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Consensus Study Report


Vaccines have made it possible to eradicate the scourge of smallpox, promise the same for polio, and have profoundly reduced the threat posed by other diseases such as whooping cough, measles, and meningitis.

What is next? There are many pathogens, autoimmune diseases, and cancers that may be promising targets for vaccine research and development.

This volume provides an analytic framework and quantitative model for evaluating disease conditions that can be applied by those setting priorities for vaccine development over the coming decades. The committee describes an approach for comparing potential new vaccines based on their impact on morbidity and mortality and on the costs of both health care and vaccine development. The book examines:

  • Lessons to be learned from the polio experience.
  • Scientific advances that set the stage for new vaccines.
  • Factors that affect how vaccines are used in the population.
  • Value judgments and ethical questions raised by comparison of health needs and benefits.

The committee provides a way to compare different forms of illness and set vaccine priorities without assigning a monetary value to lives. Their recommendations will be important to anyone involved in science policy and public health planning: policymakers, regulators, health care providers, vaccine manufacturers, and researchers.

Suggested Citation

Institute of Medicine. 2000. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press.

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Publication Info

472 pages |  6 x 9 | 

  • Hardcover:  978-0-309-05646-5
  • Ebook:  978-0-309-17498-5
Chapters skim
Front Matter i-xii
Executive Summary 1-10
Introduction 11-16
Progress in Vaccine Development 17-38
Considerations of Candidate Vaccines 39-52
Overview of Analytic Approach and Results 53-92
Review of the Analytical Model 93-108
Ethical Considerations and Caveats 109-122
Observations 123-132
References 133-142
Appendix 1: Borrelia burgdorferi 143-148
Appendix 2: Chlamydia 149-158
Appendix 3: Coccidioides Immitis 159-164
Appendix 4: Cytomegalovirus 165-172
Appendix 5: Enterotoxigenic E. coli 173-176
Appendix 6: Epstein-Barr Virus 177-180
Appendix 7: Helicobacter pylori 181-188
Appendix 8: Hepatitis C 189-194
Appendix 9: Herpes Simplex Virus 195-206
Appendix 10: Histoplasma capsulatum 207-212
Appendix 11: Human Paillomavirus 213-222
Appendix 12: Influenza A and B 223-232
Appendix 13: Insulin-Dependent Diabetes Mellitus 233-238
Appendix 14: Melanoma 239-244
Appendix 15: Multiple Sclerosis 245-250
Appendix 16: Mycobacterium tuberculosis 251-256
Appendix 17: Neisseria gonnorrhea 257-266
Appendix 18: Neisseria meningitidis 267-272
Appendix 19: Parainfluenza Virus 273-278
Appendix 20: Respiratory Syncytial Virus 279-284
Appendix 21: Rheumatoid Arthritis 285-290
Appendix 22: Rotavirus 291-294
Appendix 23: Shigella 295-298
Appendix 24: Streptococcus, Group A 299-304
Appendix 25: Streptococcus, Group B 305-312
Appendix 26: Streptococcus pneumoniae 313-322
Appendix 27: Information on accessing Electronic Spreadsheets 323-324
Appendix 28: Summary of Workshops 325-434
Appendix 29: Questions Posed to Outside Experts and List of Responders 435-442
Index 443-460

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