levels, including the identification of significant disparities, gaps, and vaccine safety concerns.

• Sustain and improve immunization coverage levels within child and adult populations, especially in vulnerable communities.

• Use primary care and public health resources efficiently in achieving national immunization goals.

The last of these roles provides overarching support for the other five, and was the focus of the committee’s charge. In conducting the study, we gave particular attention to the responsibilities of federal and state health agencies and the burden of effort required to support each of the above roles in an integrated manner. Figure 1–6 displays these roles as components of the national immunization partnership.

We recognize that the U.S. immunization infrastructure involves a broader set of activities than can be incorporated within the six roles described above. For example, the separate cycles of research, development, licensing, and production of vaccines and the selection of vaccines

FIGURE 1–6 Six roles of the national immunization system.