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The Global Advisory Committee on Vaccine Safety and its Communication Strategy. Philippe Duclos World Health Organization VHPB Meeting, Ferney Voltaire, 13-14 March 2003. Characteristics Global (origin & impact) Not limited to: industrialized countries countries with high coverage
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The Global Advisory Committee on Vaccine Safety and its Communication Strategy Philippe Duclos World Health Organization VHPB Meeting, Ferney Voltaire, 13-14 March 2003
Characteristics Global (origin & impact) Not limited to: industrialized countries countries with high coverage Detrimental with variable impact Solutions Proactive Rapid exchange of information Quick reactive capability Vaccine scares
Global issues with some regional differences Implicate active ingredients or non specific substances and diseases of unknown etiology “Amalgamation” Potential of signal generation and systematic search to identify spurious associations and generate false hypothesis Can generate huge amount of work and undue fear Need for quick hypothesis testing and international collaboration Science compounded by legal issues Never a end Misperception that vaccines from developing countries and WHO standards for them are inferior Vaccine Safety IssuesWHO perspective
Risk benefit logic challenged Limited resources to address Limited data for a response Anti-vaccination groups can coalesce on specific issues Vaccine Safety IssuesNational program perspective
Dealing with rumours: the environment • Anti-vaccination movement very successful in applying “Internet logic” • Limits to existing web sites (isolation, language) • Limits to country web sites (capacity) • Perception issue -- authoritative information & advocacy • Frequent need for new scientific data • Strong international collaboration needed
How to improve international communications? • Consistency among key authorities • Preparedness using credible scientific data • Independent international reviews of issues and issuance of authoritative statements from neutral organizations • Direct, early (even prior to going public) and clear communications between authorities and all parties
Global Advisory Committee on Vaccine Safety (GACVS) • To respond promptly, efficiently, independently and with scientific rigor to vaccine safety issues of global importance • Review of latest knowledge in collaboration with all parties involved • Determination of causal relationships • Multidisciplinary, global, and under strict conflict of interest and confidentiality rules • Ad hoc specialists teams and mandate to commission research • Decides which issue should be reviewed Best judgement in front of uncertainty
Global Advisory Committee on Vaccine Safety: Examples of Issues 2001/2002 • Macrophagic myofasciitis (MMF) • Immunization and autoimmune diseases • Safety of thiomersal • MS and hepatitis B vaccination • Leukemia following hepatitis vaccination • Yellow fever vaccine-related deaths • Child survival following immunization • MMR and autism • Bell’s Palsy following intranasal vaccination
Current Communications Ad hoc basis
Vaccine Safety-Net: Brainstorming Meeting • Situation and concept • Existing sites have weak linkages & predominately in English --->limits effectiveness • Difficult access to WHO and GACVS information ------>collaborative network under GACVS general direction • Meeting objectives • Discuss value and feasibility of VSN • Identify critical issues for successful implementation • Identify potential core partners • Participants • Professional and governmental organizations • GACVS • UNICEF and WHO
Vaccine Safety-Net Meeting: Outcome • More specificity to target audience • Coordinated network concept could undermine impact and independence of GACVS and WHO • However, • Supported key role of GACVS and expanding communications around GACVS • Encouraged links to “qualified” sites • Important considerations • Communication about facts not advocacy • All safety facts good or bad! • Do not cover all issues • Focus on internet
Expanding Communications Around GACVS • Build on existing platform - major enhancements • Characteristics • Rapid communications - speed of updating • Quick links and easy search • Appealing presentation • Headlines and more specific • Issues • Sharing of confidential information • Languages • WHO HQ • WHO Regions • Countries
Networking • Links between GACVS/WHO & qualified sites • Advance release of information on emerging issues to key partners • Advantages • Identify emerging concerns • Mechanism to flag issues for research • Increase ability to answer legitimate questions • Improve likelihood of site identification in searches • Added credibility of sites through GIPs qualification • Criteria for reliable websites
Next Steps? • Improve the GACVS/WHO safety website • Discussions about proper and efficient structure • Implementation • Review criteria for websites • Review existing criteria and information • Discussion at the next meeting of the GACVS (criteria and “qualification”) • Sites search and establishment of a directory • Implementation of linkages • Evaluation