Evidence to Recommendations Frameworks

The following are the Evidence to Recommendations (EtR) frameworks that describe information considered in moving from evidence to ACIP vaccine recommendations.

The purpose of EtR frameworks is to help panels making recommendations move from evidence to decisions, and to provide transparency around the impact of additional factors on deliberations when considering a recommendation. These tables accompany ACIP recommendations published in the Morbidity and Mortality Weekly Reports (MMWR).

List of Evidence to Recommendations Framework Tables

Listed in most recently published order.

• ACIP Evidence to Recommendations for Use of Pfizer’s Pentavalent Meningococcal Vaccine (MenACWY-TT/MenB-FHbp) | CDC
  Linked from MMWR; April 18, 2024 / 73(15);345–350
• ACIP Evidence to Recommendations for Primary Polio Vaccination Among Adults Aged ≥18 Years
  Linked from MMWR; December 7, 2023 / 72(49);1327–1330
• ACIP Evidence to Recommendations for Booster Doses of Inactivated Poliovirus Vaccine (IPV) Among Adults Aged ≥18 Years
  Linked from MMWR; December 7, 2023 / 72(49);1327–1330
• ACIP Evidence to Recommendations Framework for Tick-Borne Encephalitis (TBE) Vaccination for Persons Who Travel Abroad
  Linked from MMWR; November 10, 2023 / 72(5);1–29
• ACIP Evidence to Recommendations Framework for Tick-Borne Encephalitis (TBE) Vaccination for Laboratory Workers
  Linked from MMWR; November 10, 2023 / 72(5);1–29
• EtR framework for Use of an Updated (Monovalent XBB Containing) COVID-19 Vaccine Under an Emergency Use Authorization | CDC
  Linked from MMWR; October 20, 2023 / 72(42);1140-1146
• ACIP Evidence to Recommendations for Use of Pfizer RSVpreF in Pregnant People | CDC
  Linked from MMWR; October 13, 2023 / 72(41);1115-1122
• EtR framework for PCV20 use in children aged 2–18 years with certain underlying conditions that increase the risk of pneumococcal disease
  Linked from MMWR; September 29, 2023 / 72(39);1072
• EtR framework for PCV20 use in children aged <2 years
  Linked from MMWR; September 29, 2023 / 72(39);1072
• EtR Framework for Adults Aged 19–64 Years With an Immunocompromising Condition, Cochlear Implant, or Cerebrospinal Fluid Leak Who Have Previously Received Both PCV13 and PPSV23
  Linked from MMWR; September 8, 2023 / 72(3);1–39
• EtR Framework for Adults Aged ≥65 Years Who Have Previously Received Both PCV13 and PPSV23
  Linked from MMWR; September 8, 2023 / 72(3);1–39
• EtR Framework for Adults Aged ≥19 Years Who Have Previously Received PCV13 Only
  Linked from MMWR; September 8, 2023 / 72(3);1–39
• EtR for Use of Nirsevimab in Infants <8 months of age born during the RSV season or entering their first RSV season
  Linked from MMWR; August 25, 2023 / 72(34);920–925
• EtR for Use of Nirsevimab in Children 8–19 months of age at increased risk of severe disease entering their second RSV season
  Linked from MMWR; August 25, 2023 / 72(34);920–925
• Evidence to Recommendations (EtR) Framework: Safety of Influenza Vaccines for Persons with Egg Allergy
  Linked from MMWR; August 25, 2023 / 72(2);1–25
• EtR for Use of GSK Adjuvanted RSVPreF3 Vaccine (AREXVY) in Adults Ages 60 and Older
  Linked from MMWR; July 21, 2023 / 72(29);793–801
• EtR for Use of Pfizer Bivalent RSVpreF Vaccine (ABRSYVO) in Adults Ages 60 and Older
  Linked from MMWR; July 21, 2023 / 72(29);793–801
• EtR for use of PRIORIX for Prevention of Measles, Mumps, and Rubella
  Linked from MMWR; November 18, 2022/ 71(46); 1465–1470
• EtR for Use of Bivalent COVID-19 Vaccine Booster Doses under an Emergency Use Authorization
  Linked from MMWR; November 11, 2022/ 71(45); 1436-1441
• EtR for Use of Novavax COVID-19 Vaccine Booster Dose for adults ages 18 years and older under an Emergency Use Authorization
  Linked from MMWR; November 11, 2022/ 71(45); 1436-1441
• EtR Framework for Use of Lyophilized CVD 103-HgR Vaccine Among Children and Adolescents Aged 2–17 years
  Linked from MMWR; September 30, 2022 / 71(2);1–8
• EtR Framework for PCV15 use in children aged <2 years
  Linked from MMWR; September 16, 2022 / 71(37);1174–1181
• EtR Framework for PCV15 use in children aged 2–18 years with certain underlying medical conditions that increase the risk of pneumococcal disease
  Linked from MMWR; September 16, 2022 / 71(37);1174–1181
• EtR Framework for Higher Dose and Adjuvanted Influenza Vaccines for Persons Aged ≥65 Years
  Linked from MMWR; August 26, 2022 / 71(1);1–28
• ACIP Evidence to Recommendations for Use of Novavax COVID-19 Vaccine, Adjuvanted in adults ages 18 years and older under an Emergency Use Authorization (cdc.gov)
  Linked from MMWR; August 4, 2022/ 71(31); 988-992
• ACIP Evidence to Recommendations for Use of Moderna COVID-19 Vaccine in Children Ages 6 – 11 years and Adolescents Ages 12 – 17 years under an Emergency Use Authorization
• ACIP Evidence to Recommendations for Use of Moderna COVID-19 Vaccine in Children Ages 6 Months – 5 Years and Pfizer-BioNTech COVID-19 Vaccine in Children Ages 6 Months – 4 Years under an Emergency Use Authorization
  Linked from MMWR; June 28, 2022/ 71(26)
• EtR for Use of JYNNEOS (orthopoxvirus) Vaccine Heterologous for Those Who Received ACAM2000 Primary Series (Policy Question 5)
  Linked from MMWR; June 3, 2022 / 71(22);734–742
• EtR for Use of JYNNEOS (orthopoxvirus) Vaccine Primary Series for Research, Clinical Laboratory, and Response Team Personnel (Policy Question 1)
  Linked from MMWR; June 3, 2022 / 71(22);734–742
• EtR for Use of JYNNEOS (orthopoxvirus) Vaccine Primary Series for Healthcare Personnel (Policy Question 2)
  Linked from MMWR; June 3, 2022 / 71(22);734–742
• EtR Update for a Pfizer-BioNTech COVID-19 Booster in Children Ages 5-11 Years
• EtR Framework for a 2nd COVID-19 Booster Dose in Adults Ages 50 Years and Older and Immunocompromised Individuals
• EtR Framework for Rabies Pre-exposure prophylaxis with a 2-dose Schedule
  Linked from MMWR; May 6, 2022 / 71(18);619–627
• EtR Framework for a Booster Dose of Rabies Vaccine After the 2-dose Pre-exposure Prophylaxis Schedule
  Linked from MMWR; May 6, 2022 / 71(18);619–627
• EtR Framework for a Universal Hepatitis B (HepB) Vaccination Strategy in Adults
  Linked from MMWR; April 1, 2022 / 71(13);477–483
• EtR Framework for use of PreHevbrio Hepatitis B (HepB) Vaccine in Adults
  Linked from MMWR; April 1, 2022 / 71(13);477–483
• EtR Framework for Moderna COVID-19 Vaccine
  Linked from MMWR; March 18, 2022 / 71(11);416–421
• EtR Framework for PCV20 Use Among Adults 19-64 Years Old
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• EtR Framework for PCV20 Use Among Adults ≥65 Years Old
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• EtR Framework for PCV15 Use Among Adults 19-64 Years Old
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• EtR Framework for PCV15 Use Among Adults ≥65 Years Old
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• EtR Framework for Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged ≥19 Years
  Linked from MMWR; January 21, 2022 / 71(3);80–84
• EtR Framework for Dengvaxia
  Linked from MMWR; December 17, 2021 / 70(6);1–16
• EtR Framework for Use of an Additional COVID-19 Vaccine Dose in Immunocompromised People
  Linked from MMWR; October 29, 2021 / 70(44)
• EtR Framework for Use of COVID-19 Vaccine Booster Doses
  Linked from MMWR; October 29, 2021 / 70(44)
• EtR Framework for Use of Janssen COVID-19 Vaccine under an Emergency Use Authorization
  Linked from MMWR; March 2, 2021 / 70(9);329–332
• EtR Framework for Use of rVSVΔG-ZEBOV-GP Ebola vaccine for persons in the U.S. population who are at potential occupational risk of exposure to Ebola virus
  Linked from MMWR; January 8, 2021 / 70(1);1–12
• EtR Framework for Use of Moderna COVID-19 Vaccine under an Emergency Use Authorization
  Linked from MMWR; January 1, 2021 / 69(5152);1653-1656
• EtR Framework for Use of Pfizer-BioNTech COVID-19 Vaccine under an Emergency Use Authorization
  Linked from MMWR; December 18, 2020 / 69(50);1922-1924
• EtR Framework for MenACWY-TT (MenQuadfi) Meningococcal Vaccine
  Linked from MMWR; September 25, 2020 / 69(9);1–41
• EtR Framework for Serogroup B Meningococcal Vaccine Booster Dose
  Linked from MMWR; September 25 / 69(9);1–41
• EtR Framework for Serogroup B Meningococcal Vaccine Booster Dose During an Outbreak
  Linked from MMWR; September 25 / 69(9);1–41
• EtR Framework for Hepatitis A Vaccine Catch-up
  Linked from MMWR; July 3, 2020 / 69(5);1–38
• EtR Framework for Hepatitis A Vaccine for Persons With HIV
  Linked from MMWR; July 3, 2020 / 69(5);1–38
• EtR Framework for Tdap Vaccines in Adolescents and Adults
  Linked from MMWR; January 24, 2020 / 69(3);77–83
• EtR Framework for PCV13 use among adults ≥65 years old
  Linked from MMWR; November 22, 2019 / 68(46);1069–75
• EtR Framework for HPV Vaccination of Adults, Ages 27 through 45 years
  Linked from MMWR; August 16, 2019 / 68(32);698–702
• EtR Framework for HPV Vaccination Harmonization across Genders, Ages 22 through 26 years
  Linked from MMWR; August 16, 2019 / 68(32);698–702
• EtR Framework for Japanese Encephalitis Vaccine
  Linked from MMWR; July 19, 2019 / 68(2);1–33