Canada Communicable Disease Report
Final Report of Outcomes from the National Consensus Conference for Vaccine-Preventable Diseases in Canada
Feedback on the 2005 Consensus Conference was solicited from participants to assist in the planning of future forums dedicated to the development of national immunization goals and recommendations. Key observations from completed evaluation forms are highlighted below.
Participants were asked to comment on the adequacy of information materials and presentations intended to support working group and plenary discussion and decision-making. Respondents remarked that conference binders contained valuable information but should have been distributed farther in advance of the meeting (e.g., at least 1 week before). The discussion guides provided to working groups were also considered useful. The suggestion was made that all participants could have benefited from having information specific to other working groups as well as their own, particularly with regard to the more complex diseases (e.g. influenza).
Both working group and plenary presentations were well received, with several participants proposing that copies of presentations be made available at the conference. Another participant recommended that, in light of time constraints, key issues for each disease be identified in presentation format to facilitate discussion and decision-making. The value of drawing on the experience in the US and other countries was also noted, recognizing that the cost versus benefit of inviting external experts must be considered.
Format and scope
Participants generally felt that more time should have been allotted for discussion and decision-making at the working group level, with only 58% of respondents agreeing or agreeing strongly that sufficient time had been provided for this purpose. The influenza group was particularly challenged to complete the agenda within the available time, prompting more than one participant to suggest that a full day be devoted to working group deliberations in future.
A number of participants commented that future consensus conferences should focus on fewer diseases, to allow sufficient time to consider evidence and make decisions. In some cases, it may be appropriate to devote an entire conference to one disease; with influenza cited as a prime example. In the latter regard, the uniqueness of influenza was highlighted along with the challenges of considering this and other diseases concurrently.
Ultimately it was proposed that the CIC be charged with determining the criteria for selecting which and how many VPDs are included in future consensus conferences, with vaccine programs (e.g. multivalent), population impact and new vaccines identified as possible decision-making considerations.
The process for achieving consensus and voting on proposed goals and recommendations was well received by participants. However, consistent with previous comments, some participants felt that more time should be allotted for presenting and discussing working group outcomes at the plenary level. A clearly defined process for second votes should be developed.
With regard to the goal setting process, it was suggested that organizers of future consensus conferences determine in advance whether participants are to develop "ideal" or "practicable" goals. In addition, prior to conference agendas being developed, proposed issues and goal-setting priorities should be identified in consultation with NACI and other stakeholders.
Overall, participants responded positively to the 2005 Consensus Conference, with those who completed evaluation forms assigning an average approval rating of over 80%. Support was expressed for future consensus conferences; the inaugural forum being described as very well organized and executed, informative, and an effective medium for discussing and making decisions on goals and recommendations for VPDs. In addition to identifying improvement opportunities in the areas of supporting information, format and scope, and process, participants raised concerns about the quality of the simultaneous translation and the redundancy of having hired note-takers as well as staff rapporteurs.
In conclusion, a number of participants stressed the importance of maintaining the momentum gained at the conference, specifically ensuring that recommendations proceed expeditiously through the national public health framework. It was further suggested that a review of provincial/territorial infrastructure be undertaken to identify needs or gaps related to the implementation of goals and recommendations. To ensure that best practices are implemented, evaluation reports have been summarized and a "Lessons Learned" exercise will be held prior to the planning of subsequent conferences.
Despite current limitations there are clear benefits to developing national goals and recommendations for vaccine-preventable diseases. As provinces and territories aspire towards the national vision, their immunizations programs will invariably improve, resulting in increased coverage. These improvements can in turn be used to justify additional funding for their immunization programs. As well, establishing national goals and recommendations provides a method of accountability at the jurisdictional level. Ultimately, the goals and recommendations from the NCC-VPD 2005 are not binding for provinces and territories. Rather, they provide members of the Pan-Canadian Public Health Network and provincial and territorial partners with a common foundation from which to initiate discussions leading to the adoption and implementation of goals at the jurisdictional level. While provincial/territorial programs and objectives may still vary at the conclusion of this process, they will now be guided by a common vision.
The national goals and recommendations from the 2005 Consensus Conference will be re-evaluated in 2010, and future consensus conferences are planned to review, develop and update national goals and recommendations for immunization coverage and disease reduction for the remaining vaccine-preventable diseases.
- Global Immunization Vision and Strategy (2006-2015). WHO Division of Immunization Vaccines and Biologics and UNICEF Program Division Health Section; http://www.who.int/vaccines-documents/DocsPDF05/GIVS_Final_EN.pdf
- 44th PAHO-WHO Directing Council 55th Session of the Regional Committee. Resolution CD44.R1 Sustaining Immunization Program - Elimination of rubella and congenital rubella syndrome (CRS). Sept 22-26, 2003.
- The process to establish and implement national goals and recommendations for vaccine-preventable diseases in Canada under the National Immunization Strategy. CCDR In press.
- Healthy People 2010. US Department of Health and Human Services. Office of Disease Prevention and Health Promotion http://www.healthypeople.gov/Document/html/uih/uih_4.htm#immuniz.
- National Advisory Committee on Immunization. NACI - update to statement on varicella vaccine. CCDR 2002;28(ACS-3):1-8.
- Preventing pneumoccocal disease A canadian consensus conference 16-18 February 1998. CCDR 1999;25(4):25-35.
- National Advisory Committee on Immunization. Statement on influenza vaccination for the 2005-2006 season. CCDR 2005;31(ACS-6):1-32.
- Canadian consensus conference on influenza. CCDR 1993;19(17):136-46.
A complete bibliography of reference articles and conference documents are available on CD-Rom by sending a request to email@example.com.
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