Walter A. Orenstein, MD

Associate Director, Emory Vaccine Center
Director, Emory Program for Vaccine Policy and Development
Formerly Director
of the National Immunization Program at the Centers
for Disease Control and Prevention (CDC), Dr. Orenstein joined
the Emory University
School of Medicine in March 2004 as
Director of a new Emory Program for Vaccine Policy and
Development and as Associate Director of the Emory Vaccine
Center.
Dr. Orenstein retired from his 26-year career at CDC where he led the National Immunization Program, a $1.6
billion
effort with more than 450 staff, dedicated to reducing
vaccine preventable disease burdens around the world including
elimination of some of the greatest causes of childhood
mortality and disability. Dr. Orenstein’s primary
appointment is in the Division of Infectious Diseases in
the Department of Medicine in the Emory
University School of Medicine. He also holds faculty appointments in Pediatrics
and in the Departments of International Health and Epidemiology
in Emory’s Rollins School of Public Health.
Dr. Orenstein is a member of the International Editorial
Board for the journal Vaccine. Along with Stanley Plotkin,
Dr. Orenstein co-edits Vaccines, 4th edition, a 1600 page
volume with more than 125 contributors that is the leading
textbook in the field. He is a fellow of the American Academy
of Pediatrics, the Infectious Diseases Society of America,
and the Pediatric Infectious Diseases Society. He has served
on the Council of the Pediatric Infectious Diseases Society,
chaired its publications committee, and is currently the
Secretary/Treasurer.
Dr. Orenstein’s many honors and awards include the
Commendation Medal and the Meritorious Service Medal from
the U.S. Public Health Service; the Surgeon General’s
Exemplary Service Medal; the Excellence in Public Health
Award of the Association of State and Territorial Health
Officials; the Distinguished Service Award from the Pediatric
Infectious Diseases Society; and in 2003, the Excellence
in Public Service Award of the American Academy of Pediatrics.
Biography
During Dr. Orenstein’s tenure at
the National Immunization Program, he led successful efforts
to combat and markedly reduce the occurrence of once common
childhood diseases, including measles, rubella, mumps,
meningitis from Haemophilus influenzae type b (Hib), varicella,
and invasive pneumococcal disease. The Immunization Program
also made major contributions: protecting adults from vaccine-preventable
diseases through eliminating barriers to vaccination and
developing new vaccine strategies, expanding vaccine safety
efforts, improving risk communication, and promoting the
use of immunization registries.
Dr. Orenstein received
his bachelor’s degree at The
City College of New York and his medical degree from the
Albert Einstein College of Medicine in 1972. He completed
an internship and a residency in pediatrics at the University
of California, San Francisco, followed by a fellowship
in infectious diseases at the University of Southern California
Medical School and a residency in preventive medicine at
the CDC. He has served in leadership roles within the CDC’s
immunization program since 1982, and from May1993 through
January 2004, had been Director of the National Immunization
Program. He has served as a consultant to the World Health
Organization and to the Pan American Health Organization
for programs in polio eradication, measles control, and
smallpox eradication in India, Brazil, Argentina and Peru.
Dr. Orenstein has served as an Assistant Surgeon General
of the U. S. Public Health Service, and he currently serves
as chairman of the World Health Organization’s Technical
Consultative Group on the Global Eradication of Poliomyelitis.
He was a member and rapporteur of the Pan American Health
Organization’s Technical Advisory Group on Vaccines
and Immunization and served as the CDC liaison member to
the National Vaccine Advisory Committee for more than 14
years, having played a major role in development of critical
immunization policy documents such as “The measles
epidemic: the problems, barriers and recommendations”(JAMA
1991;266:1547-1552). This article became the blueprint
for today’s immunization program including Federal
support for immunization infrastructure, an immunization
coverage measurement system for program accountability,
and the critical role of research in fostering immunization
improvements. During the same period as Dr. Orenstein served
on the National Vaccine Advisory Committee, he also served
as CDC liaison to the American Academy of Pediatrics Committee
on Infectious Diseases (COID), the major immunization policy
making body for private pediatricians.
Major policies
Major policies adopted during Dr. Orenstein’s
tenure at CDC include recommendations for: 1) a second
dose of measles, mumps, rubella (MMR) vaccine for all children,
2) universal vaccination of children against Haemophilus
influenzae type b, hepatitis B, varicella, and invasive
pneumococcal disease, and 3) annual vaccination of all
50-64 year old adults and 6-23 month old children against
influenza. Dr. Orenstein led the efforts to implement the
Vaccines for Children Program (VFC) an innovative entitlement
program that today overcomes financial barriers to vaccine
access for approximately 40% of the nation’s children
and allows an advisory committee of experts, the Advisory
Committee on Immunization Practices (ACIP), to see its
recommendations financed automatically without having to
go through the traditional appropriations process.
Dr. Orenstein also fostered development of a major effort
to address vaccine safety concerns including overseeing
the Vaccine Adverse Event Reporting System (VAERS), a passive
adverse reaction reporting system, the Vaccine Safety Datalink
which includes researchers from eight Health Maintenance
Organizations (HMOs) covering more than 2% of the US population,
special investigations such as the relationship between
rhesus rotavirus vaccine and intussusception, and independent
assessment of the available evidence on selected adverse
events through the Institute of Medicine. During his tenure
as leader of the nation’s immunization program, Dr.
Orenstein helped develop a large international immunization
program that plays a major role in eradicating polio, reducing
measles mortality, and introducing new vaccines into worldwide
programs.
Prior to taking over direction of the nation’s immunization
efforts, Dr. Orenstein was a major driving force in improving
the epidemiologic assessment of vaccine effectiveness,
having co-authored numerous papers on the effectiveness
of various vaccines in a post-licensure setting including
one of the critical reviews of different methods that could
be used to assess effectiveness during observational studies.
Another major focus of his work was on understanding the
barriers to elimination of indigenous measles in the United
States and strategies to overcome them.

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