National Advisory Committee on Immunization (NACI): Membership and representation

The National Advisory Committee on Immunization (NACI) is a national advisory committee of experts in the fields of pediatrics, infectious diseases, immunology, pharmacy, nursing, epidemiology, pharmacoeconomics, social science and public health. The Committee reports to the Vice-President of the Infectious Disease Prevention and Control Branch, and works with staff of the Centre for Immunization and Respiratory Infectious Diseases of the Public Health Agency of Canada to provide ongoing and timely medical, scientific and public health advice.

NACI makes recommendations for the use of vaccines currently or newly approved for use in humans in Canada, including the identification of groups at risk for vaccine-preventable diseases for whom vaccination should be targeted. NACI knowledge syntheses, analyses and recommendations on vaccine use in Canada are included in published literature reviews, statements and updates. NACI recommendations are also published in the Canadian Immunization Guide. Email updates are available through our mailing list.

Membership

Chair

Dr. Caroline Quach-Thanh

CHU Sainte-Justine, University of Montréal
Montréal, Quebec

Dr. Caroline Quach is a Professor in the Departments of Microbiology, Infectious Diseases Immunology and Pediatrics at Université de Montréal and the physician in charge of the Infection Prevention & Control Unit at the CHU Sainte-Justine. She works as a pediatric infectious diseases consultant and a medical microbiologist. She holds a cross-appointment at the Quebec Institute of Public Health (INSPQ) where she works in the Healthcare-Associated Infections and Immunization branches.

Dr. Quach graduated from the Université de Montréal Medical School, completed her pediatric residency training at the CHU Sainte-Justine, and her post-graduate training at McGill University. She is a clinician-investigator and holds a salary award from the Fonds de recherche du Québec - Santé (FRQS, mérite). She holds a Tier 1 Canada Research Chair in Infection Prevention. Her research interests are focused on the prevention of infections - both healthcare-associated infections and vaccine-preventable diseases.

Dr. Quach is the former president of the Association of Medical Microbiology and Infectious Disease - Canada's (AMMI). She is the former chair of theQuebec Immunization Committee (CIQ) and is the current chair ofthe National Advisory Committee on Immunization (NACI).

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)

Impact of conjugate pneumococcal vaccines on the incidence of invasive pneumococcal infections and antibiotic resistance.

AUF-QRF

Institution

$50,000-100,000

One-time event

Date interest arose: 2019

Date interest ended: 2021

Assessment of influenza vaccine efficacy using administrative data.

MITACS

Institution

$50,000-100,000

One-time event

Date interest arose: 2019

Date interest ended: 2022

Vaccination contre la coqueluche chez les femmes enceintes : implantation et evaluation de differents modeles d'offre de vaccination

MSSS

Institution

$100,000-500,000

One-time event

Date interest arose: 2018

Date interest ended: 2022

Site PI - Preparedness for and response to meningococcal outbreaks: a pilot study of the immunogenicity, reactogenicity and tolerability of 2 schedules of a 4CmenB vaccine in adolescents and young adult

CIRN

Institution

$50,000-100,000

One-time event

Date interest arose: 2017

Date interest ended: 2019

Site PI - A RCT to compare a 1-dose vs. 3-dose priming schedule of PCV13 in Canadian infants

CIRN and MSSS

Institution

$100,000-500,000

One-time event

Date interest arose: 2017

Date interest ended: 2019

Site PI - Is MF59-adjuvanted influenza vaccine a preferred priming vaccine for naive infants 6-24 months of age?

CIRN

Institution

$50,000-100,000

One-time event

Date interest arose: 2019

Date interest ended: 2021

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
See below N/A N/A N/A One-time event Date interest arose: see below

Please provide any additional comments, if applicable:

Reach Location/Details Subject Date
National 1. Reunion du Departement de medecine du CHUM Vaccins chez l'adulte, mise a jour 06/2018
2. Reunion du service de maladies infectieuses du CHUM Vaccins contre le zona 03/2018
3. Midi-scientifique, DPC Pierre-Boucher Vaccination - mise a jour 02/2020
4. Journees de pediatrie de 1re ligne du CHUSJ Vaccination - mise a jour 2019 11/2019
5. Podcast - Continuous professional development (U Montreal) Measles 10/2019
6. 2018 McGill Symposium in Women Health (Montreal) Vaccination in Pregnancy 09/2018
7. Colloque sante-voyage de la clinique de la Fondation du CHUM (Montreal) Vaccin Shingrix contre le zona 09/2018
8. Canadian Immunization Conference (CIC) 2018 (Ottawa) What's new with NACI? 12/2018
Internationale 9. Grand Rounds, Faculté de médecine de Rabat (Rabat, Maroc) Actualités et défis en immunisation 10/2019
10. International Federation of Infection Control and IPAC Canada (Quebec, CA) Infection prevention and control in the NICU 05/2019
11. International Federation of Infection Control and IPAC Canada (Quebec, CA) Immunization: Why should healthcare workers be vaccinated? 05/2019
12. European Society for pediatric infectious disease annual conference (Malmö, Suède) Use of microbiological methods to prevent, control and trace spread of
infections in children (in hospital settings)
06/2018
13. Pediatric Academic Societies Meeting 2018 (Toronto, CA) Influenza vaccines and antivirals in children – review of the basics and current
evidence
05/2018
14. Nosocomial Infections in Maternity/ Hospitals 16th Jornada de controle de infecçao em maternidade (Sao Paulo, Brésil) International keynote: infection prevention in the NICU and preventing CLABSI 03/2018

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates

None to declare (please go to section 8)

- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humansthat do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare

Chair, Quebec Immunization committee

Directly to the researcher

$5,000-10,000

>1 time

*4 meetings/year

Date when interest arose: 2015

Date when interest ended: 2019

Please provide any additional comments, if applicable:

Vice-chair

Dr. Shelley Deeks

Public Health Ontario
Toronto, Ontario

Dr. Shelley Deeks is the Chief Health Protection Officer at Public Health Ontario and an Associate Professor at the Dalla Lana School of Public Health, University of Toronto. She has a long-standing interest and passion for communicable disease control and immunization in general, and vaccine safety in particular, with over 120 peer-reviewed publications. Aside from her membership in the National Advisory Committee on Immunization, she is a past Chair of the World Health Organization's (WHO's) Immunization Practices Advisory Committee. Dr. Deeks holds Fellowships in Public Health in both Canada and Australia and completed the Canadian Field Epidemiology Program. She has over 20 years' experience as a public health physician and has worked at all levels of the public health system in Canada, and at the national level in Australia.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to Vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)

Is Ontario prepared for the return of measles? (Co-Investigator)

Canadian Institutes of Health Research

Institution

$100,000-500,000

One-time event

Date interest arose:
Oct 1, 2019

Date interest ended:
Sept 30, 2022

Burden, cost, and development of asthma related to severe RSV infections

SickKids, Canadian Institutes of Health Research, Institute of Human Development, Child and Youth Health

Institution

$100,000-500,000

One-time event

Date interest arose:
Feb 2019

Date interest ended:
Feb 2022

Infant susceptibility to measles: the impact of maternal vaccination on maternal and infant antibody levels and implications for public health policy in Canada (Co-Investigator)

Physicians’ Services Incorporated Foundation

Institution

$100,000-500,000

One-time event

Date interest arose:
Sept 2017

Date interest ended:
Aug 2020

Mind the gap: Duration of protection from measles maternal antibody in Canadian infants – generating evidence to update policy (Co-Investigator)

Canadian Institutes of Health Research

Institution

$100,000-500,000

One-time event

Date interest arose:
Apr 2017

Date interest ended:
Apr 2020

Vaccination & screening for control sexually transmitted infections (STIs) and STI-related cancers

Canadian Institutes of Health Research

Institution

$500,000-1,000,000

One-time event

Date interest arose:
Apr 2017

Date interest ended:
Apr 2020

Improved Immunization Coverage Initiative - Recent newcomers

Canadian Institutes of Health Research

Institution

$100,000-500,000

One-time event

Date interest arose:
Feb 2017

Date interest ended:
Feb 2019

HPV Screening & Vaccination in Underserved Population. Advancing Evidence-based Vaccination & Screening Delivery for Men who have Sex with Men and People living with HIV (Co-Investigator)

Canadian Institutes of Health Research

Institution

$100,000-500,000

One-time event

Date interest arose:
Nov 2017

Date interest ended:
Oct 2018

Un-immunized children in Ontario: how many, where and why? (Co-Investigator)

Public Health Ontario

Institution

$10,000-50,000

One-time event

Date interest arose:
Apr 2017

Date interest ended:
Mar 2018

Maximising the impact of immunization programs in Canada: bridging the gap between research and policy (Co-Investigator)

Canadian Institutes of Health Research

Institution

$5,000-10,000

One-time event

Date interest arose:
Feb 2017

Date interest ended:
Jan 2018

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates

None to declare (please go to section 5)

Chief, Communicable Diseases, Emergency Preparedness & Response Public Health Ontario (legal name Ontario Agency for Health Protection & Promotion) Full-Time Ongoing Date interest arose:
Date interest ended: Ongoing

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
New Vaccines in the next 2-5 years. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 4 2018
Immunization data capture: registry versus physician EMR. (American Immunization Registry Association National Meeting. Indianapolis, IN) - - -
Safety in Numbers: A Collaborative Workshop to Build Capacity in the Surveillance and Management of Adverse Events following Immunization. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 6 2018
Advancing Evidence-Based Human Papillomavirus Vaccination Deliver for Gay, Bisexual and Other Men who have Sex with Men and People living with HIV. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 6 2018
Where is the risk? Identification of geospacial hotspots of un-immunized children in Ontario. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 5 2018
Immunization status and other characteristics of Ontario students with non-medical exemptions: 2016-2017 school year. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 5 2018
A systematic review on the risk of herpes zoster and complications in immunocompromised adults. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 5 2018
Effectiveness of an ‘outbreak dose’ of MMR vaccine during a mumps outbreak in two First Nations communities in Northern Ontario. (Canadian Immunization Conference 2018. Ottawa, ON) - Select one Select the amount One-time event Dec 6 2018
Sero-epidemiology of Varicella in Ontario, 2013-2014. (The Ontario Public Health Convention. Toronto, ON) - Select one Select the amount One-time event Mar 21 2018
Measles Antibody Levels in Children Less than 1 Year: Assessment of Waning Immunity. (The Ontario Public Health Convention. Toronto, ON) - Select one Select the amount One-time event Mar 21 2018
The epidemiology of the increase in mumps activity in Ontario in 2017. (The Ontario Public Health Convention. Toronto, ON) - Select one Select the amount One-time event Mar 21 2018

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates

 None to declare (please go to section 7)

Travel to Geneva for VIPS meeting

GAVI, the vaccine alliance

Directly to the researcher

$1,000-5,000

>1 time

Date interest arose: Nov 2018

Date interest ended: ongoing

WHO SAGE Polio Working Group

World Health Organization

Directly to the researcher

$1,000-5,000

>1 time

Date interest arose: Oct 2017

Date interest ended: ongoing

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Members

Dr. Julie Bettinger

University of British Columbia
Vancouver, British Columbia

Dr. Julie Bettinger is an Associate Professor at the Vaccine Evaluation Center in the Department of Pediatrics at the University of British Columbia. She is an infectious disease epidemiologist whose research interests include vaccine safety and vaccine preventable diseases (specifically meningococcal and pneumococcal invasive infections), as well as attitudes and beliefs around immunization uptake and use. She is the data center director for the Canadian Immunization Monitoring Program, Active (IMPACT), an active surveillance network for vaccine preventable diseases and vaccine adverse events in 12 tertiary care pediatric hospitals across Canada and the principal investigator for CIRN's Canadian National Vaccine Safety (CANVAS) network, which monitors the safety of influenza vaccines each year.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates

None to declare (please go to section 2)

Canadian Immunization Monitoring Program, Active Data center director
Executive committee member
Lead for invasive meningococcal surveillance and invasive pneumococcal surveillance

PHAC, GSK, Merck, Pfizer, Novartis

Institution Canadian Paediatric Society, which administers IMPACT

>$1,000,000

>1 time

Date interest arose: I have been continuously working on IMPACT since 2004

Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - - Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)

“Vaccine Safety Monitoring in Canada.” And “Communication with Vaccine Hesitant Parents” and “Vaccine Hesitancy in Perspective.”

British Columbia Pediatric Society 

Directly to the researcher

<$1,000

One-time event

Date interest arose: April 11, 2019

Date interest ended: April 11, 2019

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)

Member: 2015-2019, co-chair 2020-present

BC Immunization Committee

N/A

N/A

>1 time

Date interest arose: 2015

Date interest ended:

Member

BC Centre for Disease Control New Vaccines Task Group

N/A

N/A

>1 time

Date interest arose: 2015

Date interest ended:

Member

Medical Advisory Committee for the Meningitis Research Foundation of Canada

N/A

N/A

>1 time

Date interest arose: 2016

Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
Please see my CV. I have over 100 publications related to vaccine preventable disease and vaccine safety. I have not been paid for this work outside of my university salary. Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Natalie Dayneka

Children's Hospital of Eastern Ontario (CHEO)
Ottawa, Ontario

Natalie Dayneka is a clinical specialist with the Pharmacy Department of the tertiary care pediatric teaching hospital, Children's Hospital of Eastern Ontario (CHEO). As a pediatric pharmacist, Natalie has played an active role developing pediatric guidelines for Infectious Diseases, including Immunizations. She was a co-author of the online 2015 CHEO Antimicrobial Guidelines for Children which has been offered externally as a mobile application (APP) for pediatric practitioners across Canada.

Natalie has consulted on other federal committees and was a member of the Pharmacology and Therapeutics Committee for the First Nations and Inuit Health Programs Directorate. She also served on the Canadian Paediatric Society's Drug Therapy and Hazardous Substances Committee. More recently, Natalie served on the Ontario Quality Based Procedure Tonsillectomy Clinical Expert Advisory Group.

Natalie has been very active with the Canadian Society of Hospital Pharmacists (CSHP) and was awarded the title of Fellow. She is a past Chair of the Canadian HIV/AIDS Pharmacists Network (CHAP). Natalie has presented lectures and posters at regional, national and international meetings.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one - Date interest arose:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role

Organization

Funds allocated to

Total dollar amount

Recurrence

When the association happened

None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Philippe De Wals

Département de médicine sociale et préventive
Québec, Quebec

Philippe De Wals is Professor at the Department of Social and Preventive Medicine, Laval University, in Québec City, Canada. Professor De Wals gained his Medical Degree and a Doctorate in Public Health in his home country of Belgium, at the Louvain Catholic University. His early academic and professional career combined epidemiology research studies at the School of Public Health at the Louvain Catholic University with the practice of general medicine. Between 1980 and 2000 he worked as an epidemiologist for EUROCAT, a European network of population-based registries for the epidemiologic surveillance of congenital anomalies. In 1990, he moved to Canada and became the Head of the Department of Community Health Sciences at the University of Sherbrooke. In 1997, he was appointed visiting Professor at the School of Public Health at the University of North Carolina in Chapel Hill, USA.

Professor De Wals' research is centered on the epidemiology of infectious diseases, reproductive abnormalities, and the assessment of health services and public health programs and policies. He is the author of over 150 published articles in scientific journals and has contributed several chapters to textbooks. Currently, Professor De Wals is a member of the research centers at Quebec University Hospital and the Sherbrooke University Hospital and is a medical advisor to the Quebec National Institute of Public Health. In 2011, he was appointed as Scientific Director of the Evaluation Platform on Obesity Prevention at the Quebec Cardiology and Pneumology Institute.

In 1990, Professor De Wals was awarded the Jean Van Beneden Prize in recognition of his excellent work in the public health field, and in 2005, he was elected to the Royal Academy of Medicine of Belgium.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
PI: Factors influencing decision-making on meningococcal vaccine programs Laval University,
Centre de recherché Clinique du CHU de Sherbrooke
Glaxo-Smith Kline, Pfiser, Sanofi
Institution $100,000-500,000 On-going research project Started 2016
PI: Burden of respiratoryinfections and otitis media among children in Nunavik IRSC and GSK Institution $100,000-500,000 On-going research project Started 2010
PI: Burden of respiratoryinfections and otitis media among children in Quebec GSK Institution $100,000-500,000 On-going research project Started 2012

Please provide any additional comments, if applicable:

All the research programs described are investigator-initiated grants in which sponsors have no control on the study design, collection, analysis and interpretation of date, and dissimination of results.

I am also co-investigator or collaborator in several research projects supported by recognized research funding organizations (i.e. IRSC, FQRS).

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates

None to declare (please go to section 4)

- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)

Presentations to scientific meetigs and conferences.

Reimbursment of travel expenses and registration fees from research grants, university budgets or organizations independent from pharmaceutical companies

Directly to the researcher

Select the amount

Select one

Date interest arose: December 2018

Date interest ended: November 2019

Please provide any additional comments, if applicable:

No honorarium associated with these activities

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

I wrote scientific papers and reports, participated in the elaboration of statements (i.e. NACI and CIQ), gave presentations and lectures on vaccines that were totally independent from pharmaceutical companies.

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Eve Dubé

Québec National Institute of Public Health and the Research Center of the CHU-Québec
Québec, Quebec

Eve Dubé is a medical anthropologist. She is affiliated with Quebec National Institute of Public Health and the Research Center of the CHU-Québec. She is also an invited professor in anthropology at Laval University. Her research focuses on social, cultural and ethical issues around infectious diseases prevention. Most of her research aims at understanding why people accept, refuse or hesitate to receive vaccines and why healthcare providers adhere or not to vaccination recommendation for themselves, their families and their patients. She is the lead investigator of the Social Sciences and Humanities Network of the Canadian Immunization Research Network. From 2013 to 2014, she was a member of the World Health Organization (WHO) working group on vaccine hesitancy and she is currently part of the WHO Global Advisory Committee on Vaccine Safety where she is mainly involved in vaccine risk communication.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention

Describe the research activity, including your role

Source of funding

Funds allocated to

Total dollar amount

Recurrence

Key dates

None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one -     - Date interest arose:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Vinita Dubey

Toronto Public Health

Dr. Vinita Dubey graduated from the University of Toronto's Public Health and Preventive Medicine Residency Program. She holds an Adjunct Professor appointment with the University of Toronto's Dalla Lana School of Public Health. Since 2006, she has been an Associate Medical Officer of Health for Toronto Public Health in Communicable Disease Control. Specializing with the Vaccine Preventable Disease program includes involvement in the school based vaccine program, immunization school assessment program which suspends students who are not up-to-date with required vaccines, adverse event following immunization investigations, and outbreak management including the 2017 mumps outbreak in Toronto which was the largest mumps outbreak the city has had in over 20 years. She also works as an emergency medicine physician in a small community hospital.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Soren Gantt

University of Montreal
Montreal, Quebec

Dr. Soren Gantt is a Professor in the Departments of Microbiology, Infectious Diseases Immunology and Pediatrics at Université de Montréal, and a Pediatric Infectious Diseases consultant and the Director of Clinical Research at CHU Sainte-Justine. Dr. Gantt obtained his MD and PhD (Immunology) degrees from the New York University School of Medicine. He completed his Pediatrics residency and Infectious Diseases fellowship at Seattle Children's Hospital and the University of Washington, where he also obtained an MPH (Epidemiology). He is the former Head of Pediatric Infectious Diseases and Director of Clinical Research at BC Children's Hospital. His research combines translational studies and clinical trials, with a focus on the pathogenesis and prevention of disease due to cytomegalovirus and other human herpesviruses.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
Subproject of Canadian Immunization Research Network (CIRN) II:
“Optimizing varicella immunization in children with solid organ transplants to prevent disease and improve long-term health”- Investigator
CIHR Institution $50,000-100,000 One-time event Date interest arose: 5/19
Date interest ended:
Subproject of Canadian Immunization Research Network (CIRN) II: “Control of institutional meningococcal outbreaks: a
Canadian Immunization Research Network (CIRN) randomized controlled trial of two schedules of 4CMenB vaccine in adolescents and young adults - investigator
CIHR Institution $100,000-500,000 One-time event Date interest arose: 8/14
Date interest ended: 8/19
“Study to Evaluate the Safety, Tolerability, and Immunogenicity of the Candidate Human Cytomegalovirus Vaccine in Healthy Adults” - investigator VBI Institution $100,000-500,000 One-time event Date interest arose: 4/16
Date interest ended: 3/18
“A Phase 1/2, randomized, observer-blind, controlled, multi-center, doseescalation study to evaluate safety, reactogenicity and immunogenicity of RSV investigational vaccine (ChAd155-RSV; GSK3389245A) in RSVseropositive infants” - investigator GSK Institution $100,000-500,000 One-time event Date interest arose: 4/17
Date interest ended: 3/18
“A Phase III Clinical Trial to Study the Tolerability and Immunogenicity of a 2-Dose Regimen of V503, a Multivalent Human Papillovirus (HPV) L1 Virus Like Particle (VLP) Vaccine, Administered Preadolescents and Adolescents (9 to 14 years olds) with a Comparison to Young Women (16 to 26 year olds)” - investigator Merck Institution $100,000-500,000 One-time event Date interest arose: 1/14
Date interest ended: 1/18
“Double-Blind, Randomized, Placebo-Controlled Phase 2b, Multi-center Study to Evaluate the Safety, Tolerability, Efficacy and Immunogenicity of a 2-Dose and a 3- Dose Regimen of V160 (Cytomegalovirus [CMV] Vaccine) in Healthy Seronegative Women, 16 to 35 Years of Age” - investigator Merck Institution $500,000-1,000,000 One-time event Date interest arose:
Date interest ended:
“A Phase 3 Double-Blind Randomized Controlled Trial to Compare the Immunogenicity and Safety of a Three-dose Regimen of Sci-B-Vac™ to a Three-dose Regimen of Engerix-B® in Adults (PROTECT)” - investigator VBI Institution $500,000-1,000,000 One-time event Date interest arose: 7/18
Date interest ended: 10/19
“A Phase 3, Multicenter, Randomized, Double-blind, Active Comparator Controlled Study to Evaluate the Safety and Tolerability of V114 in Healthy Infants (PNEU - LINK)” - investigator Merk Institution $10,000-50,000 One-time event Date interest arose: 2/19
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
Consultant on Shingrix safety and tolerability post-licensure (~ $2000 CAD) GSK >1 time Date interest arose: 2018
Date interest ended:
Consultant on cytomegalovirus vaccine development (~ $9000 CAD) Merck >1 time Date interest arose: 2018
Date interest ended:
Consultant on varicella-zoster vaccine development (~$7000 CAD) Curevo >1 time Date interest arose: 2018
Date interest ended:
Consultant on cytomegalovirus vaccine development (~ $7000 CAD) Moderna >1 time Date interest arose: 2019
Date interest ended:
Safety Monitoring Board Member ($2000 US/year) HIV Vaccine Trials Network >1 time Date interest arose: 2013
Date interest ended: 2018
Safety Monitoring Board Chair ($2000 US/year) HIV Vaccine Trials Network >1 time Date interest arose: 2018
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
“An Enveloped Virus-like Particle (eVLP) Cytomegalovirus (CMV) Vaccine is Immunogenic and Safe: Results of a First-in-Humans Study.” IDWeek, San Francisco, 2018 VBI Directly to the
researcher
$1,000-5,000 One-time event Date interest arose: 10/18
Date interest ended: 10/18
“Subunit adjuvanted zoster vaccine: why the fuss?”, Western Canada Immunization Forum, Vancouver, 2018. unpaid N/A N/A One-time event Date interest arose: 1/18
Date interest ended: 1/18

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
Travel to the Hague, the Netherlands for a meeting on CMV vaccine development Merck Directly to the researcher $1,000-5,000 One-time event Date interest arose: 9/19
Date interest ended: 9/19
Travel to Boston for a meeting on CMV vaccine development Merck Directly to the researcher $1,000-5,000 One-time event Date interest arose: 2/18
Date interest ended: 2/18
Travel to Boston for a meeting on CMV vaccine development Moderna Directly to the researcher $1,000-5,000 One-time event Date interest arose: 10/19
Date interest ended: 10/19
Travel to Boston for a meeting on CMV vaccine development Moderna Directly to the researcher $1,000-5,000 One-time event Date interest arose: 10/19
Date interest ended: 10/19
Travel to Seattle for a meeting on VZV vaccine development Curevo Directly to the researcher <$1,000 One-time event Date interest arose: 12/19
Date interest ended: 12/19
Travel to San Francisco to present the results of a CMV vaccine trial VBI Directly to the researcher $1,000-5,000 One-time event Date interest arose: 10/18
Date interest ended: 10/18
Travel to the Hague, the Netherlands for a meeting on CMV vaccine development Merck Directly to the researcher $1,000-5,000 One-time event Date interest arose: 9/19
Date interest ended: 9/19

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Robyn Harrison

Alberta Health Services
Grey Nuns and University of Alberta Hospitals

Dr. Robyn Harrison is an Infectious Disease Specialist who works in Edmonton, Alberta. She is a Communicable Disease Consultant for the province wide Alberta Health Services Workplace Health and Safety Program (a position she has held since 2008). She has also served as consultant for the Covenant Health Alberta Occupational Health and Safety Program (2008-2014). Dr. Harrison is keenly interested in policy development and support for clinicians to prevent infection transmission in healthcare settings. She is a member of the Alberta Advisory Committee on Immunization, and she participates in infection prevention working groups in the province of Alberta, including past work on pandemic influenza H1N1 in 2009, and avian influenza is 2014. At a national level, she is working with the Public Health Agency of Canada as a member of the Prevention and Control of Occupational Infections in Health Care Settings Guideline Working Group to update and disseminate national evidence-based infection prevention and control (IPC) guidance.

Dr. Harrison obtained her medical degree at Dalhousie University, Nova Scotia; and she completed her Internal Medicine and Infectious Diseases subspecialty training at the University of Alberta. Most recently she completed an MSc in the combined areas of Public Health and Epidemiology through the London School of Hygiene and Tropical Medicine, England.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates

None to declare (please go to section 3)

- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
Communicable Disease Consultant Alberta Health Services >1 time Date interest arose: 2009
Date interest ended: ongoing
Alberta  Advisory Committee on Immunization Alberta Health >1 time Date interest arose:2015
Date interest ended: ongoing

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
NACI PHAC supported travel to Ottawa PHAC N/A <$1,000 >1 time Date interest arose: 2017
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Kyla Hildebrand

University of British Columbia
Vancouver, Bristih Columbia

Dr. Kyla Hildebrand is a Pediatric Clinical Immunology and Allergy specialist and Clinical Associate Professor in the Department of Pediatrics at the University of British Columbia (UBC). Her subspecialty training was completed at the Hospital for Sick Children and University of Toronto. She completed a Master of Community Health Sciences program from the Dalla Lana School of Public Health, University of Toronto. She is a Clinical Investigator at the BC Children's Hospital Research Institute and Director of the Pediatric Clinical Immunology and Allergy Residency Training Program at UBC.

Dr. Hildebrand's clinical work involves assessing and managing complex patients presenting with allergic and immunological disorders including children requiring hematopoietic stem cell transplantation. She has been engaged with the Special Immunization Clinic (SIC) Network at UBC since 2014. She is a collaborator at the UBC site in the Canadian Health Infant Longitudinal Development (CHILD) study, designed to advance knowledge about the genetic and environmental determinates of atopic disease to determine how early life exposures relate to health and disease outcomes.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
 -  - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
Medical expert providing input and review of a publicly funded PIDD smart phone application - BC Provincial Blood Coordinating Office BC Provincial Blood Coordinating Office >1 time Date interest arose: 2018
Date interest ended: 2019
Children's and Women's Health Centre 1) Emergency Blood Management Committee and 2) PIDD Working group member. Provincial Health Services Authority >1 time Date interest arose:
1) 2019
2) May 2020
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates

None to declare (please go to section 6)

 -  - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Kristin Klein

Alberta Health Services
Edmonton, Alberta

Dr. Kristin Klein is public health and preventive medicine specialist based out of Edmonton, Alberta. She holds two positions with Alberta Health Services, serving as Associate Provincial Medical Officer of Health for Communicable Disease Control and as a local Medical Officer of Health for Northern Alberta. Her educational background includes a Bachelor of Science from the University of Calgary, a medical degree and fellowship training in Public Health and Preventive Medicine from the University of Alberta. Prior to her role with AHS, Dr. Klein served as the Deputy Medical Officer of Health for the Government of Alberta. She has contributed to several provincial and national committees including representing the Council of Chief Medical Officers of Health as liaison member to NACI. She also holds a clinical appointment with the Faculty of Medicine and Dentistry at the University of Alberta.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Jesse Papenburg

McGill University Health Centre
Montreal, Quebec

Dr. Jesse Papenburg is an Assistant Professor of Pediatrics and an Associate Member of the Department of Epidemiology, Biostatistics and Occupational Health at McGill University. He practices Pediatric Infectious Diseases and Medical Microbiology at the Montreal Children's Hospital of the McGill University Health Centre.

Dr. Papenburg obtained his medical degree from McGill University and completed residency and subspecialty training at the Montreal Children's Hospital. He then completed a research fellowship on the molecular virology of RNA respiratory viruses at Laval University and a MSc in epidemiology at McGill. As a clinician scientist, Dr. Papenburg's research is on the epidemiology of viral respiratory infections, with a focus on diagnostics to improve treatment and outcomes. He actively contributes to national and provincial guidelines on RSV immunoprophylaxis and influenza antiviral treatment.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)

Site Principle Investigator (PI), Industry-led trial
“A Phase 2b Randomized, Double-blind, Placebo-controlled Study to Evaluate the Safety and Efficacy of MEDI8897, a Monoclonal Antibody with an Extended Half-life Against Respiratory Syncytial Virus, in Healthy Preterm Infants.”

MedImmune

Institution

$10,000-50,000

One-time event

Date interest arose: 01 /2017

Date interest ended: 12/2018

Site PI, Industry-led trial
“QHD04 Phase II, randomized, staged, modified double-blind, multi-center study in the United States and Canada to evaluate the safety and immunogenicity of 3 dosages of QIV-HD administered intramuscularly in children 6 months to 17 years of age.”

Sanofi

Institution

$10,000-50,000

One-time event

Date interest arose: 01/2019

Date interest ended: 04/2020

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)

Medical Lead, scientific steering committee, i.e., to ensure the scientific validity of the methodology and the interpretation of the results. Primary author on submitted manuscripts.
“Impact of the lack of immunoprophylaxis for severe respiratory syncytial virus disease in infants born at 33 to 35 weeks gestational age: An observational, non-interventional study in Québec”

AbbVie

One-time event

Date interest arose: 01/2016
Date interest ended: 12/2018

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
-

Select one

Select the amount

Select one

Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Coleman Rotstein

University of Toronto and University Health Network
Toronto, Ontario

Dr. Rotstein is Professor of Medicine in the Division of Infectious Diseases at the University of Toronto and Attending Physician at the University Health Network, Toronto, Ontario. He received a Bachelor of Science at the University of Toronto and earned his medical degree from the University of Calgary in 1976. Dr. Rotstein completed his specialty training in Internal Medicine at the University of Toronto and pursued further subspecialty training in Infectious Diseases & Immunology at the Medical University of South Carolina in Charleston, South Carolina from 1980 to 1983 [ABIM (1980), FRCPC (Internal Medicine 1981), Infectious Diseases ABIM (1982)].

Dr. Rotstein is currently the Director of Oncologic Infectious Diseases at Princess Margaret Cancer Centre of the Immunocompromised Host Infectious Diseases Service at the University Health Network. He is also former Director of the Division of Infectious Diseases at McMaster University, past Chair and Secretary of the Infectious Diseases Section of the Ontario Medical Association, former Co-chair of the Emerging Infectious Diseases Network, former Past-President of the Association of Medical Microbiology and Infectious Disease Canada, former President of the Canadian Infectious Disease Society, and former Chair of the Clinical Trials Committee of the Canadian Infectious Disease Society. In addition, he has been elected a fellow of the American College of Physicians and the Infectious Diseases Society of America. He is a reviewer for several international journals and was formerly Associate Editor, Review Section, for the Canadian Journal of Infectious Diseases and Medical Microbiology.

Dr. Rotstein has published over 160 peer-reviewed papers. His research interests have focused mainly on infections in cancer patients and other immunocompromised hosts as well as fungal infections caused by Candida organisms. He maintains active research interests in clinical trials involving antifungal agents in immunocompromised hosts.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
CIDARA Research Directly to the researcher $10,000-50,000 N/A Date interest arose: Aug. 2017
Date interest ended: Present

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
Speaking Honorarium Roche Select one Date interest arose: March 2019
Date interest ended: Oct. 2019
Speaking Honorarium AVIR Select one Date interest arose: June 2019
Date interest ended: June 2019
Speaking Honorarium Merck Select one Date interest arose: June 2019
Date interest ended: Oct. 2019
Speaking Honorarium Sunovian Select one Date interest arose: June 2019
Date interest ended: Dec. 2019

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Beate Sander

Toronto General Hospital
Toronto, Ontario

Beate Sander, PhD, is a Scientist at Public Health Ontario (PHO), Assistant Professor at the University of Toronto, Adjunct Faculty at York University, and Adjunct Scientist at the Institute for Clinical Evaluative Sciences (ICES).

Beate's research interests lie in the area of economic evaluation with a focus on infectious diseases. She is leading multidisciplinary teams evaluating Zika and West Nile virus mitigation strategies using data-driven simulation models, and is linking laboratory with population-based administrative data, enabling novel approaches to study the burden of infectious diseases.

Beate served on the board of the Society of Medical Decision Making (SMDM) and is an editorial board member of the "Medical Decision Making" journal. Beate provides scientific advice to decision-makers and advisory bodies and serves on scientific working groups and networks.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Ms. Susan Smith

Alberta Health
Edmonton, Alberta

Ms. Smith is the Manager for Immunization Policy at Alberta Health. She has over thirty years of Public Health experience primarily focused on public health programs, immunization, and communicable disease control. Her roles have included front line generalist practice, nurse consultant, clinical development nurse (immunization and communicable disease control), and manager for immunization policy at Alberta Health.

Her experience includes providing immunizations, orienting/educating staff and clients on immunization and communicable disease issues, ensuring quality of immunization programs, and following up on notifiable diseases providing her with a strong clinical and operational background in public health immunization programs.

Currently, as manager for immunization policy Ms. Smith is responsible for the development and implementation of immunization policy in Alberta. This includes, coordinating and facilitating the work of the Alberta Advisory Committee on Immunization. In addition, in this role she has chaired and facilitated a number of immunization working groups comprised of medical officers of health, infectious disease physicians, nurse leaders and program staff to update and revise Alberta's immunization policy including immunization recommendations for solid organ transplant recipients, hematopoietic stem cell transplant recipients, and immunocompromised individuals; and recommendations for rotavirus, hepatitis B, varicella, and measles containing vaccines.

Ms. Smith has also been a member of in the Canadian Nursing Coalition for Immunization for the past two years and presented at the 2016 Canadian Immunization Conference.

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
Secretariat to Alberta Advisory Committee on Immunization Alberta Health Meets 2 to 3 times per year Date interest arose: Sept 2019
Date interest ended:

Please provide any additional comments, if applicable:

The Alberta Advisory Committee on Immunization (the Committee) is a multidisciplinary expert committee, reporting to the Deputy Minister of Health through the Chief Medical Officer of Health, with the mandate to provide ongoing and timely medical, scientific and public health advice related to immunization

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)

Presentation to Alberta Advisory Committee on Immunization Rabies Vaccine and RIG

n/a

N/A

Select the amount

>1 time

Date interest arose: January 2019
Date interest ended: Oct 2019

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
Manager, Immunization Policy Alberta Health N/A Select the amount Select one Date interest arose: Sept 2018
Date interest ended:

Please provide any additional comments, if applicable:

Alberta Health is my place of employment.  My major responsibility is ensuring Alberta's immunization policy is current through review of current literature, research, and consultation.  As well, as responding to health care professional inquiries on Alberta's Immunization Policy. Within the manager role is the responsibility to the Alberta Advisory Committee on Immunization as secretariat.

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
Alberta Immunization Policy N/A Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

All immunization policies are published on the web https://www.alberta.ca/alberta-immunization-policy.aspx

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Dr. Sarah Wilson

Public Health Ontario
Toronto, Ontario

Dr. Sarah Wilson is a public health physician/medical epidemiologist at Public Health Ontario PHO where she works closely with the Immunization and Vaccine-Preventable Diseases team within the Communicable Diseases and Emergency Preparedness Response Department. In this role, she provides support to the surveillance of vaccine-preventable diseases, immunization coverage, vaccine safety, outbreak management, and participates in applied research. Sarah's research interests include applied vaccine program evaluation and immunization coverage assessment using a range of data sources including both routine surveillance and administrative data. She is a Fellow of the Royal College of Physicians and Surgeons in Public Health and Preventive Medicine and a graduate of the Canadian Field Epidemiology Program. She is an Assistant Professor at the Dalla Lana School of Public Health at the University of Toronto and an Adjunct Scientist at ICES (formerly known as the Institute for Clinical Evaluative Sciences).

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
I am the Public Health Ontario (PHO) representative on Immunize Canada. I attend quarterly meetings to understand and contribute to discussions about immunization promotion (typically not vaccine specific). Immunization Canada n/a n/a n/a Date interest arose: Nov 2019
Date interest ended: ongoing
I am affiliated with the University of Toronto's Centre for Vaccine Preventable Diseases as a member of its Education committee. I attend meetings and provide input on how to improve immunization competencies among health care providers and trainees. Centre for Vaccine-Preventable Diseases, University of Toronto n/a n/a n/a Date interest arose: April 2017
Date interest ended: ongoing

Please provide any additional comments, if applicable:

I am listing my affiliation with the University of Toronto Centre for Vaccine-Preventable Diseases here as I understand the Centre has recently received funding from vaccine manufacturers to support post-doctoral fellowships that would be funded through the Centre. I will not be involved in the administration of the funds and will not receive any of the funds. I am unsure of the specific dollar amount as a formal announcement is forthcoming.

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2.  Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare

Employee of Public Health Ontario

N/A

Select the amount

>1 time

Date when interest arose: June 2012
Date when interest ended: ongoing

Please provide any additional comments, if applicable:

I receive a salary as an employee of Public Health Ontario. My role at Public Health Ontario includes providing scientific and technical advice to the Ontario Ministry of Health in regards to the implementation and monitoring of immunization programs.

Executive secretary

Dr. Matthew Tunis

Manager

Ms. Althea House

Liaison representatives

Association of Medical Microbiology and Infectious Disease Canada
Dr. Anne Pham-Huy
Ottawa, ON

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
Vaccinating children after chemotherapy or hematopoietic stem cell transplant- A Canadian Immunization Research Network Study CIHR Institution 300,000 One-time event Date interest arose:
Date interest ended:
Special Immunization Clinic Network to investigate vaccine safety issues: Optimizing the clinical management of patients with contraindication to vaccination and those with adverse events following immunization (AEFI) as a platform for observational
research
CIHR Institution 133,000 >1 time Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates

None to declare (please go to section 3)

-

Select the amount

Select one

Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- -

Select one

Select the amount

Select one

Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
-

Select one

Select the amount

Select one

Date when interest arose:

Date when interest ended:

Please provide any additional comments, if applicable:

Canadian Association for Immunization Research and Evaluation
Dr. Deshayne Fell
Ottawa, ON

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
Observational research on H1N1 influenza vaccination during pregnancy as PI or co-PI (PMID: 22515877, 27486858, 31292120) CIHR (3 grants) Institution $100,000-500,000 N/A Date interest arose: 2011
Date interest ended: ongoing
Observational research on Tdap vaccination during pregnancy as PI (no publications yet) CIHR Institution $100,000-500,000 One-time event Date interest arose: 2018
Date interest ended: ongoing

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
  None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
Member of a Data Safety Monitoring Board for a CIRN randomized trial of influenza vaccine (PI: Dr. Joanne Langley) CCfV >1 time Date interest arose: 2019
Date interest ended: ongoing
Member of a WHO Working Group on RSV vaccine WHO >1 time Date interest arose: 2017
Date interest ended: present

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

I have never received speaking fees for any presentations/lectures. I have received travel honorariums for conferences and lectures, but never any funds from a pharmaceutical company or related third party.

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

I have received funds from WHO for travel to conferences and meetings, and travel honorariums from conferences directly, but never any funds from a pharmaceutical company or related third party.

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Canadian Immunization Committee
Dr. Monika Naus
Vancouver, BC

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
Meningococcal vaccine study led by Dr. Sadarangani, I am a coinvestigator Multiple, including BCIC, CIHR-CIRN Institution $50,000-100,000 One-time event Date interest arose: 2018
Date interest ended: ongoing
Pneumococcal vaccine study (1 dose), led by Dr. Sadarangani, I am a coinvestigator Multiple, including CIHR-CIRN Institution $50,000-100,000 One-time event Date interest arose: 2018
Date interest ended ongoing
HPV vaccine studies led by Dr. Ogilvie, I am a coinvestigator Multiple, including CIHR Institution Total funds will be in the range of $10 for a variety of projects Multiyear funding Ongoing

Please provide any additional comments, if applicable:

No personal financial benefit of participation. I am not the holder of these funds.

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

I do routinely give presentations in the CME category for a variety of audiences including family physicians and other immunization service providers.

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
I am routinely involved in development of guidelines for the use of vaccines for disease prevention and control, communication of these guideline, etc. in my role as a public health physician at a provincial level n/a N/A >1 time Date interest arose:  throughout the past 5 years
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

I am a full-time employee of the University of British Columbia funded by the BC Centre for Disease Control in a grant tenure position. I am full faculty at UBC and a Professor. My full-time service role with BCCDC is as the Medical Director of the Communicable Diseases and Immunization Service and Medical Head for Immunization Programs and Vaccine Preventable Diseases.  All of the activities listed above are in the context of these positions.

Canadian Public Health Association
Dr. Lucci Bucci
Ottawa, ON

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
International Federation on Ageing Institution <$1,000 One-time event Date interest arose: June 24, 2019
Date interest ended: June 25, 2019

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
Immunize Canada Institution $100,000-500,000 One-time event Date interest arose: January 2019
Date interest ended: December 2019

Please provide any additional comments, if applicable:

Immunize Canada receives sponsorships and educational grants from various pharmaceutical companies to undertake it's educational and promotional activities. These funds go towards the operation of the coalition and Immunize Canada retains editorial control over all its' products. These grants and sponsorships are obtained on a yearly basis.

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Canadian Paediatric Society
Dr. Dorothy Moore
Montréal, QC

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)

Canadian Paediatric Society Infectious Diseases and Immunization Committee

Voluntary, not paid

N/A

Date interest arose: 1999

Date interest ended: ongoing

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
Vaccine hesitancy one-day workshop Canadian Paediatric Society Honorarium plus expenses $1,000-5,000 (total for 3 workshops) >1 time Date interest arose:
Dec  3, 2018
Mar 26, 2019
Oct 30 2019
Date interest ended:

Please provide any additional comments, if applicable:

Receive $1000.00 honorarium (for all three) and travel expenses

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
Canadian Immunization Conference 2018 Montreal Children's Hospital Personal Research Fund N/A <$1,000 Select one Date interest arose:
December 2018
Date interest ended:

Please provide any additional comments, if applicable:
Reimbursement for registration fees and travel expenses

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
Canadian Paediatric Society  (b) member N/A N/A N/A Date interest arose: 1984
Date interest ended: ongoing
Association of Medical Microbiology and Infectious Diseases, Canada  (b) member N/A N/A N/A Date interest arose: 1985
Date interest ended: ongoing
Infectious Diseases Society of America  (b) member N/A N/A N/A Date interest arose: 1986
Date interest ended: ongoing

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Center for Disease Control and Prevention
Dr. Amanda Cohn
Atlanta, Georgia, USA

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened

None to declare (please go to section 9)

- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
-

Select one

Select the amount

Select one

Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

College of Family Physicians of Canada
Dr. Julie Emili
Hamilton, ON

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
Canadian Medical Association (CMA) /Ontario Medical Association (OMA) - member - Select one Select the amount Select one Date interest arose: 2005
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
Local media Select one Select the amount Select one Date interest arose: 2005
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
Local Public Health Select one Select the amount Select one Date when interest arose: 2005
Date when interest ended:

Please provide any additional comments, if applicable:

Council of Chief Medical Officers of Health
Dr. Martin Lavoie
Vancouver, BC

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactc agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
 None to declare (please go to section 6)
Presentation at immunization conference related to my role as Deputy Chief Medical Officer of Health at Government of Alberta Travel, accommodations and registration costs covered by provincial or federal government or agency N/A N/A N/A Date interest arose:
Date interest ended: 

Please provide any additional comments, if applicable:

2016 Canadian Immunization Conference - presentation on Security of Vaccine Supply

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
Media interviews as Chief Medical Health Officer N/A N/A N/A Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

Part of my duties in the role of Chief Medical Health Officer for Fraser Health (August 2017- July 2020) was being an official spokesperson on public health issues. I spoke to the media on a regular basis. During media interviews, we refrain from using brand names, but we do promote immunization in general and often specifically mentioning vaccine products generically.

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Society of Obstetrics and Gyneacologists
Dr. Eliana Castillo
Calgary, AB

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organisation which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Canadian Nurses Association

Ms. Lorette Dupuis
Ottawa (Ontario)

Disclosure of Affiliations and Interests from the last 3 years

1. Participation in research

Have you, your spouse/partner, or your immediate family members participated (e.g., as a trial investigator) in research related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Research that will be (or is likely to be) a component of a guideline recommendation on a topic
  2. Research related to a competing intervention that will be (or is likely to be) relevant to the guideline recommendations
  3. Research related to a company that produces a specific intervention under consideration in the guideline, but not related to that specific intervention
Describe the research activity, including your role Source of funding Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 2)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

2. Equity ownership

Does you, your spouse/partner, or your immediate family members own or have owned stock, stock options, or other ownership interests in a company that manufactures or promotes a health technology related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the equity ownership Total dollar amount Recurrence Key dates
None to declare (please go to section 3)
- Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

3. Intellectual property

Does you, your spouse/partner, or your immediate family members own or have owned patents or copyrights, and/or received royalties from these rights related to a health technology relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Describe the intellectual property Total dollar amount Recurrence Key dates
None to declare (please go to section 4)
- Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

4. Paid and voluntary work

Have you, your spouse/partner, or your immediate family members participated in paid of voluntary work relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Employment in any capacity by the manufacturer of a health technology assessment under consideration
  2. Membership on a board of directors for a manufacturer of a health technology under consideration
Describe the paid or voluntary work, including your role Employer Recurrence Key dates
 None to declare (please go to section 5)
- - Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

5. Scientific meetings/lectures and speaking fees

Have you, your spouse/partner, or your immediate family members delivered presentations or lectures in scientific meetings, which are relevant to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Presentation at a scientific meeting (open or closed) in relation to an intervention or health technology that could be part of clinical practice guideline recommendations
  2. Receiving income from lectures or other forms of teaching related to the health technology that could be part of a clinical practice guideline
  3. Funding from the company producing the intervention or health technology, a competitor, or from a third party on behalf of the company / competitor to speak at conference, scientific meeting or education facility for any purpose.
Describe the presentation Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
 None to declare (please go to section 6)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

6. Sponsored travel

Have you, your spouse/partner, or your immediate family members received funding or sponsorship for travel that was related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Any domestic or international travel either personally or to family or friends, funded in part or whole by a pharmaceutical company (or other company producing a health technology of interest) or related third party
Describe the travel Source of funding (if applicable) Funds allocated to Total dollar amount Recurrence Key dates
None to declare (please go to section 7)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

7. Hospitality

Have you, your spouse/partner, or your immediate family members received any hospitality or gifts from a third party as part of an activity related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Example

  1. Hospitality or gifts provided by a pharmaceutical company (or other company producing a health technology of interest) as part of a publicity or awareness-raising campaign
Describe the hospitality Source Funds allocated to Total dollar amount Recurrence Key Dates
None to declare (please go to section 8)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

8. Sponsorship or associations

Have you, your spouse/partner, or your immediate family members been associated with an organization related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Involvement (as a general member or as part of organization's management) in an organization which receives direct funding or sponsorship from a pharmaceutical company (or other company producing a health technology of interest)
  2. Involvement (as a general member or as part of organization's management) in a non-profit or advocacy organization that may have a vested interest in the guideline topic
Describe the association, including your role Organization Funds allocated to Total dollar amount Recurrence When the association happened
None to declare (please go to section 9)
- - Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

9. Public statements about the guideline topic

Have you, your spouse/partner, or your immediate family members published any statements or opinions related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans?

Examples

  1. Advocating for a change in policy in relation to an intervention that may be part of the guideline scope
  2. Individual has made public statement advocating that a intervention or health technology under consideration should or should not be recommended
Describe the statement, including where it was published Funds allocated to Total dollar amount Recurrence When the statement happened
 None to declare (please go to section 10)
- Select one Select the amount Select one Date interest arose:
Date interest ended:

Please provide any additional comments, if applicable:

10. Other relevant disclosures related to the guideline topic that do not fit the categories above

Have you, your spouse/partner, or your immediate family members have any other interests related to vaccines used for the prevention of infection and disease and the use of certain prophylactic agents (e.g. immunoglobulins) for humans that do not fit in the categories above?

Describe the interest Funds allocated to Total dollar amount Recurrence When the interest happened
None to declare
- Select one Select the amount Select one Date when interest arose:
Date when interest ended:

Please provide any additional comments, if applicable:

Ex-officio representatives

Biologics and Genetic Therapies Directorate
Dr. Robert Pless
Health Canada
Ottawa, ON

Centre for Immunization and Respiratory Infectious Diseases (CIRID)
Immunization Programs and Pandemic Preparedness Division
Ms. Erin Henry
Public Health Agency of Canada
Ottawa, ON

Centre for Immunization and Respiratory Infectious Diseases (CIRID) 
Surveillance and Epidemiology Division
Ms. Jennifer Pennock
Public Health Agency of Canada 
Ottawa, ON

Directorate of Force Health Protection
National Defense and the Canadian Armed Forces
Vincent Beswick-Escanlar
Ottawa, ON

National Microbiology Laboratory
Dr. Guillaume Polliquin
Public Health Agency of Canada
Winnipeg, MB

First Nations and Inuit Health Branch
Dr. Tom Wong
Indigenous Services Canada
Ottawa, ON

Marketed Health Products Directorate
Dr. Deborah Danoff
Health Canada
Ottawa, ON

Public Health Ethics Consultative Group (PHECG)
Ms. Mireille Lacroix
Ottawa, ON

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