Predictions about specific vaccines and the processes used to develop them are an integral part of the selection scheme outlined in Chapter 3. These predictions are required to calculate the expected health benefits that would be derived from each new vaccine and the costs associated with achieving those benefits. The characteristics of a vaccine (e.g., live attenuated virus vs. subunit) may affect its efficacy and often have an impact on acceptance and utilization patterns (Chapter 6). The complexity of the development process affects the costs associated with producing health benefits and the time at which they would be achieved.

This chapter outlines the types of predictions included in the analysis. Predictions were developed separately for each vaccine/ disease combination, based on the available literature and a variety of other sources. The final predictions were made after extensive discussions within the committee and consultations with almost 100 individuals in academic institutions, government, and industry.

The committee defined candidates for accelerated development as those diseases for which vaccine development was foreseeable within the next decade. The criterion for inclusion was whether a reasonable consensus could be identified on the nature of potential vaccine components (protective antigens). (The selection process is described further in Appendix B).

The diseases and vaccine candidates chosen for the ranking process are shown in Table 5.1 and described in detail in Appendixes C through P. Some marginal candidates were excluded because the committee decided that it would be more appropriate to consider them in its deliberations on vaccine candidates for less technologically developed countries. The latter portion of Appendix B consists of pathogens considered by the committee to be unsuitable for accelerated vaccine development at this time.