was given after a maximum age (eg, Prevnar given after the fifth birthday) or an inadequate dose given required re-vaccination (eg, a 0.25 mL dose of Fluzone Quadrivalent given after the third birthday when a dose of 0.5 mL is recommended). The most costly errors of administration before a minimum recommended age are those requiring re-vaccination. This report identified approximately $291 000 in direct and indirect re-vaccination costs that would have been incurred in 1 year in this sample population if each error identified was corrected. An estimated annual cost on a national level would be 10-fold, ie, almost 3 million dollars.
Immunizations are a critical pillar of our children’s health, and a precious resource. Until an impossibly smart computer program can be brought to bear at the point of care to integrate each patient’s unique immunization record and need, and to preclude misuse, we will have to strive to be advocates for as well as best protectors of the precious resource.

Journal of Pediatrics
February 2018 Volume 193, p1-280
http://www.jpeds.com/current

Editorials
How to Make Pediatric Trials Better: Transparency and Accountability of Trial Registration and Reporting
Ana Marušić, Shelly M. Pranić
Published online: November 22, 2017

Journal of Pediatrics
February 2018 Volume 193, p1-280
http://www.jpeds.com/current

Original Articles
Frequency and Cost of Vaccinations Administered Outside Minimum and Maximum Recommended Ages—2014 Data From 6 Sentinel Sites of Immunization Information Systems
Loren Rodgers, Lauren Shaw, Raymond Strikas, Beth Hibbs, JoEllen Wolicki, Cristina V. Cardemil, Cindy Weinbaum
p164–171
Published online: December 14, 2017

Journal of Pediatrics
February 2018 Volume 193, p1-280
http://www.jpeds.com/current

The Conduct and Reporting of Child Health Research: An Analysis of Randomized Controlled Trials Published in 2012 and Evaluation of Change over 5 Years
Allison Gates, Lisa Hartling, Ben Vandermeer, Patrina Caldwell, Despina G. Contopoulos-Ioannidis, Sarah Curtis, Ricardo M. Fernandes, Terry P. Klassen, Katrina Williams, Michele P. Dyson
p237–244.e37
Published online: November 21, 2017

Nature 
Volume 553 Number 7689 pp380-530  25 January 2018
http://www.nature.com/nature/current_issue.html

Science after a year of President Trump
After 12 months in office, Trump’s effects on science have been as bad as feared.

Nature 
Volume 553 Number 7689 pp380-530  25 January 2018
http://www.nature.com/nature/current_issue.html

Science must get ready for the next global flu crisis
A universal flu vaccine is the only serious defence against a future flu pandemic.

New England Journal of Medicine
January 25, 2018   Vol. 378 No. 4
http://www.nejm.org/toc/nejm/medical-journal

Perspective
History of Medicine: PEPFAR — 15 Years and Counting the Lives Saved
Anthony S. Fauci, M.D., and Robert W. Eisinger, Ph.D.
In the long history of successful public health initiatives, such as those leading to the eradication of smallpox, the elimination of polio throughout most of the world, and the marked reduction globally in vaccine-preventable childhood diseases, few programs have matched the impact of one that began in 2003, the President’s Emergency Plan for AIDS Relief, or PEPFAR. This innovative program has had an unprecedented impact on the pandemic of HIV and AIDS…

New England Journal of Medicine
January 25, 2018   Vol. 378 No. 4
http://www.nejm.org/toc/nejm/medical-journal

Treating and Preventing HIV with Generic Drugs — Barriers in the United States
Erika G. Martin, Ph.D., M.P.H., and Bruce R. Schackman, Ph.D.
Combination antiretroviral therapy (ART) has dramatically improved survival rates among people with HIV and is a mainstay of HIV prevention; evidence shows that durable viral suppression prevents the transmission of infection. In addition, preexposure prophylaxis (PrEP) is an emerging approach to preventing HIV acquisition for certain high-risk groups. Generic ART medications offer the potential for treating and preventing HIV with fewer resources. Generic versions of lamivudine, abacavir, and efavirenz became available in the United States within the past 6 years at prices lower than their brand-name counterparts, a generic version of PrEP (emtricitabine and tenofovir disoproxil fumarate) was approved in 2016, and generic versions of tenofovir disoproxil are expected later in 2018. Yet most of the discussion about the availability of generic HIV drugs focuses on low- and middle-income countries…

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 27 January 2018)

Research Article
The cost-effectiveness of alternative vaccination strategies for polyvalent meningococcal vaccines in Burkina Faso: A transmission dynamic modeling study
The introduction of a conjugate vaccine for serogroup A Neisseria meningitidis has dramatically reduced disease in the African meningitis belt. In this context, important questions remain about the performance of different vaccine policies that target remaining serogroups. Here, we estimate the health impact and cost associated with several alternative vaccination policies in Burkina Faso. The introduction of a conjugate vaccine for serogroup A Neisseria meningitidis has dramatically reduced disease in the African meningitis belt. In this context, important questions remain about the performance of different vaccine policies that target remaining serogroups. Here, we estimate the health impact and cost associated with several alternative vaccination policies in Burkina Faso.
Reza Yaesoubi, Caroline Trotter, Caroline Colijn, Maziar Yaesoubi, Anaïs Colombini, Stephen Resch, Paul A. Kristiansen, F. Marc LaForce, Ted Cohen
| published 24 Jan 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002495

PLoS One
http://www.plosone.org/
[Accessed 27 January 2018]

Research Article
The influence of political ideology and trust on willingness to vaccinate
Bert Baumgaertner, Juliet E. Carlisle, Florian Justwan
Research Article | published 25 Jan 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0191728
Abstract
In light of the increasing refusal of some parents to vaccinate children, public health strategies have focused on increasing knowledge and awareness based on a “knowledge-deficit” approach. However, decisions about vaccination are based on more than mere knowledge of risks, costs, and benefits. Individual decision making about vaccinating involves many other factors including those related to emotion, culture, religion, and socio-political context. In this paper, we use a nationally representative internet survey in the U.S. to investigate socio-political characteristics to assess attitudes about vaccination. In particular, we consider how political ideology and trust affect opinions about vaccinations for flu, pertussis, and measles. Our findings demonstrate that ideology has a direct effect on vaccine attitudes. In particular, conservative respondents are less likely to express pro-vaccination beliefs than other individuals. Furthermore, ideology also has an indirect effect on immunization propensity. The ideology variable predicts an indicator capturing trust in government medical experts, which in turn helps to explain individual-level variation with regards to attitudes about vaccine choice.

Qualitative Health Research
Volume 28, Issue 3, February 2018
http://qhr.sagepub.com/content/current
Special Issue: Methods

A Guide to Field Notes for Qualitative Research: Context and Conversation
Julia Phillippi, Jana Lauderdale
First Published April 5, 2017; pp. 381–388
Abstract
Field notes are widely recommended in qualitative research as a means of documenting needed contextual information. With growing use of data sharing, secondary analysis, and metasynthesis, field notes ensure rich context persists beyond the original research team. However, while widely regarded as essential, there is not a guide to field note collection within the literature to guide researchers. Using the qualitative literature and previous research experience, we provide a concise guide to collection, incorporation, and dissemination of field notes. We provide a description of field note content for contextualization of an entire study as well as individual interviews and focus groups. In addition, we provide two “sketch note” guides, one for study context and one for individual interviews or focus groups for use in the field. Our guides are congruent with many qualitative and mixed methodologies and ensure contextual information is collected, stored, and disseminated as an essential component of ethical, rigorous qualitative research.

Science         
26 January 2018  Vol 359, Issue 6374
http://www.sciencemag.org/current.dtl

In Depth
Critics see only risks, no benefits in horsepox paper
By Kai Kupferschmidt
Science26 Jan 2018 : 375-376 Restricted Access
Scientists say their labmade virus could make a new smallpox vaccine. Others call it a “mistake” and a “stunt.”
Summary
A highly controversial study in which researchers synthesized the horsepox virus from scratch was finally published in PLOS ONE on 19 January. The study stirred alarm when Science first reported about it in July 2017 because it might give would-be terrorists a recipe to construct smallpox virus, a major human scourge vanquished in 1980. And now that the paper is out, many scientists say it doesn’t answer the most pressing question: Why did they do it? The team claims its work, funded by Tonix, a pharmaceutical company headquartered in New York City, could lead to a safer, more effective vaccine against smallpox. But safe smallpox vaccines already exist, and critics say there is no market for a horsepox-based replacement.
 

Vaccine
Volume 36, Issue 4   Pages 427-594 (25 January 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/4

Regular papers
How close are countries of the WHO European Region to achieving the goal of vaccinating 75% of key risk groups against influenza? Results from national surveys on seasonal influenza vaccination programmes, 2008/2009 to 2014/2015
Open access – Original research article
Pages 442-452
Pernille Jorgensen, Jolita Mereckiene, Suzanne Cotter, Kari Johansen, … Caroline Brown

Vaccine
Volume 36, Issue 4   Pages 427-594 (25 January 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/4

Parent perceptions of dentists’ role in HPV vaccination
Original research article
Pages 461-466
Gabriela E. Lazalde, Melissa B. Gilkey, Melanie L. Kornides, Annie-Laurie McRee
Offering HPV vaccine in settings beyond the traditional medical home holds promise for increasing the currently low levels of coverage. As adolescents frequently visit dentists, dental practices may be one such alternative vaccination setting. This study assessed parent attitudes about the roles dental providers could play in HPV prevention, including vaccine provision.

Vaccine
Volume 36, Issue 4   Pages 427-594 (25 January 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/4

Willingness to accept a future influenza A(H7N9) vaccine in Beijing, China
Original research article
Pages 491-497
Shuangsheng Wu, Jianting Su, Peng Yang, Haiyan Zhang, … Quanyi Wang

Vaccine
Volume 36, Issue 4   Pages 427-594 (25 January 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/4

Bacillus Calmette-Guérin (BCG) vaccine: A global assessment of demand and supply balance
Open access – Original research article
Pages 498-506
Tania Cernuschi, Stefano Malvolti, Emily Nickels, Martin Friede