Methods for developing evidence-based recommendations by the Advisory Committee on Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC)

Article from Vaccine, Volume 29, Issue 49, 15 November 2011, Pages 9171-9176. During the October 2010 ACIP meeting, the ACIP voted to adopt a new framework for developing evidence-based recommendations that is based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Key factors considered in the development of recommendations include the balance of benefits and harms, type of evidence, values and preferences of the people affected, and health economic analyses. Category A recommendations will be made for all persons in an age- or risk-factor-based group. Category B recommendations will be made for individual clinical decision making; category B recommendations do not apply to all members of an age- or risk-factor-based group, but in the context of a clinician–patient interaction, vaccination may be found to be appropriate for a person. Evidence tables will be used to summarize the benefits and harms and the strengths and limitations of the body of evidence. The new evidence framework will enhance the ACIP's decision-making process by making it more transparent, consistent and systematic.