REQUESTS FOR PROPOSALS FOR PROJECTS RELATED TO QUANTITATIVE RESEARCH IN IMMUNIZATON
Other Quantitative Research Projects
A. Decision Analysis to Guide Policy on the Introduction of a Routine 2nd Dose of Measles Vaccine
The current WHO policy recommendation is that countries should provide all children with a 2nd opportunity for measles immunization either through regular mass vaccination campaigns (in countries with moderate to low immunization coverage) or through a routine 2nd dose (in countries with high coverage). However, there is no consensus on what constitutes "high coverage". WHO is requesting proposals that will conduct a decision analysis using a fully dynamic model of measles transmission that:
- Accurately describes measles transmission in a developing country setting
- Estimates the impact introduction of a routine 2nd dose of measles vaccine on population immunity, disease transmission, and disease incidence and mortality
- Evaluates the effect of different levels of coverage with both the 1st and 2nd dose on disease incidence and mortality
- Explores the definition of what constitutes "high coverage" -- that is the level of 2nd dose coverage above which significant gains occur in population immunity
- Enables addition of cost parameters in order to calculate the cost-effectiveness of different vaccination scenarios including a comparison between introduction of a routine 2nd dose and conducting regular follow-ups campaigns
B. Decision analysis of pursuing global eradication of measles versus achieving and sustaining the current regional elimination and/or control targets.
Measles is thought to have the biological characteristics and an effective intervention (measles vaccine) that would allow it to be eradicated. However, debate continues as to whether the world should target measles for global eradication given its highly infectious nature, the relatively weak state of some national immunization programmes and the fact that polio eradication is not yet completed.
The Region of the Americas has stopped endemic measles transmission since November 2002 but continues to get importations of measles that result in costly outbreak response efforts. Three WHO regions (European, Eastern Mediterranean, and Western Pacific) have established measles elimination goals. The remaining two regions (Africa and SE Asia) have measles mortality reduction goals and the overriding global goal for measles control is a 90% reduction in measles deaths by 2010 compared with 2000 levels.
WHO is seeking letters of intent describing an approach to a decision analysis contrasting a programme targeting global eradication of measles with the current regional elimination and/or mortality reduction goals. This approach should include:
- Use of a fully dynamic model of measles transmission applied to actual country and regional data of measles vaccination coverage.
- Assumptions and parameters in the model should be based on a recent review of the published literature.
- A description of the data needs and rough time frame for conducting the disease burden and economic analyses required for the project.
C. A systematic review of the literature on the impact of routine immunization on child mortality.
As progress towards achieving the Millennium Development Goals is monitored, a question arises, particularly for MDG 4, as to the specific contribution immunization has made to reducing child mortality.
The goal of this project would be to conduct a systematic literature review to document the impact of routine immunization on overall child mortality levels, and to analyse the results of that literature review.