Report at a Glance

As a fundamental component of medical care and of public health, vaccinations prevent the spread of infectious and potentially deadly diseases. However, there are many complexities involved in the process of making and providing vaccines, from research and development of new vaccines to the financing of immunization services. The National Vaccine Plan was required by the 1986 National Childhood Vaccine Injury Act to facilitate coordination of the vaccine enterprise across the United States. The National Vaccine Plan is centered on five goals:

• Goal 1: Develop new and improved vaccines
• Goal 2: Enhance the safety of vaccines and vaccination practices
• Goal 3: Support informed vaccine decision-making by the public, providers, and policy makers
• Goal 4: Ensure a stable supply of recommended vaccines, and achieve better use of existing vaccines to prevent disease, disability, and death in the United States
• Goal 5: Increase global prevention of death and disease through safe and  effective vaccination.

In 2008, the National Vaccine Program Office (NVPO),which is located in the Office of the Assistant Secretary for Health in the Department of Health and Human Services (HHS), asked the Institute of Medicine (IOM) to convene a committee to hold workshops with national expert stakeholders in medicine, public health, and vaccinology. The committee was charged with reviewing a draft update of the National Vaccine Plan and identifying priority actions under each of the five goals that NVPO and its partners can take when finalizing and implementing the Plan. The committee found that although the National Vaccine Program has had some great successes and can provide examples of excellent coordination, neither the NVPO nor the Plan have functioned as intended in the 1986 legislation. Overall, the committee concludes that because vaccines are considered a major public health intervention that involves multiple government agencies and stakeholders (including health care providers, patients, researchers, health departments, and vaccine manufacturers), an effective coordinating entity is required. Therefore, the committee recommends the Secretary of HHS demonstrate support for the National Vaccine Plan by declaring its primacy as the strategic planning tool applicable to all relevant federal agencies and by allocating the resources necessary to assure robust planning and implementation.

VACCINE DEVELOPMENT

Currently, there is no process for identifying priority vaccines that involves relevant stakeholders. The committee recommends that the National Vaccine Plan incorporate a process for prioritizing new and improved vaccine candidates in order to accelerate their development, making it easier to identify the public health need for a given vaccine.