Page Comparison

Two Shot Same Day Exception Rules for COVID-19

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Series

- at the vaccine group level at 6 months old, or at the recommended interval, whichever date is later.
- otherwise, recommend at the vaccine group level at the recommended due date.

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

If the patient has no shots on record,
- and is < 5 years old, recommend CVX 218 at 5 years old.
- and is > = 5 years old and < 12 years old, recommend CVX 218 at today's date.
- and is > = 12 years old6 months old, recommend at the vaccine group level with recommendation reason at 6 months of age.
- otherwise, recommend at the vaccine group level at today's today’s date.
If the patient has shots on record and the series is not complete,
- and is < 5 years 6 months old, recommend CVX 218 at 5 years old.
- and is > = 5 years old and < 12 years old (or will be < 12 years old at the recommended due date), recommend CVX 218 for the next target dose.
- and is > = 12 years old (or will be >= 12 years old at the recommended due date) and < 18 years old, recommend at the vaccine group level for the next target dose.
- and is > = 18 years old and is in the following series:
  - Pfizer COVID-19 2-dose Series, recommend at the vaccine group level for the next target dose.
  - Moderna COVID-19 2-dose Series, recommend at the vaccine group level for the next target dose.
  - Janssen COVID-19 1-dose Series, recommend at the vaccine group level for the next target dose.

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Series Completion Special Rule

Once a patient completes:
- the Pfizer a COVID-19 2-dose series, Moderna COVID-19 2-dose series, a COVID-19 vaccine series not authorized by the FDA, but authorized vaccine series not authorized by the FDA, but authorized by the WHO, or a COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine,
  - recommend a booster dose of COVID-19 (at vaccine group level) at recommended interval (5 months) or at recommended age (12 years), whichever date is later, along with recommendation reason code BOOSTER_DOSE.
  - and receives an additional dose1 (see “Rules for Additional Dose” for information on what constitutes an additional dose ¹and how is evaluated), the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.and receives a booster dose², the Recommendation is Not Recommended and the reason code is COMPLETE
  - See “Rules for Booster Dose” for booster dose recommendations for the these series.
- the Pfizer Moderna COVID-19 (5-17) 2-dose series,
  and is >= 12 Series,
  - and is < 5 years old, the recommendation is Not Recommended and the reason code is COMPLETE.
  - and is < 18 years old, the recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
  - and is >= 18 years old, recommend a booster dose of COVID-19 (at vaccine group level) at recommended interval (5 months) or at recommended age (
    12
    18 years), whichever date is later, along with recommendation reason code BOOSTER_DOSE
  - and
    is < 12 years old, the recommendation is Conditional
    receives an additional dose¹ (see “Rules for Additional Dose” for information on what constitutes an additional dose and how is evaluated), the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
  - and receives an additional dose¹, the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
  - and receives a booster dose², the Recommendation is Not
  - See “Rules for Booster Dose” for booster dose recommendations for the Moderna COVID-19 ~~(5-17) 2-dose~~ Series.
- the Pfizer COVID-19 Series or Mixed Product Series
  - and is < 5 years old, the recommendation is Not Recommended and the reason code is COMPLETE.
  the Janssen COVID-19 1-dose series,
  - and is >= 12 5 years old, recommend recommend a booster dose of COVID-19 (at vaccine group level) at recommended interval (5 months) or at recommended interval age (8 weeks)5 years), whichever date is later, along with recommendation reason code BOOSTER_DOSE.
  - and is < 12 years old, the recommendation is Conditional receives an additional dose¹, the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
  - and receives a booster dose², the Recommendation is Not Recommended and the reason code is COMPLETE.

Rules for an Additional Dose¹

If a patient completes a COVID-19 vaccine series via the Pfizer
- the Janssen COVID-19
2
- 1-dose series,
Moderna COVID-19 2-dose series, COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a COVID-19 vaccine series not authorized by the
- - and is >= 12 years old, recommend a booster dose of COVID-19 (at vaccine group level) at recommended interval (8 weeks), along with recommendation reason code BOOSTER_DOSE.
  - and is < 12 years old, the recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
  - See “Rules for Booster Dose” for booster dose recommendations for the Janssen COVID-19 1-dose series.

Rules for an Additional Dose¹

If a patient completes a COVID-19 vaccine series via the Pfizer COVID-19 series, Moderna COVID-19 series, COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine and receives an additional shot of CVX 207, CVX 208, CVX 213, CVX 217, CVX 207, 218, CVX 219, CVX 227 or CVX 213228:
- at < 28 days 5 months after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 28 days required for an Additional Dose for immunocompromised patients or the minimum interval of 5 months required for a Booster Dose."at >= 28 days and < 5 months after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 5 months required for a 5 months required for the 1st Booster Dose."
- at >= 5 months after series completion, then evaluate the shot as Valid.

If a patient is >= 5 years old, completes a COVID-19 vaccine series via the Pfizer COVID-19 (5-17) 2-dose series and receives an additional shot of CVX 218, CVX 208, CVX 217, CVX 207, or CVX 213:

at < 28 days after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 28 days required for an Additional Dose for immunocompromised patients or the minimum interval of 5 months required for a Booster Dose."
at >= 28 days and < 5 months after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 5 months required for a Booster Dose."
at >= 5 months after series completion, then evaluate the shot as Valid.

Rules for Booster Dose²

Any of the FDA-Approved COVID-19 vaccines (except CVX 218) can be used for booster vaccination, regardless of the vaccine product used for primary vaccination. When a heterologous or “mix and match” booster dose is administered, the eligible population and dosing intervals are those of the vaccine used for primary vaccination.

Recommendation Rules for Booster Dose

Recommend at the Vaccine Group Level (along
If a patient completes a COVID-19 vaccine series via the Janssen 1-dose series and receives an additional shot of CVX 207, CVX 208, CVX 213, CVX 217, CVX 218, CVX 219, CVX 227 or CVX 228:
- at < 8 weeks after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 8 weeks required for the 1st Booster Dose"
- at >= 8 weeks after series completion, then evaluate the shot as Valid.

Rules for Booster Dose²

Any of the FDA-Approved COVID-19 vaccines (except CVX 218) can be used for booster vaccination, regardless of the vaccine product used for primary vaccination. When a heterologous or “mix and match” booster dose is administered, the eligible population and dosing intervals are those of the vaccine used for primary vaccination.

Recommendation Rules for Booster Dose

Recommend at the Vaccine Group Level (along with recommendation reason code BOOSTER_DOSE)
Recommended Age = 12 years
Minimum Age = 12 years
Recommended IntervalAfter completion of Pfizer 2-dose series, Moderna 2-dose series, Pfizer COVID-19 Child (5-17) 2-dose series, COVID-19
First Booster Dose
- After completion of a COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19
vaccine
- vaccine
  - Recommended Age = 12 years
  - Minimum Age = 12 years
  - Recommended Interval = 5 months
  - Include recommendation reason Code ADMINISTER_mRNA_VACCINE (new reason code)
- After completion of
Janssen 1-dose series = 8 weeks

Evaluation Rules for Booster Dose

Any of the FDA-Approved COVID-19 vaccines (except CVX 218) are allowed for the Booster Dose.
Absolute Minimum Interval = 0 days
If a patient completes a COVID-19 vaccine series via the Pfizer 2-dose series, Moderna 2-dose series, Pfizer COVID-19 Child (5-17) 2-dose series, COVID
- the Moderna COVID-19 Series
  - Recommended Age = 18 years
  - Minimum Age = 18 years
  - Recommended Interval = 5 months
- After completion of the Pfizer COVID-19 Series or Mixed Product Series
  - Recommended Age = 5 years
  - Minimum Age = 5 years
  - Recommended Interval = 5 months
- After completion of Janssen 1-dose series
  - Recommended Age = 12 years
  - Minimum Age = 12 years
  - Recommended Interval = 8 weeks
2nd Booster Dose:
- After completion of the first booster in the Pfizer Series, Moderna ~~Series, Mixed Product Series, a COVID-19 vaccine series not authorized by the FDA~~
,
but authorized by the WHO, or a COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19
vaccine and receives a Booster Dose² of CVX 208, CVX 217, CVX 207, CVX 212, or CVX 213:
at < 28 days after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 28 days required for an Additional Dose for immunocompromised patients or the minimum interval of 5 months required for a Booster Dose."
at >= 28 days and < 5 months after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 5 months required for a Booster Dose."
at >= 5 months after series completion, then evaluate the shot as Valid.
If a patient completes a COVID-19 vaccine series via the Janssen 1-dose series and receives a Booster Dose² of CVX 208, CVX 217, CVX 207, CVX 212, or CVX 213:
at < 8 weeks after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 8 weeks required for a Booster Dose."
at >= 8 weeks after series completion, then evaluate the shot as Valid.

Rules for Extra Shots After Additional Dose¹and/or Booster Dose²

~~For patients that completed the Pfizer COVID-19 2-dose series, Additional Dose and/or Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.~~
For patients that completed the Pfizer COVID-19 Child (5-17) 2-dose Series,
is < 5 years old, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
is > = 5 years old and < 12 years old and received an Additional Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
is > = 12 years old and received an Additional Dose and/or Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
~~For patients that completed the Moderna COVID-19 2-dose series, Additional Dose and/or Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.~~
~~For patients that completed Janssen COVID-19 1-dose series and Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.~~
For patients that completed either the 1) COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a 2) COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine, Additional Dose and/or Booster Dose, any shots administered after the primary series is evaluated as Accepted/EXTRA_DOSE.

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Notes

¹Additional Dose - Defined by ACIP to be a dose administered when the immune response to a standard primary vaccine series is likely not to be protective.
²Booster Dose - Defined by ACIP to be a dose administered to restore protection after the effectiveness of protection from the primary series has declined.

COVID-19 Vaccines

~~...~~

~~CVX Code~~

~~...~~

~~Name~~

~~...~~

~~Moderna COVID-19 Vaccine~~

~~...~~

~~208~~

~~...~~

~~Pfizer COVID-19 Vaccine~~

~~...~~

~~500~~

~~...~~

~~COVID-19 Non-US Vaccine, Product Unknown~~

~~...~~

~~501~~

~~...~~

~~COVID-19 IV Non-US Vaccine (QAZCOVID-IN)~~

~~...~~

- vaccine:
  - If the patient is < 50 years of age, recommend Conditional / COMPLETE_HIGH_RISK.
  - Otherwise:
    - Minimum Age = 50 years
    - Recommended Age = 50 years
    - Recommended Interval = 4 months
- After completion of first booster dose in the Janssen series:
  - If the patient >= 12 years of age and < 18 years of age:
    - Recommend Conditional / COMPLETE_HIGH_RISK
  - If the patient >= 18 years of age:
    - and <50 years:
      - Recommend Conditional / COMPLETE_HIGH_RISK if first booster dose was an mRNA vaccine (CVX 207, CVX 208, CVX 213, CVX 217 or CVX 221)
    - and >=50 years:
      - Recommended Age = 50 years if first booster dose was an mRNA vaccine (CVX 207, CVX 208, CVX 213, CVX 217, or CVX 221)
      - Recommended Age = 18 years if first booster dose was the Janssen vaccine (CVX 212)
      - Recommended Interval = 4 months
- After completion of the 2nd booster dose² (must be mRNA), the Recommendation is Not Recommended and the reason code is COMPLETE.

Evaluation Rules for Booster Dose

Any of the FDA-Approved COVID-19 vaccines (except CVX 218) are allowed for both Booster Doses.
Absolute Minimum Interval = 0 days
First Booster Dose:
- If a patient completes a COVID-19 vaccine series via the Pfizer series, Moderna 2-dose series, COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine and receives a Booster Dose² of CVX 207, CVX 208, CVX 212, CVX 213, CVX 217 or CVX 221:
  - at < 5 months after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 5 months required for a Booster Dose."
  - at >= 5 months after series completion, then evaluate the shot as Valid.
- If a patient completes a COVID-19 vaccine series via the Janssen 1-dose series and receives a Booster Dose² of CVX 207, CVX 208, CVX 212, CVX 213, CVX 217 or CVX 221:
  - at < 8 weeks after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 8 weeks required for a Booster Dose."
  - at >= 8 weeks after series completion, then evaluate the shot as Valid.
Second Booster Dose:
- If a patient completes a COVID-19 vaccine series via the Pfizer COVID Series, Moderna COVID Series, Janssen 1-dose series, COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine and receives a Booster Dose² of CVX 208, CVX 217, CVX 207, CVX 212, CVX 213 or CVX 221:
  - at < 4 months after the first booster dose, then evaluate the shot as Valid / SUPPLEMENTAL_TEXT; Descriptive Text: “"The timing of the administration of this shot does not follow the guidelines regarding the minimum interval of 4 months required for the 2nd Booster Dose."
  - at >= 4 months after the first booster dose, evaluate the shot as Valid.

Rules for Extra Shots After Additional Dose¹and/or Booster Doses²

In the Pfizer COVID-19 Series and Mixed Product COVID-19 Series:
- is < 5 years old, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- is > = 5 years old and < 50 years old and received an Additional Dose and/or Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- is >= 50 years of age and Additional Dose and/or Booster Dose, and 2nd Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- and Additional Dose and/or 1st Booster Dose and 2nd Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE
For patients that completed the Moderna COVID-19 2-dose series:
- is < 5 years old, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE
- is >= 5 years old and < 18 years old and received an Additional Dose, any shots administered afterwards at < 18 years of age will be evaluated as Accepted/EXTRA_DOSE
- is > = 18 years old and < 50 years old and received an Additional Dose and/or Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- is >= 50 years of age and Additional Dose and/or Booster Dose, and 2nd Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- and Additional Dose and/or 1st Booster Dose and 2nd Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
For patients that completed Janssen COVID-19 1-dose series:
- is < 5 years old, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- is > = 5 years old and < 50 years old and received an Additional Dose and/or Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- is >= 50 years of age and Additional Dose and/or Booster Dose, and 2nd Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- and Additional Dose and/or 1st Booster Dose and 2nd Booster Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
For patients that completed either the 1) COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a 2) COVID-19 vaccine series not authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine, Additional Dose and/or first Booster Dose, and 2nd booster dose, any shots administered after the primary series is evaluated as Accepted/EXTRA_DOSE.

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Notes

¹Additional Dose - Defined by ACIP to be a dose administered when the immune response to a standard primary vaccine series is likely not to be protective.
²Booster Dose - Defined by ACIP to be a dose administered to restore protection after the effectiveness of protection from the primary series has declined.

COVID-19 Vaccines

~~COVAXIN~~ if ~~recommended~~ ~~503~~ ~~LAV~~ ~~COVIVAC505510~~ IV ~~BIBP, Sinopharm)511~~ IV ~~CoronaVac~~ ~~SinovacYes, only if all recommended doses are administered.~~

CVX Code	Name	Absolute Minimum Age	Absolute Maximum Age	Counts towards U.S. Vaccination
207	Moderna COVID-19 Vaccine	0 days		Yes
208	Pfizer COVID-19 Vaccine	0 days		Yes
210	AstraZeneca COVID-19 Vaccine	0 days		Yes, only if all recommended doses are administered.
211	Novavax COVID-19 Vaccine	0 days		Yes, only if all recommended doses are administered.
212	Janssen COVID-19 Vaccine	0 days		Yes
213	SARS-COV-2 (COVID-19) vaccine, UNSPECIFIED	0 days		Yes
217	Pfizer COVID-19 Vaccine	0 days		Yes
218	Pfizer COVID-19 Vaccine (5-11 years)	0 days	18 years - 1 day	Yes
219	Pfizer COVID-19 Vaccine (Preferable age range: >= 6 months to < 5 years)	0 days	6 years - 1 day	Yes
221	Moderna COVID-19 Vaccine (Preferable age ranges: >= 6 years to < 12 years OR >= 18 years)	0 days		Yes
227	Moderna COVID-19 Vaccine (Inactive)	0 days	13 years - 1 day	Yes
228	Moderna COVID-19 Vaccine (Preferable age range: >= 6 months to < 6 years)	0 days	7 years - 1 day	Yes
500	COVID-19 Non-US Vaccine, Product Unknown			No
501	COVID-19 IV Non-US Vaccine (QAZCOVID-IN)			No
502	COVID-19 IV Non-US Vaccine (COVAXIN)	0 days		Yes, only if all recommended doses are administered.
503	COVID-19 LAV Non-US Vaccine (COVIVAC)			No
504	COVID-19 VVnr Non-US Vaccine (Sputnik Light)			No
505	COVID-19 VVnr Non-US Vaccine (Sputnik V)			No
506	COVID-19 VVnr Non-US Vaccine (CanSino Biological Inc./Beijing Institute of Biotechnology)			No
507	COVID-19 PS Non-US Vaccine (Anhui Zhifei Longcom Biopharmaceutical + Institute of Microbology Chinese academy of Sciences)			No
508	COVID-19 PS Non-US Vaccine (Jiangsu Province Centers for Disease Control and Prevention)			No
509	COVID-19 PS Non-US Vaccine (EpiVacCorona)			No
510	COVID-19 IV Non-US Vaccine (	BIBP, Sinopharm)	0 days		Yes, only	if all	recommended doses are administered.
511	COVID-19	IV Non-US Vaccine (	CoronaVac, Sinovac)	No	504	COVID-19 VVnr Non-US Vaccine (Sputnik Light)	No	0 days		Yes, only if all recommended doses are administered.
512	COVID-19 VVnr VLP Non-US Vaccine (Sputnik V)	No	506	COVID-19 VVnr Non-US Vaccine (CanSino Biological Inc./Beijing Institute of Biotechnology)	No	507Medicago, Covifenz)	18 years - days		Yes, only if all recommended doses are administered.
513	COVID-19 PS Non-US Vaccine (Anhui Zhifei Longcom Biopharmaceutical + Institute of Microbology Chinese academy of Sciences, Zifivax)			No
508514	COVID-19 PS DNA Non-US Vaccine (Jiangsu Province Centers for Disease Control and PreventionZydus Cadila, ZyCoV-D)			No
509515	COVID-19 PS Non-US Vaccine (EpiVacCoronaMedigen, MVC-COV1901)			No
516	COVID-19	Inactivated Non-US Vaccine (	0 days	Yes, only if all recommended doses are administered.	Minhai Biotechnology Co, KCONVAC)			No
517	COVID-19	PS Non-US Vaccine (	Biological E Limited,	Corbevax)	0 days			No

Combination Vaccines that Include COVID-19

~~...~~

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CVX Code Specific Rules

CVX Code Absolute Minimum Age

If one of the CVX codes in the table above is administered below the absolute minimum age for that CVX code, then the Evaluation is Invalid and the reason code is BELOW_MINIMUM_AGE_VACCINE

CVX Code Absolute Maximum Age

If one of the CVX codes in the table above is administered above the absolute maximum age for that CVX code, then the Evaluation is Invalid and the reason code is ABOVE_MAXIMUM_AGE_VACCINE.

Absolute Minimum Interval Rule for Moderna Vaccines

The absolute minimum interval between a previously administered Moderna vaccine and the next shot is 24 days.

Rule for CVX 213

If the patient receives CVX 213 for:
- Target Dose 1, evaluate the shot as Valid.
  - Recommended interval = 28 days
  - Recommended age = 5 years6 months
- Target Dose 2, evaluate the shot as Valid.
- If the patient receives CVX 213 for Target Dose 1 and CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
  - evaluate Target Dose 2 (CVX 212) as Valid.
  - evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Rules for COVID-19 Vaccines Not Authorized by FDA²

The following set of rules apply to 1) COVID-19 Vaccines Not Authorized by FDA, but Authorized by WHO and, 2) COVID-19 Vaccines Not Authorized by FDA or WHO, but is an Active COVID-19 Vaccine Candidate as part of a U.S.-based Clinical Trial of a COVID-19 Vaccine.

The list of COVID-19 Vaccines Not Authorized by the FDA, but Authorized by the WHO are:
- CVX 210 - AstraZeneca COVID-19 Vaccine
- CVX 510 - BIBP, Sinopharm COVID-19 Vaccine
- CVX 511 - CoronaVac, Sinovac
- CVX 502 - COVAXIN
- CVX 211- Novavax COVID-19 Vaccine
- CVX 512 - COVID-19
  Vaccine
  VLP Non-US Vaccine (Medicago, Covifenz)
The list of COVID-19 Vaccines Not Authorized by the FDA or WHO, but is an active COVID-19 vaccine candidate as part of a U.S.-based clinical trial of a COVID-19 vaccine are:
- Note - Currently, there are no COVID-19 vaccines that fall into this category.
If the patient has received all recommended doses of the COVID-19 vaccine, then:
- Evaluate the shots as Valid; (Absolute Minimum Interval = 0 days; Absolute Minimum Age = 0 days)
- Recommend a booster dose of COVID-19 (at vaccine group level) at recommended interval (5 months), along with recommendation reason code BOOSTER_DOSE.
If the patient has received one or more doses, but has not received all the recommended doses for that COVID-19 vaccine, then:
- Evaluate the shot(s) as Valid.
- Recommendation:
  - If one of the above listed COVID-19 vaccine is the last COVID-19 shot administered, then recommend COVID-19 at the vaccine group level at last shot administered + recommended interval (28 days) or at 5years old, whichever date is later, in addition to returning recommendation reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The vaccine administered should be a single dose of a Pfizer COVID-19 vaccine."
  - Once the patient has received the recommended COVID-19 vaccine, the series is complete. Recommend a booster dose of COVID-19 (at vaccine group level) at recommended interval (5 months), along with recommendation reason code BOOSTER_DOSE.

The following set of rules apply to COVID-19 Vaccines Not Authorized by FDA or WHO.

The list of COVID-19 Vaccines Not Authorized by the FDA or WHO are:
- CVX 500 - COVID-19 Non-US Vaccine, Product Unknown
- CVX 501 - COVID-19 IV Non-US Vaccine (QAZCOVID-IN)
- CVX 503 - COVID-19 LAV Non-US Vaccine (COVIVAC)
- CVX 504 - COVID-19 VVnr Non-US Vaccine (Sputnik Light)
- CVX 505 - COVID-19 VVnr Non-US Vaccine (Sputnik V)
- CVX 506 - COVID-19 VVnr Non-US Vaccine , Product Unknown (CanSino Biological Inc./Beijing Institute of Biotechnology)
- CVX 501 507 - COVID-19 IV PS Non-US Vaccine (QAZCOVID-INAnhui Zhifei Longcom Biopharmaceutical + Institute of Microbology Chinese academy of Sciences)
- CVX 503 508 - COVID-19 LAV PS Non-US Vaccine (COVIVAC) Jiangsu Province Centers for Disease Control and Prevention)
- CVX 504 509 - COVID-19 VVnr PS Non-US Vaccine (Sputnik LightEpiVacCorona)
- CVX
  505
  513 -
  COVID
  COVID-19
  VVnr
  PS Non-US Vaccine (
  Sputnik V
  Anhui Zhifei Longcom, Zifivax)
- CVX
  506
  514 -
  COVID
  COVID-19
  VVnr
  DNA Non-US Vaccine (
  CanSino Biological Inc./Beijing Institute of Biotechnology
  Zydus Cadila, ZyCoV-D)
- CVX
  507
  515 -
  COVID
  COVID-19 PS Non-US Vaccine (
  Anhui Zhifei Longcom Biopharmaceutical + Institute of Microbology Chinese academy of Sciences
  Medigen, MVC-COV1901)
- CVX
  508
  516 -
  COVID
  COVID-19
  PS
  Inactivated Non-US Vaccine (
  Jiangsu Province Centers for Disease Control and Prevention
  Minhai Biotechnology Co, KCONVAC)
- CVX
  509
  517 -
  COVID
  COVID-19 PS Non-US Vaccine (
  EpiVacCorona
  Biological E Limited, Corbevax)
If the patient has received a COVID-19 vaccine not authorized by the FDA or WHO for all or some or the recommended doses of the COVID-19 vaccine, then:
- Evaluate the shot(s) as Invalid/ VACCINE_NOT_APPROVED_IN_US_OR_BY_WHO.
- Recommendation:
  - If one of the above listed COVID-19 vaccine is the last COVID-19 shot administered, then recommend COVID-19 at the vaccine group level at last shot administered + recommended interval (28 days) or at 5 years old, whichever date is later.
    - Example #1: Patient has 1 shot of CVX 501 on record.
      - Evaluate CVX 501 as Invalid/ VACCINE_NOT_APPROVED_IN_US_OR_BY_WHO.
      - Recommend COVID-19 at the vaccine group level for Target Dose 1 at CVX 501 + recommended interval (28 days).
    - Example #2: Patient has 1 shot of CVX 208 (Pfizer), then 1 shot of CVX 501 on record.
      - Evaluate CVX 208 as Valid and CVX 501 as Invalid/ VACCINE_NOT_APPROVED_IN_US_OR_BY_WHO.
      - Recommend COVID-19 at the vaccine group level for Target Dose 2 at CVX 501 + recommended interval (28 days).
  - If one of the above listed COVID-19 vaccine is NOT the last COVID-19 shot administered, recommend based on the series that applies for the last COVID-19 shot administered.
    - Example: If CVX 208 (Pfizer) is given after CVX 501, then recommend based on the Pfizer COVID-19 2-dose Series.

~~...~~

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Series Name

Pfizer COVID-19 Child (5-17) 2-dose SeriesPfizer
Moderna COVID-19
2-dose
Series
Moderna
Mixed Product COVID-19
2-dose
Series
Janssen COVID-19 1-dose Series

Series Selection Rules

There are four series are four series for this vaccine group: the Pfizer the Pfizer COVID-19 Child (5-17) 2-dose Series, Pfizer series, Moderna COVID-19 2-dose series, Moderna Mixed Product COVID-19 2-dose series , and the Janssen COVID-19 1-dose series. The rules for determining which series applies are:

If
patient is < 18 years anddose 1 is CVX 212
there are no doses on record, then the
Janssen
Mixed Product COVID-19
1-dose series
Series applies.
Otherwise, the Pfizer COVID-19 Child (5-17) 2-dose series applies.

If the patient is >= 18 years and

If there are doses on record:
- If dose 1 is CVX
208 or CVX 217
- 212, then the
Pfizer
- Janssen COVID-19
2
- 1-dose series applies.
dose 1 is CVX 207
- If all administered doses are a Pfizer vaccine, then the
Moderna
- Pfizer COVID-19
2-dose series
- Series applies.
dose 1 is CVX 212, then the Janssen
- If all administered doses are a Moderna vaccine, then the Moderna COVID-19
1-dose series
- Series applies.
dose 1 is CVX 213
- Otherwise,
reference the "Rule for CVX 213" rules above.
- the Mixed Product COVID-19 Series applies.

Immunization Series:

~~...~~

Pfizer COVID-19

~~...~~

Series

The Pfizer COVID-19 Child (56 months - 17 years) 2-dose Series is complete after 2 or 3 doses. Vaccine Dose Parameters - Minimum and Routine Ages , depending on age (not including booster dose(s)).

Dose	Series Name	Absolute Minimum Age

Age
Minimum Age Routine

Age Latest Recommended Age (less than) Valid CVX Code(s) per Dose for this Series Invalid CVX Code(s) per Dose for this Series
1
Pfizer COVID-19
Child (5-17) 2-dose 5 years
Series
0 days 6 months 6 months N/A
208, 217, 218, 219

N/A
2 Pfizer COVID-19 Series 0 days
5 years
6 months 6 months N/A
218,
208,
217
217,
207
218,
213
219

N/A
2
3 Pfizer COVID-19
Child (5-17) 2-dose 5 years
Series 0 days
5 years
6 months 6 months N/A
218,
208,
217
217,
207
218,
213
219

N/A

~~Vaccine Dose Parameters - Minimum and Recommended Intervals~~

Doses	Series Name	Absolute Minimum Interval	Minimum Interval	Recommended Interval	Latest Recommended Interval (less than)
Dose 1 to 2	Pfizer COVID-19

Child (5-17) 2-dose Series
17 days
21 days21 days
Series 17 days 21 days 21 days
N/A

Dose 2 to 3

Pfizer COVID-19 Series 8 weeks - 4 days 8 weeks 8 weeks N/A

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Series Special Rules

If the patient receives a shot at < ~~5 years~~6 months old, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age."

Rule for CVX 212 (Janssen COVID-19 Vaccine)

If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate Target Dose 2 (CVX 212) as Valid.
- evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Rule for CVX 207 (Moderna COVID-19 Vaccine) Administered < 18 years old

If the patient is administered Moderna COVID-19 vaccine (CVX 207):
- between ages >= 5 years and < 12 years
  - for Target Dose 1, evaluate the shot as Valid. Recommend CVX 218 for Target Dose 2 at Dose 1 + recommended interval (28 days).
  - for Target Dose 2, evaluate the shot as Valid. Recommend based on the Series Completion Special Rule.
- between ages >= 12 years and < 18 years
  - for Target Dose 1, evaluate the shot as Valid. Recommend at the vaccine group level for Target Dose 2 at Dose 1 + recommended interval (28 days).
  - for Target Dose 2, evaluate the shot as Valid. Recommend based on the Series Completion Special Rule.

Immunization Series: Pfizer COVID-19 2-dose Series

~~...~~

Vaccine to Recommend

Recommend at the vaccine group level.

Skip Dose Rule

Target Dose 3
- If 2 or more doses were administered >= 5 years of age, target dose 3 is not needed. The series is complete.

Rule for CVX 218

If the patient is >= 18 years old and administered Pfizer COVID-19 Vaccine (CVX 218):
- Evaluate as Invalid/ ABOVE_MAXIMUM_AGE_VACCINE.
- Ignore the reported CVX 218 when determining the recommended due date for the next target dose due and when evaluating the next shot based on the absolute minimum interval for that target dose. (Note - The ICE General Rule "Earliest, recommended, and past due dates must be on or after the last shot given" applies here.)

Rule for CVX 212 (Janssen COVID-19 Vaccine)

If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2 orTarget Dose 3, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate the Target Dose (CVX 212) as Valid.
- evaluate prior Target Doses as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Immunization Series: Moderna COVID-19 Series

~~The Pfizer COVID-19 Child (5-17) 2-dose Series is complete after 2 doses.~~

~~Vaccine Dose Parameters - Minimum and Routine Ages~~

Dose	Series Name	Absolute Minimum Age	Minimum Age	Routine Age	Latest Recommended Age (less than)	Valid CVX Code(s) per Dose for this Series	Invalid CVX Code(s) per Dose for this Series
1

Pfizer
Moderna COVID-19
2-dose
Series
18 years
18 years18 years

0 days
6 months

6 months
N/A
208
207, 221,
217
227,
213
228
N/A
2
Pfizer
Moderna COVID-19
2-dose
Series
18 years
18 years18 years
0 days
6 months

6 months

N/A
208
207,
217
221,
207
227,
213
228
N/A

~~Vaccine Dose Parameters - Minimum and Recommended Intervals~~

Doses	Series Name	Absolute Minimum Interval	Minimum Interval

Minimum
Recommended Interval
Latest Recommended Interval (less than)
Dose 1 to
2Pfizer COVID-19
2
-dose Series
0
days if
days if dose 2
administered
administer < 10/25/2021
17
24 days if dose 2 administered >= 10/25/2021
24 days
21
28 days
21
28 days
N/A

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Series Special Rules

Rule for CVX 218 (Pfizer COVID-19 Vaccine (5-11))

If the patient
is >= 18 years old and administered Pfizer COVID-19 Vaccine (CVX 218):as Target Dose 1 or Target Dose 2, evaluate as Invalid/ ABOVE_MAXIMUM_AGE_VACCINE. Ignore the reported CVX 218 when determining the recommended due date for the next target dose due and when evaluating the next shot based on the absolute minimum interval for that target dose. (Note - The ICE General Rule "Earliest, recommended, and past due dates must be on or after the last shot given" applies here.)
receives a shot at < 6 months old, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age."

Vaccine to Recommend

Recommend at the vaccine group level.

Rule for CVX 212 (Janssen COVID-19 Vaccine)

If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2 or Target Dose 3, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate

Target Dose 2

- the shot (CVX 212) as Valid.
- evaluate

Target Dose 1

- prior shots as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Immunization Series:

~~...~~

Mixed Product COVID-19

~~...~~

Series

~~The Moderna Pfizer COVID-19 2-dose series is complete after 2 doses.~~

~~Vaccine Dose Parameters - Minimum and Routine Ages~~

Dose	Series Name	Absolute Minimum Age	Minimum Age	Routine Age	Latest Recommended Age (less than)	Valid CVX Code(s) per Dose for this Series	Invalid CVX Code(s) per Dose for this Series
1

Moderna
Mixed Product COVID-19 Series

0 days
6 months 6 months N/A
207, 208, 213, 217, 218, 219, 221, 227, 228
N/A
2
Mixed Product COVID-
dose
19 Series
18 years - 4 days
18 years18 years
0 days
6 months
6 months
N/A
207
207, 208, 213, 217, 218, 219, 221, 227, 228
N/A
2
3
Moderna
Mixed Product COVID-19
2-dose
Series
18 years - 4 days 18 years18 years
0 days 6 months 6 months N/A
207, 208
, 217, 213
, 213, 217, 218, 219, 221, 227, 228
N/A

~~Vaccine Dose Parameters - Minimum and Recommended Intervals~~

Doses	Series Name	Absolute Minimum Interval	Minimum Interval	Minimum Recommended Interval	Latest Recommended Interval (less than)
Dose 1 to 2

Moderna
Mixed Product COVID-19
2-dose
Series
0 days if dose 2
administer
administered < 10/25/2021
24 days if dose 2 administered >= 10
/25/202128 days28 days
/25/2021
28 days
28 days
N/A
Dose 2 to 3 Mixed Product COVID-19 Series 8 weeks - 4 days 8 weeks 8 weeks N/A

~~Series Special Rules~~

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Series Special Rules

If the patient receives a shot at < 6 months old, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age."

Vaccine to Recommend

Recommend at the vaccine group level.

Skip Dose Rule

Target Dose 3
- If 2 or more doses were administered >= 5 years of age, target dose 3 is not needed. The series is complete.

Rule for CVX 218

(Pfizer COVID-19 Vaccine (5-11))

If the patient is >= 18 years old and administered Pfizer COVID-19 Vaccine (CVX 218):

as Target Dose 1 or Target Dose 2, evaluate as

- Evaluate as Invalid/ ABOVE_MAXIMUM_AGE_VACCINE.
- Ignore the reported CVX 218 when determining the recommended due date for the next target dose due and when evaluating the next shot based on the absolute minimum interval for that target dose. (Note - The ICE General Rule "Earliest, recommended, and past due dates must be on or after the last shot given" applies here.)

Rule for CVX 212 (Janssen COVID-19 Vaccine)

If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2 or Target Dose 3, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate

Target Dose 2

- the shot (CVX 212) as Valid.
- evaluate

Target Dose 1

- prior shots as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Immunization Series: Janssen COVID-19 1-dose Series

~~...~~

/25/2021	28 days	28 days	N/A
Dose 2 to 3	Mixed Product COVID-19 Series	8 weeks - 4 days	8 weeks	8 weeks	N/A

Page Comparison

Versions Compared

Old Version 17

New Version 18

Key

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

Rules for an Additional Dose1

Rules for Booster Dose2

Rules for Booster Dose2

Rules for Extra Shots After Additional Dose1and/or Booster Dose2

Notes

COVID-19 Vaccines

Rules for Extra Shots After Additional Dose1and/or Booster Doses2

Notes

COVID-19 Vaccines

Combination Vaccines that Include COVID-19

CVX Code Specific Rules

CVX Code Absolute Minimum Age

CVX Code Absolute Maximum Age

Absolute Minimum Interval Rule for Moderna Vaccines

Rule for CVX 213

Rules for COVID-19 Vaccines Not Authorized by FDA2

Series Name

Series Selection Rules

Immunization Series:

Pfizer COVID-19

Series

Series Special Rules

Rule for CVX 212 (Janssen COVID-19 Vaccine)

Rule for CVX 207 (Moderna COVID-19 Vaccine) Administered < 18 years old

Immunization Series: Pfizer COVID-19 2-dose Series

Vaccine to Recommend

Skip Dose Rule

Rule for CVX 218

Rule for CVX 212 (Janssen COVID-19 Vaccine)

Immunization Series: Moderna COVID-19 Series

Series Special Rules

Rule for CVX 218 (Pfizer COVID-19 Vaccine (5-11))

Vaccine to Recommend

Rule for CVX 212 (Janssen COVID-19 Vaccine)

Immunization Series:

Mixed Product COVID-19

Series

Series Special Rules

Vaccine to Recommend

Skip Dose Rule

Rule for CVX 218

If the patient is >= 18 years old and administered Pfizer COVID-19 Vaccine (CVX 218):

Rule for CVX 212 (Janssen COVID-19 Vaccine)

Immunization Series: Janssen COVID-19 1-dose Series

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

Rules for an Additional Dose¹

Rules for Booster Dose²

Rules for Booster Dose²

Rules for Extra Shots After Additional Dose¹and/or Booster Dose²

Rules for Extra Shots After Additional Dose¹and/or Booster Doses²

Rules for COVID-19 Vaccines Not Authorized by FDA²