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Special Communication |

Strengthening the Supply of Routinely Recommended Vaccines in the United States:  Recommendations From the National Vaccine Advisory Committee

JAMA. 2003;290(23):3122-3128. doi:10.1001/jama.290.23.3122.
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Between late 2000 and the spring of 2003, the United States experienced shortages of vaccines against 8 of 11 preventable diseases in children. In response, the Department of Health and Human Services requested that the National Vaccine Advisory Committee (NVAC) make recommendations on strengthening the supply of routinely recommended vaccines. The NVAC appointed a Working Group to identify potential causes of vaccine supply shortages, develop strategies to alleviate or prevent shortages, and enlist stakeholders to consider the applicability and feasibility of these strategies. The NVAC concluded that supply disruptions are likely to continue to occur. Strategies to be implemented in the immediate future include expansion of vaccine stockpiles, increased support for regulatory agencies, maintenance and strengthening of liability protections, improved communication among stakeholders, increased availability of public information, and a campaign to emphasize the benefits of vaccination. Strategies requiring further study include evaluation of appropriate financial incentives to manufacturers and streamlining the regulatory process without compromising safety or efficacy.

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Figure. Vaccine Manufacturers for Routinely Recommended Childhood Vaccines in the United States
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Td/DT, indicates tetanus and diphtheria/diphtheria and tetanus toxoids; DTP, diphtheria and tetanus toxoids and whole-cell pertussis vaccine; DTaP, diphtheria and tetanus toxoids and acellular pertussis vaccine; MMR, measles, mumps, and rubella vaccine; OPV, oral poliovirus vaccine; IPV, inactivated poliovirus vaccine; Hib, Haemophilus influenzae type b vaccine; Hep B, hepatitis B vaccine; varicella, varicella vaccine; and PCV7, pneumococcal conjugate vaccine. Asterisk indicates foreign-headquartered manufacturers.

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