Priorities for the National Vaccine Plan (2010) / Chapter Skim
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Introduction
Introduction
Pages 17-30
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Each chapter contains recommendations and rationale for a set of priority actions. CHARGE TO THE COMMITTEE The National Vaccine Plan originates in the 1986 National Childhood Vaccine Injury Act (NCVIA)
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The committee was asked to first "prepare a letter report on its review of the 1994 plan" and then to "hold workshops with national expert stakeholders in medicine, public health, and vaccinology to review a publicly available, draft update of the Plan" and prepare a "report with conclusions and recommendations about priority actions within the major components of the new draft plan" (see Box I-1)
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The committee acknowledged that progress in developing and delivering vaccines has benefited from essential contributions by other stakeholders, including researchers, manufacturers, state and local public health agencies, and health care providers. Based on this review of the 1994 plan, the committee offered guidance to NVPO and its partners on key process and content areas to be considered in developing the update to the National Vaccine Plan.
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METHODS The committee was charged with holding meetings with expert stakeholders to discuss the draft National Vaccine Plan and with developing "recommendations about priority actions within the major components of the draft new plan." Because of the wide range of subjects addressed and the varied level (for example, big-picture and broad versus low-level and detailed) represented among the objectives and strategies in the National Vaccine Plan (as well as input received from stakeholders and by NVPO and NVAC)
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The committee suggests that NVPO consider distinguishing between objectives or strategies that are likely to be accomplished regardless of their placement in the National Vaccine Plan and those that are unique to the plan and require coordination among agencies and with non-government stakeholders in order to be achieved.4 The committee's recommendations about "priority areas within major components of the plan" refer to the latter type of objectives and strategies. Additionally, the committee believes that the final (implementation)
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, and as public health interventions used in the population at large to prevent infectious disease outbreaks and reduce or eliminate disease, disability, and death. Given the value of vaccination,5 its enormous and continuing importance to public health and the complex issues of national health policy that it raises, the federal government's involvement is broad and deep, spanning virtually all aspects of the immunization enterprise, across multiple federal agencies and often involving collaboration with stakeholders.
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Programs such as the Indian Health Service, federally funded community health centers and services of the Veterans' Health Administration in the Department of Veterans Affairs ensure access to immunization services for key populations including veterans, the uninsured, and children and adults whose health insurance does not cover vaccinations. The Centers for Disease Control and Prevention (CDC)
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established in 1987 in accordance with the NCVIA in order to ensure that those who bear the burden of rare serious adverse events possibly caused by vaccines are compensated. The principles of public safety and beneficence also contribute to the motivation to develop new and improved vaccines to prevent diseases that cause suffering, result in higher rates of disease and death, and affect individuals' and society's economic well-being, including days of work missed due to vaccine-preventable disease and health care expenditures to treat serious sequelae of infectious diseases.
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The following activities are important to highlight: • The Vaccine Adverse Events Reporting System, a passive surveillance system that receives reports of possible adverse events via mail, e-mail, fax, and web-based submission from vaccine manufacturers, health care providers, and the public, may detect "signals" (serious adverse events that might be associated with a preceding immunization) and be used to generate hypotheses; • The Vaccine Safety Datalink project, which is a large linked database that integrates data on more than 8 million people enrolled in eight health maintenance organizations and conducts active surveillance and testing of vaccine safety hypotheses; and • The Clinical Immunization Safety Assessment network based in several academic and clinical centers, which is equipped to provide basic science and clinical investigation of adverse events following immunization.
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. Chapter 2 provides additional discussion of how information from the program can contribute to the safety research agenda, and Chapter 3 examines implications of the program's legal actions on communication about vaccine risks and benefits.
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Chapter 1 of this report discusses vaccine research and development and recommends several priority actions in Goal 1 of the National Vaccine Plan. Chapter 4 discusses vaccine supply and use and recommends several priority actions in Goal 4 of the National Vaccine Plan.
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; and immunization as an indicator of health care system quality and performance. In Chapter 5, the committee examines major issues in the global use of vaccines and makes recommendations about priority actions in Goal 5 of the National Vaccine Plan.
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. Draft Strategic National Vaccine Plan.
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2008. Initial Guidance for an Update of the National Vaccine Plan: A Letter Report to the National Vaccine Program Office.
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