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Guiding principles for development of ACIP recommendations for vaccination during pregnancy and breastfeeding
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Description:Formulating policy to guide vaccination of women during pregnancy and breastfeeding is challenging because the evidence-base to guide decisions is extremely limited. In the past, ACIP has not provided guidance to workgroups on either the process to formulate policy for this population or the format and language for recommendations. As a result, workgroups have taken a variety of approaches to considering and presenting the issues, resulting in a diversity of recommendations that vary in clarity and underlying rationale. . The principles presented here provide guidance to help standardize both the process of policy formulation and the format and language of recommendations for pregnant and breastfeeding women. All ACIP statements about vaccines and other biologics for use in adolescents or adults should include a background section on vaccination during pregnancy and breastfeeding and provide explicit pregnancy and breastfeeding recommendations using standardized language as outlined below. To arrive at pregnancy and breastfeeding recommendations, ACIP workgroups or subject matter experts charged with developing vaccine statements should review the process suggestions outlined below. These suggestions, while similar to the process generally followed by workgroups, focus specifically on issues related to pregnancy, breastfeeding and decision making in the absence of a strong evidence-base.
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