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October 2007 NVAC Meeting Minutes

homeland and national security needs, which were not considered by ACIP and NVAC during the earlier process.

Dr. Feinberg then asked when this plan would be implemented. He also wondered if the plan might need to be revisited in the moment of a pandemic and how that might actually occur. Dr. Schwartz explained that each State has their own pandemic plan and that implementation of the plan will be a challenge. Dr. Rawlins wondered if it had been taken into consideration that the Reserves or the National Guard might need to be called upon to keep public order or to transport vaccine to States. Dr. Schwartz explained that currently the Reserves and the National Guard are in the second tier; however, if they are used for other services, they could be vaccinated earlier.

In response to a question about tracking the progress of a pandemic, Dr. Schwartz explained that it is important to first quickly define the severity of the event. He explained that CDC has a team that is trained to define the severity of the event. Once the severity has been categorized, that will help determine what vaccine priority strategy to use.

Dr. Birkhead asked how States and local governments will be approached to get stakeholder input on the plan. Dr. Schwartz explained that they were included in the development of this guidance. He also explained that a stakeholder meeting would be held in next year in Washington, DC.

Dr. Strikas commented that in the 2005 ACIP/NVAC prioritization, some populations would not receive the vaccine because it would not be successful; therefore, they were not included in the tier structure. Dr. Schwartz explained that with the new prioritization, everyone has been included. He explained that it was important that everyone have the opportunity to be protected, but at the same time, he recognizes that the vaccine may not be effective in everyone.

In response to a previous question about how information is provided to the States, Dr. Jeanne Santoli (NCIRD/CDC) stated that CDC currently has a procedure in place in which they communicate periodic guidance to State grantees such as information about how to distribute and track vaccine. Therefore, there is currently a system in place to get information to the people who need it most.

Dr. Birkhead ended the discussion by saying that NVAC will look into some of the suggestions from this discussion such as a joint call with ACIP. He also stated that they will need to formulate official NVAC input within the timeframe identified by Dr. Schwartz.

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

Dr. Gordon began the discussion by revisiting the comments from Day 1 of the NVAC meeting. He explained that the main comment concerned the use of the phrase “safety profile.” Therefore, the words

“safety profile” were removed from two places (the summary table on page 21 and in the text on page 12) and replaced with the words “postlicensure experience.”

On page 3, per Dr. Birkhead’s recommendation, Dr. Gordon inserted a reference to the evidence-based studies done by the task force on community preventive services regarding a wide variety of potential measures to increase vaccine coverage. The wording for this section was taken directly from an MMWR report.

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