Lois Privor-Dumm is the Director, Policy, Advocacy & Communications at the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health. She brings extensive experience in new vaccine introduction in low-, middle- and high-income countries, and her work has both described and supported the evidence to policy and access continuum. She leads a team at IVAC that supports both country and global level policy and advocacy efforts for pediatric, adolescent and adult vaccines and has advised government, civil society and global organizations such as Gavi, WHO and UNICEF on new vaccine introduction. She worked in various capacities in the PneumoADIP and Hib Initiative, including advocacy and communications, strategy, access and implementation to help accelerate pneumococcal vaccine decisions in more than 50 low income countries and Hib vaccines in all Gavi-eligible countries. Prior to joining Hopkins, she worked nearly 18 years in the private sector, most notably launching the pneumococcal conjugate vaccine in the US and supporting other countries in Latin America and Europe to introduce. She held many roles in marketing, finance, research, and commercial operations. She holds a Master of International Business Studies (now International Master of Business Administration, IMBA) from the University of South Carolina and specialized in finance and French. She also studied and worked in Belgium. She earned her Bachelor of Science degree in Business Administration and Spanish from University at Albany and studied abroad in Madrid, Spain.
Adult vaccination decision making, uptake, and opportunities for a global policy framework
Despite a growing population of older adults and a substantial burden of infectious disease, vaccines for adults have not been adopted widely in most countries. To explore the heterogeneity of country-level decision making, both across countries and across various vaccines within a country, we analyzed vaccine policy and uptake in more than 30 countries across various geographies and income strata. A particular, but not exclusive, focus of the analysis was centered on decision making process for and uptake of influenza, pneumococcal polysaccharide, pneumococcal conjugate, and herpes zoster vaccines. For decision making and policy, factors included: presence of defined criteria for decision making; trends in policies regarding age recommendations, risk groups, and importance and type of economic data considered; engagement of champions and various stakeholders (i.e., healthy aging experts and advocates, geriatricians and other specialists, advocacy groups and charities) in the process; and political prioritization. We also assessed the following factors influencing uptake: differences in how health systems deliver, pay for, and incentivize vaccines; political priority for life course immunization and prevention of disease in older adults; and the voice of champions and presence of advocacy and communications efforts. We supplemented the analysis with in-depth key informant interviews in six countries in the Americas, Europe, and Asia Pacific to describe challenges and opportunities in decision making. We conducted a thematic analysis of data and described country archetypes. Although country characteristics and processes are nuanced, these archetypes can help guide efforts to build political priority in various settings.
Understanding the decision-making process and how it varies from country to country can enable further examination of data gaps and support a global policy framework for adult immunization that recognizes country needs and differences between vaccines, while still providing critical guidance and support for adult vaccination broadly.