General Best Practice Guidelines for Immunization

On April 20, 2017, CDC released the General Best Practice Guidelines for Immunization(https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html). The General Best Practice Guidelines for Immunization replace the 2011 General Recommendations on Immunization.
According to ACIP Executive Secretary Amanda Cohn, MD, “The General Best Practice Guidelines for Immunization is a living document, and releasing it as an online report allows ACIP to update the document more quickly, giving vaccination providers the most up-to-date guidance on vaccination practice.”
According to the introduction of the document: The Centers for Disease Control and Prevention (CDC) recommends routine vaccination to prevent 17 vaccine-preventable diseases that occur in infants, children, adolescents, or adults. This report provides information for clinicians and other health care providers about concerns that commonly arise when vaccinating persons of various ages. Providers and patientsmust navigate numerous issues, such as the timing of each dose, screening for contraindications and precautions, the number of vaccines to be administered, the educational needs of patients and parents, and interpreting and responding to adverse events. Vaccination providers help patients understand the substantial body of (occasionally conflicting information about vaccination. This vaccination best practice guidance is intended for clinicians and other health care providers who vaccinate patient s in varied settings, including hospitals, provider offices, pharmacies, schools, community health centers, and public health clinics. The updated guidelines include 1) new information on simultaneous vaccination and febrile seizures; 2) enhancement of the definition of a “precaution” to include any condition that might confuse diagnostic accuracy; 3) confirmation that if a patient is not acutely moderately or severely ill, vaccination during hospitalization is a best practice; 4) more descriptive characterization of anaphylactic allergy; 5) incorporation of protocols for management of anaphylactic allergy; 6) allowances for alternate route (subcutaneous instead of intramuscular) for hepatitis A vaccination; 7) an age cutoff of 12 years through 17 years of age for validating a dose of intradermal influenza vaccine; 8) deletion of much of the content from storage and handling, including storage units, temperature monitoring, and expiration dates (because this content is now codified and continually updated in the CDC’s Vaccine Storage and Handling Toolkit, available at

Infectious Diseases Society of America guidance on vaccination of persons
with altered immunocompetence; 10) timing of intramuscular administration in patients with bleeding disorders; 11) updated data on vaccination record policy; 12) additional
impacts of the Affordable Care Act (1,2) on adult vaccination; and 13) updated
programmatic contact information on source material for vaccine information.

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