National Vaccine Advisory Committee Approves Recommendations to Improve HPV and Maternal Vaccine Efforts
Jun 18, 2014

 

The National Vaccine Advisory Committee (NVAC) met last week in Washington, D.C. to deliberate recommendations aimed at continually improving our nation’s immunization system.

This federal advisory committee, which was authorized in 1987, provides vaccine and immunization policy recommendations to the U.S. Department of Health and Human Services (HHS).  The NVAC committee is made up of individuals with a wide variety of expertise including physicians, consumer organizations, state and local health agencies, vaccine researchers and manufacturers.

 

The NVAC is chartered to:

• Study and recommend ways to encourage the availability of an adequate supply of safe and effective vaccination products in the States;
• Recommend research priorities and other measures the Director of the National Vaccine Program should take to enhance the safety and efficacy of vaccines;
• Advise the Director of the Program in implementation of sections 2102 and 2103 of the Public Health Service Act; and
• Identify annually for the Director of the program the most important areas of government and non-government cooperation that should be considered in implementing sections 2102 and 2103 of the Public Health Service Act.

 

The NVAC has made recommendations on a wide variety of issues since its inception in 1987 at a time when vaccine supply, the improvement on existing vaccines, and vaccine resources and financing needs were the main focus of the committee’s time.  As issues arise which require further input to inform the full committee, NVAC forms subcommittees who, with tremendous support from the National Vaccine Program Office staff, deliberate the issue, conduct extensive research, and eventually develop draft recommendations.  The full committee reviews the report and votes to make recommendations on the issues at hand to the Assistant Secretary of Health.  These committees typically meet throughout the year on regular teleconferences; bringing in experts from a variety of health-related fields to inform their work.  A typical workgroup might meet for more than a year prior to developing a report and set of recommendations for full committee consideration.

The NVAC is one of several federal advisory committees who report, either directly or indirectly, to the Secretary of Health on issues related to vaccine development, approval and safety oversight.

This valuable schematic, which was published in public health reports in larger format, includes each of the federal advisory committees along with the agency that supports their work.  Each of these committees provides liaison reports and input during the February, June and September meetings of the NVAC, along with several Ex Officio organizations.  This allows for better coordination of efforts at the national level on all matters related to the immunization system.

At the most recent NVAC meeting the HPV Working Group and the Maternal Immunization Working Group provided final recommendations for vote by the full NVAC.

The HPV working group was charged “to review the current state of HPV immunization, to understand the root cause(s) for the observed relatively low vaccine uptake (both initiation and series completion), and to identify existing best practices all with a goal of providing recommendations on how increase use of this vaccine in young adolescents.”   The committee was conducting their research at the same time as the President’s Cancer Panel (PCP), which was also preparing recommendations on a wide variety of cancer-related issues.  Recently the PCP report was released, with great focus on the importance of increasing HPV vaccination rates in order to reduce the number of cancers in women and men.  The NVAC HPV Working Group focused their recommendations in support of the PCP report and will continue to investigate the need for additional recommendations to the Assistant Secretary.

The NVAC approved the following recommendations in full, which will be posted in the near future for the public:

1. NVAC and the ASH should endorse the President’s Cancer Panel (PCP) report, Accelerating HPV Vaccine Uptake: Urgency for Action to Prevent Cancer, and adopt the recommendations outlined therein.

2. As written in the PCP report, NVAC should, “monitor the status of uptake and implementation of the recommendations.” This should be done by hearing an annual progress report from stakeholders identified in the PCP report.

3.  The working group will continue to work on a shortened schedule and will report back to NVAC on whether there are additional recommendations to me made.

The Maternal Immunization Working Group also made a series of significant recommendations aimed at fulfilling their charge “to review the current state of maternal immunizations and existing best practices.”  The working group was asked to first identify programmatic barriers to implementation of current recommendations regarding maternal immunization and make recommendations for overcoming these barriers. Efforts to identify barriers to and opportunities for developing vaccines for pregnant women should then be identified as well as ways to overcome these barriers and leveraging the opportunities.

In particular the working group made a series of recommendations aimed at:

1. Enhancing communication to address the safety and effectiveness of all currently recommended immunizations during pregnancy;

2. Maximizing obstetric provider recommendation and administration of recommended maternal immunizations;

3. Focusing efforts to improve financing for immunization services during pregnancy and postpartum;

4. Supporting efforts to increase the use of electronic health records (EHRs)and Immunization Information Systems (IISs) among obstetrical care providers; and

5. Recognizing and addressing current vaccine liability law barriers to optimize investigations and uptake of recommended and future vaccines during pregnancy

This committee’s work will be instrumental in forwarding the efforts to ensure the vaccination of pregnant women against whooping cough and influenza and build on policies and procedures necessary as potential new vaccines are recommended for the benefit of pregnant women and their newborns.  The recommendations, which are extensive, will be available to the public in the near future, at which time Every Child By Two will provide them to our readers.

The Vaccine Hesitancy Working Group will continue its research and prepare a draft report and recommendations to the full NVAC at the September 9 – 10 meeting.  To register for this public meeting please visit the National Vaccine Program Office website.  Note that all meetings are webcasted live to the public as well.  Stay tuned.

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