Vaccines: The Week in Review

22 February 2010
Center for Vaccine Ethics & Policy
http://centerforvaccineethicsandpolicy.wordpress.com/
A program of
- Center for Bioethics, University of Pennsylvania
http://www.bioethics.upenn.edu/
- The Wistar Institute Vaccine Center
http://www.wistar.org/vaccinecenter/default.html
- Children’s Hospital of Philadelphia, Vaccine Education Center
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp

This weekly summary targets news and events in the global vaccines field gathered
from key governmental, NGO and company announcements, key journals and
events. This summary provides support for ongoing initiatives of the Center for
Vaccine Ethics & Policy, and is not intended to be exhaustive in its coverage.
Vaccines: The Week in Review is now also posted in a blog format at
http://centerforvaccineethicsandpolicy.wordpress.com/. Each item is treated as an individual
post on the blog, allowing for more effective retrospective searching. Given email
system conventions and formats, you may find this alternative more effective. This
blog also allows for RSS feeds, etc.
Comments and suggestions should be directed to David Curry, Editor and
Executive Director of the Center, at
david.r.curry@centerforvaccineethicsandpolicy.org.

The WHO continues to issue weekly “updates” and briefing notes on the
H1N1 pandemic at: http://www.who.int/csr/disease/swineflu/en/index.html
Pandemic (H1N1) 2009 - update 88
Weekly update
19 February 2010
As of 14 February 2010, worldwide more than 212 countries and overseas
territories or communities have reported laboratory confirmed cases of
pandemic influenza H1N1 2009, including at least 15921 deaths.
WHO is actively monitoring the progress of the pandemic through frequent
consultations with the WHO Regional Offices and member states and through
monitoring of multiple sources of information.
Situation update:
The situation is largely unchanged since the previous update. In the
temperate zone of the northern hemisphere, active but declining pandemic
influenza transmission persists in limited areas of eastern and southern
Europe, South Asia, and in East Asia. Several countries in West Africa
reported increases in the number of cases but there is as yet insufficient
evidence to conclude that widespread community transmission is occurring.
An increasing trend in respiratory diseases activity was reported in Thailand
and Jamaica, however the cause of the respiratory disease is uncertain at this
point.
More at: http://www.who.int/csr/don/2010_02_19/en/index.html
 The WHO released “Recommended viruses for influenza vaccines for
use in the 2010-2011 northern hemisphere influenza season,
February 2010.” WHO noted that it “convenes technical meetings1 in
February and September each year to recommend viruses for inclusion in
influenza vaccines for the northern and southern hemispheres, respectively.
This recommendation relates to the influenza vaccines for the forthcoming
influenza season in the northern hemisphere (2010 - 2011). A
recommendation will be made in September 2010 relating to vaccines that
will be used for the influenza season in the southern hemisphere (2011). For
countries in equatorial regions epidemiological considerations will influence
which recommendation (February or September) individual national and
regional authorities consider more appropriate.”
“…Based on the analyses it is expected that A(H1N1) pandemic 2009,
A(H3N2) and B viruses will co-circulate in the northern hemisphere 2010-
2011 with the likelihood that the pandemic A(H1N1) 2009 viruses will
predominate. Based on recent epidemiological evidence it is anticipated that
seasonal A(H1N1) viruses are unlikely to circulate at significant levels during
the 2010-2011 northern hemisphere season; hence it has not been
recommended for inclusion in the 2010-2011 vaccine. A B/Victoria/2/87
lineage virus, the predominant lineage of type B viruses circulating since
September 2009, has been recommended.
“It is recommended that the following viruses be used for influenza
vaccines in the 2010- 2011 influenza season (northern hemisphere):
– an A/California/7/2009 (H1N1)-like virus;
– an A/Perth/16/2009 (H3N2)-like virus;#
– a B/Brisbane/60/2008-like virus.
# A/Wisconsin/15/2009 is an A/Perth/16/2009 (H3N2)-like virus and is a 2010
southern hemisphere vaccine virus…
http://www.who.int/csr/disease/influenza/201002_Recommendation.pdf

The Weekly Epidemiological Record (WER) for 12 February 2010,

vol. 85, 7 (pp 49–56) includes: Update on human cases of highly pathogenic
avian influenza A(H5N1) infection: 2009; Meeting of the International Task
Force for Disease Eradication, October 2009
http://www.who.int/wer/2010/wer8507.pdf

Journal Watch
[Editor’s Note]
Vaccines: The Week in Review continues its weekly scanning of key journals
to identify and cite articles, commentary and editorials, books reviews and
other content supporting our focus on vaccine ethics and policy. Journal
Watch is not intended to be exhaustive, but indicative of themes and
issues the Center is actively tracking. We selectively provide full text of
some editorial and comment articles that are specifically relevant to our
work. Successful access to some of the links provided may require
subscription or other access arrangement unique to the publisher. Our initial
scan list includes the journals below. If you would like to suggest other titles,
please write to David Curry at
david.r.curry@centerforvaccineethicsandpolicy.org

JAMA
Vol. 303 No. 7, pp. 587-682, February 17, 2010
http://jama.ama-assn.org/current.dtl
[No relevant content]

Journal of Infectious Diseases

15 March 2010 Volume 201, Number 6
http://www.journals.uchicago.edu/toc/jid/current
[No relevant content]

The Lancet
Feb 20, 2010 Volume 375 Number 9715 Pages 611 - 696
http://www.thelancet.com/journals/lancet/issue/current
[No relevant content]

The Lancet Infectious Disease

Feb 2010 Volume 10 Number 2 Pages 67 - 138
http://www.thelancet.com/journals/laninf/issue/current
Correspondence
GAVI's Advance Market Commitment
Donald W Light
Preview
The World Report on GAVI's Advance Market Commitment (AMC; Dec 5, p
1879)1 contains irreconcilable claims by GAVI and reveals the inability of the
AMC approach to make new vaccines available to low-income countries on a
sustainable basis.
GAVI's Advance Market Commitment
Nina Schwalbe, Ibrahim El-Ziq
Preview
In response to Ann Usher's World Report,1 it is necessary to clarify how the
pilot Advance Market Commitment (AMC) works. The pilot AMC aims to
stimulate the manufacture of an adequate supply of affordable pneumococcal
vaccines for developing countries. The price of the vaccine is capped at
US$3·50 per dose, paid by the GAVI Alliance and countries. Six donors will
pay an additional contribution per dose to participating manufacturers in the
early years of each contract to offset costs of expanding production.
HPV vaccination: waiting for evidence of effectiveness
Eric J Suba, Stephen S Raab, on behalf of the Viet/American Cervical Cancer
Prevention Project
Preview
As noted by Gary Clifford (Dec 12, p 1948),1 the greatest source of
uncertainty about the potential effectiveness of human papillomavirus (HPV)
vaccines remains the duration of the immune response. However, even if the
most optimistic scenario of HPV vaccine effectiveness is realised, the
introduction of HPV vaccines to populations not yet fully covered by
screening services may compete with limited budgets for the build-out of
screening services and thereby decelerate global reductions in deaths from
cervical cancer by creating populations of women who will not be protected
by either screening or vaccination.
Review
Biological, clinical, and ethical advances of placebo effects
Damien G Finniss, Ted J Kaptchuk, Franklin Miller, Fabrizio Benedetti
Preview
For many years, placebos have been defined by their inert content and their
use as controls in clinical trials and treatments in clinical practice. Recent
research shows that placebo effects are genuine psychobiological events
attributable to the overall therapeutic context, and that these effects can be
robust in both laboratory and clinical settings. There is also evidence that
placebo effects can exist in clinical practice, even if no placebo is given.
Further promotion and integration of laboratory and clinical research will
allow advances in the ethical use of placebo mechanisms that are inherent in
routine clinical care, and encourage the use of treatments that stimulate
placebo effects.

Nature
Volume 463 Number 7283 pp849-990 18 February 2010
http://www.nature.com/nature/journal/v463/n7283/
[No relevant content]

New England Journal of Medicine

Volume 362 — February 18, 2010 — Number 7
http://content.nejm.org/current.shtml
[No relevant content]

Pediatrics
February 2010 / VOLUME 125 / ISSUE 2
http://pediatrics.aappublications.org/current.shtml
[Reviewed earlier]

PLoS Medicine
(Accessed 21 February 2010)
http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-
1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1
&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1
c2a2501181c#results
[No relevant content]
Science
19 February 2010 Vol 327, Issue 5968, Pages 907-1040
http://www.sciencemag.org/current.dtl
[No relevant content]

Vaccine
Volume 28, Issue 7, Pages 1661-1892 (17 February 2010)
http://www.sciencedirect.com/science?
_ob=PublicationURL&_cdi=5188&_pubType=J&_acct=C000050221&_version
=1&_urlVersion=0&_userid=10&md5=06a70dff873c73731f4a31331c8deee2
&jchunk=28#28
[Reviewed earlier]