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New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986)
Board on Population Health and Public Health Practice (BPH)

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. "6. Assessing the Likely Utilization of New Vaccines." New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries. Washington, DC: The National Academies Press, 1986.

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries

also recognizes that various technical problems could interfere with the addition of these vaccines to the EPI. For example, antagonisms could exist between potential vaccine candidates and those already included in the WHO program. Moreover, changes may be made in the basic EPI as new and better vaccines are developed or as information on current vaccine use is refined. Further research will be needed to investigate the feasibility and desirability of substantially increasing the number of antigens administered at any one time.

SUMMARY

The expected health benefits from a vaccine depend, in part, on the proportion of the target population that actually receives it (which, in turn, affects the probability of acquiring the disease). Predicting utilization rates is complicated by various factors, including availability, cost, the health system capacity to deliver vaccine, statutory interventions, the target population, and provider and recipient acceptance.

Because delivery of vaccines would probably be achieved through the WHO-EPI, the committee assumed for the analysis that utilization rates of vaccine candidates would be uniform across target populations. (Actual decisions about whether to incorporate specific vaccines into EPI should be based on local assessments of disease burdens, resources, and other considerations.) Thus, utilization is not used to differentiate among vaccine candidates in this analysis. Methods described in the committee’s previous report can be adapted if utilization is expected to differ among vaccines.

REFERENCES

Adeniyi, J.D. 1972. Cholera control: Problems of beliefs and attitudes. Int. J. Health Educ. 15:238–245.

Azurin, J.C., and M.Alvero. 1971. Cholera incidence in a population offered cholera vaccination: Comparison of cooperative and uncooperative groups. Bull. WHO 44:815–819.


Becker, M.H., ed. 1974. The Health Belief Model and Personal Health Behavior. Thorofare, N.J.: Charles B.Slack.


Henderson, R.H. 1985. Personal communication. World Health Organization, Geneva.

Hingson, R. 1974. The impact of health beliefs on behavior during an immunization program in rural Haiti, 1972. Health Educ. Mono. 2:505–508.

Hingson, R., and N.Lin. 1972. Communication participation and individual receptivity to health innovations. Int. J. Health Educ. 16:5–14.

Hsu, F.L.K. 1955. A cholera epidemic in a Chinese town. Pp. 135–154in Health Culture and Community, B.Paul, ed. New York: Russell Sage Foundation.

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Front Matter (R1-R16)
1. Summary (1-18)
2. Priority Setting for Health-Related Investments: A Review of Methods (19-29)
3. Overview of the Analytic Approach (30-43)
4. Comparison of Disease Burdens (44-62)
5. Predictions of Vaccine Development (63-75)
6. Assessing the Likely Utilization of New Vaccines (76-81)
7. Calculation and Comparison of the Health Benefits and Differential Costs Associated with Candidate Vaccines (82-105)
8. Additional Issues in the Selection of Priorities for Accelerated Vaccine Development (106-120)
9. Findings, Conclusions, and Recommendations (121-142)
Appendix A: Selection of Vaccine Candidates for Accelerated Development (143-148)
Appendix B: The Burden of Disease Resulting from Acute Respiratory Illness (149-158)
Appendix C: The Burden of Disease Resulting from Diarrhea (159-169)
Appendix D-1: The Prospects for Immunizing Against Dengue Virus (170-177)
Appendix D-2: The Prospects for Immunizing Against Escherichia coli (178-185)
Appendix D-3: The Prospects for Immunizing Against Hemophilus influenzae Type b (186-196)
Appendix D-4: The Prospects for Immunizing Against Hepatitis A Virus (197-207)
Appendix D-5: The Prospects for Immunizing Against Hepatitis B Virus (208-222)
Appendix D-6: The Prospects for Immunizing Against Japanese Encephalitis Virus (223-240)
Appendix D-7: The Prospects for Immunizing Against Mycobacterium leprae (241-250)
Appendix D-8: The Prospects for Immunizing Against Neisseria meningitidis (251-266)
Appendix D-9: The Prospects for Immunizing Against Parainfluenza Viruses (267-274)
Appendix D-10: The Prospects for Immunizing Against Plasmodium spp. (275-286)
Appendix D-11: The Prospects for Immunizing Against Rabies Virus (287-298)
Appendix D-12: The Prospects for Immunizing Against Respiratory Syncytial Virus (299-307)
Appendix D-13: The Prospects for Immunizing Against Rotavirus (308-318)
Appendix D-14: The Prospects for Immunizing Against Salmonella typhi (319-328)
Appendix D-15: The Prospects for Immunizing Against Shigella spp. (329-337)
Appendix D-16: The Prospects for Immunizing Against Streptococcus Group A (338-356)
Appendix D-17: The Prospects for Immunizing Against Streptococcus pneumoniae (357-375)
Appendix D-18: The Prospects for Immunizing Against Vibrio cholerae (376-389)
Appendix D-19: The Prospects for Immunizing Against Yellow Fever (390-402)
Appendix E: Questionnaire for Assessing Morbidity-Mortality Trade-Offs (403-411)
Appendix F: Technical Notes (412-412)
Appendix G: Biographical Notes on Committee Members (413-417)
Appendix H: Additional Sources of Advice to the Committee (418-419)
Appendix I: Contents of Supplement to Volume II (420-420)
Appendix J: Preface to Volume I (421-422)
Appendix K: Contents to Volume I (423-423)
Index (424-432)