1. Expert Working Group
Planning for adolescent & adult
vaccination in middle and low income
countries
September 4-5, 2013
Aeras
1405 Research Blvd.
Rockville, MD

2. Aims and outcomes of the workshop
Aims of the workshop
•
•
•
To identify what is known about adolescent and adult vaccination and the
critical gaps in knowledge (current schedules, coverage rates, barriers…)
To identify what is known about measuring social and behavioral determinants
for adult vaccination
To identify and prioritize the key elements of an adolescent and adult
vaccination research agenda to inform vaccine development and effective
vaccination strategies that reduce the risk of illnesses in these populations
Expected Outcomes of the Workshop
•
•
•
Research agenda identified and prioritized to pinpoint where better information
or research would fill critical knowledge gaps to better inform decision makers
Key social and behavioral determinants identified for adult vaccination
Publication of a meeting summary
2

3. Agenda – Day 1
What do we really know about adult vaccination?
Time
12:00 - 12:30
Topic
Presenter
Lunch
12:30 – 12:45 Welcome and Introductions
T. Evans
12:45 - 1:15
Agenda review and purpose of meeting; setting the stage
A. Nanni
1:15 – 1:45
Literature review - social and behavioral determinants of
adult vaccination
Q&A
S. Gati
1:45 – 2:45
Social and behavioral determinants
Q&A
2:45 – 3:00
BREAK
3:00 - 3:30
3:30 – 4:00
4:00 – 4:30
4:30 – 5:00
5:00-5:15
6:30 -
Ethical issues specific to adult and adolescent vaccination
Q&A
HIV/AIDS - Epidemiology of HIV /AIDS infection and disease
Q&A
TB - TB infection and disease; the case for adolescent &
adult vaccination
Q&A
Malaria Vaccines: Change from control to
elimination/eradication Q&A
Wrap up Day 1
Dinner – Change in Venue
A. Glattman-Freedman
D. Curry
A. Naeveke
A. Ginsberg
C. Botting
All
Thai Pavilion
Rockville Town Square, 29 Maryland
Ave #308 Rockville, MD 20850
3

4. Agenda - Day 2
The Shifting Global Distribution of Poverty and
the Impact on Disease Burden
Time
Topic
9:00 - 9:15
Breakfast
9:15 - 9:30
Recap of Day 1
Presenter
9:30 – 10:00
10:00 – 10:30
10:30- 10:45
10:45 – 12:45
UNICEF
Q&A
The potential health impact on countries graduating to MICs
segments; a case for TB
Q&A
Break
Global Health and the New Bottom Billion; Input into thinking about
policy implications for adult vaccination in middle-income countries
Urbancity and urbanization: Challenges for adult access to vaccines
12:45 – 1:15
1:15 – 2:15
Lunch
Global Health and the New Bottom Billion
Discussion – implications for global health
2:15 – 3:45
Group Discussion - Framing and formation of the research questions
3:00 - 3:15
Closing and next steps
T. O’Connell
V. Cardenas
A. Glassman
D. Ompad
A. Glassman/All
Break
3:45 – 4:00
A. Nanni
L. Privor-Dumm
All
4

5. Life-Course Immunization;
Not just for infants and children under-five
anymore
• “Disease-free, (young adults and) older adults can remain
active, healthy participants in society while curtailing
increases in healthcare expenses and more fully engaging
in economic life.”
• “…researchers have argued before, this creates a multitiered win for individuals and societies. Health costs are
contained, and economic productivity goes up.”
The economic benefit of healthy adult
populations, specifically in middle and low income
economies, is unrealized
Source: Garau, Hodin, …Life Course Immunization; A driver of healthy aging.
Global Coalition on Aging

6. Why now? The case for adult immunization
•
•
In the developing world, there is often lack of resources, political will and
awareness on immunization and the impact on health, it takes years to build
As we have seen with childhood vaccinations, access is only part of the
equation. The other part is raising awareness and understanding of how
vaccines can improve health and economies
Adult immunizations have:
– complex vaccination schedules
– inadequate physician and patient knowledge
– patients have limited awareness of the benefits of vaccinations for themselves and
their families
– lack of vaccination recommendation alignment among national and global bodies
– lack of patients complying with recommendations
It takes decades for new public health
interventions to reach those most in need

7. Adult immunization should be a major policy
priority for policymakers and other stakeholders
• Creating and gathering the data that supports the
public health benefits of adult immunizations could
lead to:
– New vaccine innovations
– Expansion of the vaccine market; incentives for R&D and
pharmaceutical companies to bring products to market
– Potential economic growth in middle and low income
countries
This is also how childhood immunizations were
developed, and the model of success should be
brought to innovations in adult vaccines
7

8. Bringing adult immunization into global
public health in the 21st century
The GAVI Alliance has done a tremendous job of creating
an appreciation and delivering children’s vaccines in the
developing world.
Now is the time to create similar levels of attention on
the critical value of adolescent & adult vaccines as the
global population ages