Meeting all of the criteria does not necessarily imply that these

Meeting all of the criteria does not necessarily imply that these ITAGs function efficiently or that other ITAGs are not effective – each ITAG has strengths and weaknesses. However, these ITAGs possess what we believe to be the minimum required criteria of an ideal ITAG. The validity of the responses in this survey is unknown. When compared with a systematic review on the same topic [2], 12 of the 14 countries who reported having national ITAGs were consistent

in their survey responses. One of the countries mistakenly reported the presence of an ITAG in the survey but this group is within the national government [15] and so was not considered an independent national ITAG by the BIBW2992 datasheet authors. The reason for the other contradictory case, where the systematic review reported a national ITAG but the survey response indicated the opposite, is unknown. Of the 12 countries that

reported having a national ITAG in the systematic review and also reported the presence of a national ITAG on the questionnaire, the great majority of the information that was found in the systematic review was confirmed by the responses on the questionnaire. One exception was the number of members reported which may have been due to membership changes between the date of publication of the sources and the time when the survey was completed. The main limitation of this study is the collection of data through two different questionnaires, due to the exclusion of the European region from the global survey. The information from the European region is more limited and hence could not be aggregated with the rest of the data for all criteria. As a result, there is not global CT99021 mw level data available for all topics

addressed which precludes a global depiction of many of the characteristics of national ITAGs as was originally planned. Another limitation is the potential that the questions or responses were misconstrued in translation. There was at least one inaccurate translation into Spanish that resulted in missing data for the from intended question from 12 countries. Lastly, the information was collected through self-report and hence may not have reflected actual practice. Although national ITAGs appear to be valued and have a strong global presence, the credibility of the group lies in true independence from the government. There appears to be overlap between government employees and core members on some ITAGs. While it is important to have a close relationship between the government, who is generally responsible for the final immunization policy and its implementation, and the national ITAG, it is crucial that government representatives are not core members of the group who participate in making final recommendations to maintain the independence and credibility of the ITAG. There is a need for clear definitions and general guidelines on national ITAGs outlining their mandates and examples of ideal modes of functioning.

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