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Centre for Health Economics and Policy Analysis


Neighbouring countries' practices impact decisions on vaccine use

16 Mar 2010

Jessica Shearer, who joined the Health Policy PhD program last September, is the lead author of a publication showing that policies of neighbouring countries have a significant impact on a nation’s decision to adopt the use of Haemophilus influenza Type b vaccine (Hib).

The paper published in PLoS Medicine on March 16 is the result of a study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health, analyzing worldwide use of the Hib vaccine. Shearer led the project while working as a research associate at John Hopkins before joining McMaster.

The study analyzed data from 147 countries from 1990 to 2007, to identify factors that influence the time taken to introduce routine vaccination against Hib. It found that in addition to neighbouring countries’ practice, support from the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunization) was also a major influence in the decision to offer the vaccine.

“This study is the first to measure how countries' decisions to adopt new vaccines are highly influenced by their neighbours’ decisions,” said Shearer. “Countries seem to be engaging in an arms race to vaccinate - decisions which will save millions of lives.”

According to the study, the receipt of GAVI support accelerated the time to take the decision to use Hib vaccine by 63 per cent. The presence of two or more neighbouring countries using Hib vaccine accelerated adoption by 50 per cent. An increase in price increased the time it took a country to adopt Hib vaccine, which substantiated the findings of previous studies.

 “While high vaccine prices hinder adoption, the absence of long-term, stable financing policies at the global level had an even more detrimental effect,” said Shearer.

The World Health Organization estimates 2.1 million people died worldwide in 2002 due to vaccine-preventable diseases.

Since 2002, Canada has committed $348 million to the GAVI Alliance, a public-private partnership committed to increasing access to vaccines for the world’s poorest children.

Shearer has a master’s of health sciences degree from the Johns Hopkins School of Public Health and is a graduate of McMaster’s Arts & Science Program. She has worked in India and Senegal evaluating community-based public health projects, and with India's national immunization program. At McMaster she is exploring public health policymaking in West Africa, including the role of research evidence and networks of stakeholders, under the supervision of John Lavis.

To view Shearer’s publication, click here.

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