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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="Institute of Medicine (US) Committee to Study Priorities for Vaccine Development; Kathleen R. Stratton, Jane S. Durch, Robert S. Lawrence" /><meta name="citation_title" content="Vaccines for the 21st Century" /><meta name="citation_publisher" content="National Academies Press (US)" /><meta name="citation_date" content="2000" /><meta name="citation_author" content="Institute of Medicine (US) Committee to Study Priorities for Vaccine Development" /><meta name="citation_author" content="Kathleen R. Stratton" /><meta name="citation_author" content="Jane S. Durch" /><meta name="citation_author" content="Robert S. Lawrence" /><meta name="citation_pmid" content="25121214" /><meta name="citation_doi" content="10.17226/5501" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK233313/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Vaccines for the 21st Century" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Academies Press (US)" /><meta name="DC.Contributor" content="Institute of Medicine (US) Committee to Study Priorities for Vaccine Development" /><meta name="DC.Contributor" content="Kathleen R. Stratton" /><meta name="DC.Contributor" content="Jane S. Durch" /><meta name="DC.Contributor" content="Robert S. Lawrence" /><meta name="DC.Date" content="2000" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK233313/" /><meta name="DC.Language" content="en" /><meta name="description" content="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." /><meta name="og:title" content="Vaccines for the 21st Century" /><meta name="og:type" content="book" /><meta name="og:description" content="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." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK233313/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nap5501-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/nap5501/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK233313/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.nap.edu/catalog.php?record_id=5501" title="National Academies Press (US)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nap5501-lrg.png" alt="Cover of Vaccines for the 21st Century" /></a><div class="icnblk_cntnt"><h1 id="_NBK233313_"><span itemprop="name">Vaccines for the 21st Century</span></h1><div class="subtitle">A Tool for Decisionmaking</div><p class="contrib-group"><h4>Contributors</h4><span itemprop="author">Institute of Medicine (US) Committee to Study Priorities for Vaccine Development</span>; Editors: <span itemprop="editor">Kathleen R. Stratton</span>, <span itemprop="editor">Jane S. Durch</span>, and <span itemprop="editor">Robert S. Lawrence</span>.</p><div class="half_rhythm">Washington (DC): <a href="http://www.nap.edu/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Academies Press (US)</span></a>; <span itemprop="datePublished">2000</span>.<div class="small">ISBN-10: <span itemprop="isbn">0-309-05646-2</span></div></div><div><a href="/books/about/copyright/">Copyright</a> 2000 by the National Academy of Sciences. All rights reserved.</div><div class="small half_rhythm bk_noprnt"><a href="http://www.nap.edu/catalog.php?record_id=5501" ref="pagearea=body&targetsite=external&targetcat=link&targettype=publisher">Hardcopy Version at National Academies Press</a></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><p>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.</p><p>What is next? There are many pathogens, autoimmune diseases, and cancers that may be promising targets for vaccine research and development.</p><p>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:</p><ul><li class="half_rhythm"><div>Lessons to be learned from the polio experience.</div></li><li class="half_rhythm"><div>Scientific advances that set the stage for new vaccines.</div></li><li class="half_rhythm"><div>Factors that affect how vaccines are used in the population.</div></li><li class="half_rhythm"><div>Value judgments and ethical questions raised by comparison of health needs and benefits.</div></li></ul><p>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.</p></div><div><h2>Contents</h2><ul id="toc_tllNBK233313_ddd00004" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00004"><a href="/books/n/nap5501/ddd00004/" class="toc-item">THE NATIONAL ACADEMIES</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00005"><a href="/books/n/nap5501/ddd00005/" class="toc-item">COMMITTEE TO STUDY PRIORITIES FOR VACCINE DEVELOPMENT</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00007"><a href="/books/n/nap5501/ddd00007/" class="toc-item">Acknowledgments</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00009"><a href="/books/n/nap5501/ddd00009/" class="toc-item">Executive Summary</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00014"><a href="/books/n/nap5501/ddd00014/" class="toc-item">1 Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00020"><a href="/books/n/nap5501/ddd00020/" class="toc-item">2. Progress in Vaccine Development</a><ul id="toc_lst_NBK233313_ddd00021" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00021"><a href="/books/n/nap5501/ddd00020/#ddd00021" class="toc-item">PRIORITIES OF THE IOM COMMITTEE IN 1985</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00022"><a href="/books/n/nap5501/ddd00020/#ddd00022" class="toc-item">LITIGATION AS A BARRIER TO VACCINE DEVELOPMENT</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00024"><a href="/books/n/nap5501/ddd00020/#ddd00024" class="toc-item">A CASE STUDY OF SUCCESS</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00028"><a href="/books/n/nap5501/ddd00020/#ddd00028" class="toc-item">ADVANCES IN BIOTECHNOLOGY AND MOLECULAR IMMUNOLOGY AND NEW OPPORTUNITIES FOR VACCINES</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00042"><a href="/books/n/nap5501/ddd00042/" class="toc-item">3. Considerations of Candidate Vaccines</a><ul id="toc_lst_NBK233313_ddd00043" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00043"><a href="/books/n/nap5501/ddd00042/#ddd00043" class="toc-item">EXCLUSION CRITERIA</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00047"><a href="/books/n/nap5501/ddd00042/#ddd00047" class="toc-item">ADDITIONAL CONSIDERATIONS FOR INCLUSION</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00053"><a href="/books/n/nap5501/ddd00053/" class="toc-item">4. Overview of Analytic Approach and Results</a><ul id="toc_lst_NBK233313_ddd00054" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00054"><a href="/books/n/nap5501/ddd00053/#ddd00054" class="toc-item">A COST-EFFECTIVENESS APPROACH</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00060"><a href="/books/n/nap5501/ddd00053/#ddd00060" class="toc-item">MODEL OVERVIEW</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00075"><a href="/books/n/nap5501/ddd00053/#ddd00075" class="toc-item">EXAMPLES: HYPOTHETICAL VACCINE X</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00082"><a href="/books/n/nap5501/ddd00053/#ddd00082" class="toc-item">RESULTS</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00084"><a href="/books/n/nap5501/ddd00084/" class="toc-item">5. Review of the Analytic Model</a><ul id="toc_lst_NBK233313_ddd00085" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00085"><a href="/books/n/nap5501/ddd00084/#ddd00085" class="toc-item">UNIT OF ANALYSIS</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00086"><a href="/books/n/nap5501/ddd00084/#ddd00086" class="toc-item">IMPLEMENTING THE ANALYSIS</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00089"><a href="/books/n/nap5501/ddd00084/#ddd00089" class="toc-item">CALCULATION OF HEALTH BENEFITS</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00102"><a href="/books/n/nap5501/ddd00084/#ddd00102" class="toc-item">COST FACTORS</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00106"><a href="/books/n/nap5501/ddd00084/#ddd00106" class="toc-item">VACCINE EFFICACY AND UTILIZATION</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00107"><a href="/books/n/nap5501/ddd00084/#ddd00107" class="toc-item">COST-EFFECTIVENESS RATIOS</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00108"><a href="/books/n/nap5501/ddd00108/" class="toc-item">6. Ethical Considerations and Caveats</a><ul id="toc_lst_NBK233313_ddd00109" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00109"><a href="/books/n/nap5501/ddd00108/#ddd00109" class="toc-item">ETHICAL AND VALUE JUDGMENTS BUILT INTO THE MODEL</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00115"><a href="/books/n/nap5501/ddd00108/#ddd00115" class="toc-item">CONSIDERATIONS OF JUSTICE</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00119"><a href="/books/n/nap5501/ddd00108/#ddd00119" class="toc-item">CONCLUSION</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00120"><a href="/books/n/nap5501/ddd00120/" class="toc-item">7. Observations</a><ul id="toc_lst_NBK233313_ddd00121" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK233313_ddd00121"><a href="/books/n/nap5501/ddd00120/#ddd00121" class="toc-item">THE FUNDING OF RESEARCH</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00122"><a href="/books/n/nap5501/ddd00120/#ddd00122" class="toc-item">NEGLECTED OPPORTUNITIES FOR VACCINE R&D</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00126"><a href="/books/n/nap5501/ddd00120/#ddd00126" class="toc-item">QUALITATIVE JUDGMENTS</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00127"><a href="/books/n/nap5501/ddd00120/#ddd00127" class="toc-item">VACCINE PROGRAM CONCERNS</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00128"><a href="/books/n/nap5501/ddd00128/" class="toc-item">References</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00129"><a href="/books/n/nap5501/ddd00129/" class="toc-item">APPENDIX 1 Borrelia burgdorferi</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00140"><a href="/books/n/nap5501/ddd00140/" class="toc-item">APPENDIX 2 Chlamydia</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00153"><a href="/books/n/nap5501/ddd00153/" class="toc-item">APPENDIX 3 Coccidioides immitis</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00164"><a href="/books/n/nap5501/ddd00164/" class="toc-item">APPENDIX 4 Cytomegalovirus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00175"><a href="/books/n/nap5501/ddd00175/" class="toc-item">APPENDIX 5 Enterotoxigenic E. coli</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00186"><a href="/books/n/nap5501/ddd00186/" class="toc-item">APPENDIX 6 Epstein-Barr Virus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00197"><a href="/books/n/nap5501/ddd00197/" class="toc-item">APPENDIX 7 Helicobacter pylori</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00208"><a href="/books/n/nap5501/ddd00208/" class="toc-item">APPENDIX 8 Hepatitis C</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00219"><a href="/books/n/nap5501/ddd00219/" class="toc-item">APPENDIX 9 Herpes Simplex Virus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00239"><a href="/books/n/nap5501/ddd00239/" class="toc-item">APPENDIX 10 Histoplasma capsulatum</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00250"><a href="/books/n/nap5501/ddd00250/" class="toc-item">APPENDIX 11 Human Papillomavirus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00261"><a href="/books/n/nap5501/ddd00261/" class="toc-item">APPENDIX 12 Influenza A and B</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00272"><a href="/books/n/nap5501/ddd00272/" class="toc-item">APPENDIX 13 Insulin-Dependent Diabetes Mellitus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00283"><a href="/books/n/nap5501/ddd00283/" class="toc-item">APPENDIX 14 Melanoma</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00294"><a href="/books/n/nap5501/ddd00294/" class="toc-item">APPENDIX 15 Multiple Sclerosis</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00305"><a href="/books/n/nap5501/ddd00305/" class="toc-item">APPENDIX 16 Mycobacterium tuberculosis</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00316"><a href="/books/n/nap5501/ddd00316/" class="toc-item">APPENDIX 17 Neisseria gonorrhea</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00327"><a href="/books/n/nap5501/ddd00327/" class="toc-item">APPENDIX 18 Neisseria meningitidis B</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00338"><a href="/books/n/nap5501/ddd00338/" class="toc-item">APPENDIX 19 Parainfluenza Virus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00349"><a href="/books/n/nap5501/ddd00349/" class="toc-item">APPENDIX 20 Respiratory Syncytial Virus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00360"><a href="/books/n/nap5501/ddd00360/" class="toc-item">APPENDIX 21 Rheumatoid Arthritis</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00371"><a href="/books/n/nap5501/ddd00371/" class="toc-item">APPENDIX 22 Rotavirus</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00382"><a href="/books/n/nap5501/ddd00382/" class="toc-item">APPENDIX 23 Shigella</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00393"><a href="/books/n/nap5501/ddd00393/" class="toc-item">APPENDIX 24 Streptococcus, Group A</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00404"><a href="/books/n/nap5501/ddd00404/" class="toc-item">APPENDIX 25 Streptococcus, Group B</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00417"><a href="/books/n/nap5501/ddd00417/" class="toc-item">APPENDIX 26 Streptococcus pneumoniae</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00428"><a href="/books/n/nap5501/ddd00428/" class="toc-item">APPENDIX 27 Information on Accessing Electronic Spreadsheets</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00429"><a href="/books/n/nap5501/ddd00429/" class="toc-item">APPENDIX 28 Summary of Workshops</a></li><li class="half_rhythm" id="toc_itm_NBK233313_ddd00456"><a href="/books/n/nap5501/ddd00456/" class="toc-item">APPENDIX 29 Questions Posed to Outside Experts and List of Responders</a></li></ul></div><div><p>This project has been funded in whole with federal funds from the National Institutes of Allergy and Infectious Diseases, National Institutes of Health, under Contract No. N01-AI-45237. The views presented are those of the Institute of Medicine Committee to Study Priorities for Vaccine Development and are not necessarily those of the funding organization.</p></div><div><p>NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.</p></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> 2000 by the National Academy of Sciences. All rights reserved.</div><div class="small"><span class="label">Bookshelf ID: NBK233313</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/25121214" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">25121214</a></span>DOI: <a href="http://dx.crossref.org/10.17226/5501" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">10.17226/5501</a></div><div style="margin-top:2em" class="bk_noprnt"><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nap5501/ddd00004/" title="Next page in this title">Next ></a></div></div></div></div>
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