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How to establish the effectiveness of Pnc <strong>vaccine</strong>s in settings where the impact is in doubt? • Before and after? • Case control study? • RCT?
Before and after… • Need consistent and complete case ascertainment • Outcomes: – Invasive pneumococcal disease – Pneumonia – Mortality • Problems – Viral epidemics – Changing referral patterns
Page 1 and 2: How to determine the effectiveness
Page 3 and 4: But difficult questions have arisen
Page 5 and 6: Bohol study of PCV‐11 • 12,194
Page 7 and 8: But difficult questions have arisen
Page 9: So the key questions are… • How
Page 13 and 14: ARI surveillance system Viet Nam Ta
Page 15 and 16: Seasonal Prevalence of Major Pediat
Page 17 and 18: Before and after ‐ conclusions
Page 19 and 20: Community controls • Usually matc
Page 21 and 22: Potential for bias • Community co
Page 23 and 24: Lau et al. Acta Paediatr 1995;84:17
Page 25 and 26: An Effectiveness Trial of Hib Vacci
Page 27 and 28: How to establish the effectiveness
Page 29 and 30: Lancet 2005;365:43‐52
Page 31 and 32: Pneumonia results Incidences per 10
Page 33 and 34: Consider country X • East Asia
Page 35 and 36: Phased introduction • Risks - May
Page 37 and 38: What of serotype replacement? • O
Page 39 and 40: IPD in high risk groups • Immunoc

For vaccine - GLOBE NETWORK

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