Key takeaways:
- Virtual meeting format allowed emergency meetings to be quickly scheduled and enabled members of the public to attend.
- Efforts should always be made to include diverse populations in clinical trials.
- Equitable access to vaccines for children should be a priority.
- Transparency is key to safeguarding public health and maintaining public trust.
The Advisory Committee on Immunization Practices (ACIP) plays a crucial role in how the Centers for Disease Control and Prevention (CDC) sets vaccination schedules for children and adults. This work was particularly critical during the COVID-19 pandemic with the remarkable advancement of vaccines amid growing public distrust of those vaccine recommendations.
To highlight the ACIP’s work during this challenging time, committee members are sharing their insights and experiences with a focus on pediatrics.
A paper, authored by Katherine A. Poehling, M.D., professor of pediatrics at Wake Forest University School of Medicine and Grace Lee, M.D., professor of pediatric infectious diseases at Stanford University School of Medicine, appears online in Academic Pediatrics.
“By reflecting on the work of ACIP, its decision-making and dedication to transparency, we hope to build trust among families and communities,” said Poehling, the paper’s corresponding author. “We also believe pediatricians and primary care providers can benefit in better understanding the role that the ACIP plays in reducing vaccine-preventable diseases.”
When the pandemic began, ACIP transitioned its meetings to a virtual format, which allowed for more frequent emergency meetings as needed. Typically, the committee would meet three times a year, in person.
Poehling said these emergency meetings enabled the group to meet for timely discussions and evidence review following FDA authorization of COVID-19 vaccines, typically within 24 hours.
“By pivoting to these virtual meetings, we were able to respond to public health needs to ensure transparent decision-making,” Poehling said.
In December 2020, the committee also held two public meetings to discuss the allocation of vaccines following the FDA’s emergency use authorizations of the Moderna and Pfizer vaccines.
Poehling said these virtual meetings received intense attention with one of the public meetings recording more than 50,000 people in attendance.
“With such a large and diverse audience, we had the unique opportunity to clearly explain key points of the critical issues that were being discussed,” Poehling said.
Vaccine safety was a primary focus in all phases - vaccine development, evaluation, approval and use. The ACIP created vaccine safety work groups, which served as a hub for safety data and real-time safety surveillance.
Poehling said these work groups evaluated safety data from multiple sources across the nation and around the world and met at least once a week to interpret the data as quickly as possible.
One early topic of discussion was ensuring that clinical trials included underrepresented and diverse groups that were disproportionately affected by COVID-19.
“One of the primary lessons we learned is that clinical trials can efficiently include diverse populations when prioritized,” Poehling said.
However, improving equity by age, sex, race, ethnicity, existing medical conditions and socioeconomic status is an ongoing challenge in vaccine development, highlighted by the pandemic. For example, COVID-19 vaccines became available for ages 16 and older in less than one year while a vaccine for children under the age of 5 was delayed by nearly 18 months.
Poehling noted that a key equity opportunity is to shorten the time in vaccine availability between adults and children.
“This experience underscores the importance of prioritizing equitable access for children,” Poehling said. “As pediatricians, we must continue to advocate for the needs of children to ensure faster development and access to immunizations.”
Poehling also said that the insights gained during the COVID-19 pandemic will only strengthen the role of ACIP and other federal advisory committees in addressing future pandemics.
“Transparency is a key element in our efforts to safeguard public health and to maintain public trust,” Poehling said.
Media contact: Myra Wright, mgwright@wakehealth.edu