Introduction and Sustainable Use of Vaccines in Developing CountriesColloquium Considers Vaccine Availability to World’s Poor

International public health, government,

and industry experts convened October

19-21 for the 12th Sabin Vaccine Policy

Colloquium, which focused on the “In-

troduction and Sustainable Use of Vac-

cines in Developing Countries.” The col-

loquium, sponsored by the Bill & Melinda

Gates Foundation, was conducted at the

Banbury Center of Cold Spring Harbor

Laboratory in Lloyd Harbor, New York.

The past 12 years, the Institute has

organized a meeting where experts con-

sider a vaccine policy issue of global im-

portance. The group set out to address

some of the most critical issues facing

financiers, industry and the developing

countries that receive or need funds for

vaccine purchase; define performance

criteria that can help benefactors and

developing countries measure their

progress; and make realistic recommen-

dations that best enhance the prospects

for sustained use of needed vaccines in

developing economies. Topics included

developing country challenges for long-

term immunization programs, vaccine fi-

nancing, vaccine supply, political com-

mitment, and how best to coordinate the

working relationships and responsibilities

among the myriad of organizations that

provide assistance for immunization pro-

grams.

The 35 participants represented mul-

tilateral agencies, and the manufactur-

ing sector with international delegates

from countries including Angola, Bra-

zil , Ethiopia, Ghana, Guyana,

Mozambique, Sudan, Tanzania,

Uganda, Vietnam, and Zimbabwe. Co-

chairs were Kevin Reilly, an expert on

vaccine production and marketing, and

Francisco F. Songane, MD, MPH,

MSc, former minister of health of

Mozambique.

Steve Landry, senior program officer

for Global Health Strategies at the Bill

& Melinda Gates Foundation, said, “It

is unacceptable that millions of children

in developing countries die each year be-

cause they weren’t immunized.” He

added that “[the colloquium can] address

some of the most important obstacles to

expanding access to lifesaving vac-

cines.”

“Vaccination programs that can be

sustained over a long period of time will

be essential to the health and well being

of generation after generation of chil-

dren in developing countries,” said Dean

Mason, SVI president. “The stakes, in

terms of life quality and human suffer-

ing, are most significant.”

The proceedings of the colloquium,

including recommendations reached dur-

ing the consensus, will be published in

the early part of 2006.

Read from the colloquium keynote

address by Sir George A.O. Alleyne,

MD on page 6.

SVI Vaccine PolicyColloquium del-egates review pre-sentation notes:from left, Jean-MarieOkwo-Bele, direc-tor, Immunization,Vaccines andBiologicals, WorldHealth Organization;Davies Dhlakama,director, TechnicalServices, Ministry ofHealth, Zimbabwe;and Mary Kitambi,EPI manager, Dar esSalaam, Tanzania.

Sabin Vaccine

The newsletter of the Albert B. Sabin Vaccine Institute — dedicated to disease prevention

R E P O R TVolume VIII, Number 3

Winter 2005

I nsidePresident’s Message ......................... 2Colloquium on Varicella Vaccine ... 3ViewPoint: Neglected Diseases ........ 4Cancer Vaccine Consortium News .... 5Book Corner ................................... 8ACIP Recommendations .................. 9Interview: Communicating About

Children’s Health ....................... 10Calendar ........................................ 11

www.sabin.org

Photo

by

Mir

iam

Chua,

CSL

.

Sir George Alleyne discusses im-

munization and human develop-

ment, page 6.

WINTER 2005 SABIN VACCINE REPORT2

A Top-Ten List of Vaccine NeedsMessage from SVI President, Dean D. Mason

I acknowledge a certain affinity for top-ten rankings,ranging from David Letterman’s nightly subjects tothe best ten teams in different sports. In that spirit Ihave prepared a list of the vaccine and immunizationissues that I believe to be among the most criticaltopics that we must address.

10... Clone the Bill & Melinda GatesFoundation It is probably not fair to single outone group when there are a number ofphilanthropic organizations committed to thepromotion of good health through globalvaccination programs. However, the impact of thisfoundation cannot be denied. The commitment ofother philanthropic groups gives greater globalpromise for the equal access of all children to lifesaving vaccines.

9... Vaccine Stockpiling Domestic vaccinesupply shortages remain a very real threat. Thoughsome progress has been made, we need to establisha six-month vaccine inventory for each of ourroutinely recommended pediatric vaccines.

8... Vaccines Against Bioterrorism Continueto support vaccine research, development andpreparedness plans in anticipation of terrorist threatsto introduce infectious organisms into our society.

7... Liability Protection and Fair Compen-sation To better assure a viable industry andproduce vaccines at reasonable costs, manufacturersneed government protections against frivolous orfinancially excessive lawsuits. An equal responsibilityis to assure there is adequate compensation (mostoften through the Vaccine Injury CompensationProgram) for those rare instances when a child isinjured or dies as a consequence of a vaccination.

6... Parental Education and Vaccine SafetyThrough the use of good and transparent science,promote the use of safe and effective vaccines thatincludes appropriate information on the benefitsversus risks. Both the public and health careproviders must be adequately informed on true risksversus unsubstantiated or unlikely claims thatdiscredit life-saving vaccines or discourage parentsfrom fully protecting their children against vaccinepreventable diseases at the age appropriate times.

5... Pandemic Influenza Planning andResponse Through November 29, 2005 WHOhas reported 133 laboratory confirmed avianinfluenza cases with 68 deaths. The Spanishinfluenza of 1918-1919 should be a grim reminderthat we cannot await the domestic introduction of adeadly pandemic influenza strain before we respond.Our plan must include early global detection, rapidresponse, anti-virals and treatment supports,stockpiling and the mass production of as safe and

Dean D. Mason

The Sabin Vaccine Report

is published by the

Albert B. Sabin Vaccine Institute

Subscriptions are free. Direct inquiries to:

SABIN VACCINE REPORT1889 F Street, N.W., Suite 200S

Washington, DC 20006-4400

phone: 202.842.5025/fax: 202.842.7689

www.sabin.org/email: sabin@sabin.org

EDITOR

Raymond MacDougall

COPY EDITOR

David Bedell

OFFICERS OF THE SVI BOARD OF TRUSTEES

H. R. Shepherd, DSc, Chairman

William R. Berkley, Co-Chairman

Michael E. Whitham, Esq., Secretary/Treas.

SVI STAFF

Dean D. Mason, President/CEO

Fran G. Sonkin, Executive Vice President

Ciro de Quadros, MD, MPH, Director,

International Programs

Robert Allen, MD, Health and Science

Director

David Bedell, Director, Educational

Programs

Karen Bodick, Assistant to the Chairman

Ana Carvalho, Assistant to the Director,

International Programs

David J. Diemert, MD, Chief Medical

Officer, HHVI

Kristin Lee, Assistant to the President

Raymond MacDougall, Director of Commu-

nications

Jean Mitchell, Development Officer

Noor Seddiq, Fiscal and Grants Manager

Ami Shah-Brown, PhD, MPH, QA &

Regulatory Manager, HHVI

Kari Stoever, CCRP, Program Director,

Human Hookworm Vaccine Initiative

SVI ADVISORS

Philip K. Russell, MD, Senior Advisor to the

Chairman

Peter J. Hotez, MD, PhD, Senior Fellow &

Chair, Scientific Advisory Council

Anne Gershon, MD, Co-chair, Scientific

Advisory Council

Hugh E. Evans, MD, Sabin Fellow

William Muraskin, PhD, Sabin Fellow

Patricia Thomas, Sabin Fellow

Nancy Gardner Hargrave, Development

Counsel

_____

The Sabin Vaccine Institute gratefully

acknowledges the generous unrestricted

educational grant from Chiron Foundation to

support the publication of this newsletter.

effective a vaccine as canbe developed under thecircumstances.

4... More VaccineM a n u f a c t u r e r sBetween 2000 and 2004in the United States weexperienced vaccineshortages in nine of the 13vaccines that were a part of the routine pediatricschedule. For seven vaccines we are now dependentupon only one manufacturer. An additional concernto supply disruptions is manufacturing capacity.

3... Support for the Research andDevelopment of New Vaccines We must expandour commitment to find safe and effective vaccinesagainst AIDS, Malaria and Tuberculosis. We mustalso add to the armamentarium by developingvaccines against “orphan diseases” such ashookworm and schistosomiasis. Another excitingarea with much promise is in support of research todevelop anti-cancer vaccines.

2... Global Vaccination Programs Those mostimpoverished suffer the most from diseases that arepreventable through vaccination. We are in need ofa global strategy that will allow for the supply ofvaccines in a sufficient and timely way to all infantsand children. The major issues involve adequateand sustainable funding, government commitmentsand affordable pricing that includes necessaryprofits for those manufacturing the vaccines.

...and most importantly

1... Adequate Vaccine Financing In the UnitedStates the introduction of each new vaccine brings acrisis in funding. States express concerns aboutunfunded mandates, insurance companies can beslow in adding coverage and children served throughERISA plans or who do not have adequate insurancemay have no vaccine benefits whatsoever. Acoordinated and comprehensive strategic financialplan should be developed between the public andprivate market forces that shape our health caredelivery systems. The plan would systemize coveragefor infants, children, adolescents and adults.

What subjects would you add or subtract from thislist? How would you re-prioritize? I would welcomeyour feedback. Please feel free to email yoursuggestions to sabin@sabin.org.

Sincerely,

Dean D. Mason

dedicated to disease prevention www.sabin.org 3

Many of the world’s leading experts

on the varicella-zoster virus (VZV)—

which causes chickenpox (varicella),

shingles (herpes zoster) and postherpetic

neuralgia (PHN)—convened in New

York on Nov. 7, 2005 at the

New York Academy of Medi-

Colloquium Assesses 10 Years of Chickenpox VaccinationNewly-Approved MMRV and Potential Shingles Vaccine Also Focus of Global Forum

rubella, and varicella vaccine) [see re-

lated news brief on page 9], the ef-

fectiveness of an experimental shingles

vaccine in reducing the incidence of

shingles, and the potential need for a

varicella vaccine booster shot to en-

hance immunity.

Faculty presenters at the colloquium

included infectious disease experts from

68

C O L LO Q U I U M O N T H E

VARICELLA VACCINEA D E C A D E O F P R E V E N T I O N & T H E WAY F O RWA R D

V A R I C E L L A , H E R P E S Z O S T E R , P H N

Live, attenuated varicella vaccinewas licensed in 1995 and is recom-mended for susceptible persons 12months of age. It is well recognizedthat the efficacy of a vaccine as it isused in clinical practice, also referredto as effectiveness, may be differentfrom that in the setting of a carefullycontrolled clinical trial. As with othernew vaccines, numerous questionshave emerged since licensure re-garding varicella vaccine’s use andeffectiveness.

Post licensure studies have foundvaricella vaccine to be highly effective(80-90%) in preventing varicella dis-ease of any severity—its effectivenessreaching almost 100% against mod-erate and severe cases of the infec-tion. However, as the proportion ofchildren in the U.S. who have receivedthe varicella vaccine has increased,there have been several reports inwhich the effectiveness of vaccine wassubstantially lower than expected. Inparticular, reports during outbreaksof varicella in children have noted in-creases in breakthrough disease inthose vaccinated at an age less than15 months, in children with asthma,in those who have received the vari-

cella vaccine soon after the MMR vac-cine (<28 days), and in children whohave received the vaccine more than 3years before developing disease.

Duration of immunity after varicellavaccine continues to be an importantquestion of public health concern; ifimmunity is not long lasting, then willbooster doses of vaccine be required?Post-licensure studies following vac-cines for up to 10 years after immuni-zation have shown that the long-termeffectiveness of the vaccine remainsgood. Nevertheless, it should bepointed out that these studies haveassessed the effectiveness of the vari-cella vaccine in an environment inwhich primary varicella infections andnatural boosting of immunity are stillcommon. It is unknown if and howthe effectiveness of the vaccine willchange once natural boosting of indi-viduals ceases to occur.

An ongoing community-based case-control study of children withchickenpox has found no statisticallysignificant differences in the overalleffectiveness of varicella vaccine inchildren immunized at <15 monthsof age compared to those who havereceived the vaccine at >15 months

of age, but found that the vaccine’seffectiveness in the first year after vac-cination was substantially lower inthose vaccinated at <15 months ofage. Currently, available data do notsupport a delay in the earliest recom-mended age of immunization, as thebenefit of increased effectivenesswould have to be balanced againstboth the risk of leaving children un-protected for 3 months and againstthe possibility that such children maynot return at a later time for immuni-zation with varicella vaccine.

Widespread use of varicella vaccinein the US over the last 10 years hasresulted in significant changes in theepidemiology of this viral infection—most notable, a dramatic decline inits annual incidence. Although recentreports of vaccine failures in outbreaksettings have sparked controversy andengendered multiple questions re-garding varicella vaccine, undeniably,vaccination remains the most effec-tive approach to prevent disease. Well-designed, controlled studies that cancontinue to monitor disease and as-sess varicella vaccine and its effectsover time are necessary to guide fu-ture vaccine policies.

The following abstract, The Effectiveness of Varicella Vaccine, 10 Years Later, is

from the presentation at the Colloquium on Varicella Vaccine by Marietta

Vazquez, MD, Yale University (Reprinted with permission of the author)

Continued on page 12

Among the full schedule

of presentations, the

abstract at right

represents one of the many

excellent scientific reports

delivered at the

colloquium.

cine for a colloquium that co-

incided with the 10-year an-

niversary for the licensure of

the vaccine in the United

States. The “Colloquium on

the Varicella Vaccine: A De-

cade of Prevention & the

Way Forward,” was jointly

sponsored by the Sabin Vac-

cine Institute (SVI) and The

New York Academy of Medi-

cine. SVI Scientific Advisory

Council co-chair Anne

Gershon, MD, Columbia Uni-

versity College of Physicians

and Surgeons, chaired the col-

loquium steering committee.

Global VZV issues re-

ceived the focus of attention

at the meeting, including the

impact of the vaccine in dis-

ease reduction, the FDA’s

recent approval of MMRV

(combined measles, mumps,

WINTER 2005 SABIN VACCINE REPORT4

Controlling Neglected Tropical Diseases Could Help Make Poverty HistoryFrom the Open Access Journal, PLoS Medicine, Available at www.plosmedicine.org

“The big three” infections—AIDS,

TB and malaria—have caught the

world’s attention but other disabling and

fatal infectious diseases in Africa are

being ignored, say three eminent tropi-

cal disease researchers in the interna-

tional health journal PLoS Medicine.

The article by David H. Molyneux,

Peter J. Hotez, and Alan Fenwick con-

siders the neglected tropical diseases,

which include sleeping sickness, river

VIEWPOINT

All works published in PLoS Medicine are open

access. Everything is immediately available without

cost to anyone, anywhere—to read, download,

redistribute, include in databases, and otherwise use—

subject only to the condition that the original

authorship is properly attributed. Copyright is

retained by the authors. The Public Library of Science

uses the Creative Commons Attribution License.

blindness, hookworm, elephantiasis, and

blinding trachoma. These diseases af-

fect several hundred million people, and

kill at least half a million annually, yet

they garner little attention from donors,

policymakers, and public health officials.

The researchers argue that a “rapid

impact package”—

distribution of four

anti-parasitic drugs

across Africa to treat

seven neglected dis-

eases—would bring

tangible benefits to

the world’s poorest

communities.

The cost of the

package, they say,

would be negli-

gible—a mere 40

cents per person per

year, compared with

$200 per person per

year to treat HIV/

AIDS, $200 to treat

a single episode of

Geographic Overlap of the Neglected Tropical Diseases (Molly Brady, Emory University)

TB, and $7-10 to treat a single episode

of malaria.

Three of the drugs in the package

(ivermectin, azithromycin, and

albendazole) are being donated by their

manufacturers, and the fourth

(praziquantel) now costs only 7 cents per

tablet. The researchers suggest that a

rapid impact package against some of

the neglected tropical diseases could

permanently reduce their incidence.

For costs that are relatively modest

compared to controlling “the big three,”

an integrated control package for ne-

glected tropical diseases could have a

proportionately greater impact on more

poor people’s health as well as being

more equitable for the majority of

Africa’s poorest and marginalised com-

munities.

The researchers “urge policy makers

and health economists to recognize that

although HIV, TB, and malaria are the

most serious problems facing health

planners, other diseases exist that can

be addressed at realistic costs with ef-

fective interventions.”

“Controlling Africa’s neglected dis-

eases is one of the more convincing

ways to ‘make poverty history’ through

affordable, pro-poor, effective, and

tested strategies.”

Citation: Molyneux DH, Hotez PJ,

Fenwick A (2005) “Rapid-impact inter-

ventions”: How a policy of integrated

control for Africa’s neglected tropical

diseases could benefit the poor. PLoS

Med 2(11): e336.

The authors were cited in a story ap-

pearing in the Oct. 10, 2005 BBC News

World Edition and the October 11, 2005

edition of The Guardian.

Range of Treatment Costs/Year for Treating HIV/AIDS, TB,Malaria, & Neglected Tropical Diseases (“Rapid ImpactPackage”)

dedicated to disease prevention www.sabin.org 5

Cancer Vaccine Consortium UpdateCancer Vaccine Trials and ELISPOT Proficiency Take Spotlight

The Sabin Vaccine Institute spon-

sored the workshop of the Cancer

Vaccine Clinical Trials Working Group

(CVCTWG), Nov. 10, 2005, and the

meeting of the Cancer Vaccine Con-

sortium (CVC), November 13-14, in

Alexandria, Virginia.

Cancer Vaccine Clinical

Trials Workshop

The CVCTWG was a yearlong,

multi-disciplinary, international joint ini-

tiative of the CVC and the Interna-

tional Society for the Biological

Therapy of Cancer (iSBTc). Over

150 stakeholders of the cancer vac-

cine community, representing academic

institutions and biotech and pharma-

ceutical industries, came together at

the culminating workshop to reach a

broad consensus on a new paradigm

for clinical trials. In addition, the

CVCTWG was strongly supported by

representatives from regulatory au-

thorities through active participation in

its discussions.

The workshop addressed four broad

topics: 1. Clinical Endpoints to Support

Efficacy, 2. Design Methodologies for

Cancer Vaccine Trials, 3. Technical

Challenges in Cancer Vaccine Trials,

and 4. Enabling Technologies and Com-

binations of Investigational Agents.

“The CVCTWG initiative was char-

acterized by an unprecedented degree

of open discussion and collaboration

between a broad array of major stake-

holders in cancer immunotherapy de-

velopment,” said Axel Hoos, MD,

PhD, of Bristol-Myers Squibb Global

Clinical Oncology, one of the four

workshop organizers. “It is remark-

able that the consensus reached on the

clinical development paradigm for can-

cer vaccines and related immunothera-

pies can be regarded as representa-

tive for the entire field.”

The group is now in the process of

submitting reports for publication in

scientific journals. A report will also

be given to the FDA as the basis for a

guidance document governing drug

development and approval processes

for cancer vaccines.

ELISPOT Proficiency Panel

Sylvia Janetzki of ZellNet Consult-

ing presented the results to date of the

largest ELISPOT proficiency panel

ever conducted. Thirty-six labs in nine

countries participated in this standard-

ization and validation experiment and

then met in Alexandria to discuss re-

sults and next steps. A follow-up

ELISPOT panel will be conducted in

2006, and new initiatives for Tetramer

and Cytokine assays are in the works

as well. Laboratories interested in

participating should contact CVC Ex-

ecutive Director Susan Geiger.

In addition to these working group

accomplishments presented at the

meeting, three keynote speakers

shared their perspectives from indus-

try, regulatory, and academic back-

grounds. Rachel Humphrey, MD,

Vice President of Global Immuno-On-

cology at Bristol-Myers Squibb, spoke

on the limitations and promises of can-

cer vaccine research, reviewing a va-

riety of single-agent and combination

vaccine strategies. Celia Witten,

MD, PhD, Director of the Office of

Cellular, Tissue and Gene Therapies

(OCTGT) at the Center for Biologics

Evaluation and Research (CBER), pre-

sented the workings of OCTGT, in-

cluding early and late phase clinical

development plans, how to interact

with FDA, guidance documents and

other FDA resources available for

product development. Carl June,

MD, Director of Translational Re-

search at the Abramson Cancer Cen-

ter at the University of Pennsylvania,

discussed combination immunotherapy

and showed how vaccination may re-

store tumor immunity and lead to im-

proved outcomes following high dose

chemotherapy.

by H.R. Shepherd, Chairman, SVII recently read a New York Times op-ed that

took to task the good intentioned efforts ofwealthy and celebrity philanthropists. The au-thor had experience serving in the Peace Corpsin a developing country and a perspective thatpoor countries would do better to eschew thecharity garnered by wealthy or celebrity West-erners whose efforts he characterized as“dumping more money in the same old way.”

This op ed represented, I believe, a simpli-fied and skewed perspective. It simplifies theefforts of wealthy and celebrity philanthropists,prejudicing their efforts as uninformed andbrash. It skews good intent, since the goal ofphilanthropy is to buoy the underserved anddemonstrate compassionate humanity.

What the author of that op ed might not real-ize is the degree of scientific rigor and eco-nomic analysis that precedes the allocation offunding for global development and health pro-grams. Decisions about where funds are tar-geted are conducted in an atmosphere of sci-entific expertise and consultation. There alsoexists a high degree of accountability for use offunds dispersed. At least that is the case for thefoundations with which I have been impressed.

Sure, the Western media enterprise putsimmense value on celebrity voice and popularreach. So be it. The economists and scientiststhat work behind the scenes to develop medi-cines and vaccines and programs to reach theimpoverished may not have a popularity tomatch such celebrity voices. But they work to-ward a goal of providing for the underservedand desperately in need the hope of globalhealth and economic relief that may ultimatelylead to freedom from neglect and underdevel-opment.

Given the resources of wealth or celebrity, itis far better that these be utilized for the benefitof the poor and underserved, than if they con-tinue to benefit only the economic and enter-tainment interests of popular Western culture.Wealthy and celebrity philanthropists, or anycharitable contributors, play a role that isunique and is among the best things that theycan do with the resources at their disposal.

Say It Ain’t SoStraightening the Record on

Uncharitable Op Ed

WINTER 2005 SABIN VACCINE REPORT6

I call this talk “An Apology for Immuniza-tion.” I use the word “apology” in the origi-nal sense of the Greek term as Socrates usedit—”apologia”—”a speech in defense of.”So this is a speech in defense of immuniza-tion, and why immunization needs to be de-fended if it is to achieve the proper place thatit richly deserves.

The hypothesis proposed to me for com-ment is: “If we provide the vaccines we al-ready have to all who need them, we will con-tribute to health and human development.”

Human DevelopmentAmong at least three books that I have read

and reread over the last few years is the UNDP1990 Human Development Report. In it, forthe first time much of the thinking of theeconomists actually got synthesized into someidea of what human development stood for.Let me quote from what Mahbub ul Haq wrotein the 1990 report: “People are the realwealth of a nation. The basic objective ofdevelopment is to create an enabling envi-ronment for people to live long and creativelives. Human development is a process of en-larging people’s choices. In principle, thesechoices can be infinite, and they can changeover time. But at all levels of development,the three essential ones are for people to livea long and healthy life, to acquire knowledge,and to have access to resources needed for adecent standard of living.”

Role of Health in Human DevelopmentThere has been a consensus about the

contribution of health to a country’s economicgrowth only over the last 15 or 20 years.Nobel Prize winner Robert Fogel points outthat some 30 to 50 percent of Europe’s eco-nomic growth in the 19th century was due tohealth and nutrition.

Health figures prominently among thethings that contribute to economic growth.By good health we contribute to the quantityand the quality of the capital stock. Everyoneagrees now that human capital is criticallyimportant for economic growth. So, healthdoes contribute fundamentally to the quan-

Immunization for All — A Condition for Health and DevelopmentFrom the Keynote Address by Sir George A.O. Alleyne to the

12th Sabin Vaccine Institute Annual Vaccine Policy Colloquium, October 19, 2005

tity and quality of the human capital stock.Also, savings rates are higher in countries

that are healthier. As people are healthier andhave a better perspective on what life has tooffer, their savings rates increase. We knowthat increasing savings leads to increasedeconomic growth.

David Bloom describes the phenomenonof a demographic dividend, which is relatedto immunization—I will explain how thatphenomenon can be responsible for muchof a country’s economic growth.

The negative aspect, of course, is alsoobvious. If there is ill health, then there is acost of illness, and the cost of illness is notborne only by the person who is ill, but thepersons who are a part of his or her sup-port group. Numerous studies show thedirect and indirect costs of illness. It is alsowell establ ished that heal th leads toincreased productivity. We know from stud-ies that whatever metric you use of a country’sinvestment in health, after a suitable lag pe-riod, you can see that investment reflectedin economic growth.

More recently, economists have decidedthat the products and income accounts thathave been the standard ingredients in grossdomestic product do not really reflect actualhuman welfare, and they have come up withother metrics. They have established a mea-sure of full income which adds a value of lifeexpectancy to GDP. They point out that in theUnited States, certainly, the contribution ofhealth to full income is as great as the contri-bution of goods and services.

Role of Vaccines in Health’s Contribu-tion to Human Development

How does immunization contribute? Sim-plistically, one could say that vaccines pre-vent deaths; therefore, they must contributeto economic growth. But let us examine this abit further and try to separate out some of thediverse functions of immunization.

We would all agree, I think, that child-hood immunization prevents deaths. We allwould agree that much of the increased life

expectancy at birth is due to childhoodimmunization.

For eight years I worked in nutrition, mainlyon child malnutrition. It was tragic to seechildren start with measles, have recurrentbouts of infection, and then becoming moreand more malnourished, until they eventu-ally would die. I had absolutely no doubt thatthe application of the antigens known thenwould stop a child from stepping onto thatslippery slope which would lead inevitably todeath, and that immunization against measlesis a potent protector of a child’s nutrition.

I mentioned the demographic dividendand the extent to which health contributes toit. The evidence from all over the world showsthat decreased child mortality is followed bya fall in fertility. As child mortality falls andfertility falls later on, there is a gap in whichthere is a bulge of persons with the capacityto produce. Given the other infrastructurenecessities or possibilities, you find that bulgeof persons of a productive age contributesenormously to a country’s economic growth.It has been shown in such “Asian tigers” asKorea and Singapore that demographic divi-dend corresponds very well with take-off interms of their economic growth.

In cases in which immunization has animpact in reducing child mortality and in-creasing life expectancy, the effect is to con-tribute to the quantity of the capital stock.

Sir George A. O. Alleyne, MD

dedicated to disease prevention www.sabin.org 7

Participants in the 2005 Sabin Vaccine Institute Vaccine Policy Colloquium assembled for the groupphoto above, include Kwadwo Odei Antwi-Agyei, MD, National EPI manager (Ghana); Jon Kim Andrus,MD, Pan American Health Organization (Washington, DC); Tesfanesh Belay, Ministry of Health (Ethiopia);Jean-Marie Okwo-Bele, MD, MPH, World Health Organization (Switzerland); Louis Z. Cooper, MD, ColumbiaUniversity (New York, NY); Rudolph O. Cummings, MD, MPH, Ministry of Health (Guyana); Ciro A. deQuadros, MD, MPH, SVI (Washington, DC); Davies Dhlakama, Ministry of Health (Zimbabwe); MaryHarvey, USAID (Washington, DC); Stephen Jarrett, UNICEF-Supply Division (New York, NY); Samuel L.Katz, MD, Duke University Medical Center (Durham, NC); Mary Kitambi, EPI manager (Tanzania); GeoffreyLamb, World Bank (Washington, DC); Steve Landry, PhD, Bill & Melinda Gates Foundation (Seattle,WA); Luciana de Cerqueira Leite, PhD, Butantan Institute (Brazil); Ruth Levine, Center for GlobalDevelopment (Washington, DC); Julian Lob-Levyt, GAVI (Switzerland); Dean D. Mason, SVI (Washington,DC); Raymond MacDougall, SVI (Washington, DC); Adel Mahmoud, MD, PhD, Merck and Co., Inc.(Whitehouse Station, NJ); Issa Makumbi, Ministry of Health (Uganda); Lewis A. Miller, WentzMiller andAssociates LLC (Darien, CT); Samantha Naidoo, World Bank (Washington, DC); Deo Nshimirimana,World Health Organization (Congo); Melanie H. Ram, PhD, Japan International Cooperation Agency(Washington, DC); Kevin L. Reilly, former president, Wyeth Vaccines and Nutrition, SVI trustee (US);Francisco F. Songane, Former Minster of Health (Mozambique); Hilary Sunman, Department forInternational Development (London, UK); Fatima Valente, EPI manager (Angola); Walter Vandersmissen,GSK Biologicals (Belgium); Nguyen Van Cuong, MD, MCTM, National EPI (Vietnam); Maja Zecevic, PhD,MPH, The Lancet (New York, NY).

We know that there are good data fromeconomists showing the value of dollars in-vested in immunization. Studies in this coun-try show that when children are vaccinatedagainst nine vaccine-preventable diseases,this can save almost $18 in direct and indi-rect costs of illness.

The October 13, 2005 article “Vaccination:A Drop of Pure Gold,” in The Economistpoints out that an investment in GAVI is goodbusiness; that in the short term there is a12 percent return, and over the long termthis increases to 18 percent

What about immunization and health interms of education? Again, there is no doubtthat immunization of children makes themhealthier, more able to learn. But anotherimportant component, which was pointed outsome 30 years ago, is that life expectancy,when it increases, allows an increase of thereturns from investment in education. If youdie at age twenty-five, you have lost most ofthat investment in your education.

So immunization, primarily by increasinglife expectancy at birth, is likely to lead to agreater return from the investment in educa-tion, not to speak of the quality of life of thechildren who have been immunized.

You can’t look at the effect of immuniza-tion apart from economic growth and edu-cation. We in PAHO have been very keen onthe idea that things like immunization havehelped to reduce the possibility of war. Thereis no doubt that war—certainly war in thecountries that are warring—is a great deter-rent to those countries’ economic growth.

Something engraved in my memory foreveris going to El Salvador during the period whenthe whole of Central America was riven bywar and conflict, and going there to partici-pate in a national immunization day. On thatday, not a shot was fired. The guerillas cameup in their jeeps saying, “Bring out your chil-dren,” and the government forces came andsaid, “Bring out your children.” They wentback to fighting afterward, but on that day nota single shot was fired.

We know the impact of health on economicgrowth; that is now well described. We knowthe power of immunization; that is wellknown. Yet we are still contending with twomajor overriding challenges: that safe andeffective vaccines are lacking for some old

infectious diseases and for the new andemerging infectious diseases, and that evenwhen we have the vaccines, they are notemployed on an appropriate scale.

Success, Otherness, and ModestyI would posit three reasons for this. One is

the seduction of success; two is the obscenityof otherness; and three is the modesty ofmedicine. I would cite the seduction of suc-cess, the obscenity of otherness, and themodesty of medicine as reasons for our diffi-culty in surmounting the two challenges.

The seduction of success. The world en-tered a period of apathy after the great fan-fare of the elimination of smallpox. The suc-

Continued on page 9

cess that came with smallpox and the discus-sion about the savings resulting from small-pox immunization, have seduced us into notdoing as much as we should.

About the obscenity of otherness. Per-haps until very recently there was not the con-cept of a global partnership, a global interre-lationship. There has been humanitarian as-sistance for “the others.” There is the viewthat charity is fine, but it is not quite so goodto engage in cooperation. Our experience inPAHO has corrected this misperception. If youput forward the right scheme then it is pos-sible to demonstrate to all countries that theywill all benefit. Although it is accepted that

Photo

by

Mir

iam

Chua,

CSL

.

WINTER 2005 SABIN VACCINE REPORT8

BOOKCORNER

New Book by Dr. Paul Offit Explores Impact of Cutter Incident

Vaccines have saved more lives than

any other single medical advance. To-

day, however, only four companies make

vaccines for the US market, and there

is a growing crisis in vaccine availabil-

ity. Why has this happened? A new

book by Paul Offit, MD, The Cutter

Incident: How America’s First Polio

Vaccine Led to the Growing Vaccine

Crisis, explores this question in histori-

cal detail and current perspective.This

remarkable book recounts for the first

time a devastating episode in 1955 at

Cutter Laboratories in Berkeley, Califor-

nia, that set the stage for many pharma-

ceutical companies abandoning vaccine

manufacture.

Drawing on interviews with public

health officials, pharmaceutical com-

pany executives, attorneys, Cutter em-

ployees, and victims of the vaccine, as

well as previously unavailable archives,

Dr. Paul Offit offers a full account of

the Cutter disaster. He describes the

nation’s relief when the polio vaccine

was developed by Jonas Salk in 1955,

the production of the vaccine at indus-

trial facilities such as the one operated

by Cutter, and the tragedy

that occurred when 200,000

people were inadvertently in-

jected with live virulent polio

virus: 70,000 became ill, 200

were permanently paralyzed,

and 10 died. Dr. Offit also

explores how, as a conse-

quence of the tragedy, one

jury’s verdict set in motion

events that eventually sup-

pressed the production of

vaccines already licensed and

deterred the development of

new vaccines that hold the promise of

preventing other fatal diseases.

“Dr. Offit brings us into the entangled

world of medicine and law. Readers will

have a better understanding of the im-

pact that legal suits have on the vaccine

industry, investment, and decisions not

to pursue lifesaving vaccines because

of liability issues,” said Dean Mason,

SVI president.

ISBN:0300108648Publish Date:10/10/2005Publisher:Yale University Press

David J. Diemert, MD, FRCPC Joins SVI Human Hookworm Vaccine Initiative Team

Dr. David J. Diemert

David J. Diemert,

MD, FRCPC recently

joined the SVI’s Hu-

man Hookworm Vac-

cine Initiative as chief

medical officer. He

will direct the HHVI

clinical development

program, including

oversight of the plan-

ning and execution of

all clinical trials of

HHVI candidate vac-

cines in both the United States and in en-

demic areas. With the ongoing field trials

in Minas Gerais, Brazil, and with the ap-

proaching Phase I clinical trials, Diemert

has visited the site twice this past fall.

Formerly, Diemert served for four

years as staff clinician/clinical trialist at

the Malaria Vaccine Development

Branch, (MVDB) National Institute of

Allergy and Infectious Dis-

eases, National Institutes of

Health. There, he was princi-

pal investigator on Phase 1

clinical trials of candidate ma-

laria vaccines in Mali, West

Africa. He was also co-inves-

tigator on multiple Phase 1 tri-

als of malaria vaccines in the

United States and had over-

sight of the clinical program of

the MVDB in Mali, which in-

cluded establishing clinical test-

ing sites, performing large-scale baseline

studies of malaria epidemiology and im-

munology, and establishing clinical labo-

ratory testing facilities in the field.

He has also served as an attending

consultant physician in the Department

of Infectious Diseases and Microbiol-

ogy, Royal Victoria and St. Mary’s Hos-

pitals, in Montreal, Quebec. As an at-

tending physician on the infectious dis-

eases service for these two large ter-

tiary care teaching hospitals, he taught

medical students and internal medicine

residents and directed the hospitals’ mi-

crobiology laboratories.

Diemert received his medical degree

from the University of Alberta in

Edmonton, Alberta and completed his

residency in internal medicine at McGill

University in Montreal followed by a

fellowship in infectious diseases and

medical microbiology at McGill.

“The HHVI team has a clear vaccine

development plan with definite goals in

terms of vaccine trials,” said Diemert.

“The team is a fun and cohesive group

of people but very productive at the

same time. They have a distinct need

for someone with my skills in setting up

a field site for performing vaccine trials

and actually conducting the trials.”

dedicated to disease prevention www.sabin.org 9

Recommendations for MMR+V and Tdap CombinationVaccines Introduced by Advisory Committee

The U.S. Centers for Disease Control and Prevention’s (CDC) Advisory

Committee on Immunization Practices (ACIP) met in Atlanta this past October,

making several recommendations that would take advantage of new vaccine

combinations available in the United States. Expanding its advisement from

earlier in the year, the committee recommended that adults from 19-64 years of

age be vaccinated with a newly licensed adult booster tetanus, diphtheria and

pertussis (whooping cough) vaccine (Tdap); the new vaccine was recommended

in May for adolescents. The committee also recommended use of a new measles,

mumps, rubella, and varicella vaccine and Hepatitis A vaccine for children.

Tdap Addresses Need for Adults to Receive Pertussis Booster

The ACIP recommended that adults receive a booster dose of Tdap vaccine

against tetanus, diphtheria and pertussis if they have not received a tetanus and

diphtheria (Td) booster dose in ten or more years. Adding the pertussis component

to the Td vaccine is an important new development. Pertussis, which can be

very severe and even life-threatening in infants, can be transmitted between

adults and children. In adults, pertussis can result in weeks of coughing, cracked

ribs from severe coughing spells, pneumonia, and other complications. Most

reported pertussis cases among adolescents and adults occur because of decline

in protective immunity, which wanes five to ten years after the last vaccination.

Susceptible infants acquire pertussis, quite often from siblings and parents at

home.

Reported pertussis cases in the United States have increased from a low of

1,020 cases in 1976 to 25,827 cases in 2004, a 40-year high. Reported pertussis-

related deaths among infants increased from about ten per year in the 1990s to

about 20 per year during this decade. According to the World Health

Organization, in 2000, an estimated 39 million cases and 297,000 deaths occurred

worldwide, due to pertussis.

MMRV Should Improve Chickenpox Vaccine Coverage Rates

The ACIP voted to recommend MMRV for inclusion in the Vaccines for

Children Program. The quadrivalent vaccine manufactured by Merck received

FDA approval this past September 2005 and is a combination of two well-

established vaccines against measles, mumps, rubella and the other protecting

against varicella (chickenpox). The vaccine is for children 12 months to 12

years of age. Vaccination with the MMR in the United States has contributed to

a greater than 99 % reduction in the incidence of measles, mumps and rubella,

diseases associated with serious complications that once claimed tens of

thousands of lives each year in this country. Since 1995, the chickenpox vaccine

has contributed to a significant reduction in cases in the United States and

declines in related hospitalizations and deaths. Potential advantages of

combination vaccines include reducing multiple injections, improving timely

vaccination coverage, reducing the costs of stocking and administration of

separate vaccines for health care providers and reducing health care costs for

extra health visits, according to the CDC.

Hepatitis A Recommended for All Children

The committee also expanded to all children its recommendation for

vaccination with hepatitis A vaccine. A 1999 ACIP recommendation called for

vaccinations in states with the highest rates of hepatitis A. The vaccine is to be

administered when a child is between 1 and 2 years of age in a two-dose series.

Sir George AlleyneOffers Insights About

Immunization, Health, andDevelopment

from page 7

immunization will help children in the devel-oping countries, the idea that the economicadvance of those persons or their health isgood for everyone hasn’t gained currency. Istill believe there is room for advocating thatotherness has really no place in health.

About the modesty of medicine. When Ilook at most of the documents that make thecase for immunization, they are cast in wel-fare terms—what a noble thing it is to savethe lives of millions of poor children. It is as ifit is a good thing but it has no instrumentalvalue.

I have learned over the years that it is fineto speak about the constitutive value of health,but you have to also advocate for some in-strumental value to what we do. Let me cite anexample from Jeffrey Sachs’ recent book,speaking of investment and poverty, how somesectors see things differently. He writes: “Con-sider the case of fertilizers, which are cur-rently unused. Fertilizer application of $100per hectare, combined with or substituted byimproved farrows, as appropriate, could raisecrop yields in a normal season from one tonper hectare to three tons per hectare, with amarketable value of the increment of roughly$200-to-$400 per hectare.” That is how theyput their arguments.

What is the solution?Immunization for all is to be seen as a ma-

jor contribution to human development, andnot simply a mechanism for achieving one ofthe Millennium Development Goals. I wouldsay that there is a need for much more ag-gressive advocacy for the reduction in theobscenity of otherness, and certainly muchless modesty on the part of people like our-selves, who have not been brought up to be-lieve that you get what you market.

When these are done, there will be no ques-tion, I think, that immunization will have comein from the cold.

WINTER 2005 SABIN VACCINE REPORT10

Q&A with Peter Hotez, MD, PhD on Communication and Children’s Health RisksResearcher/Pediatrician/Parent Shares Insights from Years of Speaking to the Media about Children’s Health

SR. How are research findings about vac-cines reported to the public and what aresome obstacles?PJH. Our society has some terrific mecha-nisms in place to ensure balanced sciencereporting to the public. All professional sci-entists are aware that their findings must firstbe vetted through peer-review. This ensuresthat data and conclusions are not publishedin scientific journals unless they have beenreviewed objectively by other qualified scien-tists and physicians. A scientist who tries tocircumvent this process is roundly con-demned by scientific societies and fundingagencies, and is usually put out of business inthe process. Helping this system are estab-lished science journalists who honor andrespect the peer-review process and reportfindings in newspapers, magazines, and theelectronic media only after publication. Ibelieve that our nation’s professional sciencejournalists are the unsung heroes in educat-ing the public. This system breaks down inthe rare occasions when scientists (andsometimes pharmaceutical companies) sendpress releases and advertisements to the pub-lic before peer-review. In addition, anotherdamaging circumstance occurs when un-scrupulous parent advocacy organizationshave a bias and misrepresent scientificfindings or conclusions, or even com-pletely ignore the weight of scientific data inorder to promote an agenda.

SR. What is the responsibility of theresearcher in communicating with the pub-lic, especially when consumers are receivingmixed messages?PJH. As a profession, we do not try hardenough to communicate with the public, eventhough we have great advocates and allies inscience journalists and correspondents.When a science journalist contacts us, Ibelieve we have an obligation to take the call.Most biomedical scientists are federallyfunded and it is reasonable to expect that thepublic wants to know what they are getting

for their money. Given our training, commu-nicating with journalists is not something thatcomes naturally. It takes practice to get it right.However, this is worth the investment of time.In the end our willingness to educate the pub-lic about what we do is the best way to eraseignorance and backwardness. Our profes-sional future depends on living in a civil soci-ety with a high degree of scientific literacy.

SR. Where do you stand on the vaccinesand autism debate?PJH. Although vaccines have some welldescribed side effects, from my review of thecurrent data and understanding about thenatural history and genetics of autism, I con-clude that there is no relationship betweenvaccines and autism, nor is there a relation-ship between thimerosal and autism, or evenmercury and autism. Autism is probably oneof our most common heritable genetic syn-dromes, with a prevalence of 3 to 6 per 1,000,and a male to female ratio of 3:1. Astonish-ingly, despite the enormous health and eco-nomic impact of this genetic syndrome, thetotal NIH budget for autism research is lessthan $100 million, or about 1/10th that offunds spent on bioterrorism, and roughly theamount of money we spend in less than aweek on the war in Iraq. As a result, we are inour infancy in identifying the genes linked toautism, other than the two identified so far—chromosomes 7 and 15. We have no geneticscreening and no gene targets to develop newdrugs. I believe this situation exists becauseof the inability of Congress to keep its eyes onthe prize. This in turn is partly because of thedistractions arising from the noise aboutautism and vaccines.

SR. How should consumers weigh andassess the health risks and benefits of vac-cines in a broader context?PJH. The best source of vaccine informationfor parents is still the family pediatrician orpediatric nurse practitioner. Both receive asignificant amount of training on this topic,

Peter J. Hotez, MD, PhD, discusses his position onvaccine safety and the importance of immunization.

The following interview is based on the remarks by Peter J. Hotez, MD, PhD presented at theNational Consumers League’s Risk and the Media Symposium, Oct. 14, 2005. Withpermission from Dr. Hotez, we present the remarks as an interview for our readers’ benefit.

and they are required to be educated aboutvaccines in order to pass board examinations.They know first-hand the consequences ofnot vaccinating children and the deadly na-ture of the diseases that vaccines are designedto prevent. They also can provide reassur-ance that a vaccine adverse-events reportingsystem is already in place, which has had agreat track record of detecting problems in atimely manner. We are learning that the world-wide web is an avenue that must be negoti-ated with some caution, and yet one that can-not be ignored because it is increasingly pro-viding a lion’s share of information and mis-information about vaccines and about autism.Pediatricians and nurses can help by provid-ing URLs of legitimate and balanced websites,and ones that provide some details about thediseases that vaccines prevent.

SR. What other message would you haveabout communicating children’s health risks?PJH. I believe that childhood vaccines rep-resent one of humankind’s greatest victories,having so far saved more lives than all of thelives lost from wars during the 20th century.The fact that the safety record of vaccines hasbeen distorted to the point where some par-ents now think twice about vaccinating theirchild is cause for grave concern. Our nation’spediatric societies and federal agencies needto work closely and think creatively about howthe media can be engaged in order to pre-vent tragic deaths because a child did notreceive his vaccinations or because he re-ceived toxic and off-beat therapies that haveno rational or scientific basis.

dedicated to disease prevention www.sabin.org 11

Ciro de Quadros Receives Honors in Chile, MexicoRecognition Follows Years of Creative Immunization Program Strategies

Fall 2005 was a season of

international recognition for

Director of SVI International

Programs Ciro de Quadros,

MD, MPH. In Chile, he re-

ceived the Order of Bernardo

O’Higgins, and in Mexico he

was named an honorary mem-

ber of the Mexican Academy

of Medicine.

The Order of Bernardo

O’Higgins was established in

1956 to honor distinguished for-

eigners and friends of Chile. It

is the highest honor bestowed

upon foreign citizens for out-

standing contributions to the

arts, sciences, education, in-

dustry or commerce. Captain

General Bernardo O’Higgins

was Chile’s hero of indepen-

dence and first president. The

award was presented in a cer-

emony in Santiago, Chile, by

Minister of Health Pedro

García Aspillaga.

Ciro de Quadros, MD, MPH, director of SVI InternationalPrograms, is congratulated by Chilean Minister of HealthPedro García Aspillaga, upon receipt of the Order BernardoO’Higgins, the highest honor of the government of Chile.

ANNOUNCING OUR

NEW ADDRESSES

National Headquarters1889 F Street, N.W., Suite 200S

Washington, DC 20006-4400Ph. 202-842-5025/Fx. 202-842-7689

Chairman’s OfficeP.O. Box 848

New Canaan, CT 06840-0848Ph. 203-972-7907/Fx. 203-966-4763

Cancer Vaccine Consortium555 E. Wells Street, Suite 1100

Milwaukee, WI 53202-3823Ph. 414-918-3199/Fx. 414-276-3349

www.sabin.org

NPR Reports from Brazil,Site of HookwormVaccine Field Trial

Report Airs in Conjunction withTime Global Health Summit Held

in New York City

National Public Radio Science cor-

respondent Joe Palca and producer

Brigid McCarthy travelled with the

SVI Human Hookworm Vaccine Ini-

tiative team to prepare a report titled,“In Brazil, a New Effort to Wipe OutHookworm,” which aired on October29, 2005. The audio and text of thereport can be accessed atwww.npr.org or at the SVI website,

www.sabin.org. The story was part

of the Global Health: Rx for Sur-

vival: A Global Health Challenge

series, with reports from around the

world on some of the most urgent

emerging global health issues. The

wave of reporting on global health

topics ranged from making affordable

drugs in Africa, to efforts in Vietnam

to head off a flu pandemic, to a re-

port on reaching remote Africa with

new malarial therapy.

SAVE THE DATE

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WINTER 2005 SABIN VACCINE REPORT12

Colloquium Hosted by SVIand NYAM Marks 10thAnniversary of Safe and

Effective Varicella Vaccine

SABINCALENDAR

JANUARY-JUNE 2006January 2006January 30 - February 1 Baltimore, MarylandPhacilitate Vaccine Forum Baltimore 2006www.phacilitate.co.uk

February 2006February 7 - 8 Washington , DCNational Vaccine Advisory Committee (NVAC)Meetingwww.hhs.gov/nvpo/nvacv

February 22 - 23 Atlanta, GeorgiaAdvisory Committee on Immunization Practices(ACIP) Meetingwww.cdc.gov/nip/ACIP/dates.htm

March 2006March 3 - 7 Miami Beach, Florida62nd Annual Meeting of the American Academyof Allergy, Asthma and Immunologywww.aaaai.org

March 6 - 9 Atlanta, Georgia40th National Immunization Conferencewww.cdc.gov/nip/NIC

March 19 - 22 Atlanta, GeorgiaInternational Conference on EmergingInfectious Diseaseswww.iceid.org

March 20 - 23 Washington DCWorld Vaccine Congresswww.lifescienceworld.com/2006/wvcm%5FCA

April 2006April 16 - 20 Varadero, Cuba3rd International Workshop on VaccineAdjuvants and Glycoconjugateswww.finlay.edu.cu/adjuvant

April 19 - 21 Vienna, AustriaSecond International Conference on TBVaccines for the Worldwww.meetingsmanagement.com/tbv_2006

May 2006May 8 - 10 Baltimore, MarylandNinth Annual Conference on Vaccine Researchwww.nfid.org

May 9 Baltimore, MarylandSabin Gold Medal Ceremonywww.sabin.org

June 2006June 6 - 7 Washington, DCNational Vaccine Advisory Committee (NVAC)Meetingwww.hhs.gov/nvpo/nvac

June 12 - 13 Lisbon, Portugal7th International Rotavirus Symposiumwww.sabin.org

June 19 - 21 Amsterdam, The NetherlandsPhacilitate Vaccine Forum Amsterdam 2006www.phacilitate.co.uk

June 20 - 21 Atlanta, GeorgiaAdvisory Committee on Immunization Practices(ACIP) Meetingwww.cdc.gov/nip/ACIP/dates.htm

June 26 - 28 Bethesda, MarylandAnnual Conference on Antimicrobial Resistancewww.nfid.org

June 28 New York, New YorkSabin Annual Awards Celebrationwww.sabin.org

the United States—including the Cen-

ters for Disease Control and Prevention

(CDC) and the National Institutes of

Health (NIH)—in addition to leading

scientists from Australia, Belgium,

Canada, Finland, Germany, Japan and

the United Kingdom. Keynote presen-

tations included a lecture on the research

into the varicella vaccine by its devel-

oper, Michiaki Takahashi, MD, DMSc,

Research Foundation for Microbial Dis-

eases of Osaka University, Japan.

Dalya Guris, MD, MPH, of the CDC,

discussed the impact of the varicella

vaccine since its introduction in 1995.

Michael N. Oxman, MD, chairman of

the Shingles Prevention Study, re-

viewed the findings of a recently-com-

pleted study which concluded that an

experimental zoster vaccine signifi-

cantly reduced the incidence of

shingles and PHN.

The colloquium was attended by SVI

president, Dean D. Mason. “To my

knowledge this was the most compre-

hensive public meeting specifically fo-

cused on varicella, herpes zoster and

shingles--related subjects held to date,”

he said. “The colloquium focused our

attention on the challenges ahead in ad-

vocating for the introduction of safe and

effective vaccines against zoster, pro-

moting studies concerning the need for

a second dose of varicella vaccine, and

evaluating the country’s response to the

introduction of the MMRV combination

vaccine.”

The colloquium received key sponsor-

ship from the Research Foundation for

Microbial Diseases of Osaka University,

Osaka, Japan; GlaxoSmithKline

Biologicals, Rixensart, Belgium; and the

March of Dimes. A forthcoming pro-

ceedings document is in press.

from page 3