Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine A Global, Multivariable Analysis 英文参考文献.docVIP

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Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine A Global, Multivariable Analysis 英文参考文献.doc

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Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine A Global, Multivariable Analysis 英文参考文献

AcceleratingPolicyDecisionstoAdoptHaemophilus influenzaeTypebVaccine:AGlobal,Multivariable Analysis JessicaC.Shearer1,2*¤,MeghanL.Stack1,2,MarcieR.Richmond1,2,AllysonP.Bear1,2,RanaA.Hajjeh1,2 DavidM.Bishai1 , 1JohnsHopkinsBloombergSchoolofPublicHealth,Baltimore,Maryland,UnitedStatesofAmerica,2HibInitiative,Baltimore,Maryland,UnitedStatesofAmerica Abstract Background:Adoptionofnewandunderutilizedvaccinesbynationalimmunizationprogramsisanessentialsteptowards reducingchildmortality.Policydecisionstoadoptnewvaccinesinhighmortalitycountriesoftenlagbehinddecisionsin high-incomecountries.UsingthecaseofHaemophilusinfluenzaetypeb(Hib)vaccine,thispaperendeavorstoexplainthese delaysthroughtheanalysisofcountry-leveleconomic,epidemiological,programmaticandpolicy-relatedfactors,aswellas theroleoftheGlobalAllianceforVaccinesandImmunisation(GAVIAlliance). Methods and Findings: Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identifyfactorsthatareassociatedwiththetimetodecisiontoadoptHibvaccine.Inmultivariablemodelsthatcontrolfor GrossNationalIncome,region,andburdenofHibdisease,thereceiptofGAVIsupportspeededthetimetodecisionbya factorof0.37(95%CI0.18–0.76),or63%.Thepresenceoftwoormoreneighboringcountryadoptersaccelerateddecisions toadoptbyafactorof0.50(95%CI0.33–0.75).Foreach1%increaseinvaccineprice,decisionstoadoptaredelayedbya factorof1.02(95%CI1.00–1.04).Globalrecommendationsandlocalstudieswerenotassociatedwithtimetodecision. Conclusions:Thisstudysubstantiatespreviousfindingsrelatedtovaccinepriceandpresentsnewevidencetosuggestthat GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisionswasalsohighlysignificant,suggestingthatapproachestosupporttheadoptionofnewvaccinesshouldconsider supply-anddemand-sidefactors. PleaseseelaterinthearticlefortheEditors’Summary. Citation:ShearerJC,StackML,RichmondMR,BearAP,HajjehRA,etal.(2010)AcceleratingPolicyDecisionstoAdoptHaemophil