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Special Communication
December 17, 2003

Strengthening the Supply of Routinely Recommended Vaccines in the United States: Recommendations From the National Vaccine Advisory Committee

National Vaccine Advisory Committee
Author Affiliations

Authors/National Vaccine Advisory Committee: Georges Peter, MD (chair), Brown Medical School, Providence, RI; Ann Margaret Arvin, MD, Stanford University School of Medicine, Stanford, Calif; Jeffrey P. Davis, MD, Wisconsin Division of Health, Madison, Wis; Michael D. Decker, MD, MPH, Aventis Pasteur, Swiftwater, Pa; Patricia Fast, MD, PhD, International AIDS Vaccine Initiative, New York, NY; Fernando A. Guerra, MD, MPH, San Antonio Metropolitan Health District, San Antonio, Tex; Charles M. Helms, MD, PhD, University of Iowa Hospital and Clinics, Iowa City; Alan Richard Hinman, MD, Task Force for Child Survival and Development, Decatur, Ga; Ruth Katz, JD, MPH, George Washington University School of Public Health and Health Services, Washington, DC; Jerome O. Klein, MD, Boston Medical Center, Boston, Mass; Mary Beth Koslap-Petraco, MS, CPNP, Suffolk County Department of Health Services, Lindenhurst, NY; Peter R. Paradiso, PhD, Wyeth Vaccines, Henrietta, NY; William Schaffner, MD, Vanderbilt University School of Medicine, Nashville, Tenn; Patricia N. Whitley-Williams, MD, Robert Wood Johnson Medical School, New Brunswick, NJ; Donald E. Williamson, MD, Alabama Department of Public Health, Montgomery; and Bruce Gellin, MD, executive secretary of NVAC, Washington, DC.

JAMA. 2003;290(23):3122-3128. doi:10.1001/jama.290.23.3122

Between late 2000 and the spring of 2003, the United States experienced shortages of vaccines against 8 of 11 preventable diseases in children. In response, the Department of Health and Human Services requested that the National Vaccine Advisory Committee (NVAC) make recommendations on strengthening the supply of routinely recommended vaccines. The NVAC appointed a Working Group to identify potential causes of vaccine supply shortages, develop strategies to alleviate or prevent shortages, and enlist stakeholders to consider the applicability and feasibility of these strategies. The NVAC concluded that supply disruptions are likely to continue to occur. Strategies to be implemented in the immediate future include expansion of vaccine stockpiles, increased support for regulatory agencies, maintenance and strengthening of liability protections, improved communication among stakeholders, increased availability of public information, and a campaign to emphasize the benefits of vaccination. Strategies requiring further study include evaluation of appropriate financial incentives to manufacturers and streamlining the regulatory process without compromising safety or efficacy.

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