Joint Committee on Vaccination and Immunisation

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert advisory committee of the United Kingdom Department of Health. JCVI was established, in 1963, "To advise the Secretaries of State for Health, Scotland, Wales and Northern Ireland on matters relating to communicable diseases, preventable and potentially preventable through immunisation." The advisory body makes recommendations to the British government concerning mandatory vaccination schedules and vaccine safety.

JCVI is recognized as a Non-Departmental Public Body (NDPB) in the UK. It is a statutory expert Standing Advisory Committee established in England and Wales under the National Health Service (NHS) Act 1977, and the NHS Order 1981, as the Standing Advisory Committee on Vaccination and Immunisation. It is also a Sub-Committee of the National Professional Advisory Council covering Scotland.

Roles and Responsibilities

The JCVI has a responsibility to provide high quality and considered advice and recommendations to the UK Health Ministers. This includes giving advice on recommendations on matters of both a 'routine' nature and also on any specific or special matters that Ministers may request. In formulating any advice and recommendations, the Committee must take into account the need for and impact of vaccines, the quality of vaccines and the strategies to ensure that their greatest benefit to the public health can be obtained from the most appropriate use of vaccines.

JCVI's members play a role in ensuring its continued standing as an internationally recognised leading body in the field of immunisation. They are people who are committed to the continuing development and improvement of public health policy on immunisation. Members bring relevant experience to the Committee and contribute to the provision of high quality and considered advice to UK ministers of health.

Accountability

The Secretary of State for Health is accountable to Parliament of the United Kingdom for the performance of the JCVI and for ensuring that it continues to observe the highest standards of propriety including impartiality, integrity and objectivity in the execution of its role and responsibilities.

All papers presented to JCVI --which often include pre-publication copies of research or documents of commercial significance-- must be treated as confidential. All matters discussed at JCVI are confidential. Members should take care to avoid premature or selective disclosure of the Committee's deliberations. A full explanation of confidentiality matters will be given to members on attendance at meetings and these will be recorded in the minutes.

JCVI members meet and report as one Committee usually three times a year. Its recommendations, as accepted by the Secretaries of State, are published in "Immunisation against infectious diseases" and also through other routes as necessary (e.g., Chief Medical Officer (CMO) Letters).

Leadership

The JCVI chairman is Professor Andrew Hall, MB, BS, MSC, PHD, FRCP, FFPH, of the London School of Hygiene and Tropical Medicine.

Membership

The current members' names and affiliations are published online [http://www.advisorybodies.doh.gov.uk/jcvi/members.htm] although year of appointment is not stated. According to the published code of practice [http://www.advisorybodies.doh.gov.uk/jcvi/code.htm] appointments are normally of four years duration.

Position on MMR

The JCVI has firmly endorsed the efficacy and safety of the MMR vaccine. Among many developments, in February, 1988, fifteen experts and officials met in the UK to discuss adverse events reported after the administration of the vaccines which contained the attenuated Urabe mumps virus strain. According to JCVI's minutes, the group "read a report of cases of mumps encephalitis which had been associated with MMR vaccine containing the Urabe strain of the mumps virus."

The JCVI "expressed concern" about giving triple vaccines to children with a personal or family history of convulsions, but considered it appropriate to proceed with a planned introduction of the MMR vaccine in October 1988, including two products containing Urabe strain. After the start of the mass MMR immunisation programme, additional evidence that the strain was linked with viral meningitis surfaced in a number of countries, and by 1990, many had withdrawn products containing it. In November 1992, it was withdrawn in the UK, following the publication of government-sponsored research [http://aje.oxfordjournals.org/cgi/content/full/kwk045v1] which confirmed a high incidence of transitory mild meningtis. [http://doctor.medscape.com/viewarticle/553729] Since that time, government agencies have acted to prevent the importation of single vaccines containing this strain. [http://www.ukmicentral.nhs.uk/headline/database/viewnewssearch.asp?offset=4490&NewsID=1434] .

In 2001, Andrew Wakefield published what he said were his concerns in the "Journal of Adverse Drug and Toxicological Reviews" commenting on early studies of MMR, none of which were critical of the vaccine. The article was reviewed by the JCVI, which unequivocally rejected Wakefield's claims, with government agencies publishing a detailed rebuttal [http://www.hpa.org.uk/infections/topics_az/vaccination/012201wakefield.htm] .

Position on thimerosal

As is the case in the United States and many other countries, the mercury-based additive thimerosal, previously thought necessary for multi-dose vials of vaccines such as the DPT shot, has largely been phased out. According to the JCVI, it has been shown that the amount of mercury in the blood of children receiving thimerosal-containing vaccines is well below levels that may be "associated with any toxic effects." Reports reviewed by the JCVI contend that mercury exposure in the UK immunisation programme is low. However, JCVI endorsed recommendations to remove the preservative "even though there is no evidence of toxicity, as a precautionary measure, thiomersal should be phased out over time..." [http://www.hps.scot.nhs.uk/immvax/thiomersal.aspx]

External links

* [http://www.advisorybodies.doh.gov.uk/jcvi/ AdvisoryBodies.doh.gov.uk] - Official website
* [http://www.guardian.co.uk/science/story/0,,1931069,00.html Guardian.co.uk] - 'Influenza vaccine to be encouraged for women in late pregnancy', Sarah Boseley, "The Guardian" (October 25, 2006)

* [http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2007/03/05/hmmr105.xml Telegraph.co.uk] - 'Early fears about MMR in secret papers', Mark Watts, "Daily Telegraph" (March 5, 2007)

ee also

* Advisory Committee on Immunization Practices