Chapter 1: Introduction

Summary

The U.S. Advisory Committee on Immunization Practices (ACIP) provides expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) and the Secretary of the Department of Health and Human Services (HHS) on the use of vaccines and related agents for control of vaccine-preventable disease in the U.S. civilian population.

Information on the charter, structure, role, processes, procedures, and membership of the ACIP are available at General Committee-Related Information.

The ACIP unanimously voted during the October 2010 meeting to adopt the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for developing evidence-based recommendations1. The GRADE approach provides a framework for assessing the certainty (i.e., quality or confidence) of the evidence and moving from evidence to decision making (i.e., recommendations).

This handbook provides guidance to the ACIP workgroups on how to use the GRADE approach for assessing the certainty of evidence. The following sections include a brief overview of evidence retrieval and synthesis process to contextualize where the GRADE evidence assessment fits into the guideline development process.

Since 2010, there have been many advancements in the methods used to review the evidence and assess its certainty. This document replaces the 2013 version to include these updates and practical examples of all stages of the process.

Please refer to the ACIP Evidence to Recommendation User’s Guide available at Evidence-Based Recommendations—GRADE for guidance on moving from evidence to decision-making, including whether GRADE should be used to address a policy question.

Resources and tools for implementing ACIP recommendations are available at Vaccines & Immunizations.