History of Public Engagement at the National Vaccine Program Office
The committee has followed with great interest and appreciation the efforts of the National Vaccine Program Office (NVPO) and its National Vaccine Advisory Committee (NVAC) to engage the general public on the National Vaccine Plan and on the research agenda of the Immunization Safety Office (ISO). The activities conducted in 2008 and 2009 followed an occasional series of notable public engagement activities on vaccine policy issues spearheaded by the Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), and NVPO over the past decade and a half.
In 2002, working through NVPO, the U.S. Public Health Service agencies and the Johnson Foundation in Wisconsin jointly sponsored the Wingspread Public Engagement Planning Group, which was facilitated by the Keystone Group (Keystone Center, 2003). The purpose of this group was to explore whether and how to enhance public engagement in government decision making on vaccine policy issues. The Wingspread Public Engagement Planning Group considered the recommendations of its Steering Committee and finalized its best judgment on how to enhance public engagement, which is captured in the proposal to create the Vaccine Policy Analysis Collaborative (VPACE), a 3-year demonstration project designed to conduct dialogue and collaborative deliberations on selected vaccine issues with representative segments of the general public and stakeholder groups (Hamlin, 2004).
In 2004, CDC convened a Blue Ribbon Panel of health and safety science professionals, as well as consumer advocates, to provide their independent assessments of CDC immunization safety activities, including the organizational placement of ISO (CDC, 2005).
Also in 2004, the NVAC’s Working Group on Public Participation convened a meeting to consider options for enhancing public participation in vaccine policy deliberations and to evaluate the proposal from the Wingspread Public Engagement Planning Group for VPACE.
In July 2005, the Public Engagement Pilot Project on Pandemic Influenza (PEPPPI) process was initiated to discuss and rank goals for a pandemic influenza vaccination program and to pilot-test a new model for engaging citizens on vaccine-related policy decisions. PEPPPI was sponsored by a network of 14 public and private organizations throughout the United States. The project provided “proof of principle” that a large and diverse group of citizens and stakeholders could be recruited successfully to deliberate thoughtfully, interact respectfully, and reach a productive agreement on the topic of immunizations (Bernier, 2006). The principal conclusions reached in the pilot project received serious consideration at the national level and were reflected in the national Pandemic Influenza Plan released in November 2005 (Bernier and Marcuse, 2005).
More recently, beginning in April 2008, NVAC (supported by NVPO) has been involved in two major public engagement activities: (1) a review of the draft ISO research agenda to identify gaps and help set priorities and (2) engagement with the public and other stakeholders to obtain input on the draft National Vaccine Plan. As part of the NVAC-NVPO process for the ISO agenda, one stakeholder and three public engagement workshops (convened in Alabama, Oregon, and Indiana) have been held; stakeholder and public comments have been solicited via the Federal Register and other outreach; and an NVAC vaccine safety writing group developed a list of research gaps and criteria for prioritizing items in the ISO research agenda, which was used as a basis for discussion at a stakeholder meeting in March 2009 (HHS, 2009b). The public engagement activities were coordinated by the Keystone Center, and the committee was greatly impressed by the systematic process that NVPO-NVAC and Keystone used.
For the draft National Vaccine Plan, NVPO has solicited feedback via the Federal Register; through vaccine-related meetings in which NVPO staff discussed the plan; and at an NVAC meeting in February 2009 to discuss the plan and comments on the draft plan received by NVPO. NVPO also held three public engagement activities in March and April 2009 in Saint Louis, Missouri; Syracuse, New York; and Columbus, Ohio (HHS, 2009a).
NVAC, with the support of NVPO, is also beginning work on a review of the current federal vaccine safety system and development of “a White Paper describing the infrastructure needs for a federal vaccine safety system to fully characterize the safety profile of vaccines in a timely manner, reduce adverse events whenever possible, and maintain and improve public confidence in vaccine safety” (HHS, 2009b). The committee praises CDC and ISO for going substantially beyond the recommendation of the 2005
Institute of Medicine committee that public input be obtained on the Vaccine Safety Datalink (VSD) research plan. CDC and ISO have opened the entire ISO agenda to public viewing and wide input, facilitated by NVAC and NVPO.
Bernier, R.H. 2006 (March). Public Engagement Pilot Project on Pandemic Influenza (PEPPPI). Available: http://cdc.confex.com/recording/cdc/nic2006/pps/free/4db77adf5df9fff0d3caf5cafe28f496/paper11639_2.pps [accessed January 27, 2009].
Bernier, R.H., and E.K. Marcuse. 2005. Citizen Voices on Pandemic Flu Choices: A Report of the Public Engagement Pillot Project on Pandemic Influenza. Available: http://ppc.nebraska.edu/documents/PEPPPI_FINALREPORT_DEC_2005.pdf [accessed January 27, 2009].
CDC (Centers for Disease Control and Prevention). 2005. Blue Ribbon Panel Meeting, Summary Report, June 3 and 4, 2004. Available: http://www.cdc.gov/od/ads/brpr/brprsumm.htm [accessed January 27, 2009].
Hamlin, M.D. 2004. Vaccine Policy Analysis Collaborative. Available: http://www.hhs.gov/nvpo/meetings/sep2004/VPACE.ppt#263 [accessed January 27, 2009].
HHS (Department of Health and Human Services). 2009a. U.S. National Vaccine Plan. Available: http://www.hhs.gov/nvpo/vacc_plan/index.html [accessed August 13, 2009].
HHS. 2009b. Vaccine Safety Working Group. Available: http://www.hhs.gov/nvpo/nvac/subgroups/vaccinesafety.html#1 [accessed August 13, 2009].
Keystone Center. 2003. Final Summary Report and Proposal for the Vaccine Policy Analysis Collaborative (VPACE). Available: http://keystone.org/files/file/about/publications/VPACE_FINALREPORT10_04.pdf [accessed January 27, 2009].