Vaccines for the 21st century : a tool for decisionmaking

Vaccines for the 21st century a tool for decisionmaking

Detalles Bibliográficos
Autor principal: Institute of Medicine (U.S.).
Autor Corporativo: Institute of Medicine (U.S.). Committee to Study Priorities for Vaccine Development (-)
Otros Autores: Stratton, Kathleen R. (-), Durch, Jane, Lawrence, Robert S., 1938-
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press c2000.
Edición:1st ed
Materias:
Vaccines > Research > United States > Planning.
Immunization > Research > United States > Planning.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820304306719
Tabla de Contenidos:
  • Vaccines for the 21st Century
  • Copyright
  • Acknowledgments
  • Contents
  • Executive Summary
  • THE ANALYTIC FRAMEWORK
  • ETHICAL ISSUES
  • RESULTS
  • OBSERVATIONS
  • 1 Introduction
  • CONSIDERATIONS RELATED TO THE MODEL AND THE STUDY
  • ORGANIZATION OF THE REPORT
  • Charge to the Committee
  • Committee Membership and Meetings
  • Organization of the Report
  • 2 Progress in Vaccine Development
  • PRIORITIES OF THE IOM COMMITTEE IN 1985
  • LITIGATION AS A BARRIER TO VACCINE DEVELOPMENT
  • Immunization of Pregnant Women
  • A CASE STUDY OF SUCCESS
  • Disease Burden
  • Polio Vaccine Development
  • Advantages of Evolving Vaccine Strategies
  • ADVANCES IN BIOTECHNOLOGY AND MOLECULAR IMMUNOLOGY AND NEW OPPORTUNITIES FOR VACCINES
  • Fundamental Understanding of Helper T Cells for Antibody Versus CMI Responses, and for Cytotoxicity
  • Major Advances in Mucosal Immunity
  • Mucosal Immune System Organization
  • Molecular Aspects of Virulence and Design of Recombinant Protein Vaccines
  • Novel Vaccine Delivery Systems
  • Recent Advances in Development of Novel Adjuvants
  • Scientific Rationale for Vaccines against Autoimmune Diseases
  • Immune Tolerance Induction
  • Immune Deviation
  • Receptor-Centered Regulation
  • Targeting Cytokines or Their Receptors
  • Viral Vectors in Autoimmune Therapy
  • Preventive Vaccines for Autoimmune Diseases
  • 3 Considerations of Candidate Vaccines
  • EXCLUSION CRITERIA
  • Insufficient Basic Science Information
  • Existence of Appropriate Prevention Interventions
  • International Burden of Disease
  • ADDITIONAL CONSIDERATIONS FOR INCLUSION
  • Therapeutic Vaccines
  • Programmatic Considerations
  • Delivery of Vaccines to Children
  • Delivery of Vaccines to Adults
  • Delivery of Vaccines to Pregnant Women
  • 4 Overview of Analytic Approach and Results
  • A COST-EFFECTIVENESS APPROACH.
  • Reasons for Using Cost-Effectiveness Analysis
  • Limits of Cost-Effectiveness Analysis
  • Ethical Issues
  • Analytic Perspectives
  • Time Horizon and Discounting
  • MODEL OVERVIEW
  • Health Benefits: The Denominator
  • Quality Adjustments: Weighting
  • Morbidity Scenarios
  • Quality Adjustments for Average Population Health States
  • Disease Incidence and Death Rates
  • Time Intervals
  • QALYs Gained with Vaccine Use
  • Costs: The Numerator
  • Cost of Research and Development
  • Cost of Vaccine Use
  • Health Care Costs
  • Vaccine Efficacy and Utilization
  • Cost-Effectiveness Ratios
  • Exclusions from the Analysis
  • EXAMPLES: HYPOTHETICAL VACCINE X
  • Target Population
  • Program Considerations
  • Disease Severity
  • Discounting
  • An Idealized Scenario
  • Summary
  • RESULTS
  • Challenges
  • 5 Review of the Analytic Model
  • UNIT OF ANALYSIS
  • IMPLEMENTING THE ANALYSIS
  • Basic Model
  • Performing the Analysis
  • CALCULATION OF HEALTH BENEFITS
  • Quality-Adjusted Life Years
  • Quality-Adjustment Weights Based on the Health Utilities Index
  • Steps in the Calculation of Anticipated Health Benefits from Vaccine Use
  • Develop Morbidity Scenarios
  • Calculate Quality-Adjustment Weights
  • Calculate Discounted Quality-Adjusted Life Expectancies
  • Establish Age-Specific Incidence and Death Rates
  • Calculate Time Intervals for Discounting Future Health Benefits
  • Calculate Condition-Related Life Expectancies
  • Adjust for the Underlying Health Status of the Population
  • Calculate Discounted QALYs for Each Health State
  • Calculate Total QALYs Gained with Vaccine Use
  • COST FACTORS
  • Vaccine Development
  • Vaccine Use
  • Cost of Care
  • VACCINE EFFICACY AND UTILIZATION
  • COST-EFFECTIVENESS RATIOS
  • 6 Ethical Considerations and Caveats
  • ETHICAL AND VALUE JUDGMENTS BUILT INTO THE MODEL
  • All QALYs Count Equally.
  • Years of Life at Different Ages Are Weighted by Quality
  • The Value of Life Extension with and without Disabilities
  • Discount Rates for Costs and Benefits
  • Which Benefits and Costs Should Be Counted in the Prioritization Process?
  • CONSIDERATIONS OF JUSTICE
  • Small Benefits to Many Versus Large Benefits to a Few
  • What Priority Should Be Given to the Worst-Off or Sickest?
  • Fair Chances Versus Best Outcomes
  • CONCLUSION
  • 7 Observations
  • THE FUNDING OF RESEARCH
  • NEGLECTED OPPORTUNITIES FOR VACCINE R&amp
  • D
  • International Considerations
  • Small Target Populations
  • Liability Concerns
  • QUALITATIVE JUDGMENTS
  • VACCINE PROGRAM CONCERNS
  • References
  • APPENDIX 1 Borrelia burgdorferi
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 2 Chlamydia
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios: Women
  • Disease Scenarios: Men
  • Disease Scenarios: Infants
  • COSTS INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 3 Coccidioides immitis
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 4 Cytomegalovirus
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 5 Enterotoxigenic E. coli
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios.
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 6 Epstein-Barr Virus
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 7 Helicobacter pylori
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 8 Hepatitis C
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 9 Herpes Simplex Virus
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • Oral Infections
  • Ocular Infections
  • Central Nervous System Infections
  • Genital Infections
  • Neonatal Infections
  • COST INCURRED BY DISEASE
  • Oral and Ocular Infections
  • Central Nervous System Infections
  • Genital Infections
  • Neonatal Infections
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 10 Histoplasma capsulatum
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 11 Human Papillomavirus
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT.
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 12 Influenza A and B
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 13 Insulin-Dependent Diabetes Mellitus
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 14 Melanoma
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 15 Multiple Sclerosis
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 16 Mycobacterium tuberculosis
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 17 Neisseria gonorrhea
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT
  • VACCINE PROGRAM CONSIDERATIONS
  • Target Population
  • Vaccine Schedule, Efficacy, and Costs
  • RESULTS
  • READING LIST
  • APPENDIX 18 Neisseria meningitidis B
  • DISEASE BURDEN
  • Epidemiology
  • Disease Scenarios
  • COST INCURRED BY DISEASE
  • VACCINE DEVELOPMENT.
  • VACCINE PROGRAM CONSIDERATIONS.

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