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Rules Based on Patient's Age

For males and females:

• If a patient is < 27 years old, follow the Immunization Series and Selection Rules (listed below).
• If a patient is >= 27 years and < 46 years old and:
• Has one or more doses at < 46 years old

• , has not completed the series,

• and will be < 46 years old at the next recommended due date, then recommend based on table rules. 
• Does NOT have any doses at < 46 years old, then Recommendation is Conditional and the reason code is CLINICAL_PATIENT_DISCRETION.
• Shots administered to a patient who is >= 27 years and < 46 years will continue to be evaluated (based on minimum intervals) and, if valid, will count toward completion of the series.
• If the patient is >= 46 years old, (or will be >= 46 years old

• at the next recommended due date), then:
• Recommendation is Not Recommended and the reason code is TOO_OLD. 
• If a dose is administered at >= 46 years, the Evaluation is Accepted and the reason code is ABOVE_REC_AGE_SERIES.
• The series can NOT be initiated and completed once the patient is >= 46 years old.

Rules for Recommending at the CVX Code vs. Vaccine Group Level

• When recommending in the HPV 3-dose series or HPV 2-dose series, always recommend at the vaccine group level.