[T]he principal coordinating organization for the NVP is the National Vaccine Program Office (NVPO), within the Public Health Service (PHS). The NVPO’s responsibilities include providing overall leadership for the collaborative effort and monitoring the progress being made in achieving the plan’s goals. Within the PHS, the NVPO has the task of reviewing all budget requests associated with vaccine development and immunization programs to ensure that all major priorities are adequately covered and that there is no duplication of effort. (NVPO, 1994)
The legislation represented a response to several different developments. These developments included problems of vaccine safety; the reemergence of vaccine-preventable diseases, especially pertussis and measles, in the United States and other developed countries; the persistence of these and other vaccine-preventable diseases in developing countries; and vaccine industry concern regarding financial and liability-related impediments to the development of new vaccines. The legislation also contained provisions aimed at improved monitoring of the safety of recommended vaccines and at reducing industry concern about liability risks. The Vaccine Adverse Events Reporting System (VAERS) and the National Vaccine Injury Compensation Program both became operational in 1988.
The release of the 1994 National Vaccine Plan coincided with other federal action to expand immunization coverage among children and adults. Such actions included increased federal appropriations for state immunization efforts and passage of the Vaccines for Children (VFC) amendments to Medicaid (Public Law 103-66). VFC, building on the existing entitlement to immunizations for children enrolled in Medicaid, strengthened federal immunization coverage standards while extending the immunization entitlement to uninsured children, children served by American Indian and Alaska Native health programs, and underinsured children served through Federally Qualified Health Centers (FQHCs). In 1990, DHHS released Healthy People 2000, which set forth 19 objectives related to reducing infectious disease and improving immunization coverage among children and adults.
Various nonprofit organizations interested in children’s health and welfare also were part of efforts in the early 1990s to improve immunization services. Every Child By Two, for example, sought to draw family and community attention to the need to ensure that young children received vaccines according to the recommended schedule, not simply in response to school entry requirements. The Children’s Vaccine Initiative, begun in 1990 under the auspices of United Nations agencies, focused on delivery of vaccines to children in developing countries.