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Updates from June 2017 Meeting of the Advisory Committee on Immunization Practices

July 13, 2017 2 comments

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Recently, the Advisory Committee on Immunization Practices (ACIP) met to discuss several important developments concerning vaccines. As you may be aware, this impartial group of experts advises the U.S. Centers for Disease Control and Prevention (CDC) on all matters related to vaccine recommendations. In the coming years, the ability of the CDC and public health departments to implement the recommendations of this group may be under threat from proposed provisions within the health care reform bills and congressional budget cuts.

The activities of the ACIP are supported by staff at the CDC, which receives annual appropriations from the federal government to fulfill its duties.  This federal immunization funding is at risk of being drastically cut if the Prevention and Public Health Fund (PPHF) is eliminated. (Click here to see a breakdown of the impact of the elimination of the PPHF funds by state.) If Congress follows the recommendation of the President, funding will be reduced by another 14% beginning in Fiscal Year (FY) 2018.

The result is that CDC may no longer be able to fully support its immunization functions including:

  • ACIP staffing;
  • Vaccine purchase and supply management;
  • Vaccine safety monitoring;
  • Education initiatives;
  • Disease surveillance;
  • Outbreak response; and
  • Funding support for state, territory, and city immunization programs.

An example of the critical activities conducted by the CDC includes support for the ACIP.  This committee of experts from diverse fields such as vaccinology, immunology, pediatrics, internal medicine, nursing, family medicine, virology, public health, infectious diseases, and\preventive medicine meets three times a year to review and discuss vaccine research and scientific data related to vaccine effectiveness and safety, clinical trial results, outbreaks of vaccine-preventable disease or changes in vaccine supply.

There are 15 voting members, 8 ex officio members who represent other federal agencies with responsibility for immunization programs in the United States, and 30 non-voting representatives of liaison organizations that bring related immunization expertise. All members volunteer their time and come from many leading professional and public organizations such as the American Academy of Pediatrics, the National Foundation for Infectious Diseases, and the American Geriatrics Society. This is the only meeting to gather such a comprehensive group of experts whose aim it is to protect individual and public health.

The current health care reform discussions that are happening in Congress may have a direct impact on this Committee. Please continue to reach out to your Representatives and Senators to let them know the importance of keeping PPHF and CDC fully funded. (You can find your Members of Congress at http://whoismyrepresentative.com/ and some suggestive language to share here.) 

The value of the ACIP can not be overstated. During their most recent committee meeting in June, members discussed several important issues recapped in the summary below.

Read more…

ACIP: Fifty Years of Vaccine Recommendations Continue with an Eye Towards Safety and Efficacy

July 11, 2014 3 comments

This year marks the 50th anniversary of the Advisory Committee on Immunization Practices (ACIP).

Use of a jet injector during the 1976 New Jersey Influenza A immunization project in which 45 million adults in the United States received a vaccine containing the A/New Jersey/76 influenzavirus ("swine flu" virus).

Use of a jet injector during the 1976 New Jersey Influenza A immunization project in which 45 million adults in the United States received a vaccine containing the A/New Jersey/76 influenzavirus (“swine flu” virus).

The Committee, founded by the Surgeon General in 1964, originally consisted of 10 members and included influenza vaccine as one of its first agenda items.  When the committee convened last week to continue their ongoing efforts to develop safe and effective vaccine recommendations, there were over 50 members present and influenza was once again on the agenda.

The changes in immunization recommendations in the past fifty years have been nothing short of astounding.  Not only do we continue to see new vaccines, but we have exceptional standards in place to evaluate the increased safety and efficacy of these new recommendations.  The Committee’s commitment to the public is exemplified by the great lengths they take to examine all the evidence prior to making their recommendations.

After an extensive review of the data compiled by a special Influenza Working Group, a unanimous decision was made by the ACIP to recommend the Live Attenuated Influenza Vaccine (LAIV), commonly referred to as the nasal mist vaccine, as the preferred influenza vaccine to be administered to healthy 2-8 year olds when available.   Through their further review of the scientific research presented at the February meeting, the Committee found that LAIV was a more effective vaccine for this age group.  The studies also confirmed that there were no identifiable safety concerns that would prevent the Committee from recommending LAIV over the Inactivated Influenza Vaccine (IIV), commonly referred to as the flu shot.

While the recommendation can be applauded for providing better flu protection among a vulnerable age group, there were some concerns that the recommendation comes too late in the year.  Most pediatric providers have already submitted their vaccine supply orders for the upcoming flu season and without anticipating this new recommendation they may not have ordered enough LAIV to accommodate their patients. It is also unknown whether the vaccine manufacturer has planned to produce enough vaccine to meet the public’s demand.   To help address these concerns, the Committee emphasized that while LAIV is preferred, if it is not immediately available, the injectable vaccine should be used and vaccination should not be delayed.

It should be noted that some people should not receive the live attenuated influenza vaccine.  (For details of the ACIP’s specific recommendations and a list of those with LAIV contraindications, click here.)   Also, regardless of whether children receive the LAIV or IIV, the recommendation remains that children, age 6 months through 8 years of age, should receive 2 doses of flu vaccine in the first year that they are vaccinated for influenza.

In addition to voting on influenza vaccine recommendations, the Committee also heard various presentations related to influenza vaccine safety.  Read more…