Clinical Decision Support

As the immunization landscape evolves, IIS programs may need to support vaccine recommendations and schedules from multiple sources. In addition to CDC guidance, national medical societies, including the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the Infectious Diseases Society of America (IDSA), are developing their own immunization recommendations and schedules.

As multiple recommendations emerge, AIRA is providing resources and Supporting Data to help IIS, electronic health records (EHRs), and other health IT systems implement the guidance they choose to adopt within their jurisdictions and healthcare systems.

Resources on this page include Supporting Data informed by recommendations from national medical societies, as well as Supporting Data, Test Cases, and Logic Specifications associated with recommendations from the Advisory Committee on Immunization Practices (ACIP). At this time, Test Cases are not available for the medical society recommendations, but additional implementation resources may be developed in the future.

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Supporting Data for National Medical Society Recommendations

The resources in the table below were developed by AIRA and our partners using the recommendations provided by the medical societies included.

Release Date	Primary Changes from Version 4.65 of the CDSi Project	Supporting Data	Logic Specification Match to Supporting Data
September 2026	This release focuses specifically on the 2026-2027 respiratory seasonal recommendations for influenza, RSV, and COVID. The zip file includes only files needed to support these recommendations and does not include files for all vaccine preventable diseases. The release notes document and the Change History tab in each Excel file detail changes from the most recent CDSi Supporting Data, version 4.65.	Supporting Data, 26.1 Sept. 2026	Logic Specification, 4.6 Dec. 2024 The existing CDC CDSi Logic Specification should be used with AIRA’s medical societies Supporting Data.

CDC Resources

The resources in the table, below, were previously published by CDC:

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

To view current CDC CDSi resources, visit www.cdc.gov/iis/cdsi/index.html.

Release Date

Primary Changes from Version 4.65

Supporting Data

Test Cases
Match to Supporting Data

Logic Specification
Match to Supporting Data

August 2026

Reverted prior Flu and MMRV changes in accordance with the current legal stay.
Retained 2025–2026 Flu, COVID-19, and RSV recommendations to support evaluation of previously administered doses.
Added Vaccine Recommendation Category supporting data to identify Routine, High-Risk, and Shared Clinical Decision Making (SCDM) forecasts.
Incorporated numerous antigen-specific corrections and improvements, including HPV, Pertussis, Varicella, and other supporting data updates.
Updated all supporting data files to meet ADA accessibility requirements.

Supporting Data, 4.65
Aug. 2026

Healthy Childhood and Adult, 4.46
Aug. 2026

Underlying Conditions, 4.6
Aug. 2026

Logic Specification, 4.6

Dec. 2024

New to CDS? Explore the Resources Below

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.