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David curry

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  • 1. Evidence, Ethical Imperatives and Policy Priorities: adult and adolescent vaccination Planning for Adult Vaccination in Middle and Low Income Countries – HIV, TB, and Malaria Workshop Aeras, 4-5 September 2013 David R. Curry, MS Executive Director Center for Vaccine Ethics and Policy Associate Faculty, Department of Medical Ethics NYU Medical School, NYU Langone Medical Center david.r.curry@centerforvaccineethicsandpolicy.org
  • 2. Mission: Contribute to public health as the leading independent, academically-based center focused on global immunization and vaccine ethics and policy
  • 3. Three Ideas:  Evidence-based Policy Consensus  Bioethics/Ethical Principles & Imperatives  (Harsh) Realities of Immunization Priorities (GVAP)
  • 4. Evidence-based Policy Consensus A threshold in policy evolution where available evidence and its analysis is sufficient to drive broad alignment across relevant scholarly, professional and regulatory communities Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 5. Bioethics Bioethics provides an orderly way of thinking about where and how "values" should inform policy, practice and action. Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 6. Ethical Principles Underlying Vaccine Policy Formation Harm Principle Autonomy Beneficence Non-maleficence Justice Laws Social Norms Effectiveness Proportionality Necessity Infringement Public Justification Religious/Cultural Frameworks Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 7. Are “values” and “social norms” forms of evidence? How to portray the “available evidence” and incorporate “values”? Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 8. Draft “Future State” Conceptual Map ?2015 Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011 David R. Curry, MS Executive Director Center for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics University of Pennsylvania david.r.curry@centerforvaccineethicsandpolicy.org
  • 9. Draft “Future State” Conceptual Map ?2015 “Values” Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania grounded parameters Care Personnel Influenza Vaccination Subgroup NVAC Health 31 May 2011 David R. Curry, MS Executive Director Center for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics University of Pennsylvania david.r.curry@centerforvaccineethicsandpolicy.org
  • 10. Ethical Imperatives Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 11. Ethical Imperative An ethical imperative states a principle of action or a condition to be achieved which is supported by compelling moral argument and difficult to challenge on any grounds Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 12. CVEP: Ethical Imperative We believe the ethical imperative for vaccine policy is to accelerate the development and delivery of needed vaccines – producing sustained immunity and therapeutic benefit for all people at risk – assuring affordable, equitable and effective access regardless of circumstance or geography. Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 13. Ethical Imperative: Citizens and Immunization As citizens, we share an ethical imperative to help assure the highest level of health in our communities and globally by protecting our fellow citizens through personal immunization against geographically-relevant infectious diseases for which there are safe, effective and available vaccines. Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011
  • 14. Science 12 May 2006: Vol. 312 no. 5775 pp. 854-855 DOI: 10.1126/science.1125347 Life-Cycle Allocation Principle …based on the idea that each person should have an opportunity to live through all the stages of life…(8, 9). There is great value in being able to pass through each life stage—to be a child, a young adult, and to then develop a career and family, and to grow old—and to enjoy a wide range of the opportunities during each stage… …People strongly prefer maximizing the chance of living until a ripe old age, rather than being struck down as a young person (10, 11). …Although the life-cycle principle favors some ages, it is also intrinsically egalitarian (7). Unlike being productive or contributing to others’ well-being, every person will live to be older unless their life is cut short.
  • 15. [faint praise]
  • 16. [faint praise]
  • 17. No substantive engagement of vaccines or immunization…at all…
  • 18. Draft “Future State” Conceptual Map ?2015 “Values” Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania grounded parameters Care Personnel Influenza Vaccination Subgroup NVAC Health 31 May 2011 David R. Curry, MS Executive Director Center for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics University of Pennsylvania david.r.curry@centerforvaccineethicsandpolicy.org
  • 19. Questions/Comments/ Ideas David R. Curry, MS Executive Director Center for Vaccine Ethics and Policy Associate Faculty, Department of Medical Ethics, NYU Medical School david.r.curry@centerforvaccineethicsandpolicy.org 267.251.2305 Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of Science University of Pennsylvania NVAC Health Care Personnel Influenza Vaccination Subgroup 31 May 2011

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