GRADE Evidence Tables – Recommendations in MMWR

The following summarize GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methods and evidence tables that accompany ACIP recommendations published in the Morbidity and Mortality Weekly Reports (MMWR).

This standardized and more explicit process for developing ACIP recommendations is expected to enhance transparency, consistency, and communication.

List of GRADE Materials and Evidence Tables

Listed in most recently published order.

• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer’s Pentavalent Meningococcal Vaccine (MenACWY-TT/MenB-FHbp)
  Linked from MMWR; April 18, 2024 / 73(15);345–350
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) for Tick-Borne Encephalitis (TBE) Vaccine
  Linked from MMWR; November 10, 2023 / 72(5);1–29
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Updated COVID-19 vaccine (2023-2024 Formulation) | CDC
  Linked from MMWR; October 20, 2023 / 72(42);1140-1146
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer Maternal RSV Vaccine | CDC
  Linked from MMWR; October 13, 2023 / 72(41);1115–1122
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) for children aged 2 through 18 years with underlying medical conditions
  Linked from MMWR; September 29, 2023 / 72(39);1072
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) for children aged <2 years
  Linked from MMWR; September 29, 2023 / 72(39);1072
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) use among adults aged 19–64 years with an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant who previously received a 13-valent pneumococcal conjugate vaccine (PCV13)
  Linked from MMWR; September 8, 2023 / 72(3);1–39
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) use among adults aged ≥65 years who previously received a 13-valent pneumococcal conjugate vaccine (PCV13)
  Linked from MMWR; September 8, 2023 / 72(3);1–39
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Nirsevimab, Season 1
  Linked from MMWR; August 25, 2023 / 72(34);920–925
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Nirsevimab, Season 2
  Linked from MMWR; August 25, 2023 / 72(34);920–925
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Safety of Influenza Vaccines for Persons with Egg Allergy
  Linked from MMWR; August 25, 2023 / 72(2);1–25
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): GSK RSVPreF3 Vaccine (AREXVY)
  Linked from MMWR; July 21, 2023 / 72(29);793–801
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer RSVpreF Vaccine (ABRYSVO)
  Linked from MMWR; July 21, 2023 / 72(29);793–801
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Lyophilized CVD 103-HgR Vaccine Among Children and Adolescents Aged 2–17 Years
  Linked from MMWR; September 30, 2022 / 71(2);1–8
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 15-valent pneumococcal conjugate vaccine (PCV15) use in children aged <2 years
  Linked from MMWR; September 16, 2022 / 71(37);1174–1181
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 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
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Higher Dose and Adjuvanted Influenza Vaccines for Persons Aged ≥65 Years
  Linked from MMWR; August 26, 2022 / 71(1);1–28
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Novavax COVID-19 Vaccine (cdc.gov)
  Linked from MMWR; August 4, 2022/ 71(31); 988-992
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Moderna COVID-19 Vaccine for Children Aged 6–11 Years
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Moderna COVID-19 Vaccine for Persons Aged 12-17 Years
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Moderna COVID-19 Vaccine for Children Aged 6 Months–5 Years
  Linked from MMWR; June 28, 2022/ 71(26)
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer-BioNTech COVID-19 Vaccine for Children Aged 6 Months–4 Years
  Linked from MMWR; June 28, 2022/ 71(26)
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Use of JYNNEOS® (orthopoxvirus) vaccine heterologous for those who received ACAM2000 primary series
  Linked from MMWR; June 3, 2022 / 71(22);734–742
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Use of JYNNEOS (orthopoxvirus) vaccine primary series for research, clinical laboratory, response team, and healthcare personnel (Policy Questions 1 and 2)
  Linked from MMWR; June 3, 2022 / 71(22);734–742
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Use of JYNNEOS® (orthopoxvirus) vaccine booster (Policy Questions 3 and 4)
  Linked from MMWR; June 3, 2022 / 71(22);734–742
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 2-dose Rabies Vaccination Schedule
  Linked from MMWR; May 6, 2022 / 71(18);619–627
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Booster Dose of Rabies Vaccine
  Linked from MMWR; May 6, 2022 / 71(18);619–627
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Hepatitis B (HepB) Vaccine
  Linked from MMWR; April 1, 2022 / 71(13);477–483
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): PreHevbrio Hepatitis B (HepB) Vaccine
  Linked from MMWR; April 1, 2022 / 71(13);477–483
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Moderna COVID-19 Vaccine
  Linked from MMWR; March 18, 2022 / 71(11);416–421
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) for adults aged 19–64 years with underlying medical conditions or other risk factors
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) for adults aged ≥65 years
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE):15-valent pneumococcal conjugate vaccine (PCV15) in series with 23-valent pneumococcal conjugate vaccine (PPSV23) for adults aged 19–64 years with underlying medical conditions or other risk factors
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 15-valent pneumococcal conjugate vaccine (PCV15) in series with 23-valent pneumococcal conjugate vaccine (PPSV23) for adults aged ≥65 years
  Linked from MMWR; January 28, 2022 / 71(4);109–117
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged ≥19 Years
  Linked from MMWR; January 21, 2022 / 71(3);80–84
• GRADE Analysis: Dengvaxia® Dengue Vaccine
  Linked from MMWR; December 17, 2021 / 70(6);1–16
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer-BioNTech COVID-19 Vaccine for Children 5-11 Years
  November 5, 2021
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer-BioNTech, Moderna, and Janssen COVID-19 booster doses
  Linked from MMWR; October 29, 2021 / 70(44)
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer-BioNTech COVID-19 Vaccine for Persons Aged 12-15 Years
  May 14, 2021
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Janssen COVID-19 Vaccine
  Linked from MMWR; March 2, 2021 / 70(9);329–332
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 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
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Moderna COVID-19 Vaccine
  Linked from MMWR; January 1, 2021 / 69(5152);1653-1656
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): Pfizer-BioNTech COVID-19 Vaccine
  Linked from MMWR; December 18, 2020 / 69(50);1922-1924
• Use of MenACWY-TT (MenQuadfi) as an option for meningococcal serogroup A, C, W, and Y (MenACWY) vaccination
  Linked from MMWR; September 25, 2020 / 69(9);1–41
• Use of Serogroup B Meningococcal (MenB) vaccines for persons at increased risk for serogroup B meningococcal disease
  Linked from MMWR; September 25, 2020 / 69(9);1–41
• Use of Hepatitis A Vaccine for Persons With HIV
  Linked from MMWR; July 3, 2020 / 69(5);1–38
• Use of PCV13 among adults ≥65 years old
  Linked from MMWR; November 22, 2019 / 68(46)
• Use of HPV Vaccine in Adults, Ages 27 through 45 years
  Linked from MMWR; August 16, 2019 / 68(32);698-702
• Use of Japanese Encephalitis Vaccine
  Linked from MMWR; July 19, 2019 / 68(2);1–33
• Use of Hepatitis A Vaccine for Persons Experiencing Homelessness
  Linked from MMWR; February 15, 2019 / 68(6);153-6
• Use of Hepatitis A vaccine for post-exposure prophylaxis in adults >40 years of age
  Linked from MMWR; November 1, 2018 / 67(43);1216-1220
• Use of Heplisav-B (HepB-CpG)
  Linked from MMWR; April 20, 2018 / 67(15);455–458
• Use of Recombinant Zoster Vaccine (RZV) and Herpes Zoster Live-Attenuated Vaccine (ZVL)
  Linked from MMWR; January 26, 2018 / 67(3);103-8
• Use of a Third Dose of Mumps Virus-Containing Vaccine in Persons at Increased Risk for Mumps Disease Because of a Mumps Outbreak
  Linked from MMWR; January 12, 2018 / 67(1);33–8
• Use of Cholera Lyophilized CVD 103-HgR Vaccine
  Linked from MMWR; May 12, 2017 / 66(18);482-5
• Use of a 2-Dose Schedule for Human Papillomavirus Vaccination
  Linked from MMWR; December 16, 2016 / 65(49);1405-8
• Use of Meningococcal Conjugate Vaccines in HIV-Infected Persons
  Linked from MMWR; November 4, 2016 / 65(43);1189-94
• Use of Smallpox Vaccine in Laboratory and Health-Care Personnel at Risk for Occupational Exposure to Orthopoxviruses
  Linked from MMWR; March 18, 2016 / 65(10);257-62
• Use of Serogroup B Meningococcal (MenB) Vaccines in Adolescents and Young Adults (Including College Students)
  Linked from MMWR; October 23, 2015 / 64(41);1171-6
• Use of Yellow Fever Vaccine Booster Doses
  Linked from MMWR; June 19, 2015 / 64(23);647-650
• Use of Serogroup B Meningococcal (MenB) Vaccines in Persons at Increased Risk for Serogroup B Meningococcal Disease
  Linked from MMWR; June 12, 2015 / 64(22);608-612
• Use of 9-Valent Human Papillomavirus Vaccine (9vHPV) in Females and Males
  Linked from MMWR; March 27, 2015 / 64(11);300-304
• Use of Pneumococcal Vaccines for Adults aged ≥65 years
  Linked from MMWR; September 19, 2014 / 63(37);822-815
• Use of LAIV in children aged 2 through 8 years
  Linked from MMWR; August 15, 2014 / 63(32);691-697
• Use of Japanese Encephalitis Vaccine in Children
  Linked from MMWR; November 15, 2013 / 62(45);898-900
• Pneumococcal Vaccines for Immunocompromised Children
  Linked from MMWR; June 28, 2013 / 62(25);521-524
• Infant Meningococcal Vaccines
  Linked from MMWR; March 22, 2013 / 62(RR02);1-22
• Pneumococcal Vaccines for Immunocompromised Adults
  Linked from MMWR; October 12, 2012 / 61(40);816-819
• Quadrivalent HPV Vaccine for Males
  Linked from MMWR; December 23, 2011 / 60(50);1705-8
• Hepatitis B Vaccine in Adults with Diabetes
  Linked from MMWR; December 23, 2011 / 60(50);1709-11
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) for children aged 2 through 18 years with underlying medical conditions
  Linked from MMWR; September 29, 2023 / 72(39);1072
• Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 20-valent pneumococcal conjugate vaccine (PCV20) for children aged <2 years
  Linked from MMWR; September 29, 2023 / 72(39);1072