The National Vaccine Advisory Committee (NVAC) was established by the National Childhood Vaccine Injury Act of 1986 to achieve optimal prevention of human infectious diseases through immunization and to achieve optimal prevention against adverse reactions to vaccines. There is wide consensus, however, that NVAC has not achieved its potential. This report seeks to identify the reasons the committee has not had a greater impact and suggests strategies to improve its effectiveness. The authors conducted a review of the literature on advisory committees, reviewed recommendations made by NVAC since 1998 with a focus on their characteristics, and conducted a series of interviews with key informants. Among the report’s findings: NVAC should proactively seek input regarding priority vaccine and immunization issues. Its recommendations should be written in a manner specific enough to be easily actionable, and it should monitor the status of those recommendations on a regular basis. Finally, it should think more strategically about its dissemination efforts, clearly delineating the intended audiences and identifying innovative and effective ways to reach them.