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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.
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