IDSA GUIDELINES Bundle

Vaccination of the Immunocompromised Host

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Key Points Strength of Recommendation and Quality of Evidence Category/Grade Definition Recommendation SR – Strong Clear desirable or undesirable effects WR – Weak Desirable and undesirable effects closely balanced or uncertain Quality of Evidence H – High Consistent evidence from well-performed RCTs or exceptionally strong evidence from unbiased observational studies M – Moderate Evidence from RCTs with important limitations or moderately strong evidence from unbiased observational studies L – Low Evidence for ≥1 critical outcome from observational studies, from RCTs with serious flaws or from indirect evidence VL – Very low Evidence for ≥1 critical outcome from unsystematic clinical observations or very indirect evidence Grade Implication Comment SR-H Applies to most patients in most circumstances Further research is unlikely to change estimate SR-M Further research may change estimate SR-L SR-VL Estimate of effect for at least one critical outcome is very uncertain WR-H e best action may differ depending on circumstances or patients or societal values Further research is unlikely to change estimate WR-M Alternative approaches likely to be better for some patients under some circumstances Further research may change estimate WR-L Other alternatives may be equally reasonable WR-VL Any estimate of effect, for at least one critical outcome, is very uncertain RCTs, randomized controlled trials. For the complete Grading of Recommendations Assessment, Development and Evaluation (GRADE) Strength of Recommendations and Quality of the Evidence Table, visit the IDSA website: http://www.idsociety.org/Guidelines_Other/.

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