Revised Recommendations for Vaccines Are Being Phased In, CDC Report Says [View all]

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Can vaccines be more useful for some people than for others?

Until now, most physicians have recommended immunizations for all infants and children, as well as for adults at various ages who may have missed shots. But new guidelines that take into account the strength of scientific evidence and individual health to determine whether specific vaccines should be recommended or simply optional for patients are being used in medicine for the first time, a report by the Centers for Disease Control and Prevention says.

The recommendations are based on a framework for evaluating science used by more than 60 major organizations, including the American College of Physicians and the World Health Organization, and will each fall in one of two categories, reflective of evidence that a vaccine is essential to good health. Category A recommendations will include vaccinations considered necessary for all people of a certain age or those who are at an increased risk for contracting a vaccine-preventable disease. Category B recommendations will provide guidance to physicians in the context of individual cases where patients with varying health conditions may or may not benefit from a vaccine.

“Over the years, the science of developing recommendations has changed,” said Faruque Ahmed, PhD, a senior scientist at the CDC and a member of the U.S. Department of Health and Human Services’ Advisory Committee on Immunization Practices (ACIP), which is leading the effort, in a telephone interview.

The need for updating immunization guidelines stems from the fact that the current language does not always indicate the importance of some vaccines over others. For example, the meningococcal vaccine, which protects against a debilitating and potentially life-threatening disease and can be routinely administered at various stages in a patient’s life, may be recommended with the same urgency as the hepatitis B vaccine for older adults with diabetes, for whom that vaccine is not always beneficial.

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Ahmed also noted that if recommendations are made more clear, physicians will find them easier to follow and patients will likely gain more confidence in vaccines. To this point, he said some opponents of routine vaccinations have attended his group’s meetings over the years and are now supportive of the new approach. SafeMinds, (which is labeled an anti-vaccine advocacy group) which promotes the idea that mercury in vaccines is associated with autism, attention deficit disorder, and other neurological impairments, is one of those supporters that have signaled their approval for using evidence-based guidelines.

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Finally, the CDC is inching toward a thoughtful, patient centered approach to vaccination.