Vaccine Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 381

of 147 countries. But only 26 % of the NITAGs met all indicators of a well functioning
NITAG. 15 The factors most widely considered by NITAGs when making recom-
mendations are vaccine safety (100 % of countries), disease burden in the home
country (99 %), public health/epidemiology (95 %), fi nancial aspects such as cost-
effectiveness (91 %), public perception of the disease (59 %), and recommendations
from NITAGs in other countries (55 %). Vaccine effectiveness was the most widely
used factor (98 %) in non-European countries (Bryson et al. 2010 ).

13.3.4.2 National Medical Societies

Many national medical societies issue vaccine recommendations. An internet search
of recommendations on HPV vaccination identifi ed four issuing organizations in
the United States, fi ve in Canada, and fi ve in Spain, among others (Marquez-
Calderon et al. 2009 ). Recommendations by medical societies have a signifi cant
impact on physicians' vaccination behavior (see section “Medical Concerns” ).
National medical societies can also infl uence recommendations issued by
NITAGs. For example, the US ACIP includes liaison representatives from medical
societies as nonvoting committee members. 16 They are required to bring the per-
spective of their organizations to the ACIP and to disseminate ACIP's recommenda-
tions back to their membership. ACIP recommendations may be developed and
issued jointly with medical societies (Smith et al. 2009 ; Smith 2010a ).

13.3.4.3 The World Health Organization

The WHO, an agency of the United Nations (UN), defi nes global immunization
goals and plays an important role in all stages of the vaccine value chain. WHO sup-
ports vaccine and immunization R&D through partnerships (e.g., the Meningitis
Vaccine Project (MVP), Butler 2010 ), issues recommendations to help countries
decide which vaccines to introduce, sets technical specifi cations that form the basis
of guidelines for vaccine production and prequalifi cation, prequalifi es vaccines,
provides technical support to countries for the introduction of new vaccines, esti-
mates the burden of vaccine-preventable diseases, monitors countries' immuniza-
tion policies, and plays a key role in managing pandemics such as the 2009 H1N1
pandemic.

15 The SIVAC Initiative (Senouci et al. 2010 ) and PAHO's ProVac Initiative (Jauregui et al. 2011),
both funded by the Bill & Melinda Gates Foundation, have as their main mission to help countries
establish or strengthen their NITAG's capacity to make informed, evidence-based decisions on the
introduction of new vaccines.
16 As of 1 January 2010, ACIP liaison representatives include representatives from the American
Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP; two representa-
tives), American College of Obstetricians & Gynecologists (ACOG), American College of
Physicians (ACP), and American Medical Association (AMA), among others (Smith 2010a ).