Skip directly to site content Skip directly to search


Español  Other Languages


Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People
 Search
		×
			Vaccines site
			Vaccines site
				All CDC
				Submit
			For a full list of topics:A-Z Index
			Advanced Search
		Advanced Search


Advisory Committee on Immunization Practices (ACIP)








Grading of Recommendations Assessment, Development and Evaluation (GRADE) for use of PCV13 among adults ≥65 years old						Print
																Related Pages
										On This Page
			IntroductionMethodsResultsGRADE SummarySummary
		
Printer friendly version of this page [11 pages]
Introduction
On August 13, 2014, ACIP recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13) in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults aged ≥65 years. At the time, the recommendation was warranted because PCV13-type disease among adults was assessed to be an important public health problem. However, in the long-term ACIP recognized that continued reductions in PCV13-type disease due to indirect effects from pediatric PCV13 use might limit the utility of this recommendation. Therefore, ACIP proposed that the recommendation for routine PCV13 use among adults ≥65 years old be re-evaluated in 2018 and revised as needed. As part of ACIP’s process, a systematic review and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) of the evidence for PCV13 use among adults ≥65 years old was conducted. The policy question was “Should PCV13 be administered routinely to all immunocompetenti adults aged ≥65 years in the context of indirect effects from pediatric PCV use experienced to date?”
Introduction Footnote
i Immunocompetent defined in discussion as adults without an immunocompromising condition (chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, human immunodeficiency virus, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease, or other hemoglobinopathies), CSF leak, or cochlear implant.
**Top of PageMethods
Evidence of benefits and harms for the routine use of PCV13 among adults aged ≥65 years old was reviewed based on the GRADE approach. GRADE was adopted by ACIP in 2010 as the framework for evaluating the scientific evidence that informs recommendations for vaccine use. The benefits and harms considered as critical outcomes in GRADE are listed in Table 1. The evidence type for each critical outcome was derived through a review of study design, risk of bias, inconsistency, indirectness, and imprecision.
The population was adults aged 65 years and older who do not have an immunocompromising conditionii, cerebrospinal fluid (CSF) leak, or cochlear implant; the intervention was PCV13 in series with PPSV23 versus PPSV23 alone, in the context of indirect effects; and the outcomes were prevention of invasive pneumococcal disease (IPD), pneumonia, mortality, and PCV13 safety.
Scientific literature was searched in Medline, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, and clinicaltrials.gov between January 1, 2014 and July 3, 2018. Search terms are listed in the Appendix. This search identified 6,788 references.
The primary reviewer screened title and abstracts. Articles were included if they provided data on vaccination with PCV13 and included primary data on outcomes of interest among ≥65 years old who do not have an immunocompromising conditionii. Efforts were made to obtain additional published studies by cross-referencing included studies’ reference lists. Additionally, unpublished studies were sought out by consulting with vaccine manufacturers and subject matter experts. After title and abstract screening, 364 studies were identified for in-depth review. Of these, 344 were among other populations, did not use PCV13, or did not evaluate an outcome of interest. Additionally, observational studies were excluded if the coverage in the population was <20% or if the indirect effects were dissimilar to those experienced in the U.S. (i.e. low pediatric vaccine coverage, no pediatric PCV13 program, low-income country). Randomized control trials (RCT) that examined the safety outcome were excluded if PCV13 was co-administered with another vaccine, because SAEs could not be attributed to PCV13, and if there was no PPSV23 or placebo comparison group. This left 20 studies for the GRADE analysis [1-20].
Methods Footnote
ii Immunocompromising conditions include: chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, HIV, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease, or other hemoglobinopathies.
Table 1: Critical Outcomes Included in GRADE
Critical outcomes included in GRADE
Outcomes
Importance
TypePCV13 efficacy, effectiveness, and impact on PCV13-type IPD
Critical
BenefitsPCV13 efficacy, effectiveness, and impact on PCV13-type non-bacteremic pneumococcal pneumonia (NIPP)
CriticalPCV13 efficacy, effectiveness, and impact on mortality associated with PCV13-type disease
CriticalSerious adverse events including deaths associated with PCV13
Critical
Harms**Top of Page
Results
Table 2: PCV13 efficacy, effectiveness, and impact on PCV13-type IPD (critical outcomes)

PCV13 efficacy, effectiveness, and impact on PCV13-type IPD
Study
Population
Method
Outcome
VE
(95%CI)Bonten[1]*
Dutch adults ≥65 years old
Community Acquired Pneumonia Immunization Trial in Adults (CAPiTA) RCT (PCV13 vs placebo) (n=84,496)
1st episode of PCV13-type IPD
75%
(41, 91)Gessner[2]*
Dutch adults ≥65 years old
CAPiTA RCT (PCV13 vs placebo) (n=84,496)
All episodes of PCV13-type IPD using modified intent-to- treat (mITT)
76%
(48, 89)Pilishvili[3]
US adults ≥65 years old
Case-control; Active Bacterial Core Surveillance (ABCs) IPD cases and age- and zip code matched population-based controls (n=1,530)
PCV13-type IPD
59%
(11, 81)Pilishvili[4]
US adults ≥65 years old
Case-control; ABCs IPD cases enrolled in Medicare part B matched to controls on age group, census tract, and length of enrollment in part B (n=10,851)
PCV13-type IPD
47%
(4, 71)% change
(95%CI)Pilishvili[5]
US adults ≥65 years old
Pre-post analysis comparing incidence in 2013-14 vs 2016-17
PCV13-type IPD
-13%
(-26, 2)Table 2 Footnotes
* Pfizer funded studies
**Top of PageTable 3: PCV13 efficacy, effectiveness, and impact on pneumonia (critical outcomes)
PCV13 efficacy, effectiveness, and impact on pneumonia
Study
Population
Method
Outcome
VE
(95%CI)Bonten[1]*
Webber[6]*
Gessner[2]*
Dutch adults ≥65 years old
CAPiTA RCT (PCV13 vs placebo) (n=84,496)
1st episode of PCV13-type pneumonia
45%
(14, 65)All episodes PCV13-type pneumonia excluding IPD
43%
(12, 63)All episodes clinically confirmed pneumonia
8%
(1, 15)McLaughlin[7]*
U.S. adults ≥65 years old
Louisville cohort study[8] nested test negative design case-control; non-PCV13-type pneumonia as controls (n=2,034)
PCV13-type pneumonia
71%
(6, 91)iiiPCV13-type pneumonia excluding IPD
70%
(4, 91)Prato[9]*
Italian adults ≥65 years old
Test-negative design case-control; non-PCV13-type pneumonia as controlsiv (n=186)
PCV13-type pneumonia
38%
(-131, 89)Lessa[10]
U.S. adults ≥65 years old enrolled in Medicare part A/B
Cohort; discrete time survival model stratified by influenza vaccine receipt and influenza season (n=24,121,625)
All-cause pneumonia defined by ICD codes
6–11%
(4,8; 9,13)% change
(95%CI)Swerdlow[11]*
U.S. adults ≥65 years old
Louisville cohort study[8] pre-post analysis comparing incidence in June 2014-May 2015 vs June 2015-May 2016
PCV13-type pneumonia
-32%
(-8, -49)Gierke[12]
US adults ≥65 years old
Surveillance for Non-Invasive Pneumococcal Pneumonia (SNiPP) pre-post analysis comparing incidence in 2013-14 vs 2015-16
Non-Invasive Pneumococcal Pneumonia
-35%
(-14, -49)vTable 3 Footnotes
* Pfizer funded studies
iii In the primary analysis, the controls were defined as all non-PCV13-type pneumonia. In a sensitivity analysis, controls were defined as non-PCV13-type *pneumococcal* pneumonia (VE 69% [-47, 93]).
*ivS. pneumoniae* confirmed in nasopharyngeal, sputum, bronchoalveolar-lavage, or sterile site on polymerase chain reaction (PCR) or culture
v No change observed from 2014–2016 (most recent year of data), p=0.5.Table 4: PCV13 efficacy, effectiveness, and impact on mortality (critical outcomes)
PCV13 efficacy, effectiveness, and impact on mortality
Study
Population
Method
Outcome
VE
(95%CI)CAPiTA[1]*
Dutch adults ≥65 years old
RCT (PCV13 vs placebo) (n=84,496)
PCV13-type disease mortality
0%
(-1280, 93)All-cause mortality during 4 year follow up period
-0.03%
(-5, 5)% change
(95%CI)Pilishvili[5]
US adults ≥65 years old
Pre-post analysis comparing incidence in 2013-14 vs 2016-17
Death during hospitalization for PCV13-type IPD
2%
(-30, 49)Table 4 Footnotes
* Pfizer funded studiesTable 5: PCV13 Safety — serious adverse events (SAEs) reported in randomized control trials (RCT)
PCV13 Safety — serious adverse events (SAEs) reported in randomized control trials (RCT)
Study
Population
Study Design
Observation period
% SAE reported among PCV13 only group
# vaccinated with PCV13
% SAE reported among control group (placebo or PPSV23)
# in the control groupBonten[1]vi*
Dutch adults ≥65 years old
RCT (PCV13 vs placebo)
1 month
0.8%
42,237
0.7%vii
42,255Juergens[13]*
South African adults ≥65 years old
RCT (PCV13 vs PCV13 without aluminum phosphate vs PPSV23) open-labelviii
43 days
0.6%ix
309
0.3%
301Shiramoto[14]*
Japanese adults ≥65 years old
RCT (PCV13 vs PPSV23)
43 days
0.3%x
382
0%
382Table 5 Footnotes
* Pfizer funded studiesvi Safety sub-study (n=2,011) groups followed for 6 months after vaccination: SAE among PCV13 7% vs placebo 6%, p=0.41vii No statistically significant difference in all SAEs combined, p=0.61. Safety difference noted were: 23 patients who received PCV13 vs 7 patients who received placebo had general disorders and administration site conditions (p=0.003); 12 patients who received PCV13 vs 2 patients who received placebo had non-cardiac chest pain and 5 patients who received PCV13 vs 1 patients who received placebo had “events of chest pain” though overall 72 patients who received PCV13 v 74 patients who received placebo had cardiac disorders (p=0.9)viii Additional doses of PCV13 given to those who were part of the initial group who received PCV13; among those who received PCV13 again 1 year later (n=136) SAE 2.2% including 1 death, SAEs deemed not related to the vaccine; among those who received PCV13 again (2 years after previous PCV13 and 1 year after PPSV23) (n=105) SAE 1.9% including 1 death, SAEs deemed not related to the vaccine.ix All SAEs deemed not related to the vaccinex 1 SAE which was deemed not related to the vaccineTable 6: PCV13 Safety — serious adverse events (SAEs) reported in observational studies
PCV13 Safety — serious adverse events (SAEs) reported in randomized control trials (RCT)
Study
Population
Study Design
Observation period
% SAE among PCV13 only group
# vaccinated with PCV13
% SAE among control group (placebo or PPSV23)
# in the control groupDurando[15]*
Italian adults ≥70 years old
Cohort study (voluntary enrollment after PCV13 vaccination)
6 months
0.1%xi
871
NA
NAHaber[16]
US adults ≥65 years old
Passive surveillance through the Vaccine Adverse Events Reporting System (VAERS)
—
<0.01%xii
~9,269,000xiii
NA
NAJackson[17]
US adults 55-74 years old
Observational cohort for PCV13 SAE (designed as RCT with varying number of PCV13 doses)
6 months
2.3%xiv
883
NA
NAShiramoto[18]*
Japanese adults ≥50 years old
Cohort study, open-label
1 month
0%
271
NA
NATinoco[19]*
Mexican adults ≥65 years old
Cohort study, open-label
1 month
1.2%xv
161
NA
NATseng[20]
US adults ≥65 years old
Cohort comparing PCV13 vs PPSV23
6 months
1.2%-5.8%
5,055
2.4%-5.5%
1,124Table 6 Footnotes
* Pfizer funded studiesxi 2 SAEs, 1 of which occurred at 29 days post vaccination and was deemed to be possibly related to PCV13. Less than 40% completed 6 month safety follow-up.xii 14 deaths and 138 other SAEs, percentage calculated as 152/9,269,000=0.00164%xiii Approximate denominator calculated using Pfizer reported 23% PCV13 coverage among adults ≥65 years old at the end of this study (December 2015)*40,300,000 ≥65 years old population from the 2010 U.S. Census=9,269,000xiv Overall 27 SAEs among 25 patients; all of which researches deemed not to be vaccine related. Among 883 patients, 1,117 doses of PCV13 so SAE rate=27/1,117=2.3%xv 2 SAEs which were both deemed not related to the vaccineGRADE Summary
GRADE Summary
Outcome
Design
# studies —[references]
Initial Evidence Typexvi
Risk of Bias
Inconsistency
Indirectness
Imprecision
Evidence TypexviBenefitsPCV13-type invasive pneumococcal disease (IPD)
RCT
1 — [1, 2]
1
Not serious
N/A
Seriousxvii
Serious
3PCV13-type pneumonia
1 —[1, 2, 6]
1
Not serious
N/A
Seriousxvii
Serious
3Mortality from PCV13-type disease
1 — [1]xviii
1
Not serious
N/A
Seriousxvii
Very serious
4PCV13-type IPD
Observational
3— [3-5]
3
Seriousxix
Not serious
Not serious
Very serious
4PCV13-type pneumonia
5 — [7, 9-12]
3
Very seriousxx
Very serious
Seriousxxi
Very serious
4Mortality from PCV13-type disease
1 — [5]
3
Seriousxxii
N/A
Not serious
Very serious
4HarmsSerious adverse events
RCT
3 — [1, 13, 14]
1
Seriousxxiii
Not Serious
Seriousxvii
—
3Observational
6 — [15-20]
3
Seriousxxiv
Not Serious
Not Serious
—
3xxvShow More
GRADE Summary Table Footnotes
xvi Evidence levels: 1) High, 2) Moderate, 3) Low, 4) Very Lowxvii Downgraded since the RCT (CAPiTA) was among a population with low PCV13 indirect effects from pediatric PCV13 use and low PPSV23 coveragexviii Mortality was not a primary end-point in this RCT, and there were very few deaths caused by PCV13-type diseasexix Potential unmeasured confounding, misclassification of vaccine status, and indirectness for impact studies that examined the population level impactxx In addition to the risk of bias for the IPD outcome, the pneumonia outcome studies also had short observation periods and used non-specific outcomesxxi Two studies did not measure specific outcome of interest (i.e. PCV13-type pneumococcal pneumonia)xxii Active Bacterial Core surveillance only captures inpatient mortality or in the outpatient setting, deaths that occur very proximally to the diagnosis of IPDxxiii Modified blinding procedures, open label, and short follow up periodxxiv Inadequate or no control/comparison groupxxv Upgraded since multiple observational studies with consistent results
Summary
In 2014, the GRADE conclusion was that PCV13 was efficacious in preventing PCV13-type disease in aged ≥65 years with an overall moderate level of evidence. Since 2014, there have been 16 studies (2 RCTs and 14 observational) added to the body of evidence. Observational studies are a lower evidence type in GRADE. However, the updated evidence continues to support that PCV13 is efficacious and effective for preventing invasive and non-invasive PCV13-type disease among adults aged ≥65 years. Additionally, there have been no concerning safety signals detected. In addition to safety and efficacy, the current policy question is “in the context of indirect effects from pediatric PCV13 use.” The indirect effects from pediatric PCV used reduced PCV13-type disease in older adults to all-time lows prior to 2014. Since 2014, PCV13 coverage among adults ≥65 years old steadily risen to 40% in 2017 [21]. Since the introduction of PCV13 for all adults aged ≥65 years, no impact on PCV13-type IPD at the population-level has been observed [5] and the data across studies that measure the impact on pneumonia have been inconsistent [11, 12].
At the June 2019 meeting, after reviewing the Evidence to Recommendation Framework including the GRADE analysis, ACIP voted to change the policy and recommended PCV13 based on shared clinical decision making for adults ≥65 years old who do not have an immunocompromising conditionii, cerebrospinal fluid (CSF) leak, or cochlear implant and who have not previously received PCV13. For more information see 2019 policy note: Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults ≥65 Years Old: Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP)[21].Appendix: Search Methods
Database, Strategy, run date, records
Database
Strategy
Run Date
RecordsMedline
(OVID)
1946-
(Pneumococcal ADJ5 Vaccin*)  OR (pneumococcus ADJ5 vaccin*) OR (pneumonia* ADJ5 vaccin*) OR PCV13 OR pneumovax OR PPSV23 OR prevnar* OR pnu-immune
AND
senior* OR aged OR older adult* OR elderly OR (over ADJ2 65) OR  (older ADJ2 65) OR >=65 OR =>65
7/3/2018
4407Embase
(OVID)
1947-
(Pneumococcal ADJ5 Vaccin*)  OR (pneumococcus ADJ5 vaccin*) OR (pneumonia* ADJ5 vaccin*) OR PCV13 OR pneumovax OR PPSV23 OR prevnar* OR pnu-immune
AND
senior* OR aged OR older adult* OR elderly OR (over ADJ2 65) OR  (older ADJ2 65) OR >=65 OR =>65
NOT
Pubmed/medline
7/3/2018
4822
-2707
duplicates
=2115
unique itemsCINAHL
(Ebsco)
(Pneumococcal N5 Vaccin*)  OR (pneumococcus N5 vaccin*) OR (pneumonia* N5 vaccin*) OR PCV13 OR pneumovax OR PPSV23 OR prevnar* OR pnu-immune
AND
senior* OR aged OR older adult* OR elderly OR (over N2 65) OR  (older N2 65) OR >=65 OR =>65

exclude Medline records
7/3/2018
122
-26
duplicates
=96
unique itemsCochrane Library
(Pneumococcal NEAR/5 Vaccin*)  OR (pneumococcus NEAR/5 vaccin*) OR (pneumonia* NEAR/5 vaccin*) OR PCV13 OR pneumovax OR PPSV23 OR prevnar* OR pnu-immune
AND
senior* OR aged OR older adult* OR elderly OR (over NEAR/2 65) OR  (older NEAR/2 65) OR >=65 OR =>65
NOT
PubMed:so
7/3/2018
198
-109
duplicates
=89
unique itemsClinicaltrials.gov
Pneumococcal Conjugate Vaccine OR pneumococcal polysaccharide vaccine OR PCV13 OR pneumovax OR PPSV23 OR prevnar* OR pnu-immune
7/3/2018
181References
Bonten MJ, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med 2015;372:1114–25. PubMed.
Gessner BD, Jiang Q, Van Werkhoven CH, et al. A public health evaluation of 13-valent pneumococcal conjugate vaccine impact on adult disease outcomes from a randomized clinical trial in the Netherlands. Vaccine 2019;37:5777–87. PubMed.
Pilishvili T, Almendares O, Xing W, et al. Effectiveness of pneumococcal vaccines against invasive pneumococcal disease (IPD) among adults >65 years old. Presented at the International Symposium on Pneumococci and Pneumococcal Diseases, Melbourne, Australia; April 15–19, 2018.
Pilishvili T, Almendares O, Nanduri S, et al. Evaluation of pneumococcal vaccines effectiveness against invasive pneumococcal disease (IPD) among U.S. Medicare beneficiaries ≥65 years old. Presented at the International Symposium on Pneumococci and Pneumococcal Diseases, Melbourne, Australia; April 15–19, 2018.
Pilishvili T, Gierke R, Xing W, et al. Changes in invasive pneumococcal disease (IPD) among adults following 6 years of 13-valent pneumococcal conjugate vaccine use in the U.S. Presented at the International Symposium on Pneumococci and Pneumococcal Diseases, Melbourne, Australia; April 15–19, 2018.
Webber C, Patton M, Patterson S, et al. Exploratory efficacy endpoints in the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA). Vaccine 2017;35:1266–72. Pub Med https://doi.org/10.1016/j.vaccine.2017.01.032.
McLaughlin JM, Jiang Q, Isturiz RE, et al. Effectiveness of 13-valent pneumococcal conjugate vaccine against hospitalization for community-acquired pneumonia in older US adults: a test-negative design. Clin Infect Dis 2018;67:1498–506. PubMed.
Ramirez JA, Wiemken TL, Peyrani P, et al. Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality. Clin Infect Dis 2017;65:1806–12. Pub Med https://doi.org/10.1093/cid/cix647.
Prato R, Fortunato F, Cappelli MG, Chironna M, Martinelli D. Effectiveness of the 13-valent pneumococcal conjugate vaccine against adult pneumonia in Italy: a case-control study in a 2-year prospective cohort. BMJ Open 2018;8:e019034. PubMed.
Lessa FC, Spiller M. Effectiveness of PCV13 in adults hospitalized with pneumonia using Centers for Medicare & Medicaid data, 2014–2017. Presented at the Advisory Committee on Immunization Practices meeting, Atlanta, GA; February 2019.
Swerdlow D. Incidence of community-acquired pneumonia in a US adult population. Presented at the Advisory Committee on Immunization Practices meeting, Atlanta, GA; October 2018.
Gierke R. Estimating impact of 13-valent pneumococcal conjugate vaccine on pneumococcal pneumonia among US adults. Presented at the Advisory Committee on Immunization Practices meeting, Atlanta, GA; October 2018.
Juergens C, de Villiers PJ, Moodley K, et al. Safety and immunogenicity of 13-valent pneumococcal conjugate vaccine formulations with and without aluminum phosphate and comparison of the formulation of choice with 23-valent pneumococcal polysaccharide vaccine in elderly adults: a randomized open-label trial. Hum Vaccin Immunother 2014;10:1343–53. PubMed.
Shiramoto M, Hanada R, Juergens C, et al. Hum Vaccin Immunother 2015;11:2198–206. >PubMed.
Durando P, Rosselli R, Cremonesi I, et al. Safety and tolerability of 13-valent pneumococcal conjugate vaccine in the elderly. Hum Vaccin Immunother 2015;11:172–7. PubMed.
Haber P, Arana J, Pilishvili T, Lewis P, Moro PL, Cano M. Post-licensure surveillance of 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ≥19years old in the United States, Vaccine Adverse Event Reporting System (VAERS), June 1, 2012–December 31, 2015. Vaccine 2016;34:6330–4. PubMed.
Jackson LA, El Sahly HM, George S, et al. Randomized clinical trial of a single versus a double dose of 13-valent pneumococcal conjugate vaccine in adults 55 through 74 years of age previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine 2018;36:606–14. PubMed.
Shiramoto M, Irie S, Juergens C, et al. Immunogenicity and safety of 13-valent pneumococcal conjugate vaccine when administered to healthy Japanese adults aged ≥50 years. An open-label trial. Hum Vaccin Immunother 2014;10:1850–8. PubMed.
Tinoco JC, Juergens C, Ruiz Palacios GM, et al. Open-label trial of immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine in adults ≥ 50 years of age in Mexico. Clin Vaccine Immunol 2015;22:185–92. PubMed.
Tseng HF, Sy LS, Qian L, et al. Pneumococcal conjugate vaccine safety in elderly adults. Open Forum Infect Dis 2018;5:1–8. PubMed.
Matanock A, Lee G, Gierke R, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults ≥65 years old: Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2019;68(46);1069–75.Top of Page
					View Page In:Print version		
					
							Last Reviewed:  November 21, 2019						Source: 	National Center for Immunization and Respiratory Diseases
					Facebook
        Twitter
        LinkedIn
        Syndicate homeACIP Home
Meeting Information
Committee Informationplus icon
Role of the ACIP in CDC’s Vaccine Recommendations
Charter
Economics Studies
Committee Membersplus icon
ACIP Membership Roster
Apply for ACIP Membership
Work Groupsplus icon
VaST Reportsplus icon
June 28, 2021
May 24, 2021
May 17, 2021
March 29, 2021
Recommendationsplus icon
Shared Clinical Decision-Making Recommendations
Evidence Based Recommendationsplus icon
About GRADE
Grade Evidence Tables
Evidence to Recommendations Frameworks Vaccines & ImmunizationsImmunization SchedulesVFC ResolutionsVaccine Information Statements (VISs)
  1600 Clifton Road, N.E., Mailstop A27
Atlanta, GA 30329-4027acip@cdc.gov


About CDC
					Contact Us
					800-232-4636
 Facebook Twitter Instagram LinkedIn Youtube Pinterest Snapchat
 CONTACT CDC
				Contact Us
							Call 800-232-4636
							Email Us
			ABOUT CDC
				About CDC
							Jobs
							Funding
			POLICIES
				Accessibility
							External Links
							Privacy
							Policies
							No Fear Act
							FOIA
							OIG
							Nondiscrimination
							Vulnerability Disclosure Policy
			CONNECT WITH US
				Facebook
								Twitter
								Instagram
								LinkedIn
							Youtube
								Pinterest
								Snapchat
								Email
			LANGUAGES
				Español
							繁體中文
							Tiếng Việt
							한국어
							Tagalog
							Русский
							العربية
							Kreyòl Ayisyen
							Français
							Polski
							Português
							Italiano
							Deutsch
							日本語
							فارسی
							English


U.S. Department of Health & Human Services
			Accessibility
			External Links
			Privacy
			Policies
			No Fear Act
			FOIA
			Nondiscrimination
			OIG
			Vulnerability Disclosure Policy
			USA.gov


Exit Notification / Disclaimer Policy Close
 Links with this icon  indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
				Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
				You will be subject to the destination website's privacy policy when you follow the link.
				CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Website Disclaimers
 Cancel Continue