Johns Hopkins Vaccine Initiative 2014 Vaccine Internship Experience at WHO (VIEW) Sample Internship Descriptions A. Monitoring the progress of the Launching of Global Vaccine Action Plan (GVAP) (Senouci) ................................................................................................. 2 B. Support Understanding Factors Associated with Vaccine Receipt to Inform Field Evaluations of Influenza Vaccine Effectiveness (Ortiz) ........................... 4 C. Supporting the Introduction and Use of Vaccines Through the Collection, Analysis and Reporting of Global VPD Surveillance Data (Agocs) ......................................................................................................................... 6 D. Supporting the Work of the Strategic Advisory Group (SAGE) on Immunization within the WHO Immunization Policy Unit (Schuster) ......................... 8 E. Systematic reviews of vaccine economic studies in low and middle income countries (LMICs) (Hutubessy) ...................................................................... 10 1 | P a g e A. Monitoring the progress of the Launching of Global Vaccine Action Plan (GVAP) (Senouci) Objectives: Background: The Global Vaccine Action Plan (GVAP)1 ― endorsed by the 194 Member States of the World Health Assembly in May 2012 ― is a framework to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities. GVAP aims to strengthen routine immunization to meet vaccination coverage targets; accelerate control of vaccine-­‐preventable diseases with polio eradication as the first milestone; introduce new and improved vaccines and spur research and development for the next generation of vaccines and technologies. In May 2013, the Sixty-­‐sixth World Health Assembly noted the Secretariat’s report with its proposed framework for monitoring, evaluation and accountability2 as well as the process for reviewing and reporting progress under the independent oversight of the Strategic Advisory Group of Experts on immunization.3 Scope of Work for GVAP Monitoring and Evaluation !
Assist in the development of the annual GVAP Secretariat Report which covers all aspects of the Immunization Policies and Programmes at Country levels (coverage, prices, demand, quality, safety, logistics etc) !
Conduct descriptive analysis on National and Local level Immunization Coverage using Countries’ data !
Develop innovative visual data representation to facilitate the understanding of the weaknesses and challenges countries are facing in the immunization area !
Collaborate with Countries to develop case studies on best practices in the immunization area Note: Discussions would be held with the selected candidate to determine a mutually agreeable and specific scope of work that draws from the above points. Necessary skills: Languages: Fluency in English. Computer skills: Proficiency with Microsoft Excel, Word, PowerPoint and e-­‐mail. Experience with database software such as Microsoft Access desirable. 1
http://www.who.int/immunization/global_vaccine_action_plan/en/
2
http://www.who.int/entity/immunization/global_vaccine_action_plan/GVAP_Annex6.pdf
3
http://www.who.int/immunization/sage/sage_wg_decade_vaccines/en/index.html
2 | P a g e Professional Experience: Understanding of immunization challenges in Low and Middle income countries. Training and experience with collection, analysis and representation of data. Training and experience in quantitative data analysis. Useful, but not required: Experience in working with Low and Middle Income Countries. Experience with data visualisation software. Name of supervisor: Dr Kamel Senouci WHO/IVB 3 | P a g e B. Support Understanding Factors Associated with Vaccine Receipt to Inform Field Evaluations of Influenza Vaccine Effectiveness (Ortiz) Objectives: Background: Given the high burden of severe influenza disease in early childhood, the World Health Organization (WHO) recommends countries considering the initiation or expansion of influenza vaccine programs should give pregnant women the highest priority for influenza vaccine receipt. WHO noted that additional risk groups to be considered for vaccination, should include children aged 6–59 months, the elderly, individuals with specific chronic medical conditions, and health-­‐care workers. Influenza vaccination is the best way to prevent severe influenza illness, yet many low and middle income countries do not use influenza vaccine in their routine immunization programs. Many countries cite the absence of national/subregional data for vaccine effectiveness as a key impediment to developing policies for routine influenza immunization. To assist countries to generate data on influenza vaccine performance, WHO is developing a field guide to assist public health officials to assess the effectiveness of influenza vaccine in observational studies. Observational studies of influenza vaccine effectiveness are subject to a number of biases. One important bias, confounding bias, occurs when the effect of vaccination on the risk of the outcome of interest (laboratory-­‐confirmed influenza infection) is distorted by other factors associated both with vaccination and influenza infection. Knowledge of the factors associated with vaccine receipt will allow public health researchers to account for these factors in study design and analysis. Scope of Work for VPD Surveillance !
Assist in the development of two systematic review analysis plans: 1) a systematic review of the biomedical literature to determine factors associated with seasonal influenza vaccine receipt categorized by low and high resource setting; 2) a systematic review of the biomedical literature to determine factors associated with tetanus vaccine receipt during pregnancy through routine immunization programs (and not campaigns or supplemental immunization activities). !
Develop data abstraction forms to ensure critical study data are captured. !
Conduct systematic biomedical literature search for relevant articles, abstract data, and organize data to assist data visualization. !
Conduct narrative review of other data sources, such as UNICEF reports, to identify potential factors (system and individual-­‐level factors) associated with tetanus receipt during pregnancy. 4 | P a g e !
Synthesize data and report to WHO Initiative for Vaccine Research (IVR) on the project findings !
Make recommendations to IVR on how to account for potential confounding in vaccine effectiveness evaluations. !
Assist with the development of a report for publication describing the two reviews. !
Assist with the development of data collection tools to be used in field evaluations of influenza vaccine effectiveness !
Draft a chapter of the WHO Influenza Vaccine Effectiveness Field Guide on factors associated with vaccine receipt. Note: Discussions would be held with the selected candidate to determine a mutually agreeable and specific scope of work that draws from the above points. Necessary skills: Languages: Fluency in English. Working knowledge of French desirable. Computer skills: Proficiency with Microsoft Excel, Word, PowerPoint, e-­‐mail, and reference management software (such as Endnote). Professional Experience: An understanding of systematic reviews, and their strengths and limitations. Working knowledge of research using biomedical databases including EMBASE, Pubmed, and Cochrane databases. Training and experience in quantitative data analysis. Name of supervisor: Justin Ortiz, MSc, MD Lead Influenza projects Initiative for Vaccine Research 5 | P a g e C. Supporting the Introduction and Use of Vaccines Through the Collection, Analysis and Reporting of Global VPD Surveillance Data (Agocs) Objectives: Background: Vaccines are one of the most cost-­‐effective interventions to improve public health. In addition to the six traditional vaccines against diphtheria, tetanus, pertussis, polio, measles and tuberculosis (BCG), recent years have seen a dramatic increase in the number of new vaccines that can provide additional prevention of untimely deaths and disabilities. These include vaccines against hepatitis B, invasive Haemophilus influenzae type b (Hib) disease, pneumococcus, rotavirus, Human Papilloma Virus (HPV) and rubella. As countries are considering including these new and relatively expensive vaccines into their immunization schedules, decision makers require reliable data to determine how to best allocate their resources in support of public health programmes. Additionally, vaccine coverage monitoring is critical in order to evaluate the effectiveness of vaccine delivery programmes and to evaluate vaccine impact 5-­‐30 years after immunization. During the past several years, various data collection systems have been established to provide surveillance data for decision makers around the introduction of new and underutilized vaccines. These various systems are being transitioned into the WHO surveillance reporting network and are now allowing global comparisons to be made between countries and over time. During this process, due attention is being paid to ensuring that data are collected in a standardized and routine manner for quality assurance and data comparison purposes. Scope of Work for VPD Surveillance !
Analysis of surveillance data over time to identify trends in sentinel surveillance data for rotavirus and invasive bacterial vaccine preventable diseases (IB-­‐VPD) from 2008 to present to identify any significant changes, globally, regionally or by country; !
Assist in reviewing the WHO surveillance performance indicators for rotavirus and IB-­‐VPD sentinel surveillance to identify areas for improvement in reporting and monitoring the indicators; !
Develop a surveillance performance ‘report card’ that can be visually used to monitor data quality by country; !
Assess VPD surveillance data reported to WHO by Member States via the Joint Reporting Form; and !
Synthesize the existing information to provide recommendations in how to target efforts to strengthen surveillance and to better understand the surveillance data. 6 | P a g e Note: Discussions would be held with the selected candidate to determine a mutually agreeable and specific scope of work that draws from the above points. Necessary skills: Languages: Fluency in English. Working knowledge of French desirable. Computer skills: Proficiency with Microsoft Excel, Word, PowerPoint and e-­‐mail. Experience with database software such as Microsoft Access desirable. Professional Experience: An understanding of surveillance systems and their strengths and limitations. Training and experience in quantitative data analysis. Useful, but not required: Experience with collection or analysis of survey data; experience evaluating vaccination coverage. Name of supervisor: Dr Mary Agocs WHO/IVB/EPI 7 | P a g e D. Supporting the Work of the Strategic Advisory Group (SAGE) on Immunization within the WHO Immunization Policy Unit (Schuster) Background: SAGE is the principal advisory group to WHO for vaccines and immunization. It is charged with advising WHO on overall global policies and strategies, ranging from vaccines and technology, research and development, to delivery of immunization and its linkages with other health interventions. SAGE is concerned not just with childhood vaccines and immunization, but all vaccine-­‐preventable diseases. Under the supervision of the Senior Health Adviser of the Immunization Policy Unit, Dr Philippe Duclos, the intern will contribute to the work of the unit and assist in the formulation of evidence-­‐based policy recommendations for immunization and the improvement of the related processes for the development of such policies both at global and country level. In particular the intern will be tasked to facilitate the functioning of SAGE, its related working groups and the development of global vaccination guidelines (vaccine position papers) and possibly to contribute to the strengthening of National Immunization Technical Advisory Groups and the monitoring of this activity. Scope of work: •
retrieve, review, summarize and present evidence relevant to SAGE and/or its related working groups •
critically appraise and assess the strength of evidence in support of key recommendations •
attend SAGE meetings if within period of the internship (April or October 2014) •
attend SAGE working group and editorial board meetings (the IVB editorial board oversees the production of vaccine position papers) •
help with improvement of standard operating procedures for SAGE and vaccine position papers •
assist with SAGE related communication activities, such as the update or revision of SAGE websites or key documents •
develop summary of WHO position papers as power point presentation to be published on WHO website Skills necessary: •
Experience in the field of vaccinology and immunization •
Background in epidemiology, capacity to analyze data (quanitative) •
Good writing skills 8 | P a g e •
Proficiency with literature searches on PubMed and preferably other databases •
Tact and ability to work with people of different technical and cultural backgrounds •
Proficiency with email, web and MS Office software (Word, Excel, PowerPoint) •
Fluency in English •
Experience in the field of communications, legal or policy/decision making would be an asset •
Working knowledge of either of Arabic/Chinese/French/Spanish/Russian would be an asset •
An understanding of GRADE methodology and its strengths and limitations would be an asset The specific activities and project(s) will be agreed with the intern and will depend on period set for the internship, its duration, as well as the skills and interest of the incumbent and evolution of the needs. Name of supervisor: Ms Melanie Schuster WHO/IVB 9 | P a g e E. Systematic reviews of vaccine economic studies in low and middle income countries (LMICs) (Hutubessy) Background: Over the next decade several new vaccines will become available against infectious diseases of major public health importance. Public health decision-­‐makers will need to make choices, between vaccines and between other preventive interventions. New vaccines (e.g. pneumococcal, rotavirus and human papillomavirus vaccines) are more expensive compared to the dollar cents traditional vaccines costs (e.g. diphtheria, tetanus, pertussis, polio, measles and tuberculosis) while countries increasingly have to carry the full costs of vaccination programs. Among other things decision makers need information on the relative cost-­‐effectiveness (CE) of vaccines compared to other preventive interventions. In order to assist countries in the collection of local economic evidence for vaccine introduction decisions WHO is engaged in performing systematic reviews of published costing and cost-­‐
effectiveness studies of different vaccines available in low and middle-­‐income countries. These reviews are a crucial and integral part of various work packages ongoing within the WHO Initiative for Vaccine Research (IVR) such as comprehensive WHO cervical cancer prevention and control costing project4, dengue vaccine cost-­‐effectiveness comparison exercise and WHO-­‐
CHOICE for vaccine preventable diseases5. The WHO Guide on standardization of economic evaluations of immunization programs6 is a generic key document in WHO IVR’s work on vaccine economics. Scope of Work: The WHO IVR seeks an intern to work under the supervision of WHO technical staff of the implementation research group to undertake a project with the aim to perform systematic reviews of published cost-­‐effectiveness and costing studies from low and middle income countries for various vaccine preventable disease such as cervical cancer, influenza, dengue, pneumonia etc. The detailed terms of reference can be tailored to the specific interests and experience of the intern. It is intended that a review publication will arise from this project. Skills Necessary: Fluency in English 4
http://www.who.int/immunization/diseases/hpv/cervical_cancer_costing_tool/en/index.html
5
See : http://www.who.int/choice
6
See http://whqlibdoc.who.int/hq/2008/WHO_IVB_08.14_eng.pdf.who.int/immunization/
10 | P a g e Proficiency with Microsoft Excel, email and word processing software Proficiency with literature searches on PubMed and preferably other databases Training and experience in health economics Name of Supervisor: Dr Raymond Hutubessy WHO/IVB/IVR 11 | P a g e