The role of epidemiology in the introduction of vi polysaccharide typhoid fever vaccines in Asia.
Despite the availability of at least two licensed typhoid fever vaccines--injectable sub-unit Vi polysaccharide vaccine and live, oral Ty21a vaccine--for the last decade, these vaccines have not been widely introduced in public-health programmes in countries endemic for typhoid fever. The goal of the multidisciplinary DOMI (Diseases of the Most Impoverished) typhoid fever programme is to generate policy-relevant data to support public decision-making regarding the introduction of Vi polysaccharide typhoid fever immunization programmes in China, Viet Nam, Pakistan, India, Bangladesh, and Indonesia. Through epidemiological studies, the DOMI Programme is generating these data and is offering a model for the accelerated, rational introduction of new vaccines into health programmes in low-income countries. Practical and specific examples of the role of epidemiology are described in this paper. These examples cover: (a) selection of available typhoid fever vaccines to be introduced in the programme, (b) generation of policy-relevant data, (c) providing the 'backbone' for the implementation of other multidisciplinary projects, and (d) generation of unexpected but useful information relevant for the introduction of vaccines. Epidemiological studies contribute to all stages of development of vaccine evaluation and introduction.
Acosta
Camilo J
CJ
International Vaccine Institute, Seoul, Republic of Korea. Camilo_acosta2003@yahoo.com
Galindo
Claudia M
CM
Ochiai
R Leon
RL
Danovaro-Holliday
M Carolina
MC
Page
Anne-Laure
AL
Thiem
Vu Dinh
VD
Park
Jin Kyoung
JK
Park
Eunsik
E
Koo
Hyewon
H
Wang
Xuan-Yi
XY
Abu-Elyazeed
Remon
R
Ali
Mohammad
M
Albert
M John
MJ
Ivanoff
Bernard
B
Pang
Tikki
T
Xu
Zhi-Yi
ZY
Clemens
John D
JD
D001208:Asia / Q000453:epidemiology; D001428:Bacterial Vaccines; D017281:Cost of Illness; D003906:Developing Countries / Q000191:economics; D016021:Epidemiologic Studies; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D011135:Polysaccharides, Bacterial / Q000008:administration & dosage; D012485:Salmonella typhi / Q000276:immunology; D014435:Typhoid Fever / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D014436:Typhoid-Paratyphoid Vaccines / Q000008:administration & dosage; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated
D001428:Bacterial Vaccines; D011135:Polysaccharides, Bacterial; D014436:Typhoid-Paratyphoid Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated; C057664:Vi polysaccharide vaccine, typhoid