Two Shot Same Day Exception Rules for Meningococcal B
If CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) 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)) 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) administered at 16 years old. CVX 162 (Trumenba) 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.)
Meningococcal B Vaccine Group Evaluation and Forecasting Rules
General Rules for Meningococcal B
General rules are not series-specific; general rules apply to the entire vaccine group.
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)) 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)) 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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Meningococcal B Vaccines
CVX Code | Name | Absolute Minimum Age |
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162 | Meningococcal B FHbp, recombinant (Trumenba) | 10 years - 4 days |
163 | Meningococcal B 4C, OMV (Bexsero) | 10 years - 4 days |
CVX Code Specific RulesCVX Code Absolute Minimum AgeRule 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.
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Combination Vaccines that Include Meningococcal B
No combination vaccines exist, at this time, that include Meningococcal B and count toward completion of the Meningococcal B series.
Immunization Series and Selection Rules
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)) and
- Invalid for the MenB FHbp 2-dose Series, but valid for MenB FHbp 3-dose Series, the MenB FHbp 3-dose series applies.
- 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) and
- target dose 2 is CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) 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)) 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)) 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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Immunization Series: MenB FHbp 2-dose series
The MenB FHbp 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 | MenB FHbp 2-dose | 16 years - 4 days | 16 years | 16 years | N/A | 162 | N/A
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2 | MenB FHbp 2-dose | N/A | N/A | N/A | N/A | 162 | 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 | MenB FHbp 2-dose | 6 months - 4 days | 6 months | 6 months | N/A |
Series Special RulesRule for CVX 163 (Meningococcal B 4C, OMV (Bexsero))- If CVX 163 (Meningococcal B 4C, OMV (Bexsero)) is reported, then evaluate as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
Ignore the reported CVX 163 when determining the recommended vaccine and calculating the recommended due date for the next target dose.
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Immunization Series: MenB FHbp 3-dose Series
The MenB FHbp 3-dose series is complete after 3 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 | MenB FHbp 3-dose | 10 years - 4 days | 10 years | 10 years
| N/A | 162 | N/A
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2 | MenB FHbp 3-dose | N/A | N/A | N/A | N/A | 162 | N/A
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3 | MenB FHbp 3-dose | N/A | N/A | N/A | N/A | 162 | N/A
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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 | MenB FHbp 3-dose | 4 weeks - 4 days | 4 weeks | 4 weeks | 8 weeks |
Dose 2 to 3 | MenB FHbp 3-dose | 4 months - 4 days | 4 months | 4 months | N/A |
Dose 1 to 3 | MenB FHbp 3-dose | 0 days | 6 months | 6 months | N/A |
Series Special RulesRule for CVX 163 (Meningococcal B 4C, OMV (Bexsero))- If CVX 163 (Meningococcal B 4C, OMV (Bexsero)) is reported, then evaluate as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
Ignore the reported CVX 163 when determining the recommended vaccine and calculating the recommended due date for the next target dose.
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Immunization Series: MenB 4C 2-dose Series
The MenB 4C 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 | MenB 4C 2-dose | 10 years - 4 days | 10 years | 10 years
| N/A | 163 | N/A
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2 | MenB 4C 2-dose | N/A | N/A | 10 years, 1 month | N/A | 163 | N/A
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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 | MenB 4C 2-dose | 1 month - 4 days | 1 month | 1 month | N/A |
Series Special RulesRule for CVX 162 (Meningococcal B FHbp, recombinant (Trumenba))- If CVX 162 (Meningococcal B FHbp, recombinant (Trumenba)) 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 when determining the recommended vaccine and calculating the recommended due date for the next target dose.
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