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Rules Based on Patient Age

Recommendation Rules

• If a patient is < 8 months,
  • and is not complete for the RSV Infant Series,
    • and is not in the RSV season as of the evaluation date, 
      • and will be < 8 months at the next RSV season start date, the recommendation is Future Recommended with reason code SUPPLEMENTAL_TEXT, descriptive text, "If the patient's mother was not vaccinated during pregnancy, the mother’s vaccination status is unknown, or the mother was vaccinated within 14 days of the patient’s birth: Administer RSV mAb dose based on patient weight shortly before or during the RSV season."
      • and will be >= 8 months at the next RSV season start date, the recommendation is Conditional with reason code HIGH_RISK.  
    • and is in the RSV season as of the evaluation date, the recommendation is Recommended with reason code SUPPLEMENTAL_TEXT, descriptive text, "If the patient's mother was not vaccinated during pregnancy, the mother’s vaccination status is unknown, or the mother was vaccinated within 14 days of the patient’s birth: Administer RSV mAb dose based on patient weight shortly before or during the RSV season." 
  • and is complete for the RSV Infant Series, the recommendation is Not Recommended and the reason code is COMPLETE_HIGH_RISK. 
• If a patient is >= 8 months and < 20 months, the recommendation is Conditional and the reason code is HIGH_RISK.
• If a patient is >= 20 months and < 60 years old,
  • and is not complete for the RSV Adult Series, the recommendation is Future Recommended with reason code SUPPLEMENTAL_TEXT with descriptive text,   "The RSV evaluations and recommendations in ICE primarily target the routine series. RSV is recommended as a single lifetime dose for all adults 75 years of age and older and adults 60–74 years of age and older who are at increased risk of severe RSV disease. Note:  RSV RSV vaccine is also recommended for pregnant persons at 32-36 weeks' gestation, using seasonal administration."
  • and is complete for the RSV Adult Series, the recommendation is Not Recommended with the reason code COMPLETE. 
• If a patient is >= 60 years old and < 75 years old,
  • and is not complete for the RSV Adult Series, the recommendation is Conditional with reason codes HIGH_RISK and SUPPLEMENTAL_TEXT with descriptive with descriptive text, "The RSV evaluations and recommendations in ICE primarily target the routine series. Adults ages 60- 74 RSV is recommended as a single lifetime dose for all adults 75 years of age and older and adults 60–74 years of age who are at increased risk of severe RSV disease receive a single dose of RSV vaccine. RSV vaccination is recommended as a single lifetime dose only. Persons who have already received RSV vaccination are NOT recommended to receive another dose."
  • and is complete for the RSV Adult Series, the recommendation is Not Recommended with the reason code COMPLETE.
• If a patient is >= 75 years old,
  • and is not complete for the RSV Adult Series, the recommendation is Recommended.
  • and is complete for the RSV Adult Series, the recommendation is Not Recommended with the reason code COMPLETE.
• The first season of the RSV Infant Series started on 10/1/2023. Therefore, the earliest recommendation date for an RSV dose in the Infant Series is 10/1/2023.
• The recommended date for the RSV Adult Series is the later of the calculated forecast date or June 26, 2024.

Evaluation of Shots Administered at age >= 8 months and < 50 years

• If any RSV shot is administered at age >= 8 months and < 50 years, evaluate the shot as Accepted / OUTSIDE_ROUTINE_SERIES.
  • Note: This rule overrides the ICE General Rule "Evaluation Selection Priority" in all cases, except where the ICE General Rule "Evaluation of Shots Above the Vaccine Code Absolute Maximum Age" applies. 

RSV Shots Administered Prior to 10/1/2023

If an RSV shot is administered prior to 10/1/2023, evaluate as Invalid with reason code VACCINE_NOT_YET_AVAILABLE_ON_DATE_SPECIFIED.