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October 2007 NVAC Meeting Minutes - page 11 / 40





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October 2007 NVAC Meeting Minutes

determine where, within the current structure, some of these issues can be addressed. Dr. Pavia concluded the discussion by calling the Committee’s attention to an article published a few months ago in Clinical Infectious Diseases that discussed lessons learned from pediatric immunization successes and how they apply to adolescent and adult immunizations.

Adolescent Immunization Working Group Progress Report—Dr. Gary L. Freed

Dr. Freed noted that the Working Group had been given a problem statement that was approved by NVAC. The Working Group came up with, and approved internally, recommendations for five of the six problem areas that were identified: Financing, mandates, communications and public engagement, consent, and venue and utilization.

The Working Group hopes to have recommendations for the last problem areasurveillanceby the end of the calendar year. Once the Working Group has the final set of recommendations, they will bring back the package of full recommendations for NVAC to comment on and ultimately approve.

The Adolescent Immunization Working Group made financing recommendations that were sent to the Financing Working Group for their review and comment. All of the recommendations of the Adolescent Immunization Working Group focus on adolescent immunization issues in an attempt to not overlap with the work of other Working Groups and Subcommittees.


Dr. Schuchat asked for clarification as to whether the problem area of surveillance would focus on vaccine-preventable diseases in adolescents or immunization coverage in adolescents. Dr. Pavia explained that the Working Group is in the process of figuring this out; however, during their meeting yesterday, they focused on surveillance of immunization coverage. He also reiterated that it is NVAC’s role to say what the role of surveillance is and what kinds of things need to be looked at, not to think about how to do it.

Discussion and Vote on Draft Report and Recommendations Entitled “Mandates for Adolescent Immunizations”—Dr. Lance K. Gordon

Dr. Freed began the discussion by explaining that this particular report, the “The Promise and Challenge of Adolescent Immunization” was made available to the public for comment through the Federal Register.  The initial report was prepared at the request of the Assistant Secretary for Health by the NVAC’s Adolescent Immunization Working Group.  After reviewing public comments, the full committee voted to endorse the document as an official NVAC report.

Dr. Gordon provided the Committee with background by explaining that this was a yearlong effort that built upon previous policy recommendations. He noted that the Working Group had to deal with several difficult questions, such as balancing the benefits of mandates with the ethical and logistical difficulties in creating mandates.

Dr. Feinberg wondered if it was within the purview of NVAC to make recommendations to the Assistant Secretary, who would then make recommendations to the State. Dr. Gordon explained that this had been reviewed with Ms. Emily M. Levine (HHS) and that the Working Group had adopted specific language recommendations from the NVAC Council.

Dr. Feinberg noted that States were assuming responsibilities that had been traditionally viewed as those of the Federal Government. He gave the examples of the FDA licensing vaccines based on safety

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