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WHAT'S NEW THIS THURSDAY: THREE REPORTS FROM THE INSTITUTE OF MEDICINE -- CHRONIC DISEASE, AEFI, VACCINE RANKING

Monday, 28th of May 2012

THREE REPORTS FROM THE INSTITUTE OF MEDICINE
COUNTRY-LEVEL DECISION MAKING FOR CONTROL OF CHRONIC DISEASES

Best viewed at

http://www.iom.edu/Reports/2012/Country-Level-Decision-Making-for-Control-of-Chronic-Diseases.aspx

Country-Level Decision Making for Control of Chronic Diseases - Workshop Summary

Released: April 2, 2012

Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

A 2010 IOM report, Promoting Cardiovascular Health in the Developing World, found that not only is it possible to reduce the burden of cardiovascular disease and related chronic diseases in developing countries, but also that such a reduction will be critical to achieving global health and development goals. One key step to achieving this outcome is to identify practical ways to assist low- and middle-income countries in improving control of chronic diseases through the approaches that are led by a country’s decision makers and stakeholders and that will be most appropriate, effective, and feasible based on a country’s circumstances.

As part a series of follow-up activities to the 2010 report, the IOM planned a workshop to explore ideas and opportunities for supporting country-specific assessment of resource needs and planning of resource allocation for chronic diseases as part of the broader process of priority setting, decision making, and planning. The workshop, held in July 2011, aimed to identify what is needed to create tools for country-led planning of effective, efficient, and equitable provision of programs to prevent and reduce the burden of chronic diseases. This document summarizes the workshop.

ADVERSE EFFECTS OF VACCINES: EVIDENCE AND CAUSALITY

From the Institute of Medicine

Best viewed at

http://www.iom.edu/Reports/2011/Adverse-Effects-of-Vaccines-Evidence-and-Causality.aspx

Released: August 25, 2011

Immunizations are a cornerstone of the nation’s efforts to protect people from a host of infectious diseases. Though generally very rare or minor, there are side effects, or “adverse effects,” associated with some vaccines. Importantly, some adverse events following a vaccine may be due to coincidence and are not caused by the vaccine. To make this distinction, researchers use evidence to determine if adverse events following vaccination are causally linked to a specific vaccine; if so, these events are referred to as adverse effects. The Health Resources and Services Administration asked the IOM to review a list of adverse events associated with eight vaccines—varicella zoster, influenza (except 2009 H1N1), hepatitis B, HPV, MMR, hepatitis A, meningococcal, and those that contain tetanus—and evaluate the scientific evidence about the event–vaccine relationship. The IOM committee appointed to this task was not asked to assess the benefits or effectiveness of vaccines but only the risk of specific adverse events.

Using epidemiologic and mechanistic evidence, the committee developed 158 causality conclusions and assigned each relationship between a vaccine and an adverse health problem to one of four categories of causation:

Evidence convincingly supports a causal relationship
Evidence favors acceptance of a causal relationship
Evidence favors rejection of a causal relationship
Evidence is inadequate to accept or reject a causal relationship

The committee finds that evidence convincingly supports a causal relationship between some vaccines and some adverse events—such as MMR, varicella zoster, influenza, hepatitis B, meningococcal, and tetanus-containing vaccines linked to anaphylaxis. Additionally, evidence favors rejection of five vaccine-adverse event relationships, including MMR vaccine and autism and inactivated influenza vaccine and asthma episodes. However, for the majority of cases (135 vaccine-adverse event pairs), the evidence was inadequate to accept or reject a causal relationship. Overall, the committee concludes that few health problems are caused by or clearly associated with vaccines.

Report at a Glance

Graphic: Strength of Evidence that Determined the Causality Conclusions (PDF, HTML)

Press Release (HTML)

RANKING VACCINES

Ranking Vaccines: A Prioritization Framework - Phase I: Demonstration of Concept and a Software Blueprint

From the Institute of Medicine. Best viewed at

http://www.iom.edu/Reports/2012/Ranking-Vaccines-A-Prioritization-Framework-Phase-I.aspx

Released: May 10, 2012

Access the recorded webinar: http://www.iom.edu/smartvaccineswebinar

As a number of diseases emerge or reemerge, thus stimulating new vaccine development opportunities to help prevent those diseases, it can be especially difficult for decision makers to know where to invest their limited resources. Therefore, it is increasingly important for decision makers to have the tools that can assist and inform their vaccine prioritization efforts.

In this first phase report, the IOM offers a framework and proof of concept to account for various factors influencing vaccine prioritization—demographic, economic, health, scientific, business, programmatic, social, policy factors and public concerns. Ranking Vaccines: A Prioritization Framework describes a decision-support model and the blueprint of software—called Strategic Multi-Attribute Ranking Tool for Vaccines or SMART Vaccines. SMART Vaccines should be of help to decision makers. SMART Vaccines Beta is not available for public use, but SMART Vaccines 1.0 is expected to be released at the end of the second phase of this study, when it will be fully operational and capable of guiding discussions about prioritizing the development and introduction of new vaccines.