| アブストラクト | The Food and Drug Administration (FDA) approves vaccines when their benefits outweigh the risks for their intended use. In this article we review the standard FDA approach to vaccine evaluation, which underpins its current approaches to assessment of vaccines to prevent coronavirus disease 2019 (COVID-19). The FDA has established pathways to accelerate vaccine availability before approval, such as Emergency Use Authorization, and to channel resources to high-priority products and allow more flexibility in the evidence required for approval, including accelerated approval based on surrogate markers of effectiveness. Among the thirty-five new vaccines approved in the US from 2006 through October 2020, about two-thirds of their pivotal trials used the surrogate outcome of immune system response, and only one-third evaluated actual disease incidence. Postapproval safety surveillance of new vaccines, and particularly vaccines receiving expedited approval, is crucial. This has generally been accomplished through such mechanisms as the Centers for Disease Control and Prevention (CDC) and FDA Vaccine Adverse Event Reporting System, the CDC Vaccine Safety Datalink, and the CDC Clinical Immunization Safety Assessment Project. Adverse events detected in this way may lead to changes in a vaccine's recommended use or withdrawal from the market. Regulatory oversight of new vaccines must balance speed with rigor to effectively address the pandemic. |
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| ジャーナル名 | Health affairs (Project Hope) |
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| 投稿日 | 2020/11/20 |
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| 投稿者 | Kesselheim, Aaron S; Darrow, Jonathan J; Kulldorff, Martin; Brown, Beatrice L; Mitra-Majumdar, Mayookha; Lee, ChangWon C; Moneer, Osman; Avorn, Jerry |
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| 組織名 | Aaron S. Kesselheim (akesselheim@bwh.harvard.edu) is a professor of medicine and;the director of the Program on Regulation, Therapeutics, and Law in the Division;of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham;and Women's Hospital and Harvard Medical School, in Boston, Massachusetts.;Jonathan J. Darrow is an assistant professor of medicine in the Division of;Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and;Women's Hospital and Harvard Medical School.;Martin Kulldorff is a professor of medicine in the Division of;Beatrice L. Brown is a research assistant in the Division of Pharmacoepidemiology;and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and;Harvard Medical School.;Mayookha Mitra-Majumdar is a research scientist in the Division of;ChangWon C. Lee is a research assistant in the Division of Pharmacoepidemiology;Osman Moneer is a medical student at the Yale School of Medicine, in New Haven,;Connecticut.;Jerry Avorn is a professor of medicine in the Division of Pharmacoepidemiology |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33211535/ |
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