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New Vaccine Development: Establishing Priorities: Volume I, Diseases of Importance in the United States (1985)
Board on Population Health and Public Health Practice (BPH)

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. "Appendix P: Prospects for Immunizing Against Streptococcus group B." New Vaccine Development: Establishing Priorities: Volume I, Diseases of Importance in the United States. Washington, DC: The National Academies Press, 1985.

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New Vaccine Development Establishing Priorities, Volume I: Diseases of Importance in the United States
Lay Acceptance

Lay perceptions of the risk and severity of illness have been judged to be moderately low, primarily because the public is thought to be relatively unfamiliar with GBS disease. The potential benefits of the vaccine probably would be perceived as high because of physician cueing. Many women are reluctant to be vaccinated when pregnant, however, so the barriers to vaccination may be high.

Provider Acceptance

Overall, provider perception of the risk of illness is expected to be moderate (the high perception of risk in some areas will be balanced by a very low perception of risk among providers for populations in which the disease is rare). The perceived severity of disease is likely to be high. Even though the predicted efficacy of the vaccine is relatively low, when it is efficacious it will prevent very severe disease; thus, perceived benefits are likely to be high. Liability concerns arising from immunization of pregnant women may act as a barrier to vaccination; these concerns may be somewhat less than those associated with a live preparation. Provider acceptance also may depend, in part, on the availability of alternative strategies such as chemoprophylaxis.

Cost of Illness

The scope and purpose of the calculations included below are described in Chapters 4 and 7. These calculations are based on certain simplifying procedures and assumptions that have been judged not to compromise their utility for the purposes of this disease comparison. The total costs should be taken only as an approximation of the direct cost of this disease.

Cost of Total Disease Burden

Category A & B n/a

 

 

Category C

 

 

Early and late onset disease—meningitis, bacteremia, pneumonia, septicemia

 

 

# of cases=11,083

 

 

100% of cases typically receive 7 days neonatal ICU hospitalization at $800/day

= $

62,009,000

100% of cases typically receive additional 14 days of normal hospitalization at $400/day

= $

62,009,000

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434
Front Matter (R1-R14)
1. Summary (1-16)
2. Priority Setting for Health Related Investments: A Review of Methods (17-27)
3. Overview of the Analytic Approach (28-38)
4. Comparison of Disease Burdens and Costs (39-58)
5. Predictions on Vaccine Development (59-66)
6. Assessing the Likely Utilization of New Vaccines (67-91)
7. Calculation and Comparison of the Health Benefits and Costs Associated with Candidate Vaccines (92-120)
8. Additional Issues in the Selection of Priorities for Accelerated Vaccine Development (121-126)
9. Findings, Conclusions, and Recommendations (127-148)
Appendix A: Some Examples of the Application of Project Selection Method (149-152)
Appendix B: Pathogenic Agents for Which Accelerated Vaccine Development Does Not Appear Appropriate (153-170)
Appendix C: Prospects for Immunizing Against Bordetella pertussis (171-182)
Appendix D: Prospects for Immunizing Against Coccidioidomycosis (183-197)
Appendix E: Prospects for Immunizing Against Cytomegalovirus (198-234)
Appendix F: Prospects for Immunizing Against Hemophilus influenzae type b (235-251)
Appendix G: Prospects for Immunizing Against Hepatitis A Virus (252-260)
Appendix H: Prospects for Immunizing Against Hepatitis B Virus (261-279)
Appendix I: Prospects for Immunizing Against Herpes Simplex Viruses 1 and 2 (280-312)
Appendix J: Prospects for Immunizing Against Herpesvirus varicellae (313-341)
Appendix K: Prospects for Immunizing Against Influenza Viruses A and B (342-364)
Appendix L: Prospects for Immunizing Against Neisseria gonorrhoeae (365-384)
Appendix M: Prospects for Immunizing Against Parainfluenza Viruses (385-396)
Appendix N: Prospects for Immunizing Against Respiratory Syncytial Virus (397-409)
Appendix O: Prospects for Immunizing Against Rotavirus (410-423)
Appendix P: Prospects for Immunizing Against Streptococcus group B (424-439)
Appendix Q: Questionnaire for Assessing Morbidity-Mortality Trade-Offs (440-443)
Appendix R: Technical Notes (444-444)
Appendix S: Biographical Notes on Committee Members (445-449)
Appendix T: Additional Sources of Advice to the Committee (450-452)
Index (453-458)