Jessica Shearer and colleagues analyze data from 147 countries to identify factors that influence the time taken to introduce routine vaccination against Haemophilus influenzae type b (Hib)

A Brooks

AH Baqui

Allyson P. Bear

D DeRoeck

David M. Bishai

H Akaike

IA Rossi

JD Wenger

Jessica C. Shearer

JK Andrus

JP Watt

Keith P. Klugman

LJ Wei

M Cleves

M Pokorn

MA Miller

Marcie R. Richmond

MC Danovaro-Holliday

MD Knoll

Meghan L. Stack

MG Marshall

MS Soltani

O Garpenholt

R O'Loughlin

R Widdus

RA Adegbola

Rana A. Hajjeh

RF Lewis

SL Munira

V Gauri

W Weibull

English

PubMed

Adoption of new and underutilized vaccines by national immunization programs is an essential step towards reducing child mortality. Policy decisions to adopt new vaccines in high mortality countries often lag behind decisions in high-income countries. Using the case of Haemophilus influenzae type b (Hib) vaccine, this paper endeavors to explain these delays through the analysis of country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance).Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identify factors that are associated with the time to decision to adopt Hib vaccine. In multivariable models that control for Gross National Income, region, and burden of Hib disease, the receipt of GAVI support speeded the time to decision by a factor of 0.37 (95% CI 0.18-0.76), or 63%. The presence of two or more neighboring country adopters accelerated decisions to adopt by a factor of 0.50 (95% CI 0.33-0.75). For each 1% increase in vaccine price, decisions to adopt are delayed by a factor of 1.02 (95% CI 1.00-1.04). Global recommendations and local studies were not associated with time to decision.This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors

Jessica C Shearer

Meghan L Stack

Marcie R Richmond

Allyson P Bear

Rana A Hajjeh

David M Bishai

Directory of Open Access Journals

PLoS Medicine

Accelerating policy decisions to adopt haemophilus influenzae type B vaccine: a global, multivariable analysis.

 type b (Hib) vaccine, this paper endeavors to explain these delays through the analysis of country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance).Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identify factors that are associated with the time to decision to adopt Hib vaccine. In multivariable models that control for Gross National Income, region, and burden of Hib disease, the receipt of GAVI support speeded the time to decision by a factor of 0.37 (95% CI 0.18–0.76), or 63%. The presence of two or more neighboring country adopters accelerated decisions to adopt by a factor of 0.50 (95% CI 0.33–0.75). For each 1% increase in vaccine price, decisions to adopt are delayed by a factor of 1.02 (95% CI 1.00–1.04). Global recommendations and local studies were not associated with time to decision.This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors.Please see later in the article for the Editors' Summar

Shearer Jessica C.

Stack Meghan L.

Richmond Marcie R.

Bear Allyson P.

Hajjeh Rana A.

Bishai David M.

Public Library of Science (PLOS)

 Type b Vaccine: A Global, Multivariable Analysis

Crossref

Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global, Multivariable Analysis

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Global reduction of Hib disease: What are the next steps?

State of the world’s vaccines and immunizations.

World Health Organization

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Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global, Multivariable Analysis

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Directory of Open Access Journals

Public Library of Science (PLOS)

Public Library of Science (PLOS)

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