ACIP and its role in the pandemic vaccine response

CDC’s Advisory Committee on Immunization Practices (ACIP), through its COVID-19 Vaccine Workgroup, is tasked with making evidence-based policy recommendations from the pool of vaccines being developed against coronavirus. While ACIP has long been a key voice on vaccination policy, COVID-19 is especially tricky. The panel usually has decades of research results to help build a risk-benefit profile, but that is not the case with this ongoing pandemic. Also, routinely recommended vaccines often target children, while COVID-19 disproportionately affects older adults. Another layer of complexity comes from the high disease burden among specific populations—including Blacks, Hispanics, and American Indian/Alaska Natives—regardless of age. With these challenges in mind, ACIP in June underscored several principles that should inform decision-making. Committee members agreed that monitoring safety and efficacy in real time and ensuring diverse participation by at-risk groups in clinical trials is paramount. Additionally, considering longtime disparities in adult vaccination coverage, they emphasized the importance of efficient and equitable distribution of vaccines. ACIP’s vaccine recommendations, according to the viewpoint authors, will require robust partnerships with pharmacies, health care systems, immunization registries, insurers, and other stakeholders as well as public engagement. “Rapid, accurate, transparent, and timely communication efforts targeting both health care clinicians and the public are necessary to enhance trust,” they write, “particularly because policies will need to adapt to reflect rapidly changing circumstances and new knowledge.”