JCVI gives advice to Ministers based on the best evidence reflecting current good practice and/or expert opinion. The process involves a robust, transparent, and systematic appraisal of all the available evidence from a wide range of sources. The committee is appointed by the Appointments Commission and is independent of the Department of Health.

Identifying evidence

Identification of evidence involves searching for papers and information from a wide range of sources. The aim is to generate a comprehensive body of evidence that will:

• allow the relevant question to be answered, and
  
• highlight any important gaps in the evidence.
  

Systematic literature review

A systematic literature review is ideal and involves searching a wide range of medical and scientific databases. This allows JCVI to be sure that it has examined all the currently available evidence.

Commissioning work

DH may commission additional work or information as required, for example

• a UK based cost effectiveness review
• qualitative research to give feedback on public and professional acceptability and appropriateness of a new vaccine or immunisation for the UK and the information needs of the target audience.
  

The results are then presented to JCVI (or a sub-group) for their consideration.

Review of evidence

Once papers and information have been identified, an appraisal process assesses and interprets the evidence by considering its

• quality
• validity
• results and
• relevance

Only papers relevant to the issue are selected.

Expert review

Key experts in the relevant fields are involved in the review process. They will be aware of any unpublished work or ongoing research, which should be included or considered.

Expert review may involve setting up a JCVI subgroup or expert group to review the available evidence, or writing to key experts on a particular issue for their opinion. This expert review will include members of JCVI with relevant expertise and individuals currently conducting relevant research or with particular expertise in the question. These experts are identified in consultation between the JCVI and the Department of Health.

All available data (published and unpublished) is evaluated and knowledge gaps or research identified. (Unpublished confidential data is on occasion provided by vaccine manufacturers and others who are active in research.) Any extra work is agreed and any necessary external expertise identified. As part of this review process, recommendations or advice from international and national bodies (e.g. WHO, ACIP, IoM or NICE) is also considered.

Agreement and publication of JCVI recommendations

Papers summarising the evidence base for a recommendation(s) are provided to JCVI for their consideration. Once agreed, a JCVI statement and accompanying background papers may be placed on the JCVI website.

The contribution of JCVI members to decisions made by the committee are governed by JCVI rules on members interests. The final decision is made by the full JCVI with the exception of members who have specific, personal conflicts of interest who play no part in the decision.

JCVI members are not remunerated by the Department of Health other than for expenses incurred from attending meetings.

Table 1: Grades of evidence

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