TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Helene Gayle A2 - William Foege A2 - Lisa Brown A2 - Benjamin Kahn TI - Framework for Equitable Allocation of COVID-19 Vaccine SN - DO - 10.17226/25917 PY - 2020 UR - https://nap.nationalacademies.org/catalog/25917/framework-for-equitable-allocation-of-covid-19-vaccine PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - In response to the coronavirus disease 2019 (COVID-19) pandemic and the societal disruption it has brought, national governments and the international community have invested billions of dollars and immense amounts of human resources to develop a safe and effective vaccine in an unprecedented time frame. Vaccination against this novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), offers the possibility of significantly reducing severe morbidity and mortality and transmission when deployed alongside other public health strategies and improved therapies. Health equity is intertwined with the impact of COVID-19 and there are certain populations that are at increased risk of severe illness or death from COVID-19. In the United States and worldwide, the pandemic is having a disproportionate impact on people who are already disadvantaged by virtue of their race and ethnicity, age, health status, residence, occupation, socioeconomic condition, or other contributing factors. Framework for Equitable Allocation of COVID-19 Vaccine offers an overarching framework for vaccine allocation to assist policy makers in the domestic and global health communities. Built on widely accepted foundational principles and recognizing the distinctive characteristics of COVID-19, this report's recommendations address the commitments needed to implement equitable allocation policies for COVID-19 vaccine. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Andrew Ford A2 - Erin Rusch A2 - Ellen Wright Clayton TI - Adverse Effects of Vaccines: Evidence and Causality SN - DO - 10.17226/13164 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13164/adverse-effects-of-vaccines-evidence-and-causality PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - In 1900, for every 1,000 babies born in the United States, 100 would die before their first birthday, often due to infectious diseases. Today, vaccines exist for many viral and bacterial diseases. The National Childhood Vaccine Injury Act, passed in 1986, was intended to bolster vaccine research and development through the federal coordination of vaccine initiatives and to provide relief to vaccine manufacturers facing financial burdens. The legislation also intended to address concerns about the safety of vaccines by instituting a compensation program, setting up a passive surveillance system for vaccine adverse events, and by providing information to consumers. A key component of the legislation required the U.S. Department of Health and Human Services to collaborate with the Institute of Medicine to assess concerns about the safety of vaccines and potential adverse events, especially in children. Adverse Effects of Vaccines reviews the epidemiological, clinical, and biological evidence regarding adverse health events associated with specific vaccines covered by the National Vaccine Injury Compensation Program (VICP), including the varicella zoster vaccine, influenza vaccines, the hepatitis B vaccine, and the human papillomavirus vaccine, among others. For each possible adverse event, the report reviews peer-reviewed primary studies, summarizes their findings, and evaluates the epidemiological, clinical, and biological evidence. It finds that while no vaccine is 100 percent safe, very few adverse events are shown to be caused by vaccines. In addition, the evidence shows that vaccines do not cause several conditions. For example, the MMR vaccine is not associated with autism or childhood diabetes. Also, the DTaP vaccine is not associated with diabetes and the influenza vaccine given as a shot does not exacerbate asthma. Adverse Effects of Vaccines will be of special interest to the National Vaccine Program Office, the VICP, the Centers for Disease Control and Prevention, vaccine safety researchers and manufacturers, parents, caregivers, and health professionals in the private and public sectors. ER - TY - BOOK AU - Institute of Medicine TI - Priorities for the National Vaccine Plan SN - DO - 10.17226/12796 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12796/priorities-for-the-national-vaccine-plan PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Vaccination is a fundamental component of preventive medicine and public health. The use of vaccines to prevent infectious diseases has resulted in dramatic decreases in disease, disability, and death in the United States and around the world. The current political, economic, and social environment presents both opportunities for and challenges to strengthening the U.S. system for developing, manufacturing, regulating, distributing, funding, and administering safe and effective vaccines for all people. Priorities for the National Vaccine Plan examines the extraordinarily complex vaccine enterprise, from research and development of new vaccines to financing and reimbursement of immunization services. Priorities for the National Vaccine Plan examines the extraordinarily complex vaccine enterprise, from research and development of new vaccines to financing and reimbursement of immunization services. The book makes recommendations about priority actions in the update to the National Vaccine Plan that are intended to achieve the objectives of disease prevention and enhancement of vaccine safety. It is centered on the plan's five goals in the areas of vaccine development, safety, communication, supply and use, and global health. ER - TY - BOOK AU - Institute of Medicine A2 - Heather M. Colvin A2 - Abigail E. Mitchell TI - Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C SN - DO - 10.17226/12793 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12793/hepatitis-and-liver-cancer-a-national-strategy-for-prevention-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The global epidemic of hepatitis B and C is a serious public health problem. Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. In the next 10 years, 150,000 people in the United States will die from liver disease or liver cancer associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Today, between 800,000 and 1.4 million people in the United States have chronic hepatitis B and between 2.7 and 3.9 million have chronic hepatitis C. People most at risk for hepatitis B and C often are the least likely to have access to medical services. Reducing the rates of illness and death associated with these diseases will require greater awareness and knowledge among health care workers, improved identification of at-risk people, and improved access to medical care. Hepatitis B is a vaccine-preventable disease. Although federal public health officials recommend that all newborns, children, and at-risk adults receive the vaccine, about 46,000 new acute cases of the HBV infection emerge each year, including 1,000 in infants who acquire the infection during birth from their HBV-positive mothers. Unfortunately, there is no vaccine for hepatitis C, which is transmitted by direct exposure to infectious blood. Hepatitis and Liver Cancer identifies missed opportunities related to the prevention and control of HBV and HCV infections. The book presents ways to reduce the numbers of new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis. It identifies priorities for research, policy, and action geared toward federal, state, and local public health officials, stakeholder, and advocacy groups and professional organizations. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen R. Stratton A2 - Jane S. Durch A2 - Robert S. Lawrence TI - Vaccines for the 21st Century: A Tool for Decisionmaking SN - DO - 10.17226/5501 PY - 2000 UR - https://nap.nationalacademies.org/catalog/5501/vaccines-for-the-21st-century-a-tool-for-decisionmaking PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Donna A. Almario A2 - Theresa M. Wizemann A2 - Marie C. McCormick TI - Immunization Safety Review: Vaccinations and Sudden Unexpected Death in Infancy SN - DO - 10.17226/10649 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10649/immunization-safety-review-vaccinations-and-sudden-unexpected-death-in-infancy PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - With current recommendations calling for infants to receive multiple doses of vaccines during their first year of life and with sudden infant death syndrome (SIDS) the most frequent cause of death during the postneonatal period, it is important to respond to concerns that vaccination might play a role in sudden unexpected infant death. The committee reviewed epidemiologic evidence focusing on three outcomes: SIDS, all SUDI (sudden unexpected death in infancy), and neonatal death (infant death, whether sudden or not, during the first 4 weeks of life). Based on this review, the committee concluded that the evidence favors rejection of a causal relationship between some vaccines and SIDS; and that the evidence is inadequate to accept or reject a causal relationship between other vaccines and SIDS, SUDI, or neonatal death. The evidence regarding biological mechanisms is essentially theoretical, reflecting in large measure the lack of knowledge concerning the pathogenesis of SIDS. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Donna A. Almario A2 - Marie C. McCormick TI - Immunization Safety Review: SV40 Contamination of Polio Vaccine and Cancer SN - DO - 10.17226/10534 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10534/immunization-safety-review-sv40-contamination-of-polio-vaccine-and-cancer PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Immunization Safety Review Committee was established by the Institute of Medicine (IOM) to evaluate the evidence on possible causal associations between immunizations and certain adverse outcomes, and to then present conclusions and recommendations. The committee's mandate also includes assessing the broader societal significance of these immunization safety issues. While all the committee members share the view that immunization is generally beneficial, none of them has a vested interest in the specific immunization safety issues that come before the group. The committee reviews three immunization safety review topics each year, addressing each one at a time. In this fifth report in a series, the committee examines the hypothesis that exposure to polio vaccine contaminated with simian virus 40 (SV40), a virus that causes inapparent infection in some monkeys, can cause certain types of cancer. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Gillian J. Buckley A2 - Brian L. Strom TI - Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report SN - DO - 10.17226/23407 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23407/eliminating-the-public-health-problem-of-hepatitis-b-and-c-in-the-united-states PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world's hepatocellular carcinoma and more than half of all fatal cirrhosis. In 2013 viral hepatitis, of which hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common types, surpassed HIV and AIDS to become the seventh leading cause of death worldwide. The world now has the tools to prevent hepatitis B and cure hepatitis C. Perfect vaccination could eradicate HBV, but it would take two generations at least. In the meantime, there is no cure for the millions of people already infected. Conversely, there is no vaccine for HCV, but new direct-acting antivirals can cure 95 percent of chronic infections, though these drugs are unlikely to reach all chronically-infected people anytime soon. This report, the first of two, examines the feasibility of hepatitis B and C elimination in the United States and identifies critical success factors. The phase two report will outline a strategy for meeting the elimination goals discussed in this report. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen R. Stratton A2 - Cynthia J. Howe A2 - Richard B. Johnston, Jr. TI - Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality SN - DO - 10.17226/2138 PY - 1994 UR - https://nap.nationalacademies.org/catalog/2138/adverse-events-associated-with-childhood-vaccines-evidence-bearing-on-causality PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Childhood immunization is one of the major public health measures of the 20th century and is now receiving special attention from the Clinton administration. At the same time, some parents and health professionals are questioning the safety of vaccines because of the occurrence of rare adverse events after immunization. This volume provides the most thorough literature review available about links between common childhood vaccines—tetanus, diphtheria, measles, mumps, polio, Haemophilus influenzae b, and hepatitis B—and specific types of disorders or death. The authors discuss approaches to evidence and causality and examine the consequences—neurologic and immunologic disorders and death—linked with immunization. Discussion also includes background information on the development of the vaccines and details about the case reports, clinical trials, and other evidence associating each vaccine with specific disorders. This comprehensive volume will be an important resource to anyone concerned about the immunization controversy: public health officials, pediatricians, attorneys, researchers, and parents. ER - TY - BOOK AU - Institute of Medicine A2 - Christopher P. Howson A2 - Cynthia J. Howe A2 - Harvey V. Fineberg TI - Adverse Effects of Pertussis and Rubella Vaccines SN - DO - 10.17226/1815 PY - 1991 UR - https://nap.nationalacademies.org/catalog/1815/adverse-effects-of-pertussis-and-rubella-vaccines PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Parents have come to depend on vaccines to protect their children from a variety of diseases. Some evidence suggests, however, that vaccination against pertussis (whooping cough) and rubella (German measles) is, in a small number of cases, associated with increased risk of serious illness. This book examines the controversy over the evidence and offers a comprehensively documented assessment of the risk of illness following immunization with vaccines against pertussis and rubella. Based on extensive review of the evidence from epidemiologic studies, case histories, studies in animals, and other sources of information, the book examines: The relation of pertussis vaccines to a number of serious adverse events, including encephalopathy and other central nervous system disorders, sudden infant death syndrome, autism, Guillain-Barre syndrome, learning disabilities, and Reye syndrome. The relation of rubella vaccines to arthritis, various neuropathies, and thrombocytopenic purpura. The volume, which includes a description of the committee's methods for evaluating evidence and directions for future research, will be important reading for public health officials, pediatricians, researchers, and concerned parents. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Donna A. Alamario A2 - Theresa Wizemann A2 - Marie C. McCormick TI - Immunization Safety Review: Influenza Vaccines and Neurological Complications SN - DO - 10.17226/10822 PY - 2004 UR - https://nap.nationalacademies.org/catalog/10822/immunization-safety-review-influenza-vaccines-and-neurological-complications PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Infection with the influenza virus can have a serious effect on the health of people of all ages, although it is particularly worrisome for infants, the elderly, and people with underlying heart or lung problems. A vaccine exists (the “flu” shot) that can greatly decrease the impact of influenza. Because the strains of virus that are expected to cause serious illness and death are slightly different every year, the vaccine is also slightly different every year and it must be given every year, unlike other vaccines. The Immunization Safety Review committee reviewed the data on influenza vaccine and neurological conditions and concluded that the evidence favored rejection of a causal relationship between influenza vaccines and exacerbation of multiple sclerosis. For the other neurological conditions studied, the committee concluded the evidence about the effects of influenza vaccine is inadequate to accept or reject a causal relationship. The committee also reviewed theories on how the influenza vaccine could damage the nervous system. The evidence was at most weak that the vaccine could act in humans in ways that could lead to these neurological problems. ER - TY - BOOK AU - Institute of Medicine A2 - Guruprasad Madharan A2 - Kinpritma Sangha A2 - Charles Phelps A2 - Dennis Fryback A2 - Tracy Lieu A2 - Rose Marie Martinez A2 - Lonnie King TI - Ranking Vaccines: A Prioritization Framework: Phase I: Demonstration of Concept and a Software Blueprint SN - DO - 10.17226/13382 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13382/ranking-vaccines-a-prioritization-framework-phase-i-demonstration-of-concept PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - As a number of diseases emerge or reemerge thus stimulating new vaccine development opportunities to help prevent those diseases, it can be especially difficult for decision makers to know where to invest their limited resources. Therefore, it is increasingly important for decision makers to have the tools that can assist and inform their vaccine prioritization efforts. In this first phase report, the IOM offers a framework and proof of concept to account for various factors influencing vaccine prioritization-demographic, economic, health, scientific, business, programmatic, social, policy factors and public concerns. Ranking Vaccines: A Prioritization Framework describes a decision-support model and the blueprint of a software-called Strategic Multi-Attribute Ranking Tool for Vaccines or SMART Vaccines. SMART Vaccines should be of help to decision makers. SMART Vaccines Beta is not available for public use, but SMART Vaccines 1.0 is expected to be released at the end of the second phase of this study, when it will be fully operational and capable of guiding discussions about prioritizing the development and introduction of new vaccines. ER - TY - BOOK AU - Institute of Medicine A2 - Guruprasad Madhavan A2 - Kinpritma Sangha A2 - Charles Phelps A2 - Dennis Fryback A2 - Rino Rappuoli A2 - Rose Marie Martinez A2 - Lonnie King TI - Ranking Vaccines: A Prioritization Software Tool: Phase II: Prototype of a Decision-Support System SN - DO - 10.17226/13531 PY - 2013 UR - https://nap.nationalacademies.org/catalog/13531/ranking-vaccines-a-prioritization-software-tool-phase-ii-prototype-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - SMART Vaccines—Strategic Multi-Attribute Ranking Tool for Vaccines—is a prioritization software tool developed by the Institute of Medicine that utilizes decision science and modeling to help inform choices among candidates for new vaccine development. A blueprint for this computer-based guide was presented in the 2012 report Ranking Vaccines: A Prioritization Framework: Phase I. Ranking Vaccines: A Prioritization Software Tool,Phase II extends the proof-of-concept presented in the Phase I report, which was based on multi-attribute utility theory. This report refines a beta version of the model developed in the Phase I report and presents its next iteration, SMART Vaccines 1.0. Ranking Vaccines: Phase II discusses the methods underlying the development, validation, and evaluation of SMART Vaccines 1.0. It also discusses how SMART Vaccines should—and, just as importantly, should not—be used. The report also offers ideas for future enhancements for SMART Vaccines as well as for ideas for expanded uses and considerations and possibilities for the future. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Alicia Gable A2 - Padma Shetty A2 - Marie McCormick TI - Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism SN - DO - 10.17226/10101 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10101/immunization-safety-review-measles-mumps-rubella-vaccine-and-autism PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Immunization is widely regarded as one of the most effective and beneficial tools for protecting the public's health. In the United States, immunization programs have resulted in the eradication of smallpox, the elimination of polio, and the control and near elimination of once-common, often debilitating and potentially life-threatening diseases, including measles, mumps, rubella, diphtheria, pertussis, tetanus, and Haemophilus influenza type b. Along with the benefits of widespread immunization, however, have come concerns about the safety of vaccines. No vaccine is perfectly safe or effective, and vaccines may lead to serious adverse effects in some instances. Furthermore, if a serious illness is observed after vaccination, it is often unclear whether that sequence is coincidental or causal, and it can be difficult to determine the true nature of the relationship, if any, between the vaccination and the illness. Ironically, the successes of vaccine coverage in the United States have made it more difficult for the public to weigh the benefits and complications of vaccines because the now-controlled diseases and their often-serious risks are no longer familiar. However, because vaccines are so widely used-and because state laws require that children be vaccinated before entering daycare and school, in part to protect others-it is essential that safety concerns be fully and carefully studied. Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism, the first of a series from the Institute of Medicine (IOM) Immunization Safety Review Committee, presents an assessment of the evidence regarding a hypothesized causal association between the measles-mumps-rubella (MMR) vaccine and autism, an assessment of the broader significance for society of the issues surrounding the MMR-autism hypothesis, and the committee's conclusions and recommendations based on those assessments. ER - TY - BOOK AU - Institute of Medicine TI - Calling the Shots: Immunization Finance Policies and Practices SN - DO - 10.17226/9836 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9836/calling-the-shots-immunization-finance-policies-and-practices PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Calling the Shots examines the basic strategies that finance the national immunization system in the current health care climate. It is a comprehensive volume, rich with data and highlighted examples, that explores: The evolution of the system in light of changing U.S. demographics, development of new vaccines, and other factors. The effectiveness of public health and health insurance strategies, with special emphasis on the performance of the "Section 317" program. The condition of the infrastructure for control and prevention of infectious disease, surveillance of vaccines rates and safety, and efforts to sustain high coverage. Calling the Shots will be an indispensable resource to those responsible for maintaining our nation's vaccine vigilance. ER - TY - BOOK AU - Institute of Medicine TI - The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies SN - DO - 10.17226/13563 PY - 2013 UR - https://nap.nationalacademies.org/catalog/13563/the-childhood-immunization-schedule-and-safety-stakeholder-concerns-scientific-evidence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Vaccines are among the most safe and effective public health interventions to prevent serious disease and death. Because of the success of vaccines, most Americans today have no firsthand experience with such devastating illnesses as polio or diphtheria. Health care providers who vaccinate young children follow a schedule prepared by the U.S. Advisory Committee on Immunization Practices. Under the current schedule, children younger than six may receive as many as 24 immunizations by their second birthday. New vaccines undergo rigorous testing prior to receiving FDA approval; however, like all medicines and medical interventions, vaccines carry some risk. Driven largely by concerns about potential side effects, there has been a shift in some parents' attitudes toward the child immunization schedule. The Childhood Immunization Schedule and Safety identifies research approaches, methodologies, and study designs that could address questions about the safety of the current schedule. This report is the most comprehensive examination of the immunization schedule to date. The IOM authoring committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule. Should signals arise that there may be need for investigation, however, the report offers a framework for conducting safety research using existing or new data collection systems. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Alicia Gable A2 - Marie C. McCormick TI - Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders SN - DO - 10.17226/10208 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10208/immunization-safety-review-thimerosal-containing-vaccines-and-neurodevelopmental-disorders PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - In this report, the Immunization Safety Review committee examines the hypothesis of whether or not the use of vaccines containing the preservative thimerosal can cause neurodevelopmental disorders (NDDs), specifically autism, attention deficit/hyperactivity disorder (ADHD), and speech or language delay. ER - TY - BOOK AU - Institute of Medicine TI - Financing Vaccines in the 21st Century: Assuring Access and Availability SN - DO - 10.17226/10782 PY - 2004 UR - https://nap.nationalacademies.org/catalog/10782/financing-vaccines-in-the-21st-century-assuring-access-and-availability PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The national immunization system has achieved high levels of immunization, particularly for children. However, this system faces difficult challenges for the future. Significant disparities remain in assuring access to recommended vaccines across geographic and demographic populations. These disparities result, in part, from fragmented public–private financing in which a large number of children and adults face limited access to immunization services. Access for adults lags well behind that of children, and rates of immunizations for those who are especially vulnerable because of chronic health conditions such as diabetes or heart and lung disease, remain low. Financing Vaccines in the 21st Century: Assuring Access and Availability addresses these challenges by proposing new strategies for assuring access to vaccines and sustaining the supply of current and future vaccines. The book recommends changes to the Advisory Committee on Immunization Practices (ACIP)-the entity that currently recommends vaccines-and calls for a series of public meetings, a post-implementation evaluation study, and development of a research agenda to facilitate implementation of the plan. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen Stratton A2 - Donna A. Almario A2 - Marie C. McCormick TI - Immunization Safety Review: Hepatitis B Vaccine and Demyelinating Neurological Disorders SN - DO - 10.17226/10393 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10393/immunization-safety-review-hepatitis-b-vaccine-and-demyelinating-neurological-disorders PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Immunization to protect infants and children from vaccine-preventable diseases is one of the greatest achievements of public health. Immunization is not without risks, however. It is well established, for example, that the oral polio vaccine can on rare occasion cause paralytic polio.The Immunization Safety Review Committee was established by the Institute of Medicine (IOM) to evaluate the available evidence on a series of immunization safety concerns. The committee is charged with examining three immunization safety hypotheses each year during the three-year study period (2001- 2003). While all of the committee members share the view that immunization is generally beneficial, none of them has a vested interest in the specific immunization safety issues that come before the group. In this report, which is the fourth in the series, the committee examines the hypothesis that the hepatitis B vaccine increases the risk for demyelinating disorders of the central or peripheral nervous systems, including multiple sclerosis (MS) and Guillain-Barré syndrome (GBS). ER - TY - BOOK AU - Institute of Medicine TI - Vaccines Against Malaria DO - 10.17226/9027 PY - 1996 UR - https://nap.nationalacademies.org/catalog/9027/vaccines-against-malaria PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER -