# Presentation: 917053

## Vaccine Safety at CDC:
Immunization Program Perspective

**Immunization Program Perspective**

**Melinda Wharton, MD, MPH**
**National Center for Immunization and Respiratory Diseases**

## Immunization Program Perspective

**CDC’s Advisory Committee on Immunization Practices makes vaccine recommendations**
**Recommendations are implemented through both public and private sectors, affecting health of all children in the U.S.**
**Vaccine safety is critical to public health**

## The Cutter Incident

**April 25, 1955:  Paralytic polio reported among children who had received inactivated polio vaccine**
**April 28:  CDC’s Epidemic Intelligence Service mobilized as the Polio Surveillance Unit**
**Two production pools of Cutter polio vaccine contained live polio virus**

## The Cutter Incident and Vaccine Safety at CDC

**In face of uncertainty, importance of rapid response**

## The Cutter Incident and Vaccine Safety at CDC

**In face of uncertainty, importance of rapid response**
**National surveillance and multi-state field investigation are key tools**

## RotaShield® and Intussusception

**Late May:  Cases of intussusception among recipients of RotaShield****® reported to VAERS**
**Early June: CDC launches multi-state investigation**
**Early July:  Preliminary data from multi-state investigation identifies additional cases among vaccinated children**
**July 16, 1999:  CDC suspends use of the vaccine**

## The Cutter Incident and Vaccine Safety at CDC

**In face of uncertainty, importance of rapid response**
**National surveillance and multi-state field investigation are key tools**
**Public confidence is fragile, and once lost is difficult to regain**

## Resuming Polio Vaccination, May 1955

**“****The nation, which mere weeks ago clamored with one voice for the Salk vaccine, now is skeptical.  The faith of the reading, listening and watching public has been severely shaken.  The delays in school inoculation programs, the starts and stops in vaccine production, the cloak-and-dagger meetings in Washington, the recurring rumors that Secy. Oveta Culp Hobby would resign – all this had raised doubts.  Nobody seems to be giving straight answers.  It has the look of a cover-up.”**

## Current Organizational Structure

**February 2005:  Immunization safety moved from the National Immunization Program**
**Move separated risk assessment from risk management**
**Immunization program continues to be responsible for immunization recommendations**

## National Center for Immunization and Respiratory Diseases

**Brings together most of the vaccine-preventable disease work of CDC into a new Center**
**Laboratory, epidemiology, vaccine development work from NCID**
**Epidemiology, global and domestic immunization program from NIP**
**Hepatitis, HPV, travelers’ vaccines in other Centers**

## Vaccine Safety and Immunization Programs

**Immunization programs affect the health of all children in the United States**
**Good information on vaccine risks is critical**

## Vaccine Safety and Immunization Programs

**Immunization programs affect the health of all children in the United States**
**Good information on vaccine risks is critical**
***The right answer***

## Vaccine Safety and Immunization Programs

**Immunization programs affect the health of all children in the United States**
**Good information on vaccine risks is critical**
**The right answer**
***Urgently obtained***

## Vaccine Safety and Immunization Programs

**Immunization programs affect the health of all children in the United States**
**Good information on vaccine risks is critical**
**The right answer**
**Urgently obtained**
***Communicated clearly***