The Global Advisory Committee on Vaccine Safety and

The Global Advisory Committee on Vaccine Safety and its Communication Strategy Philippe Duclos World Health Organization VHPB Meeting, Ferney Voltaire, 13 -14 March 2003

Vaccine scares z. Characteristics y. Global (origin & impact) y. Not limited to: xindustrialized countries xcountries with high coverage y. Detrimental with variable impact z. Solutions y. Proactive y. Rapid exchange of information y. Quick reactive capability

Vaccine Safety Issues WHO perspective 1. Global issues with some regional differences 2. Implicate active ingredients or non specific substances and diseases of unknown etiology 3. “Amalgamation” 4. Potential of signal generation and systematic search to identify spurious associations and generate false hypothesis 5. Can generate huge amount of work and undue fear 6. Need for quick hypothesis testing and international collaboration 7. Science compounded by legal issues 8. Never a end 9. Misperception that vaccines from developing countries and WHO standards for them are inferior

Vaccine Safety Issues National program perspective 4 Risk benefit logic challenged 4 Limited resources to address 4 Limited data for a response 4 Anti-vaccination groups can coalesce on specific issues

Dealing with rumours: the environment z Anti-vaccination movement very successful in applying “Internet logic” z Limits to existing web sites (isolation, language) z Limits to country web sites (capacity) z Perception issue -- authoritative information & advocacy z Frequent need for new scientific data z Strong international collaboration needed

How to improve international communications? z. Consistency among key authorities z. Preparedness using credible scientific data z. Independent international reviews of issues and issuance of authoritative statements from neutral organizations z. Direct, early (even prior to going public) and clear communications between authorities and all parties

Global Advisory Committee on Vaccine Safety (GACVS) z To respond promptly, efficiently, independently and with scientific rigor to vaccine safety issues of global importance z Review of latest knowledge in collaboration with all parties involved z Determination of causal relationships z Multidisciplinary, global, and under strict conflict of interest and confidentiality rules z Ad hoc specialists teams and mandate to commission research z Decides which issue should be reviewed

Global Advisory Committee on Vaccine Safety: Examples of Issues 2001/2002 z Macrophagic myofasciitis (MMF) z Immunization and autoimmune diseases z Safety of thiomersal z MS and hepatitis B vaccination z Leukemia following hepatitis vaccination z Yellow fever vaccine-related deaths z Child survival following immunization z MMR and autism z Bell’s Palsy following intranasal vaccination

Current Communications

Vaccine Safety-Net: Brainstorming Meeting z Situation and concept y Existing sites have weak linkages & predominately in English --->limits effectiveness y Difficult access to WHO and GACVS information ------>collaborative network under GACVS general direction z Meeting objectives y. Discuss value and feasibility of VSN y. Identify critical issues for successful implementation y. Identify potential core partners z Participants y Professional and governmental organizations y GACVS y UNICEF and WHO

Vaccine Safety-Net Meeting: Outcome z More specificity to target audience z Coordinated network concept could undermine impact and independence of GACVS and WHO z However, y. Supported key role of GACVS and expanding communications around GACVS y. Encouraged links to “qualified” sites z Important considerations y. Communication about facts not advocacy y. All safety facts good or bad! y. Do not cover all issues y. Focus on internet

Expanding Communications Around GACVS z Build on existing platform - major enhancements z Characteristics y Rapid communications - speed of updating y Quick links and easy search y Appealing presentation y Headlines and more specific z Issues y Sharing of confidential information y Languages x. WHO HQ x. WHO Regions x. Countries

Networking z Links between GACVS/WHO & qualified sites z Advance release of information on emerging issues to key partners z Advantages y. Identify emerging concerns y. Mechanism to flag issues for research y. Increase ability to answer legitimate questions y. Improve likelihood of site identification in searches y. Added credibility of sites through GIPs qualification z Criteria for reliable websites

Next Steps? z Improve the GACVS/WHO safety website y. Discussions about proper and efficient structure y. Implementation z Review criteria for websites y. Review existing criteria and information y. Discussion at the next meeting of the GACVS (criteria and “qualification”) z Sites search and establishment of a directory z Implementation of linkages z Evaluation