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3/18/2024: Release v1.42.1.4

  • Fixes a COVID-19 dose numbering issue to support incrementing of dose number for patients who did not complete a < 5 years series prior to 9/12/2023 and are continuing in a < 5 years series.
  • Clarification to a COVID-19 Sept 2023 COVID-19 Series (>= 5 years) series special rule and corresponding logic update to address an exception related to handling CVX 313 in the >= 5 years series. 
  • Extends the "start" date for COVID-19 vaccine from 12/01/2020 to 1/01/1970 to prevent COVID-19 shots administered prior to 12/01/2020 from being assigned to the "Other" vaccine group. 

3/07/2024: Release v1.42.1.3

  • Fixes an issue discovered in v1.42.1.2. In certain situations, some historical COVID doses prior to September 12, 2023 were being evaluated as Accepted rather than Valid. This release fixes this issue.

3/05/2024: Release v1.42.1.2

  • Fixes an issue discovered in v1.42.1 where some shots in the COVID-19 >= 5yr series were incorrectly being marked as Invalid.

3/01/2024: Release v1.42.1

COVID-19 - September 2023 Onwards

  • Added support for COVID-19 recommendations introduced on September 12, 2023. These recommendations are supported by an additional set of logic for the COVID-19 Vaccine Group, COVID-19 Vaccine Group - September 2023 Onwards.
  • Added support for five new series: 

    • Sept 2023 COVID-19 Series (>= 5 years),

    • Sept 2023 Pfizer COVID-19 Series (< 5 years),

    • Sept 2023 Moderna COVID-19 Series (< 5 years),

    • Sept 2023 Mixed Product COVID-19 Series (< 5 years), and

    • Sept 2023 Novavax COVID-19 Series. 

  • Added support for the updated (2023–2024 formula) COVID-19 vaccines: CVX 308, CVX 309, CVX 310, CVX 311, CVX 312, and CVX 313. 

COVID-19 Vaccine Group Rule Sets

  • COVID-19 shots administered before 9/12/2023 are evaluated according to the logic specified in the COVID-19 Vaccine Group - Prior to September 12, 2023 wiki. Shots administered on or after 9/12/2023 are evaluated according to the logic specified in the new COVID-19 Vaccine Group - September 2023 Onwards wiki. 
  • The two COVID-19 Vaccine Group rule sets are designed to work with one another, with prior history (i.e., before 9/12/2023) influencing current recommendations, as per the ACIP and CDC guidelines. 

11/03/2023: Release v1.41.1

Pneumococcal

  • Added support for PCV20 (CVX 216) use in children, with the following changes in the Pneumococcal Child Series:
    • Lowered the absolute minimum age of CVX 216 from 18 years - 4 days to 6 weeks - 4 days.
    • Incorporated CVX 216 as a valid CVX code per dose. 
  • The CVX 216 changes are in the Pneumococcal Child Series only. In a future release, HLN will refine the logic for handling of CVX 216 administered between the ages of 6 and 19 years when intended for the adult series.

Note: There are no changes to the ICE Implementation Guide. 

10/06/2023: Release v1.40.1

General Rule - Live Vaccine Interval

  • Updated the live vaccine interval rule to allow for an absolute minimum interval of 24 days, instead of 28 days, for live virus vaccines from the same vaccine group. Note, this is relevant for the following vaccine groups: H1N1, Influenza, MMR, Varicella, Zoster. 

DTP

  • Added logic to recommend Tdap (CVX 115) when a patient is < 7 years, the series is not complete, and the recommendation date is at >= 7 years.
  • Updated the recurring booster dose to recommend at the vaccine group level instead of a specific CVX, with a new recommendation reason code: ADMINISTER_TDAP_OR_TD.

Influenza

  • Updated CVX names to better align with CDC CVX code descriptions.
  • Minor rule edits to enhance rule clarity. 

MMR

  • Updated the dose 1 to dose 2 absolute minimum interval from 28 days to 24 days.
  • Updated MMR deduplication/same day logic to evaluate an MMRV shot first, followed by MMR, then other MMR vaccine group vaccines, in accordance with the Two Shots, Same Vaccine Group, Same Day Exception Rules for MMR.
  • Addressed an issue where ICE incorrectly indicated a single antigen or a double antigen vaccine as a valid dose of MMR for adults age 19 years and older. 

Varicella

  • Updated the dose 1 to dose 2 absolute minimum interval from 28 days to 24 days for patients >= 13 years of age. 

8/21/2023: Release v1.39.2

COVID-19

  • Pfizer Series: In certain circumstances (as follow), when recommending for the 2nd dose of the Pfizer series for patients >= 5 years of age and the 1st dose was administered with a monovalent vaccine and within 8 weeks before 4/19/2023, ICE (1.39.1) incorrectly uses a 21 day interval rather than an 8 week interval. We have updated the COVID-19 Vaccine Group page with these changes, which are noted in blue in the Pfizer and Mixed Product Series interval tables near the bottom of the page.
  • Novavax Series: If the Novavax Series was completed after 4/19/2023, ICE (1.39.1) was indicating that the series was complete. Instead, the correct recommendation is a bivalent dose 8 weeks later.

7/20/2023: Release v1.39.1

COVID-19

  • Added support for a Pfizer bivalent booster dose for children aged 6 months through 4 years who previously completed a Pfizer-BioNTech 3-dose primary series. For children ages 6 months and older who have previously completed a 3-dose monovalent Pfizer-BioNTech primary series and have not received any bivalent vaccines, ICE recommends 1 bivalent Pfizer-BioNTech booster dose at least 2 months after completion of the monovalent primary series when the execution date is 3/17/2023 or later. 
  • Added support for bivalent vaccines in the primary series.
  • Added support for the recommendation for patients aged 6 months and older to receive a bivalent COVID-19 vaccine; this recommendation is applicable when the execution date is 4/19/2023 or later. 
  • Added a new recommendation reason code: ADMINISTER_COVID19_BIVALENT_VACCINE.
  • Fix to address a processing issue when two CVX 212 vaccines were administered to the same patient on the same day.

Influenza

  • Updated wiki to reflect the 2023-2024 season. Note: there are no evaluation and forecasting changes for the 2023-2024 season.
  • Added support for CVX 231 (Influenza, Southern Hemisphere, high-dose, quadrivalent). Note: this CVX does not count toward immunity.

Pneumococcal

  • Fix to the Adult Recommendation Rules supplemental text descriptive text when a patient is >= 19 years and < 65 years of age and the series is not complete. The descriptive text now indicates patients who previously received a PCV13 should receive PCV20 or PPSV23 (previously only PPSV23 was noted). 

3/17/2023: Release v1.38.1

COVID-19

  • COVID-19 CVX Code Updates: 230, 302, 518, 519, 520, 521 (new).
  • Expanded bivalent vaccine recommendations for children ages 6 months through 5 years.
  • Logic tweak: If the Janssen (CVX 212) and another COVID-19 FDA-approved shot are administered on the same day, evaluate the other shot first.

DTP

  • Added vaccines: (1) CVX 196 (Td); (2) CVX 195 (DT-IPV, Non-US)

Polio

  • Added vaccines: CVX 195 (DT-IPV, Non-US)

Orthopoxvirus

  • Tweak logic to not trigger live interval rule for shots administered after completion of the series. (Shots as Accepted / EXTRA_DOSE)

Hep B

  • Added a bug fix to the ICE series selection rules; ICE was incorrectly selecting the Hep B 2-dose series, in some instances, when it should have selected the Hep B 3-dose series.

Pneumococcal

  • Supplemental text working change. Remove mention of Pfizer in the last sentence of one of the supplemental text descriptions.

12/12/2022: Release v1.37.2

COVID-19

  • Incorrect evaluation of some shots due to malformed XML in the Mixed Product Series and series selection logic related to CVX 213.

Hep B

  • When no shots are administered, incorrect conditional status for patients >= 19 years of age. Conditional status should start at age >= 60 years.

12/7/2022: Release v1.37.1

CVX Update:

  • Added CVX 198 (DTP-hepB-Hib Pentavalent Non-US)

COVID-19 Update:

  • Added support for Novavax as a primary series option for ages 12 and older: new Novavax COVID-19 Series
  • Added support for bivalent boosters for ages 5 and older
  • Added support for Novavax monovalent booster for adults ages 18 and older
  • Added support for new vaccines: CVX 229, CVX 300, and CVX 301
  • Updated the Pfizer COVID-19 Series
    • additional valid CVX codes per dose: CVX 300, CVX 301
    • indication of an invalid CVX code per dose: CVX 229
    • indication of a latest recommended interval for dose 1 to dose 2: 8 weeks
    • additional series special rules
  • Updated the Moderna COVID-19 Series
    • additional series special rules
  • Updated the Mixed Product COVID-19 Series
    • additional valid CVX codes per dose: CVX 211, CVX 300, CVX 301
    • indication of an invalid CVX code per dose: CVX 229
    • additional series special rules
    • removed Rule for CVX 218
  • Updated General Rules
    • Updated Series Completion Special Rules
      • Moderna COVID-19 Series: Added logic based on execution date
      • Pfizer COVID-19 Series or Mixed Product COVID-19 Series: Added logic based on execution date
      • 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: Added logic based on execution date
    • Updated and added Booster Dose rules: Added recommendation and evaluation rules for third booster dose
    • Updated and added Additional Dose rules

Hepatitis B Update: 

  • Added support for universal recommendation of Hepatitis B for adults age 19 through 59 years: new Hepatitis B 3-dose Adult Series
  • Modified the Hepatitis B 3-dose Child/Adult Series to be a Hepatitis B 3-dose Child/Adolescent Series

Orthopoxvirus Update:

  • Added new series selection rule: when two shots are administered on the same day, follow the Orthopoxvirus 2-dose Series, not the Orthopoxvirus 1-dose Series

Pneumococcal Update:

  • Added support for PCV15 as an option for pneumococcal conjugate vaccination of persons age <19 years
  • Fixed bug that, in certain circumstances, recommended an extra PPSV23 after the series had already been completed at >= 65 years

8/31/2022: Release v1.36.1

Orthopoxvirus Vaccine Group - May 2022 Emergency Use Authorization (EUA) for Monkeypox (Optional):

  • The vaccine group can optionally be enabled or disabled.
    • In the zipfile distribution, the Orthopoxvirus vaccine group is disabled by default.. It can be enabled by removing the property value VACCINE_GROUP_CONCEPT.860 from the vaccine_group_exclusions property in the ice.properties file. The vaccine_group_exclusions property is a way to omit vaccine groups from the forecast, comma-delimited.
    • In the docker image distribution, the Orthopoxvirus vaccine group is enabled by default. It can be disabled by setting the VACCINE_GROUP_EXCLUSIONS environment variable with the value VACCINE_GROUP_CONCEPT.860.
  • New vaccines: CVX codes 75, 105, 206

Pneumococcal Update:

  • Added new recommendation rule: "If the patient is < 65 years of age, received a valid dose in an Adult Series at < 65 years old, and the series is not complete, recommend Conditional/ HIGH_RISK".

7/25/2022: Release v1.35.3

COVID-19 Update:

  • Improved series selection handling to ensure that a series which was completed earlier is always selected
  • If CVX 213 (NOS) is administered as the first dose, the recommended interval is 28 days, not 21 days

7/21/2022: Release v1.35.2

COVID-19 Update:

  • This release fixes an issue identified in yesterday's release (v1.35.1) which occasionally results in requests to fail due to an error in the COVID-19 series implementation. Both the zipfile distribution and docker image have been updated with this latest release. 

7/20/2022: Release v1.35.1

Pneumococcal Update:

  • This release includes the following Pneumococcal updates:
    • Updated Pneumococcal rules to accommodate changes to the Adult Schedule
    • Added support for new adult vaccines: CVX 215 (PCV15) and CVX 216 (PCV20)

COVID-19 Update:

  • This release includes the following COVID-19 updates:
    • Updated booster dose logic to support recommendation of a 2nd booster dose, when applicable
    • Updated the schedule for patients 6 months and over, and added support for newer vaccines: CVX codes 219, 221, 227, 228, 512, 513, 514, 515, 516, 517

Hep B Update:

  • Added support for the CVX 220 (PreHevbrio) to the Hep B schedule

Additional Updates:

  • A new endpoint to request the version of the service that is running: http(s)://<host>:<port>/path/to/opencds-decision-support-service/version
  • Fix for occasional "getValidShotByDoseNumber()" error

2/1/2022: Release v1.34.1

COVID-19 Update:

  • This release includes the following COVID-19 updates:
    • Added additional support and logic in ICE to handle the following:
      • Booster Dose Rules 
        • Updated booster dose recommended age to 12 years
        • Updated booster dose recommended interval to 5 months after completion of mRNA vaccine primary series. 
      • Additional Dose Rules 
        • Added support for additional dose for immunocompromised persons aged 5+
      • COVID-19 Vaccines Not Authorized by FDA Rules
        • Updated rules for Novavax (CVX 211) COVID-19 vaccine now that WHO has approved it for use under their EUL
        • Updated rules to accommodate the fact that patients who have not completed all recommended doses of a COVID-19 vaccine series not authorized by FDA, but approved by WHO, do not need to restart a primary vaccination series in the United States. 

12/22/2021: Release v1.33.1

COVID-19 Update:

  • This release includes the following COVID-19 updates:
    • Added additional support and logic in ICE to handle the following:
      • COVID-19 Booster Dose rules - Updated and added additional rules for patients who completed Pfizer 2-dose series, Moderna 2-dose series, Janssen 1-dose series, Pfizer COVID-19 Child (5-17) 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. 
        • Booster Dose Minimum Age has been updated to 16 years to support new CDC recommendation that 16-17 year olds "may" receive a Pfizer booster.
      • COVID-19 Additional Dose rules - Updated and added additional rules for patients who completed Pfizer 2-dose series, Moderna 2-dose series, Janssen 1-dose series, Pfizer COVID-19 Child (5-17) 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. 
      • New COVID-19 vaccine (CVX 217) - Added support and logic
        • Note - CVX 217 is a new Pfizer formulation for ages 12+ under EUA; can be used in the same way as CVX 208
      • Pfizer 2-dose series
        • Updated Absolute Minimum Intervals between Dose 1 and Dose 2
      • Moderna 2-dose series 
        • Updated Absolute Minimum Intervals between Dose 1 and Dose 2
        • Updated Absolute Minimum Age for Dose 1
        • Updated Absolute Minimum Age for Dose 2
        • Updated Minimum Age for Dose 2
        • Updated Routine Age for Dose 2
  • This release includes an important security update. We strongly recommend that users update to this release as soon as possible.

12/13/2021: Release v1.32.2

  • This release adds an important security update. We strongly recommend that users update to this release as soon as possible.

11/24/2021: Release v1.32.1

COVID-19 Update:

  • This release includes the following COVID-19 updates:
    • Added additional support and logic in ICE to handle the following:
      • COVID-19 Pfizer Pediatric Dose (5 through 11 years old)
      • Evaluation of Janssen booster dose as Valid
      • Added COVAXIN (CVX 502) as a WHO-approved vaccine for EUA
    • An updated Implementation Guide with the following new codes:
      • CVX 218 - vaccine code for the COVID-19 Pfizer pediatric vaccine
      • BOOSTER_DOSE - new recommendation reason code to indicate that the recommendation is for a booster dose.
  • Note about upcoming ICE release (scheduled for December 2021)
    • As always, HLN is actively monitoring all news and updates in regards to new and existing COVID-19 vaccines. Currently, we are working on adding additional support and logic (based on latest published guidance) in ICE to handle the following:
      • Updates to Booster Dose rules
      • Updates to Additional Dose rules 
      • Updated Absolute Minimum Intervals and Absolute Minimum Ages

10/25/2021: Release v1.31.1

COVID-19 Update:

  • This release includes the following COVID-19 updates:
    • Added additional support and logic in ICE to handle the following:
      • COVID-19 Booster Dose for Pfizer Vaccine
    • Performance Improvement:
      • On service start up, if the km.threads property configuration value is increased, ICE no longer requires additional memory to establish the increased number of threads.
  • Note about upcoming ICE release (tentatively scheduled for mid-November 2021)
    • As always, HLN is actively monitoring all news and updates in regards to new and existing COVID-19 vaccines. Currently, we are working on adding additional support and logic (based on latest published guidance) in ICE to handle the following:
      • COVID-19 Booster Dose for Moderna and Janssen Vaccines

9/21/2021: Release v1.30.1

COVID-19 Update:

  • This release includes the following COVID-19 updates:
    • Added additional support and logic in ICE to handle the following:
      • COVID-19 Additional Dose - a dose administered when the immune response to a standard primary vaccine series is likely not to be protective.
        • Note - Alternatively, a “booster” dose of vaccine is a dose administered to restore protection after the effectiveness of protection from the primary series has declined. Once FDA approval is granted and ACIP recommendations are published in regards to "booster" doses, ICE will be updated accordingly; updates will likely be included in the next release of ICE. 
      • COVID-19 Vaccines Not Authorized by FDA, but Authorized by WHO
        • Note - The previous version of ICE, Version 1.29.1 supports the handling of one COVID-19 vaccine that falls under this category - AstraZeneca COVID-19 vaccine (CVX 210).
      • COVID-19 Vaccines Not Authorized by the FDA or WHO
      • 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

Live Virus Bug Fix:

  • Fix bug where, in certain circumstances, ICE is incorrectly recommending Varicella or MMR 28 days later rather than on the same day.

5/14/2021: Release v1.29.1

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  • This release includes the following COVID-19 updates:
    • Updates have been made to expand age ranges down to >=12 years old for the Pfizer COVID-19 Vaccine (CVX 208).
    • For patients with no prior doses of COVID-19 vaccine, updated recommendations to recommend COVID-19 to patients >= 12 years old.   
      • Note - ICE previously had a conditional recommendation for patients with no prior doses of COVID-19 vaccine. 
    • Support has been added to handle AstraZeneca COVID-19 vaccine (CVX 210) shots reported on the patient record.
      • As of now, the AstraZeneca COVID-19 vaccine has not yet been FDA approved in the U.S. , but is approved by the WHO. See COVID-19 Vaccine Group - Prior to September 12, 2023 page for details.
      • When the FDA approves the AstraZeneca COVID-19 vaccine (CVX 210) for use in the U.S., ICE will be updated as necessary.
  • In addition to the above updates, added evaluation reason code VACCINE_NOT_APPROVED_IN_US to the ICE Implementation Guide. 
  • Note: This is implementation of COVID-19 Vaccine Group in ICE based on interim recommendations from ACIP.  As additional guidelines from ACIP are published and/or vaccines become available, the COVID-19 logic in ICE will be updated.

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  • This is implementation of COVID-19 Vaccine Group in ICE based on interim recommendations from ACIP.  As additional guidelines from ACIP are published and/or vaccines become available, the COVID-19 logic in ICE will be updated.
  • This release includes support for the Pfizer COVID-19 vaccine (CVX 208), Moderna COVID-19 vaccine (CVX 207), and COVID-19, Unspecified Formulation (CVX 213). 
  • In addition to the above CVX codes, added recommendation reason code BASED_ON_VAC_AVAIL_AND_PRIORITY_RECS to the ICE Implementation Guide. 
  • The updated ICE Implementation Guide documents these codes. version of this same guide with the changes since 1.24.1 highlighted and a Google Sheet with the same ICE codes are also available as an added convenience.

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  • Updated Pneumococcal rules as per the June 2019 ACIP Vote:
    • PCV13 vaccination is no longer routinely recommended for all adults aged ≥65 years. Instead, shared clinical decision-making for PCV13 use is recommended for persons aged ≥65 years who do not have an immunocompromised condition, CSF leak, or cochlear implant and who have not previously received PCV13. 
    • ACIP continues to recommend that all adults aged ≥65 years receive 1 dose of PPSV23. A single dose of PPSV23 is recommended for routine use among all adults aged ≥65 years.
    • Reference MMWR, November 22, 2019, Vol. 68, No. 46 for additional information.

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  • Updated HPV rules as per the June 2019 ACIP Vote:
    • Harmonized recommendation for catch-up vaccination for males and females through age 26 years who are not adequately vaccinated.
    • Recommends vaccination based on shared clinical decision making for individuals aged 27 through 45 years who are not adequately vaccinated. 

General Update

  • A duplicate shot/same day fix whereby, in certain circumstances, a non-combination shot might be selected instead of the combination shot.
  • Slight change to the way the dose number included in the vMR output is determined. The dose number represents the targeted number of the dose in the series, whether the dose is valid or invalid (so, for instance, both a "valid" second dose following an invalid second dose will have dose number 2 indicated). However, if the patient has passed the eligible last date for a particular dose (e.g., Hib, Pneumococcal) and receives a subsequent dose, the dose number of that subsequent dose will indicate the count of actual doses received and will not consider the earlier dose that was missed which cannot now be administered.

8/28/2019: Release v1.20.1

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  • Updated the DTP Adolescent Tdap Recommendation and Evaluation rules as per the new Tdap guidance included in the 2019 CDC Immunization Schedule
  • Added a DTP 3-dose series exception rule requiring that in order for a primary series to be complete via the DTP 3-dose series, at least one of the doses given must be a pertussis-containing dose

5/31/2019: Release v1.17.1

HPV Update

  • Updates to HPV 3-dose series to align with CDSi
    • Updated Recommended Interval between Dose 1 and 2 from 1 month to 4 weeks
    • Updated Absolute Minimum Interval between Dose 1 and 3 from 112 days to 5 months - 4 days

DTP Update

  • Updated the DTP 3-dose series Absolute Minimum Interval between Dose 2 and 3 from 164 days to 6 months - 4 days to align with CDSi. 
  • Updated Adolescent Tdap Exception A Rule to "The patient DOES NOT have a dose of pertussis vaccine at >= 4 years - 4 days."

Zoster Update

  • Added rule "Recommended Interval After Adult Varicella (CVX 21) Doses"
    • If patient is administered adult varicella (CVX 21) doses, the minimum interval and recommended interval between the adult varicella (CVX 21) doses to Zoster is 8 weeks. 
    •  Example:
      • Varicella (CVX 21) at 50 years, 1 month.
      • Varicella (CVX 21) at 50 years, 3 months. 
      • Recommend Zoster (CVX 187) at Varicella Dose 2 + recommended interval (8 weeks)

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General - Same Day Shots Update

  • Updated and improved the handling of shots administered on the same day. 

3/7/2019: Release v1.16.1

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  • Please refer to the March 7 News entry for general information and suggestions related to this release.

Pneumococcal Update

  • Updated recommendation rule to distinguish between patients >=5 years old who have completed the childhood Pneumococcal series and patients who have not. The updated rule states:
    • "If a patient is >= 5 years (or will be >= 5 years at the recommended due date) and < 65 years, and they have completed the Child Series, then the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK; otherwise the Recommendation is Conditional and the reason code is HIGH_RISK."

Polio Update

  • Updated Series complete with 3-doses rule to include the minimum interval = 6 months and absolute minimum interval = 6 months - 4 days. 

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Shots Administered "before" the Patient's DOB

  • Improved handling of shots marked as administered before the patient's date of birth.

Overdue Date/Earliest Date

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