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may lead to changes in the factors that govern industry’s interest in vaccine innovation. The level of industry’s interest in specific vaccines also may change over time as new development techniques are refined.

This committee probably was not aware of all pertinent vaccine-related activity in the private sector, either U.S. or foreign. Given this situation, no formal attempt was made to incorporate the level of industrial interest in individual vaccines into the mechanism designed for selecting priorities for accelerated development.

The committee suggests, however, that decisions on implementation of an accelerated vaccine development program should incorporate a review of relevant activities in the private sector. This review should focus on (1) identifying projects for which mutual collaboration might facilitate industrial development of a needed vaccine and (2) identifying high-priority vaccines for which obvious disincentives exist (e.g., special liability issues or limited sales potential, resulting from small market size or particularly severe restrictions on the ability of potential recipients to pay for vaccines). Government funding of the development of such vaccines might make them more attractive to manufacturers.

Periodic reassessment, preferably biennially, of this aspect of the program is particularly desirable because of rapid changes in the technology of producing new vaccines.

INTEREST IN OTHER COUNTRIES OR INTERNATIONAL ORGANIZATIONS

Opportunities for acceleration of vaccine development by U.S. collaboration with other countries and international organizations may also influence the final choices of vaccines for development. The committee recommends that government decision makers consider such opportunities in selecting projects to be pursued.

OTHER DIEASE CHARACTERSTICS RELEVANT TO ESTABLISHING PRIORITIES

Alternative Disease Control Measures

The method devised ranks vaccine candidates on the basis of their potential health benefits. It does not address the relative benefits of disease prevention, control, or treatment by approaches other than immunization.

In some situations, the availability of effective alternatives to immunization might be an important consideration in setting priorities for vaccine development projects. For example, if two vaccine candidates ranked similarly on potential health benefits and costs, vaccine development might be considered more urgent for the candidate for which alternative prevention, control, or treatment measures were less satisfactory.



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