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Index

A

Accounting, multiattribute, see Multiattribute accounting

Adjusted time, 90

Adoption, time to, 65, 67, 90

Adverse reactions, vaccine, 34, 35, 69, 71, 74, 86

Affordability, 3, 12, 39, 106, 121

of vaccine candidates, 127

Age groups

mortality trade-off across, 407–408

population by, 46

Age-neutral perspective, 106, 141

Age-related morbidity-mortality trade-offs, 410, 411

Age-related weights, 106–107

AGN (acute post-streptococcal glomerulonephritis), 338

Amortized cost of vaccine development, 34

Annual costs, 94, 96–99

Annualized benefits, 33

Annualized equivalent, 34

Annualized present value of potential health benefits, 84

ARF (acute rheumatic fever), 338–339

ARI, see Respiratory illness, acute

Assumptions, reasons for, 30

Availability, vaccine, 77–78

B

Bacteremia, pneumococcal, see Streptococcus pneumoniae

Benefit-cost analysis, 26

Benefits

health, see Health benefit

hypothetical, 38

relative, 35

of vaccine candidates, 127

Biographical notes on committee members, 413–417

Birth rate, crude, 45

Burden, disease, see Disease burden

Burden-of-illness profiles, 108

C

Carcinoma, primary hepatocellular (PHC), 211, 213, 214

Central analysis, 122

results of, 122–138

Cholera, see Vibrio cholerae

Cirrhosis, 213, 215

Clinical trial difficulty, 68, 70

Committee members, biographical notes on, 413–417

Comprehensive analytic strategy, summary of, 36–37

Contents

of supplement to Volume 2, 420

to Volume 1, 423

Cost calculations, 11–13

procedures for, 33–35

Cost components, 12

Cost-effectiveness analysis, 3, 24–26

application of, 25

Cost-effectiveness ratio, 25

Cost-utility analysis, 24–25

Cost-utility ratio, 25

Costs

amortized, of vaccine development, 34

annual, 94, 96–99

comparison of, 57–58

development, 64, 66, 73

estimating aggregate direct, 58

indirect, 58

net opportunity, of resources, 123

Countries, developing, 44–46

D

Days of hospitalization, 108

Decision analysis with multiple objectives, 22, 24, 27

limitations of, 59–61

overview of, 30–43

Decision-making process, 1–3

Delivery requirements, 69, 71, 74

Dengue virus

annual number of vaccinees and delay in benefits, 87

as candidate, 5

disease burden, 172, 173

disease description, 170–171

disease distribution, 172

health benefits and expenditures associated with, 124

host immune response, 171

pathogen description, 171

prediction tables, 64–65, 68–69

probable vaccine target population, 172, 174

prospects for immunizing against, 170–176

prospects for vaccine development, 175–176

relationships between expenditures and health benefits, 128–129

suitability for vaccine control, 174

times associated with, 91

total disease burden value, 59, 60

vaccine preventable illness, 174



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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries Index A Accounting, multiattribute, see Multiattribute accounting Adjusted time, 90 Adoption, time to, 65, 67, 90 Adverse reactions, vaccine, 34, 35, 69, 71, 74, 86 Affordability, 3, 12, 39, 106, 121 of vaccine candidates, 127 Age groups mortality trade-off across, 407–408 population by, 46 Age-neutral perspective, 106, 141 Age-related morbidity-mortality trade-offs, 410, 411 Age-related weights, 106–107 AGN (acute post-streptococcal glomerulonephritis), 338 Amortized cost of vaccine development, 34 Annual costs, 94, 96–99 Annualized benefits, 33 Annualized equivalent, 34 Annualized present value of potential health benefits, 84 ARF (acute rheumatic fever), 338–339 ARI, see Respiratory illness, acute Assumptions, reasons for, 30 Availability, vaccine, 77–78 B Bacteremia, pneumococcal, see Streptococcus pneumoniae Benefit-cost analysis, 26 Benefits health, see Health benefit hypothetical, 38 relative, 35 of vaccine candidates, 127 Biographical notes on committee members, 413–417 Birth rate, crude, 45 Burden, disease, see Disease burden Burden-of-illness profiles, 108 C Carcinoma, primary hepatocellular (PHC), 211, 213, 214 Central analysis, 122 results of, 122–138 Cholera, see Vibrio cholerae Cirrhosis, 213, 215 Clinical trial difficulty, 68, 70 Committee members, biographical notes on, 413–417 Comprehensive analytic strategy, summary of, 36–37 Contents of supplement to Volume 2, 420 to Volume 1, 423 Cost calculations, 11–13 procedures for, 33–35 Cost components, 12 Cost-effectiveness analysis, 3, 24–26 application of, 25 Cost-effectiveness ratio, 25 Cost-utility analysis, 24–25 Cost-utility ratio, 25 Costs amortized, of vaccine development, 34 annual, 94, 96–99 comparison of, 57–58 development, 64, 66, 73 estimating aggregate direct, 58 indirect, 58 net opportunity, of resources, 123 Countries, developing, 44–46 D Days of hospitalization, 108 Decision analysis with multiple objectives, 22, 24, 27 limitations of, 59–61 overview of, 30–43 Decision-making process, 1–3 Delivery requirements, 69, 71, 74 Dengue virus annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 172, 173 disease description, 170–171 disease distribution, 172 health benefits and expenditures associated with, 124 host immune response, 171 pathogen description, 171 prediction tables, 64–65, 68–69 probable vaccine target population, 172, 174 prospects for immunizing against, 170–176 prospects for vaccine development, 175–176 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 174 times associated with, 91 total disease burden value, 59, 60 vaccine preventable illness, 174

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries Department of Health and Human Services (DHHS), 421 Description disease, see Disease description pathogen, see Pathogen description Developing countries, 44–46 Development, successful, probability of, 64–65, 68–69, 72 Development costs, 64, 66, 73 Development scenario, alternative, 135 expenditures and, 139 IME units and, 138 DHHS (Department of Health and Human Services), 421 Diarrheal diseases, 51 annual incidence of, 160 diarrheal episodes in, 161 disease burden, 159–169 by etiology, 162 mortality from, 161 population in, 160 Differential utilization (U), 35 effect of, 135 Discount rate, 33, 34, 90, 134–135 expenditures and, 137 IME and, 136 Discounting procedure, 11, 33 Disease burden acute respiratory illness, 149–158 aggregate nature of calculations of, 108 assumptions for, 132–134 comparison of, 44–61 dengue virus, 172, 173 diarrheal disease, 159–169 enterotoxigenic Escherichia coli, 163, 179–182 equity considerations in, 106–111 estimates, 7, 8, 47 Haemophilus influenzae, 155 Haemophilus influenzae type b, 188–191 hepatitis A virus, 198–203 hepatitis B virus, 210–216 Japanese encephalitis virus, 227–230 modification of, 166 Mycobacterium leprae, 242–244 Neisseria meningitidis, 255–260 parainfluenza viruses, 149–158, 268–270 Plasmodium spp., 277–279, 282 rabies virus, 291, 292, 293 respiratory syncytial virus, 149–158, 301, 302 rotavirus, 164, 311, 312, 313 Salmonella typhi, 321–324 Shigella spp., 165, 331–333 streptococcus A, 342–345, 346 Streptococcus pneumoniae, 158, 359–370 trends in, 85–86 Vibrio cholerae, 378–381 yellow fever virus, 392–397 Disease characteristics not recognized by system, 60–61 Disease control measures, alternative, 113–114, 116–117 Disease description dengue virus, 170–171 enterotoxigenic Escherichia coli, 178 Haemophilus influenzae type b, 186–187 hepatitis A virus, 197–198 hepatitis B virus, 208–209 Japanese encephalitis virus, 223–224 Mycobacterium leprae, 241 Neisseria meningitidis, 251–253 parainfluenza viruses, 267 Plasmodium spp., 275 rabies virus, 287–289 respiratory syncytial virus, 299 rotavirus, 308–309 Salmonella typhi, 319 Shigella spp., 329–330 streptococcus A, 338–339 Streptococcus pneumoniae, 357–358 Vibrio cholerae, 376–377 yellow fever virus, 390–391 Disease distribution dengue virus, 172 enterotoxigenic Escherichia coli, 179, 182 Haemophilus influenzae type b, 188–190 hepatitis A virus, 198–202 hepatitis B virus, 210–213 Japanese encephalitis virus, 226–230 Mycobacterium leprae, 242–244 Neisseria meningitidis, 255–260 parainfluenza viruses, 268–269 Plasmodium spp., 277–278 rabies virus, 290–291 respiratory syncytial virus, 300–301 rotavirus, 310–311 Salmonella typhi, 320–321 Shigella spp., 331–333 streptococcus A, 342–345 Streptococcus pneumoniae, 359–370 Vibrio cholerae, 378–381 yellow fever virus, 392–397 Disease estimates general procedures and assumptions in, 51 limitations of current, 51–54 procedures used in deriving, 50–51 Disease incidence, 53 Diseases costs associated with, see under Costs distribution of, 108–109 eradication of, 115 important, in developing countries, 146–147 interactions of, 115 ranking of, 15 second-order effects of, 166, 169 synergistic interaction with, 61 Dominance concept of, 13 test for, 40 Dose(s) cost per, 65, 67, 74 number of, 65, 67, 74 Drug resistance, 114 Dysentery, see Shigella spp. E Ectopic pregnancy, 56 Effectiveness, 25 Efficacy, 35, 65, 67, 73–74 Efficacy score, 24 Encephalitis, see Japanese encephalitis virus Endemic meningococcal meningitis, 257–259 Enterotoxigenic Escherichia coli annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 163, 179–182 disease description, 178 disease distribution, 179, 182 health benefits and expenditures associated with, 124 host immune response, 179 pathogen description, 178–179 prediction tables, 64–65, 68–69 probable vaccine target population, 182–183 prospects for immunizing against, 178–185 prospects for vaccine development, 184–185 relationships betweenexpenditures and health benefits, 128–129 suitability for vaccine control, 183–184 times associated with, 91

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries total disease burden value, 59, 60 vaccine preventable illness, 182–183 EPI, see World Health Organization’s Expanded Program on Immunization Epidemic meningococcal meningitis, 256–259 Epidemics, widespread, 114–115, 118 Equity considerations, 106–111 Equivalent, annualized, 34 Eradication, disease, 115 Escherichia coli, enterotoxigenic, see Enterotoxigenic Escherichia coli Estimates reasons for, 30 sources of, 27 Expanded Program on Immunization, see World Health Organization’s Expanded Program on Immunization Expenditures annual, 94 discount rate and, 137 hypothetical, 38 F Fertility control, 107 Formalin-inactivated cell culture vaccine, 233 Formalin-inactivated mouse brainvaccine, 233 G Global health benefit, potential, 39, 121 Glomerulonephritis, acute post-streptococcal (AGN), 338 Gonorrhea, 56 Government-industry relations, 422 Group A streptococcus (GrAS), see Streptococcus A H Haemophilus influenzae type b annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 149–158, 188–191 disease description, 186–187 disease distribution, 188–190 health benefits and expenditures associated with, 124 host immune response, 187–188 pathogen description, 187 prediction tables, 64–65, 68–69 probable vaccine target population, 190–192 prospects for immunizing against, 186–194 prospects for vaccine development, 192–194 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 192 times associated with, 91 total disease burden value, 59, 60 vaccine preventable illness, 190, 192 HAV, see Hepatitis A virus HBM (health belief model), 78 HBV, see Hepatitis B virus Health belief model (HBM), 78 Health benefit associated with candidate vaccines, 82–105 calculating potential, 82–84 comparing, 104 determination of, 6–9 expected, 76 possible, 95, 100–104 potential, see Potential health benefits steady-state yield of, 90 times for occurrence of vaccine-associated, 86 Health benefit rankings, 13 Health-related investments, priority setting for, 19–29 Heart disease, rheumatic (RHD), 339, 343–345 Hepatitis A virus (HAV) annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 198–203 disease burden estimates, 7, 8, 47 disease description, 197–198 disease distribution, 198–202 health benefits and expenditures associated with, 124 host immune response, 198 pathogen description, 198 prediction tables, 64–65, 68–69 probable vaccine target population, 202, 204 prospects for immunizing against, 197–206 prospects for vaccine development, 205–206 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 204–205 times associated with, 91 total disease burden value, 52–53, 59, 60 vaccine preventable illness, 204 Hepatitis B, acute, 210–211, 212 Hepatitis B virus (HBV) annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 210–216 disease description, 208–209 disease distribution, 210–213 health benefits and expenditures associated with, 124 host immune response, 209 pathogen description, 209 prediction tables, 64–65, 68–69 probable vaccine target population, 213, 217 prospects for immunizing against, 208–219 prospects for vaccine development, 217–219 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 217 times associated with, 91 total disease burden value, 59, 60 vaccine preventable illness, 217 Hepatocellular carcinoma, primary (PHC), 211, 213, 214 Hospitalization, days of, 108 Host immune response dengue virus, 171 enterotoxigenic Escherichia coli, 179 Haemophilus influenzae type b, 187–188 hepatitis A virus, 198 hepatitis B virus, 209 Japanese encephalitis virus, 225 Mycobacterium leprae, 242 Neisseria meningitidis, 254–255 parainfluenza viruses, 268 Plasmodium spp., 276–277 rabies virus, 290 respiratory syncytial virus, 300 rotavirus, 310

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries Salmonella typhi, 320 Shigella spp., 331 streptococcus A, 341–342 Streptococcus pneumoniae, 358–359 Vibrio cholerae, 377 yellow fever virus, 391–392 Hypothetical benefits and expenditures, 38 I IME, see Infant mortality equivalence values Immune response, host, see Host immune response Immunization benefits, delay in, 87–89 Immunization efforts, interdependence of, 111–112 Immunization merits, relative, 114 Immunization prospects, see Prospects for immunizing against Immunization requirements, mandatory, 78 Industry interest in vaccines, 112–113 Industry-government relations, 422 Infant mortality, fertility control and, 107 Infant mortality equivalence (IME) values, 7, 9, 48, 82, 108, 123, 141 discount rate and, 136 example of, 50 median, 55, 56, 57 perspective used in study, 55 perspectives, other, 55–57 resulting from diseases, 59 Streptococcus pneumoniae vaccine and, 140 use of, 54 Infant mortality rate, 45 Influenza, 55–56 J Japanese encephalitis virus (JE) annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 227–230 disease description, 223–224 disease distribution, 226–230 formalin-inactivated cellculture vaccine, 233 formalin-inactivated mouse brain vaccine, 233 health benefits and expenditures associated with, 124 host immune response, 225 live attenuated vaccine, 234 pathogen description, 224 prediction tables, 64–65, 68–69 probable vaccine target population, 227, 231 prospects for immunizing against, 223–236 prospects for vaccine development, 232–236 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 232 times associated with, 91 total disease burden value, 59, 60 vaccine preventable illness, 231–232 JE, see Japanese encephalitis virus L Labile vaccines, 112 Leprosy, see Mycobacterium leprae Lexicographic methods, 27 Licensure estimation of time to, 10–11 time to, 65, 67, 73, 73, 86 Live attenuated vaccines, 383–384 M M protein, 340 chemically synthesized fragments, 350–352 structure of, 349–350 Malaria, see Plasmodium spp. Mandatory immunization requirements, 78 Measles vaccine, 112 Meningitis, see also Neisseria meningitidis meningococcal, see Meningococcal meningitis pneumococcal, see Streptococcus pneumoniae Meningococcal meningitis endemic, 257–259 epidemic, 256–259 Morbidity burdens, 44 elements of system for comparing, 46–54 expression of, 48–49 possible reduction in, 83–84 resulting from diseases, 59 value judgments in quantifying, 54–57 Morbidity categories, 8, 47, 48, 49, 409 Morbidity-mortality trade-offs across age groups, 407–408 age-related, 410, 411 questionnaire for assessing, 403–411 Mortality burdens, 44 elements of system for comparing, 46–54 expression of, 48–49 possible reduction in, 83–84 resulting from diseases, 59 value judgments in quantifying, 54–57 Mortality-morbidity trade-offs, see Morbidity-mortality trade-offs Mortality rate, infant, 45 Multiattribute accounting, 20–22 Multiattribute scoring, 22, 23 MULTIPLAN program, 412 Mycobacterium leprae annual number of vaccinees and delay in benefits, 87 as candidate, 5 disease burden, 242–244 disease description, 241 disease distribution, 242–244 health benefits and expenditures associated with, 125 host immune response, 242 pathogen description, 241–242 prediction tables, 64–65, 68–69 probable vaccine target population, 245 prospects for immunizing against, 241–249 prospects for vaccine development, 246–249 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 245–246 times associated with, 92 total disease burden value, 59, 60 vaccine preventable illness, 245 N National Institute of Allergy and Infectious Diseases (NIAID), 19, 39, 61, 143, 421–422 Neisseria meningitidis

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries annual number of vaccinees and delay in benefits, 88 as candidate, 5 disease burden, 255–260 disease description, 251–253 disease distribution, 255–260 health benefits and expenditures associated with, 125 host immune response, 254–255 pathogen description, 253–254 prediction tables, 64–65, 68–69 probable vaccine target population, 261–262 prospects for immunizing against, 251–264 prospects for vaccine development, 262–264 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 262 times associated with, 92 total disease burden value, 59, 60 vaccine preventable illness, 261 Net opportunity cost of resources, 123 NIAID, see National Institute of Allergy and Infectious Diseases Nonquantifiable factors, 106, 119 O Opportunity cost, net, of resources, 123 Oral rehydration therapy (ORT), 51, 133, 166 enterotoxigenic Escherichia coli and, 167, 181 rotavirus and, 168, 313 ORT, see Oral rehydration therapy Otitis media, see Streptococcus pneumonia P Parainfluenza viruses (PIV) annual number of vaccinees and delay in benefits, 88 as candidate, 5 disease burden, 149–158, 268–270 disease description, 267 disease distribution, 268–269 health benefits and expenditures associated with, 125 host immune response, 268 pathogen description, 267–268 prediction tables, 64–65, 68–69 probable vaccine target population, 269, 271 prospects for immunizing against, 267–273 prospects for vaccine development, 271–273 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 271 times associated with, 92 total disease burden value, 59, 60 vaccine preventable illness, 269, 271 Parental behavior, 107 Pathogen description dengue virus, 171 enterotoxigenic Escherichia coli, 178–179 Haemophilus influenzae type b, 187 hepatitis A virus, 198 hepatitis B virus, 209 Japanese encephalitis virus, 224 Mycobacterium leprae, 241–242 Neisseria meningitidis, 253–254 parainfluenza viruses, 267–268 Plasmodium spp., 275–276 rabies virus, 289–290 respiratory syncytial virus, 299–300 rotavirus, 309 Salmonella typhi, 320 Shigella spp., 330 streptococcus A, 340–341 Streptococcus pneumoniae, 358 Vibrio cholerae, 377 yellow fever virus, 391 Pertussis vaccine, 111 PHC (primary hepatocellular carcinoma), 211, 213, 214 PIV, see Parainfluenza viruses Plasmodium spp. annual number of vaccinees and delay in benefits, 88 as candidate, 5 disease burden, 277–279, 282 disease description, 275 disease distribution, 277–278 health benefits and expenditures associated with, 125 host immune response, 276–277 pathogen description, 275–276 prediction tables, 64–65, 68–69 probable vaccine target population, 278, 280–281 prospects for immunizing against, 275–285 prospects for vaccine development, 283–285 relationships between expenditures and health benefits, 128–129 suitability for vaccine control, 281, 283 times associated with, 92 total disease burden value, 59, 60 vaccine preventable illness, 281 Pneumococcal meningitis, see Streptococcus pneumoniae Pneumococcal meningitis, see Streptococcus pneumoniae Pneumonia, see Streptococcus pneumonia Poliomyelitis vaccine, 112 Population by age groups, 46 estimates, 44–46 growth, 107 trends in, 85–86 world, 45 Portfolio approach for ranking vaccines, 110–111 “Portfolio” question, 28 Possible reduction in morbidity and mortality (PRMM), 83–84 Post-streptococcal glomerulonephritis, acute (AGN), 338 Potential global health benefit, 39 Potential health benefits, 3 annualized present value of, 84 calculation of, 11, 12 global, 32, 121 rankings of vaccine candidates based on, 17 Preface to Volume 1, 421–422 Pregnancy, ectopic, 56 Present value, method of, 25 Primary hepatocellular carcinoma (PHC), 211, 213, 214 Priority list, 14 Priority rankings, 13 Priority setting approach, 422 for health-related investments, 19–29 PRMM (possible reduction in morbidity and mortality), 83–84 Probable vaccine target population defined, 10 dengue virus, 172, 174

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries enterotoxigenic Escherichia coli, 182–183 Haemophilus influenzae type b, 190–192 hepatitis A virus, 202, 204 hepatitis B virus, 213, 217 Japanese encephalitis virus, 227, 231 Mycobacterium leprae, 245 Neisseria meningitidis, 261–262 parainfluenza viruses, 269, 271 Plasmodium spp., 278, 280–281 rabies virus, 291, 294 respiratory syncytial virus, 301, 303 rotavirus, 311, 314 Salmonella typhi, 321, 325 Shigella spp., 333 streptococcus A, 345, 347 Streptococcus pneumoniae, 370–372 Vibrio cholerae, 378, 382 yellow fever virus, 397–399 Project ranking and selection, methods for, 19–26 issues in, 27–28 Projects, interdependence among, 27–28 Prospects for immunizing against dengue virus, 170–176 enterotoxigenic Escherichia coli, 178–185 Haemophilus influenzae type b, 186–194 hepatitis A virus, 197–206 hepatitis B virus, 208–219 Japanese encephalitis virus, 223–236 Mycobacterium leprae, 241–249 Neisseria meningitidis, 251–264 parainfluenza viruses, 267–273 Plasmodium spp., 275–285 rabies virus, 287–297 respiratory syncytial virus, 299–305 rotavirus, 308–316 Salmonella typhi, 319–327 Shigella spp., 329–336 streptococcus A, 338–352 Streptococcus pneumoniae, 357–374 Vibrio cholerae, 376–387 yellow fever virus, 390–401 Prospects for vaccine development dengue virus, 175–176 enterotoxigenic Escherichia coli, 184–185 Haemophilus influenzae type b, 192–194 hepatitis A virus, 205–206 hepatitis B virus, 217–219 Japanese encephalitis virus, 232–236 Mycobacterium leprae, 246–249 Neisseria meningitidis, 262–264 parainfluenza viruses, 271–273 Plasmodium spp., 283–285 rabies virus, 296–297 respiratory syncytial virus, 303–305 rotavirus, 314–316 Salmonella typhi, 325–327 Shigella spp., 335–336 streptococcus A, 348–352 Streptococcus pneumoniae, 373–374 Vibrio cholerae, 383–387 yellow fever virus, 400–401 PRP vaccine, 94 Q Quality-adjusted years of life saved, 26 Quantitative scores, 22 Quantitative structured model, 2–3 Questionnaire for assessing morbidity-mortality trade-offs, 403–411 R Rabies vaccines, 288–289 Rabies virus annual number of vaccinees and delay in benefits, 88 as candidate, 5 disease burden, 291, 292, 293 disease description, 287–289 disease distribution, 290–291 health benefits and expenditures associated with, 125 host immune response, 290 pathogen description, 289–290 prediction tables, 66–67, 70–71 probable vaccine target population, 291, 294 prospects for immunizing against, 287–297 prospects for vaccine development, 296–297 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 295–296 times associated with, 92 total disease burden value, 59, 60 vaccine preventable illness, 294–295 Ranking vaccines, 13 Reductionist method, 33 Rehydration therapy, oral, see Oral rehydration therapy Relative benefits, 35 Research, basic scientific, 31 Resource constraints on ranking of vaccine candidates, 16, 132, 421 Resource costs, 25 Resources, net opportunity cost of, 123 Respiratory disease, acute (ARI) deaths due to, 151 disease burden from, 149–158 estimated mortality of, 150 population distribution and, 150 relative case frequencies, 153 Respiratory syncytial virus (RSV) annual number of vaccinees and delay in benefits, 88 as candidate, 6 disease burden, 149–158, 301, 302 disease description, 299 disease distribution, 300–301 health benefits and expenditures associated with, 125 host immune response, 300 pathogen description, 299–300 prediction tables, 66–67, 70–71 probable vaccine target population, 301, 303 prospects for immunizing against, 299–305 prospects for vaccine development, 303–305 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 303 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 303 RHD (rheumatic heart disease), 339, 343–345 Rheumatic fever, acute (ARF), 338–339 Rheumatic heart disease (RHD), 339, 343–345 Rotavirus annual number of vaccinees and delay in benefits, 89 as candidate, 6 disease burden, 164, 311, 312, 313

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries disease description, 308–309 disease distribution, 310–311 health benefits and expenditures associated with, 126 host immune response, 310 pathogen description, 309 prediction tables, 66–67, 70–71 probable vaccine target population, 311, 314 prospects for immunizing against, 308–316 prospects for vaccine development, 314–316 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 314 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 311, 314 Route of administration, 69, 71, 74 RSV, see Respiratory syncytial virus S Salmonella typhi annual number of vaccinees and delay in benefits, 89 as candidate, 6 disease burden, 321–324 disease description, 319 disease distribution, 320–321 health benefits and expenditures associated with, 126 host immune response, 320 pathogen description, 320 prediction tables, 66–67, 70–71 probable vaccine target population, 321, 325 prospects for immunizing against, 319–327 prospects for vaccine development, 325–327 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 325 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 321, 325 Scientific research, basic, 31 Scoring, multiattribute, see Multiattribute scoring Selection criteria, 13 Sensitivity analyses, 2, 3, 4, 141 discount rate effect on expenditure, 137 discount rate effect on IME, 136 Sequential screening methods, 27 Severity, levels of, 46 Shigella spp. annual number of vaccineesand delay in benefits, 89 as candidate, 6 disease burden, 165, 331–333 disease description, 329–330 disease distribution, 331–333 health benefits and expenditures associated with, 126 host immune response, 331 pathogen description, 330 prediction tables, 66–67, 70–71 probable vaccine target population, 333 prospects for immunizing against, 329–336 prospects for vaccine development, 335–336 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 334 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 333 Side effects, see Adverse reactions Streptococcus A annual number of vaccinees and delay in benefits, 89 as candidate, 6 disease burden, 342–345, 346 disease description, 338–339 disease distribution, 342–345 health benefits and expenditures associated with, 126 host immune response, 341–342 pathogen description, 340–341 prediction tables, 66–67, 70–71 probable vaccine target population, 345, 347 prospects for immunizing against, 338–352 prospects for vaccine development, 348–352 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 347–348 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 345, 347 Streptococcus pneumoniae annual number of vaccinees and delay in benefits, 89 as candidate, 6 disease burden, 149–158, 359–370 disease burden table, 158 disease description, 357–358 disease distribution, 359–370 health benefits and expenditures associated with, 126 host immune response, 358–359 pathogen description, 358 prediction tables, 66–67, 70–71 probable vaccine target population, 370–372 prospects for immunizing against, 357–374 prospects for vaccine development, 373–374 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 372–373 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 371–372 Streptococcus pneumoniae vaccine, 140 Subscores, 22 Suitability for vaccine control dengue virus, 174 enterotoxigenic Escherichia coli, 183–184 Haemophilus influenzae type b, 192 hepatitis A virus, 204–205 hepatitis B virus, 217 Japanese encephalitis virus, 232 Mycobacterium leprae, 245–246 Neisseria meningitidis, 262 parainfluenza viruses, 271 Plasmodium spp., 281, 283 rabies virus, 295–296 respiratory syncytial virus, 303 rotavirus, 314 Salmonella typhi, 325 Shigella spp., 334

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries streptococcus A, 347–348 Streptococcus pneumoniae, 372–373 Vibrio cholerae, 382 yellow fever virus, 399 Surveillance data, 52 Synthetic vaccines, 386–387 T T protein, 340 Target populations, 64–65, 68–69, 72, 85, 134 individuals entering, 87–89 probable vaccine, see Probable vaccine target population TDBV, see Total disease burden values Technical notes, 412 Total disease burden values (TDBV), 9, 94 assumptions for, 132–134 calculating, 82 example of, 52–53 ranking of diseases by, 15 Trade-off values, 48 example of, 49 morbidity-mortality, see Morbidity-mortality trade-offs mortality, see Mortality trade-offs Typhoid fever, see Salmonella typhi U U, see Differential utilization Urban population, 45 Utilization, vaccine, 31, 78–80 in developing world, 79–80 differential, see Differential utilization prediction of, in defined populations, 78 treatment of, 10 Utilization rates, 76–77 V Vaccination, see Immunization entries Vaccine candidates benefits and affordability of, 127 health benefits associated with, 82–105 rankings based on potential health benefits, 17 resource constraints on, 16, 132, 421 selection of, 4–6, 63 target populations and, 72 Vaccine control, suitability for, see Suitability for vaccine control Vaccine coverage, 24 Vaccine development, accelerated, 106–119 basic research priorities and, 144 judging feasibility of, 143–144 pathogens not candidates but discussed in first report, 148 potential candidate diseases for, 148 selecting candidates for, 144–145 selection of candidates for, 143–148 Vaccine development predictions, 9–10, 63–75 adverse reactions, 74 cost of development, 73 cost per dose, 74 delivery requirements, 74 efficacy, 73–74 need for, 63 number of doses, 74 probability of successful development, 72 production technology, 74 route of administration, 74 time to licensure, 73 vaccine characteristics, 73–74 Vaccine development prospects, see Prospects for vaccine development Vaccine dominance, 41 Vaccine improvement projects, 94–95 Vaccine preventable illness (VPI), 83, 85 assumptions on, 134 defined, 182n dengue virus, 174 enterotoxigenic Escherichia coli, 182–183 estimation of, 11 Haemophilus influenzae type b, 190, 192 hepatitis A virus, 204 hepatitis B virus, 217 Japanese encephalitis virus, 231–232 Mycobacterium leprae, 245 Neisseria meningitidis, 261 parainfluenza viruses, 269, 271 Plasmodium spp., 281 rabies virus, 294–295 respiratory syncytial virus, 303 rotavirus, 311, 314 Salmonella typhi, 321, 325 Shigella spp., 333 streptococcus A, 345, 347 Streptococcus pneumoniae, 371–372 Vibrio cholerae, 382 yellow fever virus, 398–399 Vaccine preventable proportion, 82–83 Vaccine target population, probable, see Probable vaccine target population Vaccines accelerated, see Vaccine development, accelerated administration of, cost of, 32 adoption of, time to, 10–11 amortized cost of, 34 availability of, 77–78 benefits of, equity considerations in, 106–111 candidates for, see Vaccine candidates characteristics of, 9–13, 85 combination of, 28 development of, 1 hypothetical, rankings of, 40 incorporation into WHO-EPI, 69, 71 industry interest in, 112–113 interdependence of development efforts for, 111 labile, 112 live attenuated, 383–384 new, assessing likely utilization of, 76–80 portfolio approach for ranking, 110–111 predictions for, see Vaccine development predictions preventable illness, see Vaccine preventable illness priorities for, 3–4, 7, 422 prospects for, see Prospects for vaccine development rabies, 288–289 ranking, 13 recommendations for use of, 110 secondary impacts of, 32 side effects of, 34, 35 stage of development of, 110 synthetic, 386–387 target population, see Probable vaccine target population total time to steady-state use of, 91–93 types of, 64, 66, 68, 70 utilization of, see Utilization, vaccine Value judgments, 2 individual, see Trade-off values in quantifying morbidity and mortality, 54–57

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries Vector control, 114 Vibrio cholerae annual number of vaccinees and delay in benefits, 89 as candidate, 6 disease burden, 378–381 disease description, 376–377 disease distribution, 378–381 health benefits and expenditures associated with, 126 host immune response, 377 pathogen description, 377 prediction tables, 66–67, 70–71 probable vaccine target population, 378, 382 prospects for immunizing against, 376–387 prospects for vaccine development, 383–387 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 382 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 382 Volume 1, contents to, 423 Volume 2, contents of supplement to, 420 VPI, see Vaccine preventable illness W Weighted scores, 22 WHO-EPI, see World Health Organization’s Expanded Program on Immunization Widespread epidemics, 114–115, 118 World Health Organization’s Expanded Program on Immunization (WHO-EPI), 10, 32, 79 vaccine incorporation into, 69, 71 World population data, 45 Y Years of life saved, quality-adjusted, 26 Yellow fever virus (YF) annual number of vaccinees and delay in benefits, 89 as candidate, 6 disease burden, 392–397 disease description, 390–391 disease distribution, 392–397 health benefits and expenditures associated with, 126 host immune response, 391–392 pathogen description, 391 prediction tables, 66–67, 70–71 probable vaccine target population, 397–399 prospects for immunizing against, 390–401 prospects for vaccine development, 400–401 relationships between expenditures and health benefits, 130–131 suitability for vaccine control, 399 times associated with, 93 total disease burden value, 59, 60 vaccine preventable illness, 398–399 YF, see Yellow fever virus