From science to guidance: How we make family medicine vaccine recommendations

Editor’s note: Watch aafp.org for updated respiratory vaccine recommendations coming in early September.

“How do you know your vaccine guidance is still valid?”

I get a version of that question a lot these days from AAFP members, other organizations and even reporters.

Many of you are having these conversations in exam rooms, during school physicals, and with families who are simply trying to make the right decision for their children and themselves.

It’s a fair question, and I want to answer it by showing you the work.

One road for all evidence-based guidelines

Here’s something worth knowing up front: Vaccines don’t get a special process at the AAFP. Immunization guidance travels the same road as our cancer screening recommendations, blood pressure guidance, everything. There are three phases:

It’s the same road every time.

That consistency isn’t bureaucratic habit. It’s the thing that makes the guidance checkable.

This part changed in spring 2025 to guarantee that the whole process is grounded in the latest research and free from non-scientific influence.

For decades, the systematic evidence review that fed our process came largely through the CDC’s Advisory Committee on Immunization Practices and its work groups, alongside the parallel work of our peer professional societies. That’s where the synthesis happened. We didn’t duplicate it because duplicating good work isn’t a virtue.

Today, that evidence review comes through the Vaccine Integrity Project (an independent group of public health and policy experts founded by the Center for Infectious Disease Research and Policy at the University of Minnesota) in collaboration with the AMA.

The VIP conducts systematic reviews and writes evidence briefs. The AMA coordinates communication across the medical community. The Council of Medical Specialty Societies helps those societies compare what they are seeing, including early vaccine product information, so we are not surprised by data that is already on the way.

Peer professional societies remain part of the conversation, just as they always have.

One detail I’d underline, because it’s the one a skeptical patient should care about: The VIP’s work is independently funded through philanthropy. Not by manufacturers, not by anyone with a product in the review. Its methods and its data are public.

Different source. Same standard: Published data are reviewed systematically by people with nothing riding on the answer.

The evidence briefs land where they always landed—with family physicians.

Something else that is new this year is the AAFP’s Vaccine Evidence Review Council. As the workload grew, we wanted a dedicated group conducting reviews rather than put more weight on the Academy’s Science Advisory Panel. The VERC is made up of family physicians with national reputations in evidence review, immunization science and implementation. It’s not a committee assembled for optics. It’s people who do this work.

From there, nothing is new. The AAFP’s Subcommittee on Clinical Preventive Services writes a draft. The Commission on Health of the Public and Science reviews, vets and, where needed, helps write it.

And everyone in this picture discloses anything that might be considered an outside influence. Not just the AAFP Board and the Commission—the VERC, the Science Advisory Panel, the subcommittee, the Health of the Public staff who support the work and the member representatives who serve as our liaisons to peer professional organizations all complete a conflict-of-interest disclosure at least annually. They are expected to update it whenever something changes and to recuse themselves when they should.

That last part is where disclosure stops being paperwork. It isn’t something that happens once a year or only at a Board meeting. It happens at the table where the decision is being made—including at a vaccine evidence review meeting.

The Board of Directors reviews and approves the recommendation. The Congress of Delegates ratifies it. These are physicians you elected, who answer to you.

This phase hasn’t changed at all.

Immunization recommendations are updated annually—the science doesn’t wait five years, so neither do we.

When a patient asks where your recommendation came from, you can tell them the truth: It came from published evidence that was synthesized by independently funded reviewers with nothing to sell, interpreted by family physicians who disclose their interests and see patients like yours, and approved by physicians your colleagues elected.

That matters because trust is easier to hold onto when the path from evidence to recommendation is visible.

The front end of the road to evidence-based immunization recommendations was rebuilt, but the road itself is the same. And the standard it has to meet never wavered.

Vaccines are still critical to public health, and your patients can still count on AAFP recommendations.