Two Shot Same Day Exception Rules for COVID-19
The Duplicate Shot, Same Day rules do not apply for COVID-19 Vaccine Group for >= 18 yrs of age, due to the fact that the absolute minimum intervals between dose 1 and dose 2 = 0 days in both the Pfizer COVID-19 2-dose Series and Moderna COVID-19 2-dose Series. (Note - Once the latest absolute minimum interval updates are incorporated into ICE in December 2021, the Duplicate Shot, Same Day rules will apply.)
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| Rules for Recommending at the CVX Code vs. Vaccine Group Level
- When recommending in the Pfizer COVID-19 2-dose Series, recommend CVX 208 for the next target dose.
- When recommending in the Moderna COVID-19 2-dose Series, recommend CVX 207 for the next target dose.
- When recommending in the Janssen COVID-19 1-dose Series, recommend CVX 212 for the next target dose.
- If patient has no shots on record, and is > = 12 years old, recommend If the patient has no shots on record,
- and is < 5 years old, recommend CVX 218 at 5 years old.
- and is > = 5 years old and < 12 years old, recommend CVX 218 at today's date.
- and is > = 12 years old and < 18 years old, recommend CVX 208 at today's date.
- and is > = 18 years old, recommend at the vaccine group level at today's date.
- If the patient has shots on record
- and is < 12 5 years old, recommend at the vaccine group level at 12 years old.
Series Completion Special Rule- Once a patient completes:
- the Pfizer COVID-19 2-dose series with CVX 208 as Dose 1 and Dose 2,CVX 218 at 5 years old.
- and is > = 5 years old and < 12 years old (or will be < 12 years old at the recommended due date), recommend CVX 218 for the next target dose.
- and is > = 65 12 years old , recommend a booster dose of Pfizer (CVX 208) at Dose 2 + recommended interval (6 months), along with recommendation reason code SUPPLEMENTAL_TEXT; Descriptive Text: "Although patients are considered fully vaccinated two weeks after their second dose of the Pfizer COVID-19 vaccine, a booster dose is recommended 6 months after the second dose for patients >= 65 years old."
- and is >= 18 years and < 65 years old, the recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
and is < 18 years old, the recommendation is Conditional/ (or will be >= 12 years old at the recommended due date) and < 18 years old, recommend CVX 208 for the next target dose.
- and is > = 18 years old and is in the following series:
- Pfizer COVID-19 2-dose Series, recommend CVX 208 for the next target dose.
- Moderna COVID-19 2-dose Series, recommend CVX 207 for the next target dose.
- Janssen COVID-19 1-dose Series, recommend CVX 212 for the next target dose.
Series Completion Special Rule- Once a patient completes:
- the Pfizer COVID-19 (5-17) 2-dose series,
- and is < 18 years old, the recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
- and receives an additional dose1 or booster dose2, the the Recommendation is Not Recommended is Conditional and the reason code is COMPLETE_HIGH_RISK.
- the Pfizer COVID-19 2-dose series where not all doses administered were CVX 208 or the Moderna COVID-19 2-dose series,
- the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
and with CVX 208 as Dose 1 and Dose 2,- and is >= 65 years old, recommend a booster dose of Pfizer (CVX 208) at Dose 2 + recommended interval (6 months), along with recommendation reason codes BOOSTER_DOSE. (new recommendation reason code)
- and is >= 18 years and < 65 years old, the recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
- and receives an additional dose1 or booster dose2, the Recommendation is Not Recommended and the reason code is COMPLETE.
- either the 1) Janssen Pfizer COVID-19 12-dose series , 2) where not all doses administered were CVX 208 or the Moderna COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, 2-dose series,
- the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK.
- and receives an additional dose1, the Recommendation is Not Recommended and the reason code is COMPLETE.
- either the 1) Janssen COVID-19 1-dose series, 2) COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a 3) 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, the Recommendation is Not Recommended/ COMPLETE_HIGH_RISK.
Rules for an Additional Dose1- If a patient completes a COVID-19 vaccine series via the Pfizer 2-dose series or Moderna 2-dose series and receives an additional shot of CVX 208, CVX 207, or CVX 213:
- at < 28 days - 4 days after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."
- at >= 28 days - 4 days after series completion, then evaluate the shot as Valid.
- If a patient receives a subsequent shot(s) after they have received an additional dose1, then evaluate that shot(s) as Accepted/ EXTRA_DOSE.
Rules for Booster Dose2If a patient - is >=12 years old, completes a COVID-19 vaccine series via the Pfizer COVID-19 (5-17) 2-dose series
(with CVX 208 only) and a booster dose2 of CVX 208, - and receives an additional shot of CVX 218, CVX 208, 207, or CVX 213:
days after - days after series completion, then evaluate the shot
as Valid SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."- BELOW_MINIMUM_INTERVAL.
- at >= 28 days - 4
days after series completion then - then evaluate the shot as Valid.
Rules for Booster Dose2 receives an additional shot(s) after they have received a booster dose2, then evaluate those shots as Accepted/ EXTRA_DOSE. |
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Notes- 1Additional Dose - Defined by ACIP to be a dose administered when the immune response to a standard primary vaccine series is likely not to be protective.
- 2Booster Dose - Defined by ACIP to be a dose administered to restore protection after the effectiveness of protection from the primary series has declined.
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COVID-19 Vaccines
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CVX Code
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Name
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Moderna COVID-19 Vaccine
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208
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Pfizer COVID-19 Vaccine
...
- completes a COVID-19 vaccine series via the Pfizer 2-dose series (with CVX 208 only) and a booster dose2 of CVX 208,
- at < 28 days - 4 days after series completion, then evaluate the shot as Valid/ SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."
- at >= 28 days - 4 days after series completion, then evaluate the shot as Valid.
- If a patient completes a COVID-19 vaccine series via the Janssen 1-dose series and a booster dose of CVX 212, CVX 208, CVX 207, or CVX 213, then evaluate the booster dose as Valid.
Rules for Extra Shots After Additional Dose1and/or Booster Dose2- For patients that completed the Pfizer COVID-19 Child (5-17) 2-dose Series,
- is < 12 years old, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
- is > = 12 years old and received an Additional Dose, any shots administered afterwards will be evaluated as Accepted/EXTRA_DOSE.
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Notes- 1Additional Dose - Defined by ACIP to be a dose administered when the immune response to a standard primary vaccine series is likely not to be protective.
- 2Booster Dose - Defined by ACIP to be a dose administered to restore protection after the effectiveness of protection from the primary series has declined.
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COVID-19 Vaccines
CVX Code | Name | Absolute Minimum Age | Absolute Maximum Age | Counts towards U.S. Vaccination |
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207 | Moderna COVID-19 Vaccine | 0 days |
| Yes213 |
208 | SARS-COV-2 (COVID-19) vaccine, UNSPECIFIEDPfizer COVID-19 Vaccine | 0 days |
| Yes |
500210 | AstraZeneca COVID-19 Non-US Vaccine, Product Unknown | No | 501 | COVID-19 IV Non-US Vaccine (QAZCOVID-IN) | No | 502 | COVID-19 IV Non-US Vaccine (COVAXIN) | No | 503 | COVID-19 LAV Non-US Vaccine (COVIVAC) | No | 504 | COVID-19 VVnr Non-US Vaccine (Sputnik Light) | No | 505 | COVID-19 VVnr Non-US Vaccine (Sputnik V) | No | 506 | COVID-19 VVnr Non-US Vaccine (CanSino Biological Inc./Beijing Institute of Biotechnology) | No | 507 | COVID-19 PS Non-US Vaccine (Anhui Zhifei Longcom Biopharmaceutical + Institute of Microbology Chinese academy of Sciences) | No | 508 | COVID-19 PS Non-US Vaccine (Jiangsu Province Centers for Disease Control and Prevention) | No | 509 | COVID-19 PS Non-US Vaccine (EpiVacCorona) | No |
510 | COVID-19 IV Non-US Vaccine (BIBP, Sinopharm) | 0 days | Yes, only if all recommended doses are administered. |
511 | COVID-19 IV Non-US Vaccine (CoronaVac, Sinovac) | 0 days | Yes, only if all recommended doses are administered. |
Combination Vaccines that Include COVID-19
No combination vaccines exist, at this time, that include COVID-19 and count toward completion of the Pfizer COVID-19 2-dose series.
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CVX Code Specific Rules
CVX Code Absolute Minimum Age
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Vaccine | 0 days |
| Yes, only if all recommended doses are administered. |
211 | Novavax COVID-19 Vaccine | 0 days |
| Yes, only if all recommended doses are administered. |
212 | Janssen COVID-19 Vaccine | 0 days |
| Yes |
213 | SARS-COV-2 (COVID-19) vaccine, UNSPECIFIED | 0 days |
| Yes |
218 | Pfizer COVID-19 Vaccine (5-11 years) | 0 days | 18 years minus 1 day | Yes |
500 | COVID-19 Non-US Vaccine, Product Unknown |
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| No |
501 | COVID-19 IV Non-US Vaccine (QAZCOVID-IN) |
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| No |
502 | COVID-19 IV Non-US Vaccine (COVAXIN) | 0 days |
| Yes, only if all recommended doses are administered. |
503 | COVID-19 LAV Non-US Vaccine (COVIVAC) |
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| No |
504 | COVID-19 VVnr Non-US Vaccine (Sputnik Light) |
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| No |
505 | COVID-19 VVnr Non-US Vaccine (Sputnik V) |
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| No |
506 | COVID-19 VVnr Non-US Vaccine (CanSino Biological Inc./Beijing Institute of Biotechnology) |
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| No |
507 | COVID-19 PS Non-US Vaccine (Anhui Zhifei Longcom Biopharmaceutical + Institute of Microbology Chinese academy of Sciences) |
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| No |
508 | COVID-19 PS Non-US Vaccine (Jiangsu Province Centers for Disease Control and Prevention) |
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| No |
509 | COVID-19 PS Non-US Vaccine (EpiVacCorona) |
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| No |
510 | COVID-19 IV Non-US Vaccine (BIBP, Sinopharm) | 0 days |
| Yes, only if all recommended doses are administered. |
511 | COVID-19 IV Non-US Vaccine (CoronaVac, Sinovac) | 0 days |
| Yes, only if all recommended doses are administered. |
Combination Vaccines that Include COVID-19
No combination vaccines exist, at this time, that include COVID-19 and count toward completion of the Pfizer COVID-19 2-dose series.
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CVX Code Specific RulesCVX Code Absolute Minimum AgeRule for CVX 213CVX Code Absolute Maximum Age patient receives CVX 213 for:Target Dose 1, evaluate the Rule for CVX 213- If the patient receives CVX 213 for:
- Target Dose 1, evaluate the shot as Valid.
- Recommend Target Dose 2 at Vaccine Group level
- Recommended interval = 28 days
- Recommended age = 18 years
- Target Dose 2, evaluate the shot as Valid.
- If the patient receives CVX 213 for Target Dose 1 and CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate Target Dose 2 (CVX 212) as Valid.
- evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
- If the patient has CVX 213 on their patient record AND receives all recommended doses of a 1) COVID-19 vaccine not authorized by the FDA, but authorized by the WHO or 2) COVID-19 vaccine 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, then
- evaluate CVX 213 shots given before series completion as Accepted/ VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
- Example Scenario #1 - Patient receives the following shots (listed in order): CVX 213, CVX 210 (AstraZeneca), CVX 210 (AstraZeneca)
- CVX 213 shot is evaluated as Accepted/ VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN
- Both CVX 210 shots are evaluated as Valid (series is complete via AstraZeneca 2-dose series)
- Example Scenario #2 - Patient receives the following shots (listed in order): CVX 210 (AstraZeneca), CVX 213, CVX 210 (AstraZeneca)
- CVX 213 shot is evaluated as Accepted/ VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN
- Both CVX 210 shots are evaluated as Valid (series is complete via AstraZeneca 2-dose series)
- evaluate CVX 213 shots given after series completion as Accepted/ EXTRA_DOSE.
- Example Scenario #1 - Patient receives the following shots (listed in order): CVX 210 (AstraZeneca), CVX 210 (AstraZeneca), CVX 213
- Both CVX 210 shots are evaluated as Valid (series is complete via AstraZeneca 2-dose series)
- CVX 213 is evaluated as Accepted/ EXTRA_DOSE
Rules for COVID-19 Vaccines Not Authorized by FDA2The following set of rules apply to 1) COVID-19 Vaccines Not Authorized by FDA, but Authorized by WHO and, 2) COVID-19 Vaccines Not Authorized by 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. The list of COVID-19 Vaccines Not Authorized by the FDA, but Authorized by the WHO are: The list of 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 are: - If the patient has received all recommended doses of the COVID-19 vaccine, then:
- Evaluate the shots as Valid; (Absolute Minimum Interval = 0 days; Absolute Minimum Age = 0 days)
- No additional doses of COVID-19 vaccine are needed; Recommendation: Not Recommended/ COMPLETE_HIGH_RISK.
- If the patient has received one or more doses, but has not received all the recommended doses for that COVID-19 vaccine, then:
- Evaluate the shot(s) as Accepted/ VACCINE_NOT_APPROVED_IN_US.
- Recommendation:
- If one of the above listed COVID-19 vaccine is the last COVID-19 shot administered, then recommend COVID-19 at the vaccine group level at last shot administered + recommended interval (28 days) or at 5 years old, whichever date is later.
- Example #1: Patient has 1 shot of CVX 210 (AstraZeneca) on record.
- Evaluate CVX 210 as Accepted/ VACCINE_NOT_APPROVED_IN_US.
- Recommend COVID-19 at the vaccine group level for Target Dose 1 at CVX 210 + recommended interval (28 days).
- Example #2: Patient has 1 shot of CVX 208 (Pfizer), then 1 shot of CVX 210 (AstraZeneca) on record.
- Evaluate CVX 208 as Valid and CVX 210 as Accepted/ VACCINE_NOT_APPROVED_IN_US.
- Recommend COVID-19 at the vaccine group level for Target Dose 2 at CVX 210 + recommended interval (28 days).
- If one of the above listed COVID-19 vaccine is NOT the last COVID-19 shot administered, recommend based on the series that applies for the last COVID-19 shot administered.
- Example: If CVX 208 (Pfizer) is given after CVX 210 (AstraZeneca), then recommend based on the Pfizer COVID-19 2-dose Series.
The following set of rules apply to COVID-19 Vaccines Not Authorized by FDA or WHO. |
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Series Name- Pfizer COVID-19 Child (5-17) 2-dose Series
- Pfizer COVID-19 2-dose Series
- Moderna COVID-19 2-dose Series
- Janssen COVID-19 1-dose Series
Series Selection RulesThere are three four series for this vaccine group: the the Pfizer COVID-19 Child (5-17) 2-dose Series, Pfizer COVID-19 2-dose series, Moderna COVID-19 2-dose series, and Janssen COVID-19 1-dose series. The rules for determining which series applies are: - If patient is < 18 years, and dose 1 is CVX 218 or CVX 208, then the Pfizer COVID-19 Child (5-17) 2-dose series applies.
- If patient is >= 18 years and dose 1 is CVX 208, then the Pfizer COVID-19 2-dose series applies.
- If dose 1 is CVX 207, then the Moderna COVID-19 2-dose series applies.
- If dose 1 is CVX 212, then the Janssen COVID-19 1-dose series applies.
- If dose 1 is CVX 213, reference the "Rule for CVX 213" rule rules above.
- If no shots are on patient record, reference the "Rules for Recommending at the CVX Code vs. Vaccine Group Level" rules above.
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Immunization Series:
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Pfizer COVID-19 Child (5-17) 2-dose
...
Series
The Pfizer COVID-19 Child (5-17) 2-dose series Series is complete after 2 doses.
Vaccine Dose Parameters - Minimum and Routine Ages
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 |
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1 | Pfizer COVID-19 Child (5-17) 2-dose Series
| 0 days |
12 12
| 5 years | N/A | | N/A |
2 | Pfizer COVID-19 |
2-Child (5-17) 2-dose Series | 0 days |
12 12
| 5 years
| N/A | 218, 208, 207, 213 | N/A
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Vaccine Dose Parameters - Minimum and Recommended Intervals
Doses | Series Name | Absolute Minimum Interval | Minimum Interval |
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Minimum Recommended Interval | Latest Recommended Interval (less than) |
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Dose 1 to 2 | Pfizer COVID-19 Child (5-17) 2-dose Series |
0 days17 days | 21 days | 21 days | N/A |
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Series Special RulesIf the patient receives a shot at < 12 years - 4 days of age and/or < 21 days - 4 days interval between dose 1 and 25 years old, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."
Rule for CVX 212 (Janssen COVID-19 Vaccine)- If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate Target Dose 2 (CVX 212) as Valid.
- evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
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Immunization Series:
...
Pfizer COVID-19 2-dose
...
Series
The Moderna Pfizer COVID-19 2-dose series is complete after 2 doses.
Vaccine Dose Parameters - Minimum and Routine Ages
...
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 |
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1 |
Moderna Pfizer COVID-19 2-dose Series |
0 days18 years | 18 years | 18 years | N/A |
2072 | Moderna COVID-19 2-dose Series | 0 days | 12 years | 12 years | N/A | 207, 208, 213 | N/A
Vaccine Dose Parameters - Minimum and Recommended Intervals
...
Doses
...
Series Name
...
Absolute Minimum Interval
...
Recommended Interval
...
Dose 1 to 2
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Moderna COVID-19 2-dose Series
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0 days
...
28 days
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Series Special Rules
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2 | Pfizer COVID-19 2-dose Series | 18 years | 18 years | 18 years | N/A | 208, 207, 213 | 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) |
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Dose 1 to 2 | Pfizer COVID-19 2-dose Series | 0 days | 21 days | 21 days
| N/A |
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Series Special Rules- If the patient receives a shot at < 21 days - 4 days interval between dose 1 and 2, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."
Rule for CVX 218 (Pfizer COVID-19 Vaccine (5-11))- If the patient is >= 18 years old and administered Pfizer COVID-19 Vaccine (CVX 218):
- as Target Dose 1 or Target Dose 2, evaluate as Invalid/ ABOVE_MAXIMUM_AGE_VACCINE.
Rule for CVX 212 (Janssen COVID-19 Vaccine)- If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate Target Dose 2 (CVX 212) as Valid.
- evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
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Immunization Series: Moderna COVID-19 2-dose series
The Moderna COVID-19 2-dose series is complete after 2 doses.
Vaccine Dose Parameters - Minimum and Routine Ages
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 |
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1 | Moderna COVID-19 2-dose Series | 0 days | 18 years | 18 years | N/A | 207, 213 | N/A
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2 | Moderna COVID-19 2-dose Series | 0 days | 12 years | 12 years | N/A | 207, 208, 213 | N/A
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Vaccine Dose Parameters - Minimum and Recommended Intervals
Doses | Series Name | Absolute Minimum Interval | Minimum Interval | Recommended Interval | Latest Recommended Interval (less than) |
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Dose 1 to 2 | Moderna COVID-19 2-dose Series | 0 days | 28 days | 28 days | N/A |
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Series Special Rules- If the patient receives a shot at < 18 years - 4 days of age and/or < 28 days - 4 days interval between dose 1 and 2, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."
Rule for CVX 218 (Pfizer COVID-19 Vaccine (5-11))- If the patient is >= 18 years old and administered Pfizer COVID-19 Vaccine (CVX 218):
- as Target Dose 1 or Target Dose 2, evaluate as Invalid/ ABOVE_MAXIMUM_AGE_VACCINE.
Rule for CVX 207 (Moderna COVID-19 Vaccine) Administered < 18 years old- If the patient is administered Moderna COVID-19 vaccine (CVX 207):
- between ages >= 5 years and < 12 years
- for Target Dose 1, evaluate the shot as Valid. Recommend CVX 218 for Target Dose 2 at Dose 1 + recommended interval (28 days).
- for Target Dose 2, evaluate the shot as Valid. Recommend Conditional/ COMPLETE_HIGH_RISK.
- between ages >= 12 years and < 18 years
- for Target Dose 1, evaluate the shot as Valid. Recommend CVX 208 for Target Dose 2 at Dose 1 + recommended interval (28 days).
- for Target Dose 2, evaluate the shot as Valid. Recommend Conditional/ COMPLETE_HIGH_RISK.
Rule for CVX 212 (Janssen COVID-19 Vaccine)- If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,
- evaluate Target Dose 2 (CVX 212) as Valid.
- evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
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Series Special Rules- If the patient receives a shot at < 18 years - 4 days of age, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines regarding the minimum age and/or minimum interval."
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