Evidence-Based Recommendations—GRADE

At a glance

CDC vaccine recommendations are developed using an explicit evidence-based method based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

About GRADE

Key factors considered in development of recommendations include balance of benefits and harms, type or quality of evidence, values and preferences of the people affected, and health economic analyses.

See complete list of GRADE materials linked from MMWR

Resources for Learning More About GRADE

GRADE Working Group web site
Full description and answers to frequently asked questions about GRADE

  • GRADE online learning modules

These online learning modules are designed to help guideline developers and authors of systematic reviews learn how to use the GRADE approach to grade the evidence in systematic reviews, to create Summary of Findings Tables and GRADE Evidence Profiles, and move from evidence to making recommendation

Publications:

Handbook:

U.S. ACIP Handbook for Developing Evidence-based Recommendations Atlanta, GA: Centers for Disease Control and Prevention (CDC); April 2024.
U.S. Advisory Committee on Immunization Practices (ACIP) Handbook for Developing Evidence-based Recommendations: Formulating questions, conducting the systematic review, and assessing the certainty of the evidence using GRADE.