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A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults.

Hepatitis B vaccination is the most effective measure to prevent hepatitis B virus (HBV) infection and its consequences, including cirrhosis of the liver, liver cancer, liver failure, and death. In adults, ongoing HBV transmission occurs primarily among unvaccinated persons with behavioral risks for HBV transmission (e.g., heterosexuals with multiple sex partners, injection-drug users [IDUs], and men who have sex with men [MSM]) and among household contacts and sex partners of persons with chronic HBV infection. This report, the second of a two-part statement from the Advisory Committee on Immunization Practices (ACIP), provides updated recommendations to increase hepatitis B vaccination of adults at risk for HBV infection. The first part of the ACIP statement, which provided recommendations for immunization of infants, children, and adolescents, was published previously (CDC. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices [ACIP]. Part 1: immunization of infants, children, and adolescents. MMWR 2005;54[No. RR-16]:1-33). In settings in which a high proportion of adults have risks for HBV infection (e.g., sexually transmitted disease/human immunodeficiency virus testing and treatment facilities, drug-abuse treatment and prevention settings, health-care settings targeting services to IDUs, health-care settings targeting services to MSM, and correctional facilities), ACIP recommends universal hepatitis B vaccination for all unvaccinated adults. In other primary care and specialty medical settings in which adults at risk for HBV infection receive care, health-care providers should inform all patients about the health benefits of vaccination, including risks for HBV infection and persons for whom vaccination is recommended, and vaccinate adults who report risks for HBV infection and any adults requesting protection from HBV infection. To promote vaccination in all settings, health-care providers should implement standing orders to identify adults recommended for hepatitis B vaccination and administer vaccination as part of routine clinical services, not require acknowledgment of an HBV infection risk factor for adults to receive vaccine, and use available reimbursement mechanisms to remove financial barriers to hepatitis B vaccination.

Adult↗

The Delaware School Health Advisory Committee.

For nearly 40 years, the Delaware School Health Advisory Committee (SHAC) has been improving school health education and school health services in the state. The SHAC has recommended policies to the Delaware Board of Education and the state legislature, conducted conferences and workshops, and published brochures, studies, resource guides, curricula, and pamphlets. The key to SHAC success has been its diverse membership and the cooperation it engendered in the state.

Adolescent↗

Prevention of varicella. Update recommendations of the Advisory Committee on Immunization Practices (ACIP).

In February 1999, the Advisory Committee on Immunization Practices (ACIP) expanded recommendations for varicella (chickenpox) vaccine to promote wider use of the vaccine for susceptible children and adults. The updated recommendations include establishing child care and school entry requirements, use of the vaccine following exposure and for outbreak control, use of the vaccine for some children infected with the human immunodeficiency virus (HIV), and vaccination of adults and adolescents at high risk for exposure. These recommendations also provide new information on varicella vaccine postlicensure safety data.

Adolescent↗

Poliomyelitis prevention. Immunization Practices Advisory Committee Centers for Disease Control.

This revised Immunization Practices Advisory Committee recommendation on poliomyelitis prevention addresses issues important in poliomyelitis prevention addresses issues important in poliomyelitis control in the United States today. Specifically, situations that constitute increased risk are defined, and alternatives for protection are outlined. Recommendations for immunization of adults are presented, clarifying the role of inactivated polio vaccine in immunizing adults. These recommendations also address the problems of interrupted immunization schedules and completion of primary immunization. Oral polio vaccine remains the vaccine of choice for primary immunization of children.

Adolescent↗

Report of the Graduate Medical Education National Advisory Committee to the secretary.

The Graduate Medical Education National Advisory Committee (GMENAC) was charged with the task of advising the Secretary of the Department of Health and Human Services on overall strategies on the present and future supply and requirements of physicians by specialty and geographic location. In September of 1980, GMENAC submitted its final report to the Secretary. Included in this report are policy directives that were issued in the form of recommendations; several of these recommendations are directed specifically at the independent non-physician health care professions. The potential impact of these recommendations upon the profession of optometry is monumental; and, the authority of GMENAC to issue directives regarding the supply of optometrists and the future requirements of optometric manpower must be challenged.

Allied Health Personnel↗

Recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians: use of reminder and recall by vaccination providers to increase vaccination rates.

This statement by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) presents and recommends a programmatic strategy-the use of a reminder and/or recall (R/R) system by vaccination providers-to increase vaccination rates. In 1992, a national survey indicated that 8% of pediatricians and 5% of family physicians had implemented a manual vaccination R/R system and 6% and 5%, respectively, used a computer-based system for vaccination R/R messages. In 1993, the National Vaccine Advisory Committee issued the "Standards for Pediatric Immunization Practices," which recommend that all public and private health-care providers use a vaccination R/R system. These standards were endorsed by ACIP, AAP, and AAFP. By 1995 a survey indicated that R/R systems were used by 35% of pediatricians and 23% of family physicians (R. Zimmerman, University of Pittsburgh School of Medicine, personal communication, 1995).

Child↗

Guidelines for development and application of aquatic animal health regulations and control programs. AVMA Aquaculture and Seafood Advisory Committee.

The creation of sound health regulations or disease control programs for any animal species is a complex endeavor. When the diverse stakeholder interests related to aquaculture are considered, this endeavor becomes daunting. The AVMA Aquaculture and Seafood Advisory Committee designed the following guidelines as a tool to assist aquatic animal health professionals who discuss potential regulations or control programs with government and industry entities. The guide focuses on determining whether a regulation or program is appropriate and, if so, developing a suitable and effective aquatic animal health plan. The Aquaculture and Seafood Advisory Committee was established in 1992 as an ad hoc committee of the AVMA Executive Board. The committee is composed of 9 veterinarians with diverse interests in aquaculture and seafood, and one non-veterinarian who represents the aquaculture industry. Participants from the USDA/APHIS and FDA serve as consultants to the Committee.

Animals↗

Should consensus be 'the commission method' in the US? The perspective of the Federal Advisory Committee Act, regulations, and case law.

This paper examines the drive for consensus from the perspective of the good government framework for federal advisory commissions in the United States. Specifically, the paper examines the Federal Advisory Committee Act (FACA)--the statute, its regulations, and case law. It shows that the FACA was intended to be an antidote to abuses in consensus-making processes, including the failure to fully include competing views on commissions. The index of suspicion in the FACA scheme rises when a group work product--including a consensus report--is to be the basis of recommendations to federal officials. Once FACA's requirements regarding committee composition are satisfied, the index of suspicion drops and FACA is indifferent to consensus-making; but the conditions for informed, meaningful participation apply to members who dissent from, as well as those who participate in, consensus. In negotiated rulemaking, the push for consensus and closure creates unacceptable tension with the good government goals of openness and accountability. Proponents of consensus-only bioethics commissions can learn from FACA-related legislative, agency, and judicial insights that consensus-seeking is not always desired by government officials; is rarely cost free; and that diversity and dissent enhance openness, accountability, and fairness. The burden of proof is therefore on proponents of a consensus-only standard for bioethics commissions to demonstrate that a drive for consensus furthers sound decision-making by government officials more than it sets back openness and accountability to a diverse public.

Advisory Committees↗