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

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. "Overview of Analytic Approach and Results." 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

BOX 4–4 Examples of Quality-Adjustment Weights Obtained Using the Health Utility Index

today, the life-expectancy is 29.2 years; the discounted quality-adjusted present value of that life expectancy is 15.7 years.

The average health status in the population represents the maximum level of health that can be achieved by use of the vaccines under study. Although an individual might be considered to experience periods of perfect health, represented by a quality-adjustment weight of 1.0, the health status of a population will reflect a range of individual quality levels and should not be represented by a quality-adjustment weight set at 1.0. The committee adopted HUI Mark II-based age- and sex-specific health status results from the Canadian NPHS (Wolfson, 1996) to serve as the quality-adjustment weights for the health status of the U.S. population. The weighted average of the population HUI ranges from 0.92 for people 44 years of age and under to 0.66 for people 85 years of age and older.

Disease Incidence and Death Rates

Estimates of current age-specific incidence and mortality for each condition were assembled on the basis of the published literature, the advice of experts in clinical medicine and epidemiology, and the judgment of committee members. Although data are available from surveillance systems for some of the condi-

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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)