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IOM Issues Guidance on National Vaccine Plan Update

By Matthew Watson, June 20, 2008

On June 11th, 2008, an Institute of Medicine (IOM) committee released a report entitled Initial Guidance for an Update of the National Vaccine Plan: A Letter Report to the National Vaccine Program Office.¹ The IOM committee was charged by the National Vaccine Program Office (NVPO) of the U.S. Department of Health and Human Services (HHS) with reviewing the current federal vaccine plan and providing guidance on a forthcoming update.

First implemented by the federal government in 1994, the current National Vaccine Plan (NVP) calls for vaccine development and immunization efforts to reduce morbidity and mortality caused by infectious diseases. The four goals of the plan are to:

1. develop new and improved vaccines,
2. ensure the optimal safety and effectiveness of vaccines and immunization,
3. better educate the public and members of the health professions on the benefits and risks of immunizations, and 
4. achieve better use of existing vaccines to prevent disease, disability and death.

The first section of the report is a review of progress achieved in these areas during the last fourteen years. The analysis identifies changes to the healthcare delivery system, medical technology, and the global environment as factors that have produced changes sufficient to merit an update of the NVP.¹

The remainder of the document outlines the committee’s guidance on how an update of the NVP would address its current limitations. Recommendations include:

• Expanding the NVP to facilitate interaction and planning with stakeholders outside the federal government.
• Including performance measures and milestones to improve accountability and delivery on objectives the plan sets forth.
• Providing strategies and incentives to motivate stakeholders to actively participate in planning objectives.
• Ensuring transparency during the planning process by providing an explanation of what was included and why, as well as justification for those decisions.

The Committee also “noted some important omissions in the 1994 plan and identified several emerging areas and changes in context that will require attention in a major national document on the future of vaccine development and immunization.” The following are specific additions that the Committee suggests the federal government should consider in updating the NVP:

1. Adding mechanisms to identify and react to new opportunities or challenges as vaccine development and technology continues to move forward.
2. Considering, addressing, and facilitating the financing issues associated with vaccine use, as vaccine administration and development are a subset of a patchwork, volatile American healthcare system.
3. Considering mechanisms to improve access to vaccines across socio-economic boundaries. Specifically, the plan must ensure the ability for all state and local level departments of health to provide vaccines at low or no cost.
4. Including a framework for communicating the benefits and risks of immunization to the general public, healthcare workers, and other interested stakeholders.
5. Encouraging inquiry into how to decrease or eliminate shortages of vaccine.
6. Being especially vigilant going forward as global health events may have a direct impact on American vaccine use. The committee notes that globalization renders the distinction between domestic and international vaccination largely artificial.¹

The IOM report notes that the committee’s continuing work, which includes review of the evidence and input received from national stakeholders, “will form the basis for more detailed recommendations on priorities in the update to National Vaccine Plan.” 

References

1. Broome, CV [letter report]. Initial guidance for an update of the National Vaccine Plan. Washington, DC: The National Academies Press; June 11, 2008. http://www.iom.edu/CMS/3793/55143.aspx. Accessed June 20, 2008.