Immunization Best Practices: An Introduction to ACIP’s Guidance for Vaccinators

CDC recommends routine vaccination to prevent 17 vaccine-preventable diseases that affect infants, children, adolescents and adults. Vaccinating well involves many practical questions: when each dose should be given, how to screen for contraindications and precautions, how many vaccines to give at once, what patients and parents need to know, and how to interpret and respond to adverse events. Vaccine providers also help patients make sense of a large and sometimes conflicting body of information.

The General Best Practice Guidelines for Immunization, from the Advisory Committee on Immunization Practices (ACIP), are written for clinicians and others who vaccinate in hospitals, doctors’ offices, pharmacies, schools, community health centers and public health clinics in the United States — other countries may need different guidance.

What the guidance covers

It is organized in ten parts, with a glossary:

1. Timing and spacing of immunobiologics
2. Contraindications and precautions
3. Preventing and managing adverse reactions
4. Vaccine administration
5. Storage and handling of immunobiologics
6. Altered immunocompetence
7. Special situations
8. Vaccination records
9. Vaccination programs
10. Vaccine information sources

What was updated

The updated guidelines added or changed:

• new information on simultaneous vaccination and febrile seizures;
• a broader definition of a precaution, to include any condition that could confuse a diagnosis;
• confirmation that vaccinating during a hospital stay is best practice unless the patient is moderately or severely ill;
• a fuller description of anaphylactic allergy, and protocols for managing it;
• permission to give hepatitis A vaccine under the skin instead of into the muscle;
• an age range of 12 through 17 years for validating a dose of intradermal flu vaccine;
• removal of most storage and handling detail, now kept current in CDC’s Vaccine Storage and Handling Toolkit;
• the Infectious Diseases Society of America’s guidance on vaccinating people with weakened immune systems;
• timing of intramuscular injections for people with bleeding disorders;
• updated data on vaccination record policy;
• more on the Affordable Care Act’s effects on adult vaccination; and
• updated contact information for vaccine information sources.

Why it matters

The guidance is meant to help providers weigh the benefits and risks of vaccines, use recommended administration practices, understand the most effective ways to keep population coverage high, and explain why vaccination matters in reducing vaccine-preventable disease.

Sources

Based on "Introduction to Immunization Best Practice," Vaccines & Immunizations, Centers for Disease Control and Prevention; a work of the United States government in the public domain.