Wellcome Trust [to 4 March 2017]
https://wellcome.ac.uk/news
News / Published: 28 February 2017
Epidemic tracking tool wins Open Science Prize
An online tool that helps researchers and public health workers track epidemics in real time has won the Open Science Prize.
Nextstrain.org (opens in a new tab) is a prototype online platform that visualises viral genome data in real time to track the spread of global pathogens such as Zika and Ebola.
Viral genomes provide a hugely valuable insight into the spread of an infectious disease. But for this information to be useful during an epidemic, samples have to be collected, analysed and the results disseminated in near real time.
NextStrain can conduct statistical analyses in minutes, revealing when diseases were introduced into a population and their patterns of geographic spread. It can also help public health officials to connect individual cases to aid contact tracing…

FDA [to 4 March 2017]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
FDA News Release
Mutual Recognition promises new framework for pharmaceutical inspections for United States and European Union
March 2, 2017
The United States and the European Union (EU) completed an exchange of letters to amend the Pharmaceutical Annex to the 1998 U.S.-EU Mutual Recognition Agreement. Under this agreement, U.S. and EU regulators will be able to utilize each other’s good manufacturing practice inspections of pharmaceutical manufacturing facilities.
The amended agreement ‎represents the culmination of nearly three years of U.S. Food and Drug Administration and EU cooperation as part of the Mutual Reliance Initiative and will allow the FDA and EU drug inspectors to rely upon information from drug inspections conducted within each other’s borders. Ultimately, this will enable the FDA and EU to avoid the duplication of drug inspections, lower inspection costs and enable regulators to devote more resources to other parts of the world where there may be greater risk.
“The Mutual Recognition Agreement is an important step in working collaboratively and strategically with key partners to help ensure that American patients have access to safe, effective and high quality drugs,” said Dara Corrigan, FDA’s associate commissioner for global regulatory policy…

What’s New for Biologics
:: Post-Licensure Rapid Immunization Safety Monitoring (PRISM) Public Workshop Transcript (PDF – 622KB) Posted: 3/3/2017
:: February 23, 2017 Approval Letter – RotaTeq (PDF – 48KB) Posted: 3/3/2017
:: February 16, 2017 Summary Basis for Regulatory Action – VARIVAX (PDF – 152KB) Posted: 2/27/17

UNAIDS [to 4 March 2017]
http://www.unaids.org/
Update
First Lady of Benin launches the Claudine Talon Foundation to improve the lives of women and children across the country
03 March 2017
The First Lady of Benin has launched a foundation to improve the lives of the most vulnerable women and children in the western African country, nestled between Nigeria and Togo. The foundation will work under the umbrella of six core values: solidarity, the family, respect for differences, integrity, humility and efficiency.
The Claudine Talon Foundation will take a holistic approach to improving health and social outcomes for women and children in Benin. It will focus on expanding maternal and paediatric health services, improving general hygiene and sanitation, increasing access to quality drinking water, improving standards of nutrition and raising literacy rates through a wider access to education. Activities will include increasing access to HIV testing in paediatric health centres and supporting organizations caring for orphans. It will also focus on ending discrimination for people living with and affected by HIV…

.

Update
Hospitals in South-East Asia ramp up efforts against HIV-related stigma
02 March 2017
The Bamrasnaradura Infectious Disease Institute in Nonthaburi is one of Thailand’s premier hospitals in AIDS treatment and care. Its waiting rooms welcome many patients. This month, people waiting for appointments will see on hospital screens stories about people living with HIV who overcame stigma thanks to support from their communities. Bamrasnaradura is one of around 1000 hospitals in Thailand that have joined the zero discrimination in health-care settings campaign.
The Ministry of Public Health of Thailand, the Thai Network of People Living with HIV/AIDS (TNP+) and UNAIDS launched the campaign on 2 March at Bamrasnaradura.
“More than 30 years since HIV was detected in Thailand, stigma still remains a major challenge,” said Jessada Chokdamrongsuk, Director-General, Department of Disease Control, Ministry of Public Health. “Thailand is committed to ensuring health-care settings are safe and supportive environments.”…

IVI [to 4 March 2017]
http://www.ivi.int/
February 27, 2017
High incidences of typhoid and invasive Salmonella infection confirmed in sub-Saharan Africa
– Findings of IVI-led study in 10 African countries published in The Lancet Global Health – High disease burden findings support the introduction of typhoid conjugate vaccines in high-incidence settings
An IVI-led study found that typhoid fever and invasive non-typhoidal Salmonella (iNTS) disease are major causes of invasive bacterial febrile illness in some African countries, and they most commonly afflict children in low and high population density settings.
Large variations exist in the disease burden of Salmonella Typhi and non-typhoidal Salmonella in sub-Saharan Africa, with rates of disease reaching as high as 383 per 100,000 persons per years (PY) for S. Typhi and 237 per 100,000 PY for iNTS disease in Burkina Faso. A rate of more than 100 per 100,000 is considered “high” as defined by the World Health Organization (WHO). Typhoid was found in both infants and school-age children, with a higher incidence in children below 15 years old, according to the study recently published in The Lancet Global Health…

EDCTP [to 4 March 2017]
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.
28 February 2017
UK All-Party Parliamentary Group on Global Health hosted meeting on value of EDCTP
The meeting on EDCTP as ‘African-European partnership for global health benefit’ took place on 27 February 2017 at the Houses of Parliament in London, United Kingdom. It was hosted by Dr Daniel Poulter MP of the UK All-Party Parliamentary Group on Global Health.
The development of paediatric fixed-dose combination therapy for HIV-infected children in two EDCTP-funded trials, CHAPAS-1 and CHAPAS-3, was presented as a case study of the impact of the programme. CHAPAS-1 resulted in the first paediatric antiretroviral formula which was rolled out on a large scale. CHAPAS-3 developed paediatric formulas for a new generation of antiretrovirals. Dr Veronica Mulenga, paediatrician at the University Teaching Hospital in Lusaka, Zambia and Professor Diana Gibb, programme Leader of the Paediatric Programme of trials and cohorts at the MRC Clinical Trials Unit at University College London, United Kingdom presented these trials…

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

IAVI – International AIDS Vaccine Initiative [to 4 March 2017]
https://www.iavi.org/
Technical Report
Regulatory Capacity Strengthening in Africa-2017
African research partners consistently state the need to strengthen national regulatory and research facilities. This need is echoed in national frameworks and strategies related to HIV/AIDS and health research. While IAVI/partner commitment to health research capacity building has remained consistent, more recently it has focused on nationally- and regionally- defined research- and regulatory-strengthening initiatives to increase country ownership and commitment to health research.
Moving forward, IAVI and its partners remain committed to supporting locally defined and country-owned plans to strengthen regulatory and ethics bodies. This work will continue to improve their capacity to effectively review HIV vaccine research submissions, ensure adequate national and regional policy frameworks to effectively and efficiently review HIV vaccine research submissions, and support nationally and regionally defined regulatory/ethics strengthening initiatives. Such investments advance HIV vaccine research and development while strengthening local health research overall.
PDF: https://www.iavi.org/phocadownload/userupload/regulatory%20capacity%20strengthening%20in%20africa-2017.pdf

::::::

IFPMA [to 4 March 2017]
http://www.ifpma.org/resources/news-releases/
28 February 2017
IFPMA launches new policy principles and report on Rare Disease Day 2017 to benefit patients, patients, healthcare and society
:: New set of policy principles outlines critical elements for a global framework on rare disease policy.
:: New report “Rare diseases: shaping a future with no one left behind” is a new resource to understand key challenges in areas such as R&D, clinical trials, diagnosis, and access to treatment.
:: More than 560 medicines are currently being developed for patients with rare diseases thanks to new technologies and a growing scientific understanding of these diseases[1].

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PhRMA
http://www.phrma.org/press-room
February 28, 2017
Rare Disease Day: Accelerating innovation for patients in need
The biopharmaceutical industry is committed to advancing novel therapies for the more than 30 million Americans suffering from a rare disease today.

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
March 01, 2017 Volume 45, Issue 3, p215-340, e34-e44
http://www.ajicjournal.org/current

Major Articles
The behind-the-scenes activity of parental decision-making discourse regarding childhood vaccination
Anat Gesser-Edelsburg, Nathan Walter, Yaffa Shir-Raz, Oshrat Sassoni Bar-Lev, Shira Rosenblat
p267–271
Published online: November 14, 2016
Abstract
Background
Vaccine compliance has long been a cause for concern for health authorities throughout the world. However very little effort has been made to examine parental discourse during the decision-making process.
Methods
An online survey was conducted (N = 437) to examine predictors of parents’ attitudes regarding childhood vaccination.
Results
Hesitant parents were 4 times more likely to conduct intrafamily discussion regarding vaccination compared with provaccination parents (Exp[B] = 4.26). There were no significant differences between hesitant and antivaccination parents with respect to intrafamily discussion. Hesitant parents were also 4 times more likely than provaccination parents to report intrafamily disagreements regarding vaccination (Exp[B] = 4.27). They were also twice as likely as antivaccination parents to express disagreements regarding vaccination within their families (Exp[B] = 2.33). Likewise, Jewish parents were significantly more likely to define themselves as vaccination-hesitant, whereas Muslim parents were significantly more likely to be provaccination.
Conclusions
To improve the way health organizations communicate information about vaccines and increase parental trust in immunization programs, we should not only look at the level of understanding, perceptions, and biases of different groups, but also thoroughly examine parents’ decision-making processes and the discourse during this process. We must communicate risk to all groups, including the provaccination group, to improve parents’ decision making and the process of informed consent.

American Journal of Infection Control
March 01, 2017 Volume 45, Issue 3, p215-340, e34-e44
http://www.ajicjournal.org/current

Major Articles
Hospital influenza pandemic stockpiling needs: A computer simulation
Mark N. Abramovich, John C. Hershey, Byron Callies, Amesh A. Adalja, Pritish K. Tosh, Eric S. Toner
p272–277
Published online: December 2, 2016

American Journal of Preventive Medicine
March 2017 Volume 52, Issue 3, p263-416, e67-e94
http://www.ajpmonline.org/current

From the U.S. CDC Director
A Safer, Healthier U.S.: The Centers for Disease Control and Prevention, 2009–2016
Thomas R. Frieden
p263–275
Published online: January 14, 2017

American Journal of Preventive Medicine
March 2017 Volume 52, Issue 3, p263-416, e67-e94
http://www.ajpmonline.org/current

Research Articles
National and State-Specific Shingles Vaccination Among Adults Aged ≥60 Years
Peng-jun Lu, Alissa O’Halloran, Walter W. Williams, Rafael Harpaz
p362–372
Published online: October 5, 2016
Abstract
Introduction
Shingles (herpes zoster) causes substantial morbidity, especially among older adults. The shingles vaccine has been recommended for people aged ≥60 years since 2006. This study assessed recent shingles vaccination at national and state levels among adults aged ≥60 years.
Methods
The 2014 Behavioral Risk Factor Surveillance System data were analyzed in 2015 to assess shingles vaccination coverage among adults aged ≥60 years at national and state levels. Multivariable logistic regression and predictive marginal models identified factors independently associated with vaccination.
Results
Shingles vaccination coverage among adults aged ≥60 years was 31.8% (95% CI=1.4%, 32.2%). Among states, shingles vaccination coverage ranged from 17.8% (95% CI=5.8%, 20.0%) in Mississippi to 46.6% (95% CI=4.3%, 48.8%) in Vermont, with a median of 33.3%. Coverage was <25% in four states and >40% in nine states. For all states, coverage was significantly higher among non-Hispanic whites compared with non-white races except for Oregon, with coverage differences ranging from –33.2% in the District of Columbia to 0.9% in Oregon and a median of –16.0%. Characteristics independently associated with vaccination were age, race/ethnicity, sex, education, employment status, household income, region, perceived health status, health insurance status, personal healthcare provider, routine checkup status, and whether reporting that cost was a barrier to seeing a doctor.
Conclusions
Coverage varied dramatically by state. State-level comparisons may aid in designing tailored intervention programs through sharing of best practices. Strategies are needed to mitigate financial barriers for both provider and patients, improve awareness, and increase provider recommendation of the vaccine.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 4 March 2017)

Research article
Clinical trials from the patient perspective: survey in an online patient community
Developing new medicines relies on the successful conduct of clinical trials. As trial protocols become more arduous, it becomes harder to recruit and retain patient volunteers, although recent efforts such as OMERACT and I-SPY2 show that partnering with patients can be beneficial. We sought to describe drivers and barriers to trial participation, as well as condition-specific trial preferences.
Pronabesh DasMahapatra, Priya Raja, Jeremy Gilbert and Paul Wicks
BMC Health Services Research 2017 17:166
Published on: 27 February 2017

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 4 March 2017)

Research article
Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination
The aims of this cross-sectional survey were to examine the knowledge, the attitudes, and the behavior regarding the varicella infection and its vaccination and to get insight into their determinants among par…
Luigi Vezzosi, Gabriella Santagati and Italo F. Angelillo
BMC Infectious Diseases 2017 17:172
Published on: 27 February 2017
Abstract
Background
The aims of this cross-sectional survey were to examine the knowledge, the attitudes, and the behavior regarding the varicella infection and its vaccination and to get insight into their determinants among parents of children in Italy.
Methods
From May to June 2015 in the geographic area of Naples (Italy) a random sample of 675 parents of children aged 4-7 years received a self-administered anonymous questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards varicella and its vaccination.
Results
A total of 414 parents responded to the questionnaire, for a response rate of 61.3%. A history of varicella was reported in 163 children (39.6%). Only 26.6% parents knew that the vaccine was available and the number of doses and this knowledge was significantly higher in those who had a university degree, in those who had received information on the vaccination from a health care provider, and in those who had vaccinated their child. The perceived utility towards vaccination had a mean value of 5.7. The positive attitude towards the utility of the vaccination was higher in parents with a level of education not higher than middle school, in those who had vaccinated their child, in those who considered the varicella a dangerous disease, and in those who had received information from a health care provider. More than one-third had vaccinated their child. Immunization was more frequent in parents who had knowledge about the vaccination, who beliefs that the immunization was useful, who believed that the disease was not dangerous, and who had not a history of varicella among their children.
Conclusions
Educational programs are needed among parents as support to improve knowledge about vaccination and immunization coverage.

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 4 March 2017)

Research article
Policy perspectives on post pandemic influenza vaccination in Ghana and Malawi
Evanson Z. Sambala and Lenore Manderson
BMC Public Health 2017 17:227
Published on: 28 February 2017
Abstract
Background
In the late 1990s, in the context of renewed concerns of an influenza pandemic, countries such as Ghana and Malawi established plans for the deployment of vaccines and vaccination strategies. A new pandemic was declared in mid-June 2009, and by April 2011, Ghana and Malawi vaccinated 10% of the population. We examine the public health policy perspectives on vaccination as a means to prevent the spread of infection under post pandemic conditions.
Methods
In-depth interviews were conducted with 46 policymakers (Ghana, n = 24; Malawi, n = 22), identified through snowballing sampling. Interviews were supplemented by field notes and the analysis of policy documents.
Results
The use of vaccination to interrupt the pandemic influenza was affected by delays in the procurement, delivery and administration of vaccines, suboptimal vaccination coverage, refusals to be vaccinated, and the politics behind vaccination strategies. More generally, rolling-out of vaccination after the transmission of the influenza virus had abated was influenced by policymakers’ own financial incentives, and government and foreign policy conditionality on vaccination. This led to confusion about targeting and coverage, with many policymakers justifying that the vaccination of 10% of the population would establish herd immunity and so reduce future risk. Ghana succeeded in vaccinating 2.3 million of the select groups (100% coverage), while Malawi, despite recourse to force, succeeded only in vaccinating 1.15 million (74% coverage of select groups). For most policymakers, vaccination coverage was perceived as successful, despite that vaccination delays and coverage would not have prevented infection when influenza was at its peak.
Conclusions
While the vaccination strategy was problematic and implemented too late to reduce the effects of the 2009 epidemic, policy makers supported the overall goal of pandemic influenza vaccination to interrupt infection. In this context, there was strong support for governments engaging in contracts with pharmaceutical companies to ensure the timely supply of vaccines, and developing well-defined guidelines to address vaccination delays, refusals and coverage.

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 4 March 2017)

Research article
Utilization of outreach immunization services among children in Hoima District, Uganda: a cluster survey
The global vaccine action plan 2011–2020 was endorsed by 194 states to equitably extend the benefits of immunization to all people. However, gaps in vaccination coverage remain in developing countries such as Uganda. One of the strategies used to tackle existing inequities is implementation of outreach immunization services to deliver services to those with poor geographical access. However, reports of inconsistent use of these services prevail; therefore understanding the factors associated with use of these services is critical for improving service delivery. This study examined the factors associated with utilization of outreach immunization services among children aged 10–23 months in Hoima District, Uganda.
Paul Oryema, Juliet N. Babirye, Charles Baguma, Peter Wasswa and David Guwatudde
BMC Research Notes 2017 10:111
Published on: 27 February 2017

Bulletin of the World Health Organization
Volume 95, Number 3, March 2017, 165-240
http://www.who.int/bulletin/volumes/95/3/en/

Research
Risk of microcephaly after Zika virus infection in Brazil, 2015 to 2016
Thomas Jaenisch, Kerstin Daniela Rosenberger, Carlos Brito, Oliver Brady, Patrícia Brasil & Ernesto TA Marques
http://dx.doi.org/10.2471/BLT.16.178608

Bulletin of the World Health Organization
Volume 95, Number 3, March 2017, 165-240
http://www.who.int/bulletin/volumes/95/3/en/

Research
Hepatitis B vaccination timing: results from demographic health surveys in 47 countries
Aparna Schweitzer, Manas K Akmatov & Gérard Krause
http://dx.doi.org/10.2471/BLT.16.178822
Objective
To examine the impact of hepatitis B vaccination schedules and types of vaccines on hepatitis B vaccination timing.
Methods
We used data for 211 643 children from demographic and health surveys in 47 low- and middle-income countries (median study year 2012). Data were from vaccination cards and maternal interviews. We grouped countries according to the vaccination schedule and type of vaccine used (monovalent or combination). For each country, we calculated hepatitis B vaccination coverage and timely receipt of vaccine doses. We used multivariable logistic regression models to study the effect of vaccination schedules and types on vaccination delay.
Findings
Substantial delays in vaccination were observed even in countries with fairly high coverage of all doses. Median delay was 1.0 week (interquartile range, IQR: 0.3 to 3.6) for the first dose (n = 108 626 children) and 3.7 weeks (IQR: 1.4 to 9.3) for the third dose (n = 101  542). We observed a tendency of lower odds of delays in vaccination schedules starting at 6 and at 9 weeks of age. For the first vaccine dose, we recorded lower odds of delays for combination vaccines than for monovalent vaccines (adjusted odds ratio, aOR: 0.76, 95% confidence interval, CI: 0.71 to 0.81).
Conclusion
Wide variations in hepatitis B vaccination coverage and adherence to vaccination schedules across countries underscore the continued need to strengthen national immunization systems. Timely initiation of the vaccination process might lead to timely receipt of successive doses and improved overall coverage. We suggest incorporating vaccination timing as a performance indicator of vaccination programmes to complement coverage metrics.

Bulletin of the World Health Organization
Volume 95, Number 3, March 2017, 165-240
http://www.who.int/bulletin/volumes/95/3/en/

SYSTEMATIC REVIEWS
Pre-exposure rabies prophylaxis: a systematic review
Jocelyn A Kessels, Sergio Recuenco, Ana Maria Navarro-Vela, Raffy Deray, Marco Vigilato, Hildegund Ertl, David Durrheim, Helen Rees, Louis H Nel, Bernadette Abela-Ridder & Deborah Briggs
http://dx.doi.org/10.2471/BLT.16.173039
Objective
To review the safety and immunogenicity of pre-exposure rabies prophylaxis (including accelerated schedules, co-administration with other vaccines and booster doses), its cost–effectiveness and recommendations for use, particularly in high-risk settings.
Methods
We searched the PubMed, Centre for Agriculture and Biosciences International, Cochrane Library and Web of Science databases for papers on pre-exposure rabies prophylaxis published between 2007 and 29 January 2016. We reviewed field data from pre-exposure prophylaxis campaigns in Peru and the Philippines.
Findings
Pre-exposure rabies prophylaxis was safe and immunogenic in children and adults, also when co-administered with routine childhood vaccinations and the Japanese encephalitis vaccine. The evidence available indicates that shorter regimens and regimens involving fewer doses are safe and immunogenic and that booster intervals could be extended up to 10 years. The few studies on cost suggest that, at current vaccine and delivery costs, pre-exposure prophylaxis campaigns would not be cost-effective in most situations. Although pre-exposure prophylaxis has been advocated for high-risk populations, only Peru and the Philippines have implemented appropriate national programmes. In the future, accelerated regimens and novel vaccines could simplify delivery and increase affordability.
Conclusion
Pre-exposure rabies prophylaxis is safe and immunogenic and should be considered: (i) where access to postexposure prophylaxis is limited or delayed; (ii) where the risk of exposure is high and may go unrecognized; and (iii) where controlling rabies in the animal reservoir is difficult. Pre-exposure prophylaxis should not distract from canine vaccination efforts, provision of postexposure prophylaxis or education to increase rabies awareness in local communities.

Bulletin of the World Health Organization
Volume 95, Number 3, March 2017, 165-240
http://www.who.int/bulletin/volumes/95/3/en/

LESSONS FROM THE FIELD
Adapting Nepal’s polio eradication programme
Krishna P Paudel, Lee M Hampton, Santosh Gurung, Rajendra Bohara, Indra K Rai, Sameer Anaokar, Rachel D Swift & Stephen Cochi
http://dx.doi.org/10.2471/BLT.16.173674

PERSPECTIVES
Therapeutic antibodies for infectious diseases
Erin Sparrow, Martin Friede, Mohamud Sheikh & Siranda Torvaldsen
http://dx.doi.org/10.2471/BLT.16.178061

Epidemiology and Infection
Volume 145 – Issue 4 – March 2017
http://www.cambridge.org/core/journals/epidemiology-and-infection/latest-issue

Original Papers
Factors associated with influenza vaccine uptake in older adults living in the community in Singapore
L. W. ANG, J. CUTTER, L. JAMES, K. T. GOH
DOI: https://doi.org/10.1017/S0950268816002491
Published online: 08 December 2016, pp. 775-786
Abstract
In Singapore, influenza vaccination is recommended for persons at higher risk of complications of seasonal influenza, including those with chronic medical conditions and the elderly (individuals aged ⩾65 years). We investigated the factors associated with influenza vaccine uptake based on a nationally representative sample of community-dwelling adults aged >50 years. The data for this study were obtained from the National Health Surveillance Survey (NHSS) 2013. The association between influenza vaccine uptake and socio-demographic and health-related variables was analysed using univariable and multivariable logistic regression models. Of 3700 respondents aged ⩾50 years in the NHSS, 15·2% had received seasonal influenza vaccination in the past year. Older age, single marital status and economic inactivity were the socio-demographic variables independently associated with vaccine uptake. Health-related factors which were predictive of influenza vaccine uptake were sufficient total physical activity, better self-rated health, having at least one medical condition at risk of influenza complications and a regular family doctor/general practitioner. Influenza vaccine uptake in community-dwelling older adults was low. Our findings are of relevance in the formulation of public health policies and targeted health promotion strategies to increase vaccine uptake in this population group.

Health Research Policy and Systems

[Accessed 4 March 2017]

Research
Pathways to research impact in primary healthcare: What do Australian primary healthcare researchers believe works best to facilitate the use of their research findings?
Primary healthcare researchers are under increasing pressure to demonstrate measurable and lasting improvement in clinical practice and healthcare policy as a result of their work. It is therefore important to…
Richard L. Reed, Ellen McIntyre, Eleanor Jackson-Bowers and Libby Kalucy
Health Research Policy and Systems 2017 15:17
Published on: 2 March 2017

International Journal of Community Medicine and Public Health
Vol 4, No 3 (2017) March 2017
http://www.ijcmph.com/index.php/ijcmph/issue/view/21

Original Research Articles
Is mothers’ knowledge and practice regarding childhood immunization compliant with immunization completeness?
Nafeha Sameen Siddiqui, Arvind K. Gaikwad, Bina M. Kuril, Rajendra T. Ankushe, Mohan K. Doibale, Sandeep B. Pund, Purushottam Kumar
Abstract
Background: Immunization is one of the most effective, safest and efficient public health interventions. Despite the concrete efforts of government and other health agencies, a large proportion of vulnerable infants and children in India remain unimmunized. In order to improve immunization coverage, factors such as knowledge, attitude and practices of parents/caretakers are known to contribute to success or failure of immunization program. The aim of present study is to assess the knowledge and practice of mothers with respect to immunization completeness of their child.
Methods: This is a descriptive cross sectional study involving 364 mothers attending immunization OPD in Government Medical College, Aurangabad, Maharashtra, India during month of September till December 2015.
Results: 78.5% children were completely immunized as per date. 57.97% of the study population was found to have adequate knowledge-practice scores. A significant association of immunization completeness with KP scores of mothers (p<0.05) was found.
Conclusions: Future efforts are required to improve immunization rate and parents’ knowledge and practice.

International Journal of Community Medicine and Public Health
Vol 4, No 3 (2017) March 2017
http://www.ijcmph.com/index.php/ijcmph/issue/view/21

Original Research Articles
Assessment of under-five immunization coverage among the population of slum areas in Mangalore taluk, India
Saurabh Kumar, Sudhir Prabhu, Arun P. Jose, Sowmya Bhat, Oliver D. Souza, Narayana V.
Abstract
Background: Immunization coverage is better in urban than rural areas. However, we anticipate and argue that within the urban areas disparities and inequities persist in immunization coverage and that the socioeconomically disadvantaged, particularly those who reside in slum areas are more vulnerable and may contribute to the lower uptake of immunization. The objectives of the study were to assess the under-five immunization coverage amongst the households in slums of Mangalore taluk and to identify determinants of full immunization uptake among under 5 in the slums population and to know the reasons for non-immunization or partial immunization of children.
Methods: Community Based Cross sectional study was conducted in the notified slum areas of Mangalore during August-November 2015. Information was collected from the parents regarding vaccination of their children and sociodemographic variables using a semi-structured interview schedule.
Results: 88 (57.7%) of under 5 children were fully immunized, 62 (41.3%) were partially immunized in the slum areas of Mangalore, Karnataka, India. Mean age of the children in our study was found to be 35.15 months. Immunization coverage was found to be associated with the presence of immunization card, occupation of mother, knowledge about universal immunization programme (UIP), knowledge about protection offered by vaccines.
Conclusions: Unfortunately, the immunization coverage was found to be very bad in the slum areas of Mangalore city, Karnataka, India. There is an urgent need to ensure that regular health education sessions are conducted. Secondly, slum areas should be the target of RCH programme with special focus on immunization related activities e.g. ensuring that all households with children should have immunization cards, as the slum areas remain the neglected section of the society due to various reasons.

JAMA
February 28, 2017, Vol 317, No. 8, Pages 783-880
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Linking Immunization Status and Eligibility for Welfare and Benefits Payments The Australian “No Jab, No Pay” Legislation
Y. Tony Yang, ScD, LLM, MPH; David M. Studdert, LLB, ScD, MPH
The recent outbreaks of vaccine-preventable diseases have refocused attention on the threat posed by unvaccinated and undervaccinated individuals.1 Governments around the world have responded by strengthening laws and policies directed at increasing vaccination rates. The standard menu of options includes education and information initiatives, incentives, and mandates; these may be directed at the general public, health care organizations, or practitioners.

Journal of Medical Ethics
March 2017 – Volume 43 – 3
http://jme.bmj.com/content/current

Editorials
Introduction: Special Issue on the Ethics of Incentives in Healthcare
Anca Gheaus, Verina Wild
This special issue is the result of a conference organised by Verina Wild and Anca Gheaus, at the Ludwig-Maximilians University of Munich in December 2014. The conference addressed normative issues raised by the use of incentive mechanisms to promote better health, and included papers by most contributors to this special issue. So far, the normative discussion on health incentives focussed on questions of autonomy, paternalism, motivation and responsibility. This resulting special issue responds to a need to expand the normative analysis of such measures to other issues of justice, which have so far been largely ignored.
Recent policies and programmes in health prevention tend to appeal to, and encourage, individual responsibility with respect to lifestyle choices. One way of advancing this goal is via schemes that provide individuals with incentives to live healthy lives. For example, individuals may be offered discounted health insurance rates if they adopt healthy lifestyles or be given vouchers to purchase healthy food or to use fitness centres. Such programmes often use so-called ‘nudging’ mechanisms, meant to motivate people without coercively interfering with their private choices and to improve health outcomes without overregulating the market for products that are detrimental to health. They also raise many normative questions…

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Public health ethics
Paper: Paying for antiretroviral adherence: is it unethical when the patient is an adolescent?
Justin Healy, Rebecca Hope, Jacqueline Bhabha, Nir Eyal

.

Which strings attached: ethical considerations for selecting appropriate conditionalities in conditional cash transfer programmes
Carleigh B Krubiner, Maria W Merritt

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Paper: Solidarity, justice and unconditional access to healthcare
Anca Gheaus

The Lancet
Mar 04, 2017 Volume 389 Number 10072 p881-982 e3
http://www.thelancet.com/journals/lancet/issue/current

Editorial
Syndemics: health in context
The Lancet
Syndemics, as a new Series published in today’s Lancet details, is a conceptual framework for understanding diseases or health conditions that arise in populations and that are exacerbated by the social, economic, environmental, and political milieu in which a population is immersed. A syndemic, or synergistic epidemic, is more than a convenient portmanteau or a synonym for comorbidity. The hallmark of a syndemic is the presence of two or more disease states that adversely interact with each other, negatively affecting the mutual course of each disease trajectory, enhancing vulnerability, and which are made more deleterious by experienced inequities.

Perhaps the most unique feature of the syndemic approach to understanding various disease states and the way in which they cluster is the emphasis on the situation and circumstances in which individuals live. In other words, syndemics fundamentally rely on context. When introduced in the 1990s by medical anthropologist Merrill Singer, the notion of a syndemic was used to describe the interactions among substance abuse, violence, and AIDS (SAVA), that had become a full-blown health crisis in Hartford, CT, USA. While investigating HIV prevention in drug users, researchers took notice of the constellation of elements that impinged on risk, structural factors such as lack of housing and poverty, and social aspects such as stigma and lack of support systems—all reinforcing the disease burden.

The observation that these factors did not merely exist in parallel, but were intertwined and cumulative, offered a branch point for clinical medicine and public health interventions. These fields have made appreciable strides in recognising that interventions for combating and treating disease must take a more multifactorial tack, nevertheless there exists a great need and opportunity to more widely apply the principles of the syndemic approach. In the years since SAVA was identified, there have been other syndemics described that include HIV/AIDS as a component, such as the HIV–malnutrition–food insecurity syndemic in sub-Saharan Africa. Alternatively, other existing and emerging syndemics centre on non-communicable diseases (NCDs) such as VIDDA (violence, immigration, depression, type 2 diabetes, and abuse) in women who have emigrated to the USA from Mexico.

Whether communicable diseases or NCDs, or set in high-income countries or low-income and middle-income countries (LMICs), there are similar forces at work that can perpetuate or accelerate existing syndemics. Specifically, rapid changes can precipitate conditions conducive to developing syndemics. For example, globalisation patterns have quickly and fundamentally changed dietary patterns in LMICs by increasing access to high-calorie foods and processed carbohydrates, radically increasing the proportion of individuals with type 2 diabetes. Changes in political and economic conditions, and relatedly the breakdown of protective health measures or infrastructure, can induce differentially and additive detrimental effects on specific populations.

The political and public health changes underway in the USA are especially worrisome in their potential for spurring a new wave of unforeseen health crises. The VIDDA syndemic may serve as a harbinger of sorts for other potential immigrant health-related syndemics because of the current uncertainty around immigration policy. After the executive order issued on Jan 25, 2017, immigration enforcement has pushed many people who were previously at low risk for deportation into an uneasy and unwelcome spotlight. Several major news outlets have reported recently that health-care centres have already noted a downturn in the number of immigrant patients keeping appointments for chronic conditions such as diabetes and hypertension. It is well documented that Hispanic patients are less likely to seek medical attention than are other ethnic groups, but in the wake of an already precarious climate for Mexican immigrants, the emerging accounts highlight an even greater vulnerability because of new political threats. From a clinical perspective, applying a syndemic approach is novel and valuable for expanding the focus from why a patient has a poor outcome (eg, dysregulated blood sugar) to what other factors are contributing.

Although there may be little that clinical practitioners and public health interventionists can do about the presence of social and political circumstances that might negatively affect health, the syndemic framework allows for the potential to mitigate those effects by appreciating the complex nature of certain diseases and conditions and for addressing the array of factors that give rise to them. In the pursuit of practising more socially conscious medicine, syndemics suggest that context is key.

The Lancet
Mar 04, 2017 Volume 389 Number 10072 p881-982 e3
http://www.thelancet.com/journals/lancet/issue/current

Editorial
Research matters: challenges of replication
The Lancet
Summary
Scientific progress builds on an ever-accumulating body of evidence gathered over generations, and is deeply rooted in tenets of reliability and reproducibility. Last week, in Nature, Jeffery Mogil and Malcolm Macleod proposed a new framework that aims to instil greater confidence in research, calling for findings from basic research laboratories to be validated by a definitive preclinical trial before testing in human beings.
In their article, Mogil and Macleod highlight concerns of a so-called reproducibility crisis in scientific research. And they are by no means the first. In 2016, results of a brief online questionnaire of over 1500 basic science researchers published in Nature revealed that as many as 90% of those surveyed agreed that there was a reproducibility crisis in science. The Reproducibility Project: Cancer Biology aims to independently reproduce published results of high profile studies in cancer biology. In January this year, eLife published findings from the first five replication studies, some of which showed mixed results.
Such endeavours should be applauded for their intentions to ensure dissemination of robust findings in a culture often driven by fierce competition for publications and funding. But use of the term crisis over-generalises complex issues that are specific to highly intricate biological systems—such terminology could dangerously undermine public confidence in science and researchers. In an era when alternative facts are presented as truth, and lines between fact and fiction are increasingly blurred, trust in research integrity must be reaffirmed and defended.
Replicating studies is important, but to conclude that a failure to reproduce specific findings is failed science oversimplifies the problem. Novel research is, by nature, exploratory and diverse, and variations exist between experimental sites and individuals. Prescriptive regulation of scientific thought and processes that stifle creativity under a guise of enforcing reliability could ultimately impede discovery and advancement. Stakeholders, including funders, publishers, industry, and academics must enter a dialogue to establish nuanced solutions to improve transparency, accountability, and reporting of research.

The Lancet
Mar 04, 2017 Volume 389 Number 10072 p881-982 e3
http://www.thelancet.com/journals/lancet/issue/current

Series
Syndemics
Syndemics and the biosocial conception of health
Merrill Singer, Nicola Bulled, Bayla Ostrach, Emily Mendenhall
Summary
The syndemics model of health focuses on the biosocial complex, which consists of interacting, co-present, or sequential diseases and the social and environmental factors that promote and enhance the negative effects of disease interaction. This emergent approach to health conception and clinical practice reconfigures conventional historical understanding of diseases as distinct entities in nature, separate from other diseases and independent of the social contexts in which they are found. Rather, all of these factors tend to interact synergistically in various and consequential ways, having a substantial impact on the health of individuals and whole populations. Specifically, a syndemics approach examines why certain diseases cluster (ie, multiple diseases affecting individuals and groups); the pathways through which they interact biologically in individuals and within populations, and thereby multiply their overall disease burden, and the ways in which social environments, especially conditions of social inequality and injustice, contribute to disease clustering and interaction as well as to vulnerability. In this Series, the contributions of the syndemics approach for understanding both interacting chronic diseases in social context, and the implications of a syndemics orientation to the issue of health rights, are examined.

The Lancet
Mar 04, 2017 Volume 389 Number 10072 p881-982 e3
http://www.thelancet.com/journals/lancet/issue/current

Syndemics
Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations
Emily Mendenhall, Brandon A Kohrt, Shane A Norris, David Ndetei, Dorairaj Prabhakaran
Summary
The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.

The Lancet
Mar 04, 2017 Volume 389 Number 10072 p881-982 e3
http://www.thelancet.com/journals/lancet/issue/current

Syndemics
Syndemic vulnerability and the right to health
Sarah S Willen, Michael Knipper, César E Abadía-Barrero, Nadav Davidovitch
Summary
Investigators working both in syndemics, a field of applied health research with roots in medical anthropology, and in the field of health and human rights recognise that upstream social, political, and structural determinants contribute more to health inequities than do biological factors or personal choices. Syndemics investigates synergistic, often deleterious interactions among comorbid health conditions, especially under circumstances of structural and political adversity. Health and human rights research draws on international law to argue that all people deserve access not only to health care, but also to the underlying determinants of good health. Taking the urgent matter of migrant health as an empirical focus, we juxtapose the fields of syndemics and health and human rights, identify their complementarities, and advocate for a combined approach. By melding insights from these fields, the combined syndemics/health and human rights approach advanced here can provide clinicians and other key stakeholders with concrete insights, tools, and strategies to tackle the health inequities that affect migrants and other vulnerable groups by: (1) mapping the effect of social, political, and structural determinants on health; (2) identifying opportunities for upstream intervention; and (3) working collaboratively to tackle the structures, institutions, and processes that cause and exacerbate health inequities. Undergirding this approach is an egalitarian interpretation of the right to health that differs from narrow legalistic and individual interpretations by insisting that all people are equal in worth and, as a result, equally deserving of protection from syndemic vulnerability.

The Lancet
Mar 04, 2017 Volume 389 Number 10072 p881-982 e3
http://www.thelancet.com/journals/lancet/issue/current

Viewpoint
Co-occurring epidemics, syndemics, and population health
Alexander C Tsai, Emily Mendenhall, James A Trostle, Ichiro Kawachi
Summary
As originally theorised, three concepts underlie the notion of a syndemic: disease concentration, disease interaction, and the large-scale social forces that give rise to them.1,2 The concept of disease concentration holds that two or more epidemics co-occur in particular temporal or geographical contexts due to harmful social conditions. This aspect of the theory of syndemics is not necessarily what makes its contribution distinctive. For example, anthropologists have long called attention to the manner in which large-scale political, economic, and cultural forces have given rise to clustered epidemics of various infectious diseases, most prominently HIV and tuberculosis;3–5 and the theory of fundamental causes highlights the roles of these forces in driving concentrated health disadvantage.

Lancet Global Health
Mar 2017 Volume 5 Number 3 e229-e369
http://www.thelancet.com/journals/langlo/issue/current

Articles
Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review
Luke Allen, Julianne Williams, Nick Townsend, Bente Mikkelsen, Nia Roberts, Charlie Foster, Kremlin Wickramasinghe

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First estimates of the global and regional incidence of neonatal herpes infection
Katharine J Looker, Amalia S Magaret, Margaret T May, Katherine M E Turner, Peter Vickerman, Lori M Newman, Sami L Gottlieb

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Immunity duration of a recombinant adenovirus type-5 vector-based Ebola vaccine and a homologous prime-boost immunisation in healthy adults in China: final report of a randomised, double-blind, placebo-controlled, phase 1 trial
Jing-Xin Li, Li-Hua Hou, Fan-Yue Meng, Shi-Po Wu, Yue-Mei Hu, Qi Liang, Kai Chu, Zhe Zhang, Jun-Jie Xu, Rong Tang, Wen-Juan Wang, Pei Liu, Jia-Lei Hu, Li Luo, Rong Jiang, Feng-Cai Zhu, Wei Chen

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Community resource centres to improve the health of women and children in informal settlements in Mumbai: a cluster-randomised, controlled trial
Neena Shah More, Sushmita Das, Ujwala Bapat, Glyn Alcock, Shreya Manjrekar, Vikas Kamble, Rijuta Sawant, Sushma Shende, Nayreen Daruwalla, Shanti Pantvaidya, David Osrin

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Levels and trends in contraceptive prevalence, unmet need, and demand for family planning for 29 states and union territories in India: a modelling study using the Family Planning Estimation Tool
Jin Rou New, Niamh Cahill, John Stover, Yogender Pal Gupta, Leontine Alkema

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Effectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children: a case-control study
Cheryl Cohen, Claire von Mollendorf, Linda de Gouveia, Sarona Lengana, Susan Meiring, Vanessa Quan, Arthermon Nguweneza, David P Moore, Gary Reubenson, Mamokgethi Moshe, Shabir A Madhi, Brian Eley, Ute Hallbauer, Heather Finlayson, Sheeba Varughese, Katherine L O’Brien, Elizabeth R Zell, Keith P Klugman, Cynthia G Whitney, Anne von Gottberg for the South African IPD Case-Control Study Group

Lancet Infectious Diseases
Mar 2017 Volume 17 Number 3 p237-348 e70-e106
http://www.thelancet.com/journals/laninf/issue/current

Articles
Mortality in children diagnosed with tuberculosis: a systematic review and meta-analysis
Helen E Jenkins, Courtney M Yuen, Carly A Rodriguez, Ruvandhi R Nathavitharana, Megan M McLaughlin, Peter Donald, Ben J Marais, Mercedes C Becerra

Lancet Infectious Diseases
Mar 2017 Volume 17 Number 3 p237-348 e70-e106
http://www.thelancet.com/journals/laninf/issue/current

Serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumococcal pneumonia in adults aged 65 years or older: a multicentre, prospective, test-negative design study
Motoi Suzuki, Bhim Gopal Dhoubhadel, Tomoko Ishifuji, Michio Yasunami, Makito Yaegashi, Norichika Asoh, Masayuki Ishida, Sugihiro Hamaguchi, Masahiro Aoshima, Koya Ariyoshi, Konosuke Morimoto on behalf of the Adult Pneumonia Study Group-Japan (APSG-J)

Lancet Infectious Diseases
Mar 2017 Volume 17 Number 3 p237-348 e70-e106
http://www.thelancet.com/journals/laninf/issue/current

Spread of yellow fever virus outbreak in Angola and the Democratic Republic of the Congo 2015–16: a modelling study
Moritz U G Kraemer, Nuno R Faria, Robert C Reiner Jr, Nick Golding, Birgit Nikolay, Stephanie Stasse, Michael A Johansson, Henrik Salje, Ousmane Faye, G R William Wint, Matthias Niedrig, Freya M Shearer, Sarah C Hill, Robin N Thompson, Donal Bisanzio, Nuno Taveira, Heinrich H Nax, Bary S R Pradelski, Elaine O Nsoesie, Nicholas R Murphy, Isaac I Bogoch, Kamran Khan, John S Brownstein, Andrew J Tatem, Tulio de Oliveira, David L Smith, Amadou A Sall, Oliver G Pybus, Simon I Hay, Simon Cauchemez
Open Access

Lancet Infectious Diseases
Mar 2017 Volume 17 Number 3 p237-348 e70-e106
http://www.thelancet.com/journals/laninf/issue/current

Series
Dengue
Disease and economic burdens of dengue
Marcia C Castro, Mary E Wilson, David E Bloom

Dengue
Prevention and control of dengue—the light at the end of the tunnel
Tikki Pang, Tippi K Mak, Duane J Gubler

Dengue
Dengue: knowledge gaps, unmet needs, and research priorities
Leah C Katzelnick, Josefina Coloma, Eva Harris
e88

Personal View
Epidemic arboviral diseases: priorities for research and public health
Annelies Wilder-Smith, Duane J Gubler, Scott C Weaver, Thomas P Monath, David L Heymann, Thomas W Scott

Nature
Volume 543 Number 7643 pp8-144 2 March 2017
http://www.nature.com/nature/current_issue.html

Editorial
Data on movements of refugees and migrants are flawed
Accurate and timely information on the flow of people is crucial for policymaking and apolitical interpretations.

New England Journal of Medicine
March 2, 2017  Vol. 376 No. 9
http://www.nejm.org/toc/nejm/medical-journal

Review Article
The Changing Face of Clinical Trials: Informed Consent
C. Grady and Others
This multipart review provides an overview of innovative approaches to improving and expanding the informed consent process for researchers and participants, along with short essays covering specific areas of innovation.

New England Journal of Medicine
March 2, 2017  Vol. 376 No. 9
http://www.nejm.org/toc/nejm/medical-journal

Special Report
Conflicts of Interest for Patient-Advocacy Organizations
M.S. McCoy and Others
Share:
In this examination of 104 large patient-advocacy organizations, 83% receive financial support from drug, device, and biotechnology companies, and industry executives often serve on governing boards. The authors recommend more transparency about industry involvement.

Pediatrics
March 2017, VOLUME 139 / ISSUE 3
http://pediatrics.aappublications.org/content/139/3?current-issue=y

Articles
Poverty and Trends in Three Common Chronic Disorders
For asthma, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), the objectives were to (1) describe the percent increases in prevalence and comorbidity and how these vary by poverty status, and (2) examine the extent to which poverty status is a predictor of higher than average comorbid conditions.
Christian D. Pulcini, Bonnie T. Zima, Kelly J. Kelleher, Amy J. Houtrow
Pediatrics Mar 2017, 139 (3) e20162539; DOI: 10.1542/peds.2016-2539

Pediatrics
March 2017, VOLUME 139 / ISSUE 3
http://pediatrics.aappublications.org/content/139/3?current-issue=y

Articles
Safety of Second-Dose Single-Antigen Varicella Vaccine
We identified no new or unexpected safety concerns for second-dose varicella vaccination. Robust safety monitoring remains an important component of the national varicella vaccination program.
John R. Su, Zanie Leroy, Paige W. Lewis, Penina Haber, Mona Marin, Jessica Leung, Emily Jane Woo, Tom T. Shimabukuro
Pediatrics Mar 2017, 139 (3) e20162536; DOI: 10.1542/peds.2016-2536

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
[Accessed 4 March 2017]

Research Article
Vaccine Hesitancy: In Search of the Risk Communication Comfort Zone
March 3, 2017 ·
Introduction: This paper reports the findings of a national online survey to parents of children aged 5 and younger. The objectives of the study were to assess parental understanding of childhood immunizations, identify sources of information that they trust for vaccine-related content, assess where parents with young children stand on the key issues in the public debate about vaccination, and identify which risk communication messages are most effective for influencing the behaviours of vaccine hesitant parents.
Methods: A total of 1,000 surveys (closed and open-ended questions) were administered in November 2015 using the Angus Reid Forum Panel, a key consumer panel consisting of approximately 150,000 Canadian adults aged 18 and older, spread across all geographic regions of Canada.
Results: Approximately 92% of the Canadian parents surveyed consider vaccines safe and effective, and trust doctors and public health officials to provide timely and credible vaccine-related information. However, a concerning number of them either believe or are uncertain whether there is a link between vaccines and autism (28%), worry that vaccines might seriously harm their children (27%), or believe the pharmaceutical industry is behind the push for mandatory immunization (33%). Moreover, despite the common assumption that social media are becoming the go-to source of health news and information, most parents still rely on traditional media and official government websites for timely and credible information about vaccines and vaccine preventable diseases, particularly during community-based disease outbreaks. Finally, parents reported high levels of support for pro-vaccine messaging that has been demonstrated in previous research to have little to no positive impact on behaviour change, and may even be counterproductive.
Discussion: The study’s results are highly relevant in a context where public health officials are expending significant resources to increase rates of childhood immunization and combat vaccine hesitancy. The data offer insight into where parents stand on the political and public debate about mandatory vaccination, what aspects of vaccine science remain uncertain to them, which media and institutional sources they use and trust to navigate the health information environment, how they look for information and whom they trust during periods of health emergency or crisis, and which communication strategies are considered most effective in persuading vaccine hesitant parents to immunize their children.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 March 2017)

Perspective
The potential benefit of scaling up malaria prevention to reduce low birth weight in Africa
James G. Beeson, Julie A. Simpson
Perspective | published 28 Feb 2017 P
http://dx.doi.org/10.1371/journal.pmed.1002244

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 March 2017)

Perspective
Hope for HIV control in southern Africa: The continued quest for a vaccine
Linda-Gail Bekker, Glenda E. Gray
Perspective | published 28 Feb 2017 P
http://dx.doi.org/10.1371/journal.pmed.1002241
… The findings of the HVTN 702 trial have the potential to be a great leap in HIV prevention research, with vaccine efficacy results anticipated in early 2021. But, even if efficacious, a paramount challenge will be getting the vaccine out of the laboratory and to those people who need it most—particularly, difficult-to-reach populations in low- and middle-income countries. Notably, the cost of vaccine manufacturing will play a large role, as developing countries are already having to make tough decisions regarding optimal funding of HIV prevention and treatment programs. If a vaccine is at best only partially efficacious, the correct combination of preventative measures will need to be explored, likely on a population-specific basis, and choices made. From current predictions, however, a safe vaccine of even modest efficacy could be the game changer necessary to close the HIV prevention gap.

PLoS One
http://www.plosone.org/
[Accessed 4 March 2017]

Research Article
Determinants of geographic inequalities in HPV vaccination in the most populated region of France
Delphine Héquet, Roman Rouzier
Research Article | published 03 Mar 2017 P
http://dx.doi.org/10.1371/journal.pone.0172906

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Impact of ten-valent pneumococcal conjugate vaccine on pneumonia in Finnish children in a nation-wide population-based study
Arto A. Palmu, Hanna Rinta-Kokko, Hanna Nohynek, J. Pekka Nuorti, Terhi M. Kilpi, Jukka Jokinen
Research Article | published 01 Mar 2017 P
http://dx.doi.org/10.1371/journal.pone.0172690

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Impact of vaccine herd-protection effects in cost-effectiveness analyses of childhood vaccinations. A quantitative comparative analysis
Marisa Holubar, Maria Christina Stavroulakis, Yvonne Maldonado, John P. A. Ioannidis, Despina Contopoulos-Ioannidis
Research Article | published 01 Mar 2017
http://dx.doi.org/10.1371/journal.pone.0172414

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Assessments of global drivers of vaccine hesitancy in 2014—Looking beyond safety concerns
Melanie Marti, Monica de Cola, Noni E. MacDonald, Laure Dumolard, Philippe Duclos
Research Article | published 01 Mar 2017 P
http://dx.doi.org/10.1371/journal.pone.0172310

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HPV vaccine knowledge and acceptability among Peruvian men who have sex with men and transgender women: A pilot, qualitative study
Jerome T. Galea, Emmi Monsour, César R. Nureña, Magaly M. Blas, Brandon Brown
Research Article | published 28 Feb 2017 P
http://dx.doi.org/10.1371/journal.pone.0172964

Science
03 March 2017 Vol 355, Issue 6328
http://www.sciencemag.org/current.dtl

Editorial
Evolving policy with science
By R. Alta Charo, Richard O. Hynes
Science03 Mar 2017 : 889
Summary
Albert Schweitzer, physician and Nobel laureate, wrote: “The first step in the evolution of ethics is a sense of solidarity with other human beings.” The evolution of U.S. policy governing heritable human germline modification reflects this observation, and a “Human Genome Editing” consensus study committee of the U.S. National Academy of Sciences and National Academy of Medicine (NAM) concluded last month that clinical trials for heritable editing, under strict regulations, may eventually be permissible for parents hoping to prevent serious diseases in their children.

Science
03 March 2017 Vol 355, Issue 6328
http://www.sciencemag.org/current.dtl

Policy Forum
The need for a translational science of democracy
By Michael A. Neblo, William Minozzi, Kevin M. Esterling, Jon Green, Jonathon Kingzette, David M. J. Lazer
Science03 Mar 2017 : 914-915 Restricted Access
The political science community should focus on how to foster the health of democracy
Summary
The bitterly factious 2016 U.S. presidential election campaign was the culmination of several trends that, taken together, constitute a syndrome of chronic ailments in the body politic. Ironically, these destructive trends have accelerated just as science has rapidly improved our understanding of them and their underlying causes. But mere understanding is not sufficient to repair our politics. The challenge is to build a translational science of democracy that maintains scientific rigor while actively promoting the health of the body politic.

Science Translational Medicine
01 March 2017 Vol 9, Issue 379
http://stm.sciencemag.org/

Editorial
Rx for Innovation: A path forward for us all
By Margaret Anderson
Science Translational Medicine01 Mar 2017 Full Access
The health citizenship movement can provide a platform for citizens—healthy and ill—to engage with researchers, industry, and regulators.

Social Science & Medicine
Volume 174, Pages 1-228 (February 2017)
http://www.sciencedirect.com/science/journal/02779536/173

Original Research Article
Governance of global health research consortia: Sharing sovereignty and resources within Future Health Systems
Pages 113-121
Bridget Pratt, Adnan A. Hyder
Abstract
Global health research partnerships are increasingly taking the form of consortia that conduct programs of research in low and middle-income countries (LMICs). An ethical framework has been developed that describes how the governance of consortia comprised of institutions from high-income countries and LMICs should be structured to promote health equity. It encompasses initial guidance for sharing sovereignty in consortia decision-making and sharing consortia resources. This paper describes a first effort to examine whether and how consortia can uphold that guidance. Case study research was undertaken with the Future Health Systems consortium, performs research to improve health service delivery for the poor in Bangladesh, China, India, and Uganda. Data were thematically analysed and revealed that proposed ethical requirements for sharing sovereignty and sharing resources are largely upheld by Future Health Systems. Facilitating factors included having a decentralised governance model, LMIC partners with good research capacity, and firm budgets. Higher labour costs in the US and UK and the funder’s policy of allocating funds to consortia on a reimbursement basis prevented full alignment with guidance on sharing resources. The lessons described in this paper can assist other consortia to more systematically link their governance policy and practice to the promotion of health equity.

Social Science & Medicine
Volume 174, Pages 1-228 (February 2017)
http://www.sciencedirect.com/science/journal/02779536/173

Original Research Article
Dynamic axes of informed consent in Japan
Pages 159-168
Laura Specker Sullivan
Abstract
Scholarship in cross-cultural bioethics routinely frames Japanese informed consent in contrast to informed consent in North America. This contrastive analysis foregrounds cancer diagnosis disclosure and physician paternalism as unique aspects of Japanese informed consent that deviate from American practices. Drawing on in-depth interviews with 15 Japanese medical professionals obtained during fieldwork in Japan from 2013 to 15, this article complicates the informed consent discourse beyond East-West comparisons premised on Anglo-American ethical frameworks. It expands professional perspectives to include nurses, medical social workers, clinical psychologists, and ethicists and it addresses informed consent for a broad range of conditions in addition to cancer. The results suggest that division of affective labor is an under-theorized dimension of informed consent that is perceived as at odds with principled demands for universal informed consent. These practical tensions are conceptualized as cultural differences, with Japan identified in terms of omakase as practical and supportive and the United States identified in terms of jiko kettei as principled and self-determining. These results have implications for the methodology of cross-cultural bioethics as well as for theories and practices of informed consent in both Japan and the United States. I conclude that responsible cross-cultural work in bioethics must begin from the ground up, incorporating all relevant stakeholder perspectives, attitudes, and experiences.