The Immunization Calculation Engine (ICE) Advisory Group met on September 29, 2025, to discuss the evolving immunization landscape and its impact on clinical guidelines within ICE. The group brought together over thirty immunization experts from nearly twenty organizations, including public health, healthcare organizations, and health IT providers. With functional roles spanning leadership, clinical, operational, and technical disciplines, the group engaged in a rich discussion to advise the HLN ICE team on navigating the current challenges.
A significant portion of the discussion centered on the approach to clinical guidelines within the ICE open source software. Historically, the recommendations of the Advisory Committee on Immunization Practices (ACIP) served as the evidence-based foundation for the immunization clinical decision support in ICE. These evidence-based recommendations are reflected in the ICE default immunization schedule logic and implementation, supporting evaluation and forecasting for 18 vaccine groups across the lifespan.
Driven by recent changes at the federal level and in ACIP’s makeup and processes, the ICE Advisory Group discussed alternate sources for evidence-based immunization guidelines. The discussion highlighted the divergence in recent immunization recommendations as issued by the ACIP compared to those issued by professional medical societies, new regional collaboratives, and state public health agencies.
Additionally, the group also acknowledged the inherent challenges created by this fractured landscape, including:
- Jurisdictional requirements for adherence to ACIP recommendations.
- Complexities in understanding coverage for vaccines, particularly regarding the Vaccines for Children (VFC) program and private payers.
- Concerns over federal funding implications for jurisdictional public health agencies.
HLN looks forward to continued discussion and collaboration with the ICE Advisory Group to navigate these challenges in the rapidly changing environment. For more information about ICE and/or the ICE Advisory Group, please reach out to us at ice@hln.com.