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Phased introduction • In part or all of the country • Stage 1 – At least 30 administrative units randomized to receive or not receive vaccine – Annual analysis of pneumonia (and possibly mortality) rates • Compare rates of disease in vaccinated and unvaccinated sectors • Support with case control study • Stage 2 – Introduce vaccine into other areas – Consider introduction of second vaccine and continue analysis
Phased introduction • Risks – May delay vaccine introduction – Interim analyses may produce misleading results – Measured effectiveness may decline later due to serotype replacement – Groups may be unbalanced with respect to: • Risk of disease • Access to health care
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 and 10: So the key questions are… • How
Page 11 and 12: Before and after… • Need consis
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: Consider country X • East Asia
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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