creation of this framework has so far proceeded in two phases. In Phase I a 15-member committee developed a multi-attribute utility model and an associated software blueprint called SMART Vaccines, an abbreviation for Strategic Multi-Attribute Ranking Tool for Vaccines. The committee evaluated the model using hypothetical vaccine candidates for the prevention of influenza, tuberculosis, and group B streptococcal infection in the United States and South Africa. The methodologies and the software framework are described in the 2012 report Ranking Vaccines: A Prioritization Framework (IOM, 2012).
The Phase II study described in this report, Ranking Vaccines: A Prioritization Software Tool, is a continuation of the Phase I work. A committee of 18 members further refined the multi-attribute utility model and also enhanced the software, creating a new version—SMART Vaccines 1.0—for public release.
Prioritization Models for New Vaccine Development
The IOM has contributed scholarly work to the subject of vaccine prioritization since the 1980s. In 1985 and 1986 the IOM published two reports under the same title, New Vaccine Development: Establishing Priorities, one that focused on vaccine priorities for the United States (IOM, 1985) and another that focused on international priorities (IOM, 1986). These two reports used equivalents of infant lives saved as the sole measure of benefit in prioritizing vaccines. IOM’s next prioritization report, Vaccines for the 21st Century (IOM, 2000), used an efficiency measure (in the form of a cost-effectiveness ratio) rather than a direct benefit measure such as life-years saved and focused only on U.S. vaccine priorities. The approach used in Ranking Vaccines: A Prioritization Framework (IOM, 2012) and in this report has been informed by these previous studies but has significantly expanded the attributes that are relevant for the prioritization and development of new vaccines.
The committee, which gathered feedback from groups and individuals with a broad range of perspectives about the 1985–1986 and the 2000 reports, regularly heard that while those reports were valuable, their focus on life-years saved and cost-effectiveness ratios as outcomes limited their usefulness. The Phase I committee thus chose an approach that provided users and stakeholders with a list of vaccine attributes and allowed them to choose which particular ones they would use in prioritizing vaccines. The committee also developed an intuitive approach to prioritizing vaccines, based on the multi-attribute utility model, which allows users to develop prioritizations based on their assessments of the relative importance of