General Best Practice Guidelines for Immunization

The Centers for Disease Control and Prevention (CDC) has released the General Best Practice Guidelines for Immunization, which is now available on the Advisory Committee on Immunization Practices (ACIP) website. These guidelines replace the General Recommendations on Immunization, last published in the Morbidity and Mortality Weekly Report (MMWR) in 2011.

The General Best Practice Guidelines for Immunization goes beyond vaccination recommendations to give providers guidelines on vaccination practice. The document will help vaccination providers to assess vaccine benefits and risks, use recommended administration practices, understand the most effective strategies for ensuring that vaccination coverage in the population remains high, and communicate the importance of vaccination to reduce the effects of vaccine-preventable disease. By releasing the General Best Practice Guidelines for Immunization as an online report, ACIP will be able to update the document more quickly, giving vaccination providers the most up-to-date guidance on vaccination practice.

The updated guidelines include:

  1. Confirmation that if a patient is not acutely, moderately, or severely ill, vaccination during hospitalization is a best practice;
  2. New information on simultaneous vaccination and febrile seizures;
  3. Enhancement of the definition of “precaution” to include any condition that might confuse diagnostic accuracy;
  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 for validating a dose of intradermal influenza vaccine;
  8. Deletion of much of the storage and handling content, including information on storage units, temperature monitoring, and expiration dates (this content is now contained and continually updated in CDC’s Vaccine Storage and Handling Toolkit, available at;
  9. Incorporation of the 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 on adult vaccination; and
  13. Updated programmatic contact information on source material for vaccine information.

To receive updates on this and other ACIP recommendations and guidelines, sign up at

About Kim Rodgers

Kim Rodgers serves as a Communications Specialist at NACCHO. Her work includes promoting local health departments' best practices, as well as partner tools and resources, in infectious disease and preparedness through NACCHO's communications channels, storytelling, and outreach to various audiences.

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