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If a patient is >= 19 years and did NOT complete the series before 19 years of age, then the Recommendation is Conditional and the reason code is HIGH_RISK.⁶
Shots administered to a patient who is >= 19 years and < 22 years of age will continue to be evaluated (based on minimum intervals) and, if valid, will count toward completion of the series.
If a patient's age at administration is >= 22 years and the patient did NOT complete the series before 22 years of age, then the Evaluation is Accepted and the reason code is ABOVE_REC_AGE_SERIES. (Shots administered to a patient >= 22 years of age do NOT count toward completion of the series; the series can NOT be completed once the patient is >= 22 years old.)

Once a patient completes the MCV4 2-dose series the Recommendation is Not Recommended and the reason code is COMPLETE_HIGH_RISK.⁵ (Meningococcal should never have a recommendation of Not Recommended/Complete.)

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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	MCV4 2-dose	10 years	11 years	11 years	13 years + 4 weeks	114, 136, 108, 147, 32	N/A
2	MCV4 2-dose	16 years - 4 days	16 years	16 years	17 years + 4 weeks	114, 136, 108, 147, 32	N/A

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Doses	Series Name	Absolute Minimum Interval	Minimum Interval	Minimum Recommended Interval	Latest Recommended Interval (less than)
Dose 1 to 2	MCV4 2-dose	52 days	56 days	56 days²	6 years + 4 weeks

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If a shot of meningococcal is given below the series absolute minimum age (10 years), and above the CVX minimum age, then the Evaluation is accepted and the reason code is BELOW_REC_AGE_SERIES.³ Shots that are accepted do not count toward the series.

If the patient is >= 16 years and < 19 years at time of execution and has no doses on record, then only 1 dose is indicated at >= 16 years; the series is complete after the single dose is administered at >= 16 years and < 19 years.

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The recommended interval between dose 1 and dose 2 in the table above (56 days)² differs from the CDC CDSi recommended interval of 4 years. While the recommended intervals differ, in practice ICE and CDC CDSi will come up with the same recommended due date. CDC CDSi only uses the recommended interval when the recommended age is not provided. See the CDC CDSi Logic Specification for details on how they calculate their recommended due date.
Although shots administered below the series absolute minimum age are evaluated as Accepted³ rather than Invalid, the ICE general rule for Shots Administered Below Series Minimum Age for Dose 1 still applies. No minimum or recommended interval applies from the meningococcal shot given below the series absolute minimum age to target dose 1.
A shot of meningococcal administered below the series absolute minimum age should never be evaluated as Invalid/Below Minimum Age Series.

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