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How is the Immunization Schedule Developed?

For some reason, there still seems to be a lot of confusion out there about just how the immunization schedule is developed.

Jay Gordon wonders about the research used to set the current immunization schedule...
ICYMI – Jay Gordon was Jenny McCarthy‘s pediatrician.

Who decides which vaccines we give and get?

How do they make that decision?

History of Immunization Schedule Development

While the current immunization schedule is developed by the CDC based on recommendations of the Advisory Committee on Immunization Practices (ACIP), that’s not how it was always done.

It has just been since 1995 that we have had this single, simple vaccine schedule and format.

The first unified immunization schedule was developed in 1995.
The first unified immunization schedule was developed in 1995.

Before that, we had separate vaccine schedules from the:

Even earlier, we had recommendations and schedules from

  • WHO Expanded Programme on Immunization (EPI)
  • AAP’s Special Committee on Prophylactic Procedures Against Communicable Diseases – from its start in the early 1930s, it evolved into today’s Committee on Control of Infectious Diseases
  • American Public Health Association Subcommittee on Communicable Disease Control

Differences in those schedules, which could lead to confusion, lead experts to create a simpler, unified schedule.

Well, at least in the United States. Of course, other countries still set their own schedules…

The Science Behind Setting the Immunization Schedule

Now that you know who sets the immunization, you are probably wondering how they set the immunization schedule.

To truly understand how the immunization schedule gets set up, it is best to go to an ACIP meeting when they make those decisions.

Can’t make it to Atlanta for one of the ACIP meetings?

You can watch them online!

Thoughtful discussions on setting the immunization schedule at ACIP.
Thoughtful discussions on setting the immunization schedule at ACIP.

Past ACIP meetings, agendas, minutes, slides, and videos, are archived online too.

Reading the minutes from the third meeting of the Advisory Committee on Immunization Practices on November 19-20, 1964 shows how they work, looking at data to make decisions about our vaccines and set the immunization schedule.
Reading the minutes from the third meeting of the Advisory Committee on Immunization Practices on November 19-20, 1964 shows how they work, looking at data to make decisions about our vaccines and set the immunization schedule.

Review them and you will get a very good idea of how the immunization schedule gets set up.

The first flu vaccine was developed in 1945.

ACIP basically told folks to go back to the drawing board and make a better flu vaccine at this 1966 meeting.
ACIP basically told folks to go back to the drawing board and make a better flu vaccine at this 1966 meeting.

Did you ever wonder why it took so long to get it on the immunization schedule?

Why was the primary series of polio vaccines made up of three doses?

At the Advisory Committee on Immunization Practices meeting on May 24-26, 1967 they discussed polio vaccine scheduling.
At the Advisory Committee on Immunization Practices meeting on May 24-26, 1967 they discussed polio vaccine scheduling.

Hopefully you are starting to understand how this works…

And no, all of this work doesn’t get done over a couple of days a few times a year. ACIP members belong to workgroups which focus on specific vaccines and they gather, analyze, and prepare information and research about those vaccines throughout the year.

It is at the ACIP meetings where the workgroup findings are presented.

“Development of vaccine schedules is based on a large body of basic sciences and epidemiologic research. There is constant review of evidence, adverse events, and epidemiology by a panel of experts.”

Shetty et al on Rationale for the Immunization Schedule: Why Is It the Way It Is?

And yes, among that body of research are studies of vaccines tested together, vaccines tested with placebos, vaccines tested vs unvaccinated kids, vaccines tested for long periods of time, and studies looking at risk factors to make sure vaccines don’t cause long-term health problems.

It’s a very thorough process!

And that’s why the great majority of folks understand that following the immunization schedule is the best way to keep their kids protected from vaccine-preventable diseases.

Vaccines are safe, with few risks, and are obviously necessary.

What’s not safe? What hasn’t been well studied?

Following a non-standard, parent-selected, delayed protection vaccine schedule.

Thinking that an individualized approach is better doesn't trump the 55 years of ACIP meetings that went into setting the current immunization schedule...
Thinking that an individualized approach is better doesn’t trump the 55 years of ACIP meetings that went into setting the current immunization schedule…

Studies have actually shown that delaying or skipping vaccines offers no benefits and actually puts kids at extra risk.

It puts the rest of us at risk too.

More on Setting the Immunization Schedule

Last Updated on July 10, 2019

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