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Public Participation
Executive Summary: NVAC Public Participation Working Group Meeting
September 13-14, 2004
On September 13 and 14, 2004 the National Vaccine Advisory Committee's Working Group on Public Participation convened a meeting to consider options for enhancing public participation in vaccine policy deliberations and to evaluate the proposal from the Wingspread Public Engagement Planning Group for a demonstration project - the Vaccine Policy Analysis Collaborative (VPACE).
Meeting Background
The purpose of this meeting was to provide the working group with an overview of different public engagement models and to learn how these models might be applied in developing a public engagement model for vaccine policy issues.
Presentations were provided by representatives from organizations with established models for engaging the public in discussions and decision making. (A copy of the agenda is attached as appendix A) These included: the American Academy for the Advancement of Science , America Speaks, , Deliberative Democracy Consortium, the Department of Defense, Department of Energy, the Environmental Protection Agency, (Superfund and Water Divisions), the National Aeronautical and Space Agency, the National Institutes of Health (HIV/AIDS and NIH community liaison activities), and Study Circles. In addition, a model for public engagement in vaccine decisions - the VPACE proposal - was discussed. Each invited organization was asked to summarize:
- The issues for which they are seeking public participation
- Their model/how they are organized
- The process they used to select/reach out to public participants
- The mission/charter of their public participation group
- Ways that the model has been sustained
- Perceived successes and lessons learned
A detailed description of these organizations and their comments is attached as appendix B.
In addition to the presenters noted above, staff from the Department of Transportation and National Park Service provided background information on their agencies'efforts. Federal Advisory Committee Act (FACA) considerations were presented by the Office of General Counsel.
More than 40 people attended the meeting, including representatives from several government agencies, private foundations and advocacy organizations, and pharmaceutical and biotechnology companies. A participants list is attached as appendix C.
Much of the discussion focused on examining how topics were determined, the role of the public in policy decisions, and the lessons learned from the experience of these organizations. Many presentations stressed the need to define who the public was and to understand the attitudes and concerns of the public, so that this knowledge can guide topics and the use of appropriate models for dialogue. Participants also noted that development of public engagement models requires effort and time and should be approached with realistic expectations and understand that progress will likely be incremental.
Conclusions from the Meeting
There is a need for enhanced efforts to engage the broad public in vaccine policy discussions. Communication with the public on vaccine issues can and should be improved. Current practices such as public comment periods are not adequate or well-suited for the bidirectional dialog needed for vaccine discussions.
NVAC has an important role to play in supporting public engagement. Working group members support a role for NVAC and noted that public engagement will require a consistent institutional base and some assurance that the public's perspectives can reach decision makers. The National Vaccine Advisory Committee, staffed by the National Vaccine Program Office, is an appropriate home for these activities. They noted that additional resources are likely to be needed.
The NVAC should consider creating a standing working group that will report to the full committee. The intent of this working group will be to identify topics for discussion (informed by public perceptions, attitudes, and concerns) and determine the most appropriate strategy for engaging the public. In some situations a town hall meeting approach may be the most reasonable approach, for other issues a focused group discussion may be more feasible. This working group should include members of the broad public. Criteria should be developed for selection of members. Topics for discussion by this group will be selected from surveys of the public perceptions/concerns.
The general public must be adequately represented. The forum for this dialogue should represent all vaccine partners and more must be done to engage the broad American public, not just advocacy groups. Several of the presenters stressed the need to ensure a balanced representation based on data of the various perspectives.
In order to ensure that public engagement activities are based on an understanding of the scientific strong scientific foundation, training of public representatives may need to be provided. NVPO should consider approaches for providing public participation working group members with training, as needed, to better understand vaccines, the vaccine system in the U.S., and the role of the Federal government.
A one size fits all approach will not fit provide enough flexibility to address all vaccine topics. NVPO and NVAC should ensure a flexible approach, which allows for strategies based on specific issues of concern, but that is achieved in consultation with the NVAC public participation working group.
Forums for communication about these issues should continue. The opportunity for a frank and honest discussion about these issues was valuable to meeting participants and they stressed the need for and the desire to have continued dialogue among all parties.
The VPACE proposal, as currently proposed, is not fully understood by the committee and does not adequately meet all of the needs for public engagement in vaccine discussions. The committee noted that the VPACE proposal should be recognized for drawing attention to the importance and need for enhanced public engagement. However, the VPACE, as currently proposed, has several weaknesses (lack of broad stakeholder involvement, an inadequate process for selecting issues to examine) that make it unlikely to adequately represent the public. In addition, the model does not provide sufficient flexibility to address the myriad of vaccine issues for which public engagement could be sought. Therefore, other models should continue to be evaluated that may be better suited for addressing a broad range of vaccine issues.
Next Steps
- Develop a mission statement for the working group with clear objectives and a draft strategic plan for enhancing public engagement on vaccine policies.
- Ensure that there is at least one member of the public on the full NVAC.
- Continue to assess opportunities for public input in ongoing vaccine related activities.
- Actively solicit attitudes, concerns, and suggestions from the public, providers, industry about their perspectives, experiences, concerns, and perceptions of vaccines.
- Assemble and measure knowledge and attitudes toward and concerns about vaccines by the U.S. public and use that information to guide selection of issues for discussion by the working group.
- Develop and promote communication with the general public through enhanced outreach activities e.g. periodic reports and media releases, newsletters, hotlines, web sites and chat rooms.
- Encourage other advisory committees and agencies involved with vaccines (e.g. ACIP, ACCV) work to more effective engage the public.
- Solicit input from other advisory committees on how the NVAC Public Participation Working Group could be utilized.
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