Evidence-based vaccinology: the work of the Cochrane Vaccines Field.

The volume of vaccine analytical literature is notable (the journal Vaccine alone having published 231 trials on diVerent vaccines between 1983 and 1994 ). However, to date little attention has been paid to summarising and evaluating its significance in the assessment of vaccine quality (defined as eYcacy, eVectiveness, eYciency, safety, and acceptability). Quality assessment is important as vaccines are a widely used preventive technology, vaccination programmes are mostly publicly funded, and decisions to immunise whole populations must be made on the best available evidence, especially if such practice is regulated by law. Additionally the current array of vaccines is likely to be augmented considerably in scope and variety by new vaccines imposing a resource burden on society. Such a burden, set against the backdrop of increased health care costs, will necessitate discrimination of funding of preventive programmes. Discrimination should be partly based on the best available evidence of vaccine eVectiveness and safety, of the social burden of the target disease and of the ability of the vaccine to prevent that burden developing. The Cochrane Vaccines Field (CVF) was founded to facilitate the gathering of evidence on vaccines and their eVects (such as ability to prevent the target disease, short and long term