At a glance
- ACIP uses subgroups of the committee, known as work groups, to review relevant published and unpublished data and develop recommendation options for presentation to the ACIP.
- Work groups review specific topics in detail and clarify issues in a way that helps ACIP voting members make informed and efficient decisions, with the best and most current information available.
- This page lists currently active ACIP work groups and work group terms of reference.
About
ACIP uses subgroups of the committee, known as work groups, to review relevant published and unpublished data and develop recommendation options for presentation to the ACIP.
Work groups are typically task oriented and convene in response to specific policy needs. Each work group operates under specific terms of reference and disband when current work group activities are completed.
The following work groups are currently active: (Updated 11/5/2024)
Chikungunya Vaccines
- Work group purpose: The Chikungunya Vaccines Work Group reviews and evaluates data on chikungunya disease, epidemiology, and vaccines and develops policy options for ACIP’s consideration.
- Topics under discussion by the work group:
- Use of chikungunya vaccines in U.S. persons at risk of chikungunya, including those who travel abroad, laboratory workers, and residents of U.S. territories and states with, or at risk of, transmission.
- Work group activities:
- Review information on chikungunya disease, including outcomes.
- Review data on chikungunya epidemiology and burden among U.S. residents, including travelers and persons living in areas at risk for local transmission.
- Review data on safety, immunogenicity, and effectiveness of chikungunya vaccines.
- Provide evidence-based recommendation options for ACIP.
- Identify areas in need of further research for informing potential future vaccine recommendations.
- Publish chikungunya vaccine MMWR Recommendations and Reports document.
Combined Child/Adolescent and Adult Immunization Schedule
- Work group purpose: The Combined Child/Adolescent and Adult Immunization Schedule Work Group edits and maintains the child/adolescent and adult immunization schedule documents. The child/adolescent immunization schedule summarizes the ACIP vaccination recommendations for persons 18 years of age and younger, and the adult immunization schedule summarizes the ACIP vaccination recommendations for persons 19 years of age and older.
- Topics under discussion by the work group: The products of this work group do not establish new vaccine recommendations; the work group documents reflect existing ACIP recommendations.
- Work group activities:
- Publication of the child/adolescent and adult immunization schedules.
COVID-19 Immunizations
TOPICS UNDER DISCUSSION BY THE WORKGROUP
The following topics relevant to COVID-19 immunization for effective control of COVID-19 disease in the civilian population of the United States will be under discussion in the WG in multi-year efforts.
- Risk-benefit and cost-benefit analyses of existing and newly FDA-authorized mRNA and other COVID-19 immunizations, and immunization schedules as it relates to COVID-19 immunization to inform use recommendations, personalized per age-group, major risk factors and health status.
- To identify critical gaps in the existing scientific and clinical knowledge and methodologies related to the safety and efficacy of the COVID-19 immunizations, to inform the development of policy recommendations and further analyses and research by the CDC, other related federal agencies, and the scientific community.
- To review and summarize data, clinical and scientific knowledge related to adverse events associated with COVID-19 immunizations to inform immunization recommendations in terms of precautions and contraindications to receipt of immunization.
DESCRIPTION OF WORKGROUP ACTIVITIES
The following activities provide a framework for the COVID-19 immunization WG multi-year efforts which may involve data requests from other Federal and private partners:
- Review and summarize existing data and published and unpublished research and clinical knowledge related to the safety, effectiveness, and immunogenicity of COVID-19 immunizations authorized or approved in the United States.
- Summarize literature reviews of the epidemiology of COVID-19 disease and SARS-CoV-2 virus.
- Assess the benefit-risk balance for administration of COVID-19 immunization products at the same time as other immunizations.
- Identify areas where additional data and research are needed to inform COVID-19 immunization recommendations.
- Develop COVID-19 immunization recommendations.
- Review and summarize the existing clinical and scientific information available; and gaps in the existing knowledge, including from other federal agencies like the FDA, where appropriate relating to bio distribution, pharmacokinetics and persistence of the spike protein, mRNA, and lipid nanoparticles to inform immunization recommendations.
- Review and summarize the existing clinical and scientific information (including from federal agencies like the FDA, where appropriate); gaps in the existing knowledge regarding potential impurities (e.g., DNA contamination and endotoxins) in existing immunization products and their health impacts to inform immunization recommendations.
- Review and summarize the existing scientific knowledge, and gaps, regarding the cumulative short- and long-term impact of repeated boosting immunization including non-specific effects (e.g., IgG4 class switching, immune imprinting, viral evolution under leaky immunizations) to help inform immunization recommendations.
- Examine the impact of COVID-19 immunization on COVID-19 and all cause deaths, hospitalizations, and disability to inform immunization recommendations.
- Analyze existing data and scientific knowledge regarding cardiovascular, thrombotic, neurological, immunological and other serious adverse events potentially caused by COVID-19 immunization.
- Review and summarize available data, information, and gaps regarding long-term Covid effects from scientific literature and clinical experience associated with COVID-19 immunization products and COVID-19 infection to inform policy recommendations.
- Map existing COVID-19 immunization policies in countries around the world and how they compared to the US.
- Analyze existing data and scientific knowledge related to the safety of COVID-19 immunization during pregnancy.
COVID-19 Immunizations Workgroup Terms of Reference
Cytomegalovirus Vaccines
- Work group purpose: Cytomegalovirus, or CMV, is the most common infectious cause of birth defects in the United States. About 1 out of 200 babies is born with congenital CMV infection. One out of 5 babies with congenital CMV infection will have symptoms or long-term health problems, such as hearing loss. CMV is also an important cause of morbidity and mortality among people with immunocompromising conditions. Multiple candidate CMV vaccines are currently under development. The purpose of the ACIP CMV Vaccines Work Group is to review data on CMV vaccines and develop CMV vaccine policy options for ACIP consideration.
- Topics under discussion by the work group: Future use of CMV vaccines in the U.S.
- Work group activities:
- Review safety, immunogenicity, and efficacy data for CMV vaccine candidates from Phase I-III clinical trials.
- Review the epidemiology of CMV and congenital CMV infection and identify potential target populations for vaccination.
- Identify areas where additional data are needed to inform CMV vaccine policy recommendations.
- Develop CMV vaccine policy options that ACIP may consider for recommendation.
Human Papillomavirus Vaccine
- Work group purpose: The Human Papillomavirus (HPV) Vaccines Work Group reviews and evaluates data on HPV disease, epidemiology, and vaccine and to develop possible modifications to policy for ACIP’s consideration.
- Topics under discussion by the work group:
- Reducing the number of vaccine doses in the recommended HPV vaccination series.
- Wording of the age for routine vaccination.
- Guidance regarding persons in the “shared clinical decision-making” age range.
- Work group activities (1): Reducing the number of vaccine doses in the recommended HPV vaccination series
- Review evidence on immunogenicity, efficacy and effectiveness of vaccination with fewer than 2 doses in persons aged 9 through 14 years.
- Review evidence on immunogenicity, efficacy and effectiveness of fewer than 3 doses in persons older than age 15 years.
- Develop Evidence to Recommendations framework including GRADE.
- Develop policy options for presentation and discussion with ACIP.
- Update MMWR Policy Note and MMWR Recommendation and Report, as needed.
- Work group activities (2): Wording of the age for routine vaccination
- Review programmatic data on age at vaccination in the United States.
- Develop modified Evidence to Recommendations Framework.
- Develop wording options for presentation and discussion with ACIP.
- If needed, update MMWR Policy Note.
Influenza Vaccines
- Work group purpose: The Influenza Vaccine Work Group discusses the annual seasonal influenza vaccination recommendations and develops policy options for ACIP's consideration. The Work Group reviews data and literature related to influenza vaccine efficacy, effectiveness, and safety. Data concerning new licensures and licensure changes are also discussed.
- Topics under discussion by the work group:
- Assessment of specific influenza vaccines in specific populations (e.g., based upon age, risk factors for severe illness, susceptibility to adverse events).
- Timing of vaccination.
- Vaccination during pregnancy.
- Evidence assessment and policy development for new vaccines.
- Effectiveness and safety of different influenza vaccines relative to one another.
- Work group activities:
- Ongoing discussions of vaccine effectiveness (VE).
- Ongoing discussions of vaccine safety.
- Discussion of new licensures and licensure changes as relevant.
Meningococcal Vaccines
- Work group purpose: The Meningococcal Vaccines Work Group discusses meningococcal vaccine recommendations and develops policy options for ACIP’s consideration.
- Topics under discussion by the work group:
- The adolescent meningococcal vaccine schedule is being revisited to ensure vaccines are administered at a time to optimize protection for higher risk ages (e.g., re-consideration of the 11-12 year-old dose for MenACWY, higher meningitis B risk during first year of college) and reflect implementation considerations (e.g., routine vs. risk-based vs. shared clinical decision-making recommendations, harmonization with existing adolescent platform).
- Guidance for use of GSK's pentavalent meningococcal vaccine will be developed. It is anticipated that this vaccine will be licensed as a 2-dose series (doses separated by 6 months) for the prevention of Neisseria meningitidis infections in persons ages 10 through 25 years.
- Work group activities:
- Review the epidemiology of invasive meningococcal disease in the U.S., including burden in adolescents (including race/ethnicity) and breakthrough infections.
- Review immunogenicity and safety clinical trial data for GSK’s pentavalent vaccine.
- Perform economic analyses (including burden of disease averted by vaccination).
- Develop draft policy recommendations based on grading of recommendations, assessment, development and evaluation (GRADE) and the evidence to recommendations (EtR) framework.
Mpox Vaccines
- Work group purpose: The Mpox Vaccine Work Group discusses the data about use of JYNNEOS vaccine in children 12-17 years of age and develops policy options for use of the 2-dose JYNNEOS vaccine series for this population. The Work Group reviews data and literature related to mpox vaccine effectiveness, and safety and also considers other domains in the Evidence to Recommendations framework in anticipation of presenting the data to ACIP for consideration.
- Topics under discussion by the work group:
- Use of JYNNEOS (MVA-BN) in adolescents aged 12-17 years at risk for mpox during 1) an mpox outbreak* and 2) because of the ongoing clade IIb global mpox outbreak.
- Work group activities
- Review the epidemiology of mpox in children 12-17 years of age, including the burden among persons in the United States.
- Discuss safety, effectiveness, and immunogenicity of the vaccine in persons aged 12-17 years.
- Propose evidence-based recommendation options for ACIP.
- Identify areas in need of further research for informing future vaccine recommendations, including use of JYNNEOS in children under 12 years of age.
* Public health authorities determine whether there is an mpox outbreak; a single case may be considered an mpox outbreak at the discretion of public health authorities. Other circumstances in which a public health response may be indicated include ongoing risk of introduction of mpox into a community due to disease activity in another geographic area.
Pneumococcal Vaccines
- Work group purpose: Each year in the United States, pneumococcal disease causes thousands of infections, such as meningitis, bloodstream infections, pneumonia, and ear infections. The Pneumococcal Vaccines Work Group:
- Reviews current data on pneumococcal disease epidemiology;
- Reviews current data on pneumococcal vaccines and assesses the strength of the evidence;
- Assesses cost-effectiveness and public health impact of new and current vaccine policy options; and
- Develops revised or updated policy options for pneumococcal vaccines as needed.
- Topics under discussion by the work group:
- Use of new pneumococcal conjugate vaccines in U.S. adults and children.
- Work group activities
- Reviews new evidence on pneumococcal disease epidemiology and pneumococcal vaccine coverage in the United States.
- Reviews new evidence on pneumococcal vaccines that are currently recommended in the United States.
- Reviews evidence on new pneumococcal vaccines in advanced stages of development.
- Summarize evidence relevant to the policy questions considered by the ACIP using Evidence to Recommendations framework and GRADE.
- Update MMWR Policy Note and MMWR Recommendation and Report, as needed.
Respiratory Syncytial Virus Vaccines – Pediatric/Maternal
- Work group purpose: Respiratory syncytial virus (RSV) is a major cause of lower respiratory illness, particularly among infants and children and among older adults and adults with chronic medical conditions. In 2023, RSV vaccines and monoclonal antibodies were recommended by CDC for the first time, and additional candidate vaccines and long-acting monoclonal antibodies are being developed. Target populations for whom these products are intended include infants and young children, pregnant women, and older adults.
- This work group will focus on products intended for infants, young children, and pregnant women. Another Work Group will focus on products for older adults.
- Topics under discussion by the work group
- Use of RSV vaccine(s) in pregnant women and long-acting monoclonal antibody products in infants and young children.
- Work group activities: Consider recommendation options for use of RSV vaccines and long-acting monoclonal antibodies targeting prevention of RSV disease in children <18 years-old.
- Review the epidemiology and burden of RSV disease in children and pregnant women.
- Review efficacy/effectiveness, immunogenicity, safety, and cost-effectiveness of RSV vaccine(s) administered to pregnant women and long-acting monoclonal antibody products in infants and young children.
- Provide evidence-based recommendation options regarding use of RSV vaccine(s) in pregnant women and long-acting monoclonal antibody products in infants and young children.
- Identify areas in need of further research for informing potential future vaccine and long-acting monoclonal antibody recommendations.
Respiratory Syncytial Virus Vaccines – Adult
- Work group purpose: Respiratory syncytial virus (RSV) is a major cause of lower respiratory illness, particularly among infants and children and among older adults and adults with chronic medical conditions. RSV vaccine development has progressed in the past decade, with the first RSV vaccines for adults licensed and recommended in 2023. Target populations for whom these products are intended include infants and young children, pregnant women, older adults, and adults with chronic or immunocompromising medical conditions.
- This work group will consider policy questions related to vaccination to prevent severe RSV disease in adults. The separate pediatric/maternal Work Group will consider policy topics related to vaccination of infants, young children, and pregnant women.
- Topics under discussion by the work group:
- FDA- approved RSV vaccines and other immunization products pending licensure.
- Target populations for RSV vaccination recommendations, defined by age and risk factors for severe RSV disease.
- Appropriateness and timing of RSV revaccination.
- Work group activities: Consider recommendation options for the use of RSV vaccines in older adults, adults with immune compromise, and adults with other risk factors for severe RSV disease:
- Review the epidemiology and burden of RSV disease in older adults and adults with adults with risk factors for severe RSV disease.
- Review efficacy, immunogenicity, safety, and cost-effectiveness of RSV vaccine(s) in older adults and adults with risk factors for severe RSV disease.
- Provide options for evidence-based recommendations regarding use of RSV vaccine(s) in older adults and adults with risk factors for severe RSV disease.
- Identify areas in need of further research and review data on experience with current RSV vaccine recommendations to inform updates to RSV vaccine policy.