Strengthening The Supply Of Routinely Administered Vaccines In The United States: Progress And Problems - 2005

In February 2002, the National Vaccine Advisory Committee (NVAC), acting on a request from the Assistant Secretary for Health of the US Department of Health and Human Services, organized a workshop to identify reasons for vaccine shortages and to develop strategies and solutions to prevent future shortages. A report was prepared for the Assistant Secretary and was summarized in an article published in the Journal of the American Medical Association in 2003 [1]. The report concluded that the disruptions in the vaccine supply were likely to continue, and the following strategies were recommended: evaluating appropriate financial incentives for manufacturers, streamlining the regulatory process without compromising safety or efficacy, increasing support for regulatory agencies, expanding vaccine stockpiles, maintaining and strengthening liability protections, improving communication among stakeholders, increasing the availability of public information, and developing a campaign emphasizing the benefits of vaccination.Since the aforementioned report was prepared, legislative initiatives and executive approval have allowed some of the recommended strategies to be pursued; however, periodic vaccine shortages have continued to occur. In the fall of 2004, the events that led to a halt in the production of influenza virus vaccine at the Chiron manufacturing facility in Liverpool, England, underscored the continuing fragility of the US vaccine supply and stimulated the organization of a second NVAC workshop ("Strengthening the Supply of Routinely Administered Vaccines in the United States") in January 2005. Stakeholders from industry, government, and various professional and consumer groups were invited to participate. The program focused on 4 issues of importance to the vaccine supply: aligning financial incentives to ensure the supply of established vaccines, expanding vaccine stockpiles, streamlining regulatory processes, and strengthening liability protections. Each section of the program was organized to (1) evaluate the recommendations of the 2002 workshop, (2) review the progress made toward implementing those recommendations during the intervening years, and (3) review the potential solutions and strategies proposed to ensure an adequate and reliable supply of vaccines. In the present article, we provide a brief review of the discussions and proposals presented at the 2005 NVAC workshop on strengthening the vaccine supply.