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Rules Based on Patient's Age
- If a patient is >= 60 years old and did NOT get a shot of Hep B, then the Recommendation is Conditional and the reason code is HIGH_RISK.
- Shots administered to a patient who is >= 60 years of age will continue to be evaluated and, if valid, will count toward completion of the series.
Proof of Immunity Rules- If a patient has immunity (reported as having a positive titer or serology) vaccine is not recommended.
- Any shot administered prior to the date of immunity is evaluated as Valid or Invalid, based on minimum age and minimum interval rules.
- Any shot administered on or after the date of immunity is evaluated as Accepted with a reason code of PROOF_OF_IMMUNITY; Recommendation is Not Recommended and the reason code is PROOF_OF_IMMUNITY.
Atkinson (Enough is Enough) Rule
- If a patient receives target dose 3 that is invalid (e.g. due to minimum interval violation or minimum age violation), there is no minimum interval between the next-to-last shot (invalid shot) and dose 3 (the final dose), but the patient must a.) meet the minimum interval between dose 2 and the final dose (52 days), b.) meet the minimum age for the final dose in the series (164 days), and c.) meet the minimum interval between dose 1 and dose 3 of 16 weeks.
- Example: Dose 1 at 28 days, dose 2 at 113 days, invalid shot 3 (target dose 3) at 163 days (below minimum age for the series and below minimum interval), shot 4/dose 3 at 165 days = series complete (even though there is only a 2-day interval between shot 3 and shot 4/dose 3), based on the Atkinson Rule.
- The Atkinson rule does not apply to recommendations; when determining the date due the recommended interval is calculated from the last shot given.
Select Adjuvant Product IntervalRules for Recommending at the CVX Code vs. Vaccine Group Level- When recommending in the Hep B 3-dose Newborn Series, the Hep B 3-dose Child/Adolescent Series, or the Hep B 3-dose Adult Series, recommend at the vaccine group level.
- When recommending in the Hep B 2-dose Adult Series, recommend at the CVX level; vaccine recommended should be CVX 189 (Hep B, adjuvanted).
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The Hep B Child/Adolescent Series is complete after 3 doses, except when the Adolescent 2-Dose Series Rule applies.
Vaccine Dose Parameters - Minimum and Routine Ages
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