Evidence to Recommendations Frameworks

At a glance

The following is an index of the Evidence to Recommendations (EtR) frameworks that accompany ACIP recommendations. The purpose of the EtR framework is to describe information for consideration in making recommendations move from evidence to decisions, and to provide transparency around the impact of these factors on deliberations when considering a recommendation.

List of Evidence to Recommendations Framework Tables

These are indexed by alphabetical pathogen, in most recently published order:

Cholera vaccine

ACIP Evidence to Recommendations for Use of Pfizer's Pentavalent Meningococcal Vaccine (MenACWY-TT/MenB-FHbp) | CDC Linked from MMWR; April 18, 2024 / 73(15);345–350

EtR Framework for Use of Lyophilized CVD 103-HgR Vaccine Among Children and Adolescents Aged 2–17 years
Linked from MMWR; September 30, 2022 / 71(2);1–8

COVID-19 vaccines

ACIP Evidence to Recommendations (EtR) for Use of an Additional Dose of Updated (2023-2024 Formula) COVID-19 Vaccine in Older Adults
Linked from MMWR; April 25, 2024 / 73(16);377-381

EtR framework for Use of an Updated (Monovalent XBB Containing) COVID-19 Vaccine Under an Emergency Use Authorization | CDC
Linked from MMWR; October 20, 2023 / 72(42);1140-1146

EtR for Use of Bivalent COVID-19 Vaccine Booster Doses under an Emergency Use Authorization
Linked from MMWR; November 11, 2022/ 71(45); 1436-1441

EtR for Use of Novavax COVID-19 Vaccine Booster Dose for adults ages 18 years and older under an Emergency Use Authorization
Linked from MMWR; November 11, 2022/ 71(45); 1436-1441

ACIP Evidence to Recommendations for Use of Novavax COVID-19 Vaccine, Adjuvanted in adults ages 18 years and older under an Emergency Use Authorization (cdc.gov)
Linked from MMWR; August 4, 2022/ 71(31); 988-992

ACIP Evidence to Recommendations for Use of Moderna COVID-19 Vaccine in Children Ages 6 Months – 5 Years and Pfizer-BioNTech COVID-19 Vaccine in Children Ages 6 Months – 4 Years under an Emergency Use Authorization
Linked from MMWR; June 28, 2022/ 71(26)

ACIP Evidence to Recommendations for Use of Moderna COVID-19 Vaccine in Children Ages 6 – 11 years and Adolescents Ages 12 – 17 years under an Emergency Use Authorization
June 2022

EtR Framework for a 2nd COVID-19 Booster Dose in Adults Ages 50 Years and Older and Immunocompromised Individuals
May 2022

EtR Update for a Pfizer-BioNTech COVID-19 Booster in Children Ages 5-11 Years
April 2022

EtR Framework for Moderna COVID-19 Vaccine
Linked from MMWR; March 18, 2022 / 71(11);416–421

EtR Framework for Use of an Additional COVID-19 Vaccine Dose in Immunocompromised People
Linked from MMWR; October 29, 2021 / 70(44)

EtR Framework for Use of COVID-19 Vaccine Booster Doses
Linked from MMWR; October 29, 2021 / 70(44)

EtR Framework for Use of Janssen COVID-19 Vaccine under an Emergency Use Authorization
Linked from MMWR; March 2, 2021 / 70(9);329–332

EtR Framework for Use of Moderna COVID-19 Vaccine under an Emergency Use Authorization
Linked from MMWR; January 1, 2021 / 69(5152);1653-1656

EtR Framework for Use of Pfizer-BioNTech COVID-19 Vaccine under an Emergency Use Authorization
Linked from MMWR; December 18, 2020 / 69(50);1922-1924

Dengue vaccine

EtR Framework for Dengvaxia
Linked from MMWR; December 17, 2021 / 70(6);1–16

Ebola vaccine

EtR Framework for Use of 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

Hepatitis A vaccines

EtR Framework for Hepatitis A Vaccine Catch-up
Linked from MMWR; July 3, 2020 / 69(5);1–38

EtR Framework for Hepatitis A Vaccine for Persons With HIV
Linked from MMWR; July 3, 2020 / 69(5);1–38

Hepatitis B vaccine

EtR Framework for a Universal Hepatitis B (HepB) Vaccination Strategy in Adults
Linked from MMWR; April 1, 2022 / 71(13);477–483

EtR Framework for use of PreHevbrio Hepatitis B (HepB) Vaccine in Adults
Linked from MMWR; April 1, 2022 / 71(13);477–483

HPV vaccines

EtR Framework for HPV Vaccination Harmonization across Genders, Ages 22 through 26 years
Linked from MMWR; August 16, 2019 / 68(32);698–702

EtR Framework for HPV Vaccination of Adults, Ages 27 through 45 years
Linked from MMWR; August 16, 2019 / 68(32);698–702

Influenza vaccine

Evidence to Recommendations (EtR) Framework: Safety of Influenza Vaccines for Persons with Egg Allergy
Linked from MMWR; August 25, 2023 / 72(2);1–25

EtR Framework for Higher Dose and Adjuvanted Influenza Vaccines for Persons Aged ≥65 Years
Linked from MMWR; August 26, 2022 / 71(1);1–28

Japanese encephalitis vaccines

EtR Framework for Japanese Encephalitis Vaccine
Linked from MMWR; July 19, 2019 / 68(2);1–33

Mumps vaccine

EtR for use of PRIORIX for Prevention of Measles, Mumps, and Rubella
Linked from MMWR; November 18, 2022/ 71(46); 1465–1470

Meningococcal vaccines

EtR Framework for MenACWY-TT (MenQuadfi) Meningococcal Vaccine
Linked from MMWR; September 25, 2020 / 69(9);1–41

EtR Framework for Serogroup B Meningococcal Vaccine Booster Dose
Linked from MMWR; September 25, 2020 / 69(9);1–41

EtR Framework for Serogroup B Meningococcal Vaccine Booster Dose During an Outbreak
Linked from MMWR; September 25, 2020 / 69(9);1–41

Orthopoxvirus vaccines

EtR for Use of JYNNEOS (orthopoxvirus) Vaccine Heterologous for Those Who Received ACAM2000 Primary Series (Policy Question 5)
Linked from MMWR; June 3, 2022 / 71(22);734–742

EtR for Use of JYNNEOS (orthopoxvirus) Vaccine Primary Series for Research, Clinical Laboratory, and Response Team Personnel (Policy Question 1)
Linked from MMWR; June 3, 2022 / 71(22);734–742

EtR for Use of JYNNEOS (orthopoxvirus) Vaccine Primary Series for Healthcare Personnel (Policy Question 2)
Linked from MMWR; June 3, 2022 / 71(22);734–742

Pneumococcal vaccines

EtR Framework for Adults Aged 50–64 Years Who Currently Do Not Have a Risk-Based Pneumococcal Vaccine Indication
Linked from MMWR; September 12, 2024 / 73(36);793–798

EtR Framework for Adults Aged 19–49 Years Who Currently Do Not Have a Risk-Based Pneumococcal Vaccine Indication
Linked from MMWR; September 12, 2024 / 73(36);793–798

EtR Framework for Adults Aged ≥19 Years Who Currently Have a Recommendation to Receive a Pneumococcal Conjugate Vaccine
Linked from MMWR; September 12, 2024 / 73(36);793–798

EtR framework for PCV20 use in children aged 2–18 years with certain underlying conditions that increase the risk of pneumococcal disease
Linked from MMWR; September 29, 2023 / 72(39);1072

EtR Framework for PCV20 use in children aged <2 years
Linked from MMWR; September 29, 2023 / 72(39);1072

EtR Framework for Adults Aged ≥65 Years Who Have Previously Received Both PCV13 and PPSV23
Linked from MMWR; September 8, 2023 / 72(3);1–39

EtR Framework for Adults Aged 19–64 Years With an Immunocompromising Condition, Cochlear Implant, or Cerebrospinal Fluid Leak Who Have Previously Received Both PCV13 and PPSV23
Linked from MMWR; September 8, 2023 / 72(3);1–39

EtR Framework for Adults Aged ≥19 Years Who Have Previously Received PCV13 Only
Linked from MMWR; September 8, 2023 / 72(3);1–39

EtR Framework for 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

EtR Framework for PCV15 use in children aged <2 years
Linked from MMWR; September 16, 2022 / 71(37);1174–1181

EtR Framework for PCV20 Use Among Adults ≥65 Years Old
Linked from MMWR; January 28, 2022 / 71(4);109–117

EtR Framework for PCV20 Use Among Adults 19-64 Years Old
Linked from MMWR; January 28, 2022 / 71(4);109–117

EtR Framework for PCV15 Use Among Adults ≥65 Years Old
Linked from MMWR; January 28, 2022 / 71(4);109–117

EtR Framework for PCV15 Use Among Adults 19-64 Years Old
Linked from MMWR; January 28, 2022 / 71(4);109–117

EtR Framework for PCV13 use among adults ≥65 years old
Linked from MMWR; November 22, 2019 / 68(46);1069–75

Polio vaccines

ACIP Evidence to Recommendations for Primary Polio Vaccination Among Adults Aged ≥18 Years
Linked from MMWR; December 7, 2023 / 72(49);1327–1330

ACIP Evidence to Recommendations for Booster Doses of Inactivated Poliovirus Vaccine (IPV) Among Adults Aged ≥18 Years
Linked from MMWR; December 7, 2023 / 72(49);1327–1330

Rabies vaccine

EtR Framework for Rabies Pre-exposure prophylaxis with a 2-dose Schedule
Linked from MMWR; May 6, 2022 / 71(18);619–627

EtR Framework for a Booster Dose of Rabies Vaccine After the 2-dose Pre-exposure Prophylaxis Schedule
Linked from MMWR; May 6, 2022 / 71(18);619–627

RSV immunizations

ACIP Evidence to Recommendations for Use of Moderna RSV Vaccine (mResvia) in All Adults Aged ≥75 years and in Adults Aged 60–74 at Increased Risk of Severe RSV Disease
Linked from MMWR; August 6, 2024 / 73

ACIP Evidence to Recommendations for Use of Protein Subunit RSV vaccines (GSK Arexvy or Pfizer Abrysvo) in All Adults Aged ≥75 years and in Adults Aged 60–74 at Increased Risk of Severe RSV Disease
Linked from MMWR; August 6, 2024 / 73

ACIP Evidence to Recommendations for Use of Pfizer RSVpreF in Pregnant People | CDC
Linked from MMWR; October 13, 2023 / 72(41);1115-1122

EtR for Use of Nirsevimab in Children 8–19 months of age at increased risk of severe disease entering their second RSV season
Linked from MMWR; August 25, 2023 / 72(34);920–925

EtR for Use of Nirsevimab in Infants <8 months of age born during the RSV season or entering their first RSV season
Linked from MMWR; August 25, 2023 / 72(34);920–925

EtR for Use of GSK Adjuvanted RSVPreF3 Vaccine (AREXVY) in Adults Ages 60 and Older
Linked from MMWR; July 21, 2023 / 72(29);793–801

EtR for Use of Pfizer Bivalent RSVpreF Vaccine (ABRSYVO) in Adults Ages 60 and Older
Linked from MMWR; July 21, 2023 / 72(29);793–801

Tdap vaccines

EtR Framework for Tdap Vaccines in Adolescents and Adults
Linked from MMWR; January 24, 2020 / 69(3);77–83

Tick-borne encephalitis vaccine

ACIP Evidence to Recommendations Framework for Tick-Borne Encephalitis (TBE) Vaccination for Persons Who Travel Abroad
Linked from MMWR; November 10, 2023 / 72(5);1–29

ACIP Evidence to Recommendations Framework for Tick-Borne Encephalitis (TBE) Vaccination for Laboratory Workers
Linked from MMWR; November 10, 2023 / 72(5);1–29

Zoster vaccine

EtR Framework for Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged ≥19 Years
Linked from MMWR; January 21, 2022 / 71(3);80–84

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Content Source:
National Center for Immunization and Respiratory Diseases (NCIRD)