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El. knyga: Vaccines for the 21st Century: A Tool for Decisionmaking

  • Formatas: 472 pages
  • Išleidimo metai: 21-Feb-2001
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309174985
Kitos knygos pagal šią temą:
  • Formatas: 472 pages
  • Išleidimo metai: 21-Feb-2001
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309174985
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Vaccines have made it possible to eradicate the scourge of smallpox, promise the same for polio, and have profoundly reduced the threat posed by other diseases such as whooping cough, measles, and meningitis.



What is next? There are many pathogens, autoimmune diseases, and cancers that may be promising targets for vaccine research and development.



This volume provides an analytic framework and quantitative model for evaluating disease conditions that can be applied by those setting priorities for vaccine development over the coming decades. The committee describes an approach for comparing potential new vaccines based on their impact on morbidity and mortality and on the costs of both health care and vaccine development. The book examines:







Lessons to be learned from the polio experience. Scientific advances that set the stage for new vaccines. Factors that affect how vaccines are used in the population. Value judgments and ethical questions raised by comparison of health needs and benefits.



The committee provides a way to compare different forms of illness and set vaccine priorities without assigning a monetary value to lives. Their recommendations will be important to anyone involved in science policy and public health planning: policymakers, regulators, health care providers, vaccine manufacturers, and researchers.

Table of Contents



Front Matter Executive Summary Introduction Progress in Vaccine Development Considerations of Candidate Vaccines Overview of Analytic Approach and Results Review of the Analytical Model Ethical Considerations and Caveats Observations References Appendix 1: Borrelia burgdorferi Appendix 2: Chlamydia Appendix 3: Coccidioides Immitis Appendix 4: Cytomegalovirus Appendix 5: Enterotoxigenic E. coli Appendix 6: Epstein-Barr Virus Appendix 7: Helicobacter pylori Appendix 8: Hepatitis C Appendix 9: Herpes Simplex Virus Appendix 10: Histoplasma capsulatum Appendix 11: Human Paillomavirus Appendix 12: Influenza A and B Appendix 13: Insulin-Dependent Diabetes Mellitus Appendix 14: Melanoma Appendix 15: Multiple Sclerosis Appendix 16: Mycobacterium tuberculosis Appendix 17: Neisseria gonnorrhea Appendix 18: Neisseria meningitidis Appendix 19: Parainfluenza Virus Appendix 20: Respiratory Syncytial Virus Appendix 21: Rheumatoid Arthritis Appendix 22: Rotavirus Appendix 23: Shigella Appendix 24: Streptococcus, Group A Appendix 25: Streptococcus, Group B Appendix 26: Streptococcus pneumoniae Appendix 27: Information on accessing Electronic Spreadsheets Appendix 28: Summary of Workshops Appendix 29: Questions Posed to Outside Experts and List of Responders Index
Executive Summary 1(10)
Introduction
11(6)
Considerations Related to the Model and the Study
12(1)
Organization of the Report
13(4)
Progress in Vaccine Development
17(22)
Priorities of the IOM Committee in 1985
18(2)
Litigation as a Barrier to Vaccine Development
20(3)
A Case Study of Success
23(3)
Advances in Biotechnology and Molecular Immunology and New Opportunities for Vaccines
26(13)
Considerations of Candidate Vaccines
39(14)
Exclusion Criteria
39(4)
Additional Considerations for Inclusion
43(10)
Overview of Analytic Approach and Results
53(40)
A Cost-Effectiveness Approach
53(8)
Model Overview
61(15)
Examples: Hypothetical Vaccine X
76(10)
Results
86(7)
Review of the Analytic Model
93(16)
Unit of Analysis
93(1)
Implementing the Analysis
94(1)
Calculation of Health Benefits
95(9)
Cost Factors
104(3)
Vaccine Efficacy and Utilization
107(1)
Cost-Effectiveness Ratios
108(1)
Ethical Considerations and Caveats
109(14)
Ethical and Value Judgments Built into the Model
111(5)
Considerations of Justice
116(6)
Conclusion
122(1)
Observations
123(10)
The Finding of Research
123(3)
Neglected Opportunities for Vaccine R&D
126(3)
Qualitative Judgments
129(1)
Vaccine Program Concerns
130(3)
References 133(310)
Appendixes
1 Borrelia burgdorferi
143(6)
2 Chlamydia
149(10)
3 Coccidioides Immitis
159(6)
4 Cytomegalovirus
165(8)
5 Enterotoxigenic E. coli
173(4)
6 Epstein-Barr Virus
177(4)
7 Helicobacter pylori
181(8)
8 Hepatitis C
189(6)
9 Herpes Simplex Virus
195(12)
10 Histoplasma capsulatum
207(6)
11 Human Papillomavirus
213(10)
12 Influenza A and B
223(10)
13 Insulin-Dependent Diabetes Mellitus
233(6)
14 Melanoma
239(6)
15 Multiple Sclerosis
245(6)
16 Mycobacterium tuberculosis
251(6)
17 Neisseria gonorrhea
257(10)
18 Neisseria meningitidis B
267(6)
19 Parainfluenza Virus
273(6)
20 Respiratory Syncytial Virus
279(6)
21 Rheumatoid Arthritis
285(6)
22 Rotavirus
291(4)
23 Shigella
295(4)
24 Streptococcus, Group A
299(6)
25 Streptococcus, Group B
305(8)
26 Streptococcus pneumoniae
313(10)
27 Information on Accessing Electronic Spreadsheets
323(2)
28 Summary of Workshops
325(110)
29 Questions Posed to Outside Experts and List of Responders
435(8)
Index 443


Kathleen R. Stratton, Jane S. Durch, and Robert S. Lawrence, Editors, Committee to Study Priorities for Vaccine Development, Division of Health Promotion and Disease Prevention, Institute of Medicine