Mid-course Review
Overview
The Mid-course Review reflects the priorities and progress toward goals laid out in the 2010 National Vaccine Plan (NVP), which provides strategic guidance through 2020. Conducted from 2015- 2016, the review addresses the following fundamental questions:
- Broadly speaking, is the NVP meeting its goals?
- Which key opportunities in the national vaccine and immunization enterprise are poised for significant progress between now and 2020?
- Is the vaccine and immunization enterprise moving in the direction needed based on the current environment?
In addition to this NVPO Mid-course Review report, the National Vaccine Advisory Committee will provide a separate report to the Assistant Secretary for Health with their perspective in addressing the questions above.
Goals
The Mid-course Review had three goals:
- Identify the top achievements from the first five years (2010 to 2015).
- Determine the three to five greatest opportunity areas for the timeframe 2016 to 2020, and define what success will look like (outcomes) in each area.
- Develop indicators or metrics that can be used to track progress against each of the top three to five opportunity areas.
Process
Led and coordinated by the National Vaccine Program Office, the Mid-course Review reporting was developed through a highly collaborative effort—involving input from many federal and non-federal stakeholders. Months of gathering data, synthesizing achievements and opportunities, validating and prioritizing findings, and identifying indicators yielded the final report.
Findings
Findings of the report include a number of top achievements as well as five opportunity areas--areas primed for major progress in the next five years. The report also includes suggested indicators for tracking. The findings provide a framework for the development of future NVP strategies.
Top Achievements
The report provides an overview of game-changing achievements that have had a significant impact on the vaccine ecosystem since the current NVP was originally created in 2010. Top achievements, 2010-2015 are outlined below.
- New vaccines coming to market and new indications for existing vaccines (e.g., human papillomavirus [HPV], MenB, pneumococcal disease)
- Improvements in the influenza vaccine, including the use of cell-based technologies, adjuvants, recombinant DNA, quadrivalent vaccines, and high-dose vaccines, and new delivery technologies (e.g., Jet Injector and ID injection)
- Basic research to improve our understanding of the host immune response, especially as it relates to vaccination
- Vaccines resulting from strong public-private development partnerships, such as MenAfriVac®, ROTAVAC®, and Ebola vaccines
- U.S. safety systems (Postlicensure Rapid Immunization Safety Monitoring [PRISM], Vaccine Safety Datalink [VSD], and Vaccine Adverse Event Reporting System [VAERS]) are robust and effective, with good collaboration at the federal, state, and local levels
- Global leadership from the USG on the use of new technologies to produce safer, more effective vaccines (i.e., FDA’s role in developing WHO Guidelines on the Nonclinical Evaluation of Vaccine Adjuvants and Adjuvanted vaccines)
- Ability to rapidly acquire and analyze safety data during an emergency (e.g., WHO data sharing in the context of public health emergencies)
- Implementing collaborative, comprehensive approaches to promote vaccine uptake (e.g., HPV vaccination among adolescents)
- Engagement and collaboration on efforts to better understand and increase parent, health care provider, and public confidence in recommended vaccines and immunizations
- Broad federal and nonfederal collaboration to help foster recognition of the value of vaccines and the importance of immunization recommendations among policymakers and public health advocates
- Reducing financial barriers: near-universal coverage for children and first-dollar coverage under the Affordable Care Act
- Vaccine Injury Compensation Program (VICP) and Countermeasures Injury Compensation Program (CICP) compensation programs addressed critical safety and liability factors; both programs are working well
- Continued high vaccine coverage rates for pediatric vaccines and increased coverage rates observed across the lifespan and in special populations, including pregnant women
- Promotion of adult standards and the development of a National Adult Immunization Plan to help improve coverage rates among adults
- Updated preparedness and response framework for influenza pandemics including development of CDC’s Influenza Risk Assessment Tool
- Improving access to and acceptance of vaccination providers in nontraditional health care settings (e.g., pharmacists, public health departments)
- Advances in the use of health IT, including the rollout of scanable two-dimensional (2 D) bar codes and development of Immunization Information System (IIS) query/response standards
- Progress against global elimination goals, including polio, measles, and rubella
- Endorsement of the GVAP from 194 countries at the 65th World Health Assembly to set a united, global vision for a world free of VPDs
- Introduction of new vaccines into Gavi, the Vaccine Alliance, -eligible countries
Opportunity Areas
The report also identifies opportunity areas primed with the potential to have great impact on future NVP strategic planning efforts.
| Mid-course Review Opportunity Areas |
|---|
| Strengthen health information and surveillance systems to track, analyze, and visualize disease, immunization coverage, and safety data, both domestically and globally. |
| Foster and facilitate efforts to strengthen confidence in vaccines and the immunization system to increase coverage rates across the lifespan. |
| Eliminate financial and systems barriers for providers and consumers to facilitate access to routine, recommended vaccines. |
| Strengthen the science base for the development and licensure of vaccines. |
| Facilitate vaccine development. |
