Planning and priority setting for vaccine development and immunization.

Area of Science:

• Public Health
• Health Policy
• Decision Science

Background:

• The United States has a history of strategic planning for prioritizing new vaccine candidates.
• The Institute of Medicine has led three distinct priority-setting initiatives since 1985.
• Previous methods relied on single metrics, such as infant mortality equivalents and cost-effectiveness.

Purpose of the Study:

• To review the evolution of vaccine candidate prioritization strategies in the US.
• To introduce a modern multi-criteria decision support system for vaccine policy.
• To highlight the advantages of a flexible, systems-based approach over static, single-metric methods.

Main Methods:

• Review of historical strategic planning efforts and methodologies for vaccine prioritization.
• Description of a multi-criteria systems approach implemented in 2015.
• Incorporation of stakeholder feedback on the developed decision support tool.

Main Results:

• Evolution from infant mortality equivalents and cost-effectiveness to a flexible multi-criteria system.
• The new system allows for dynamic evaluation of vaccine candidates based on multiple attributes.
• Overcomes limitations of static, single-metric approaches that struggle with new data.

Conclusions:

• A multi-criteria systems approach enhances vaccine policy decision-making by incorporating diverse factors.
• This flexible approach can adapt to emerging pathogens, scientific advances, and changing intervention costs.
• The enhanced system provides a more robust framework for informing and supporting vaccine policies.