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Two Shot Same Day Exception Rules for Meningococcal B

If CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and CVX 163 (Meningococcal B 4C, OMV (Bexsero)) are reported as administered on the same day, then:

  • evaluate CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) as Invalid with a reason code of DUPLICATE_SAME_DAY
  • evaluate CVX 163 (Meningococcal B 4C, OMV (Bexsero)) as Valid
  • recommend based on the MenB 4C 2-dose Series.  

However, if both Meningococcal B vaccines are administered on the same day, and one vaccine would complete a Meningococcal B series, then evaluate that vaccine as Valid and the other Meningococcal B vaccine as Invalid with a reason code of DUPLICATE_SAME_DAY.  (Example - CVX 162 (Trumenba) or CVX 316 (Meningococcal MenABCWY (Penbraya)) administered at 16 years old.  CVX CVX 162 (Trumenba) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and CVX 163 (Bexsero) administered on same day (at 16 years, 6 months old). Trumenba 2-dose series applies/Series Complete. CVX 163 would be evaluated as Invalid/DUPLICATE_SAME_DAY.)

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Rules Based on Patient's Age

  • If no doses are on record and
    • the patient is < 10 years old, then the Recommendation is Not Recommended and the reason code is BELOW_MINIMUM_AGE_HIGH_RISK_SERIES. 
    • the patient is >= 10 years old and < 16 years old, then the Recommendation is Conditional and the reason code is HIGH_RISK.
    • the patient is >= 16 years old and < 24 years old, then the Recommendation is Conditional and the reason code is CLINICAL_PATIENT_DISCRETION.
    • the patient is >= 24 years old, then the Recommendation is Conditional and the reason code is HIGH_RISK.

Rules for Recommending at the CVX Code vs. Vaccine Group Level 

  • When recommending in the MenB 4C 2-dose Series, recommend CVX 163 for the next target dose.
    • If patient has at least one CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and at least one CVX 163 (Meningococcal B 4C, OMV (Bexsero)) on record, recommend CVX 163 and include the reason codes: DUE_NOW or DUE_IN_FUTURE and OTHER_VACCINE_PRODUCT_POSSIBLE.
  • When recommending in the MenB FHbp 2-dose Series or MenB FHbp 3-dose Series, recommend CVX 162 for the next target dose.
    • If patient has at least one CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and at least one CVX 163 (Meningococcal B 4C, OMV (Bexsero)) on record, then recommend CVX 162 and include the reason codes: DUE_NOW or DUE_IN_FUTURE and OTHER_VACCINE_PRODUCT_POSSIBLE. 
  • If recommendation is Conditional, recommend at the vaccine group level.

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CVX Code

Name

Absolute Minimum Age
162

Meningococcal B FHbp, recombinant (Trumenba)

10 years - 4 days

163

Meningococcal B 4C, OMV (Bexsero)

10 years - 4 days

Combination Vaccines that Include Meningococcal B


CVX Code

Vaccine Name

Component
CVX Code

Component
Vaccine Name

316

Meningococcal MenABCWY (Penbraya)

162

Meningococcal B FHbp, recombinant (Trumenba)


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CVX Code Specific Rules

CVX Code Absolute Minimum Age

  • If one of the CVX codes in the table above is administered below the absolute minimum age for that CVX code, then the Evaluation is Invalid and the reason code is BELOW_MINIMUM_AGE_VACCINE. 

Rule for CVX 164 (Meningococcal B, NOS)  

  • CVX 164 (Meningococcal B, NOS) is not listed in the table above because it does not count toward the completion of the Meningococcal B series. CVX 164 is categorized in the "Other Vaccine Group". (Reference the General Rules for more details.) If CVX 164 is reported, then evaluate as NOT_EVALUATED and the reason code is VACCINE_NOT_SUPPORTED. Ignore the reported CVX 164 when determining the recommended vaccine and calculating the recommended due date for the next target dose.

Combination Vaccines that Include Meningococcal B

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Immunization Series and Selection Rules

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Series Name

  • MenB FHbp 2-dose Series
  • MenB FHbp 3-dose Series
  • MenB 4C 2-dose Series

Series Selection Rules

There are three series for this vaccine group: the MenB FHbp 2-dose Series, MenB FHbp 3-dose Series, and MenB 4C 2-dose Series. The rules for determining which series applies are:

  • If dose 1 is CVX 163 (Meningococcal B 4C, OMV (Bexsero)), then the MenB 4C 2-dose series applies.
  • If target dose 1 is CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and:
    • Invalid invalid for the MenB FHbp 2-dose Series, but valid for MenB FHbp 3-dose Series, the MenB FHbp 3-dose series applies.
    • Valid valid for the MenB FHbp 2-dose Series AND valid for MenB FHbp 3-dose Series, the MenB FHbp 2-dose series applies.
  • If dose 1 is CVX 162 (Meningococcal B FHbp, recombinant (Trumenba) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and:
    • target dose 2 is CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and:
      • valid for the MenB FHbp 2-dose series, the MenB FHbp 2-dose series applies.
      target dose 2 is CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) and
      • invalid for the MenB FHbp 2-dose series, but valid for MenB FHbp 3-dose series, the MenB FHbp 3-dose series applies.
      target dose 2 is CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) and
      • invalid for BOTH the MenB FHbp 2-dose series and MenB FHbp 3-dose series, the MenB FHbp 2-dose series applies. 
  • If both CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) and CVX 163 (Meningococcal B 4C, OMV (Bexsero)) are on the patient record, then the series in which the Meningococcal B vaccine last administered applies. Ignore the reported shot of the other Meningococcal B vaccine.
    • If CVX 163 (Meningococcal B 4C, OMV (Bexsero)) is the last shot administered on the patient record, then the MenB 4C 2-dose series applies.
    • If CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) is the last shot administered on the patient record, then either the MenB FHbp 2-dose series applies or the MenB FHbp 3-dose series applies. (See preceding Series Selection Rules to determine whether the MenB FHbp 2-dose series or MenB FHbp 3-dose series applies.)

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Vaccine Dose Parameters - Minimum and Routine Ages 

Dose

Series Name

Absolute Minimum
 AgeMinimum 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

MenB FHbp 2-dose 

16 years - 4 days

16 years

16 years

N/A162, 316

N/A


2

MenB FHbp 2-dose 

N/A

N/AN/AN/A162, 316

N/A


Vaccine Dose Parameters - Minimum and Recommended Intervals

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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 SeriesInvalid CVX Code(s) per Dose for this Series

1

MenB FHbp 3-dose

10 years - 4 days

10 years

10 years


N/A162, 316

N/A


2

MenB FHbp 3-dose

N/A

N/A

N/A

N/A162, 316

N/A


3MenB FHbp 3-dose N/AN/A

N/A

N/A162, 316

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

MenB FHbp 3-dose

4 weeks - 4 days

4 weeks

4 weeks

8 weeks
Dose 2 to 3MenB FHbp 3-dose

4 months - 4 days

4 months4 monthsN/A
Dose 1 to 3MenB FHbp 3-dose

0 days

6 months6 monthsN/A

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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 SeriesInvalid CVX Code(s) per Dose for this Series

1

MenB 4C 2-dose

10 years - 4 days

10 years

10 years


N/A163

N/A


2

MenB 4C 2-dose

N/A

N/A10 years, 1 monthN/A163

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

MenB 4C 2-dose

1 month - 4 days

1 month

1 month

N/A

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Series Special Rules

Rule for CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya))

  • If CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) or CVX 316 (Meningococcal MenABCWY (Penbraya)) is reported, then evaluate as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
    Ignore the reported CVX 162 or CVX 316 when determining the recommended vaccine and calculating the recommended due date for the next target dose.

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