Improving accountability in vaccine decision-making

James Kenneth Timmis*, Steven Black, Rino Rappuoli

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Introduction: Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures. In this communication, we review the consequences and utility of stakeholder-centered core considerations to increase transparency in and accountability of decision-making procedures, in general, and of the benefits gained by their inclusion in Multi-Criteria-Decision-Analysis tools, exemplified by SMART Vaccines, specifically. Expert commentary: To increase effectiveness and comparability of health decision outcomes, decision procedures should be properly standardized across equivalent (national) decision bodies. To this end, including stakeholder-centered criteria in decision procedures would significantly increase their transparency and accountability, support international capacity building to improve health, and reduce societal costs and inequity resulting from suboptimal health decision-making.

Original languageEnglish
Pages (from-to)1057-1066
Number of pages10
JournalExpert Review of Vaccines
Issue number11
Publication statusPublished - 2 Nov 2017
Externally publishedYes


  • accountability for reasonableness
  • accountable decision-making
  • core values
  • Health Technology Assessment (HTA)
  • MCDA
  • public health policy
  • SMART vaccines
  • transparency
  • Vaccine evaluation
  • vaccine policy


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