The National Immunization Technical Advisory Group in Israel

Abstract

National Immunization Technical Advisory Groups (NITAGs) are defined by the World Health Organization as multidisciplinary groups of health experts who are involved in the development of a national immunization policy. The NITAG has the responsibility to provide independent, evidence-informed advice to the policy makers and national programme managers, on policy issues and questions related to immunization and vaccines.This paper aims to describe the NITAG in Israel. The Israeli NITAG was established by the Ministry of Health in1974. The NITAG’s full formal name is “the Advisory Committee on Infectious Diseases and Immunizations in Israel”. The NITAG is charged with prioritizing choices while granting maximal significance to the national public health considerations. Since 2007, the full minutes of the NITAG’s meetings have been publicly available on the committee’s website (at the Ministry of Health website, in Hebrew).According to the National Health Insurance Law, all residents of Israel are entitled to receive universal health coverage. The health services basket includes routine childhood immunizations, as well as several adult and post - exposure vaccinations. The main challenge currently facing the NITAG is establishing a process for introducing new vaccines and updating the vaccination schedule through the annual update of the national health basket. In the context of the annual update, vaccines have to “compete” with multiple medications and technologies which are presented to the basket committee for inclusion in the national health basket. Over the years, the Israeli NITAG’s recommendations have proved essential for vaccine introduction and scheduling and for communicable diseases control on a national level. The NITAG has established structured and transparent working processes and a decision framework according to WHO standards, which is evidence-based and country-specific to Israel.The recent global COVID-19 pandemic is a major concern for all countries as well as a challenge for NITAGs. Currently, the NITAGs have a key role in advising both on sustainment of the routine immunization programs and on planning of the COVID-19 vaccination campaigns, with ongoing updates and collaboration with the Ministry of Health and health organizations.

Israel’s rapid rollout of vaccinations for COVID-19

“…making decisions about vaccinations and support tools for assisting in the implementation of vaccination campaigns 26 Israel has a well-established national Epidemic Management Team (EMT) and a well-established National Immunization Technical Advisory Group (NITAG) [42]. In the last quarter of 2020, the MOH general director appointed a special committee ("the COVID-19 vaccine prioritization committee"), comprised of members of those two long-standing committees, which then held regular (Zoom) meetings several times a week, and provided recommendations to the MoH.…”

Invasive Disease Due to Neisseria meningitidis: Surveillance and Trends in Israel Prior to and during the COVID-19 Pandemic

“…The Israel Defense Forces (IDF) had adopted, some two decades ago, a MenACWY vaccination program aimed at army recruits and showing a decline in incidence in the IDF [ 37 , 38 ]. However, in Israel, most IMD cases occur in young children (in the current study, the IMD cases’ median age was three years), and most cases are attributed to serogroup B. Israel’s National Immunization Technical Advisory Group (NITAG) has recommended the use of the MenB vaccine in infants and toddlers in 2019 [ 39 ]. To date, the MenB vaccine has not been introduced into the routine (free of charge) childhood vaccination program, mainly due to budgetary constraints [ 39 , 40 ].…”

“…However, in Israel, most IMD cases occur in young children (in the current study, the IMD cases’ median age was three years), and most cases are attributed to serogroup B. Israel’s National Immunization Technical Advisory Group (NITAG) has recommended the use of the MenB vaccine in infants and toddlers in 2019 [ 39 ]. To date, the MenB vaccine has not been introduced into the routine (free of charge) childhood vaccination program, mainly due to budgetary constraints [ 39 , 40 ]. The application to include the 4CMENB vaccine into the routine vaccination program has been recently submitted to the national committee for the 2023 expansion of the health services basket and has not been approved due to high costs [ 41 ].…”

The health and economic impact of switching vaccines in universal varicella vaccination programs using a dynamic transmission model: An Israel case study

“…Vaccination costs were computed by multiplying the number of vaccine doses over the 50-year time horizon, assuming a 97% coverage rate (consistent with current coverage for MMRV in Israel) 36 , by the vaccine price per dose along with administration costs. Direct medical costs for outpatient visits were calculated by multiplying the expected number of outpatient visits (number of cases × proportion of cases with outpatient visits × average number of visits per case) by the average cost per outpatient visit.…”