Vaccine Supply and Innovation (1985) / Chapter Skim
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7 An Approach to Problems of Communication, Coordination, and Collaboration in Vaccine Policy
7 An Approach to Problems of Communication, Coordination, and Collaboration in Vaccine Policy
Pages 123-135
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From page 123... ...
In November 1976, the Office of the Assistant Secretary for Health convened a National Immunization Conference, which was followed by workshops on specific policy issues. It was expected that the output of the conference and the work groups' recommendations would be used by the Office of the Assistant Secretary to develop an integrated national immunization policy for "departmental guidance and transmittal to Congress.n1 The principal recommendation arising from the endeavor was to establish a National Immunization Commission, but the report also contained comprehensive analyses of and recommendations on virtually all areas of vaccine development and use.
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From page 124... ...
Establish a permanent interagency body within the Department of Health, Education and Welfare to · develop priorities for facilitating and coordinating vaccine research, development, and evaluation in the public sector; · monitor vaccine research, development, and production in the private sector; and · report to Congress periodically e 2. Establish either a small- or a large-scale federal vaccine production program.
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From page 125... ...
Addressing these problems earlier could save valuable time and improve the public health returns on vaccine investments. Lack of an overall immunization and vaccine development policy does not appear to have greatly affected vaccine regulation.
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From page 126... ...
Industry also may refrain from interactions with federal agencies in the research and development phases because of the complexity of federal contracting and reporting procedures. These factors may have played a role in the lack of a commercial response to a NIAID request for proposals to develop an improved pertussis vaccine.7 Concerns about the effectiveness of public-private sector communications also were raised during recent congressional hearings on the events preceding and following recommendations made by the Interagency Group to Monitor Vaccine Development, Supply, and Usage in response to the anticipated DTP vaccine shortage.8~9 Provider and Recipient Perceptions Chapter 3 describes the tendency in the current health care system to emphasize the use of diagnostic and therapeutic technologies rather than preventive technologies, even when the latter have been documented to be highly beneficial and cost effective.
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From page 127... ...
A recent study by another Institute of Medicine group -- the Committee on Issues and Priorities for New Vaccine Development -- concluded that while the health benefits of an improved pertussis vaccine would be small compared with those of new vaccines for certain other diseases, a pertussis improvement project deserves immediate attention for humanitarian and public policy reasons.12 The second situation pertains to the coordinated development of
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From page 128... ...
Early, coordinated efforts to correct public and physician misperceptions of this matter could have resulted in utilization rates considerably higher than the estimated 10 to 25 percent achieved in the target population once the vaccine's efficacy had been scientifically verified.l2'14 (The committee recognizes that, initially, low utilization of the pneumococcal vaccine also may have been due to the scientific controversy surrounding its efficacy.) Concerted immunization and/or vaccine development efforts for adolescents and young adults who may have missed school immunization programs and for health care providers have not yet been undertaken but are highly desirable.
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From page 129... ...
These groups would be encouraged to assist in the development of new approaches to sustaining and stimulating commercial interest in production and innovation, ensuring improvement of vaccines, designing clinical and epidemiological research, restructuring liability and A , commission or similar body also would provide an appropriate forum in which to explore applications of new scientific technologies to vaccine development. compensation, and increasing Public and Professional awareness.
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From page 130... ...
· The capacity to ensure that necessary programs are instituted. This will probably require: -- the ability to sustain commission efforts irrespective of fluctuations in the level of political interest in its mission; -- the ability to make direct representation to the federal legislature on budgetary matters related to its mission; -- the ability to call upon existing federal agencies in the collaborative pursuit of objectives; -- the ability to elicit greater industry interest in collaborative efforts than is presently forthcoming, possibly through the use of direct contracts; -- the ability to receive funds from any source (e.g., private foundations, industry)
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From page 131... ...
led to the suggestion that a vaccine commission be appointed by the Secretary (National Immunization Work Groups, 1977~. To date, however, the executive branch has not acted to establish such a commission.
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From page 132... ...
It could maintain an impartial, independent focus on vaccine development and immunization problems and, through reports submitted directly to Congress and the President, draw their attention to issues of concern. It is recognized, however, that some existing quasiindependent corporations serving general public needs have not operated in financially successful fashion due to difficulty in raising funds from private sector sources or revenues.
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From page 133... ...
public health needs and the special needs of the military · monitoring the vaccine needs of developing countries and promoting efforts to meet those needs · evaluating the potential applications of advances in basic biotechnology to vaccine development · evaluating the application of knowledge from the behavioral sciences in the design of campaigns to promote vaccines · reviewing the effectiveness of promotional campaigns · monitoring and evaluating patterns of infectious disease as an aid to determining priorities · monitoring the training of personnel needed to ensure continued vaccine innovation · monitoring and evaluating legal issues related to vaccine development and use
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From page 134... ...
It also would help to educate and inform the public, physicians, and government decision makers about the effects of various immunization actions and policies. When necessary, the commission would become an impartial broker to promote the availability of needed vaccines and to coordinate collaborative activities for which no suitable mechanism exists.
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From page 135... ...
1984. update of Federal Activities Regarding the Use of Pneumococcal Vaccine.
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