This document addresses the use of childhood and adult immunizations as recommended by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC). Immunization is a technique used to induce immune resistance to a specific disease in humans by exposing the individual to an antigen in order to raise antibodies to that antigen. This process increases an individual’s reaction to an antigen and therefore improves the ability to resist or overcome infection. Current immunization schedules and recommendations can be found at the following websites:

• American Academy of Family Physicians: https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines.html
• American Academy of Pediatrics: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Pages/Immunization-Schedule.aspx
• Advisory Committee on Immunization Practices: https://www.cdc.gov/vaccines/schedules

Position Statement

Medically Necessary:

For Childhood Immunizations:
The most recent recommendations of the American Academy of Family Physicians (AAFP), or the American Academy of Pediatrics (AAP), or the affirmative recommendations of the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) for childhood immunizations are considered medically necessary.

For Adult Immunizations:
The most recent recommendations of the American Academy of Family Physicians (AAFP) or affirmative recommendations of the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) for adult immunizations are considered medically necessary.

Not Medically Necessary:

Childhood and adult immunizations are considered not medically necessary for all other indications not listed above.

Note:
Permissive recommendations of the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) for childhood and adult immunizations are reviewed on an individual basis to determine medical necessity and will be listed in the position statement of this document when determined to be not medically necessary.