Vaccines for the 21st Century: A Tool for Decisionmaking

	3. Learns and remembers very slowly and usually requires special assistance in learning situations		0.88
	4. Unable to learn and remember		0.65
4. Cognitive Total				b4=.95
5. Self-care	1. Eats, bathes, dresses, and uses the toilet normally for age		1.00
	2. Eats, bathes, dresses, or uses the toilet independently with difficulty		0.97
	3. Requires mechanical equipment to eat, bathe dress, or use the toilet independently	√	0.91
	4. Requires the help of another person to eat, bathe, dress, or use the toilet		0.80
5. Self-care Total				b5=.9 1
6. Pain	1. Free of pain and discomfort		1.00
	2. Occasional pain; discomfort relieved by nonprescription drugs or self-control activity without disruption of normal activities		0.97
	3. Frequent pain; discomfort relieved by oral medicines with occasional disruption of normal activities		0.85
	4. Frequent pain; frequent disruption of normal activities; discomfort requires prescription narcotics for relief	√	0.64
	5. Severe pain; pain not relieved by drugs and constantly disrupts normal activities		0.38
Pain Total				b6=.64
7. Fertility	1. Able to have children with a fertile spouse		1.00
	2. Difficulty in having children with a fertile spouse	√	0.97
	3. Unable to have children with a fertile spouse		0.88
Fertility Total				b7=.97
Health State: Utility Function	1.06 • (b1 • b2 • b3 • b4 • b5 • b6 • b7) –.06
	[1.06 • (1.0 • .73 • .70 • .95 • .91 • .64 • .97) –.06=.23]			HUI=.23

For most of the conditions included in the committee’s analysis, several scenarios were required to depict the associated morbidity. To illustrate some of the features of these scenarios, the scenarios developed for Neisseria meningitidis B are presented in Box 4–3.

Table of Contents

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