Joint Committee on Vaccination and Immunisation

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert advisory committee that advises United Kingdom health departments on immunisation, making recommendations concerning vaccination schedules and vaccine safety. It has a statutory role in England and Wales, and health departments in Scotland and Northern Ireland may choose to accept its advice.

History

The committee was established in 1963, having been until then an advisory board for polio immunisation.[1] It gained statutory status as the Standing Advisory Committee on Vaccination and Immunisation, a non-departmental public body[2] advising the Secretary of State for Social Services and the Secretary of State for Wales, under the National Health Service (Standing Advisory Committees) Order 1981.[3]

Since the devolution of government powers to Wales, the JCVI continues to advise Welsh ministers.[1] For England, the Health Protection (Vaccination) Regulations 2009 require the Secretary of State for Health to implement the committee's recommendations regarding national immunisation programmes.[2] The committee has no statutory role in Scotland or Northern Ireland.[1]

Following the government's review of public bodies that completed in 2012, JCVI was reconstituted as a departmental expert committee, although its statutory status under the 1981 order continues.[4]

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 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).[5]

Membership

The JCVI chairman is Professor Andrew Pollard of Oxford Vaccine Group in the Department of Paediatrics at the University of Oxford.[5]

The current members' names and affiliations are published online[5] although year of appointment is not stated. According to the published code of practice[1] appointments are normally of three years' duration. In accordance with the Code of Practice issued by the Commissioner for Public Appointments, members cannot serve on the Committee for more than 10 years.

A previous chairman, Andrew Hall, was appointed Knight Bachelor in the 2013 Birthday Honours.[6]

Notable work

Position on MMR (1988 onwards)

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[7] which confirmed a high incidence of transitory mild meningitis.[8] Since that time, government agencies have acted to prevent the importation of single vaccines containing this strain.[9]

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.[10] In 2010, Wakefield was struck off by the General Medical Council for fabrication of results and failure to declare a financial interest in the importation of single strain vaccines.[11]

Position on thimerosal (2001)

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 contended that mercury exposure in the UK immunisation programme was low. However, in 2001, JCVI endorsed recommendations to remove the preservative, stating: "even though there is no evidence of toxicity, as a precautionary measure, thiomersal should be phased out over time...".[12]

COVID-19 vaccines (2020)

During the COVID-19 pandemic, in autumn 2020 the committee gave advice to the recently formed Vaccine Taskforce on the groups of people that should be prioritised for vaccination, giving regard to health inequalities.[13][14] This advice was refined in December of that year.[15]

See also

References
  1. "Joint Committee on Vaccination and Immunisation: Code of Practice" (PDF). GOV.UK. Joint Committee on Vaccination and Immunisation. June 2013. Retrieved 6 October 2020.
  2. "The Health Protection (Vaccination) Regulations 2009". legislation.gov.uk. 1 April 2009. Retrieved 6 October 2020.
  3. "The National Health Service (Standing Advisory Committees) Order 1981". legislation.gov.uk. 13 May 1981. Retrieved 6 October 2020.
  4. "Health and Social Care Act 2012: Explanatory Notes". legislation.gov.uk. 27 March 2012. Retrieved 6 October 2020.
  5. "Joint Committee on Vaccination and Immunisation". Gov.UK. Retrieved 26 June 2018.
  6. "Number 60534, Supplement 1: Birthday Honours List – United Kingdom". The London Gazette. 15 June 2013. p. 1. Retrieved 6 October 2020.
  7. E Miller; N Andrews; J Stowe; A Grant; P Waight; B Taylor (15 March 2007). "Risks of Convulsion and Aseptic Meningitis following Measles-Mumps-Rubella Vaccination in the United Kingdom". American Journal of Epidemiology. 165 (6): 704–9. doi:10.1093/aje/kwk045. PMID 17204517.
  10. "Comments on "Measles, mumps, rubella vaccine: Through a glass darkly" by Wakefield and Montgomery". January 2001. Archived from the original on 14 July 2007. Retrieved 11 February 2008.
  11. Deer B (5 January 2011). "How the case against the MMR vaccine was fixed". BMJ. 342: c5347. doi:10.1136/bmj.c5347. PMID 21209059.
  12. "Meeting minutes". JCVI. 2 November 2001. Archived from the original on 9 June 2007.
  13. "Covid-19: Most vulnerable 'could get vaccine by Christmas'". BBC News. 17 October 2020. Retrieved 21 December 2020.
  14. "Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI". GOV.UK. Department of Health and Social Care. 2 December 2020. Retrieved 21 December 2020.
  15. "Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI". GOV.UK. 30 December 2020. Retrieved 31 December 2020.
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