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Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
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Vaccines for the 21st Century

A TOOL FOR DECISIONMAKING

Kathleen R.Stratton, Jane S.Durch, and Robert S.Lawrence, Editors

Committee to Study Priorities for Vaccine Development

Division of Health Promotion and Disease Prevention

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
×

NATIONAL ACADEMY PRESS
2101 Constitution Avenue, N.W. Washington, DC 20418

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This project has been funded in whole with federal funds from the National Institutes of Allergy and Infectious Diseases, National Institutes of Health, under Contract No. N01-AI-45237. The views presented are those of the Institute of Medicine Committee to Study Priorities for Vaccine Development and are not necessarily those of the funding organization.

Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee to Study Priorities for Vaccine Development.

Vaccines for the 21st century: a tool for decisionmaking/Kathleen R.Stratton, Jane S.Durch, and Robert S.Lawrence, editors; Committee to Study Priorities for Vaccine Development, Division of Health Promotion and Disease Prevention, Institute of Medicine.

p.; cm.

Includes bibliographical references and index.

ISBN 0-309-05646-2 (hard cover)

1. Vaccines—Research—United States—Planning. I. Stratton, Kathleen R. II. Durch, Jane. III. Lawrence, Robert S., 1938- IV. Title.

[DNLM: 1. Vaccines. 2. Economics, Pharmaceutical. 3. Models, Theoretical. 4. Research. QW 805 I592v 2000]

RA638 .I556 2000

615'.372'072073—dc21

00–025528

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Copyright 2000 by the National Academy of Sciences. All rights reserved.

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Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
×

“Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Goethe

INSTITUTE OF MEDICINE

Shaping the Future for Health

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
×

THE NATIONAL ACADEMIES

National Academy of Sciences

National Academy of Engineering

Institute of Medicine

National Research Council

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A.Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I.Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M.Alberts and Dr. William A.Wulf are chairman and vice chairman, respectively, of the National Research Council.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
×

COMMITTEE TO STUDY PRIORITIES FOR VACCINE DEVELOPMENT

ROBERT S.LAWRENCE, M.D. (Chair), Associate Dean for Professional Education and Programs and Professor of Health Policy and Management,

Johns Hopkins School of Hygiene and Public Health

CAROL J.BAKER, M.D.,

Texas Children’s Hospital Foundation

Chair and Professor of Pediatrics, Microbiology, and Immunology and

Head,

Section of Infectious Diseases, Baylor College of Medicine

DAN W.BROCK, Ph.D., Charles C.Tillinghast, Jr.,

University Professor of Philosophy and Biomedical Ethics,

Director,

Center for Biomedical Ethics, Brown University

K.LYNN CATES, M.D., Associate Professor of Pediatrics,

Case Western Reserve University School of Medicine

ANNE A.GERSHON, M.D., Professor of Pediatrics,

College of Physicians and Surgeons, Columbia University

PETER M.HOWLEY, M.D., George Fabyan Professor and Chairman,

Department of Pathology, Harvard Medical School

SAMUEL L.KATZ, M.D., Wilburt C.Davison Professor and Chairman Emeritus,

Department of Pediatrics, Duke University Medical Center

JEFFREY KOPLAN, M.D., M.P.H.,* Executive Vice President and Director,

Prudential Center for Health Care Research, Atlanta

F.MARC LaFORCE, M.D., Professor of Medicine,

University of Rochester School of Medicine and Dentistry

JERRY R.McGHEE, Ph.D., Director,

Immunobiology Vaccine Center and

Professor of Microbiology,

University of Alabama at Birmingham

PEARAY L.OGRA, M.D., John Sealy Distinguished Chair and Professor of Pediatrics,

Children’s Hospital, University of Texas Medical Branch at Galveston

JUNE E.OSBORN, M.D., President,

Josiah Macy, Jr. Foundation, New York City

ELI E.SERCARZ, Ph.D., Professor Emeritus,

Department of Microbiology and Molecular Genetics, University of California at Los Angeles, and

Head and Member,

Division of Immune Regulation, La Jolla Institute for Allergy and Immunology, San Diego

MILTON C.WEINSTEIN, Ph.D., Henry J.Kaiser Professor of Health Policy and Management,

Harvard School of Public Health

Staff

KATHLEEN STRATTON, Ph.D., Study Director

JANE DURCH, Program Officer

CYNTHIA HOWE, Program Officer

*  

Member until September 1998. He became director of the Centers for Disease Control and Prevention in October 1998.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
×

DOROTHY MAJEWSKI, Project Assistant

HOLLY DAWKINS, Research Assistant

DONNA DUNCAN, Division Assistant

LAURIE GILL, EXCEL Consultant

ANNA MEADOWS, M.D., Scholar-in-Residence

MICHAEL A.STOTO, Ph.D., Director,

Division of Health Promotion and Disease Prevention (until January 1, 1997)

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press. doi: 10.17226/5501.
×

Acknowledgments

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report:

Charles C.J.Carpenter, M.D., Brown University;

Gordon DeFriese, Ph.D., University of North Carolina at Chapel Hill;

Roger D.Feldman, Ph.D., University of Minnesota;

Harvey V.Fineberg, M.D., Ph.D., Harvard University;

Fernando Guerra, M.D., M.P.H., San Antonio Metropolitan Health District;

Michael Katz, M.D., March of Dimes Birth Defects Foundation;

Louis Lasagna, M.D., Tufts University School of Medicine; and

Henry W.Riecken, Ph.D., University of Pennsylvania.

While the individuals listed above have provided constructive comments and suggestions, it must be emphasized that responsibility for the final content of this report rests entirely with the authoring committee and the institution.

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Vaccines have made it possible to eradicate the scourge of smallpox, promise the same for polio, and have profoundly reduced the threat posed by other diseases such as whooping cough, measles, and meningitis.

What is next? There are many pathogens, autoimmune diseases, and cancers that may be promising targets for vaccine research and development.

This volume provides an analytic framework and quantitative model for evaluating disease conditions that can be applied by those setting priorities for vaccine development over the coming decades. The committee describes an approach for comparing potential new vaccines based on their impact on morbidity and mortality and on the costs of both health care and vaccine development. The book examines:

  • Lessons to be learned from the polio experience.
  • Scientific advances that set the stage for new vaccines.
  • Factors that affect how vaccines are used in the population.
  • Value judgments and ethical questions raised by comparison of health needs and benefits.

The committee provides a way to compare different forms of illness and set vaccine priorities without assigning a monetary value to lives. Their recommendations will be important to anyone involved in science policy and public health planning: policymakers, regulators, health care providers, vaccine manufacturers, and researchers.

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