Joint Committee on Vaccination and Immunisation

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert advisory committee of the United Kingdom Department of Health. JCVI was established, in 1963, "To advise the Secretaries of State for Health, Scotland, Wales and Northern Ireland on matters relating to communicable diseases, preventable and potentially preventable through immunisation." The advisory body makes recommendations to the British government concerning mandatory vaccination schedules and vaccine safety.

JCVI is recognized as a Non-Departmental Public Body (NDPB) in the UK. It is a statutory expert Standing Advisory Committee established in England and Wales under the National Health Service (NHS) Act 1977, and the NHS Order 1981, as the Standing Advisory Committee on Vaccination and Immunisation. It is also a Sub-Committee of the National Professional Advisory Council covering Scotland.

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's members play a role in ensuring its continued standing as an internationally recognised leading body in the field of immunisation. They are people who are committed to the continuing development and improvement of public health policy on immunisation. Members bring relevant experience to the Committee and contribute to the provision of high quality and considered advice to UK ministers of health.

Accountability
The Secretary of State for Health is accountable to Parliament of the United Kingdom for the performance of the JCVI and for ensuring that it continues to observe the highest standards of propriety including impartiality, integrity and objectivity in the execution of its role and responsibilities.

All papers presented to JCVI --which often include pre-publication copies of research or documents of commercial significance-- must be treated as confidential. All matters discussed at JCVI are confidential. Members should take care to avoid premature or selective disclosure of the Committee's deliberations. A full explanation of confidentiality matters will be given to members on attendance at meetings and these will be recorded in the minutes.

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).

Leadership
The JCVI chairman is Professor Andrew Hall, MB, BS, MSC, PHD, FRCP, FFPH, of the London School of Hygiene and Tropical Medicine.

Thimerosal controversy
According to the JCVI, it has been shown that the amount of mercury in the blood of children receiving thimerosal containing vaccines (TCVs) is well below levels that may be "associated with any toxic effects." Reports reviewed by the (JCVI) contend that mercury exposure in the UK immunisation programme is low. However, JCVI endorses recommendations to ban the vaccine preservative "even though there is no evidence of toxicity, as a precautionary measure, thiomersal should be phased out over time..."

MMR controversy
In February, 1988, fifteen experts and officials met in the UK to discuss reports of neurological damage suffered by children who were subjects in trials of an early MMR vaccine which contained the attenuated Urabe mumps virus strain. According to JCVI's minutes, the group "read a report of cases of mumps encephalitis which had been associated with MMR vaccine containing the Urabe strain of the mumps virus."

The JCVI "expressed concern" about giving triple vaccines to children with a personal or family history of convulsions. Yet the British government proceeded with mass immunisations using the combined measles, mumps and rubella vaccine containing the Urabe mumps strain in October, 1988. After the start of the mass MMR immunisation programme, additional evidence of harm surfaced around the world, and by 1990, most countries had withdrawn licensure of the MMR vaccine with the Urabe mumps strain. It was not until 1992 that Britain stopped injecting children with Urabe MMR, replacing it with MMR2, which contains a less dangerous form of the mumps virus.

In 2001, Andrew Wakefield published concerns in the Journal of Adverse Drug and Toxicological Reviews that reported early studies of the MMR showed evidence of vaccine injury problems and that its licensure was premature. The article was reviewed by the JCVI, which unequivocally rejected Wakefield's article and his calls for single jab vaccines spaced at full one year intervals. The committee based its findings on a report by Dr. Eric Fombonne, which found no change in incidence of regressive autism following the introduction of MMR, who concluded that there was no evidence for a new syndrome (dubbed autistic enterocolitis by Wakefield) linking bowel disease with autistic spectrum disorders.