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Vaccines for the 21st Century: A Tool for Decisionmaking (2000)
Institute of Medicine (IOM)

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. "Introduction." Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press, 2000.

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Vaccines for the 21st Century: A Tool for Decisionmaking

The committee intends this model to be used as a dynamic instrument for the responsible prioritization of vaccine development and vaccination program implementation. The basic model and the mathematics used to create the model are described in detail in Chapter 4 and 5. Anyone with a personal computer and a spreadsheet software package could reprogram this model. Those with a mathematical understanding of modeling could do so quickly and easily. A reader could change the basic model if he or she so desired. A reader could change the data run through the model if the reader takes great exception to the data used by the committee. In order to facilitate such use of this model, it can be accessed electronically without charge (see Appendix 27). The committee also believes that this model has great utility even for those not charged with prioritizing vaccine development. Because only part of the model accounts for vaccine development time and costs, the model can be used after licensure of a vaccine to study and plan for vaccination program implementation.

ORGANIZATION OF THE REPORT

Charge to the Committee

The Committee to Study Priorities for Vaccine Development was charged with three main tasks:

  1. Assessing the progress in vaccine development since publication of the 1985 IOM report.

  2. Describing barriers to vaccine research and development.

  3. Developing a framework by which vaccine research and development could be prioritized.

The first part of the charge is addressed in Chapter 2. The second task is addressed in part in Chapter 2 and in part in Chapter 7. The third part of the charge is addressed in Chapters 4 and 5. The application and interpretation of the analytic framework are discussed in Chapters 5 and 6 and the appendixes. It is important to discuss the specifics of the committee’s third task with particular emphasis on what it does not entail. Specifically, the committee was asked to develop a model that could be applied to diseases affecting the U.S. population. As discussed in several places within the report, this influenced specific variables in the model and the choices of candidate vaccines to be used to illustrate the model. This restriction also caused the committee great concerns. Concerns about international health and disease burden are expressed in this chapter and in Chapter 7, Observations.

The committee was also asked to exclude vaccine candidates directed against human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Research and development (R&D) related to these vaccines is a priority of the National Institutes of Health (NIH) and many vac

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Front Matter (R1-R12)
Executive Summary (1-10)
Introduction (11-16)
Progress in Vaccine Development (17-38)
Considerations of Candidate Vaccines (39-52)
Overview of Analytic Approach and Results (53-92)
Review of the Analytical Model (93-108)
Ethical Considerations and Caveats (109-122)
Observations (123-132)
References (133-142)
Appendix 1: Borrelia burgdorferi (143-148)
Appendix 2: Chlamydia (149-158)
Appendix 3: Coccidioides Immitis (159-164)
Appendix 4: Cytomegalovirus (165-172)
Appendix 5: Enterotoxigenic E. coli (173-176)
Appendix 6: Epstein-Barr Virus (177-180)
Appendix 7: Helicobacter pylori (181-188)
Appendix 8: Hepatitis C (189-194)
Appendix 9: Herpes Simplex Virus (195-206)
Appendix 10: Histoplasma capsulatum (207-212)
Appendix 11: Human Paillomavirus (213-222)
Appendix 12: Influenza A and B (223-232)
Appendix 13: Insulin-Dependent Diabetes Mellitus (233-238)
Appendix 14: Melanoma (239-244)
Appendix 15: Multiple Sclerosis (245-250)
Appendix 16: Mycobacterium tuberculosis (251-256)
Appendix 17: Neisseria gonnorrhea (257-266)
Appendix 18: Neisseria meningitidis (267-272)
Appendix 19: Parainfluenza Virus (273-278)
Appendix 20: Respiratory Syncytial Virus (279-284)
Appendix 21: Rheumatoid Arthritis (285-290)
Appendix 22: Rotavirus (291-294)
Appendix 23: Shigella (295-298)
Appendix 24: Streptococcus, Group A (299-304)
Appendix 25: Streptococcus, Group B (305-312)
Appendix 26: Streptococcus pneumoniae (313-322)
Appendix 27: Information on accessing Electronic Spreadsheets (323-324)
Appendix 28: Summary of Workshops (325-434)
Appendix 29: Questions Posed to Outside Experts and List of Responders (435-442)
Index (443-460)