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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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. "5. Predictions on Vaccine Development." 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

Time to Licensure

The time to licensure is defined as the earliest time that a vaccine could be licensed if all developmental stages are completed without major delays. Factors considered in determining this time were similar to those used to estimate the cost of development.

Comments

The committee also considered interrelationships between the probability of success, the cost of development, and the time to licensure, for example, the extent to which extra funding could significantly reduce the time to licensure for a particular vaccine.

Predictions on Vaccine Characteristics

The committee based predictions on the characteristics of individual vaccines primarily on known characteristics of existing vaccines of similar type, e.g., live attenuated virus, polysaccharide, or subunit vaccine. These predictions also incorporate assumptions about likely licensure requirements.

Efficacy

The prediction of a vaccine’s efficacy represents a population-based measure of protection* rather than a measure of antibody production in an individual. Factors considered in estimating the efficacy were the type of pathogen and number of serotypes involved in the disease, the nature of the vaccine candidate, and the extent of immunity from natural infection.

Adverse Reactions

Adverse side effects of a vaccine, especially those likely to occur at very low frequency, are extremely difficult to predict but can seriously affect acceptance. Predictions about side effects are based on the nature of the vaccine envisaged and its purity, and observations of similar existing vaccines. Predictions concerning the incidence of adverse reactions are expressed “per dose” rather than “per vaccinee.”

*

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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)