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Table of Contents

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Rules Based on Patient's Age

  • 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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CVX Code

Vaccine Name

Component
CVX Code

Component
Vaccine Name

110

DTaP/HepB/IPV

10

IPV

120

DTaP/IPV/Hib 

10

IPV

130DTaP/IPV10IPV
132DTaP-IPV-Hib-Hep B, historical10IPV
146DTaP, IPV, Hib, Hep B10IPV
170DTaP-IPV-Hib10IPV
195DT-IPV adsorbed Non-US10IPV


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CVX Code Specific Rules

Rule for CVX 178 and CVX 179

  • If a patient receives CVX 178 or CVX 179, evaluate these shots as Invalid with reason code MISSING_ANTIGEN.

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The Polio 4-dose series is complete after 4 doses, except when one of the 743513834-dose Series Exception Rules apply.

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 SeriesInvalid CVX Code(s) per Dose for this Series

1

Polio 4-dose

38 days

42 days (6 weeks)

2 months

3 months + 4 weeks 02, 10, 89, 110, 120, 130, 132, 146, 170, 182, 195
 N/A

2

Polio 4-dose

66 days

70 days (10 weeks)

4 months

5 months + 4 weeks 02, 10, 89, 110, 120, 130, 132, 146, 170, 182, 195
 N/A

3

Polio 4-dose

94 days

98 days (14 weeks)

6 months

19 months + 4 weeks 02, 10, 89, 110, 120, 130, 132, 146, 170, 182, 195
 N/A

4

Polio 4-dose

122 days if dose 4 administered < 8/7/2009

4 years - 4 days if dose 4 administered >= 8/7/2009

126 days if dose 4 administered < 8/7/2009

4 years if dose 4 administered >= 8/7/2009

4 years

7 years + 4 weeks 02, 10, 89, 110, 120, 130, 132, 146, 170, 182, 195
 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

Polio 4-dose

24 days

28 days

28 days

15 months + 4 weeks

Dose 2 to 3

Polio 4-dose

24 days

28 days

28 days

13 weeks

Dose 3 to 4

Polio 4-dose

24 days if dose 4 was administered before 8/7/2009

6 months minus 4 days if dose 4 was administered >= 8/7/2009

28 days if dose 4 was administered before 8/7/2009

6 months if dose 4 was administered >= 8/7/2009

6 months

6 years + 4 weeks

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Series Special Rules 

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4doseseriesexceptionrules
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4-dose Series Exception Rules

The 4-dose series above applies unless:

  • Series complete with 3 doses:
    • If patient is >= 4 years old (or will be >= 4 years old at the dose 3 recommended due date), recommend target dose 3 (and final dose) at 4 years old; recommended interval = 6 months. (Minimum interval= 6 months; absolute minimum interval = 6 months - 4 days)
    • If dose 3 was administered when the patient was >= 4 years and was administered at least 6 months - 4 days after the previous dose, then the series is complete with 3 doses. 
  • For children who received target dose 4 at >= 8/7/2009 and before 4 years - 4 days of age, evaluate target dose 4 as Accepted/ BELOW_MINIMUM_AGE_FINAL_DOSE (if absolute minimum interval is met). (An additional dose will be recommended at >= 4 years of age).

OPV Rule

If a patient receives shots of OPV administered >= 4/1/2016, these shots do not count towards the series. Evaluate these shots as Invalid with reason code MISSING_ANTIGEN.

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