Clinical Decision Support

The purpose of this webpage is to provide continued access to Clinical Decision Support (CDS) resources, many originally published by the Centers for Disease Control and Prevention (CDC), so they remain available for reference and use by the immunization information system (IIS) and public health community.

To support this effort, AIRA is hosting key Clinical Decision Support for Immunization (CDSi) resources for ongoing use, including Supporting Data, Test Cases, and Logic Specification:

• Supporting Data: Structured datasets to implement the logic consistently across systems
• Test Cases: Example scenarios for routine age-based vaccinations and vaccinations influenced by risk factors and underlying conditions
• Logic Specification: Clear, system-neutral rules for applying ACIP vaccine recommendations

The resources in the table, below, were previously published by CDC. To view current CDC CDSi resources, visit www.cdc.gov/iis/cdsi/index.html.

Release Date	Primary Changes from Previous Version	Supporting Data	Test Cases Match to Supporting Data	Logic Specification Match to Supporting Data
November 2025	2025-2026 Flu, COVID (SCDM), and RSV Use of MMRV (Proquad) under 4 years not recommended Inclusion of Penmenvy (Mening ACWY&B vaccine)	Supporting Data, 4.64   [2 MB] Nov. 2025	Healthy Childhood and Adult, 4.45   Nov. 2025  Underlying Conditions, 4.6   Sept. 2025	Logic Specification, 4.6   [4.6 MB, 151 pages]  Dec. 2024
May 2025	Improved Contraindication support	Supporting Data, 4.62   [2 MB] May 2025	Healthy Childhood and Adult, 4.43  May 2025  Underlying Conditions, 4.5   May 2024	Logic Specification, 4.6   [4.6 MB, 151 pages] Dec. 2024

What is CDS and Why It Matters

Clinical Decision Support (CDS) for immunizations, also known as evaluation and forecasting, is an automated process that helps healthcare providers determine which vaccines a patient needs. CDS tools are integrated into Health Information Systems (HIS) such as Electronic Health Records (EHRs), Immunization Information Systems (IIS), and Health Information Exchanges (HIEs). These systems generate vaccine recommendations based on guidelines from recommending bodies like the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), etc., which establish schedules for vaccine administration, dosing intervals, and precautions.

Translating recommendations into a format that HIS systems can use is complex. Historically, CDS outputs could vary because each system interpreted the guidance independently. The CDC’s Clinical Decision Support for Immunization (CDSi) project addressed this need by providing standardized, implementation-neutral specifications and supporting data that translate ACIP recommendations into consistent, actionable rules. Future CDS may be generated based on recommendations from other organizations. Currently, the only publicly available CDS uses the ACIP recommendations.

Additional Resources 

AIRA Resources
	AIRA’s microlearning, From Complexity to Clarity: What Clinical Decision Support (CDS) Does for Vaccines, breaks down how CDS supports immunization decision-making within systems like IIS and EHRs. Designed for public health professionals who are new to CDS, this course provides foundational guidance to support a rapidly evolving immunization landscape.
	An accompanying CDS one-sheet describes the role of CDS in immunizations, including key functions, benefits, and considerations for maintaining clear and consistent vaccine guidance.
CDC Resources
	CDC's 8-page CDSi mini-guide offers a concise, easy-to-read overview of the CDSi resources above.
	A CDSi infographic presents a high-level, visual overview of CDSi resources in a single-page format.