A shot in the arm for immunization research

The Centers for Disease Control and Prevention's (CDC) Immunization Safety Office (ISO) has developed a scientific draft agenda to guide research over five years. Some of the many proposed topics include the immunization schedule for premature and low birth weight infants, the safety of simultaneous vaccination, the potential association of live attenuated influenza vaccine with increased asthma and/or wheezing risk, the potential immunization risk for children with mitochondrial dysfunction, and the potential association of measles, mumps, rubella, and varicella vaccine (MMRV) with febrile seizure.

Currently, a Department of Health and Human Services working group with the National Vaccine Advisory Commitee (NVAC) is reviewing the agenda. NVAC advises the National Vaccine Program Office (NVPO).

As part of that review, the committee will hold a series of public meetings in October, according to Daniel Salmon, a vaccine safety specialist with the NVPO.

Following the the public meetings, there will be a few small meetings with "stakeholders." Stakeholders are broadly defined as "groups that have a primary interest in vaccine safety," Salmon said, indicating there is still discussion on how those organizations will be identified.

"We have struggled mightily with some of the items on the scientific agenda and things that aren't on there," added Tawny Buck, a representative on the working group. "And subpopulations and special populations are definitely an area that we have looked at."

A report on the meetings may go to the working group in December, Salmon said. NVAC may do a final review and vote on the ISO agenda next year. He also reported the plans to the Advisory Commission on Childhood Vaccines, which makes recommendations to the Vaccine Injury Compensation Program.

Some of the changes or adjustments that the draft ISO report recommends include:

The draft report notes, among other issues, that the number of licensed vaccines, currently at 59, is rising. This makes the immunization schedule more complex. For example, the number of vaccines recommended for one age group expanded from seven to 13 in the last decade.

When it finishes this review, the NVAC working group will look at the whole vaccine safety system. It will develop a white paper on the best system to detect and prevent adverse events, and ensure public confidence in immunization.

The research agenda and other information are available at http://www.hhs.gov/nvpo/, and at http://www.cdc.gov/vaccinesafety/agenda.htm.