April 2021
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April 15, 2021 | Using PriorityVax with Frameworks for Equitable Allocation of COVID-19 Vaccines
As vaccines continue to become available they hold the promise of relieving the humanitarian and economic crises brought on by COVID-19. But while demand for such vaccines outstrips supply, equitable access must be ensured. PriorityVax provides a customizable, web-based tool in which users can employ the national and subnational data they have identified as best-suited to inform their priority-setting decisions and to place equity at the center of vaccine selection, allocation, and distribution. The platform’s priority-setting analyses can easily be adapted to support a range of established frameworks for COVID-19 vaccine allocation and data generation. Analytical templates have been developed to support both the WHO and NASEM equitable allocation frameworks and the use of model-generated data from sources such as the Africa COVID Community Vulnerability Index. A brief demonstration of these analyses and how the tool works are described in the video above.
Nov 30, 2020 | PriorityVax precursor published in BMJ Global Health:
Priority setting is critical to making sustainable decisions for introducing new and underutilized vaccines, in choosing among vaccine products, and in determining who gets a vaccine first when supplies are limited. In resource-constrained environments, priority setting enables complex choices that often must be made among a growing range of vaccines. Today, as every country anticipates allocation of limited supplies of a SARS-CoV-2 vaccine, the difficulty of optimizing immunization outcomes—and the need for robust priority setting—are clearer than ever.
The goal of priority setting is to drive vaccine decisions based on local knowledge of health systems, epidemiology, national capacity and financial sustainability. Establishing a local context is crucial to making tractable, useful, evidence-informed decisions.
The web-based decision-support tool, SMART Vaccines 2.0, based on Multi-Criteria Decision Analysis methodology, was designed to elicit the subjective and competing aspects of vaccine decision making, and to combine those with both quantitative and qualitative evidence. This tool was implemented in a pilot project by the Uganda National Immunisation Technical Advisory Group (NITAG), the results of which were recently published in BMJ Global Health.
The Ugandan Ministry of Health had requested the NITAG to develop recommendations on the prioritized introduction of five new vaccines. McCormick and coauthors report on the NITAG’s use of SMART Vaccines 2.0, in parallel to existing decision-making processes, as they produced recommendations that were accepted in full. They found that SMART Vaccines 2.0 revealed committee preferences and biases that influenced recommendations, an important test of their sensitivity.
Feedback from this pilot informed further evolution of the tool to meet the needs of decision makers, resulting in its next-generation version, PriorityVax. This improved platform, supported by the Sabin Vaccine Institute, has a more streamlined user experience and a clearer selection and use of attributes. Users can easily tailor PriorityVax to incorporate local evidence-to-recommendation processes.
About PriorityVax
Welcome to PriorityVax – an interactive, online tool to support deliberations and decision-making using evidence-to-recommendation frameworks. Here, we introduce the tool and take a quick tour of its background and features.
As resources are limited and the costs and range of available vaccines increase, priority setting is needed to help balance the many competing needs within a health system and to equitably and transparently establish how to select appropriate vaccines. PriorityVax has been designed to support decision-making that emphasizes the importance of local context in identifying key criteria for decisions and the evaluation of related evidence.
Use Case 1: Considering new vaccines for introduction in Uganda
In this use case, we follow the deliberative process of the Uganda National Immunization Technical Advisory Group (NITAG) as they prioritized between new vaccines that were under consideration for introduction to routine immunization. We look at entering evidence gathered through a systematic review and GRADE process and then use PriorityVax to explore opinions within the committee.
Use Case 2: Selection of Pneumococcal Conjugate Vaccine products in Papua New Guinea
In this use case, we compare two Pneumococcal Conjugate Vaccine (PCV) products that were considered for introduction into Papua New Guinea. Comparing different vaccine formulations and profiles is likely an increasing concern for countries that are graduating from Gavi, the vaccine alliance. We additionally review how the tool supports the updating of evidence over time to re-assess prioritization and to explore putative scenarios to reflect future constraints (e.g. costs or storage space requirements).
PriorityVax User Guide
The PriorityVax User Guide is a how-to manual for navigating the PriorityVax decision-making tool.
Additional Resources
SMART Vaccines 2.0 decision-support platform: a tool to facilitate and promote priority setting for sustainable vaccination in resource-limited settings, Stacey L Knobler, Benjamin J McCormick, Peter Waiswa, Celia Nalwadda, Nelson K Sewankambo; BMJ Global Health 2020;5:e003587.
Supporting immunization decision-making in low and lower-middle-income countries, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health
Informing vaccine decision-making: A strategic multi-attribute ranking tool for vaccines—SMART Vaccines 2.0, Stacey Knobler, Karin Bok, Bruce Gellin; Vaccine, Volume 35, Supplement 1, 2017, https://doi.org/10.1016/j.vaccine.2016.10.086.
Who gets a COVID vaccine first? Access plans are taking shape, Nidhi Subbaraman, Nature, 18 September 2020, https://www.nature.com/articles/d41586-020-02684-9
Ranking Vaccines: Applications of a Prioritization Software Tool: Phase III: Use Case Studies and Data Framework, National Academy of Engineering, Institute of Medicine, Committee on Identifying and Prioritizing New Preventive Vaccines for Development, 19 December 2017, https://www.nap.edu/download/18763
Priority setting: what constitutes success? A conceptual framework for successful priority setting, Shannon L Sibbald, Peter A Singer, Ross Upshur, Douglas K Martin; Department of Health Policy, Management and Evaluation, University of Toronto, 5 March 2009, https://pubmed.ncbi.nlm.nih.gov/19265518/
Gavi's balancing act: Accelerating access to vaccines while ensuring robust national decision-making for sustainable programmes, Stephen Sosler, Judith Kallenberg, Hope L Johnson; Gavi, the Vaccine Alliance, 7 May 2015, https://pubmed.ncbi.nlm.nih.gov/25919172/
Contact Us
For more information, email PriorityVax@Sabin.org
About the Sabin Vaccine Institute
The Sabin Vaccine Institute is a leading advocate for expanding vaccine access and uptake globally, advancing vaccine research and development, and amplifying vaccine knowledge and innovation. Unlocking the potential of vaccines through partnership, Sabin has built a robust ecosystem of funders, innovators, implementers, practitioners, policy makers and public stakeholders to advance its vision of a future free from preventable diseases. As a non-profit with more than two decades of experience, Sabin is committed to finding solutions that last and extending the full benefits of vaccines to all people, regardless of who they are or where they live. At Sabin, we believe in the power of vaccines to change the world. For more information, visit sabin.org and follow us on Twitter, @SabinVaccine
Credits:
Created with images by Dylan Gillis - "Teamwork makes the dream work." • alirazagurmani9272 - "vaccine covid-19 vial" • SZappi - "africa sand road horizon"