Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global, Multivariable Analysis

Shearer, Jessica; Stack, Meghan L.; Richmond, Marcie R.; Bear, Allyson Perry; Hajjeh, Rana; Bishai, David

doi:10.1371/journal.pmed.1000249

Cited by 37 publications

(25 citation statements)

References 22 publications

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“…Second, donor financing, especially through the GAVI Alliance, will be critical to avoid long delays in vaccine introduction in many low- and lower-middle income endemic countries. GAVI eligibility shortened the time for countries to decide to introduce Hib vaccine by 63% and made up for differences in income levels between countries [21]. Finally, according to informants in several countries, policymakers will be more inclined to introduce a dengue vaccine if it can be incorporated into the countries' childhood immunization schedules.…”

Section: Discussionmentioning

confidence: 99%

Will Dengue Vaccines Be Used in the Public Sector and if so, How? Findings from an 8-country Survey of Policymakers and Opinion Leaders

Douglas¹,

DeRoeck

Mahoney

et al. 2013

PLoS Negl Trop Dis

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BackgroundA face-to-face survey of 158 policymakers and other influential professionals was conducted in eight dengue-endemic countries in Asia (India, Sri Lanka, Thailand, Vietnam) and Latin America (Brazil, Colombia, Mexico, Nicaragua) to provide an indication of the potential demand for dengue vaccination in endemic countries, and to anticipate their research and other requirements in order to make decisions about the introduction of dengue vaccines. The study took place in anticipation of the licensure of the first dengue vaccine in the next several years.Methods/Principal FindingsSemi-structured interviews were conducted on an individual or small group basis with government health officials, research scientists, medical association officers, vaccine producers, local-level health authorities, and others considered to have a role in influencing decisions about dengue control and vaccines. Most informants across countries considered dengue a priority disease and expressed interest in the public sector use of dengue vaccines, with a major driver being the political pressure from the public and the medical community to control the disease. There was interest in a vaccine that protects children as young as possible and that can fit into existing childhood immunization schedules. Dengue vaccination in most countries surveyed will likely be targeted to high-risk areas and begin with routine immunization of infants and young children, followed by catch-up campaigns for older age groups, as funding permits. Key data requirements for decision-making were additional local dengue surveillance data, vaccine cost-effectiveness estimates, post-marketing safety surveillance data and, in some countries vaccine safety and immunogenicity data in the local population.Conclusions/SignificanceThe lookout for the public sector use of dengue vaccines in the eight countries appears quite favorable. Major determinants of whether and when countries will introduce dengue vaccines include whether WHO recommends the vaccines, their price, the availability of external financing for lower income countries, and whether they can be incorporated into countries' routine immunization schedules.

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Section: Discussionmentioning

confidence: 99%

Will Dengue Vaccines Be Used in the Public Sector and if so, How? Findings from an 8-country Survey of Policymakers and Opinion Leaders

Douglas¹,

DeRoeck

Mahoney

et al. 2013

PLoS Negl Trop Dis

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“…Seventy-eight (89 %) out of 88 NITAGs reported using WHO position papers when making recommendations (Bryson et al 2010 ). However, an analysis of country adoption of Haemophilus infl uenzae Type b (Hib) vaccine found no infl uence of WHO position papers on country time to adoption (Shearer et al 2010 ).…”

Section: Who Vaccine Recommendationsmentioning

confidence: 99%

“…Other variables associated with a longer time to adoption were a higher vaccine price and higher GAVI cofi nancing uncertainty. Variables associated with a shorter time to adoption were eligibility for GAVI fi nancial support, having neighbor countries who already have adopted the vaccine, and a higher degree of democracy (Shearer et al 2010 ).…”

Section: The Decision To Purchase a Vaccinementioning

confidence: 99%

Vaccine Marketing

Angelmar¹,

Morgon²

2013

International Series in Quantitative Marketing

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Long perceived as an unattractive segment of the pharmaceutical industry, most of the leading fi rms have stepped up vaccine investments in recent years. Unlike mainstream pharmaceuticals, vaccines generally treat healthy individuals, most are administered only once or very infrequently during a life time, and they engender positive externalities, because vaccinated individuals reduce the risk of transmission to unvaccinated persons, leading authorities to mandate some vaccinations. Resistance to vaccination may lead to immunization failure and disease resurgence.The public and private market each account for about one-half of the global vaccine market in value. Bringing new vaccines to market requires carefully orchestrated programs targeting the multiple types of customers. For example, in parallel with the clinical development program designed to obtain FDA approval for its HPV vaccine Gardasil, Merck developed health-economic evidence to obtain a positive recommendation for vaccination and public fi nancing. Physician educational programs and unbranded DTC campaigns were started many months prior to launch. Following FDA approval and positive vaccination and public fi nancing recommendations, Merck developed market access programs targeted at states and private insurers, and launched branded physician and DTC campaigns.Successful global diffusion of a vaccine generally requires the development of a tiered pricing policy which takes country differences in per capita income into account.A successful launch often creates new problems for vaccine marketers. They must maintain the motivation to engage in and pay for vaccination despite the quasi-disappearance of the disease. And they must combat anti-vaccination information claiming that the vaccine is the cause of serious side effects.

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“…Slow adoption is not particular to malaria interventions. As suggested by Shearer et al (2010), the adoption of Hib vaccine in resource-poor countries was slow until certain factors were in place: financing, advocacy efforts, interpersonal contact with national decision makers and technical support.…”

Section: Introductionmentioning

confidence: 99%

Brokering the boundary between science and advocacy: the case of intermittent preventive treatment among infants

Cruz

Walt

2012

Health Policy and Planning

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The process of translating research into policy has gained considerable attention in recent years and a number of studies have investigated the nexus between the two ‘worlds’ of research and policy. One issue that has been little addressed is about the boundaries between research and advocacy: how far scientists do, or should, promote particular findings to policy makers and others. This article analyses a particular intervention in malaria control and the Consortium set up to accelerate its potential implementation. Using a framework that emphasizes the interplay of interests, institutions and ideas, it provides an example of how a network of committed researchers and funders attempted to follow a rational policy process, but faced conflicts and fundamental questions about their roles in generating scientific evidence and influencing global health policy. In an era of ever more and larger researcher groups and consortia, the findings offer insights and lessons to those engaged in the process of knowledge translation.

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Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global, Multivariable Analysis

Abstract: Jessica Shearer and colleagues analyze data from 147 countries to identify factors that influence the time taken to introduce routine vaccination against Haemophilus influenzae type b (Hib).

Cited by 37 publications

References 22 publications

Will Dengue Vaccines Be Used in the Public Sector and if so, How? Findings from an 8-country Survey of Policymakers and Opinion Leaders

Will Dengue Vaccines Be Used in the Public Sector and if so, How? Findings from an 8-country Survey of Policymakers and Opinion Leaders

Vaccine Marketing

Brokering the boundary between science and advocacy: the case of intermittent preventive treatment among infants

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