Let's begin by examining the 2010-2020 National Adult Immunization Plan's current schedule of recommended and approved vaccines for adults or the advisory committee on Immunization Practices Recommended Immunization 2014 schedule for adults aged 19 years or older in the United States.

The stated goals of the CDC's National Adult Immunization Plan for the year 2020 are as follows:

#1  to strengthen the adult immunization infrastructure

#2 improve access to adult vaccines

#3 increase community demand for adult immunizations

#4 foster innovation in adult vaccine development and vaccination related technologies.

However since 2010 when the National Adult Immunization Plan was first introduced efforts to improve adult immunization have been in their own opinion disappointing necessitating the issuance of the

(What follows is my own "edited for brevity" draft of the CDC's 2015 "Executive Summary" Italics and bold are mine not theirs)

"Vaccination is considered one of the most important public health achievements of the 20th century and continues to offer great promise in the 21st century. Vaccines save lives and improve the quality of life by preventing serious diseases and their consequences.  However, the benefits of vaccines are not realized equally across the U.S. population.  Adult vaccination rates remain low in the United States, and significant racial and ethnic disparities also exist.

"The US Department of Health and Human Services National Vaccine Plan (NVP), released in 2010, is a road map for vaccines and immunization programs for the decade 2010-2020.  While the NVP provides a vision for improving protections from vaccine preventable diseases across the lifespan, vaccination coverage levels among adults are not on track to meet Healthy People 2020 targets.  The National Vaccine Advisory Committee and numerous stakeholder groups have emphasized the need for focused attention on adult vaccines and vaccinations.  The National Adult Immunization Plan (NAP) outlined here results from the recognition that progress has been slow, and there is a need for a national adult immunization strategic plan.

"The NAIP is intended to facilitate coordinated actions by federal and non-federal partners to protect public health and achieve optimal prevention of infectious diseases and their consequences through vaccination of adults.  The NAIP includes indicators to draw attention to and track progress against core goals. These indicators will measure progress against set standards and inform future implementation and quality improvement methods"

And so to accomplish the stated goals of the "strategic plan" instituted in 2015 the National Vaccine Advisory Committee was created  and members of that Committee are listed in Appendix #1 which include but are not limited to:

CDC, FDA, HHS, IOM, NIH along with many other lesser known Federal public health agencies various federal bureaucracies including the US Department of Defense, Homeland Security, Dept of Veterans Affairs, Dept of Justice State, Federal and local public health agencies and governments.

Non-governmental "stakeholders" listed on the NVAC are:

"Vaccine industry, academia/research organizations, health care providers, health care systems, community immunizers, professional associations, payers and plans, employers, foundations, community and patient advocacy organizations, philantrophic organizations and the general public". 

(Webster defines "conspire" thus: "to work together for any purpose or effect")

(Webster defines "conspiracy" thus: "a conspiring group")

(Would Webster define the "strategic Plan stakeholders" as a conspiracy?)

And so as the first year of the NAIP's "strategic plan" 2015 comes to an end what have they tried and more importantly what have they accomplished.  First what they tried.

1. a) There was a strong recommendation of the CDC that any adult most specifically parents, grandparents, close family adult relatives such as uncles and aunts be vaccinated with the DPaT vaccine ostensibly to create a "protective cocoon" to prevent an newborn infant or someone unvaccinated because their immune system is compromised from Pertussis better known as "whooping cough".  As far as I can determine the success of the "cocooning" process remains controversial  as evidenced by the following article from Reuters:

So let's call that effort to "guilt" adults into voluntary vaccinating to protect newborn infants in their family a "wash" as there is no evidence that vaccination of adults increased by any measureable standard.

1. b) The CDC continued their annual albeit more aggressive effort to require flu vaccines for hospital care employees with some hospitals requiring administrative personnel having no contact with patients threatened with losing their employment if they refuse the flu vaccine.  Anyone refusing the flu vaccine were required to wear a surgical type mask on their daily rounds thereby making them easily identified to patients and peers they were potential carriers of the flu.

The concerted effort to mandate annual flu vaccines for thousands of hospital or health care employees has had some measure of success however there was some organized resistance by employees that refused the vaccine preferring to wear the mask instead.  I suspect the numbers refusing the vaccine may grow should they suffer any small not uncommon reaction to the vaccine coupled with experiencing the reported failure of the vaccine to protect them as it is reported to do year after year.

1. c) In 2014 in NYC a proposal was raised by local politicians that taxi cab drivers be required to submit proof of receiving annual flu vaccine when they apply to renew their license to drive a taxi in NYC under the pretense that passengers in the confined space of a taxicab would be at higher risk of the flu if the driver was not vaccinated.  This attempt to force taxicab drivers may be a "trial balloon"  meaning  if it works  it can then be argued that adults who work in any close quarters or share elevators in high-rise buildings should also be vaccinated.

In any event  after five years 2010 through 2015 the accomplishments of the "wide-ranging" members of the National Vaccine Advisory Committee to meet the goals expected in 2020 of the National Vaccination Plan have by their own standards been rather disappointing.

And so beginning with the establishment of the "strategic" National Adult Immunization Plan (NAIP) in 2015 there are signs that a highly renewed energized effort to achieve the 2020 goals of the National Vaccine Plan is underway.

Consider:

In 2015 there has been a determined effort by federal and local public health agencies and various government "stakeholders" to seek elimination of "opt-out exemptions" for parents in many States which in retrospect may be a pre-emptive measure to ensure adults will have no "opt-out" exemptions when the NVP targets adults in the year 2020.

In 2015 Congress passed HR 6 known as the "21st Century Cares Act" by an approval vote of 344-77 which seeks to increase funding for the National Institutes of Health by nine billion dollars and asks the Food and Drug Administration to accelerate the rate of media innovations allowing the FDA to lower licensing standards for testing of experimental drugs and biological products a category that includes vaccines thereby allowing pharmaceutical companies to avoid large, case controlled clinical trials to evaluate safety and effectiveness. 

(The NIH, FDA and pharmaceutical industry are all identified as "stakeholders" in the "strategic plan.)

In 2015 the following observations were reported by the Canary Party website which was reprinted on the Age of Autism site:

"The vaccine industry is currently estimated to be a $30 billion dollar per year industry, with some projecting it will be a $100 billion dollar per year industry by 2020.  Many believed this is an absurd prediction until it became clear that the industry was not planning on increasing revenue in such a short period of time by introducing new products, but rather by compelling vaccine uptake in greater numbers and in groups that have never had mandates before.  In fact, 2015 saw more than 100 bills introduced nationwide to increase vaccine sales, not just for children and members of the military, but now for adults in the civilian world.

The veterans affairs funding bill, which has passed the Senate and is now in the House, may be one of those measures.

Concerns that U.S. military veterans may be forced to comply with the new Adult Immunization Plan began to spread in November, when Nevada Senator Dean Heller's bill, S1203 .. a bill to amend title 38, United States Code .. to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing of the Department of claims for disability compensation, and for other purposes, passed the Senate.  A section of the bill regarding immunizations, added by special interest groups while the bill was in committee, is worded so it could be used in the future to make rules that would penalize veterans for failure to comply with recommended vaccinations.

(The Department of Defense and the Department of Veterans Affairs are identified as "stakeholders" in the "strategic plan")

In 2015 professors James G. Hodge and Doug Campos-Outcalt both having called for "ways to limit Presidential candidates speech about a link between vaccines and autism suggesting that "vaccine manufacturers should sue candidates for defamation if candidates finger particular vaccines.

(Academia  (professors Hodge and Campos-Outcalt) are identified as "stakeholders" and it should also be noted the media has avoided any further questions directed towards Presidential candidates most notably Donald Trump and Dr. Ben Carson when both refused to retract their public concerns regarding the number and timing of present vaccine schedule for children).

In any event in my humble opinion the single most frightening statement in the National Adult Immunization "strategic" Plan going forward is:

"The NAIP also aims to leverage the unique opportunity presented by the implementation of the Affordable Care Act"

This statement to me is the equivalent of a veiled threat raising the following concerns:

1. a)  Does the "unique opportunity" presented by the implementation of the Affordable Care Act threaten adults no vaccinations no health care coverage?

Is it too far fetched to imagine the "wide range" of "strategic plan stakeholders" such as Federal, State, local representatives, public health agencies and bureaucracies, pharmaceutical advertising campaigns working in concert with a compliant main stream media demanding to know:

"Why should the Affordable Care Act for which everyone is now paying provide coverage for adults, seniors and veterans .. who refuse to comply to the approved and recommended adult immunization schedule should they eventually require medical treatment for a vaccine "preventable disease"?

1. b)  Does the "unique opportunity" presented by the ACA threaten employers as well as their employees:  No vaccinations no job?

Is it to far fetched those very same "wide-ranging strategic plan stakeholders" citing the economic benefits of protecting our nation's economy while greatly improving the "cost efficiency" of corporations as well a protecting the health of their employees by requiring all corporations be monitored to assure the corporation's vaccine compliance rate meets the goals established by the National Adult Immunization program .. now empowered to levy heavy financial penalties on any corporation that fails to meet the NAIP goals by 2020?

Too many questions remain unanswered but the threat  as I see it is real.  They have established a plan and there is no doubt they intend to reach their stated goals by 2020:

#1 .. to strengthen the adult immunization infrastructure

#2 .. improve access to adult vaccines

#3 .. increase community demand for adult immunizations

#4 .. foster innovation in adult vaccine development and vaccination related technologies.

Hopefully I have overstated the lengths the "stakeholders" are prepared to go to achieve their goals but as the year 2016 begins our country should none-the-less remain vigilant going forward finding strength in Thomas Paine's words like those of Benjamin Rush also written over 200 years ago in his essay, "The Crisis":

"These are times that try men's souls .. The summer soldier and the sunshine patriot will in this crisis, shrink from the service of their country, but he that stands by it now, deserves the love and thanks of man and woman.  Tyranny, like hell, is not easily conquered, yet we have this consolation with us, the harder the conflict, the more glorious the triumph".