ACIP: Vaccine Recommendations

The Advisory Committee on Immunization Practices (ACIP) is a group of medical and public health experts that provides advice to the CDC on how to use vaccines to control diseases in the United States. ACIP recommendations form the basis of the U.S. immunization schedule.

Who Serves on ACIP

ACIP consists of 15 voting members selected for their expertise:

• Experts in vaccines and immunology: Academic researchers, clinicians
• Representatives: From organizations like AAP, AAFP, IDSA
• Consumer representatives: Public members without industry ties
• Ex-officio members: From FDA, NIH, HHS, Indian Health Service

Members serve 4-year terms and meet three times annually (more during emergencies).

Conflict of Interest Rules

How Evidence Is Evaluated

ACIP uses the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework:

• Type of evidence: Randomized trials vs. observational studies
• Quality of evidence: Risk of bias, consistency, directness
• Benefits vs. harms: Balance of advantages and risks
• Values and preferences: Patient and provider preferences
• Resource use: Cost-effectiveness considerations

The Voting Process

1. CDC presents disease burden and vaccine data
2. Work Group presents evidence review and recommendation options
3. Public comments are heard
4. Committee discusses questions
and asks
5. Vote taken on each recommendation category
6. Recommendations published in MMWR

From Recommendation to Policy

ACIP recommendations become policy when:

• Recommendations are published in MMWR (Morbidity and Mortality Weekly Report)
• CDC adopts recommendations as official policy
• Recommendations are incorporated into the Immunization Schedule
• Insurance coverage is required under the Affordable Care Act

Sources & Citations

• CDC: ACIP Home
• CDC: ACIP Meeting Information