Vaccines: The Week in Review 16 February 2013 Center for Vaccine Ethics & Policy (CVEP)

This weekly summary targets news, events, announcements, articles and research in the global vaccine ethics and policy space and is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. Vaccines: The Week in Review is also posted in pdf form and as a set of blog posts at http://centerforvaccineethicsandpolicy.wordpress.com/. This blog allows full-text searching of over 3,500 entries. Comments and suggestions should be directed to David R. Curry, MS Editor and Executive Director Center for Vaccine Ethics & Policy david.r.curry@centerforvaccineethicsandpolicy.org

Editors Notes: - A pdf version of this issue is available on our blog:

http://centerforvaccineethicsandpolicy.wordpress.com/

GAVI said it was awarded 2.5 million (US$3.3 million) by the Dutch Postcode Lottery which will be doubled under the GAVI Matching Fund by the Bill & Melinda Gates Foundation. GAVI noted that the Dutch Postcode Lottery gives half the price of every purchased ticket to charitable organisations, with recipients announced at its annual gala. This year, it donated a record 291 million to more than 90 organisations thanks to lottery ticket purchases by 2.5 million players. It is the largest charity in the Netherlands and the third-largest private charity in the world. http://www.gavialliance.org/library/news/press-releases/2013/gavi-receives-%E2%82%AC-2-5million-from-dutch-postcode-lottery-under-matching-fund/

PATH said it received US$2.5 million in follow-on BARDA funding to scale up production of thermostable influenza vaccines, helping to extend product shelf life and ease logistics during vaccine introduction and rapid deployment. PATH noted that the typical stability of subunit and live attenuated influenza vaccines is less than two weeks at 37C. The lead thermostable H1N1 subunit and live attenuated influenza vaccine (LAIV) formulations developed by PATH and Aridis Pharmaceuticals during an earlier period of project work have proven to be stable at 37C for over nine months and five months, respectively. Under the new funding from BARDA, the stability of these improved formulations will continue to be monitored by PATH and Aridis Pharmaceuticals over the course of an ongoing two-year study.

PATH said it will also collaborate with Aeras to scale up the production of the leading thermostable H1N1 subunit influenza vaccine formulations by lyophilization, the processing method of choice for heat-sensitive vaccines when a reasonable shelf life cannot be achieved in a liquid product format. As part of this effort, PATH and Aeras will develop a scalable production process and make it available for technology transfer, enabling vaccine manufacturers to produce seasonal and pre-pandemic vaccines with robust stabilityhelping to ensure vaccine performance and effectiveness under a variety of temperature conditions. http://www.path.org/news/pr130212-barda.php

The Weekly Epidemiological Record (WER) for 15 February 2013, vol. 88, 7 (pp. 7380) includes: - Outbreak news: Poliomyelitis, Niger; Poliovirus isolation, Egypt - Meeting of the International Task Force for Disease Eradication November 2012 http://www.who.int/entity/wer/2013/wer8807.pdf Update: Polio this week - As of 13 February 2013 Global Polio Eradication Initiative http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx [Editors Extract and bolded text] - On 8 February, two health facilities in Kano state, Nigeria, were attacked, killing eleven people, including health workers, and injuring several others. - Such attacks on health workers are absolutely and unconditionally unacceptable, and must be condemned in the strongest terms. Our sympathy goes out to the victims and their families. It is yet another example of the heroic and courageous work of frontline health workers, often working under extremely dangerous conditions in efforts to ensure the health of populations everywhere no matter where they live. - The attacks have been widely condemned, including by the Government of Nigeria, the UN Secretary-General, the Organization of the Islamic Conference (OIC) and partner agencies of the Global Polio Eradication Initiative. Nigeria - No one has claimed responsibility for last weeks deadly attacks, and the motives are unclear. An investigation has been launched by the Government of Nigeria. - In addition to the attacks on the two health centres in Kano, there are reports of three doctors from North Korea being killed in Yobe state, in a separate incident. Pakistan - One new WPV case was reported in the past week (WPV1 from Khyber Pakhtunkhwa KP, with onset of paralysis on 26 January 2013), bringing the total number of cases for 2013 to two. The total number of WPV cases for 2012 remains 58. - No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2012 remains 16. It is the most recent cVDPV2 case in the country, and had onset of paralysis on 14 December 2012 (from Balochistan) - The security situation continues to be monitored closely, in consultation with law enforcement agencies. [Editors Note: Please see also WER, 15 Feb 2013 (above) and Polio in Niger in GAR (below)]

WHO - Global Alert and Response (GAR) Disease Outbreak News - Most recent news items - Novel coronavirus infection update 16 February 2013 http://www.who.int/csr/don/2013_02_16/en/index.html - Yellow fever in Chad 14 February 2013 - The Ministry of Health of Chad is launching an emergency massvaccination campaign against yellow fever from 22 February 2013, following laboratory confirmation of two cases in the country in December 2012. The two cases from Goz Beida and Guereda districts, were laboratory confirmation by a WHO regional reference laboratory for yellow fever, Institut Pasteur in Dakar, Senegal. They were identified through the national surveillance programme for yellow fever, following intensive surveillance which was triggered in response to the outbreak of yellow fever in neighbouring Sudans Darfur region. The intensive surveillance in Chad also reported 139 suspected cases and 9 deaths. The vaccination campaign will be conducted in 3 districts bordering Darfur, Sudan, namely Goz Beida, Guereda and Adr, targeting over a million people, including inhabitants of refugee camps in the area. The campaign is supported by the Chads Ministry of Health, the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG11), and GAVI Alliance. 1 The YF-ICG is a partnership that manages the stockpile of yellow fever vaccines for emergency response on the basis of a rotation fund. It is represented by United Nations Children's Fund (UNICEF), Mdecins Sans Frontires (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC) and WHO, which also serves as the Secretariat. The stockpile is supported by GAVI Alliance. http://www.who.int/csr/don/2013_02_14/en/index.html - Polio in Niger 12 February 2013 - Following the notification on 3 January 2013 of a wild poliovirus type 1 (WPV1) case in Niger, outbreak response is continuing in the country. A WPV1 case had been detected from Tahoua region, with onset of paralysis on 15 November 2012 (the first case in the country since December 2011). Genetic sequencing confirmed that the virus was a new importation into Niger, most closely related to virus circulating in Kaduna state, Nigeria. The Government of Niger is continuing to implement a comprehensive response in line with international outbreak response guidelines issued by the World Health Assembly (WHA) in Resolution WHA59.1. Following an initial supplementary immunization activity (SIA) on 15 January 2013 to reach approximately two million children with bivalent oral polio vaccine (OPV), nationwide SIAs were conducted from 2-5 February 2013, targeting more than five million children with trivalent OPV. A second nationwide SIA is planned for 2-5 March with bivalent OPV. Previously, nationwide SIAs had been conducted on 23 November 2012 with bivalent OPV. A joint national and international team of epidemiologists and public health experts has been deployed by the World Health Organizations (WHO) Regional Office for Africa to assist the Government of Niger in the investigations, help plan response activities and support active searches for additional cases of paralytic polio. This event confirms the risk of ongoing international spread of a pathogen (WPV) slated for eradication. In May 2012, the completion of polio eradication was declared a programmatic emergency for global public health by the WHA in Resolution WHA65.5. Given the history of international spread of polio from northern Nigeria across west Africa, WHO assesses the risk of further international spread from Nigeria as high. Based on the history of previous importations

to Niger and the ongoing response, WHO assesses the risk of further international spread from Niger as moderate to high. This risk is currently magnified by large-scale population movements across the region associated with insecurity in Mali. To minimize this risk, multi-country synchronized SIAs are planned across 13 countries of west Africa in late April and late May, using a combination of bivalent and trivalent OPV. Due to the persistence of subnational surveillance gaps in some areas of west Africa, undetected further circulation cannot be ruled out at this time. Investigations are ongoing to more clearly identify surveillance gaps in the region, including among mobile, migrant and underserved populations. Measures are being implemented to strengthen sub-national surveillance, to ensure that all groups and areas, particularly high-risk populations, are covered by high-quality surveillance. As per recommendations outlined in WHO's International travel and health, travellers to and from Niger, and other polio-affected countries, should be fully protected by vaccination. It is important that all countries, in particular those with frequent travel and contacts with polioinfected countries, strengthen surveillance for cases of acute flaccid paralysis (AFP), in order to rapidly detect any new poliovirus importations and facilitate a rapid response. Countries should also analyse routine immunization coverage data to identify any subnational gaps in population immunity to guide catch-up immunization activities and thereby minimize the consequences of any new virus introduction. Priority should be given to areas at high-risk of importations and where OPV3/DPT3 coverage is <80%. http://www.who.int/csr/don/2013_02_12/en/index.html WHO - Humanitarian Health Action http://www.who.int/hac/en/index.html No new reports

Conferences/Reports/Research/Analysis/Book Watch Vaccines: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org
Meeting: ACIP (Advisory Committee on Immunization Practices) CDC February 20-21, 2013 Atlanta, Georgia Agenda (Feb 8 update) http://www.cdc.gov/vaccines/acip/meetings/downloads/agendaarchive/agenda-2013-02.pdf Votes scheduled (from agenda) Pneumococcal Vaccines - PCV13 recommendations for children 6 through 18 years old with immunocompromising conditions - Vaccines for Children Haemophilus influenzae b (Hib) Vaccine

- Updated Hib Vaccine Recommendations - Vaccines for Children: Hib-MenCY Influenza - Proposed 2013-2014 recommendations Live Webcast information available here: http://www.cdc.gov/vaccines/acip/meetings/downloads/webcast-instructions.pdf Meeting: WHO - Strategic Advisory Group of Experts (SAGE) on Immunization 9-11 April 2013 Geneva Draft Agenda as of 13 February 2013: http://www.who.int/entity/immunization/sage/DRAFT_Agenda_SAGE_Apr_2013.pdf Selected Agenda Topics: - Dengue - Global polio eradication initiative - Yellow Fever - Non-specific effects of vaccines on childhood mortality - Overcoming vaccine hesitancy Meeting: WHO/World Bank Ministerial-level Meeting on Universal Health Coverage WHO headquarters, Geneva, Switzerland116 February 2013 All people get the good quality health services that they need without fear of financial ruin. WHO and the World Bank are co-hosting a ministerial-level meeting on universal health coverage (UHC). Universal health coverage is about ensuring that all people have access to services that promote good health, prevent illness, offer treatment and rehabilitation. The services must be of good quality and effective, and people must not suffer financial hardship when paying for them. The meeting will bring together ministers of finance and health from 27 countries with other high-level stakeholders. A series of roundtable discussions will be held: - to explore ways that countries are progressing towards universal health coverage; - to share innovative solutions; and - to identify actions the global community can take to support efforts. In addition, there will be a marketplace in the WHO foyer where development partners, including civil society, can showcase what their organizations are doing to support countries as they move towards universal health coverage. http://www.who.int/mediacentre/events/meetings/2013/universal_health_coverage/en/index.ht ml Research: Universal Health Coverage Study Series World Bank February 2013 http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATIO N/0,,contentMDK:23352920~pagePK:210058~piPK:210062~theSitePK:282511,00.html From media release

As a growing number of countries tackle the fiscal challenge of providing universal health coverage (UHC) for their citizens, today the World Bank released a set of 22 case studies of countries that have significantly expanded access to health care in the last decade, with the aim of helping countries make more informed health policy and program choices. Researchers looked systematically at countries experiences with a set of parameters related to achieving UHC, including designing and managing benefits packages, expanding coverage to the poorest and excluded populations, providing quality care, and health financing. The 22 countries studied included Argentina, Brazil, Chile, China, Colombia, Costa Rica, Ethiopia, Georgia, Guatemala, India, Indonesia, Jamaica, Kenya, Kyrgyz Republic, Mexico, Nigeria, Peru, Philippines, Thailand, Tunisia, Turkey and Vietnam. The Bank also released an analysis of the impact of UHC efforts in the developing world. The studies show that although approaches to UHC vary, four-fifths or more of the countries share common implementation instruments. These include: an explicitly defined benefits package, expansion of coverage financed by general taxation, enrollment requirements, and reform of public provision of health services, all backed by strong political support. Also notable was that less than half of the countries studied had systems in place to monitor improvements in peoples health. Lessons across the studies point to the need to ensure that the implementation of UHC is equitable, efficient, and sustainablewhich requires the use of many instruments that strengthen the accountability of all parties in the health sector. The case studies find that countries seek to strengthen accountability by: UNICO Studies Series 25 The Impact of Universal Coverage Schemes in the Developing World: A Review of the Existing Evidence Ursula Giedion, Eduardo Andrs Alfonso, Yadira Daz The World Bank, Washington DC, January 2013 http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Images/IMPACTofUH CSchemesinDevelopingCountries-AReviewofExistingEvidence.pdf Research: Countering the Problem of Falsified and Substandard Drugs IOM February 13, 2013 Falsified and substandard medicines provide little protection from disease and, worse, can expose consumers to major harm. Bad drugs pose potential threats around the world, but the nature of the risk varies by country, with higher risk in countries with minimal or non-existent regulatory oversight. While developed countries are not immune, negligent production at a Massachusetts compounding pharmacy killed 44 people from September 2012 to January 2013 the vast majority of problems occur in developing countries where underpowered and unsafe medicines affect millions. It is difficult to measure the public health burden of falsified and substandard drugs, the number of deaths they cause, or the amount of time and money wasted using them. The FDA asked the IOM to assess the global public health implications of falsified, substandard, and counterfeit pharmaceuticals to help jumpstart international discourse about this problem. At the international level, productive discussion relies on cooperation and mutual trust. This report lays out a plan to invest in quality to improve public health. http://www.iom.edu/Reports/2013/Countering-the-Problem-of-Falsified-and-SubstandardDrugs.aspx

Journal Watch Vaccines: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher. If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org
American Journal of Public Health Volume 103, Issue 3 (March 2013) http://ajph.aphapublications.org/toc/ajph/current [Reviewed earlier] Annals of Internal Medicine 5 February 2013, Vol. 158. No. 3 http://www.annals.org/content/current [Reviewed earlier] BMC Public Health (Accessed 16 February 2013) http://www.biomedcentral.com/bmcpublichealth/content [No new relevant content] British Medical Bulletin Volume 104 Issue 1 December 2012 http://bmb.oxfordjournals.org/content/current [Reviewed earlier; No relevant content] British Medical Journal 16 February 2013 (Vol 346, Issue 7895) http://www.bmj.com/content/346/7895 [No relevant content] Bulletin of the World Health Organization Volume 91, Number 2, February 2013, 81-156 http://www.who.int/bulletin/volumes/91/2/en/index.html

Special Issue on Opioids [Reviewed earlier]

Clinical Therapeutics Vol 35 | No. 1 | January 2013 | Pages 1-100 http://www.clinicaltherapeutics.com/current Commentaries Morality of influenza Vaccine Mandates Arthur L. Caplan DOI: 10.1016/j.clinthera.2012.11.010 Preview The policy of requiring health care personnel to be vaccinated against influenza as a condition of employment has been rapidly gaining adherents in the United States and Canada. In 2004, Virginia Mason... http://www.clinicaltherapeutics.com/article/S0149-2918%2812%2900672-8/fulltext Nonspecific Effects of Vaccines and the Reduction of Mortality in Children Frank Shann 04 February 2013 Abstract There is now strong evidence that vaccines have substantial nonspecific (heterologous) effects in children in high-mortality regions. The hypothesis states that, until a different vaccine is given: (1) live vaccines induce a protective nonspecific immune response, whereas inactivate vaccines cause a harmful nonspecific immune response; (2) Bacillus Calmette-Guerin (BCG) vaccine approximately halves mortality from infections other than tuberculosis; (3) provided vitamin A was not given at birth, measles vaccine approximately halves mortality from infections other than measles (this effect may be stronger if the child still has maternal antibody); and (4) whole-cell diphtheria-tetanus-pertussis (DTP) vaccine increases mortality from infections other than diphtheria, tetanus, and pertussis (this effect is stronger in girls than boys). These observations suggest that minor modifications to the routine immunization schedule could reduce child mortality by at least 30%, and they have important implications for the design of randomized trials of vaccines in high-mortality regions. Original Research Cost-Effectiveness of a 10- Versus 13-Valent Pneumococcal Conjugate Vaccine in Denmark and Sweden Rogier M. Klok, Rose-Marie Lindkvist, Mats Ekelund, Raymond A. Farkouh, et al. 14 January 2013 Abstract Background The introduction of a 7-valent pneumococcal polysaccharide-protein conjugate vaccine (PCV7) had profound public health effects across the globe. PCV7 vaccination in a national immunization program is generally considered cost-effective and potentially cost-saving. Two new PCVs have been launched, a 10-valent pneumococcal conjugate vaccine (PCV10) and a 13valent pneumococcal conjugate vaccine (PCV13). Objective This article examines the public health and economic effects of pediatric national immunization programs of PCV10 and PCV13 in Denmark and Sweden. Methods

A previously published decision-analytic model was used to estimate the impact of PCV10 and PCV13 on reducing cases of invasive pneumococcal disease (IPD), pneumonia (PNE), and acute otitis media (AOM) by using country-specific incidence, serotype coverage, disease sequelae, mortality, vaccine effectiveness, indirect effects, costs, and utilities. Direct effects for PCV13and PCV10-covered serotypes were assumed similar to PCV7. PCV13 was assumed to confer an indirect effect, similar to PCV7, whereas PCV10 was not. Assumptions were tested in sensitivity analyses. Results PCV13 is expected to save 280.7 million DKK (Danish kroner) in Denmark and 288.2 million SEK (Swedish kronor) in Sweden in direct costs compared with a vaccination program with PCV10. In both Denmark and Sweden, the results of this study indicate that, compared with PCV10, PCV13 will have a greater impact on disease in life-years gained (LYG), quality-adjusted lifeyears (QALYs) gained, IPD cases avoided, PNE cases avoided, AOM cases avoided, and in deaths avoided. For Denmark PCV13, it was estimated to result in 10,051 LYG; 9063 QALYs gained; 237 additional IPD cases avoided; 12,094 additional PNE cases avoided; 958 additional cases of AOM avoided; and 882 additional deaths avoided. For Sweden PCV13, it was estimated to result in 4245 LYG; 3953 QALYs gained; 379 additional IPD cases avoided; 8210 additional PNE cases avoided; 1459 additional cases of AOM avoided; and 378 additional deaths avoided. In all sensitivity analyses, PCV13 was less costly and more effective compared with PCV10. Conclusions In this analysis, a national immunization program with PCV13 was found to be good value for money and estimated to prevent additional cases of disease among children and nonvaccinated individuals and save additional costs due to treatment of pneumococcal disease, when compared with PCV10 in Denmark and Sweden. http://www.clinicaltherapeutics.com/article/S0149-2918%2812%2900673-X/abstract Cost Effectiveness and Resource Allocation (Accessed 16 February 2013) http://www.resource-allocation.com/ [Publication server down at inquiry] Emerging Infectious Diseases Volume 19, Number 2February 2013 http://www.cdc.gov/ncidod/EID/index.htm [Reviewed earlier] Eurosurveillance Volume 18, Issue 7, 14 February 2013 http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678 Editorials Complexities in assessing the effectiveness of inactivated influenza vaccines by H Kelly, I Steffens Excerpt For many years it has been generally accepted that well-matched vaccines are the most effective single measure to protect people who are predisposed to a more severe outcome

following infection with the influenza virus [1]. This group includes those aged at least 65 years, pregnant women and those who suffer from specific chronic conditions and/or are immunocompromised. There is nonetheless widespread professional and public interest in, and some debate about, the level of protection afforded by annual influenza vaccination [2,3]. The level of such protection is assessed in two main ways: as estimates of efficacy from randomised controlled trials and as estimates of effectiveness from observational studies. Both are estimates of the proportion of vaccinated people, compared to the proportion of unvaccinated people, who are protected from a specified influenza outcome. Efficacy estimates (from trials) may be higher than effectiveness estimates (from observational studies) because trials are conducted in a controlled environment. A recent meta-analysis of trials using laboratory-confirmed influenza based on culture or PCR testing as the study endpoint estimated influenza vaccine efficacy for healthy adults at 59% (95% confidence interval (CI): 51 to 67) for vaccines licensed in the United States (US) [4]. The majority of those included in the studies were younger than 40 years. Unfortunately there were too few methodologically acceptable observational studies for a pooled analysis of vaccine effectiveness (VE) Global Health Governance Volume VI, Issue 1: Fall 2012 December 31, 2012 [Reviewed earlier] Globalization and Health [Accessed 16 February 2013] http://www.globalizationandhealth.com/ Research An ethics curriculum for short-term global health trainees DeCamp M, Rodriguez J, Hecht S, Barry M and Sugarman J Globalization and Health 2013, 9:5 (14 February 2013) Abstract (provisional) Background Interest in short-term global health training and service programs continues to grow, yet they can be associated with a variety of ethical issues for which trainees or others with limited global health experience may not be prepared to address. Therefore, there is a clear need for educational interventions concerning these ethical issues. Methods We developed and evaluated an introductory curriculum, "Ethical Challenges in Short-term Global Health Training." The curriculum was developed through solicitation of actual ethical issues experienced by trainees and program leaders; content drafting; and external content review. It was then evaluated from November 1, 2011, through July 1, 2012, by analyzing web usage data and by conducting user surveys. The survey included basic demographic data; prior experience in global health and global health ethics; and assessment of cases within the curriculum. Results The ten case curriculum is freely available at http://ethicsandglobalhealth.org. An average of 238 unique visitors accessed the site each month (standard deviation, 19). Of users who had

been abroad before for global health training or service, only 31% reported prior ethics training related to short-term work. Most users (62%) reported accessing the site via personal referral or their training program; however, a significant number (28%) reported finding the site via web search, and 8% discovered it via web links. Users represented different fields: medicine (46%), public health (15%), and nursing (11%) were most common. All cases in the curriculum were evaluated favorably. Conclusions The curriculum is meeting a critical need for an introduction to the ethical issues in short-term global health training. Future work will integrate this curriculum within more comprehensive curricula for global health and evaluate specific knowledge and behavioral effects, including at training sites abroad. The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production. Health Affairs February 2013; Volume 32, Issue 2 http://content.healthaffairs.org/content/current Theme: New Era of Patient Engagement [No specific relevant content on vaccines/immunization] Health and Human Rights Vol 14, No 2 (2012) http://hhrjournal.org/index.php/hhr [Reviewed earlier] Health Economics, Policy and Law Volume 8 - Issue 01 - January 2013 http://journals.cambridge.org/action/displayIssue?jid=HEP&tab=currentissue Special Section: ACA [Reviewed earlier] Health Policy and Planning Volume 28 Issue 1 January 2013 http://heapol.oxfordjournals.org/content/current [Reviewed earlier] Human Vaccines & Immunotherapeutics (formerly Human Vaccines) Volume 9, Issue 2 February 2013 http://www.landesbioscience.com/journals/vaccines/toc/volume/9/issue/1/ [Reviewed earlier] Infectious Diseases of Poverty

2012, 1 http://www.idpjournal.com/content [Accessed 16 February 2013] [No new relevant content] International Journal of Infectious Diseases February 2013, Vol. 17, No. 2 http://www.ijidonline.com/ [No relevant content] JAMA February 13, 2013, Vol 309, No. 6 http://jama.ama-assn.org/current.dtl [No relevant content] JAMA Pediatrics January 2013 Vol 167, No. 1 http://archpedi.jamanetwork.com/issue.aspx?journalid=75&IssueID=926200 [Reviewed earlier] Journal of Health Organization and Management Volume 26 issue 6 - Published: 2012 http://www.emeraldinsight.com/journals.htm?issn=1477-7266&show=latest [Reviewed earlier; No relevant content] Journal of Infectious Diseases Volume 207 Issue 6 March 15, 2013 http://www.journals.uchicago.edu/toc/jid/current VIRUSES A Single Dose of Any of Four Different Live Attenuated Tetravalent Dengue Vaccines Is Safe and Immunogenic in Flavivirus-naive Adults: A Randomized, Double-blind Clinical Trial J Infect Dis. (2013) 207(6): 957-965 doi:10.1093/infdis/jis936 Anna P. Durbin, Beth D. Kirkpatrick, Kristen K. Pierce, Daniel Elwood, Catherine J. Larsson, Janet C. Lindow, Cecilia Tibery, Beulah P. Sabundayo, Donna Shaffer, Kawsar R. Talaat, Noreen A. Hynes, Kimberli Wanionek, Marya P. Carmolli, Catherine J. Luke, Brian R. Murphy, Kanta Subbarao, and Stephen S. Whitehead Abstract Background. Dengue virus (DENV) causes hundreds of millions of infections annually. Four dengue serotypes exist, and previous infection with one serotype increases the likelihood of severe disease with a second, heterotypic DENV infection. Methods. In a randomized, placebo-controlled study, the safety and immunogenicity of 4 different admixtures of a live attenuated tetravalent (LATV) dengue vaccine were evaluated in

113 flavivirus-naive adults. Serum neutralizing antibody levels to all 4 dengue viruses were measured on days 0, 28, 42, and 180. Results. A single dose of each LATV admixture induced a trivalent or better neutralizing antibody response in 75%90% of vaccinees. There was no significant difference in the incidence of adverse events between vaccinees and placebo-recipients other than rash. A trivalent or better response correlated with rash and with non-black race (P < .0001). Black race was significantly associated with a reduced incidence of vaccine viremia. Conclusions. TV003 induced a trivalent or greater antibody response in 90% of flavivirus-naive vaccinees and is a promising candidate for the prevention of dengue. Race was identified as a factor influencing the infectivity of the LATV viruses, reflecting observations of the effect of race on disease severity in natural dengue infection. Clinical Trials RegistrationNCT01072786. Largest Measles Epidemic in North America in a DecadeQuebec, Canada, 2011: Contribution of Susceptibility, Serendipity, and Superspreading Events J Infect Dis. (2013) 207(6): 990-998 doi:10.1093/infdis/jis923 Gaston De Serres, France Markowski, Eveline Toth, Monique Landry, Danielle Auger, Marlne Mercier, Philippe Blanger, Bruno Turmel, Horacio Arruda, Nicole Boulianne, Brian J. Ward, and Danuta M. Skowronski Abstract Background. The largest measles epidemic in North America in the last decade, occurred in 2011 in Quebec, Canada, where rates of 1- and 2-dose vaccine coverage among children 3 years of age were 95%97% and 90%, respectively, with 3%5% unvaccinated. Methods. Case patients identified through passive surveillance and outbreak investigation were contacted to determine clinical course, vaccination status, and possible source of infection. Results. There were 21 measles importations and 725 cases. A superspreading event triggered by 1 importation resulted in sustained transmission and 678 cases. The overall incidence was 9.1 per 100 000; the highest incidence was in adolescents 1217 years old (75.6 per 100 000), who comprised 56% of case patients. Among adolescents, 22% had received 2 vaccine doses. Outbreak investigation showed this proportion to have been an underestimate; active case finding identified 130% more cases among 2-dose recipients. Two-dose recipients had milder illness and a significantly lower risk of hospitalization than those who were unvaccinated or single-dose recipients. Conclusions. A chance superspreading event revealed an overall level of immunity barely above the elimination threshold when unexpected vulnerability in 2-dose recipients was taken into account. Unvaccinated individuals remain the immunization priority, but a better understanding of susceptibility in 2-dose recipients is needed to define effective interventions if elimination is to be achieved. Journal of Global Infectious Diseases (JGID) January-March 2013 Volume 5 | Issue 1 Page Nos. 1-36 http://www.jgid.org/currentissue.asp?sabs=n [No relevant content] Journal of Medical Ethics

February 2013, Volume 39, Issue 2 http://jme.bmj.com/content/current [Reviewed earlier; No relevant content] Journal of Medical Microbiology February 2013; 62 (Pt 2) http://jmm.sgmjournals.org/content/current [Reviewed earlier; No relevant content] Journal of the Pediatric Infectious Diseases Society (JPIDS) Volume 2 Issue 1 March 2013 http://jpids.oxfordjournals.org/content/current Washington State Licensed Child Care Facility Directors' Perspectives on Childhood Immunization Douglas J. Opel, Ashmita Banerjee, Peggy King, Cathe Paul, Danette Glassy, and Kyle Yasuda J Ped Infect Dis (2013) 2(1): 40-49 doi:10.1093/jpids/pis088 Abstract Background The study objective was to determine Washington State childcare facility directors' compliance with state immunization education and monitoring requirements and the role of directors' immunization attitudes and beliefs on compliance. Methods We mailed a self-administered survey to 2000 randomly selected childcare facility directors in Washington State. The primary outcome measures were reported compliance with state requirements to educate parents about the importance of immunizations and monitor the immunization status of enrolled children. Results Our response rate was 28%. The majority of respondents worked at facilities with a licensed capacity of <25 children, had 11 years of experience, and were parents themselves. Overall, 68% agreed that they educated enrolled parents about the importance of immunizations and 90% agreed that they monitored the immunization status of enrolled children. However, 60% were concerned that children might have a serious side effect from an immunization, 51% were concerned that any one of the childhood immunizations might not be safe, and 11% were distrustful of the immunization information they received. These beliefs were associated with a statistically significant decreased likelihood of educating parents about immunization (adjusted odds ratios [aORs]: 0.57, 0.46, 0.19, respectively) and monitoring immunization status of children (aORs: 0.32, 0.32, 0.19, respectively). Conclusions Most Washington State child care facility directors who responded to our survey are compliant with state requirements for immunization education and monitoring. A substantial number of directors are concerned about vaccine safety, however, and these concerns may decrease the likelihood of these requirements being followed. http://jpids.oxfordjournals.org/content/2/1/30.abstract The Lancet Feb 16, 2013 Volume 381 Number 9866 p507 - 598 http://www.thelancet.com/journals/lancet/issue/current Editorial Giving children a chance

The Lancet Preview Last week, the World Policy Analysis Centre released a new report, which for the first time systematically presented comparative data on laws and public policies in 191 countries covering areas essential to children's healthy development. Changing Children's Chances examines policy data and their impact in the areas of poverty, discrimination, education, health, child labour, child marriage, and parental care. The report provides a global picture of the policy tools governments can use to make a difference to children's opportunities in life. http://childrenschances.org/ Series Non-Communicable Diseases Embedding non-communicable diseases in the post-2015 development agenda George Alleyne, Agnes Binagwaho, Andy Haines, Selim Jahan, Rachel Nugent, Ariella Rojhani, David Stuckler, The Lancet Preview | Summary | Full Text | PDF Country actions to meet UN commitments on non-communicable diseases: a stepwise approach Ruth Bonita, Roger Magnusson, Pascal Bovet, Dong Zhao, Deborah C Malta, Robert Geneau, Il Suh, Kavumpurathu Raman Thankappan, Martin McKee, James Hospedales, Maximilian de Courten, Simon Capewell, Robert Beaglehole, The Lancet Preview | Summary | Full Text | PDF Inequalities in non-communicable diseases and effective responses Mariachiara Di Cesare, Young-Ho Khang, Perviz Asaria, Tony Blakely, Melanie J Cowan, Farshad Farzadfar, Ramiro Guerrero, Nayu Ikeda, Catherine Kyobutungi, Kelias P Msyamboza, Sophal Oum, John W Lynch, Michael G Marmot, Majid Ezzati, on behalf of NCD Action Group Preview | Summary | Full Text | PDF The Lancet Infectious Disease Feb 2013 Volume 13 Number 2 p97 - 182 http://www.thelancet.com/journals/laninf/issue/current [Reviewed earlier] Medical Decision Making (MDM) January 2013; 33 (1) http://mdm.sagepub.com/content/current Special Issue: Decision Aids and Risk Perception [Reviewed earlier] The Milbank Quarterly A Multidisciplinary Journal of Population Health and Health Policy December 2012 Volume 90, Issue 4 Pages 631807 http://onlinelibrary.wiley.com/doi/10.1111/milq.2012.90.issue-4/issuetoc [Reviewed earlier]

Nature Volume 494 Number 7436 pp147-276 14 February 2013 http://www.nature.com/nature/current_issue.html [No relevant content] Nature Immunology February 2013, Volume 14 No 2 pp101-185 http://www.nature.com/ni/journal/v14/n2/index.html [Reviewed earlier; No relevant content] Nature Medicine February 2013, Volume 19 No 2 pp113-246 http://www.nature.com/nm/journal/v19/n2/index.html [Reviewed earlier] Nature Reviews Immunology February 2013 Vol 13 No 2 http://www.nature.com/nri/journal/v13/n2/index.html [Reviewed earlier; No relevant content] New England Journal of Medicine February 14, 2013 Vol. 368 No. 7 http://content.nejm.org/current.shtml Perspective Epidemic Influenza Responding to the Expected but Unpredictable Joseph Bresee, M.D., and Frederick G. Hayden, M.D. N Engl J Med 2013; 368:589-592 February 14, 2013 DOI: 10.1056/NEJMp1300375 Preview The number of U.S. cases of influenza-like illness has already exceeded the baseline for 7 weeks this season, and related hospitalizations and deaths are increasing. The causes of variability in the timing and severity of influenza epidemics are incompletely understood Perspective The Cure for Cholera Improving Access to Safe Water and Sanitation Ronald J. Waldman, M.D., M.P.H, Eric D. Mintz, M.D., M.P.H., and Heather E. Papowitz, M.D., M.P.H. N Engl J Med 2013; 368:592-594 February 14, 2013 DOI: 10.1056/NEJMp1214179 Free full text: http://www.nejm.org/doi/full/10.1056/NEJMp1214179 Original Article Cholera Surveillance during the Haiti Epidemic The First 2 Years Ezra J. Barzilay, M.D., Nicolas Schaad, M.P.H., Roc Magloire, M.D., Kam S. Mung, M.D., Jacques Boncy, M.D., Georges A. Dahourou, Pharm.D., Eric D. Mintz, M.D., Maria W. Steenland, M.P.H., John F. Vertefeuille, Ph.D., and Jordan W. Tappero, M.D. N Engl J Med 2013; 368:599-609 February 14, 2013 DOI: 10.1056/NEJMoa1204927 Abstract

Background In October 2010, nearly 10 months after a devastating earthquake, Haiti was stricken by epidemic cholera. Within days after detection, the Ministry of Public Health and Population established a National Cholera Surveillance System (NCSS). Full Text of Background... Methods The NCSS used a modified World Health Organization case definition for cholera that included acute watery diarrhea, with or without vomiting, in persons of all ages residing in an area in which at least one case of Vibrio cholerae O1 infection had been confirmed by culture. Full Text of Methods... Results Within 29 days after the first report, cases of V. cholerae O1 (serotype Ogawa, biotype El Tor) were confirmed in all 10 administrative departments (similar to states or provinces) in Haiti. Through October 20, 2012, the public health ministry reported 604,634 cases of infection, 329,697 hospitalizations, and 7436 deaths from cholera and isolated V. cholerae O1 from 1675 of 2703 stool specimens tested (62.0%). The cumulative attack rate was 5.1% at the end of the first year and 6.1% at the end of the second year. The cumulative case fatality rate consistently trended downward, reaching 1.2% at the close of year 2, with departmental cumulative rates ranging from 0.6% to 4.6% (median, 1.4%). Within 3 months after the start of the epidemic, the rolling 14-day case fatality rate was 1.0% and remained at or below this level with few, brief exceptions. Overall, the cholera epidemic in Haiti accounted for 57% of all cholera cases and 53% of all cholera deaths reported to the World Health Organization in 2010 and 58% of all cholera cases and 37% of all cholera deaths in 2011. Full Text of Results... Conclusions A review of NCSS data shows that during the first 2 years of the cholera epidemic in Haiti, the cumulative attack rate was 6.1%, with cases reported in all 10 departments. Within 3 months after the first case was reported, there was a downward trend in mortality, with a 14-day case fatality rate of 1.0% or less in most areas. http://www.nejm.org/doi/full/10.1056/NEJMoa1204927 OMICS: A Journal of Integrative Biology February 2013, 17(2) http://online.liebertpub.com/toc/omi/17/2 [No relevant content] Revista Panamericana de Salud Pblica/Pan American Journal of Public Health (RPSP/PAJPH) January 2013 Vol. 33, No. 1 http://new.paho.org/journal/index.php?option=com_content&task=view&id=119&Itemid=220 [No relevant content] The Pediatric Infectious Disease Journal March 2013 - Volume 32 - Issue 3 p: A7-A8,199-305,e94-e127 http://journals.lww.com/pidj/pages/currenttoc.aspx

Early Trends for Invasive Pneumococcal Infections in Children After the Introduction of the 13-valent Pneumococcal Conjugate Vaccine Kaplan, Sheldon L.; Barson, William J.; Lin, Philana Ling; Romero, Jos R.; Bradley, John S.; Tan, Tina Q.; Hoffman, Jill A.; Givner, Laurence B.; Mason, Edward O. Jr. Pediatric Infectious Disease Journal. 32(3):203-207, March 2013. doi: 10.1097/INF.0b013e318275614b Abstract: Background: The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced for routine administration to infants and children in 2010 in the United States. We have monitored clinical and microbiologic features of invasive pneumococcal infections among children before and after PCV13 use. Methods: Infants and children cared for at 8 children hospitals in the United States with cultureproven invasive infections caused by S. pneumoniae were identified in an ongoing prospective surveillance study. Demographic and clinical data were recorded on a standard case report form. Serotype and antimicrobial susceptibilities of isolates were determined. Results: Since routine PCV13 immunization in 2010, invasive pneumococcal infections decreased 42% overall and 53% for children <24 months of age in 2011 compared with the average number of cases for 2007 to 2009. PCV13 serotype isolates decreased 57% during these same time periods; 19A, 7F and 3 decreased by 58%, 54% and 68%, respectively. The number of infections caused by serotypes 1 and 6C also decreased in 2011. The most common non-PCV13 serotypes encountered in 2010 and 2011 combined were 33F, 22F, 12, 15B, 15C, 23A and 11. Bacteremia, pneumonia and mastoiditis cases decreased more than meningitis cases. Conclusions: After the introduction of PCV13, invasive pneumococcal infections decreased among 8 children hospitals compared with the 3 years before PCV13 use. Slight increases in some non-PCV13 serotype isolates were noted in 2011. Continued surveillance is necessary to determine the effectiveness of PCV13 including herd protection as well as any emerging invasive serotypes. Pediatrics February 2013, VOLUME 131 / ISSUE 2 http://pediatrics.aappublications.org/current.shtml [Reviewed earlier] Pharmacoeconomics February 2013 - Volume 31 - Issue 2 pp: 93-176 http://adisonline.com/pharmacoeconomics/pages/currenttoc.aspx [Reviewed earlier] PLoS One [Accessed 16 February 2013] http://www.plosone.org/ High Resolution Population Distribution Maps for Southeast Asia in 2010 and 2015 Andrea E. Gaughan, Forrest R. Stevens, Catherine Linard, Peng Jia, Andrew J. Tatem Research Article | published 13 Feb 2013 | PLOS ONE 10.1371/journal.pone.0055882 Abstract

Spatially accurate, contemporary data on human population distributions are vitally important to many applied and theoretical researchers. The Southeast Asia region has undergone rapid urbanization and population growth over the past decade, yet existing spatial population distribution datasets covering the region are based principally on population count data from censuses circa 2000, with often insufficient spatial resolution or input data to map settlements precisely. Here we outline approaches to construct a database of GIS-linked circa 2010 census data and methods used to construct fine-scale (~100 meters spatial resolution) population distribution datasets for each country in the Southeast Asia region. Landsat-derived settlement maps and land cover information were combined with ancillary datasets on infrastructure to model population distributions for 2010 and 2015. These products were compared with those from two other methods used to construct commonly used global population datasets. Results indicate mapping accuracies are consistently higher when incorporating land cover and settlement information into the AsiaPop modelling process. Using existing data, it is possible to produce detailed, contemporary and easily updatable population distribution datasets for Southeast Asia. The 2010 and 2015 datasets produced are freely available as a product of the AsiaPop Project and can be downloaded from: www.asiapop.org. Characteristics of Randomized Trials Published in Latin America and the Caribbean According to Funding Source Ludovic Reveiz, Stephanie Sangalang, Demian Glujovsky, Carlos E. Pinzon, Claudia Asenjo Lobos, Marcela Cortes, Martin Can, Ariel Bardach, Xavier Bonfill Research Article | published 13 Feb 2013 | PLOS ONE 10.1371/journal.pone.0056410 Abstract Introduction Few studies have assessed the nature and quality of randomized controlled trials (RCTs) in Latin America and the Caribbean (LAC). Methods and Findings The aims of this systematic review are to evaluate the characteristics (including the risk of bias assessment) of RCT conducted in LAC according to funding source. A review of RCTs published in 2010 in which the author's affiliation was from LAC was performed in PubMed and LILACS. Two reviewers independently extracted data and assessed the risk of bias. The primary outcomes were risk of bias assessment and funding source. A total of 1,695 references were found in PubMed and LILACS databases, of which 526 were RCTs (N = 73.513 participants). English was the dominant publication language (93%) and most of the RCTs were published in non-LAC journals (84.2%). Only five of the 19 identified countries accounted for nearly 95% of all RCTs conducted in the region (Brazil 70.9%, Mexico 10.1%, Argentina 5.9%, Colombia 3.8%, and Chile 3.4%). Few RCTs covered priority areas related with Millennium Development Goals like maternal health (6.7%) or high priority infectious diseases (3.8%). Regarding children, 3.6% and 0.4% RCT evaluated nutrition and diarrhea interventions respectively but none pneumonia. As a comparison, aesthetic and sport related interventions account for 4.6% of all trials. A random sample of RCTs (n = 358) was assessed for funding source: exclusively public (33.8%); private (e.g. pharmaceutical company) (15.3%); other (e.g. mixed, NGO) (15.1%); no funding (35.8%). Overall assessments for risk of bias showed no statistically significant differences between RCTs and type of funding source. Statistically significant differences favoring private and others type of funding was found when assessing trial registration and conflict of interest reporting. Conclusion Findings of this study could be used to provide more direction for future research to facilitate innovation, improve health outcomes or address priority health problems.

PLoS Medicine (Accessed 16 February 2013) http://www.plosmedicine.org/ Scaling Up mHealth: Where Is the Evidence? Tomlinson M, Rotheram-Borus MJ, Swartz L, Tsai AC (2013) Scaling Up mHealth: Where Is the Evidence? PLoS Med 10(2): e1001382. doi:10.1371/journal.pmed.1001382 Summary Points - Despite hundreds of mHealth pilot studies, there has been insufficient programmatic evidence to inform implementation and scale-up of mHealth. - We discuss what constitutes appropriate research evidence to inform scale up. - Potential innovative research designs such as multi-factorial strategies, randomized controlled trials, and data farming may provide this evidence base. - We make a number of recommendations about evidence, interoperability, and the role of governments, private enterprise, and researchers in relation to the scale up of mHealth. Excerpt What Is the Problem? There are over 6 billion mobile phone subscribers and 75% of the world has access to a mobile phone [1]. Service and care providers, researchers, and national governments are excited at the opportunities mobile health has to offer in terms of improving access to health care, engagement and delivery, and health outcomes [2]. Interventions categorized under the rubric mobile health or mHealthbroadly defined as medical and public health practice supported by mobile devices [2]span a variety of applications ranging from the use of mobile phones to improve point of service data collection [3], care delivery [4], and patient communication [5] to the use of alternative wireless devices for real-time medication monitoring and adherence support [6]. A recent World Bank report tracked more than 500 mHealth studies, and many donor agencies are lining up to support the scaling up of mHealth interventions [7]. Yet, after completion of these 500 pilot studies, we know almost nothing about the likely uptake, best strategies for engagement, efficacy, or effectiveness of these initiatives. Currently, mHealth interventions lack a foundation of basic evidence [8], let alone a foundation that would permit evidence-based scale up. For example, in Uganda in 2008 and 2009 approximately 23 of 36 mHealth initiatives did not move beyond the pilot phase [9]. The current enthusiasm notwithstanding, the scatter-shot approach to piloting mHealth projects in the absence of a concomitant programmatic implementation and evaluation strategy may dampen opportunities to truly capitalize on the technology. This article discusses a number of points pertinent to developing a more robust evidence base for the scale up of mHealth interventions. The issues raised are primarily conceptual and methodological PLoS Neglected Tropical Diseases January 2013 http://www.plosntds.org/article/browseIssue.action [No relevant content]

PNAS - Proceedings of the National Academy of Sciences of the United States of America (Accessed 16 February 2013) http://www.pnas.org/content/early/recent [No new relevant content] Public Health Ethics Volume 5 Issue 3 November 2012 http://phe.oxfordjournals.org/content/current [Reviewed earlier] Qualitative Health Research March 2013; 23 (3) http://qhr.sagepub.com/content/current [Reviewed earlier; No relevant content] Science 15 February 2013 vol 339, issue 6121, pages 729-872 http://www.sciencemag.org/current.dtl [No relevant content] Science Translational Medicine 13 February 2013 vol 5, issue 172 http://stm.sciencemag.org/content/current CANCER VACCINES Vaccination Route Matters for Mucosal Tumors Denise Nardelli-Haefliger, Jan C. Dudda, and Pedro Romero 13 February 2013: 172fs4 Abstract Immunization route may be pivotal for tissue-specific localization of the effector T cell response (Sandoval et al., this issue). Research Articles Cancer Vaccine Mucosal Imprinting of Vaccine-Induced CD8+ T Cells Is Crucial to Inhibit the Growth of Mucosal Tumors Federico Sandoval, Magali Terme, Mevyn Nizard, Ccile Badoual, Michel-Francis Bureau, Ludovic Freyburger, Olivier Clement, Elie Marcheteau, Alain Gey, Guillaume Fraisse, Ccilia Bouguin, Nathalie Merillon, Estelle Dransart, Thi Tran, Franoise Quintin-Colonna, Gwennhael Autret, Marine Thiebaud, Muhammed Suleman, Sabine Riffault, Tzyy-Choou Wu, Odile Launay, Claire Danel, Julien Taieb, Jennifer Richardson, Laurence Zitvogel, Wolf H. Fridman, Ludger Johannes, and Eric Tartour 13 February 2013: 172ra20 Abstract

Although many human cancers are located in mucosal sites, most cancer vaccines are tested against subcutaneous tumors in preclinical models. We therefore wondered whether mucosaspecific homing instructions to the immune system might influence mucosal tumor outgrowth. We showed that the growth of orthotopic head and neck or lung cancers was inhibited when a cancer vaccine was delivered by the intranasal mucosal route but not the intramuscular route. This antitumor effect was dependent on CD8+ T cells. Indeed, only intranasal vaccination elicited mucosal-specific CD8+ T cells expressing the mucosal integrin CD49a. Blockade of CD49a decreased intratumoral CD8+ T cell infiltration and the efficacy of cancer vaccine on mucosal tumor. We then showed that after intranasal vaccination, dendritic cells from lung parenchyma, but not those from spleen, induced the expression of CD49a on cocultured specific CD8+ T cells. Tumor-infiltrating lymphocytes from human mucosal lung cancer also expressed CD49a, which supports the relevance and possible extrapolation of these results in humans. We thus identified a link between the route of vaccination and the induction of a mucosal homing program on induced CD8+ T cells that controlled their trafficking. Immunization route directly affected the efficacy of the cancer vaccine to control mucosal tumors. Vaccine Volume 31, Issue 10, Pages 1357-1452 (27 February 2013) http://www.sciencedirect.com/science/journal/0264410X Editorial United Nations mercury treaty jeopardizes vaccine protection of the world's most vulnerable children Pages 1357-1358 David N. Durrheim, Gregory A. Poland No abstract A perspective for atherosclerosis vaccination: Is there a place for plant-based vaccines? Review Article Pages 1364-1369 Jorge Alberto Salazar-Gonzlez, Sergio Rosales-Mendoza Abstract Alternatives to pharmacological treatments for atherosclerosis are highly desirable in terms of cost and compliance. During the last two decades several vaccination strategies have been reported as an effort to develop immunotherapeutic treatments. This approach consists on eliciting immune responses able to modulate either the atherosclerosis-associated inflammatory processes or the activity of some physiological mechanisms that are up-regulated under this pathologic condition. In particular, the apolipoprotein B100 (ApoB100) and the cholesterilester transferase protein (CETP) have been targeted in these strategies. It is considered that recent progress in the development of experimental models of oral vaccines against atherosclerosis has opened a new avenue in the field: as plant-based vaccines are considered a viable platform for vaccine production and delivery at low costs, they could serve as an oral-delivered therapeutic approach for atherosclerosis in an economical and patient-friendly manner. The rationale of the design, development and evaluation of possible plant-based vaccines against atherosclerosis is discussed in this review. We identify within this approach a significant trend that will positively impact the field of atherosclerosis vaccination. What college women know, think, and do about human papillomavirus (HPV) and HPV vaccine

Original Research Article Pages 1370-1376 Nop T. Ratanasiripong, An-Lin Cheng, Maithe Enriquez Abstract Objectives This cross-sectional study, guided by Ajzen's Theory of Planned Behavior, aimed to identify factors that influence the decision to obtain an HPV vaccine among college women and to examine the relationships among these factors. Methods An electronic self-administered survey was utilized to collect data. An email invitation was sent to 3074 college women attending a large, public university in southern California, aged between 18 and 26 years. The email directed the recipient to click on a link to a web-based survey if she wanted to participate in the study. Results Participants in this study were college women (n = 384; 175 HPV non-vaccinees and 209 HPV vaccinees). Women in this study knew that a Pap test is still needed after HPV vaccination and that the HPV vaccine does not protect against other Sexually Transmitted Infections. Both nonvaccinees and vaccinees had positive attitudes about mandating HPV vaccine. Knowledge and attitudes toward the vaccine were not directly linked to the outcome predictors intention to obtain the vaccine and vaccine uptake. Attitude about receiving HPV vaccine, subjective norms (complying with the expectations of others), and perceived behavioral control were correlated with the outcome predictors. Subjective norms consistently predicted intention to obtain HPV vaccine and vaccine uptake. Conclusions A proposal to mandate the HPV vaccine among young girls/women was acceptable to this population. Vaccination promotion strategies to increase the vaccine uptake rate among the catch-up group (aged 1326) should include attention to college women's subjective norms. Health care provider's recommendation and encouragement from significant others (i.e., mother and peers) are critical in order for the college women to obtain the vaccine. Evaluation of Australia's varicella vaccination program for children and adolescents Original Research Article Pages 1413-1419 Kirsten Ward, Aditi Dey, Brynley Hull, Helen E. Quinn, Kristine Macartney, Robert Menzies Abstract Objective This paper examines how the monovalent varicella vaccine for children, with an adolescent catch-up dose, was introduced into Australia's National Immunisation Program (NIP), focusing on programme implementation. Methods Semi-structured interviews were conducted with key informants involved in programme implementation. Key themes from interviews were identified through content analysis. Childhood coverage was assessed using data from the Australian Childhood Immunisation Register (ACIR) with adolescent coverage obtained from state/territory immunisation programmes. Seroprevalence data were analysed from national serosurveys conducted before and after programme commencement. Results Implementation challenges for both parents and providers included: (a) parental report of previous infection as an exclusion criterion; (b) introducing a vaccine on its own at 18 months

of age; and (c) adding the adolescent dose into existing school-based vaccination programmes with parental reported exclusion criteria. Despite these challenges, coverage rapidly reached 83% by 24 months of age and 3033% for the adolescent catch-up dose. When considered in conjunction with estimated pre-vaccination natural immunity in both target groups (20% and 83%, respectively) coverage can be considered high. The serosurvey under-estimated coverage in 2-year-old children but was useful to assess trends in population immunity. Conclusion The introduction of a single dose of monovalent varicella vaccine at 18 months of age and a school-based catch-up programme at 1113 years of age successfully achieved high coverage, notwithstanding some challenges. Reported natural infection has been an exclusion criterion for vaccination, but as the programme matures and circulation of wild-type virus decreases, the need for this warrants consideration. There is a need for sensitive laboratory assays to measure vaccine-induced immunity at a population level. U.S. Postlicensure safety surveillance for adolescent and adult tetanus, diphtheria and acellular pertussis vaccines: 20052007 Original Research Article Pages 1447-1452 Soju Chang, Patrick M. OConnor, Barbara A. Slade, Emily Jane Woo Abstract Background Pre-licensure clinical trials for two U.S. licensed tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccines did not reveal any major safety concerns. However, routine use in large adolescent and adult populations could reveal rare and potentially serious adverse events (AEs). Methods To characterize reported AEs following Tdap vaccination and identify potential safety concerns warranting further evaluation, we analyzed data from the Vaccine Adverse Event Reporting System (VAERS) and assessed the frequency and proportions of AEs and reporting rates (reports per 100,000 vaccine doses distributed). Results A total of 2090 reports (7% were serious; 55% listed Tdap alone) involving Tdap vaccines were submitted to VAERS May 2005June 2007. The crude reporting rate was 10.2 per 100,000 vaccine doses distributed. The median age of vaccinees was 22 years, and the female to male ratio was about 2 to 1. The majority of reports described common local and systemic signs and symptoms, such as injection site reactions, fever, and headache. Rarely reported AEs included myopericarditis, demyelinating diseases of the central nervous system, GuillainBarr Syndrome, syncope, encephalopathy/encephalitis, seizure, Bell's palsy, anaphylaxis, and thrombocytopenia. Conclusions Because adolescents and adults were not routinely vaccinated against pertussis in the past, this surveillance summary provides important and reassuring information about the use of Tdap in these age groups. Although subject to the limitations of passive surveillance, the findings of this VAERS review support the pre-licensure clinical trial data with regard to the safety of the U.S. licensed Tdap vaccines. Continued monitoring of clinically significant AEs that are temporally associated with Tdap vaccination and further assessment of such events using controlled observational studies may provide additional information about the safety of these vaccines.

Vaccine: Development and Therapy (Accessed 16 February 2013) http://www.dovepress.com/vaccine-development-and-therapy-journal [No new relevant content] Value in Health Vol 16 | No. 1 | January-February 2013 | Pages 1-228 http://www.valueinhealthjournal.com/current [Reviewed earlier; No relevant content]

From Google Scholar+: Dissertations, Theses, Selected Journal Articles

Lessons learnt from the first efficacy trial of a new infant tuberculosis vaccine since BCG M Tameris, H McShane, JB lMcClain, B Landry - Tuberculosis, 2013 Background New tuberculosis (TB) vaccines are being developed to combat the global epidemic. A phase IIb trial of a candidate vaccine, MVA85A, was conducted in a high burden setting in South Africa to evaluate proof-of-concept efficacy for prevention of TB in infants.... The Impact of 7-valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease: A Literature Review. TT Myint, H Madhava, P Balmer, D Christopoulou - Advances in therapy, 2013 INTRODUCTION: Streptococcus pneumoniae can cause invasive pneumococcal diseases (IPD), such as bacteremic pneumonia, bacteremia, meningitis, and sepsis, and non-IPDs, such as otitis media, nonbacteremic pneumonia, and upper respiratory tract infections... Sequential Methods for Vaccine Safety Evaluation and Surveillance in Public Health J Bartroff, TL Lai, MC Shih - Sequential Experimentation in Clinical Trials, 2013 Abstract In this chapter we describe the applications of sequential testing methodology to the problem of testing the incidence rates of adverse events in vaccine clinical trials and postmarketing safety evaluation. Section 5.1 describes typical design considerations for... Safety of the Pandemic H1N1 Influenza Vaccine Among Pregnant US Military Women and Their Newborns AMS Conlin, AT Bukowinski, CJ Sevick, C DeScisciolo - Obstetrics & Gynecology, 2013 OBJECTIVES: To assess adverse pregnancy outcomes among active-duty US military women who received pandemic H1N1 vaccine during pregnancy as well as adverse health outcomes among the newborns resulting from these pregnancies... Maternal Safety of Trivalent Inactivated Influenza Vaccine in Pregnant Women JD Nordin, EO Kharbanda, GV Benitez, K Nichol - Obstetrics & Gynecology, 2013 OBJECTIVE: To estimate the risks for medically attended events occurring within 42 days of receiving trivalent inactivated influenza vaccine and to evaluate specific risks of firsttrimester vaccination. METHODS: This retrospective observational cohort study compared...

Media Watch Beginning in June 2012, Vaccines: The Week in Review expanded to alert readers to substantive news, analysis and opinion from the general media on vaccines, immunization, global; public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology. We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. WE are conservative in our outlook of adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.
BBC http://www.bbc.co.uk/ Accessed 16 February 2013 12 February 2013 Last updated at 12:53 ET Nigeria journalists charged over Kano polio deaths Excerpt Two Nigerian journalists have been charged in court over the killing of nine female polio vaccinators in northern Kano state on Friday. They were charged with conspiracy and inciting a disturbance. Their Wazobia FM radio station had aired the views of people opposed to polio vaccinations in the mainly Muslim north two days before the killings. The New York-based Committee to Protect Journalists reportedly said it was "troubled" by the prosecution http://www.bbc.co.uk/news/world-africa-21425923 Economist http://www.economist.com/ Accessed 16 February 2013 [No new, unique, relevant content] Financial Times http://www.ft.com Accessed 16 February 2013 [No new, unique, relevant content] Forbes http://www.forbes.com/ Accessed 16 February 2013 [No new, unique, relevant content] Foreign Affairs

http://www.foreignaffairs.com/ January/February 2013 Volume 92, Number 1 Accessed 16 February 2013 [No new unique, relevant content] Foreign Policy http://www.foreignpolicy.com/ Accessed 16 February 2013] [No new unique, relevant content] The Guardian http://www.guardiannews.com/ Accessed 16 February 2013 [No new unique, relevant content] The Huffington Post http://www.huffingtonpost.com/ Accessed 16 February 2013 [No new unique, relevant content] New Yorker http://www.newyorker.com/ Accessed 16 February 2013 [No new, unique, relevant content] NPR/National Public Radio [U.S.] Public Health Accessed 16 February 2013 [No new, unique, relevant content] New York Times http://www.nytimes.com/ Accessed 16 February 2013 [No new, unique, relevant content] Reuters http://www.reuters.com/ Accessed 16 February 2013 [No new, unique, relevant content] Wall Street Journal http://online.wsj.com/home-page Accessed 16 February 2013 [No new, unique, relevant content] Washington Post http://www.washingtonpost.com/ Accessed 16 February 2013

[No new, unique, relevant content]

Twitter Watch (16 February 2013 18:59) Items of interest from a variety of twitter feeds associated with immunization, vaccines and global public health. This capture is highly selective and is by no means intended to be exhaustive.
WHO @WHO Catastrophic payments for health care push about 100m people below the poverty line each year. Universal coverage can help address this #UHC 7:48 a.m. - Feb 16 WHO @WHO How do we measure progress towards universal coverage? Range of services; % of costs for health services and % of population covered #UHC 7:58 a.m. - Feb 16 Seth Berkley @GAVISeth GAVI awarded 2.5m which matched will be 5m from the Dutch Postcode Lottery @ annual Gala. Grt donation for children http://www.noodls.com/viewNoodl/17551807/gavi-alliance/gavireceives-8364-25-million-from-dutch-postcode-lotter 1:25 p.m. - Feb 15, 2013 CDCgov @CDCgov >41,000 whooping cough cases reported in 2012. Vaccine especially important for expectant mothers. http://go.usa.gov/4e34 11:02 a.m. - Feb 15, 2013 ECDC @ECDC_EU Weekly #influenza update, week 6/2013: 20 of 28 countries reported concomitantly high/medium-intensity transmission http://bit.ly/15hH8z3 6:10 a.m. - Feb 15, 2013 WHO @WHO >100 countries do not have a system registering births, deaths; only 34 countries produce quality cause-of-death data http://goo.gl/p2LU9 3:58 a.m. - Feb 15, 2013 Sabin Vaccine Inst. @sabinvaccine Recent Acts of Violence Undermine Efforts to Eradicate Polio Worldwide | Sabin http://www.sabin.org/updates/blog/recent-acts-violence-undermine-efforts-eradicate-polioworldwide 11:32 a.m. - Feb 14, 2013 GAVI Alliance @GAVIAlliance

Follow @GAVI_Daniel 2 learn about #knowledgemanagement #supplychainmanagement & how he's improving @GAVIAlliance systems in these areas! 6:07 a.m. - Feb 14, 2013 WHO @WHO Govt of Chad will launch mass-vax campaign against #yellowfever on 22 Feb in 3 districts bordering Darfur, Sudan http://goo.gl/Bv019 3:07 a.m. - Feb 14, 2013 The Global Fund @globalfundnews We're reading: 'An Optimistic Era for Global Infectious Disease Control' via @theAtlantic #thebigpush http://bit.ly/XadWnb 2:07 a.m. - Feb 14, 2013 PAHO/WHO @pahowho @PAHOWHO Director discusses expanded cooperation with Global Fund http://new.paho.org/hq/index.php?option=com_content&view=article&id=8265%3Apahodirector-discusses-expanded-cooperation-with-global-fund&catid=1443%3Anews-front-pageitems&lang=en&Itemid=1926#.URvoh4GmiRI.twitter 11:25 a.m. - Feb 13, 2013 * * * *

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