Many parents made statements about their perceived level of knowledge after talking with the interviewers. “I didn’t realise how ill-informed I am. You just sign off on all these forms…” (E, P5). Other parents asserted that following the interview they would research more information on their own. This is the first study to examine knowledge and understanding of HPV and HPV vaccination among adolescent girls and their parents

who have recently been involved in mass school-based HPV vaccination. Adolescents in particular had limited understanding about HPV and HPV vaccination and wanted this information. These findings have important implications for future cervical cancer prevention and safer sex behaviours among vaccinated adolescents and young women. Adolescents were not provided information tailored to their age see more group; information was only directed to parents, who are required by law to provide consent. Our data indicates that only requiring consent from parents, and only providing information to parents, contributed to adolescent knowledge gaps, though parental knowledge was also low. This raises questions for policy development regarding provision of age-appropriate information

and consent for adolescents in school-based immunisation programs. Statutory law in NSW recognises young adolescents’ ability to provide informed consent to medical treatment if competent [17], and although the DAPT cell line law also provides for the parent to consent for their adolescent, obtaining informed consent from both parties is strongly recommended in clinical settings [18]. Although other school-based vaccination programs face the same information delivery challenges, Histamine H2 receptor the difference is that a lack of understanding about HPV vaccination may directly impact future health behaviours. It is crucial that adolescents understand the continued need for utilizing protection during sexual activity and for participating in cervical screening

in the future; our data indicates that adolescent understandings at the time of vaccination were unlikely to promote these behaviours. The findings about girls’ and parents’ confusion about age and target groups for HPV vaccination are consistent with past research on vaccine acceptability [19] and [20]. Our findings reflect a misconception that may arise from concerns about promiscuity or denial about sexual lives of adolescents. It has been reported that South Australian parents’ main concerns relate to side effects [21]. Most research in international populations has reported low levels of concerns about adolescent sexual activity [22], [23], [24], [25] and [26], but other qualitative work reports strong levels of concern [27]. It is possible that qualitative research has greater sensitivity to detect all the subtleties of sexual-related concerns.

Phenolic esters mainly investigated for their antitumor activity in human adenocarcinoma cell line, also propyl and octyl gallates showed a more effective activity against HeLa cells. 29 Campothecin: The alkaloid campothecin isolated

from the Chinese traditional plant Camptotheca acuminate. It is used in the treatment of gastric, rectal, colon, and bladder cancers. Their synthetic derivatives 9-aminocamptothecin, 10-hydroxycamptothecin as well as camptothecin were vastly used to treat various type of cancer. 30Vinca alkaloids (vinblastine, vincristin): Isolated of two important anticancer alkaloids vinblastine and vincristine from the plant of Catharanthus roseus are well studied, these two natural alkaloids www.selleckchem.com/products/Adriamycin.html are major use of drugs in the treatment of lymphoma and leukemia respectively. 31Colchicine: The antimitotic alkaloid colchicine was isolated from Colchicum autumnale. The plant has been traditionally

treating of gout and fever. Recent findings novel metabolites colchicine has revealed to control the tubulin binding action. Indirubin: Indirubin is an antileukemic compound isolated from the leaves of Indigofera tinctoria which is mainly used in the treatment of chronic myelocytic leukemia. 32 Diosgenin: Diosgenin is a steroidal saponin produced by many plants. The diosgenin, FK228 mw purified from the root of Polygonatum zanlanscianense Pamp., that compound will leads to cell death of tumor cells with moderate concentration. In cell culture experiments with HeLa cervix carcinoma cells diosgenin induced apoptosis in intrinsic pathway. It control the antiapoptotic protein Bcl-2 together with caspase activation was observed. This compound was also isolated

from rhizomes of Smilacina atropurpurea. It stimulates the cytotoxicity on cancer cells with minimal side effects. 33 Paclitaxel: Paclitaxel is a complex structure of diterpene isolated from the bark of Taxus brevifolia. The cytotoxic activity of Paclitaxel against mouse leukemia Adenylyl cyclase was well studied. It mainly involved in cell cycle mechanisms for induces disruptions of microtubule in tumor cells. 33Combrestatin A4: The Flavanoids and its derivatives are also inhibit many enzymes that are the targets in anticancer treatment, e.g. eukaryotic DNA topoisomerase I, Cox I and II and estrogen 2- and 4-hydroxylases. Flavonoids by interacting with P450 enzymes reduce the activation of procarcinogen substrates to carcinogens which makes them anticancer substances in cancer therapy. Podophyllotoxin: The plant derived podophyllotoxin is a bioactive component of Podophyllum pelatum, and P. pleianthum. Its main functions involved in mitotic cell division by binding reversibly to tubulin and inhibiting microtubule assembly. 34 Thymoquinone: Thymoquinone (TQ) is the bioactive constituent under the category of volatile oil. The compound is isolated fromblack seed (Nigella sativa).

In NG-001, 540 women were vaccinated,

536 (99%) completed the active phase of the study to one month after the last vaccine dose, and 514 (95%) were included in the primary ATP immunogenicity cohort. Reasons for withdrawal from each study and for exclusion from the ATP immunogenicity cohorts are shown in Fig. 1. In both studies, the mean age of participants was 21 years and the majority (≥93%) were of White Caucasian/European ethnic heritage (Table 2). In both studies, all women were seropositive for anti-HPV-16 and -18 antibodies one month after the last vaccine dose, as measured by ELISA, and remained seropositive through the last assessment (Month 48 for TETRA-051 and Month 12 for NG-001). However, there was a consistent trend for lower anti-HPV-16 and -18 GMTs one month after the last vaccine dose MK-1775 ic50 when HPV-31/45 or HPV-33/58 L1 VLPs were added to the HPV-16/18 AS04 vaccine (Fig. 2A and B, respectively). For all vaccines,

antibody titers were well above those associated with natural infection (i.e., 29.8 ELISA units [EU]/mL for anti-HPV-16 and 22.6 EU/mL for anti-HPV-18) [19]. In TETRA-051, there was no statistically Bosutinib significant difference between the 6 treatment groups in the semi-factorial design in terms of anti-HPV-16 GMTs (p = 0.3377) or -18 GMTs (p = 0.8364). In pairwise comparisons, GMTs were significantly lower for group A receiving HPV-16/18/31/45 AS04 (20/20/10/10 μg) compared with control for anti-HPV-16 antibodies (5505 [95% CI: 4386, 6910] versus 8742 [7075, 10,801] EU/mL; p = 0.0148) and anti-HPV-18 antibodies (2963 [2287, 3840] versus 5134 [4229, 6234] EU/mL; p = 0.0010) (Supplementary Table 1). For anti-HPV-16 GMTs, when the amount

of HPV-16 L1 VLP was increased from 20 μg to 30 μg (group E: 30/20/10/10 μg), there was no statistically significant difference versus control (7555 [5818, 9811] EU/mL; p = 0.4032), therefore, no further comparisons were made. For anti-HPV-18 GMTs, when the amount of HPV-18 L1 VLP was increased from 20 μg to 30 μg (group C: 20/30/10/10 μg), else the difference versus control was still statistically significant (3406 [2757, 4208] EU/mL; p = 0.0086). When the amount of HPV-31/45 VLPs was increased from 10 μg to 20 μg (group B: 20/20/20/20 μg), anti-HPV-18 GMTs were still lower versus control but not statistically different (3643 [2640, 5027] EU/mL; p = 0.0540). In Study NG-001, in women who were initially seronegative and HPV DNA negative for the corresponding HPV type, significantly lower anti-HPV-16 GMTs were observed for the HPV-16/18/33/58 AS04 vaccine containing 20 μg of each L1 VLP compared with control (6775 [5502, 8342] versus 11,246 [9133, 13,847] EU/mL; p = 0.0017) (Supplementary Table 1). However, anti-HPV-16 GMTs were significantly higher for the 3-dose tetravalent vaccine adjuvanted with AS01 (27,645 [22,713, 33,649] EU/mL; p < 0.0001) or AS02 (17,664 [14,534, 21,468] EU/mL; p = 0.0055) compared with control.

A similar model of influenza challenge showed that ablation of the NALT had no effect on T-cell recruitment, serum or nasal cavity IgG and IgA levels or on the speed at which the virus was cleared [15]. However, in contrast, an intra-nasal model of reovirus infection showed the NALT to be the inductive site of both humoral and cellular immune responses [11] and in another this website influenza virus model, depletion of T-cells prior to virus challenge, increased viral load in both the lungs and nose, implying that T-cells restrict viral

replication in both sites [16]. It was therefore of interest to assess the role of the NALT in protection induced by the viral vectored vaccine candidate Ad85A against another respiratory pathogen, M.tb. We and others have previously shown that i.n. immunisation with Ad85A in 50 μl gives protection against

M.tb challenge comparable to parenteral immunisation with BCG ( Fig. 2A and B) [4] and [9]. Here we compared the protection afforded by identical numbers of Ad85A v.p. delivered in 5–6 or 50 μl i.n. The results show that immunisation in 5–6 μl provides no protection against aerosol challenge with M.tb ( Fig. 2), despite a weak antigen-specific response in the lung ( Fig. 1). Immunisation with 5–6 μl i.n. does however induce a NALT response comparable to 50 μl ( Fig. 1A). These data indicate that the magnitude of the response in the lung, but not in the NALT, correlates with protection. Indeed, a preliminary experiment in which Ad85A was delivered directly into the trachea (i.t.), NVP-AUY922 cell line thus bypassing the NALT, indicated that this regime protected from BCG challenge to a level comparable to 50 μl i.n. immunisation. Assessment of the T-cell phenotypes generated by the 5–6 or 50 μl inocula showed that the number of CD8+ cells in the lung producing Casein kinase 1 IL-2 was greater after immunisation with 50 μl, as was the number producing TNFα, although the greatest difference was in the total producing IFNγ (Fig. 3A).

Since it has been suggested that the quality of the T-cell response plays an important role in the response to pathogens such as HIV, malaria and M.tb, with the proportion of T-cells producing more than one cytokine correlating with protection [23], [24], [27] and [28], we measured the proportions of lung CD8+ T-cells induced by immunisation with 5–6 or 50 μl producing one, two or all three of IFNγ, IL-2 and TNFα ( Fig. 3C). Despite being the protective regime, it appears that immunisation with 50 μl induces more single cytokine producing cells (1+) than with 5–6 μl ( Fig. 3C), the main difference being in the number IFNγ-only producing cells ( Fig. 3C). Therefore it is likely that a high proportion of multi-cytokine producing cells is not necessary for protection in this model.

1 mV, Fig. 8) Our analysis of MK801-induced inhibition of Kv-channel currents suggests that the drug is unlikely to interact

preferentially with open or inactivated states of the Kv channels because of the following reasons. First, the inhibition was voltage-independent (Fig. 3). Many open-channel blockers inhibit voltage-gated channels in voltage-dependent manner, especially in the activation voltage range of the channels (47) and (48), because the drug-channel interaction requires channel opening and the drug-binding site is located in the click here transmembrane pore region. Second, the steady-state activation and inactivation of Kv channels were unaffected by MK801 treatment (Fig. 5). Although alterations in the steady-state activation and inactivation curves are not strictly required in state-dependent drug-channel interaction, most state-dependent channel blockers alter the steady-state channel kinetics (such as a left-shift of inactivation) (49) and (50). Third, when spontaneous channel activation and inactivation were prevented by holding Em at a hyperpolarized potential (−110 mV), the first depolarizing pulse after the ∼2-min treatment with MK801 produced an identical MK-8776 ic50 degree and pattern of Kv-channel inhibition as in the steady-state experiments (Fig. 4). This verifies

the hypothesis that MK801 binds Kv channels in their resting closed states and inhibits them (tonic inhibition). Fourth, the use-dependency observed in this study was minimal (Fig. 3). Although use-dependent inhibition is typically strong evidence of state-dependent inhibition, the minimal use-dependency detected here does not support the state-dependent block theory. The slow inactivation time course was markedly accelerated in the presence

of MK801 (Fig. 2). However, this does not appear to contribute check substantially to MK801 inhibition of Kv channels because of the following observation: the blockade reached maximal levels within 50 ms after application of the voltage step depolarization, when slow inactivation is apparently absent (Fig. 2 and Fig. 3A), which indicates that MK801 diminished the “peak” amplitude of the Kv-channel currents at the beginning of the depolarizing pulse. Based on these results, we suggest that MK801 inhibits Kv channels primarily by binding to the channels in their closed states and reducing channel availability or decreasing channel conductance. The blockade of Kv channels by MK801 in RMASMCs reported here is highly similar to the inhibition of the channels by ketamine (14). The ketamine block of Kv channels was also voltage-independent and did not alter steady-state channel kinetics. However, MK801 inhibits Kv channels in RMASMCs more potently (IC50 of ∼100 μM) than ketamine (IC50 of ∼500 μM).

1 and 2 In contrast to the west the prevalence of ischemic heart disease in

India has been steadily increasing over the last two decades, from around 1–4% to over 10%, these figures are based on survey data which is well supported by clinical impression. 3, 4 and 5 The prevalence in rural areas is about half that of urban populations.6 The CVD will be the leading cause of death in India by SCR7 datasheet 2020. 7 and 8 Individuals with symptomatic coronary or cerebrovascular Disease or diabetes complications have over a 20% risk of a CV event in the next 5 years.9 These patient groups are at the highest risk of CVD and account for about half of all CV deaths and hospitalizations.10 International guidelines now recommend almost all such high risk individuals receive treatment with each of three classes of CV medication namely anti-platelet,

blood pressure lowering and cholesterol lowering therapies,9, 11 and 12 Provision of combined Cardiovascular (CV) medication to those selleck compound at highest risk, is a cost effective approach, which could achieve substantial benefits within a few years.13 A strategy to simultaneously reduce 3 cardiovascular risk factors (low density lipoprotein cholesterol, blood pressure and platelet function) has been recommended recently based on Meta analysis of randomized trails and cohort studies of antihypertensive drugs and statins and a Meta analysis of 15 trails of low dose (50–125 mg/day) Aspirin. The formulation, which met the objectives, had a statin (for example Atorvastatin or Simvastatin); blood pressure lowering drugs (for example, a thiazide, β-blocker and an angiotensin converting enzyme inhibitor), each at half standard dose and aspirin (75 mg). It was estimated that the combination would reduce ischemic heart disease (IHD) events by 88% and stroke by 80%.14 and 15 Hence the fixed dose combination of a statin (Simvastatin),16 and 17 an antiplatelet agent (Aspirin),

an ACE-inhibitor (Lisinopril),18 and 19 and a diuretic (Hydrochlorothiazide)20 was taken up for this study. To evaluate whether the fixed dose see more combination of Simvastatin, Aspirin, Hydrochlorothiazide and Lisinopril results in lowering blood pressure and cholesterol levels and improved adherence in patients with at least one Cardiovascular risk factor such as Hypertension and Dyslipidemia or Coronary Artery Disease. The study was a multicentre prospective open labeled single armed 12 week study with fixed dose combination of Simvastatin, Aspirin, Hydrochlorothiazide and Lisinopril. This study was conducted in Mediciti Hospitals, Hyderabad and the Principal Investigator is the sole Cardiologist in this region. The criteria for inclusion in our study were: • Adults (male or female) of age between 18 and 75 years. Patients were excluded if: • They are contraindicated/intolerant (e.g.

The data are expressed as mean ± S.E.M. The difference among means has been analyzed by one-way ANOVA. A value of p < 0.05 was considered as statistically significant. Phytochemical investigation showed that chloroform extract contains poly phenolic compounds, tannins, flavonoids, alkaloids and saponins. Acute toxicity study shows that chloroform extract was safe up to 5000 mg/kg body weight. Animals were alive, active and healthy during the observation period. The antioxidant activity was estimated by using 2, 2-diphenyl-picryl-hydrazyl (DPPH) free radical assay. And it was found that C. filiformis was having

strong antioxidant activity. In the DPPH radical scavenging assay, the IC50 value of the extract was found to be 14 μg/ml. Total phenolic OTX015 content was measured by Folin–Ciocalteau (FC) by using tannic acid as the calibration standard. The total phenolic content was measured by Folin–Ciocalteau was found to be 2.5 for tannin ( Table 1) ( Graph 1). Rats treated with CCl4 developed a significant hepatic damage which is shown by elevated serum levels of hepatospecific enzymes like SGPT, SGOT, ALP and total bilirubin levels to 223.23, 281.2, 259.3 and

I-BET151 8.5 mg/dL respectively, in compared control group. Similarly in the CCl4 intoxicated group rats resulted in enlargement of liver which is shown by increase in the wet liver weight and volume to 9.33 and 7.83 respectively when compared to normal control groups. The increased levels of serum SGPT, SGOT, ALP and total

bilirubin were significantly (p < 0.001) reduced in CF treated group in dose dependent manner. Also it has significantly reduced the wet liver weight and volume ( Table 2). The liver section in normal control animals indicated the presence of normal hepatic parenchyma (Fig. 1), whereas administration of carbon tetrachloride in animals showed severe centrilobular necrosis, fatty changes, vacuolization and ballooning degeneration indicating severe damage of liver cytoarchitecture (Fig. 2). The CF in the dose of 250 mg/kg b.w showed recovery and protection from hepatocyte degradation, centrilobular necrosis, vacuolization and fatty infiltration (Fig. 4) whereas CF 500 mg/kg b.w showed more significant protection (Fig. 5) than 250 mg/kg b.w this indicate the dose dependent hepatoprotection. All the figures are compared with standard as shown unless in (Fig. 3). Ethnobotanical survey revealed that C. filiformis have many traditional uses in the treatment of ulcer, haemorrhoids, hepatitis, and cough and also has diuretic effect. Phytochemical investigation of methanolic extract showed the presence of poly phenolic compounds, tannins, flavonoids, glycosides, alkaloids and saponins. In earlier studies, a known flavonoid – quercetin was isolated from the methanolic extract of CF. Since CF has flavonoids, it was examined for the antioxidant property by using DPPH assay method and showed a significant antioxidant activity.

Wells were washed 8 times in double distilled water (ddH2O). Di(Tris) p-nitrophenyl phosphate (PNPP) (Sigma–Aldrich Inc.) was diluted 1/100 in substrate buffer (1 mM of MgCl2, 200 mM of Tris–HCl, pH 9.8) and 100 μl/well was added. The reaction was allowed to develop for

15 min, and absorbance was read as optical density (OD) at 405 nm in a Microplate Reader (Bio-Rad Laboratories Inc., CA, USA). Results are reported as titers, which are the reciprocal of the highest dilution that gave a positive OD reading. A positive titer was defined as an OD reading that was at least two times greater than the values for a negative sample obtained from naive mice. Spleens were collected 3 and 7 days after challenge and placed in cold, minimal essential medium Selleckchem PLX3397 (GIBCO®, Carlesbad, CA, USA). The spleens were sieved through

a 40 μm nylon cell strainer (BD FALCON, selleck chemicals llc San Jose, CA, USA) using scissors and a syringe plunger. 1 ml of sterile NH4Cl lysis buffer was added to the cell suspension to lyse the erythrocytes for 1 min and lysis was stopped by immediately topping up the 15 ml tube with MEM. The splenocytes were washed once with MEM medium and resuspended in complete AIM V medium (incomplete AIM V, 0.1 mM non-essential amino acids, 1 mM sodium pyruvate, 10 mM HEPES, 1× antibiotic pen strep, 1% FBS, 20 μm l-glutamine, 50 μm 2-mercaptoethanol) to a final concentration of 1 × 107 cells/ml. Cells were counted using a MULTISIZER™ 3 COULTER COUNTER® (Beckman Coulter, ON, Canada) according to the manufacturer’s instructions. Cell concentrations were determined using software provided by the manufacturer. Nitrocellulose microtiter plates (Whatman, Florham Park, NJ, USA) were coated with 1.25 μg/ml purified rat anti-mouse IL-4 and IFN-γ capture monoclonal antibodies (BD Biosciences, Mississauga, ON, Canada) in coating buffer for 16 h at 4 °C. Plates were washed and blocked with complete AIM V medium (GIBCO) in a 37 °C incubator. Splenocytes (1 × 106 cells/well) were added in triplicates. PTd antigen (1 μg/well) was added and incubated at 37 °C for 18 h. Cell suspensions were removed and 1.25 μg/ml purified biotinylated rat anti-mouse IL-4 and IFN-γ monoclonal antibodies (BD Biosciences)

diluted in PBS and 0.1% Tween-20 (PBST) at 1.25 μg/ml were added to each plate and incubated others for 16 h at 4 °C. Plates were washed with PBST and a streptavidin alkaline phosphatase/glycerol solution was added to the plates at 1/500 dilution in PBST for 1.5 h at room temperature. The plates were washed 8 times with ddH2O and 5-bromo-4-chloro-3-indolyl phosphate/nitroblue tetrazolium (NBT/BCIP) (Sigma) insoluble alkaline substrate solution was added to all plates for 5 min at RT. Plates were finally washed with ddH2O and left to dry at RT. Spots were counted manually using a Stemo 2000 inverted light stereomicroscope (Zeiss, Toronto, ON, Canada). The data were analyzed and graphed using GraphPad Prism version 5.01 for Windows®, (GraphPad Software Inc.

, 2012) and within their neighborhoods. Heckler and colleagues highlighted that their study participants combined recreational and utilitarian walking (e.g., active transportation) to meet physical activity guidelines (Hekler et al., 2012). Therefore the use of public transport SKI606 may encourage more physical activity (Rissel et al., 2012). Of note, after the introduction of a UK national free bus pass program for adults 60 years + there was an increase in use of public transportation and therefore,

associated increased opportunities for walking (Coronini-Cronberg et al., 2012). Thus, municipal and provincial decision makers must take into account the importance of public transportation to enhance walking opportunities for older adults. Yang and Matthews (2010) noted that the built environment is more obvious than the social environment. Despite this, our participants MEK inhibitor made statements during the brainstorming session that spoke to aspects of the social environment. Many of these (perceptions of neighborhood safety, community events/activities, and social capital) were considered both important and feasible and fell within the ‘go-zone’ for action. The mechanism might be that social factors increase the desire and willingness of older adults to navigate their neighborhoods. Importantly, socialization encourages activity (Fried et al., 2004) and reduces the risk of

disability (Buchman et al., 2010, De Leon et al., 1999 and Unger et al., 1999) and the development of dementia (Rovio et al., 2005). How communities and local governments may best harness the potential of the social environment to encourage outdoor walking is still to be evaluated. The decision to walk outdoors is also influenced by older adult’s assessment of his/her physical capacity and perceived self-efficacy to safely complete the task. Older adults can ‘disengage’ from an activity if they Thymidine kinase feel unable to overcome the demands of challenging environments (Gagliardi et al., 2010)

and when there are no other transportation options. During brainstorming, stakeholders generated responses related to individual attributes or characteristics that might influence older adult walking, including physical stamina, strength, and/or sense of mastery/control. Although we did not anticipate comments on person-level characteristics, during sorting and rating we chose to retain these responses and included them in the Personal Ability cluster and also in our analyses. These findings highlight the interaction of the person within their environment and this is a key component of the social ecological model. Further, while statements in this cluster were rated as highly important, stakeholders considered them not as feasible to implement. This surprise finding recognizes that often behavior change is difficult to initiate and many people encounter challenges with maintaining positive health behaviors, such as outdoor walking.

Indeed, the commission evaluates numerous issues, including the specificities of national epidemiology, Alisertib mw organizational and legal issues, acceptance or feasibility of different implementation strategies, etc. Once the decisions are made, the recommendations are transmitted directly to the FOPH by the Secretariat, which is a part of FOPH. The recommendations are made public via official publications, the website, and through

press releases. The work of the CFV falls within a national and international context, and brings together numerous partners with the shared objective of improving individual and public health by preventing infectious diseases and their transmission. Responding to this context involves relationships with NITAGs in other countries, although there is no formal mechanism for this. The interactions among the CFV and other NITAGs during WHO conferences, meetings and other forums tend to be informal and personal. Some members of the Swiss committee are GSK1120212 order also members of other committees, but any information they obtain from the other committees falls under the confidentiality requirement of the CFV. Economic considerations have a place in committee deliberations, beginning with the issue of the cost of the vaccine. Economic analysis is done on a case-by-case basis

to assess cost-effectiveness, cost-benefit and cost-utility, as well as the overall affordability whatever and sustainability of the immunization program. However, there is no benchmarking (i.e., no predefined threshold). The issue of whether or not the vaccine should be reimbursed through social health insurance is also addressed. The committee does not have immediate access to health economics experts, and therefore,

economic analyses consist of approximate estimations, literature reviews, or work outsourced to external companies. The evaluation process takes approximately one year, and decisions are made on a case-by-case basis. When general vaccinations are being considered, the time taken for economic analysis is even longer. The committee uses results from international economic studies but assesses them for possible differences under the Swiss context, as well as for possible differences compared with its own studies. Pharmaceutical companies and manufacturers can also provide economic assessments, but in this case, the committee consults with an independent expert to verify the reliability of their assumptions and calculations. Economic evaluations are used in different ways by the CFV in the decision-making process. For example, if the vaccine’s cost-utility ratio compares favorably with that of other health interventions, it constitutes an additional favorable point in the global evaluation. On the contrary, if the vaccine is considered to be very expensive compared to its benefits, it is unlikely that it will be reimbursed by health insurance.