[delightful music]
(narrator) In recent years, serious disease outbreaks have put a
new focus on the crucial process of how we develop, test
and approve vaccinations in the United States.
The Advisory Committee on Immunization Practices, or A-C-I-P,
may be unfamiliar to many Americans, yet its role in
protecting and improving the nation's health is critical.
The committee and its work have been a part of our lives
protecting our health since the mid 20th century.
For more than 50 years, the committee has advised the
Centers for Disease Control and Prevention, also known as the
C-D-C, on vaccination recommendations for all
Americans, including who should get which vaccine and when, as
well as precautions and contraindications to vaccination.
Its recommendations are reviewed and adopted by C-D-C as
standards of care for clinicians across the country.
So who makes up the committee, and how does it reach decisions
about guidance?
The A-C-I-P consists of experts selected by the US.
Secretary of Health and Human Services following an
application and nomination process.
Most of the members are experts in vaccinology, immunology,
pediatrics, internal medicine or other important health
fields, and one voting member represents consumers offering
views on the social and community aspects of vaccination.
The committee also has non-voting representatives from
highly regarded public health and healthcare professional
organizations and Ex-Officio members representing other
federal agencies.
It's important to note committee members must declare
any conflicts of interest and recuse themselves from
discussions or votes if their conflicts are considered a
concern.
These committee members know a lot about vaccines, medicine
and public health, but their knowledge is only part of the
recommendation development process.
Before making a recommendation, A-C-I-P members carefully review
the data and information for each vaccine.
They consider the safety and effectiveness of the vaccine
when given at specific ages.
After F-D-A approves or authorizes a vaccine, A-C-I-P
reviews the rigorous studies conducted by vaccine
manufacturers to ensure that a vaccine is safe and effective
at specific ages.
Committee members evaluate the severity of the disease and the
vaccine's effectiveness in addressing the burden of disease.
Vaccines recommended for children and adults help
prevent diseases that can be serious, potentially causing
longterm health problems or death.
Some vaccines are recommended for everyone.
Others may only be recommended for certain people based on
their age or other risk factors.
Sometimes a patient and their healthcare provider will decide
together whether there is a benefit from vaccination.
Committee members also examine how feasible the
recommendations are to put into practice. Factors that can
impact the implementation of a vaccine
recommendation can also be considered. A widely used
standard for assessing information known as G-R-A-D-E or
grading of recommendations,
assessment, development, and evaluation is applied in
reviewing the information about a vaccine.
The results from this G-R-A-D-E, assessment and other evidence
that A-C-I-P considers when making a recommendation is presented
using the E-T-R or the Evidence to Recommendations framework.
This method considers key factors, including the balance
of benefits and harms, the type and quality of evidence, values
and preferences of the people affected, and a health economic
analysis.
Community impacts and reactions are also considered, as is the
impact on health equity.
Discussions and deliberations occur during A-C-I-P meetings,
which are open to the public.
The meetings also offer a public comment period for
community input to be shared before a final decision is made.
These actions provide transparency around the
committee's decisions and judgments.
(Man #1) Atmar yes. (Man #2) Bernstein yes.
(narrator) If there is enough information to
move forward with a vaccine recommendation, a quorum is
required for the committee to act.
Once the A-C-I-P makes a recommendation, the C-D-C
Director will approve, amend or reject the recommendation.
If approved, the recommendation is published in C-D-C's Morbidity
and Mortality Weekly Report and upon publication, represents
the official recommendation in the United States.
Understanding the process and importance of A-C-I-P
recommendations help healthcare professionals feel confident
that the vaccines they recommend to their patients are
safe and effective.
Visit the C-D-C's website for additional information on A-C-I-P
and to view the most up to date vaccine recommendations for
your clinical practice.