OBJECTIVES: The Evidence to Recommendation (EtR) framework was adopted by the Center for Disease Control’s Advisory Committee on Immunization Practices (ACIP) in 2018 to supplement the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach for developing evidence-based vaccination recommendation. While preference information is not required, two domains (values and acceptability) allow for the incorporation of quantitative stated preference (SP) information in the framework. We reviewed published EtR frameworks to describe how often and what type of SP information is included.
METHODS: We reviewed all EtR frameworks published in the Morbidity and Mortality Weekly Report through November 2022. SP research was defined by the use of common SP methods (e.g., discrete choice experiment [DCE], best-worst scaling [BWS], threshold technique [TT], direct elicitation [DE]) to elicit preferences. Data extracted included: whether SP information was included in the values and preferences and acceptability domains, study population, preference concepts measured, SP method, and peer review, among other things.
RESULTS: Of the 39 EtR frameworks reviewed, 23 (59.0%) included survey-based data on stakeholder values or acceptability, 8 (20.5%) included SP information (7 for consumers and 1 for HCPs). The number of frameworks with SP information has increased each year (1 in 2020, 3 in 2021, 4 in 2022). Types of SP information included vaccination intentions, relative importance of vaccine features, and preferences for changes in vaccine recommendations. In these 8 frameworks, 8 SP studies were cited a total of 15 times. Of these studies, 1 (12.5%) was DCE, 1 (12.5%) was BWS, and 6 (75.0%) were DE. 7 (87.5%) of the cited SP studies were peer-reviewed. Many studies were not published.
CONCLUSIONS: The EtR framework facilitates the use of stakeholder preferences in vaccination recommendation decisions. While most frameworks include stakeholder value and acceptability, the number using SP information has been increasing.
