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If a patient is >= 18 years old and has NOT completed the series, then the Recommendation is Conditional and the reason code is HIGH_RISK.²
Shots administered to a patient who is >= 18 years of age will continue to be evaluated (based on minimum intervals) and, if valid, will count toward completion of the series.²

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Doses

Series Name

Absolute Minimum Interval

Minimum Interval

Minimum Recommended Interval

Latest Recommended Interval (less than)

Dose 1 to 2

Polio 4-dose

24 days

28 days

15 months + 4 weeks

Dose 2 to 3

Polio 4-dose

24 days

28 days

13 weeks

Dose 3 to 4

Polio 4-dose

24 days if dose 4 was administered before 8/7/2010 ¹

6 months minus 4 days if dose 4 was administered >= 8/7/2010

28 days if dose 4 was administered before 8/7/2010 ^{1, 3}

6 months if dose 4 was administered >= 8/7/2010

6 months

6 years + 4 weeks

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ICE takes into consideration changes to the polio schedule (dose 4) made in early 2010, and will evaluate under the old schedule if the conditions are met.¹ The CDC CDSi rules do not take this into consideration in their CDS logic; the CDC CDSi uses only the "new" rules.
CDSi follows a maximum age of 18 years for all Polio series, for all doses. Therefore, according to the CDSi Logic Specifications, a shot administered at >= 18 years old would be NOT be evaluated as Valid and the patient would NOT be able to complete the series at >= 18 years old.²
In rare circumstances, when the Overdue Date calculation results in a date that is earlier than the Recommended Due Date, ICE will set the Overdue Date to be equal to the Recommended Due Date. Here's an example test scenario:³
- Patient has 3 doses on record and Dose 3 was given on 1/1/2008 (at 8 years old).
- Target Dose 4 Overdue Date would be calculated as Dose 3 + Latest Minimum Interval (28 days) = 1/29/2008.
- Recommended Due Date would be calculated as Dose 3 + Recommended Interval (6 months) = 7/1/2008.
- Since the Overdue Date results in a date that is earlier than the Recommended Due Date, ICE will set the Overdue Date to be equal to the Recommended Due Date. So adjusted Overdue Date will be set to 7/1/2008.

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