11Th ADVANCED COURSE of VACCINOLOGY- 2010

Total Page:16

File Type:pdf, Size:1020Kb

11Th ADVANCED COURSE of VACCINOLOGY- 2010 10.09.2012 11 th ADVANCED COURSE OF VACCINOLOGY- 2010 MONDAY 10 MAY 2010 Theme Coordinator : Adam Finn (Bristol, UK) 09 :00 Opening Benoit Miribel, General Director, Fondation Mérieux 09 :15 Definition of the course objectives Paul-Henri Lambert, Director of the ADVAC Course SESSION 1.- THE MULTIFACETED NATURE OF VACCINOLOGY Chairpersons: Claire-Anne Siegrist, and Paul-Henri Lambert 09:40- Opening Lecture: Stanley Plotkin, University of Pennsylvania 10:20 The history of vaccinology and its global perspectives 10:20- Discussion 10:40 10:40- Break 11:10 11:10- Impact of vaccination on disease epidemiology Roy Anderson, Imperial College, London, UK 11:55 11:55- Discussion 12:20 12:30- Lunch 14:00 14:00- Herd immunity John Clemens , IVI, Korea 14:30 14:30- Discussion 14:50 14:50- Public and media perception of vaccination during the David Salisbury , UK 15:20 course of the H1N1 pandemics 15:20- Discussion 15:40 15:40- Break 16:00 16:00- The Value of Vaccination Till Baernighausen , Harvard PHS 16:30 16:30- discussion 16:50 18 :00 Welcome reception 1 10.09.2012 Theme Coordinator : Adam Finn (Bristol, UK) TUESDAY 11 MAY 2010 SESSION 2 - HOW VACCINES WORK Chairpersons: Adam Finn and Daniel Pinschever (UNIGE) 09:00-09:30 How are vaccine responses elicited? Claire-Anne Siegrist , University of Geneva What a vaccinologist should know about the basic aspects of immunological responses a- B-cell responses 09:30-10:00 Discussion 10:00-10:30 Break 10:30-11:00 What a vaccinologist should know about the basic aspects of immunological responses Claire-Anne Siegrist , University of Geneva b- T-cell responses 11:00-11:30 Discussion 11:30-12:00 Immunological correlates of immunity: use and limitations in vaccinology: Stanley Plotkin , University of Pennsylvania, Philadelphia 12:00-12:20 Discussion Lunch 14:00-14:30 Immunological basis for responses to mucosal vaccines Adam Finn , University of Bristol 14:30-14:50 Discussion 14:50-16:00 Vaccines and Immunological memory Claire-Anne Siegrist , University of Geneva Quiz and general discussion 16:00-16:20 Break 16:30-17:10 Vaccine-induced Immunological memory Rafi Ahmed , Emory University 17:10-17:30 Discussion 2 10.09.2012 WEDNESDAY 12 MAY 2010 Theme Coordinator : Hanna Nohynek (THL, Helsinki) SESSION 3 – DECISION-MAKING IN VACCINE RESEARCH AND PRECLINICAL Chairpersons : Luc Hessel & Georges Thiry DEVELOPMENT 09:00-09:30 Vaccine adjuvants: pragmatic approaches Martin Friede , WHO, Geneva 09:30-09:50 Discussion 09:50-10:20 From pre-clinical research to vaccine development: Examples of go-no-go decisions Georges Thiry , PATH 10:20-10:40 Discussion 10:40-11:00 Break 11:00-11:30 How do vaccines cause adverse events ? Neal Halsey , Johns Hopkins B. School of Public Health, Baltimore 11:30-11:40 discussion 11:40-12:10 Special Lecture: HIV vaccines Brigitte Autran , INSERM, France 12:10-12:30 Discussion Lunch SESSION 4 - ASSESSING VACCINES IN CLINICAL TRIALS (I) Chairpersons: Hanna Nohynek 13:30-14:10 Sequential stages of clinical trials and overview of issues to be considered Myron Levine, University of Maryland, Baltimore, USA 14:10-14:30 Discussion 14:30-17:00 Regulatory barrier s e.g. re:new adjuvants Norman Baylor (FDA), Pieter Neels (Federal Agency for Medicinal and Health Round table debate Products Brussels & CHMP-EMEA ) – Thomas Verstraeten , GSKBio and Michael Decker (Sanofi Aventis,) 17:00-17:30 Lessons from pitfalls experienced in the registration process (including role of a DSMB) Luc Hessel , Sanofi Pasteur MSD, Lyon, 17:30-17:45 Discussion 3 10.09.2012 Theme Coordinator : Hanna Nohynek (THL, Helsinki) THURSDAY 13 MAY 2008 SESSION 5 - ASSESSING VACCINES IN CLINICAL TRIALS (II) Chairperson: Juhani Eskola 09:00-09:30 Essential practical aspects in conducting phase III trials Hanna Nohynek , Helsinki 9:30-09:45 Discussion 09:45-10:05 Break 10:05-10:35 Introduction to statistical aspects of clinical trials Peter Smith , LSTMH, UK 1- Defining sample size: practical approaches and examples 10:35-10:55 Discussion 10:55- 12:40 How to design, recruit volunteers for, and analyze the results of selected phase II trials 14:00- 15:00 Small group exercise: How to design a phase II trial - Group 1: Group 2: - Group 3: Group 4: Group 5: Statistical approaches-exercise- Group 6: - 12:40-13:10 lunch buffet Special lectures: New vaccines in development (1) 15:00-15:30 New approaches to vaccine development and delivery systems Carole Heilman, NIH/NIAID Discussion 15:50-16:20 The challenge of developing new tuberculosis vaccines Stefan Kaufmann (Berlin) Discussion Break 17:00-17:30 The challenge of malaria vaccines- Vasee Moorthy WHO Discussion 4 10.09.2012 FRIDAY 14 MAY 2010 Theme Coordinator : Neal Halsey (Baltimore) SESSION 6 – VACCINE SAFETY - ASSESSMENT OF ADVERSE EFFECTS Chairpersons: Noni Mc Donald and Neal Halsey 08:45-09:15 Lessons from previous adverse effects of vaccination and Assessment of causal relationships Neal Halsey, Johns Hopkins B. School of Public Health, Baltimore 09:15-09:35 Discussion 09:35-10:05 Immunological safety of vaccination ( Autoimmune and allergic diseases) Paul-Henri Lambert, 10:05-10:25 Discussion 10:25-10:40 Break 10:40-11:10 Immunization safety in developing country vaccination programs Philippe Duclos , WHO 11:10-11:30 Discussion 11:30-12:00 Risk communication: An overview Noni McDonald , Dalhousie Univ, Halifax Canada 12:00-12:20 Discussion Lunch 13:30-14:00 Introduction to statistical aspects of clinical trials- Peter Smith , LSTMH, UK 2- Statistical assessment of phase 3 trials- 30 min 14:00-14:20 Population-based post-licensure surveillance Steve Black, Cincinnati Children's Hospital Medical Center 14:20-14:50 Discussion 14:50-15:10 Discussion 15:15-18:00 Small group exercise 2: Designing and analysing the results of 3 selected phase III trial Objective: To understand how to critically appraise and compare phase III (pneumococcal conjugate vaccine in The Gambia, among Navajo Indians in the U.S. and in trial results South Africa ) Introduction to the group work Exercise: Hanna Nohynek Group 1:- Facilitator: Edwin Asturias Group 2: - Facilitator: Hanna Nohynek Group 3: - Facilitator: Steve Black Group 4: - Facilitator: Rana Haji Group 5: - Facilitator: Peter Smith 5 10.09.2012 Theme Coordinator : Edwin Asturias (Guatemala City) SATURDAY 15 MAY 2010 SESSION 7- ETHICAL ISSUES Chairpersons: Betty Dodet and Catherine Slack Ethical issues related to clinical trials – Revisiting the Helsinki Declaration 08:45-09:20 Clinical trials in developing countries: Ethical issues Catherine Slack (University of KwaZulu-Natal, South Africa) basic principles & practical approaches 09:20-09:40 Discussion 09:40-12:30 Small group exercise 3: Ethical issues – Access to treatment for participants who seroconvert Coordinated by Catherine Slack during the conduct of an HIV vaccine trial talk with her And Betty Dodet (Lyon) Group 1:- Facilitator: Hanna Nohynek Group 2: - Facilitator: Catherine Slack Group 3: - Facilitator: Noni McDonald Group 4: - Facilitator: Betty Dodet Group 5: - Facilitator: TBA Group 6: - Facilitator: Rana Haji 6 10.09.2012 Theme Coordinator : Mark Miller (Bethesda) MONDAY 17 MAY 2010 08:40-09:00 Review and conclusions of the 23 May Ethics session Cathy Slack SESSION 8.1- INTRODUCING NEW VACCINES INTO VACCINATION PROGRAMMES Chairperson: Juhani Eskola Approaches to help the decision-making process 09:00-09:30 Integration of Science, Public Health and Economics - Critical Assessment of Vaccine Policy Mark Miller, Fogarty International Center Options 09:30-09:45 Discussion 09:45- Role of disease burden assessment in the decision-making process Brad Gessner AMP 10:15 10:15-10:35 Discussion 10:35-11:00 Break 11:00-11:30 Challenge of making evidence-based vaccination policies in developing countries Rana Hajjeh, CDC, 11:30-11:50 Discussion 11:50-12:20 Access to vaccines : economic aspects, GAVI and AMC Nina Schwalbe , GAVI 12:20- Discussion 12:40 12:40-14:00 Lunch Case-specific study #1: Meningococcal vaccines 14:00-14:30 Infant responses to polysaccharide and conjugate vaccines David Goldblatt , Institute of Child Health, London 14:30-14:50 Discussion 14:50-15:20 Approaches towards new Meningococcal vaccines 15:20-15:40 Discussion Giuseppe Del Giudice, Novartis Vaccines 15:40-16:00 Break 16:00-16:30 Future vaccination strategies to prevent meningococcal epidemics in Africa Brian Greenwood (UK) 16:30-16:50 Discussion 16:50-17:20 Special lecture: Richard Moxon, Oxford University The population biology of bacterial pathogens and its importance for vaccination strategies 17:20-17:40 Discussion - 7 10.09.2012 TUESDAY 18 MAY 2010 Theme Coordinator : Mark Miller (Bethesda) SESSION 8.2 - INTRODUCING NEW VACCINES INTO VACCINATION PROGRAMMES (2) Chairperson: Alan Shaw (Vaxinnate) and Bernard Fritzell (Wyeth) Case-specific study #2: pneumococcal conjugates 08:45-09:45 Pneumococcal conjugate vaccines: overview Ron Dagan , Soroka Medical Center, Beer Sheva and Keith Klugman (Emory Univ) 09:45-10:10 Discussion 10:10-10:30 Break Case-specific study #3: Influenza- vaccination strategies and pandemic disease preparedness 10:30-11:00 Influenza biology and vaccination strategies Kathy Neuzil, PATH, Seattle 11:00-11:20 Discussion 11:20-11:50 Development of new influenza vaccines Kathy Neuzil , PATH, Seattle 11:50-12:10 Discussion 12:15-13:30 Lunch 13:30-14:00 Vaccines for pandemic response: a global vision Marie-Paule Kieny (WHO) 14:00-14:20 Discussion 14:20-14:50 Varicella and Zoster vaccines: what are the issues ? Myron Levin UCD Denver 14:50-15:10 Discussion 15:10-15:40 Case-specific study
Recommended publications
  • Thimerosal in Vaccines—An Interim Report to Clinicians
    AMERICAN ACADEMY OF PEDIATRICS Committee on Infectious Diseases and Committee on Environmental Health Thimerosal in Vaccines—An Interim Report to Clinicians ABBREVIATIONS. AAP, American Academy of Pediatrics; and for preventing bacterial contamination, particu- USPHS, US Public Health Service; FDA, Food and Drug Admin- larly in opened multidose containers. Some but not istration; IPV, inactivated polio vaccine; OPV, oral polio vaccine; all of the vaccines recommended routinely for chil- DTP, diphtheria-tetanus-pertussis (vaccine); Hib, Haemophilus in- dren in the United States contain thimerosal.1 fluenzae type b (vaccine); EPA, Environmental Protection Agency; ATSDR, Agency for Toxic Substances and Disease Registry; Thimerosal contains 49.6% mercury by weight and is HBsAg, hepatitis B surface antigen; HBIG, hepatitis B immune metabolized to ethyl mercury and thiosalicylate. globulin. Data are limited regarding potential differences in toxicity between ethyl mercury and methyl mercury. n July 7, 1999, the American Academy of Both forms of organic mercury are associated with Pediatrics (AAP) issued with the US Public neurotoxicity in high doses, and definitive data re- Health Service (USPHS) a joint statement garding the doses at which developmental effects O occur in infants are not available. When vaccines alerting clinicians and the public of concern about thimerosal, a mercury-containing preservative used containing thimerosal have been administered in the in some vaccines. That statement was disseminated recommended doses, hypersensitivity has been widely, including on the AAP members e-mail list, noted, but no other harmful effects have been report- 2 Massive overdoses from inappropriate use of and was posted on the AAP web site since July 7, ed.
    [Show full text]
  • Needle Tips Fall/Winter 1998-1999
    Volume 8 - Number 2 NEEDLE TIPS Fall/Winter 1998-1999 & the Hepatitis B Coalition News Published by the Immunization Action Coalition for individuals and organizations concerned about vaccine-preventable diseases. Holy contraindications, Robin! That person was coughing! WHAT'S ON THE INSIDE: Why did you vaccinate him? Ask the Experts CDC’s immunization expert Dr. William Atkinson answers your questions ......................... 1 CDC’s hepatitis experts, Harold Margolis, MD, and Linda Moyer, RN, answer hepatitis A and B questions .................................................................................................. 17 What’s New? Vaccinate, don’t vacillate! by Walter A. Orenstein, MD, Centers for Disease Control ........... 3 Vaccine highlights: new vaccines and new recommendations .............................................. 4 ? ? ? It’s federal law! by Neal Halsey, MD, Institute for Vaccine Safety ....................................... 6 What’s your state doing? hepatitis B laws, pneumococcal, influenza rates, etc. .................... 9 Unprotected people...five varicella-related deaths ................................................................ 13 Photocopy these materials! Holy missed opportunities, Batman! Polio Vaccine Information Statement (VIS) ......................................................................... 7 A mild illness is NOT a reason to NEW! Vaccinations for adults with hepatitis C virus infection ............................................. 10 withhold vaccinations. You’d know this, Revised!
    [Show full text]
  • Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases
    The new england journal of medicine special article Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases Saad B. Omer, M.B., B.S., Ph.D., M.P.H., Daniel A. Salmon, Ph.D., M.P.H., Walter A. Orenstein, M.D., M. Patricia deHart, Sc.D., and Neal Halsey, M.D. Abstract Vaccines are among the most effective prevention tools available to clinicians. How- From the Hubert Department of Global ever, the success of an immunization program depends on high rates of acceptance Health, Rollins School of Public Health (S.B.O.), and the Emory Vaccine Center and coverage. There is evidence of an increase in vaccine refusal in the United States (S.B.O., W.A.O.), Emory University, At- and of geographic clustering of refusals that results in outbreaks. Children with lanta; the Department of International exemptions from school immunization requirements (a measure of vaccine refusal) Health (S.B.O., D.A.S., N.H.) and the In- stitute for Vaccine Safety (N.H.), Johns are at increased risk for measles and pertussis and can infect others who are too Hopkins Bloomberg School of Public young to be vaccinated, cannot be vaccinated for medical reasons, or were vacci- Health, Baltimore; the National Vaccine nated but did not have a sufficient immunologic response. Clinicians can play a Program Office, Department of Health and Human Services, Washington, DC crucial role in parental decision making. Health care providers are cited as the most (D.A.S.); and Maternal and Child Health frequent source of immunization information by parents, including parents of un- Assessment, Washington State Depart- vaccinated children.
    [Show full text]
  • Print Who's Afraid of Gardasil?
    Who's Afraid of Gardasil? by KAREN HOUPPERT March 8, 2007 This article appeared in the March 26, 2007 edition of The Nation. The HPV vaccine story has gotten all tangled up. As recently as June 8, 2006, public health advocates, progressives and many parents were celebrating a huge victory: The Food and Drug Administration had approved Merck's new vaccine Gardasil, a shot series that would help protect girls from cervical cancer and genital warts. To their continuing delight, the Centers for Disease Control's immunization committee recommended less than a month later that the shots immediately be given to all females between the ages of 9 and 26. The committee acted on persuasive data indicating that the vaccine, which prevents the sexually transmitted human papillomavirus (HPV), works best before girls are sexually active. Human papillomavirus is the most common sexually transmitted infection in the world, and most women have had it-- 80 percent of US women, by the CDC's estimates. Often it goes away on its own, without its carrier's awareness. But each year hundreds of thousands of women and girls in the United States develop persistent infections from it, more than 10,000 get cervical cancer and 3,700 die from the cancer. Gardasil, given in a series of three shots, protects against four strains of HPV. Two of those strains cause 70 percent of the nation's cervical cancer cases, and two of them cause 90 percent of genital warts. This new vaccine, widely given, has the potential to make cervical cancer almost obsolete here.
    [Show full text]
  • Congressional Record—House H5074
    H5074 CONGRESSIONAL RECORD — HOUSE June 23, 2005 As Thomas Jefferson once said, MERCURY AND AUTISM them while at the same time changing Whenever people are well informed, The SPEAKER pro tempore. Under a the Vaccine Injury Compensation Fund they can be trusted with their own gov- previous order of the House, the gen- in a way that will protect these fami- ernment. tleman from Indiana (Mr. BURTON) is lies and help those who have been dam- Maintaining our commitment to pub- recognized for 5 minutes. aged, but so far we have gotten abso- lic broadcasting will help keep the very Mr. BURTON of Indiana. Mr. Speak- lutely nowhere with them; and it is people who elect us well informed, and er, I have been down here a lot talking something I think we need to continue in doing so, help to promote the integ- about autism over the years and my to work on. rity and proper functioning of this very committee had many hearings on the Just recently, there was an article body itself. issue of autism. My grandson became that was published in a magazine I nor- I applaud the Members of this body autistic after receiving 9 shots in one mally do not read. It is called Rolling who rose to the defense of public broad- day, 7 of which contained mercury, in a Stone, but this article was brought to casting earlier today by voting to re- product called thimerosal. And he is my attention, and I think everybody in store funding to a cherished American doing better but it has been a very dif- this body ought to read that article.
    [Show full text]
  • Pcic Remarks
    :3f47 Good Morning Commissioners of the IRRC, My name is Alison Mullins and I am here on behalf of members of The Pennsylvania Coalition for Informed Consent. Our volunteer organization is neither for nor opposed to vaccinations, believing that adults, not the government, should make health care choices for themselves and their children. I am opposed to the proposed regulation #3 147 and ask that it not be accepted. The five day provisional period was protested by 2/3 of those who commented, whether or not they were for the new mandates. Valid concerns were completely dismissed by the Department which caused many to question the validity of the entire process. The Department used the theory of Herd Immunity tojustifi the five day provisional period. However, many vaccines are designed to lessen disease symptoms instead of preventing disease transmission which would actually impact herd immunity. • Vaccines for Tetanus, inactivated Polio, and diphtheria toxoid are intended for personal protection only. • Hepatitis B is a blood borne virus and unlikely to spread in a school community. • The Hib vaccine only covers type B and the vaccine has shifted strain dominance toward types A-F, making the general population more vulnerable to the disease than prior to the start of the Hib vaccination campaign. • Asymptomatic carriers of pertussis may inadvertently spread the disease as their symptoms are diminished. When responding to a primate study which showed the acellular pertussis vaccine is not capable of preventing colonization and transmission of B. pertussis, The Department dismissively said that it “disagrees with the commentator” and said they will follow the ACIP recommendation.
    [Show full text]
  • Possible Association of Intussusception with Rotavirus Vaccination
    AMERICAN ACADEMY OF PEDIATRICS Committee on Infectious Diseases Possible Association of Intussusception With Rotavirus Vaccination ABBREVIATIONS. RRV-TV, tetravalent rotavirus vaccine; ican Academy of Pediatrics (AAP) is making the VAERS, Vaccine Adverse Event Reporting System; CDC, Centers following interim recommendations: for Disease Control and Prevention; AAP, American Academy of Pediatrics. 1. Clinicians temporarily should suspend adminis- tration of rotavirus vaccine to unimmunized and ew information indicates there may be an in- partially immunized children, pending collection creased risk of intussusception during the first and evaluation of additional information. Nfew weeks after receipt of the licensed tetrava- 2. Parents or guardians of children who have re- lent rotavirus vaccine (RRV-TV), RotaShield. Currently ceived RRV-TV within a period of approximately available data are very limited and are based on pas- 3 weeks should be advised to promptly contact sive reporting to the Vaccine Adverse Event Reporting their physician if signs or symptoms compatible System (VAERS), a postlicensure study of adverse with intussusception develop. events at Northern California Kaiser, and active case 3. All cases of intussusception that occur after finding in two states. Results thus should be considered administration of RRV-TV should be reported preliminary. To date, the Centers for Disease Control to VAERS (800-822-7967; www.fda.gov/cber/ and Prevention (CDC) has received reports of 23 cases vaers/report.htm). of intussusception after receipt of doses 1, 2, or 3 of RRV-TV. The number of children who have received Committee on Infectious Diseases, 1999–2000 RRV-TV is unknown; however, the observed rate of Jon S.
    [Show full text]
  • An Injection of Trust
    VACCINES OUTLOOK in the United States alone1. Since the 1980s, every US state has required a standard bat- tery of vaccines for school enrolment. There is strong participation too in much of West- ern Europe, where these vaccines are merely ‘recommended’. “The vast majority of children are immunized, with coverage of over 90% MARMADUKE ST. JOHN/ALAMY MARMADUKE ST. across Europe,” says Pier Luigi Lopalco, head of the vaccine-preventable diseases programme at the European Centre for Disease Prevention and Control (ECDC) in Stockholm. When Australia faced falling vaccination rates in the 1990s it introduced incentives that rewarded both clinics and parents. “Our immunization rates rose by at least 10%, which was a major increase,” says Julie Leask, a social scientist Health-care workers in New York protest against compulsory swine flu vaccination. specializing in immunization policy at the University of Sydney. PUBLIC HEALTH But some vaccination programmes allow people to refuse for personal reasons. In much of Europe, no medical consultation is required. In the United States, parents must actively An injection register their refusal; 48 states recognize reli- gious exemptions and 18 allow ‘personal belief exemptions’. The refusal numbers are low — just 2% for 2010–2011, according to the CDC of trust — but epidemiologist Saad Omer of Emory University in Atlanta, Georgia, has observed a disconcerting rise. “The rate of refusal has Faced with outbreaks of preventable diseases, public-health gone up, and even the rate of change compared experts need to win over parents who refuse vaccinations. to previous years has accelerated,” he says. Indeed, CDC data indicate that the percent- age of non-medical exemptions essentially BY MICHAEL EISENSTEIN 5,442 in just the first 4 months of 2013.
    [Show full text]
  • Vaccine Safety: Current Issues and Misunderstandings
    Vaccine Safety: Current Issues and Misunderstandings Neal Halsey M.D. Johns Hopkins University 1 Neal Halsey: Disclosures • Safety monitoring boards – Merck(Gardasil males), Takeda(Norovirus) • Advisory board: Valneva: – Experimental Lyme disease vaccine • Scientific advisory board for development of a live pertussis vaccine – ILiAD Biotechnologies Bad Science in Case Reports Autism after MMR www.autismpedia.org Decrease in HPV Acceptance in Denmark Following Promotion of Rumors by Journalists Iceland Denmark Norway Norway Finland Finland Denmark Palle Valentiner-Branth, MD, PhD Department of InfectiousDiseaseEpidemiology Statens Serum Institut, Denmark 2016 POTS Postural orthostatic tachycardia syndrome, Chronic fatigue syndrome Other illnesses Japan Stopped HPV School Immunizations 2013 Concerns regarding adverse events including complex regional pain syndrome. No systematic review of adverse events 5 American Journal of Obstetrics & Gynecology 2015 212, 405-406 Bad Science in Case Reports Continues 4 cases onset 4, 5, 5 and unknown months after vaccine Onset 1, 2, and ? years after HPV Authors falsely assumed causal Multiple causes of POI 4% autoimmune Review in preparation Junk Science Christianson, Halsey and Talaat 7 25+ Journals of Case Reports False Assumptions of Causal Associations Based Solely on Temporal Relationships 9 Addressing Serious Adverse Events(SAEs) 1. Journal editors should institute standard criteria for accepting causality assessments in case reports 2. All countries should have a standing committee to review SAEs 3. Methods for assessing SAEs should be standardized 10 Clinical Immunization Safety Assesment Review of Case Reports of Adverse Events Following Immunizations AEFI Case Report Indeterminate, Other diagnosis 1. Is the diagnosis correct? No Uncertain diagnosis uncertain Yes 2a. Is the evidence 2.
    [Show full text]
  • Individualism and Vaccine Refusal in Pockets of Socioeconomic
    ASRXXX10.1177/0003122420960691American Sociological ReviewEstep and Greenberg 960691research-article2020 American Sociological Review 1 –35 Opting Out: Individualism and © American Sociological Association 2020 https://doi.org/10.1177/0003122420960691DOI: 10.1177/0003122420960691 Vaccine Refusal in Pockets of journals.sagepub.com/home/asr Socioeconomic Homogeneity Kevin Estepa and Pierce Greenberga Abstract Cases of measles and other highly contagious diseases are rising in the United States. Public health experts blame the rise partly on the spatial concentration of parents declining to vaccinate their children, but researchers have given little attention to theorizing why this clustering occurs in particular communities. We argue that residential and school selection processes create “pockets of homogeneity” attracting parents inclined to opt out of vaccines. Structural features of these enclaves reduce the likelihood of harsh criticism for vaccine refusal and foster a false sense of protection from disease, making the choice to opt out seem both safe and socially acceptable. Examination of quantitative data on personal belief exemptions (PBEs) from school-based vaccination requirements in California schools and districts, as well as findings from parent interviews, provide empirical support for the theory. We discuss substantive implications for lawmakers and public health officials, as well as broader sociological contributions concerning neighborhood effects and residential sorting. Keywords public health, vaccination, income segregation, individualism, neighborhood effects In 2019, the United States experienced the cluster in particular communities and schools highest number of measles cases in 25 years— (Brennan et al. 2017; Carrel and Bitterman a problem many scientists attribute to the 2015; Delamater et al. 2018; Lieu et al. 2015; growing proportion of parents who choose not Omer et al.
    [Show full text]
  • Primary Vaccine Container Selection in Developing Countries Safety Neal Halsey Johns Hopkins Bloomberg School of Public Heath Issues Requested to Cover
    Primary Vaccine Container Selection in Developing Countries Safety Neal Halsey Johns Hopkins Bloomberg School of Public Heath Issues Requested to Cover 1. Rates of contamination, needlesticks, etc. due to vial size 2. Adherence to multi-dose vial policies 3. Presence or absence of preservatives 4. Practices in handling vaccines, reuse of needles, etc. Preventable Medical Errors Occur in all Countries U.S. ~1.5 million preventable adverse drug events/ year No comparable estimates for immunization related errors in any country Minimal capacity: National Pharmacovigilance Minimal Capacitycapacity includes: national reporting form for AEFI national database clear strategy or system for collating, for managing & retrieving risk communication National AEFI reports pharmacovigilance health-care workers resources national AEFI & others encouraged expert review to report vaccine committee safety issues harmonized set of standards implemented Courtesy P Zuber WHO GVS Blueprint overview – CDC 15 December 11 Indicator PM06: Capacity to detect and investigate significant vaccine safety issues according to WB income status (end 2009) Number of % Implemented Number of % Implemented Group of Number of Countries with out of the total Countries with (of those with Countries Indicator countries in the countries data available data available) Implemented region A. Industrialized 48 48 45 94 94 B. Upper middle income 39 13 5 38 13 C1.Lower middle income 57 17 5 29 9 C2.Low income 49 17 2 12 4 Courtesy P Zuber WHO GVS Blueprint overview – CDC 15 December 11 Problems in Answering Questions • No true rate data • Inadequate surveillance systems for detecting, reporting, and investigating adverse events. • Inadequate training and supervision in many settings • Underreporting, suppression/hiding of mistakes Needlestick Injuries • Safety devices: lower rates • Automatic (passive) lower than manual • France: overall rate: 2.05 injuries per 100,000 safety devices purchased.
    [Show full text]
  • The Impact of Vaccination on the Health of the World’S People Is Hard to Exaggerate
    “The impact of vaccination on the health of the world’s people is hard to exaggerate. With the exception of safe water, no other modality has had such a major effect on mortality reduction and population growth” Susan and Stanley Plotkin “The impact of vaccination on the health of the world’s peoples is hard to exaggerate. With the exception of safe water, no other modality has had such a major effect on mortality reduction and population growth” “What looks simple on retrospective, it was much complicated than you thought Susan and Stanley Plotkin WE NEED BETTER VACCINES WE NEED SAFER VACCINES WE NEED BETTER & SAFER VACCINES FASTER WE NEED THE VACCINE TO BE ADMINISTERED WE NEED TO BETTER ASSESS VACCINE IMPACT WE NEED BETTER VACCINES Understand burden of disease and clinical course Identify target population Understand the immunological response (B, T, mucosal) Identify specific vaccine antigen Improved vaccine design (next generation vaccines) Do we need to include an adjuvant to enhance/skew immune response? WE NEED BETTER VACCINES “Design vaccines for older adults, not college age kids” Keipp Talbot “There is nothing wrong with the early life immune system. It is different and we have to learn to adapt to its specificities” Claire-Anne Siegrist “Maternal immunization can benefit both the mother and the baby. Closes the window of vulnerability” Janet Englund WE NEED BETTER VACCINES Understand the immunological response “Germinal Center is the key to a successful party!!” Claire-Anne Siegrist “Structure based vaccine design will change
    [Show full text]