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other national and international organizations should consider means to improve available epidemiological data on infectious diseases.

As a group, the vaccines assessed in this report are generally further from licensure than those evaluated in the first volume of the committee’s report (Institute of Medicine, 1985). Additionally, for most there appears to be less commercial interest in their development (although this is sometimes difficult to ascertain). The committee therefore recommends to NIAID and other federal agencies the careful examination of opportunities to accelerate the development and availability of vaccines identified here as meriting high priority. Although this report nominally addresses vaccines for the developing world, many of those assessed (e.g., S. pneumoniae) would considerably benefit the population in the United States.

The committee believes that a major strength of this analysis is that it encourages those using it to examine all judgments and assumptions in the decision process. The committee recommends use of the proposed system by government decision makers. New candidates should be assessed as they become technically feasible and new data should be incorporated as they become available.

After the committee achieved consensus on vaccine development predictions (late summer 1985) preliminary unpublished results from certain ongoing studies came to their attention. These results, if confirmed, may slightly alter the predictions on some vaccine candidates, particularly on candidates targeted against the same pathogen relative to each other, e.g., as for cholera and rotavirus. The committee did not conduct calculations based on the preliminary information but believes it would not significantly alter the overall conclusions described above; it recommends early reappraisal of candidate ranking as data from ongoing studies is publicly reported.

An improved vaccine for hepatitis B virus (a polypeptide produced by recombinant DNA technology), predicted by the committee to be licensed in 1 year or less, was in fact licensed on July 24, 1986.

REFERENCE

Institute of Medicine. 1985. New Vaccine Development: Establishing Priorities, Volume I. Diseases of Importance in the United States. Washington, D.C.: National Academy Press.



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