At a glance
ACIP considers evidence for vaccine recommendations using an explicit evidence-based method based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach and the Evidence to Recommendations (EtR) framework.
About GRADE
These resources provide guidance and additional learning materials for using the GRADE approach.
- ACIP GRADE Handbook
The ACIP handbook for developing evidence-based recommendations provides guidance to the ACIP workgroups on how to use the GRADE approach for assessing the certainty of evidence.
- GRADE Working Group web site
The GRADE working group page provides a comprehensive overview of the GRADE approach, including answers to frequently asked questions.
GRADE Evidence Tables
GRADE Evidence Tables that accompany ACIP recommendations are found here: GRADE Evidence Tables – Recommendations in MMWR | ACIP | CDC
About Evidence to Recommendation
Key factors considered in development of recommendations include balance of benefits and harms, type or quality of evidence, values and preferences of the people affected, and health economic analyses.
- An Evidence to Recommendation (EtR) framework is used to summarize these key factors:
- Evidence tables are used to summarize the benefits and harms and the strengths and limitations of the body of evidence.
Evidence to Recommendation frameworks
Evidence to Recommendation frameworks that accompany ACIP recommendations are found here: Evidence to Recommendations Frameworks | ACIP | CDC
- Lee G, Carr W, ACIP Evidence-Based Recommendations Work Group. Updated Framework for Development of Evidence-Based Recommendations by the Advisory Committee on Immunization Practices. MMWR. 2018;67(45):1271-2.
- CDC. New Framework (GRADE) for Development of Evidence-Based Recommendations by the Advisory Committee on Immunization Practices. MMWR. 2012;61(18):327.
- Matysiak-Klose D, Ahmed F, Duclos P, Falck-Ytter Y, Forland F, Houweling H, et al. Report on the 1st international workshop on procedures for the development of evidence-based vaccination recommendations, Berlin, Germany, 22-23 November 2010 – Vaccine 2012;30(14):2399-404.
- Ahmed F, Temte JL, Campos-Outcalt D, Schünemann HJ, ACIP Evidence-Based Recommendations Work Group. Methods for developing evidence-based recommendations by the ACIP of the CDC – Vaccine 2011;29(49):9171-6.