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