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Guiding Principles for Development of ACIP Recommendations for Vaccination During Pregnancy and Breastfeeding

The Advisory Committee on Immunization Practices (ACIP) provides advice and guidance regarding effective control of vaccine-preventable diseases, including guidance for special populations that might warrant modification of routine recommendations (1). One such special population is pregnant and breastfeeding women. Formulation of recommendations for vaccination of pregnant and breastfeeding women is challenging because the available scientific evidence needed to guide decisions is limited. To promote use of a consistent process and uniform terminology, the ACIP Workgroup on Vaccines during Pregnancy and Breastfeeding was established in 2007 to develop guiding principles for drafting of ACIP recommendations for vaccination of pregnant and breastfeeding women. Workgroup members included ACIP members, members of professional medical organizations, experts in the field, and CDC consultants.

During April 2007--March 2008, the workgroup reviewed existing policies on use of vaccines in pregnant and breastfeeding women. On the basis of this review, opinions of workgroup members, and feedback from partner organizations, the workgroup prepared the document Guiding Principles for Development of ACIP Recommendations for Vaccination during Pregnancy and Breastfeeding, which was approved by ACIP in March 2008. This document provides guidance to help standardize procedures for policy formulation and presentation of the rationale and recommendations for vaccination of pregnant and breastfeeding women. Topics in Guiding Principles include 1) guidance for structure of the background section, 2) guidance for structure and language of recommendations, 3) clarification of the definitions of precautions and contraindications in the context of pregnant and breastfeeding women, 4) suggestions for approaches to policy decision-making in the absence of adequate data, and 5) description of a consistent process to gather expert opinion.

These principles will be applied to future ACIP vaccine statements and routine updates of existing statements in which vaccination of pregnant and breastfeeding women is considered. Guiding Principles is available at http://www.cdc.gov/vaccines/recs/acip/downloads/preg-principles05-01-08.pdf.

Reference

  1. Advisory Committee on Immunization Practices. Charter, April 2008--March 2010. Available at http://www.cdc.gov/vaccines/recs/acip/charter.htm.



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