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Appendix B: Candidate Disease Profiles and Data
Pages 127-152

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From page 127...
... B Candidate Disease Profiles and Data 127
From page 128...
... Incidence, Prevalence, and Mortality: Influenza causes annual seasonal epidemics throughout the world as well as periodic pandemics. In the United States influenza has been estimated to cause an average of approximately 36,000 annual deaths during 1990–1999 and 226,000 an nual hospitalizations during 1979–2001.
From page 129...
... One paper from the Centers for Disease Control and Prevention estimated seasonal influenza attack rates in the United States ranging from 6.6 percent in healthy young adults to 20 percent in the youngest children. The 2009 pandemic influenza virus A (H1N1)
From page 130...
... However, infection in the lung can be contained by the immune system and remains latent; fewer than 10 percent of latently infected individuals subsequently de velop reactivation pulmonary tuberculosis, generally when age, malnu trition, HIV infection, or other conditions suppress the immune system and thereby allow latent infection to reactivate. Incidence, Prevalence, and Mortality: Approximately one-third of the world's population is estimated to be latently infected with M
From page 131...
... Prevention: In most wealthy countries with low incidence rates, prevention of tuberculosis primarily rests on prompt diagnosis, correct multidrug treatment, and ensuring completion of treatment among those with pulmonary tuberculosis. Latent infected individuals are also treated with drugs, especially those at high risk of reactivation tuberculosis, such as HIV-infected individuals.
From page 132...
... 132 RANKING VACCINES: A Prioritization Framework Group B streptococcus disease profile BOX B-3 Group B Streptococcus Infectious Agent: Group B Streptococcus (Streptococcus agalactiae) is a gram-positive organism found as a normal inhabitant of the gas trointestinal and genital tract of humans.
From page 133...
... This approach was widely adopted in the United States and many developed countries and resulted in substantial declines in disease in infants younger than 7 days. In the United States, culture-based screening is used to identify candidates for chemoprophylaxis, but implementing this strategy has been a difficult in low- and middle-income countries.
From page 134...
... U.S. Population Data Femalea Population Life Table Health Productivity 134 Living Life Years Life Expectancy Standard Life Hourly Wage Rated Age Group N (lx)
From page 135...
... Malea Population Life Table Health Productivity Living Life Years Life Expectancy Standard Life Hourly Wage Rated Age Group N (lx)
From page 136...
... 94,379,233 100% 6,600 0.05 40% 75% 100% ( >65) 22,853,007 100% 9,000 1.17 60% 40% 100% Male Target Annual Vaccine Vaccine Herd Population Age Population Incidence Ratea Case Fatality Coverage Effectivenessb Immunity Groups (N)
From page 137...
... Influenza Illness Without 59.5% 0.09 0.01 0.0137 Outpatient Visit Influenza Illness With 40.0% 0.13 0.1 0.0137 Outpatient Visit Influenza Hospitalization 0.5% 0.2 0.3 0.0137 a Probability Disutility Disability Durationc Vaccine Complications per Dose (Toll) Weightb (Years)
From page 138...
... Vaccine Characteristics Length of immunitya 1 years or life a Doses required per person 1 doses b Cost per dose $13 $ c Cost to administer per dose $10 $ Research costsc $50,000,000 $ Licensure costsc $100,000,000 $ c Start-up costs $100,000 $ c Time to adoption 5 years a CDC recommends an influenza shot every year (http://1.usa.gov/tEA0Mg)
From page 139...
... <1 2,183,518 100% 1.68 9 85% 65% 100% 1–19 39,904,750 0% 1.15 9 85% 65% 100% 20–64 94,379,233 0% 3.35 9 85% 65% 100% >65 22,853,007 0% 4.54 9 85% 65% 100% Male Annual Target Incidence Vaccine Vaccine Herd Age Population Population Ratea (per Case Fatality Coveragec Effectivenessc Immunity Groups (N)
From page 140...
... Latent Tuberculosis 8.0% 0.00 0.00 0.00 (with Treatment) Extrapulmonary Tuberculosis 22.0% 0.30 0.29 0.06 (with Inpatient Treatment)
From page 141...
... Drugsb Outpatient Treatmentc $400 0 0 1 0 0 0 c Inpatient Treatment $760 1 11 0 0 3 0 Hospitalizationd $1,300 15 0 0 0 0 5 Vaccine Complications Injection Severe Site Local Health Care Services Costa Abscess Lymphadenitis Reaction Direct Observed Therapy $0 0 0 0 (DOT) Drugsb Outpatient Treatmentc $400 1 1 0 c Inpatient Treatment $760 0 0 1 d Hospitalization $1,300 0 0 0 a Costs associated with the health care services used to treat morbidity caused by the disease and vaccine.
From page 142...
... Vaccine Characteristics 142 Length of immunity a life years or life a Doses required per person 1 doses a Cost per dose $50 $ a Cost to administer per dose $25 $ Research costs a $100,000,000 $ Licensure costs a $500,000,000 $ a Start-up costs $10,000,000 $ a Time to adoption 5 years a Since BCG is not administered in the United States, these values are based on expert opinion.
From page 143...
... 94,379,233 0% 4.60 6.0 85% 80% 100% ( >65) 22,853,007 0% 25.30 11.4 85% 80% 100% Male Annual Herd Target Incidence Case Vaccine Vaccine Immunity Population Population Age Ratea (per Fatality Coverage Effectivenessb Thresholdc Groups (N)
From page 144...
... Costs Disease Health Care Respiratory Neurological Services Cost Death Meningitis Pneumonia Distress Sepsis Impairment Hospitalizationa $2,100 7 14 7 7 2 14 a Committee's expert opinion and the HCUP Nationwide Inpatient Sample Data, 2009.
From page 145...
... Vaccine Characteristics Length of immunitya life years or life a Doses required per person 1 doses Cost per dosea $100 $ Cost to administer per dosea $50 $ a Research costs $200,000,000 $ a Licensure costs $600,000,000 $ a Start-up costs $10,000,000 $ Time to adoptiona 5 years a Since a vaccine for group B streptococcus does not currently exist, these values are based on expert opinion.
From page 146...
... South Africa Population Data Femalea Population Life Table Health Productivity Standard Life 146 Life Years Life Expectancy Expectancyb Hourly Wage Rated Age Group N Living (lx)
From page 147...
... :1162–1170. Due to the lack of data for HUI-2 within South Africa, estimates for the United States are used.
From page 148...
... (%) <1 50,4851 100% 800 19 50% 60% 100% 1–19 9,593,485 0% 900 19 50% 60% 100% 20–64 13,928,527 0% 1100 22 50% 50% 100% >65 1,377,384 0% 981 20 50% 40% 100% Male Annual Herd Target Incidence Case Vaccine Vaccine Immunity Age Population Population Ratea (per Fatality Coveragec Effectivenessd Threshold Groups (N)
From page 149...
... Latent Tuberculosis 8% 0.00 0.00 0.00 (with Treatment) Extrapulmonary Tuberculosis 22% 0.30 0.29 0.06 (with Inpatient Treatment)
From page 150...
... with Treatment Tuberculosis Impairment Direct Observed Therapy $46 0 0 0 1 0 0 (DOT) Drugsa Outpatient Treatmenta $250 0 0 1 0 0 0 a Inpatient Treatment $637 0 1 0 0 3 0 b Hospitalization $360 1 0 0 0 0 5 Vaccine Complications Injection Severe Local Health Care Services Cost Site Abscess Lymphadenitis Reaction Direct Observed Therapy $46 0 0 0 (DOT)
From page 151...
... Vaccine Characteristics Length of immunitya life years or life Doses required per persona 1 doses a Cost per dose $25 $ a Cost to administer per dose $50 $ a Research costs $200,000,000 $ Licensure costsa $600,000,000 $ Start-up costsa $10,000,000 $ a Time to adoption 5 years a Committee's expert opinion.


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