NFID ACIP Liaison Report
NFID liaisons to ACIP and ACIP Work Groups must fulfill all responsibilities stated in the NFID policy (https://www.nfid.org/about-nfid/policies-bylaws/policy-on-advisory-committee-on-immunization-practices-acip-and-work-group-representation/). Reports should be submitted in a timely manner, at least annually.
Name
*
First Name
Last Name
Work Group:
*
Date of Report:
*
-
Month
-
Day
Year
Date
1. Are you currently representing any other organization besides NFID?
*
Yes
No
If yes, list other organization(s):
2. List any topics of concern (e.g., practical issues that may impact implementation of vaccine recommendations, access and coverage, shared decision making, costs):
*
3. Describe any potential opportunities that exist for NFID involvement (e.g., collaboration with partner organizations, future education/webinar topics):
*
4. Other comments (e.g., possible impacts to NFID activities that may impact planning):
5. Are you interested in continuing to represent NFID for another 1-year term?
*
Yes
No
Submit
Should be Empty: