The Advisory Committee on Immunization Practices (ACIP) consists of fifteen advisors to the Centers for Disease Control (CDC), selected by the Secretary of the United States Department of Health and Human Services, to provide advice and guidance on the most effective means to prevent diseases through nation-wide vaccination campaigns. The Centers for Disease Control and Prevention (CDC) in Atlanta is recognized as the lead United States agency for protecting the public health and safety of people by providing credible information to enhance health decisions, and promoting health through strong partnerships with state health departments and other organizations. ... The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ... A disease is an abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person afflicted or those in contact with the person. ... Vaccination is the process of administering live, albeit weakened, microbes to patients, with the intent of conferring immunity against a targeted form of a related disease agent. ...

The Committee develops written recommendations for routine administration of vaccines to the pediatric and adult populations, along with vaccination schedules regarding appropriate periodicity, dosage, and contraindications. ACIP statements are official federal recommendations for the use of vaccines and immune globulins in the US, and are published by the CDC. ACIP is the only entity in the federal government which makes such recommendations. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or ameliorate the effects of infection by any natural or wild strain of the organism. ... Over the past two decades, the recommended vaccination schedule in the United States and elsewhere has grown rapidly and become more complicated as many new vaccines have been developed and marketed. ...

Objectives

The overall goals of the ACIP are to provide advice to government agencies for reducing the incidence of vaccine preventable diseases and to increase the safe usage of vaccines and related biological products. According to government agencies, immunizations have resulted in the eradication of smallpox and poliomyelitis, and control of measles, rubella, tetanus, diphtheria, Haemophilus influenzae type b, and other infectious diseases in the United States and other parts of the world. Immunization, or immunisation, is the process by which an individual is exposed to an agent that is designed to fortify his or her immune system against that agent. ... Poliomyelitis (polio), or infantile paralysis, is a viral paralytic disease. ... Rubella (also known as epidemic roseola, German measles, liberty measles or three-day measles) is a disease caused by the Rubella virus. ... Tetanus is a serious and often fatal disease caused by the neurotoxin tetanospasmin which is produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. ... Influenza, commonly known as the flu, is an infectious disease that infects birds and mammals (primarily of the upper airways and lungs in mammals) and is caused by an RNA virus of the Orthomyxoviridae family (the influenza viruses). ...

Recommendation process

Regularly scheduled ACIP meetings are held three times a year. Notices of each meeting, along with agenda items, are published in the Federal Register in accordance with the requirements of the Federal Advisory Committee Act (FACA). A vote on vaccine recommendations may be taken when a quorum of at least seven eligible ACIP members are present. Eligible voters are those members who do not have a conflict of interest. If there are not seven eligible voting members present, the ACIP executive secretary can appoint ex officio members as voting members, as provided in the committee charter. The Federal Register contains most routine publications and public notices of United States government agencies. ... The FACA, or Federal Advisory Committee Act, is a US law (Pub. ... A conflict of interest is a situation in which someone in a position of trust, such as a lawyer, a politician, or an executive or director of a corporation, has competing professional and/or personal interests. ...

Their process includes review of labeling and package inserts; review of the scientific literature on the safety and efficacy; assessment of cost effectiveness; review of the morbidity and mortality associated with the disease; review of the recommendations of other groups; and consideration of the feasibility of vaccine use in existing programs. In general, efficacy is the ability to produce an effect, usually a specifically desired effect. ... In medicine, epidemiology and actuarial science, the term morbidity can refer to the state of being diseased (from Latin morbidus: sick, unhealthy), the degree or severity of a disease, the prevalence of a disease: the total number of cases in a particular population at a particular point in time, the...

Working groups

To ensure thorough review of available information, ACIP often appoints working groups to assist drafting its recommendations, comprised of ACIP members, CDC staff and others with immunization expertise.

Recent additions to recommended vaccination schedules

In recent years, new guidelines from ACIP have expanded the eligibility for influenza vaccination among children under the Vaccines for Children (VFC) program. The influenza vaccine is now strongly recommended by ACIP for all children six to 23 months old.

Young adolescents should be routinely vaccinated with tetravalent meningococcal polysaccharide-protein conjugate vaccine, or MCV4, which was approved by the FDA in January, 2005, for persons ages 11 to 55. The vaccine, called Menactra, was added to the CDC's recommendations that May. In October, 2005, the FDA, the CDC, and Menactra's maker, Sanofi Pasteur, warned that five US teens developed a serious neurological condition called Guillain-Barré syndrome after being vaccinated with Menactra. Sanofi pasteur is the vaccines business of sanofi-aventis Group. ... Guillain-Barré syndrome (GBS), is an acquired immune-mediated inflammatory disorder of the peripheral nervous system (i. ...

In January of 2006, a new booster vaccine for pertussis, tetanus, and diphtheria was recommended for children. 2006 (MMVI) is a common year starting on Sunday of the Gregorian calendar. ... Pertussis, also known as whooping cough, is a highly contagious disease that is one of the leading causes of vaccine-preventable deaths. ... Tetanus is a serious and often fatal disease caused by the neurotoxin tetanospasmin which is produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. ...

In February, 2006, the rotavirus vaccine was reintroduced by ACIP to its list of recommendations. An earlier version of the rotavirus vaccine was pulled off the US market in the late 1990s, after serious vaccine injury problems arose; the problems were initially identified during clinical trials. Dr. Paul Offit, who shares the rotavirus vaccine patent with Merck & Co., began his tenure on ACIP in October of 1998 and shortly thereafter voted three times in favor of inclusion of the original rotavirus vaccine in the VFC program. Species Rotavirus A (RV-A) Rotavirus B (RV-B) Rotavirus C (RV-C) Rotavirus D (RV-D) Rotavirus E (RV-E) Rotavirus F (RV-F) Rotavirus G (RV-G) Rotaviruses are a genus of viruses belonging to the Reoviridae family. ... The 1990s decade refers to the years from 1990 to 1999, inclusive. ... Vaccine injury is a term used in both medicine and law to designate alleged injuries sustained by individuals subsequent to having been vaccinated. ... Merck & Co. ... 1998 (MCMXCVIII) was a common year starting on Thursday of the Gregorian calendar, and was designated the International Year of the Ocean. ...

Compulsory immunizations

Individual states adopt ACIP vaccine recommendations as compulsory for students before admission to schools. Parents can refuse vaccinations for their children, but for enrollment in public school, an exemption is necessary to avoid compulsory vaccination requirements. In order to shield themselves from liability for compulsory vaccinations, all states provide for medical exemptions. All but three states offer a religious exemption, and nineteen states allow a philosophical exemption. Some require only a letter from a parent, whereas other states require exemptions from physicians or church leaders.[1] In the most general sense, a liability is anything that is a hindrance, or puts one at a disadvantage. ... Physician examining a child A physician is a person who practices medicine. ...

Vaccine safety

Autism

The CDC, Food and Drug Administration (FDA) and ACIP have all taken the position that the "autism epidemic" is attributable to improved diagnoses and a purely coincidental temporal connection between the vaccine schedule given to most American children, and the diagnosis of late onset autism and other learning disabilities such as ADHD. Representatives of the CDC, FDA and Amercian Academy of Pediatrics have all gone on record as stating there is no connection between vaccinations, particularly thimerosal containing vaccines and the MMR vaccine, and autism. This article or section is in need of attention from an expert on the subject. ... The number of reported cases of autism has increased dramatically over the past decade. ... DISCLAIMER Please remember that Wikipedia is offered for informational use only. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... The MMR vaccine is a mixture of live but attenuated viruses, administered via injection for immunization against measles, mumps and rubella. ... It has been suggested that Autism mercury be merged into this article or section. ...

Nevertheless, the CDC has issued an “Autism Alarm”, warning of an impending crisis due to concerns over the fact that one in six children are now being diagnosed with a behavioral or pervasive developmental disorder, and that one in 166 children are currently diagnosed with an autistic spectrum disorder. Behavior or behaviour (see spelling differences) refers to the actions or reactions of an object or organism, usually in relation to the environment. ... The autistic spectrum (sometimes referred to as the autism spectrum) is a developmental and behavioral syndrome that results from certain combinations of traits. ...

Simpsonwood

Main article: 2000 Simpsonwood CDC conference

In June of 2000, 53 scientists from the CDC, FDA, ACIP and industry met at the Simpsonwood conference center, in Norcross, Georgia, to review the findings of Dr. Thomas Verstraeten, an epidemiologist hired by CDC to review data from the Vaccine Safety Datalink. Verstraten reported a "statistically significant connection" between thimerosal and tics, verbal delays and ADHD and autism, and that "...we have found statistically significant relationships between the exposures and outcomes for these different exposures and outcomes. First, for two months of age, an unspecified developmental delay, which has its own specific ICD9 code. Exposure at three months of age, Tics. Exposure at six months of age, an attention deficit disorder. Exposure at one, three and six months of age, language and speech delays which are two separate ICD9 codes. Exposure at one, three and six months of age, the entire category of neurodevelopmental delays, which includes all of these plus a number of other disorders." The 2000 Simpsonwood CDC conference was a meeting convened in June, 2000, by the Centers for Disease Control, held at the isolated Simpsonwood Methodist retreat and conference center in Norcross, Georgia. ... This article is about the year 2000. ... Norcross is a city located in Gwinnett County, Georgia. ... Thomas Verstraeten, MD, MSc, is a vaccine researcher for GlaxoSmithKline Biologicals. ... Epidemiology (Greek epi = upon, among; demos = people, district; logos = word, discourse), defined literally, is the study of epidemics in humans. ... The Vaccine Safety Datalink Project (VSD) was established, in 1990, by the Centers for Disease Control (CDC) for the study of adverse side effects of vaccines. ...

Members

In addition to its fifteen regular members, ACIP includes ex-officio members from other Federal agencies involved with vaccine issues, and non-voting liaison representatives from professional societies and organizations responsible for immunization campaigns. ACIP membership, as of October, 2005:

• Chairman, Jon S. Abramson, MD, Wake Forest University School of Medicine
• Executive Secretary, Larry K. Pickering, MD, Senior Advisor to the Director of the CDC's National Immunization Program
• Ban Mishu Allos, MD, Assistant Professor, Division of Infectious Diseases, Vanderbilt University
• Robert L. Beck, Consumer Representative
• Judith Campbell, MD, Associate Professor of Pediatrics, Baylor College of Medicine
• Reginald Finger, MD, MPH, former medical adviser to Focus on the Family
• Janet R. Gilsdorf, MD, Director, Pediatric Infectious Diseases, Department of Pediatrics and Communicable Diseases, University of Michigan
• Harry Hull, MD, State Epidemiologist and Director Minnesota Department of Health
• Tracy Lieu, MD, Associate Professor of Ambulatory Care and Prevention, Harvard Medical School
• Edgar K. Marcuse, MD, MPH, Associate Medical Director, Seattle Children’s Hospital
• Dale L. Morse, MD, Director, Office of Science and Public Health, New York State Department of Health
• Julia Morita, MD, Immunization Program Medical Director, Chicago Department of Public Health
• Gregory A. Poland, MD, Professor of Medicine, Mayo Medical School
• Patricia Stinchfield, NP, St. Paul Children’s Hospitals and Clinics
• John J. Treanor, MD, Associate Professor of Medicine, University of Rochester
• Robin J. Womeodu, MD, Medical Director, Center on Health Disparities, University of Tennessee Health Science Center
• Ex officio members: James E. Cheek, MD, MPH; Wayne Hachey, DO, MPH, LTC; Geoffrey S. Evans, MD; Bruce Gellin, MD; Linda Murphy; George T. Curlin, MD; Norman Baylor, PhD; Kristin Lee Nichol, MD

Wake Forest University is a private university in Winston-Salem, North Carolina, known for its programs in the liberal arts. ... Vanderbilt University (colloquially known as Vandy) is a private, nonsectarian, coeducational research university in Nashville, Tennessee. ... Baylor University is a private, Baptist-affiliated research university located in Waco, Texas. ... Reginald Finger, M.D., M.P.H. is a member of the Advisory Committee on Immunization Practices (ACIP), an influential United States government committee linked to the Centers for Disease Control (CDC). ... Focus on the Family (FOTF or FotF), founded in 1977, is an evangelical Christian 501(c)(3) non-profit organization based in the United States. ... This article is about the University of Michigan in Ann Arbor. ... Official language(s) None Capital Saint Paul Largest city Minneapolis Area  Ranked 12th  - Total 87,014 sq. ... Harvard University campus (old map) Harvard University (incorporated as The President and Fellows of Harvard College) is a private university in Cambridge, Massachusetts. ... Flag Seal Nickname: The Emerald City Location Location of Seattle in King County and Washington Coordinates , Government County King Mayor Greg Nickels Geographical characteristics Area     City 369. ... State nickname: Empire State Other U.S. States Capital Albany Largest city New York Governor George Pataki Official languages None Area 141,205 km² (27th)  - Land 122,409 km²  - Water 18,795 km² (13. ... Flag Seal Nickname: The Windy City Motto: Urbs In Horto (Latin: City in a Garden), I Will Location Location in Chicagoland Coordinates , Government Country State Counties United States Illinois Cook, DuPage Mayor Richard M. Daley (D) Geographical characteristics Area     City 606. ... The entrance to the Gonda Building in downtown Rochester. ... State capitol building in Saint Paul Saint Paul is the capital and second-largest city of the state of Minnesota in the United States of America. ... The University of Rochester is a private, coeducational and nonsectarian research institution located in Rochester, New York. ... The University of Tennessee (UT), sometimes called the University of Tennessee, Knoxville (UT Knoxville or UTK), is the primary institution of the statewide land-grant University of Tennessee system, Tennessees flagship public university. ...

Conflict of interest waivers

Most ACIP members, if not all, have ties to vaccine makers, such that the CDC must grant them waivers from statutory conflict of interest rules. This professional experience contributes toward the development of their immunization expertise, and is the rationale offered by the CDC to justify waivers. The United States Congress has accepted this justification for service on federal advisory committees by experts with conflicts, and has provided for waivers from such prohibitions, under 18 USC § 208, when the need for the individual's service outweighs the potential for a conflict of interest. A waiver is the voluntary relinquishment or surrender of some known right or privilege. ... Congress in Joint Session. ...

Examples of ACIP conflict of interest issues:

• Advisory committee members own patents for vaccines under consideration
• The CDC grants conflict of interest waivers to every ACIP member
• Former committee chair, Dr. John Moldin, owned stock in Merck & Co.
• The advisory committee has only a single consumer representative

Criticism

Vaccination critics believe that ACIP's crowded immunization schedule is unsafe. They have expressed concerns that "vaccine overloads" may cause serious side effects because of an excessive burden on the 'immature' immune systems of children. The vaccine controversy encompasses many concerns over the use and lack of use of vaccines - whether vaccination in general or mass vaccination in particular is beneficial to the health of individuals and the population. ...

The Advisory Committee attracted attention in 2006, when it was reported that it might not approve an effective vaccine against HPV, the human papillomavirus. HPV is a sexually transmitted disease that affects more than half of all Americans at some point in their lives. The virus directly leads to cervical cancer, killer of almost 5000 American women each year. Health officials affiliated with the Bush administration, as well as many conservative and Christian groups, claimed that inoculation of teenage girls against a sexually transmitted disease could encourage them to become sexually active. ACIP member Dr. Reginald Finger was quoted in the press as stating that, should an HIV vaccine become available, ACIP would have to carefully consider its effects on sexual activity. HPV is an initialism that can mean : Human Powered Vehicle Human papillomavirus a type of STD High Production Volume Chemicals Health Purchasing Victoria Hypoxic Pulmonary Vasoconstriction This page concerning a three-letter acronym or abbreviation is a disambiguation page — a navigational aid which lists other pages that might otherwise share... Reginald Finger, M.D., M.P.H. is a member of the Advisory Committee on Immunization Practices (ACIP), an influential United States government committee linked to the Centers for Disease Control (CDC). ... An HIV vaccine is a hypothetical vaccine against HIV, the etiological agent of AIDS. As there is no known cure for AIDS, the search for a vaccine has become part of the struggle against the disease. ...

See also

• Herd immunity

The effectiveness of a vaccine depends, amongst other things, on the percentage of the population which has received it and is still within the period of protection offered by that vaccine. ...

External links

• CDC.gov - 'ACIP Advisory Committee on Immunization Practices' (official CDC/ACIP webpage)

• CDC.gov - 'ACIP Recommendations'
• CDC.gov - 'Provisional ACIP Recommendations' (as of December 16, 2005)

• 909Shot.com - 'State Exemptions'
• AAFP.org - 'Meningococcal Immunization: Board Chair Approved', American Academy of Family Physicians (May 25, 2005)
• Immunize.org - 'Advisory Committee on Immunization Practices (ACIP) Statements', Immunization Action Coalition
• WebMD.com - 'CDC Backs New Kids' Diarrhea Vaccine: Vaccine Targets Rotavirus, a Leading Cause of Diarrhea in Babies and Kids, Miranda Hitti, WebMD (February 22, 2006)

• WebMD.com - 'CDC Updates Kids' Vaccine Schedule: Changes Cover Whooping Cough, Meningitis, Hepatitis', Miranda Hitti, WebMD (January 5, 2006)