How CDC Is Making COVID-19 Vaccine Recommendations
When the U.S. Food and Drug Administration (FDA) authorizes or approves a COVID-19 vaccine, the Advisory Committee on Immunization Practices (ACIP) quickly holds a public meeting to review all available data about that vaccine (sign up to receive email updates whenever ACIP’s Meeting Information is updated). ACIP is an independent panel of medical and public health experts. Before making recommendations, ACIP reviews all available clinical trial information, including descriptions of:
- Who received the vaccine (age, race, ethnicity, underlying medical conditions)
- How different groups responded to the vaccine
- What side effects people had
- How common infection is within the population
- Health outcomes related to infection
Based on these data, ACIP then votes on whether to recommend the vaccine and on which populations should receive the vaccine.
Learn more about ACIP and CDC recommendations for COVID-19 vaccines.
ballot check light icon ACIP resources: Recommendation process, meeting agendas, minutes, live meetings, and presentation slides
ACIP identified four ethical principles to guide their decision-making process when supply was limited:
- Maximize benefits and minimize harms — Respect and care for people using the best available data to promote public health and minimize death and severe illness.
- Mitigate health inequities — Reduce health disparities in the burden of COVID-19 disease and death, and make sure everyone has the opportunity to be as healthy as possible.
- Promote justice — Treat affected groups, populations, and communities fairly. Remove unfair, unjust, and avoidable barriers to COVID-19 vaccination.
- Promote transparency — Make a decision that is clear, understandable, and open for review. Allow and seek public participation in the creation and review of the decision processes.
Learn more about ACIP’s ethical principles for allocating initial supplies of COVID-19 vaccine.
Vaccine Rollout Recommendations
When the U.S. supply of COVID-19 vaccine was limited, CDC provided recommendations to federal, state, and local governments about who should be vaccinated first. CDC’s recommendations were based on those from ACIP.
The recommendations were made with these goals in mind:
- Decrease death and serious disease as much as possible
- Preserve functioning of society
- Reduce the extra burden COVID-19 had on people already facing disparities
While CDC made recommendations for who should be offered COVID-19 vaccine first, each state had its own plan for who would be vaccinated first and how they could receive vaccines.
On November 2, 2021, vaccine eligibility expanded to everyone in the United States ages 5 and older.
Input from the public and the following professional groups informed ACIP’s discussions on who should receive COVID-19 vaccines when supply was limited:
- Johns Hopkins Bloomberg School of Public Health: Interim Framework for COVID-19 Vaccine Allocation and Distribution in the United Statesexternal icon
- The National Academies of Sciences, Engineering, and Medicine: Framework for Equitable Allocation of COVID-19 Vaccineexternal icon
- World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE): WHO SAGE Values Framework for the Allocation and Prioritization of COVID-19 Vaccinationpdf iconexternal icon
- WHO SAGE: WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the Context of Limited Supplypdf iconexternal icon