and promotion of vaccines. The committee's report, Vaccine Supply and Innovation (1985), contained recommendations that led, in part, to a pivotal Public Health Service (PHS) program, the National Vaccine Injury Compensation Program (discussed in detail in Adverse Events Associated with Childhood Vaccines [1993]). The committee also recommended the creation of a National Vaccine Commission, which would be a nonprofit, congressionally chartered organization, and acknowledged that other loci for the organization, for example the IOM, the Office of Technology Assessment, or the Department of Health and Human Services, would not be incompatible with its mission. No such commission was established, but the National Childhood Vaccine Injury Act did establish the National Vaccine Program within the Office of the Assistant Secretary of Health of the Department of Health and Human Services. The mandate of the National Vaccine Program includes many of the responsibilities envisioned for the commission. The notion of central responsibility for vaccine issues was raised by the Children's Vaccine Initiative committee; this is described in a later section.

The Committee on Issues and Priorities for New Vaccine Development was convened at the request of the National Institute for Allergy and Infectious Diseases (NIAID) to provide assistance in developing a more comprehensive approach to setting priorities for accelerated vaccine development. The committee developed an analytic framework to be used as an aid to decision-making. The framework took into consideration such factors as disease burden, costs to be saved by prevention of infectious diseases by vaccines, costs of the vaccine and vaccination programs, and technical feasibility of the candidate vaccines. The committee released a two-volume report: New Vaccine Development, Establishing Priorities. Volume I (1985) addressed diseases of importance in the United States, and volume II (1986) addressed diseases of importance to less technologically developed countries. The NIAID and private-sector vaccine manufacturers have used this framework to guide and support their research and development efforts. The New Vaccine Development project was considered so valuable that in 1994, NIAID asked the IOM to take a second look at prioritization issues. The Committee to Study Priorities for Vaccine Development was convened in early 1995 and will release its report in late 1996. This committee will focus exclusively on vaccines directed against conditions of importance to the United States, including contraception and chronic conditions such as cancer or autoimmune diseases; a vaccine directed against HIV/AIDS is excluded from consideration because it is already a high priority for the government.



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