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National trends in patterns of under-vaccination in early childhood: National Immunization Survey-Child, United States, 2011-2021. 幼儿期疫苗接种不足模式的全国趋势:2011-2021 年美国全国儿童免疫接种调查。
IF 5.5 3区 医学 Q1 IMMUNOLOGY Pub Date : 2024-01-01 Epub Date: 2024-08-14 DOI: 10.1080/14760584.2024.2389922
Matthew F Daley, Christina L Clarke, Jason M Glanz, Alexandria N Albers, Sarah Y Michels, Rain E Freeman, Sophia R Newcomer

Background: The study's objective was to examine national trends in patterns of under-vaccination in the United States.

Research design and methods: The National Immunization Survey-Child (NIS-Child) is an annual cross-sectional survey that collects provider-verified vaccination records from a large national probability sample of children. Records from the 2011-2021 NIS-Child were used to assess receipt of the combined 7-vaccine series by age 24 months. Based on prior work, patterns indicative of hesitancy included zero vaccines, not starting ≥1 series, and consistent vaccine-limiting. Patterns indicative of practical issues included starting all series but missing doses. Up-to-date (UTD) was defined as receiving all doses in the combined 7-vaccine series.

Results: The study population comprised 127,257 children. Over the observation period, patterns indicative of hesitancy significantly decreased (p-trend < 0.0001), patterns indicative of practical issues significantly decreased (p-trend < 0.0001), and UTD significantly increased (p-trend < 0.0001). In 2021, the weighted percentage in each category was as follows: probable hesitancy 6.3% (95% confidence interval [CI] 5.4%, 7.2%), probable practical issues 26.0% (95% CI 24.4%, 27.6%), and UTD 67.7% (95% CI 66.0%, 69.4%).

Conclusion: Over an 11-year period, vaccination coverage in the United States for the combined 7-vaccine series has improved, with patterns suggestive of practical issues or hesitancy declining.

研究背景研究目标:研究美国疫苗接种不足模式的全国性趋势:全国儿童免疫接种调查(NIS-Child)是一项年度横断面调查,它从全国大量儿童概率样本中收集由提供者验证的疫苗接种记录。2011-2021 年全国儿童免疫接种调查的记录用于评估儿童在 24 个月大前接种 7 种疫苗的情况。根据之前的工作,表明犹豫不决的模式包括零接种、未开始接种≥1个系列以及持续限制接种。表明实际问题的模式包括开始接种所有系列疫苗但缺失剂量。最新接种(UTD)的定义是接种了7种疫苗系列的所有剂量:研究对象包括 127,257 名儿童。在观察期内,表示犹豫不决的模式明显减少(P-趋势 结论:在 11 年的时间里,接种疫苗的儿童数量明显增加:在 11 年的时间里,美国 7 种疫苗联合疫苗系列的接种覆盖率有所提高,表明存在实际问题或犹豫不决的情况有所减少。
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引用次数: 0
Indirect protection from rotavirus vaccines: a systematic review. 轮状病毒疫苗的间接保护作用:系统综述。
IF 5.5 3区 医学 Q1 IMMUNOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-01 DOI: 10.1080/14760584.2024.2395534
Tyler Chavers, Jordan Cates, Eleanor Burnett, Umesh D Parashar, Jacqueline E Tate

Introduction: Rotavirus vaccines may provide indirect protection by reducing transmission in the population and thus reducing disease burden.

Methods: This systematic review summarizes estimates of indirect protection from rotavirus vaccines and the methods used to obtain these estimates.

Results: We identified 71 studies published between 2009 and 2022 that provided 399 estimates of indirect protection from rotavirus vaccine. Most estimates (73%) evaluated hospitalizations due to rotavirus gastroenteritis as the outcome and unvaccinated children <5 years old as the agegroup (64%), but there was considerable variability in methods to evaluate indirect protection. For hospitalizations due to rotavirus gastroenteritis among unvaccinated children <5 years old, the median incidence rate ratio was 0.60 (IQR: 0.40-0.87, n = 110 estimates), the median relative percent change in percent positivity was 25% (IQR: 13-44%, n = 49 estimates), and the median relative percent change in absolute number of rotavirus positive tests or rotavirus-specific International Classification of Diseases codes was 42% (IQR: 16-66%, n = 40 estimates).

Conclusions: These findings broadly suggest rotavirus vaccines provide some indirect protection. There is a need to standardize measurement of indirect rotavirus vaccine protection, particularly using consistent outcomes and metrics, and stratifying results by standardized age groups and years since vaccine introduction.

导言:轮状病毒疫苗可通过减少在人群中的传播提供间接保护,从而减轻疾病负担:本系统综述总结了轮状病毒疫苗间接保护作用的估计值以及获得这些估计值的方法:我们确定了 2009 年至 2022 年间发表的 71 项研究,这些研究提供了 399 个轮状病毒疫苗间接保护的估计值。大多数估计值(73%)将轮状病毒肠胃炎导致的住院作为评估结果,未接种疫苗的儿童n = 110个估计值),阳性率相对百分比变化的中位数为25%(IQR:13-44%,n = 49个估计值),轮状病毒阳性检测或轮状病毒特异性国际疾病分类代码绝对数量相对百分比变化的中位数为42%(IQR:16-66%,n = 40个估计值):这些发现大致表明轮状病毒疫苗提供了一些间接保护。有必要对轮状病毒疫苗的间接保护作用进行标准化测量,特别是使用一致的结果和指标,并按标准化年龄组和疫苗引入后的年限对结果进行分层。
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引用次数: 0
Recombinant transmissible vaccines will be intrinsically contained despite the ability to superinfect. 重组可传播疫苗尽管具有超强感染能力,但其本质上是封闭的。
IF 6.2 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-02-28 DOI: 10.1080/14760584.2024.2320845
James J Bull, Scott L Nuismer, Christopher H Remien, Megan E Griffiths, Rustom Antia

Introduction: Transmissible vaccines offer a novel approach to suppressing viruses in wildlife populations, with possible applications against viruses that infect humans as zoonoses - Lassa, Ebola, rabies. To ensure safety, current designs propose a recombinant vector platform in which the vector is isolated from the target wildlife population. Because using an endemic vector creates the potential for preexisting immunity to block vaccine transmission, these designs focus on vector viruses capable of superinfection, spreading throughout the host population following vaccination of few individuals.

Areas covered: We present original theoretical arguments that, regardless of its R0 value, a recombinant vaccine using a superinfecting vector is not expected to expand its active infection coverage when released into a wildlife population that already carries the vector. However, if superinfection occurs at a high rate such that individuals are repeatedly infected throughout their lives, the immunity footprint in the population can be high despite a low incidence of active vaccine infections. Yet we provide reasons that the above expectation is optimistic.

Expert opinion: High vaccine coverage will typically require repeated releases or release into a population lacking the vector, but careful attention to vector choice and vaccine engineering should also help improve transmissible vaccine utility.

导言:可传播疫苗为抑制野生动物种群中的病毒提供了一种新方法,并有可能应用于对付作为人畜共患病感染人类的病毒--拉沙病毒、埃博拉病毒和狂犬病。为确保安全,目前的设计提出了一个重组载体平台,其中的载体是从目标野生动物种群中分离出来的。由于使用地方流行的载体有可能使已有的免疫力阻碍疫苗的传播,因此这些设计的重点是能够超级感染的载体病毒,即在少数人接种疫苗后传播到整个宿主群体:我们提出了原创性的理论论据,即无论其 R0 值如何,使用超感染载体的重组疫苗在释放到已经携带载体的野生动物种群中时,都不会扩大其有效感染范围。但是,如果超感染率很高,个体一生中会反复感染,那么尽管疫苗的主动感染率很低,但种群中的免疫足迹可能会很高。然而,我们提出了上述预期过于乐观的理由:高疫苗覆盖率通常需要反复释放或释放到缺乏载体的人群中,但仔细关注载体选择和疫苗工程也有助于提高可传播疫苗的效用。
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引用次数: 0
Accelerate vaccine development using seamless phase 2/3 trial designs. 利用无缝 2/3 期试验设计加快疫苗研发。
IF 6.2 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-05-07 DOI: 10.1080/14760584.2024.2348612
Jia-Ying Yang, Guo-Chun Li, Ying Yuan

Background: Traditional vaccine development, often a lengthy and costly process of three separated phases. However, the swift development of COVID-19 vaccines highlighted the critical importance of accelerating the approval of vaccines. This article showcases a seamless phase 2/3 trial design to expedite the development process, particularly for multi-valent vaccines.

Research design and methods: This study utilizes simulation to compare the performance of seamless phase 2/3 design with that of conventional trial design, specifically by re-envisioning a 9-valent HPV vaccine trial. Across three cases, several key performance metrics are evaluated: overall power, type I error rate, average sample size, trial duration, the percentage of early stop, and the accuracy of dose selection.

Results: On average, when the experimental vaccine was assumed to be effective, the seamless design that performed interim analyses based solely on efficacy saved 555.73 subjects, shortened trials by 10.29 months, and increased power by 3.70%. When the experimental vaccine was less effective than control, it saved an average of 887.73 subjects while maintaining the type I error rate below 0.025.

Conclusion: The seamless design proves to be a compelling strategy for vaccine development, given its versatility in early stopping, re-estimating sample sizes, and shortening trial durations.

背景:传统的疫苗研发通常需要经历漫长而昂贵的三个阶段。然而,COVID-19 疫苗的迅速开发凸显了加快疫苗审批的极端重要性。本文展示了一种无缝的 2/3 期试验设计,以加快开发过程,尤其是多价疫苗的开发过程:本研究利用仿真技术比较了无缝 2/3 期设计与传统试验设计的性能,特别是通过重新设想 9 价 HPV 疫苗试验。在三个案例中,对几个关键性能指标进行了评估:总体功率、I 型错误率、平均样本量、试验持续时间、早期停止的百分比以及剂量选择的准确性:平均而言,当假定试验性疫苗有效时,仅根据疗效进行中期分析的无缝设计节省了 555.73 例受试者,缩短了 10.29 个月的试验时间,并提高了 3.70% 的功率。当试验性疫苗的疗效低于对照组时,它平均挽救了 887.73 例受试者,同时将 I 型错误率保持在 0.025 以下:无缝设计在早期停止试验、重新估计样本大小和缩短试验时间方面具有多功能性,因此被证明是一种令人信服的疫苗开发策略。
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引用次数: 0
Economic evaluation of second measles containing vaccine (MCV) dose: a systematic review of available evidence. 含麻疹成分疫苗 (MCV) 第二剂的经济评估:对现有证据的系统回顾。
IF 5.5 3区 医学 Q1 IMMUNOLOGY Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI: 10.1080/14760584.2024.2367451
Samuel Bawa, Abrham Wondimu, Maarten J Postma, Raymond Hutubessy, Marinus van Hulst

Introduction: The global measles incidence has decreased from 145 to 49 cases per 1 million population from 2000 to 2018, but evaluating the economic benefits of a second measles-containing vaccine (MCV2) is crucial. This study reviewed the evidence and quality of economic evaluation studies to guide MCV2 introduction.

Methods: The systematic review of model-based economic evaluation studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search yielded 2231 articles, with 876 duplicates removed and 1355 articles screened, with nine studies included for final analysis.

Results: Six studies reported a positive benefit-cost ratio with one resulting in net savings of $11.6 billion, and two studies estimated a 2-dose MMR vaccination program would save $119.24 to prevent one measles case, and a second dose could prevent 9,200 cases at 18 months, saving $548.19 per case. The most sensitive variables were the discount rate and vaccination administration cost.

Conclusions: Two MCV doses or a second opportunity with an additional dose of MCV were highly cost-beneficial and resulted in substantial cost savings compared to a single routine vaccine. But further research using high-quality model-based health economic evaluation studies of MCV2 should be made available to decision-makers.

Prospero registration: CRD42020200669.

导言:从 2000 年到 2018 年,全球麻疹发病率已从每 100 万人口 145 例降至 49 例,但评估第二种含麻疹成分疫苗(MCV2)的经济效益至关重要。本研究回顾了经济评估研究的证据和质量,以指导MCV2的引入:方法:根据《系统综述和元分析首选报告项目》指南,对基于模型的经济评估研究进行了系统综述。搜索共获得 2231 篇文章,删除了 876 篇重复文章,筛选了 1355 篇文章,最终分析纳入了 9 项研究:据两项研究估计,接种两剂麻风腮疫苗可预防一例麻疹病例,节省 119.24 美元;接种第二剂疫苗可在 18 个月后预防 9200 例麻疹病例,每例节省 548.19 美元。最敏感的变量是贴现率和疫苗接种管理成本:与接种一次常规疫苗相比,接种两剂麻风腮疫苗或再接种一剂麻风腮疫苗具有很高的成本效益,可节省大量成本。但决策者应利用基于模型的高质量健康经济评估研究对 MCV2 进行进一步研究:CRD42020200669。
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引用次数: 0
Efficacy and safety of hepatitis B vaccine: an umbrella review of meta-analyses. 乙型肝炎疫苗的功效和安全性:荟萃分析综述。
IF 5.5 3区 医学 Q1 IMMUNOLOGY Pub Date : 2024-01-01 Epub Date: 2023-12-14 DOI: 10.1080/14760584.2023.2289566
Jiamin Qiu, Shiwen Zhang, Yonghui Feng, Xin Su, Jun Cai, Shiyun Chen, Jiazi Liu, Shiqi Huang, Haokun Huang, Sui Zhu, Huiyan Wen, Jiaxin Li, Haoyu Yan, Zhiquan Diao, Xiaofeng Liang, Fangfang Zeng

Background: There is a lack of synthesis of literature to determine hepatitis B vaccine (HepB) strategies for hepatitis B virus (HBV) supported by quality evidence. We aimed to explore the efficacy and safety of HepB strategies among people with different characteristics.

Research design and methods: PubMed, Cochrane Library, Embase, and Web of Science were searched for meta-analyses comparing the efficacy and safety of HepB up to July 2023.

Results: Twenty-one meta-analyses comparing 83 associations were included, with 16 high quality, 4 moderate, and 1 low quality assessed by AMSTAR 2. Highly suggestive evidence supports HepB booster and HepB with 1018 adjuvant (HBsAg-1018) for improved seroprotection, and targeted and universal HepB vaccination reduced HBV infection Suggestive evidence indicated that targeted vaccination decreased the rate of hepatitis B surface antibody positivity and booster doses increased seroprotection in people aged 10-20. Weak evidence suggests potential local/systemic reaction risk with nucleotide analogs or HBsAg-1018. Convincing evidence shows HLA-DPB1*04:01 and DPB1*04:02 increased, while DPB1*05:01 decreased, hepatitis B antibody response. Obesity may reduce HepB seroprotection, as highly suggested.

Conclusion: Targeted vaccination could effectively reduce HBV infection, and adjuvant and booster vaccinations enhance seroprotection without significant reaction. Factors such as obesity and genetic polymorphisms may affect the efficacy.

背景:我们旨在探讨不同特征人群接种乙肝疫苗(HepB)策略的有效性和安全性:结果:纳入了 21 项元分析,比较了 83 种关联,其中 16 项为高质量,4 项为中等质量,1 项为低质量(由 AMSTAR 2 评估)。高度提示性证据支持乙肝疫苗加强剂和加有 1018 佐剂(HBsAg-1018)的乙肝疫苗可提高血清保护率,有针对性的和普遍的乙肝疫苗接种可减少 HBV 感染 提示性证据表明,有针对性的疫苗接种可降低乙肝表面抗体阳性率,加强剂可提高 10-20 岁人群的血清保护率。微弱证据表明,核苷酸类似物或 HBsAg-1018 有潜在的局部/全身反应风险。令人信服的证据表明,HLA-DPB1 × 04:01 和 DPB1 × 04:02 可增加乙肝抗体反应,而 DPB1 × 05:01 则可降低乙肝抗体反应。结论:结论:有针对性的疫苗接种可有效降低 HBV 感染,辅助疫苗和加强免疫可提高血清保护性,且无明显反应。肥胖和基因多态性等因素可能会影响疫苗的效果。
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引用次数: 0
Waning intra-season vaccine effectiveness against influenza A(H3N2) underlines the need for more durable protection. 甲型 H3N2 流感疫苗的季节内效力正在减弱,这凸显了提供更持久保护的必要性。
IF 6.2 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-03-18 DOI: 10.1080/14760584.2024.2331073
Alexander Domnich, Andrea Orsi, Alessio Signori, Maria Chironna, Ilaria Manini, Christian Napoli, Caterina Rizzo, Donatella Panatto, Giancarlo Icardi

Background: The question of whether influenza vaccine effectiveness (VE) wanes over the winter season is still open and some contradictory findings have been reported. This study investigated the possible decline in protection provided by the available influenza vaccines.

Research design and methods: An individual-level pooled analysis of six test-negative case-control studies conducted in Italy between the 2018/2019 and 2022/2023 seasons was performed. Multivariable logistic regression analyses were performed to estimate weekly change in the odds of testing positive for influenza 14 days after vaccination.

Results: Of 6490 patients included, 1633 tested positive for influenza. Each week that had elapsed since vaccination was associated with an increase in the odds of testing positive for any influenza (4.9%; 95% CI: 2.0-8.0%) and for A(H3N2) (6.5%; 95% CI: 2.9-10.3%). This decline in VE was, however, significant only in children and older adults. A similar increase in the odds of testing positive was seen when the dataset was restricted to vaccinees only. Conversely, VE waning was less evident for A(H1N1)pdm09 or B strains.

Conclusions: Significant waning of VE, especially against influenza A(H3N2), may be one of the factors associated with suboptimal end-of-season VE. Next-generation vaccines should provide more durable protection against A(H3N2).

背景:关于流感疫苗的有效性(VE)是否会随着冬季的到来而减弱的问题仍然没有定论,也有一些相互矛盾的研究结果。本研究调查了现有流感疫苗所提供的保护作用可能下降的情况:对 2018/2019 年至 2022/2023 年季节期间在意大利进行的六项检测阴性病例对照研究进行了个体层面的汇总分析。进行了多变量逻辑回归分析,以估计接种疫苗 14 天后流感检测呈阳性几率的每周变化:在纳入的6490名患者中,有1633人的流感检测呈阳性。接种疫苗后每过一周,任何流感检测呈阳性的几率(4.9%;95% CI:2.0-8.0%)和甲型(H3N2)流感检测呈阳性的几率(6.5%;95% CI:2.9-10.3%)都会增加。然而,VE 的下降仅对儿童和老年人有显著影响。当数据集仅限于疫苗接种者时,检测结果呈阳性的几率也出现了类似的增长。相反,A(H1N1)pdm09 或 B 株的 VE 下降并不明显:结论:VE(尤其是针对甲型 H3N2 流感的 VE)的显著减弱可能是导致季末 VE 不理想的相关因素之一。下一代疫苗应能为甲型 H3N2 流感提供更持久的保护。
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引用次数: 0
Comparing reactogenicity of COVID-19 vaccine boosters: a systematic review and meta-analysis. 比较 COVID-19 疫苗增强剂的致反应性:系统回顾和荟萃分析。
IF 6.2 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-02-26 DOI: 10.1080/14760584.2024.2315089
Alberto San Francisco Ramos, Carolina Liu Sanchez, Tatiana Bovill Rose, David Smith, Natasha Thorn, Eva Galiza, Thahmena Miah, Jennifer Pearce, Cecilia Hultin, Catherine Cosgrove, Yingfen Hsia, Paul T Heath

Introduction: Different COVID-19 vaccines are being utilized as boosters. This systematic review and meta-analysis aims to evaluate the reactogenicity of COVID-19 vaccines given as booster doses, according to vaccine type, dose, timing, participant characteristics and primary immunization regimen received.

Methods: Four databases (MEDLINE, Embase, Web of Science and CENTRAL) were searched for randomized controlled trials between 1 January 2020 and 1 January 2023 according to predetermined criteria.

Results: Twenty-eight studies describing 19 vaccines of four different types (viral vector, inactivated, mRNA and protein sub-unit) were identified. BNT162b2 vaccine (Pfizer-BioNTech) was selected as the control as it was most often compared with other vaccines. Fever, fatigue, headache, injection-site pain, redness, and swelling were the most frequently reported solicited events. mRNA vaccines were the most reactogenic, followed by viral vector vaccines and protein sub-unit vaccines, while inactivated vaccines were the least reactogenic. Full-dose vaccines were more reactogenic than half-dose vaccines. Heterologous BNT162b2 boosters were more reactogenic than boosters with the same vaccine used for primary immunization.

Conclusions: COVID-19 vaccine booster schedules have distinct reactogenicity profiles, dependent on dose and vaccine type, which may allow targeted recommendations and provide choice for specific populations. Greater standardization of adverse event reporting will aid future studies.

简介:目前正在使用不同的 COVID-19 疫苗作为加强剂。本系统综述和荟萃分析旨在根据疫苗类型、剂量、接种时间、接种者特征和接受的主要免疫方案,评估作为加强剂接种的 COVID-19 疫苗的致反应性:方法:根据预先确定的标准,在四个数据库(MEDLINE、Embase、Web of Science和CENTRAL)中检索了2020年1月1日至2023年1月1日期间的随机对照试验:结果:共发现28项研究,介绍了19种不同类型的疫苗(病毒载体、灭活疫苗、mRNA疫苗和蛋白亚单位疫苗)。由于 BNT162b2 疫苗(辉瑞生物技术公司)与其他疫苗的比较最为频繁,因此被选为对照疫苗。发热、疲劳、头痛、注射部位疼痛、红肿是最常报告的诱发事件。mRNA 疫苗的致反应性最高,其次是病毒载体疫苗和蛋白亚单位疫苗,而灭活疫苗的致反应性最低。全剂量疫苗的致反应性高于半剂量疫苗。异源 BNT162b2 增强剂的致反应性要高于初免时使用的同种疫苗的增强剂:结论:COVID-19 疫苗加强免疫程序具有不同的致反应性特征,这取决于剂量和疫苗类型,因此可为特定人群提供有针对性的建议和选择。加强不良事件报告的标准化将有助于未来的研究。
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引用次数: 0
Global pandemic preparedness: learning from the COVID-19 vaccine development and distribution. 全球大流行病防备:从 COVID-19 疫苗的开发和分发中学习。
IF 5.5 3区 医学 Q1 IMMUNOLOGY Pub Date : 2024-01-01 Epub Date: 2024-08-30 DOI: 10.1080/14760584.2024.2395546
Suneth Agampodi, Ondari D Mogeni, Rebecca Chandler, Megha Pansuriya, Jerome H Kim, Jean-Louis Excler

Introduction: The COVID-19 pandemic catalyzed unprecedented vaccine innovation, revealing critical shortcomings in achieving equitable vaccine access and underscoring the need for a focused review of the lessons learned to inform future pandemic preparedness, with emphasis on vaccine delivery, equity, and challenges in LMICs.

Areas covered: We critically analyzed the pandemic vaccine development and distribution journey and the operational mechanisms that facilitated these achievements. For this purpose, we primarily searched pandemic vaccine stakeholder websites, reports, and publications. The analysis extends beyond the scientific narrative to address the 'how' of the process while anchoring the discussion on equity and global health security as fundamental to preparing for future pandemics.

Expert opinion: Drawing on the insights gained from the COVID-19 pandemic, we identify several key challenges requiring immediate attention to fortify preparedness for future pandemics. These are cultivating leadership in the field of vaccinology, guaranteeing equitable global access to diagnostics, therapeutic agents, and vaccines, securing adequate funding for ongoing research and development, ensuring the fair distribution of vaccines, and strategically allocating biomedical manufacturing facilities to ensure a balanced global production capacity. Addressing these challenges is imperative to establish a robust pandemic response framework and mitigate the impact of future global health crises.

导言:COVID-19 大流行推动了前所未有的疫苗创新,揭示了在实现公平获得疫苗方面存在的关键缺陷,并强调有必要重点回顾所吸取的经验教训,以便为未来的大流行病防备工作提供信息,重点是疫苗交付、公平性以及低收入和中等收入国家面临的挑战:我们认真分析了大流行病疫苗的开发和分发历程,以及促进这些成就的运行机制。为此,我们主要搜索了大流行疫苗利益相关者的网站、报告和出版物。分析超越了科学叙述的范畴,探讨了这一过程的 "如何",同时将公平和全球健康安全作为讨论的基础,为未来的大流行病做好准备:根据从 COVID-19 大流行中获得的启示,我们确定了需要立即关注的几个关键挑战,以加强对未来大流行病的准备。这些挑战包括:培养疫苗学领域的领导力;保证全球公平地获得诊断、治疗药物和疫苗;为正在进行的研发工作提供充足的资金;确保疫苗的公平分配;战略性地分配生物医学生产设施,以确保全球生产能力的平衡。要建立一个强有力的大流行病应对框架并减轻未来全球健康危机的影响,应对这些挑战势在必行。
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引用次数: 0
The broader benefits of vaccines: methodologies for inclusion in economic evaluation. 疫苗更广泛的益处:纳入经济评估的方法。
IF 5.5 3区 医学 Q1 IMMUNOLOGY Pub Date : 2024-01-01 Epub Date: 2024-09-04 DOI: 10.1080/14760584.2024.2387599
Steven Simoens, Sandy Tubeuf, Nicolas Dauby, Olivier Ethgen, Sophie Marbaix, Marjan Willaert, Jeroen Luyten

Background: As the societal value of vaccines is increasingly recognized, there is a need to examine methodological approaches that could be used to integrate these various benefits in the economic evaluation of a vaccine.

Research design and methods: A literature review and two expert panel meetings explored methodologies to value herd immunity, health spillover effects (beyond herd immunity), impact on antimicrobial resistance, productivity, and equity implications of vaccines.

Results: The consideration of broader benefits of vaccines in economic evaluation is complicated and necessitates technical expertise. Whereas methodologies to account for herd immunity and work productivity are relatively well established, approaches to investigate equity implications are developing and less frequently applied. Modeling the potential impact on antimicrobial resistance not only depends on the multi-faceted causal relationship between vaccination and resistance but also on data availability.

Conclusions: Different methods are available to value the broad impact of vaccines, and it is important that analysts are aware of their strengths and limitations and justify their choice of method. In the future, we expect that an increasing number of economic evaluations will consider the broader benefits of vaccines as part of their base-case analysis or in sensitivity analyses.

背景:随着疫苗的社会价值日益得到认可,有必要研究可用于将这些不同效益纳入疫苗经济评估的方法:文献综述和两次专家小组会议探讨了疫苗的群体免疫、健康溢出效应(群体免疫之外)、对抗菌素耐药性的影响、生产率和公平影响的价值评估方法:结果:在经济评估中考虑疫苗的更广泛益处非常复杂,需要专业技术知识。虽然考虑群体免疫力和工作效率的方法已经相对成熟,但调查公平影响的方法还在发展中,应用较少。对抗菌药耐药性的潜在影响建模不仅取决于疫苗接种与耐药性之间多方面的因果关系,还取决于数据的可用性:有不同的方法可用于评估疫苗的广泛影响,重要的是分析人员要了解这些方法的优势和局限性,并证明其选择的方法是正确的。我们预计,未来将有越来越多的经济评估将考虑疫苗的广泛益处,并将其作为基础案例分析或敏感性分析的一部分。
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引用次数: 0
期刊
Expert Review of Vaccines
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