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Reviews
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What are the main claims of the paper and how important are they?
The high cost and low utility of these two vaccines have been commented on previously but this paper compares the cost -utility against simple measures like the provision of safe water and sanitation, promotion of early and exclusive breastfeeding, and improving health systems to improve child survival. The authors write convincingly that these vaccines are likely to achieve only low priority.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
The comparisons they make are novel and interesting.
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Are the claims properly placed in the context of the previous literature?
The authors quote 48 references. The latest systematic reviews are quoted. The relavent literature has been covered comprhensively. The authors go beyond simply quoting references. They draw appropriate conclusions. For example they quote the Cochrane review conclusion that the pneumococcal vaccine efficacy 80% against serotypes-IPD, but they note that there was no statistically significant reduction in all cause mortality. Thus the vaccine is no use in reducing childhood mortality.
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Do the results support the claims? If not, what other evidence is required?
The arguments are stated lucidly.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
NA
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
NA
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
No additional information is needed
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
This is a well written review. The authors adopt the perspective of developing countries and as such has a very important contribution to the literature
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Other Comments:
There are a number of typographic errors that need to be corrected. For example meagre instead of meager in Abstract Phenomenon of serotype replacement uncahnged should be unchanged etc
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Competing interests:
None
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Invited by the author to review this article? :
Yes -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
None
- How to cite: Anonymous.Review on Should Developing Countries Incorporate Pneumococcal and Rotavirus vaccines in their National Immunisation Programmes[Review of the article 'Should Developing Countries Incorporate Pneumococcal and Rotavirus vaccines in their National Immunisation Programmes ' by Dadhich J].WebmedCentral 2013;4(3):WMCRW002597
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What are the main claims of the paper and how important are they?
The paper examines the priorities of introducing pneumococcal and rotavirus vaccines in the National Immunization schedules for reducing child mortality, particularly in developing countries.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
The logic is not novel since the alternatives for reducing child mortality and their costing vis-a-vis introduction of vaccines is a well known strategy in framing public health policy. However, since in recent times there is high pressure promotion of pneumococcal and rotavirus vaccines for public health use particularly in most developing countries, the approach by the authors particularly in context of these two diseases is topical if not entirely novel.
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Are the claims properly placed in the context of the previous literature?
Yes
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Do the results support the claims? If not, what other evidence is required?
As it is a review article there are no results in the paper as such. However, the authors have included appropriate review of the evidence including the Cochrane Collaboration Reviews to buttress their claim that introduction of these vaccines in developing countries without fully working out the cost-effectiveness would be pre-mature and not a wise decision, as it would divert scarce resources from other cost-effective measures such as improving water supply, sanitation, awaareness of exclusive breast feeding and ORT.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
Not applicable
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Yes for a review article.
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
The role of the vaccine industry and the profit motive for introducing these vaccines in developing countries could have been reviewed. Difficulty may arise due to controversial nature of this aspect.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
Yes. It is outstanding since it can promote asking questions before considering introduction of any new vaccine as a public health measure. Particularly with high pressure marketing by the vaccine industry, enough questions about these issues are not asked.
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Other Comments:
No
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Competing interests:
No
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
Yes
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References:
Banerjee A , Baker C . Ethical Concerns on the Study . WebmedCentral BIOETHICS 2012;3(9):WMC003712 (Deals with the ethics of pneumococcal vaccine trials in The Gambia)
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Experience and credentials in the specific area of science:
None - How to cite: Banerjee A .Should Developing Countries Incorporate Pneumococcal and Rotavirus vaccines in their National Immunisation Programmes[Review of the article 'Should Developing Countries Incorporate Pneumococcal and Rotavirus vaccines in their National Immunisation Programmes ' by Dadhich J].WebmedCentral 2013;4(3):WMCRW002571
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Discusses cost utility factors of two vaccines, commented on its long term efficacy and finally not agreed to start mass scale immunization programme in developing countries.
Author have a fear that, the resources used to start mass scale immunization program will jeopardized the social upliftement activity of states which is more essential than these controversial vaccines.
Yes claim is novel, though it is most discussed one.
Yes, since it is a new topic to comments on, inclusion of 39 references, in my view is enough, but type of articles requires more references to justified the claim.
This article is not a balanced article, most of the references supported the negative part of mass scale immunization using these two vaccines.According to the World Health Organization in 2008, pneumonia accounted for 20% of deaths and diarrheal diseases accounted for 13% of deaths among children under 5 in India (Gargano et al.,2012)efficacy of rotavirus vaccines are already been proven in many countries (Glass et al.,2005;Tregnaghi et al.,2011; etc.), thus author must includes over more than 200 articles available on Pubmed, for their discussion.
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Not valid for review article, if it so, these kind of articles must be balanced in nature, and an open question should be left in case of controversies.( please refers: doi: 10.1016/j.jval.2011.05.025.)
More references should be included, specially the ground work.
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15 years