A critique of criteria for evaluating vaccines for inclusion in mandatory school immunization programs.
Several new vaccines for children and young adults have been introduced recently and now appear on the Advisory Committee on Immunization Practices' recommended childhood and adolescent immunization schedule (meningococcal, rotavirus, human papillomavirus). As new vaccines are introduced, states face complex decisions regarding which vaccines to fund and which vaccines to require for school or child care entry. This complexity is evidenced by the current debate surrounding the human papillomavirus vaccine. We present a critique to the approach and criteria for evaluating vaccines for inclusion in mandatory school immunization programs that have been adopted by the Washington State Board of Health by illustrating how these criteria might be applied to the human papillomavirus vaccine. We conclude that these 9 criteria can help ensure a deliberate and informed approach to important public policy decisions, but we argue that several clarifications of the review process are needed along with the addition of a 10th criterion that ensures that a new vaccine mandate relates in some manner to increasing safety in the school environment.
Opel
Douglas J
DJ
Treuman Katz Center for Pediatric Bioethics, Children's Hospital and Regional Medical Center, Seattle, Washington 98101, USA. djopel@u.washington.edu
Diekema
Douglas S
DS
Marcuse
Edgar K
EK
D000293:Adolescent; D001428:Bacterial Vaccines / Q000008:administration & dosage; D019496:Cancer Vaccines / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration*; D004219:District of Columbia; D005069:Evaluation Studies as Topic; D005260:Female; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D037141:Mandatory Programs / Q000941:ethics / Q000331:legislation & jurisprudence*; D030361:Papillomavirus Infections / Q000517:prevention & control*; D011050:Policy Making; D018570:Risk Assessment; D017749:Total Quality Management; D014611:Vaccination / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D014612:Vaccines / Q000008:administration & dosage*; D014765:Viral Vaccines / Q000008:administration & dosage; D014861:Washington
D001428:Bacterial Vaccines; D019496:Cancer Vaccines; D014612:Vaccines; D014765:Viral Vaccines