In general, ACIP Libraries recommendations have always been evidence based, due to careful scrutiny and evaluation of data by WGs prior

to formulating policy options. However, ACIP recommendations have not generally been presented in an explicit evidence-based format. The WG plans to finalize a complete methods paper by June 2010. They will then apply these methods GDC 0449 to a vaccine recommendation (“pilot test”), most likely an existing ACIP recommendation (e.g., rotavirus vaccine) in order to gain experience and to fine-tune the methods if necessary. To develop the methods paper, the WG has been reviewing approaches taken by the U.S. Preventive Services Task Force, the Task Force on Community Preventive Services, the Oxford Centre for Anti-diabetic Compound Library supplier Evidence-Based

Medicine, the Canadian Task Force on Preventive Health and others. Once the methods are finalized, all future ACIP recommendations would be prepared and presented in an explicit evidence-based format. The methods paper will provide ACIP WG staff with detailed guidance on steps taken toward developing explicit evidence-based recommendations. These include developing the analytic framework; searching for and collecting evidence; evaluating the quality of the studies; summarizing the evidence; and converting the evidence into an overall recommendation. Moreover, it has been observed that ACIP statements (published in MMWR) have become much longer over the years and that users frequently have difficulty pulling out key recommendations from the text. Some critics have said that ACIP statements have begun to resemble book chapters. The ACIP secretariat is in the process of reviewing statements and is discussing whether a more simplified, standardized approach to written statements should be taken. Currently, statement content

and length is entirely at the discretion of each individual WG. Finally, ACIP membership composition has traditionally favored pediatricians, internists, and state public health officers. With the introduction of Family Medicine as a clinical specialty in 1969, the role of family physicians has become increasingly important in the US. Similarly, obstetricians–gynecologists from have never been represented on ACIP (i.e., not as voting members). The ACIP Secretariat will review the committee’s composition to decide whether there should be some updates/modifications made. The 45 years of ACIP’s progress parallels the steady increase in the number of vaccines recommended for the US civilian population: from 6 routine childhood vaccines in 1964, to today’s 16 separate antigens that are recommended for routine use in childhood as well as the routine vaccines recommended for the adult population.