Celebrating the ACIP at 50.

In this issue, Walton, Orenstein, and Pickering provide a useul summary of the 50-year history of the Advisory Committee n Immunization Practices (ACIP). When the ACIP was formed in 964, immunization recommendations for children were primarily eveloped by the American Academy of Pediatrics (AAP), with the merican Public Health Association and other professional organiations also providing recommendations for civilian populations. he Armed Forces Epidemiological Board made recommendations or immunizations in the Armed Forces. In the early years of the CIP, its recommendations were primarily directed toward public ealth agencies, which provided approximately 50% of childhood mmunizations. The AAP, on the other hand, directed its recomendations at private practitioners, who provided the other 50% f childhood immunizations. Since 1984, the ACIP has also issued ecommendations aimed at adults – a policy area of growing imporance given the aging demographics of the U.S. Walton et al. describe some of the differences in recommenations from these bodies that caused confusion among many ractitioners, notably those relating to the age at which the secnd dose of measles–mumps–rubella (MMR) vaccine should be dministered; the ACIP recommended administering the second ose at 4–5 years, as part of school entry immunization. By contrast, he AAP initially recommended administering the second dose at 1–12 years. Conscious efforts to ensure harmonization of vaccine ecommendations among various bodies have included assuring iaison representation at ACIP meetings from bodies such as AAP, he American Academy of Family Physicians (AAFP), the American ollege of Obstetrics-Gynecology (ACOG), and the American Colege of Physicians (ACP), as well as an additional 27 organizations. s a consequence, for the past 20 years there has been harmoization among the recommendations, facilitating more effective mmunization of children and adults. Another facet of the evolution of the ACIP described by Walton t al. is the increasing rigor of the process of developing recmmendations. Initially, recommendations were written by ACIP embers themselves in consultation with CDC staff and were relaively short. Over the years, the development of recommendations as become more formal and explicit, with work groups includng ACIP members and others (including representatives of vaccine anufacturers) who review the evidence of safety and efficacy of specific vaccine over a several-month period before drafting a