Vaccine Schedules Initiative

Support for global and national policy choices about vaccine schedules in low and middle income countries.

PI: Colin Sanderson
Funding: BMGF (via WHO)

The WHO Initiative for Vaccine Research (IVR) has commissioned researchers from the Vaccine Centre (Andy Clark and Colin Sanderson) to evaluate the balance between benefit and risk for rotavirus vaccination, and the impact of different dose schedules for Hib and Pertussis vaccination. A risk/benefit model was developed to evaluate the potential benefits of mortality reduction from rotavirus versus the risk of fatal intussusception when the first dose of vaccine has to be administered by 15 weeks of age. The research showed that in developing countries, the additional lives saved by broadening the age restrictions for initiation of rotavirus vaccination would far outnumber the hypothetical excess intussusception deaths that might accompany such an approach. This work informed the WHO Strategic Advisory Group of Experts (SAGE) recommendation to remove the rotavirus vaccine age restriction in countries with high rotavirus mortality. Other country-specific models have been developed for Hib and Pertussis to assess the impact of different vaccination schedules. This work has involved the evaluation of large household surveys (DHS and MICS) in over 100 low and middle income countries to estimate the timeliness of BCG, DTP and Measles vaccination, and the development of a global database containing country-specific data on the age distribution of different disease outcomes. Other work has focused on the sequence (and possible non-specific effects) of vaccination and the prevalence of missed opportunities to vaccinate.

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