Applications of a
Prioritization Software Tool
Phase III: Use Case Studies and Data Framework
Committee on Identifying and Prioritizing
New Preventive Vaccines for Development, Phase III
Board on Population Health and Public Health Practice
Board on Global Health
Guruprasad Madhavan, Charles Phelps, Rino Rappuoli,
Rose Marie Martinez, and Lonnie King, Editors
INSTITUTE OF MEDICINE AND
NATIONAL ACADEMY OF ENGINEERING
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
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 study was supported in part by Contract No. HHSN275200900087U between the National Academy of Sciences and the Fogarty International Center of the National Institutes of Health, in collaboration with the National Vaccine Program Office of the U.S. Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
International Standard Book Number-13: 978-0-309-30403-0
International Standard Book Number-10: 0-309-30403-2
Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; www.nap.edu.
Copyright 2015 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: Institute of Medicine and National Academy of Engineering. 2015. Ranking vaccines: Applications of a prioritization software tool: Phase III: Use case studies and data framework. Washington, DC: The National Academies Press.
Software Link: SMART Vaccines 1.1 can be downloaded from www.nap.edu/smartvaccines.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
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. Ralph J. Cicerone 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. C. D. Mote, Jr., 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. Victor J. Dzau 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. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
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Committee on Identifying and Prioritizing New Preventive Vaccines for Development, Phase III
LONNIE KING (Chair), Dean, College of Veterinary Medicine, and Executive Dean, Health Sciences College, Ohio State University
PAUL CITRON, Retired Vice President, Medtronic, Inc.; Senior Fellow, William J. von Liebig Center for Entrepreneurism and Technology; and Adjunct Professor of Bioengineering, University of California, San Diego
RITA COLWELL, Chair Emeritus, Canon U.S. Life Sciences, Inc.; Distinguished Professor, University of Maryland, College Park, and Johns Hopkins Bloomberg School of Public Health; and Former Director, National Science Foundation
SIMON MERCER, Director, Health and Wellbeing, Microsoft Research Connections
CHARLES PHELPS, University Professor and Provost Emeritus, University of Rochester
RINO RAPPUOLI, Global Head, Vaccines Research, Novartis Vaccines, Italy
EDWARD SHORTLIFFE, Professor, Arizona State University; Adjunct Professor of Biomedical Informatics, Columbia University; and Scholar in Residence, New York Academy of Medicine
PETER SPEYER, Chief Data and Technology Officer, Institute for Health Metrics and Evaluation, University of Washington
GUY STEELE, Software Architect, Oracle Labs
GURUPRASAD MADHAVAN, Project Director
KINPRITMA SANGHA, Associate Program Officer (until July 2014)
ANGELA MARTIN, Senior Program Assistant
HOPE HARE, Administrative Assistant
DORIS ROMERO, Financial Associate
ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice
PATRICK KELLEY, Senior Director, Board on Global Health
PROCTOR REID, Director, Program Office, National Academy of Engineering
LORI ADAKILTY, Principal Program Manager, Microsoft Research Connections
GUTHRIE BIRKHEAD, Deputy Commissioner, New York State Department of Health
PRASAD KULKARNI, Medical Director, Serum Institute of India Limited
SCOTT LEVIN, Associate Professor of Emergency Medicine, Johns Hopkins University
EDUARDO GUZMÁN MORALES, Technical Advisor to the Undersecretary of Prevention and Health Promotion, Ministry of Health, Mexico
ESTEFANÍA DE LA PAZ NICOLAU, Advisor to the Undersecretary of Prevention and Health Promotion, Ministry of Health, Mexico
PATRICIA SATJAPOT, Associate Director, Johns Hopkins Medical International
SAULEH SIDDIQUI, Assistant Professor of Civil Engineering and Applied Mathematics & Statistics
JOHN SPIKA, Director General, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada
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 its 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 review of this report:
Rafi Ahmed, Emory Vaccine Center and Emory University School of Medicine
David Banta, Consultant on Health Technology Assessment
Diane Griffin, Johns Hopkins Bloomberg School of Public Health
Demissie Habte, Ethiopian Academy of Sciences
Joseph Jasinski, IBM Research
Gary Nabel, Sanofi
Sachiko Ozawa, Johns Hopkins Bloomberg School of Public Health
Patricia Quinlisk, Iowa Department of Public Health
Laura Snyder Rosema, Global Good
Oyewale Tomori, Nigerian Academy of Sciences
Christopher Wilson, The Bill & Melinda Gates Foundation
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Harold Sox from Dartmouth Institute for Health Policy and Clinical Practice, and Patient-Centered Outcomes Research Institute, and Lawrence Brown from the
University of Pennsylvania. Appointed by the National Research Council and the Institute of Medicine they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
One of the greatest accomplishments in global public health has been the development and use of vaccines. However, making decisions about vaccine development and their utility are becoming progressively more complex and based on a wide variety of factors. Further, these factors may vary greatly across different settings, which may ultimately result in different priorities for vaccine development and delivery.
To help facilitate improved decision making and to provide a common language across various stakeholders, the Institute of Medicine (IOM) in collaboration with the National Academy of Engineering has enhanced Strategic Multi-Attribute Ranking Tool for Vaccines—SMART Vaccines—a groundbreaking software product from the National Academies. The enhancements to the software and its use by three early stage users are discussed in this report that follows the earlier publications Ranking Vaccines: A Prioritization Framework (Phase I, 2012) and Ranking Vaccines: A Prioritization Software Tool (Phase II, 2013). These reports and the enhanced software version are available for free download at www.nap.edu/smartvaccines.
In this phase, the committee has demonstrated the practical applications of SMART Vaccines through use case scenarios in partnership with the Public Health Agency of Canada, New York State Department of Health, and the Serum Institute of India. The committee has also explored a novel application of SMART Vaccines in determining new vaccine product profiles and has offered practical strategies for data synthesis and estimation to encourage the broader use of the software.
Just as any software product, enhancements to SMART Vaccines will rely on critical user evaluations and their commitment to cycles of continuous learning and improvement. The committee envisions the use and adoption of this software by a range of stakeholders in the vaccine and the broader public health communities. In addition, SMART Vaccines could
serve as a unique tool for interdisciplinary academic programs across health sciences, engineering, and business management. Finding a reliable host for SMART Vaccines is especially critical to ensure that the tool undergoes further improvements and serves as a focal point for collaborative discussions among different users.
On behalf of the committee, I would like to thank and acknowledge a group of individuals who diligently and adroitly helped to develop the latest iteration of SMART Vaccines and produce this report. The committee is appreciative of, and indebted to, the extremely talented IOM staff, including our project director Guru Madhavan and data manager Kinpritma Sangha. Both of them have superbly contributed to this project series and have been especially recognized by the IOM for their innovative work on SMART Vaccines.
The committee has immensely benefitted from the guidance of Harvey Fineberg, former president of the IOM, Rose Marie Martinez, senior director of the IOM Board on Population Health and Public Health Practice, Patrick Kelley, senior director of the IOM Board on Global Health, Marc Gold, associate general counsel of the National Academy of Sciences, and Proctor Reid, director of programs at the National Academy of Engineering.
The committee appreciates the support of Chelsea Frakes, Greta Gorman, and Angela Martin for their superb assistance during various stages of this project. We wish to acknowledge the excellent technical work of Scott Levin, Patricia Satjapot, and Sauleh Siddiqui of Johns Hopkins University, and the terrific editorial support of Robert Pool.
A special thanks and recognition is also in order for Lori Adakilty, who added great value to our work in guiding our usability studies with the Public Health Agency of Canada, New York State Department of Health, and the Serum Institute of India. At these three organizations, we are appreciative of John Spika, Guthrie Birkhead, and Prasad Kulkarni, and their colleagues Ping Yan, Ken Eng, Gina Charos, Debra Blog, Lynn Berger, and S. Vinayak among others. Likewise, we are indebted to an exceptional group of reviewers whose insights greatly enhanced our products.
Final thanks go to the National Vaccine Program Office, the Fogarty International Center of the National Institutes of Health, and the National Academies’ Presidents Committee for their sponsorship, commitment, and support of this project.
Lonnie King, Chair
This report describes SMART Vaccines—Strategic Multi-Attribute Ranking Tool for Vaccines—an early stage software application intended to serve only as a decision-support tool. Specific decisions about vaccine priorities should not be made solely on the basis of SMART Vaccines. The examples that appear in this report are limited to comparing hypothetical vaccines only.
The National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine do not warrant the completeness of the model, the accuracy of the software in development, or the reliability of any data presented in this report.
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