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The DTP rules documented on this wiki page address 3 separate goals:  Complete the primary series (3dose or 5dose)
 Complete the adolescent Tdap dose(s)
 Complete the recurring Td booster dose every 10 years

General Rules for DTP
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Definition of "A dose of pertussis"
A dose of pertussis is defined as one of the following:  A primary series (3dose series or 5dose series) dose of CVX 01, 20, 106, 107, or 115
 A primary series shot of CVX 01, 20, 106, 107, or 115 where the shot is evaluated as Invalid with a reason code of D_AND_T_INVALID/P_VALID
 An Adolescent Tdap dose of CVX 01, 20, 106, 107, or 115
Rules for Recommending at the CVX Code vs. Vaccine Group Level Within the Primary Series
Generally, ICE recommends at the group level rather than a specific CVX code; however, DTP vaccine group recommendations are at the CVX level. When recommending DTP as part of the 3dose or 5dose series, the rules below state which CVX code to recommend. For patients >=7 years of age, the rules below also include an override to the series routine recommended age.
Rules for Adolescent Tdap and Recurring Td (Once Primary Series is Complete) Rules for Adolescent Tdap (CVX 115)
If the patient has completed the primary DTP series (3dose or 5dose), then see the "Recommendation Rules for Adolescent Tdap" below: Recommendation Rules for Adolescent Tdap  For patients who completed the primary DTP series (3dose or 5dose):
 If the patient has NOT received a pertussiscontaining dose at >= 7 years and <10 years and
 any one of the below exception rules apply (for 5dose series only), then recommend Tdap (CVX 115) at 7 years old (or apply recommended interval, if applicable).
 none of the below exception rules apply (for 5dose series only), then recommend Tdap (CVX 115) at 11 years old (or apply recommended interval, if applicable).
 If the patient has received a pertussiscontaining dose at >= 7 years and <10 years, then recommend another Tdap (CVX 115) at 11 years old.
 If the patient has received a pertussiscontaining dose at >= 10 years, then recommend the recurring Td (CVX 09) then a booster dose is recommended every 10 years. See the "Rules for Recurring Booster Dose" below.
 For patients who completed the 5dose series:
 If none of the following exceptions apply, then:
 Recommended Vaccine = Tdap (CVX 115)
 Recommended Age = 11 years unless an exception applies
 Recommended Interval = 6 months from the last dose of pertussis; 0 days from the last nonpertussis dose.
 Minimum Age = 11 years
 Minimum Interval = 6 months from last dose of pertussis; 0 days from the last nonpertussis dose
 Latest Recommended Age (less than) = 13 years + 4 weeks
 If any one of the following exceptions apply, then:
 Recommended Vaccine = Tdap (CVX 115)
 Recommended Age = 7 years
 Recommended Interval = 6 months from the last dose of pertussis; 0 days from the last nonpertussis dose.
 Minimum Age = 7 years
 Minimum Interval = 6 months from last dose of pertussis; 0 days from the last nonpertussis dose
 Latest Recommended Age (less than) = 7 years
 Exceptions:
 Exception A) The patient DOES NOT have a dose of pertussiscontaining vaccine at >= 4 years 4 days.
 Exception B) The patient DOES NOT have at least 4 doses of pertussiscontaining vaccine given at < 7 years
 For patients who completed the 3dose series (i.e., dose 1 at >=7 years):
 Recommended Age = N/A
 Recommended Interval = 6 months from the last dose of pertussis; 0 days from the last nonpertussis dose.
 Minimum Age = N/A
 Minimum Interval = 6 months from the last dose of pertussis; 0 days from the last nonpertussis dose.
 Latest Recommended Age (less than) = 13 years + 4 weeks
Evaluation Rules for Adolescent Tdap
 All pertussiscontaining vaccines in the DTP vaccine group are allowed as the Adolescent Tdap.
 Absolute Minimum Age = 7 years
 Absolute Minimum Interval:
If final dose in the primary series (or accepted/extra dose, if an extra shot exists) is a pertussiscontaining shot, then absolute minimum interval = 4 weeks If final dose in the primary series (or accepted/extra dose, if an extra shot exists) is a nonpertussiscontaining shot, then absolute minimum interval = 0 days
 When the target dose is the Adolescent Tdap, if the shot is administered after the primary series is complete but does not meet the criteria for the Adolescent Tdap dose, then the Evaluation is Accepted and the reason code is EXTRA_DOSE.
 If the shot meets the criteria for the Adolescent Tdap dose, then the Evaluation is Valid.
 If the patient has received an Adolescent Tdap dose at >= 7 years and < 10 years, then the absolute minimum age for the second Adolescent Tdap dose = 10 years.
 If the patient has received their first Adolescent Tdap dose at >= 7 years and < 10 years, evaluate subsequent shots >= 7 years and < 10 years as Accepted/Extra Dose.
Rules for Recurring Td (CVX 09)Recurring Booster DoseOnce the patient has completed the primary DTP series (3dose or 5dose) and has met the requirements for the Adolescent Tdap, a Td (09) a booster dose is needed every 10 years. Recommendation Rules for Recurring Td
Recommended Vaccine = Td (CVX 09) Booster Dose
 Recommend at the Vaccine Group Level
 Recommended Interval = 10 years
 Minimum Interval = 5 years
 Latest Recommended Interval (less than) = 10 years + 4 weeks
Evaluation Rules for Recurring TdRecurring Booster Dose  All vaccines in the DTP vaccine group are allowed for the recurring Tdbooster dose.
 Absolute Minimum interval = 0 days
 Once the primary series is complete and the patient has met the requirements for the Adolescent Tdap, any DTP shot is evaluated as VALID for the recurring Td booster dose.

DTP Vaccines
CVX Code  Name  Absolute Minimum Age 

01  DTP 

09  Td (adult), adsorbed  7 yrs  4 days^{1} 
20  DTaP 

28  DT (pediatric) 

106  DTaP, 5 pertussis antigens 

107  DTaP, unspecified formulation 

113  Td (adult) preservative free  7 yrs  4 days^{1} 
115  Tdap  7 yrs  4 days^{1} 
138  Td (adult, not adsorbed)  7 yrs  4 days^{1} 
139  Td (adult) NOS  7 yrs  4 days^{1} 
CVX Code Minimum Interval Between Tdap/DTaP and Td/DTIf Tdap (CVX 115), DTaP (CVX 20, 106, or 107), or DTP (CVX 01) is given below the minimum interval from a Rule for Td (CVX 09, 113, 138, 139)^{2}
 If Td (CVX 09, 113, 138, 139)
or DT (CVX 28), but the shot meets the minimum age, then the Tdap/DTaP/DTP is evaluated as Invalid and the reason code is D_AND_T_INVALID/P_VALID (i.e., Diphtheria and tetanus components invalid due to minimum interval violation, pertussis component valid). is administered below the CVX Absolute Minimum Age (< 7 years  4 days), evaluate as Invalid/BELOW_MINIMUM_AGE_VACCINE.
 If patient is in the DTP 5dose series, and Td (CVX 09, 113, 138, 139) is administered at > = 7 years  4 days, evaluate the shot as Valid and return evaluation reason code SUPPLEMENTAL_TEXT and Descriptive Text: "Pertussis is needed to complete the series."
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CVX Code Specific Rules Anchor 

 CVXCodeAbsoluteMinimumAge 

 CVXCodeAbsoluteMinimumAge 

 CVX Code Absolute Minimum Age
Rule for Tdap (CVX 115)^{1} The absolute minimum age^{1 }age for Tdap (CVX 115) and Td (CVX 09, 113, 138, 139) applies when Tdap /Td is given as target dose 1, 2, or 3 in the 5dose series.
 If Tdap /Td is administered below the CVX code absolute minimum age, then;
 The Evaluation is Invalid and the reason code is INSUFFICIENT_ANTIGEN.
 Refer to the 5dose series special rule for determining the due date for the next target dose.
 The absolute minimum age ^{1} does not apply when Tdap (CVX 115) or Td (CVX 09, 113, 138, 139) is administered as target dose 4 or 5 in the 5dose series.
 The absolute minimum age is only waived when the target dose is a true dose 4 or 5; the waiver does not apply when dose 1 was skipped.

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CVXCodeMinimumIntervalBetweenTdap/DTaPandTd/DT  CVXCodeMinimumIntervalBetweenTdap/DTaPandTd/DT 
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 CVXCodeMinimumIntervalBetweenTdap/DTaPandTd/DT 

 CVXCodeMinimumIntervalBetweenTdap/DTaPandTd/DT 


CVX Code Minimum Interval Between Tdap/DTaP and Td/DTIf Tdap (CVX 115), DTaP (CVX 20, 106, or 107), or DTP (CVX 01) is given below the minimum interval from a Td (CVX 09, 113, 138, 139) or DT (CVX 28), but the shot meets the minimum age, then the Tdap/DTaP/DTP is evaluated as Invalid and the reason code is D_AND_T_INVALID/P_VALID (i.e., Diphtheria and tetanus components invalid due to minimum interval violation, pertussis component valid).
Rule for DT (CVX 28)^{3}
If a patient is administered DT (CVX 28) at:
 <=7 years, evaluate the shot as Valid and return evaluation reason code SUPPLEMENTAL_TEXT and Descriptive Text: "DT should only be administered to children 6 weeks through 6 years of age with a contraindication to pertussis vaccine." (Implementation Note: this text is output via the output_supplemental_text option in ICE. If this feature is not enabled, the text is not output. See the ICE Implementation Guide for details.)
 > 7 years, evaluate the shot as Valid and return evaluation reason code SUPPLEMENTAL_TEXT and Descriptive Text: "Pertussis is needed to complete the series."
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Notes CVX 35 (Tetanus Toxoid) is not considered part of the DTP vaccines group and, therefore, is not listed in the table above. CVX 35 will not be evaluated as part of the DTP series.

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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  DTP 5dose  38 days  42 days (6 weeks)  2 months  3 months + 4 weeks  01, 20, 28^{3}, 106, 107, 115*^{1}, 09*^{2}, 113*^{2}, 138*^{2}, 139*^{2}, 22, 50, 102, 110, 120, 130, 132, 146  
2  DTP 5dose  66 days  70 days (10 weeks)  4 months  5 months + 4 weeks  01, 20, 28^{3}, 106, 107, 115*^{1}, 09*^{2}, 113*^{2}, 138*^{2}, 139*^{2}, 22, 50, 102, 110, 120, 130, 132, 146 

3  DTP 5dose  94 days  98 days (14 weeks)  6 months  7 months + 4 weeks  01, 20, 28^{3}, 106, 107, 115*^{1}, 09*^{2}, 113*^{2}, 138*^{2}, 139*^{2}, 22, 50, 102, 110, 120, 130, 132, 146 

4  DTP 5dose  1 year  4 days  15 months
 15 months
 19 months + 4 weeks  01, 20, 28^{3}, 106, 107, 115^{1}, 09^{2}, 113^{2}, 138^{2}, 139^{2}, 22, 50, 102, 110, 120, 130, 132, 146 

5  DTP 5dose  4 years  4 days  4 years  4 years  7 years  01, 20, 28^{3}, 106, 107, 115^{1}, 09^{2}, 113^{2}, 138^{2}, 139^{2}, 22, 50, 102, 110, 120, 130, 132, 146 
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, 110, 120, 130, 132, 146 

Vaccine Dose Parameters  Minimum and Recommended Intervals
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Series Special Rules Anchor 

 RecEvalNextDoseAfterBelowMinAgeTdapTD 

 RecEvalNextDoseAfterBelowMinAgeTdapTD 

 Rule for Recommending/Evaluating Next Dose From Invalid Tdap /TD Given Below Minimum Age for VaccineIf Tdap (CVX 115) or Td (CVX 09, 113, 138, 139) is given as target dose 1, 2 or 3 to a patient <7 years  4 days old, then the invalid shot should be ignored when determining the recommended due date for the next target dose due and when evaluating the next shot based on the minimum interval for that target dose.target dose due and when evaluating the next shot based on the minimum interval for that target dose. (Note  The ICE General Rule "Earliest, recommended, and past due dates must be on or after the last shot given" applies here.)  Examples:
 If CVX 09 115 is given as target dose 1 when a patient is 2 months old, the Td Tdap will be evaluated as invalid due to insufficient antigen and a DTaP will be recommended at 2 months (i.e., the invalid shot is ignored and target dose 1 is recommend based on the routine age). If the DTaP is subsequently given when the patient is 2 months and 2 weeks old, the invalid Td Tdap will be ignored and the DTaP will be evaluated as valid.
 If a patient is given a DTaP at 2 months and 4 months (doses 1 and 2), a Td Tdap at 4 months 2 weeks (target dose 3, invalid), and then a DTaP at 6 months (target dose 3), the Td Tdap will be evaluated as invalid for two reasons: 1.) insufficient antigen and 2.) because it is also below the minimum interval from dose 2. When evaluating the DTaP at 6 months, the invalid Td Tdap will be ignored and the DTaP will be evaluated as valid since it meets the minimum interval of 24 days between dose 2 (at 4 months) and the target dose 3 administered at 6 months.
Six by Seven RuleIf a child is < 7 years of age and has received >= 6 shots from the DTP vaccine group, but has not yet completed the series, then the next dose is recommended at age 7 years; follow table rules for to determine the recommended interval. (Duplicate shots (or same day shots) do not count towards this rule.) Anchor 

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 5dose Series Exception Rules
The 5dose series above applies unless: Exception 1: Series Complete with 3 Doses  If the patient is >=7 or will be >=7 as of the next due date, received the first dose at >= 12 months of age, and received at least one dose at >= 4 years^{1} ^{4} of age, then the series is complete with 3 doses (doses 2, 3 and 4).
Exception 2: Series Complete with 4 Doses  If 4 doses have been administered and the 4^{th} dose is administered at >= 4 years^{1} ^{4 }of age, then and the interval between dose 3 and 4 is >= 6 months  4 days, then the series is complete with 4 doses; the 5^{th} (booster) dose is not needed.

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Notes 
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