3/18/2024: Release v1.42.1.4

• Fixes a COVID-19 dose numbering issue to support incrementing of dose number for patients who did not complete a < 5 years series prior to 9/12/2023 and are continuing in a < 5 years series.
• Clarification to a COVID-19 Sept 2023 COVID-19 Series (>= 5 years) series special rule and corresponding logic update to address an exception related to handling CVX 313 in the >= 5 years series. 
• Extends the "start" date for COVID-19 vaccine from 12/01/2020 to 1/01/1970 to prevent COVID-19 shots administered prior to 12/01/2020 from being assigned to the "Other" vaccine group. 

3/07/2024: Release v1.42.1.3

• Fixes an issue discovered in v1.42.1.2. In certain situations, some historical COVID doses prior to September 12, 2023 were being evaluated as Accepted rather than Valid. This release fixes this issue.

3/05/2024: Release v1.42.1.2

• Fixes an issue discovered in v1.42.1 where some shots in the COVID-19 >= 5yr series were incorrectly being marked as Invalid.

3/01/2024: Release v1.42.1

COVID-19 - September 2023 Onwards

• Added support for COVID-19 recommendations introduced on September 12, 2023. These recommendations are supported by an additional set of logic for the COVID-19 Vaccine Group, COVID-19 Vaccine Group - September 2023 Onwards.

• Added support for five new series: 

  • Sept 2023 COVID-19 Series (>= 5 years),

  • Sept 2023 Pfizer COVID-19 Series (< 5 years),

  • Sept 2023 Moderna COVID-19 Series (< 5 years),

  • Sept 2023 Mixed Product COVID-19 Series (< 5 years), and

  • Sept 2023 Novavax COVID-19 Series. 

• Added support for the updated (2023–2024 formula) COVID-19 vaccines: CVX 308, CVX 309, CVX 310, CVX 311, CVX 312, and CVX 313. 

COVID-19 Vaccine Group Rule Sets

• COVID-19 shots administered before 9/12/2023 are evaluated according to the logic specified in the COVID-19 Vaccine Group - Prior to September 12, 2023 wiki. Shots administered on or after 9/12/2023 are evaluated according to the logic specified in the new COVID-19 Vaccine Group - September 2023 Onwards wiki. 
• The two COVID-19 Vaccine Group rule sets are designed to work with one another, with prior history (i.e., before 9/12/2023) influencing current recommendations, as per the ACIP and CDC guidelines. 

11/03/2023: Release v1.41.1

Pneumococcal

• Added support for PCV20 (CVX 216) use in children, with the following changes in the Pneumococcal Child Series:
  
  • Lowered the absolute minimum age of CVX 216 from 18 years - 4 days to 6 weeks - 4 days.
  • Incorporated CVX 216 as a valid CVX code per dose. 
• The CVX 216 changes are in the Pneumococcal Child Series only. In a future release, HLN will refine the logic for handling of CVX 216 administered between the ages of 6 and 19 years when intended for the adult series.

Note: There are no changes to the ICE Implementation Guide. 

10/06/2023: Release v1.40.1

General Rule - Live Vaccine Interval

• Updated the live vaccine interval rule to allow for an absolute minimum interval of 24 days, instead of 28 days, for live virus vaccines from the same vaccine group. Note, this is relevant for the following vaccine groups: H1N1, Influenza, MMR, Varicella, Zoster. 

DTP

• Added logic to recommend Tdap (CVX 115) when a patient is < 7 years, the series is not complete, and the recommendation date is at >= 7 years.
  
• Updated the recurring booster dose to recommend at the vaccine group level instead of a specific CVX, with a new recommendation reason code: ADMINISTER_TDAP_OR_TD.

Influenza

• Updated CVX names to better align with CDC CVX code descriptions.
• Minor rule edits to enhance rule clarity. 

MMR

• Updated the dose 1 to dose 2 absolute minimum interval from 28 days to 24 days.
• Updated MMR deduplication/same day logic to evaluate an MMRV shot first, followed by MMR, then other MMR vaccine group vaccines, in accordance with the Two Shots, Same Vaccine Group, Same Day Exception Rules for MMR.
• Addressed an issue where ICE incorrectly indicated a single antigen or a double antigen vaccine as a valid dose of MMR for adults age 19 years and older. 

Varicella

• Updated the dose 1 to dose 2 absolute minimum interval from 28 days to 24 days for patients >= 13 years of age. 

8/21/2023: Release v1.39.2

COVID-19

• Pfizer Series: In certain circumstances (as follow), when recommending for the 2nd dose of the Pfizer series for patients >= 5 years of age and the 1st dose was administered with a monovalent vaccine and within 8 weeks before 4/19/2023, ICE (1.39.1) incorrectly uses a 21 day interval rather than an 8 week interval. We have updated the COVID-19 Vaccine Group page with these changes, which are noted in blue in the Pfizer and Mixed Product Series interval tables near the bottom of the page.
• Novavax Series: If the Novavax Series was completed after 4/19/2023, ICE (1.39.1) was indicating that the series was complete. Instead, the correct recommendation is a bivalent dose 8 weeks later.

7/20/2023: Release v1.39.1

COVID-19

• Added support for a Pfizer bivalent booster dose for children aged 6 months through 4 years who previously completed a Pfizer-BioNTech 3-dose primary series. For children ages 6 months and older who have previously completed a 3-dose monovalent Pfizer-BioNTech primary series and have not received any bivalent vaccines, ICE recommends 1 bivalent Pfizer-BioNTech booster dose at least 2 months after completion of the monovalent primary series when the execution date is 3/17/2023 or later. 
• Added support for bivalent vaccines in the primary series.
• Added support for the recommendation for patients aged 6 months and older to receive a bivalent COVID-19 vaccine; this recommendation is applicable when the execution date is 4/19/2023 or later. 
• Added a new recommendation reason code: ADMINISTER_COVID19_BIVALENT_VACCINE.
• Fix to address a processing issue when two CVX 212 vaccines were administered to the same patient on the same day.

Influenza

• Updated wiki to reflect the 2023-2024 season. Note: there are no evaluation and forecasting changes for the 2023-2024 season.
• Added support for CVX 231 (Influenza, Southern Hemisphere, high-dose, quadrivalent). Note: this CVX does not count toward immunity.

Pneumococcal

• Fix to the Adult Recommendation Rules supplemental text descriptive text when a patient is >= 19 years and < 65 years of age and the series is not complete. The descriptive text now indicates patients who previously received a PCV13 should receive PCV20 or PPSV23 (previously only PPSV23 was noted). 

3/17/2023: Release v1.38.1

COVID-19

• COVID-19 CVX Code Updates: 230, 302, 518, 519, 520, 521 (new).
• Expanded bivalent vaccine recommendations for children ages 6 months through 5 years.
• Logic tweak: If the Janssen (CVX 212) and another COVID-19 FDA-approved shot are administered on the same day, evaluate the other shot first.

DTP

• Added vaccines: (1) CVX 196 (Td); (2) CVX 195 (DT-IPV, Non-US)

Polio

• Added vaccines: CVX 195 (DT-IPV, Non-US)

Orthopoxvirus

• Tweak logic to not trigger live interval rule for shots administered after completion of the series. (Shots as Accepted / EXTRA_DOSE)

Hep B

• Added a bug fix to the ICE series selection rules; ICE was incorrectly selecting the Hep B 2-dose series, in some instances, when it should have selected the Hep B 3-dose series.

Pneumococcal

• Supplemental text working change. Remove mention of Pfizer in the last sentence of one of the supplemental text descriptions.

12/12/2022: Release v1.37.2

COVID-19

• Incorrect evaluation of some shots due to malformed XML in the Mixed Product Series and series selection logic related to CVX 213.

Hep B

• When no shots are administered, incorrect conditional status for patients >= 19 years of age. Conditional status should start at age >= 60 years.

12/7/2022: Release v1.37.1

CVX Update:

• Added CVX 198 (DTP-hepB-Hib Pentavalent Non-US)

COVID-19 Update:

• Added support for Novavax as a primary series option for ages 12 and older: new Novavax COVID-19 Series
• Added support for bivalent boosters for ages 5 and older
• Added support for Novavax monovalent booster for adults ages 18 and older
• Added support for new vaccines: CVX 229, CVX 300, and CVX 301
• Updated the Pfizer COVID-19 Series
  • additional valid CVX codes per dose: CVX 300, CVX 301
  • indication of an invalid CVX code per dose: CVX 229
  • indication of a latest recommended interval for dose 1 to dose 2: 8 weeks
  • additional series special rules
• Updated the Moderna COVID-19 Series
  • additional series special rules
• Updated the Mixed Product COVID-19 Series
  • additional valid CVX codes per dose: CVX 211, CVX 300, CVX 301
  • indication of an invalid CVX code per dose: CVX 229
  • additional series special rules
  • removed Rule for CVX 218
• Updated General Rules
  • Updated Series Completion Special Rules
    • Moderna COVID-19 Series: Added logic based on execution date
    • Pfizer COVID-19 Series or Mixed Product COVID-19 Series: Added logic based on execution date
    • COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a 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: Added logic based on execution date
  • Updated and added Booster Dose rules: Added recommendation and evaluation rules for third booster dose
  • Updated and added Additional Dose rules

Hepatitis B Update: 

• Added support for universal recommendation of Hepatitis B for adults age 19 through 59 years: new Hepatitis B 3-dose Adult Series
• Modified the Hepatitis B 3-dose Child/Adult Series to be a Hepatitis B 3-dose Child/Adolescent Series

Orthopoxvirus Update:

• Added new series selection rule: when two shots are administered on the same day, follow the Orthopoxvirus 2-dose Series, not the Orthopoxvirus 1-dose Series

Pneumococcal Update:

• Added support for PCV15 as an option for pneumococcal conjugate vaccination of persons age <19 years
• Fixed bug that, in certain circumstances, recommended an extra PPSV23 after the series had already been completed at >= 65 years

8/31/2022: Release v1.36.1

Orthopoxvirus Vaccine Group - May 2022 Emergency Use Authorization (EUA) for Monkeypox (Optional):

• The vaccine group can optionally be enabled or disabled.
  • In the zipfile distribution, the Orthopoxvirus vaccine group is disabled by default.. It can be enabled by removing the property value VACCINE_GROUP_CONCEPT.860 from the vaccine_group_exclusions property in the ice.properties file. The vaccine_group_exclusions property is a way to omit vaccine groups from the forecast, comma-delimited.
  • In the docker image distribution, the Orthopoxvirus vaccine group is enabled by default. It can be disabled by setting the VACCINE_GROUP_EXCLUSIONS environment variable with the value VACCINE_GROUP_CONCEPT.860.
• New vaccines: CVX codes 75, 105, 206

Pneumococcal Update:

• Added new recommendation rule: "If the patient is < 65 years of age, received a valid dose in an Adult Series at < 65 years old, and the series is not complete, recommend Conditional/ HIGH_RISK".

7/25/2022: Release v1.35.3

COVID-19 Update:

• Improved series selection handling to ensure that a series which was completed earlier is always selected
• If CVX 213 (NOS) is administered as the first dose, the recommended interval is 28 days, not 21 days

7/21/2022: Release v1.35.2

COVID-19 Update:

• This release fixes an issue identified in yesterday's release (v1.35.1) which occasionally results in requests to fail due to an error in the COVID-19 series implementation. Both the zipfile distribution and docker image have been updated with this latest release. 

7/20/2022: Release v1.35.1

Pneumococcal Update:

• This release includes the following Pneumococcal updates:
  • Updated Pneumococcal rules to accommodate changes to the Adult Schedule
  • Added support for new adult vaccines: CVX 215 (PCV15) and CVX 216 (PCV20)

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Updated booster dose logic to support recommendation of a 2nd booster dose, when applicable
  • Updated the schedule for patients 6 months and over, and added support for newer vaccines: CVX codes 219, 221, 227, 228, 512, 513, 514, 515, 516, 517

Hep B Update:

• Added support for the CVX 220 (PreHevbrio) to the Hep B schedule

Additional Updates:

• A new endpoint to request the version of the service that is running: http(s)://<host>:<port>/path/to/opencds-decision-support-service/version
• Fix for occasional "getValidShotByDoseNumber()" error

2/1/2022: Release v1.34.1

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Added additional support and logic in ICE to handle the following:
    • Booster Dose Rules 
      • Updated booster dose recommended age to 12 years
      • Updated booster dose recommended interval to 5 months after completion of mRNA vaccine primary series. 
    • Additional Dose Rules 
    • Added support for additional dose for immunocompromised persons aged 5+
    • COVID-19 Vaccines Not Authorized by FDA Rules
    • Updated rules for Novavax (CVX 211) COVID-19 vaccine now that WHO has approved it for use under their EUL
    • Updated rules to accommodate the fact that patients who have not completed all recommended doses of a COVID-19 vaccine series not authorized by FDA, but approved by WHO, do not need to restart a primary vaccination series in the United States. 

12/22/2021: Release v1.33.1

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Added additional support and logic in ICE to handle the following:
    • COVID-19 Booster Dose rules - Updated and added additional rules for patients who completed Pfizer 2-dose series, Moderna 2-dose series, Janssen 1-dose series, Pfizer COVID-19 Child (5-17) 2-dose series, COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a 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. 
      • Booster Dose Minimum Age has been updated to 16 years to support new CDC recommendation that 16-17 year olds "may" receive a Pfizer booster.
    • COVID-19 Additional Dose rules - Updated and added additional rules for patients who completed Pfizer 2-dose series, Moderna 2-dose series, Janssen 1-dose series, Pfizer COVID-19 Child (5-17) 2-dose series, COVID-19 vaccine series not authorized by the FDA, but authorized by the WHO, or a 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. 
    • New COVID-19 vaccine (CVX 217) - Added support and logic
      • Note - CVX 217 is a new Pfizer formulation for ages 12+ under EUA; can be used in the same way as CVX 208
    • Pfizer 2-dose series
      • Updated Absolute Minimum Intervals between Dose 1 and Dose 2
    • Moderna 2-dose series 
      • Updated Absolute Minimum Intervals between Dose 1 and Dose 2
      • Updated Absolute Minimum Age for Dose 1
      • Updated Absolute Minimum Age for Dose 2
      • Updated Minimum Age for Dose 2
      • Updated Routine Age for Dose 2
• This release includes an important security update. We strongly recommend that users update to this release as soon as possible.

12/13/2021: Release v1.32.2

• This release adds an important security update. We strongly recommend that users update to this release as soon as possible.

11/24/2021: Release v1.32.1

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Added additional support and logic in ICE to handle the following:
    • COVID-19 Pfizer Pediatric Dose (5 through 11 years old)
    • Evaluation of Janssen booster dose as Valid
    • Added COVAXIN (CVX 502) as a WHO-approved vaccine for EUA
  • An updated Implementation Guide with the following new codes:
    • CVX 218 - vaccine code for the COVID-19 Pfizer pediatric vaccine
    • BOOSTER_DOSE - new recommendation reason code to indicate that the recommendation is for a booster dose.
• Note about upcoming ICE release (scheduled for December 2021)
  • As always, HLN is actively monitoring all news and updates in regards to new and existing COVID-19 vaccines. Currently, we are working on adding additional support and logic (based on latest published guidance) in ICE to handle the following:
    • Updates to Booster Dose rules
    • Updates to Additional Dose rules 
    • Updated Absolute Minimum Intervals and Absolute Minimum Ages

10/25/2021: Release v1.31.1

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Added additional support and logic in ICE to handle the following:
    • COVID-19 Booster Dose for Pfizer Vaccine
  • Performance Improvement:
    • On service start up, if the km.threads property configuration value is increased, ICE no longer requires additional memory to establish the increased number of threads.
• Note about upcoming ICE release (tentatively scheduled for mid-November 2021)
  • As always, HLN is actively monitoring all news and updates in regards to new and existing COVID-19 vaccines. Currently, we are working on adding additional support and logic (based on latest published guidance) in ICE to handle the following:
    • COVID-19 Booster Dose for Moderna and Janssen Vaccines

9/21/2021: Release v1.30.1

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Added additional support and logic in ICE to handle the following:
    • COVID-19 Additional Dose - a dose administered when the immune response to a standard primary vaccine series is likely not to be protective.
      • Note - Alternatively, a “booster” dose of vaccine is a dose administered to restore protection after the effectiveness of protection from the primary series has declined. Once FDA approval is granted and ACIP recommendations are published in regards to "booster" doses, ICE will be updated accordingly; updates will likely be included in the next release of ICE. 
    • COVID-19 Vaccines Not Authorized by FDA, but Authorized by WHO
      
      • Note - The previous version of ICE, Version 1.29.1 supports the handling of one COVID-19 vaccine that falls under this category - AstraZeneca COVID-19 vaccine (CVX 210).
    • COVID-19 Vaccines Not Authorized by the FDA or WHO
    • 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

Live Virus Bug Fix:

• Fix bug where, in certain circumstances, ICE is incorrectly recommending Varicella or MMR 28 days later rather than on the same day.

5/14/2021: Release v1.29.1

COVID-19 Update:

• This release includes the following COVID-19 updates:
  • Updates have been made to expand age ranges down to >=12 years old for the Pfizer COVID-19 Vaccine (CVX 208).
  • For patients with no prior doses of COVID-19 vaccine, updated recommendations to recommend COVID-19 to patients >= 12 years old.   
    • Note - ICE previously had a conditional recommendation for patients with no prior doses of COVID-19 vaccine. 
  • Support has been added to handle AstraZeneca COVID-19 vaccine (CVX 210) shots reported on the patient record.
    • As of now, the AstraZeneca COVID-19 vaccine has not yet been FDA approved in the U.S. , but is approved by the WHO. See COVID-19 Vaccine Group - Prior to September 12, 2023 page for details.
      
    • When the FDA approves the AstraZeneca COVID-19 vaccine (CVX 210) for use in the U.S., ICE will be updated as necessary.
• In addition to the above updates, added evaluation reason code VACCINE_NOT_APPROVED_IN_US to the ICE Implementation Guide. 
• Note: This is implementation of COVID-19 Vaccine Group in ICE based on interim recommendations from ACIP.  As additional guidelines from ACIP are published and/or vaccines become available, the COVID-19 logic in ICE will be updated.

Influenza Update:

• Influenza 2021-2022 Season rules remain unchanged from last season. ICE has been updated to reflect that.

3/15/2021: Release v1.28.3

COVID-19 Bug Fix:

• Fixes a bug that resulted in the earliest date to be set to 4 days earlier than the recommended due date. Earliest date should be calculated as follows:
  

  • Earliest date, which is the latest of the following dates:

    • Minimum age date
    • Latest minimum interval date (which is defined as the latest date of all calculated minimum interval dates for a given target dose)
    • Latest conflict end interval date (e.g., for LAIV vaccines)
    • Seasonal recommendation start date (e.g., for flu vaccines)

3/12/2021: Release v1.28.2

COVID-19 Bug Fix:

• Fixes a bug that resulted in, under certain circumstances, some COVID shots administered on the same day to be incorrectly evaluated. 

3/3/2021: Release v1.28.1

COVID-19 Update:

• This implementation of COVID-19 Vaccine Group in ICE based on interim recommendations from ACIP.  As additional guidelines from ACIP are published and/or vaccines become available, the COVID-19 logic in ICE will be updated.
• This release has added support for the Janssen COVID-19 Vaccine (CVX 212). 

General Rules:

• Updated the ICE General Rule "Select Adjuvant Product Interval Rule" to remove the absolute minimum interval of 24 days between the following vaccine codes. The recommended interval of 28 days between the following vaccines remains. 
  • CVX 189 (Hep B)
  • CVX 187 (Zoster)
  • CVX 168 (Influenza)
  • CVX 205 (Influenza)

12/23/2020: Release v1.27.1

COVID-19 Update:

• This is implementation of COVID-19 Vaccine Group in ICE based on interim recommendations from ACIP.  As additional guidelines from ACIP are published and/or vaccines become available, the COVID-19 logic in ICE will be updated.
• This release includes support for the Pfizer COVID-19 vaccine (CVX 208), Moderna COVID-19 vaccine (CVX 207), and COVID-19, Unspecified Formulation (CVX 213). 
• In addition to the above CVX codes, added recommendation reason code BASED_ON_VAC_AVAIL_AND_PRIORITY_RECS to the ICE Implementation Guide. 
• The updated ICE Implementation Guide documents these codes. A version of this same guide with the changes since 1.24.1 highlighted and a Google Sheet with the same ICE codes are also available as an added convenience.

12/15/2020: Release v1.26.2

COVID-19 Bug Fix:

• Bug fix for COVID-19 introduced in Version 1.26.1. Users who installed Version 1.26.1 should update to this release as soon as possible.
• Note: The subsequent release, soon after, will likely add support for the Moderna vaccine.

12/14/2020: Release v1.26.1

COVID-19 Update:

• This is a pre-release implementation of COVID-19 Vaccine Group in ICE.  We are implementing COVID-19 in stages, as more information and ACIP guidelines are published.
• This first pre-release will contain support for the Pfizer vaccine only.
• Note: The subsequent release, soon after, will likely add support for the Moderna vaccine.

12/1/2020: Release v1.25.1

Meningococcal ACWY Update

• Added support for new MeningACWY vaccine (CVX 203 - meningococcal MenACWY-TT (Menquadfi))

Hep B Update

• Updated the Hep B Newborn Series Dose 2 Routine Age from 2 months to 1 month to align with ACIP. 

• Fixed a Heplisav-B Exception Rule bug

Hep A Update

• Updated rules to recommend HepA "through" 18 years (< 19 years), rather than "up to" 18 years (<18 years) to align with CDC Schedule.

HPV Update

• Updated rules to recommend "Not Recommended/TOO_OLD" for patients that are >= 46 years (or will be >= 46 years at the next recommended due date). 

• Updated evaluation reason code ABOVE_REC_AGE to ABOVE_REC_AGE_SERIES. 

MMR Update

• Fixed a bug in Proof of Immunity Rules

11/10/2020: Release v1.24.2

Fixes to v1.24.1

• MMR: for patients >= 19 yrs of age, 1.24.1 incorrectly marked the 2nd shot Accepted when it was Valid. 
• Display: ICE was identifying itself as "ICE_1.23.1" in the output. This version of ICE correctly outputs version "ICE_1.24.2"

11/6/2020: Release v1.24.1

Software Update

• The output_supplemental_text option is now enabled by default in the downloadable distribution, but can be disabled by setting this option to "N" in the ice.properties file. Supplemental text is currently returned by some DTP and Pneumococcal rules when evaluating shots or in the recommendation. The ICE Implementation Guide describes this feature.
• Upgraded to the latest version of drools.

DTP Update

• Updated rules in regards to the recent ACIP recommendations indicating booster doses of either Td or Tdap should be administered every 10 years throughout life. The recurring booster dose will now be recommended at the vaccine group level, rather than at the CVX level.
• Updated rules to evaluate Td (CVX 09, 113, 138, 139), administered in the DTP 5-dose series:
  
  • If administered below the CVX Absolute Minimum Age (< 7 years - 4 days), evaluate as Invalid/ BELOW_MINIMUM_AGE_VACCINE. 
  • If administered above or equal to the CVX Absolute Minimum Age (>= 7 years - 4 days), evaluate as Valid and return evaluation reason code SUPPLEMENTAL_TEXT and Descriptive Text: "Pertussis is needed to complete the series.
• Updated rules to return evaluation reason code SUPPLEMENTAL_TEXT and Descriptive Text when DT (CVX 28) is administered. 
• Updated DTP 5-dose Series Exception Rule "Series Complete with 4 Doses" to include additional criteria requiring an interval between dose 3 and 4 of >= 6 months - 4 days.
• Fixed a bug where the Adolescent Tdap absolute minimum interval of 0 days was not being applied (for accepted/extra dose non-pertussis shot to target Adolescent Tdap).

Varicella Update

• Updated Varicella's Absolute Minimum Age for Dose 2 to 13 months to align with CDSi

Hib Update

• Updated rules to add all Hib vaccines as Valid CVX codes in Hib OMP Series - Dose 3.

MMR Update

• Updated rules to include a MMR Series special rule that allows for adults to complete the MMR series with 1 dose to align with ACIP. 

General Rule Update

• Added a new general rule where the "Earliest, recommended, and past due dates must be on or after the last shot given."

9/13/2020: Release v1.23.1

Influenza Update

• Added support for the following CVX codes: 194, 197, 200, 201, 202, 205

• Updated rules to indicate that the schedule for Influenza season 2020-2021 remains unchanged from the previous season.

General Update

• Updated existing general rule "Select Adjuvant Product Interval" to add CVX 205 to list of vaccine codes where this rule applies. 
• Updated the evaluation code "ABOVE_MAX_AGE_VACCINE" to "ABOVE_MAXIMUM_AGE_VACCINE". 

2/12/2020: Release v1.22.1

Pneumococcal Update

• Updated Pneumococcal rules as per the June 2019 ACIP Vote:
  • PCV13 vaccination is no longer routinely recommended for all adults aged ≥65 years. Instead, shared clinical decision-making for PCV13 use is recommended for persons aged ≥65 years who do not have an immunocompromised condition, CSF leak, or cochlear implant and who have not previously received PCV13. 
  • ACIP continues to recommend that all adults aged ≥65 years receive 1 dose of PPSV23. A single dose of PPSV23 is recommended for routine use among all adults aged ≥65 years.
  • Reference MMWR, November 22, 2019, Vol. 68, No. 46 for additional information.

DTP Update

• Fixes a bug, where in certain rare circumstances, for patients >= 7 years, ICE was not applying the minimum age override of 7 years to calculate the earliest date. 

Influenza Update

• Fixes a bug, where in certain circumstances, incorrect results may have been returned if ICE was not running on a server with its clock set to an east coast timezone. (Shots may incorrectly have been reported as OUTSIDE_FLU_SEASON when they were not.)

General Update

• Version of ICE Output in Response - ICE now outputs the version of the service in the response. See Version Number in the Response Message for details.
  
• Month-Based Forecast Calculation - ICE General Rules regarding the calculation of month-based forecasts have been updated to align with CDSi's method of calculating month-based forecasts. According to CDC: Guidance in CDSi Logic Specification, General Date Rules, CALCDT-5: A computed date which is not a real date must be moved forward to first day of the next month.
  • The ICE General Rules that have been updated are:
    • How to Calculate Recommended Age Using Calendar Months:
      • Original - When calculating recommended age using calendar months, if the date of birth anniversary day does not exist (because the anniversary month has fewer than 31 days), use the last day of the anniversary month. For example, if a patient was born on 12/31/2012 and dose 1 is recommended at 4 months, the due date would be 4/30/2013.
      • New - When calculating recommended age using calendar months, if the date of birth anniversary day does not exist (because the anniversary month has fewer than 31 days), use the first day of the next month. For example, if a patient was born on 12/31/2012 and dose 1 is recommended at 4 months, the due date would be 5/1/2013.
    • How to Calculate Recommended Interval Using Calendar Months:
      • Original - When calculating recommended interval using calendar months, if the anniversary day does not exist (because the anniversary month has fewer than 31 days), use the last day of the anniversary month.
      • New - When calculating recommended interval using calendar months, if the anniversary day does not exist (because the anniversary month has fewer than 31 days), use the first day of the next month. 
• Dose Override Feature - New Optional Feature. If this option is set to "Y" in the ice.properties file, the Dose Override Feature enables a client application to manually flag any administered shot as Invalid, Valid, or Accepted for any request it sends to the ICE service. 
  • This gives the client application the ability to “force” ICE to evaluate the shot as denoted by the client application.
  • In addition to the evaluation status (i.e. - “Invalid”, “Valid” or “Accepted”), the client application may provide one or more evaluation reason codes with the administered shot. The evaluation reason code(s) must be a code in the Evaluation Reason Code code system listed in the ICE Implementation Guide and on the Wiki.

  • When an evaluation is provided by the client application, ICE will simply skip the evaluation of the shot and return the same data in the response that was provided to it in the request. In addition, ICE will take into account the evaluation status of the manually evaluated shot when evaluating other shots that may be impacted by it (e.g. - live virus interval or other vaccines that may be impacted).”

• Output Supplemental Text Feature - New Optional Feature. If this option is set to "Y" in the ice.properties file, ICE may return supplemental text in the response. This is currently being used by the Pneumococcal Vaccine Group for shared clinical decision making in the recommendation (interpretation element). The Pneumococcal Vaccine Group rules page specifies the circumstances in which this occurs. (If the option is disabled, Pneumococcal will still operate correctly; applications simply won't benefit from additional text which may be displayed on the screen.)
• "361 days" to "1 year - 4 days" - Updated all instances of "361 days" to "1 year - 4 days" in the ICE3 rules to align with CDSi. This update affects the following vaccine groups: DTP, Hep A, Hib, MMR, Pneumococcal, and Varicella.

10/15/2019: Release v1.21.1

HPV Update

• Updated HPV rules as per the June 2019 ACIP Vote:
  
  • Harmonized recommendation for catch-up vaccination for males and females through age 26 years who are not adequately vaccinated.
  • Recommends vaccination based on shared clinical decision making for individuals aged 27 through 45 years who are not adequately vaccinated. 

General Update

• A duplicate shot/same day fix whereby, in certain circumstances, a non-combination shot might be selected instead of the combination shot.
• Slight change to the way the dose number included in the vMR output is determined. The dose number represents the targeted number of the dose in the series, whether the dose is valid or invalid (so, for instance, both a "valid" second dose following an invalid second dose will have dose number 2 indicated). However, if the patient has passed the eligible last date for a particular dose (e.g., Hib, Pneumococcal) and receives a subsequent dose, the dose number of that subsequent dose will indicate the count of actual doses received and will not consider the earlier dose that was missed which cannot now be administered.

8/28/2019: Release v1.20.1

DTP Update

• Updated the DTP Adolescent Tdap Recommendation and Evaluation rules as per the new Tdap guidance included in the 2019 CDC Immunization Schedule
• Added a DTP 3-dose series exception rule requiring that in order for a primary series to be complete via the DTP 3-dose series, at least one of the doses given must be a pertussis-containing dose

5/31/2019: Release v1.17.1

HPV Update

• Updates to HPV 3-dose series to align with CDSi
  • Updated Recommended Interval between Dose 1 and 2 from 1 month to 4 weeks
  • Updated Absolute Minimum Interval between Dose 1 and 3 from 112 days to 5 months - 4 days

DTP Update

• Updated the DTP 3-dose series Absolute Minimum Interval between Dose 2 and 3 from 164 days to 6 months - 4 days to align with CDSi. 
• Updated Adolescent Tdap Exception A Rule to "The patient DOES NOT have a dose of pertussis vaccine at >= 4 years - 4 days."

Zoster Update

• Added rule "Recommended Interval After Adult Varicella (CVX 21) Doses"
  • If patient is administered adult varicella (CVX 21) doses, the minimum interval and recommended interval between the adult varicella (CVX 21) doses to Zoster is 8 weeks. 
  •  Example:
    • Varicella (CVX 21) at 50 years, 1 month.
    • Varicella (CVX 21) at 50 years, 3 months. 
    • Recommend Zoster (CVX 187) at Varicella Dose 2 + recommended interval (8 weeks)

Pneumococcal Update

• Fixes a bug in the Adult Series where (under certain rare circumstances) the PPSV to PPSV 5 year recommended interval is not being applied when there is a valid PCV shot in between the PPSV shots. 

General - Same Day Shots Update

• Updated and improved the handling of shots administered on the same day. 

3/7/2019: Release v1.16.1

General

• Please refer to the March 7 News entry for general information and suggestions related to this release.

Pneumococcal Update

• Updated recommendation rule to distinguish between patients >=5 years old who have completed the childhood Pneumococcal series and patients who have not. The updated rule states:
  • "If a patient is >= 5 years (or will be >= 5 years at the recommended due date) and < 65 years, and they have completed the Child Series, then the Recommendation is Conditional and the reason code is COMPLETE_HIGH_RISK; otherwise the Recommendation is Conditional and the reason code is HIGH_RISK."
    

Polio Update

• Updated Series complete with 3-doses rule to include the minimum interval = 6 months and absolute minimum interval = 6 months - 4 days. 

Meningococcal B Update

• Updated recommendation reason code returned if no doses are on record and the patient is >= 24 years old, then the Recommendation is Conditional and the reason code is HIGH_RISK.

Rotavirus Update

• Updated recommendation reason code returned if the patient is >= 105 days old (i.e., >= 15 weeks old) and has not received any doses of rotavirus vaccine, then the Recommendation is Not Recommended and the reason code is TOO_OLD_TO_INITIATE (new recommendation code).

DTP Update

• Added an update to the Six by Seven rule to explicitly state that duplicate shots (or same day shots) do not count towards this rule.

Hib Update

• Fixes a bug in the duplicate shots (or same day shots) logic that resulted (under certain rare circumstances) in shots being evaluated incorrectly. 

2/1/2019: Release v1.15.1

Hep B Update

• Addition of a new 2-dose Adult series to support HEPLISAV-B
• Fixes a bug in the Hep B 3-dose Child/Adult series that resulted in (under certain circumstances) the incorrect minimum interval being applied in calculating the earliest date. 

Men B Update

• Updates to Trumenba 3-dose series to align with CDSi Men B clarifications/updates
  • Updated Routine Age for Dose 2 from 10 years, 2 months to N/A
  • Updated Routine Age for Dose 3 from 10 years, 6 months to N/A
  • Updated Absolute Minimum Interval between Dose 1 and 2 from 2 months - 4 days to 4 weeks - 4 days. 
  • Updated Recommended Interval between Dose 1 and 2 from 2 months to 4 weeks. 
  • Updated Absolute Minimum Interval between Dose 1 and Dose 3 from 6 months - 4 days to 0 days.

HPV Update

• Updated Recommended Interval between Dose 1 and Dose 2 in HPV 3-dose series from 2 months to 1 months to align with CDSi

Influenza Update

• Updated Vaccine Allowable Age Ranges for select Influenza vaccines
• Changed Flu Season Start Date from Aug 1 to July 1 (for this year and prior years)

Polio Update

• Updated Series Complete with 3 doses rule
• Updated Dose 4 grandfathered date of 8/7/2010 to 8/7/2009 to further align with CDSi

DTP Update

• Fixes a bug in the 5-dose Series Exception Rule "Series complete with 3 Doses" that resulted in (under certain circumstances) the rule not being applied. 

General Rule Update

• Added a new General Rule "Select Adjuvant Product Interval" which states:
  • The following vaccine codes must be administered with an absolute minimum interval of 24 days; otherwise the vaccine that does not meet the absolute minimum interval will be evaluated as Invalid with a reason code of “SELECT_ADJUVANT_PRODUCT_INTERVAL”. The recommended interval is 28 days.
    • CVX 189 (Hep B)
    • CVX 187 (Zoster)
    • CVX 168 (Influenza)

8/10/2018: Release v1.14.1

Overdue Date/Earliest Date

• Completed Overdue Date/Earliest Date Feature. (Functionality Added for Remaining Vaccine Groups (Hep B, DTP, HPV))

6/17/2018: Release v1.13.1

Pneumococcal Update

• Added an exception rule to the 4-dose Child Series: When patients are >=7 months and < 12 months at the time of execution and have received 1 dose prior to 7 months old, 2 additional doses are indicated at >=7 months old.

• Updated Accepted reason code: VACCINE_NOT_ALLOWED_FOR_THIS_DOSE to VACCINE_NOT_PART_OF_THIS_SERIES.

Overdue Date/Earliest Date

• Overdue Date/Earliest Date Functionality Added for Select Vaccine Groups (Pneumococcal, Hib)

4/13/2018: Release v1.12.1

Zoster Update

• Support for the new Zoster vaccine (Shingrix - CVX 187) has been added to ICE.

MMR Update

• Support for the MMR 3rd dose high risk recommendation has been added to ICE.

Hep B Update

• Support for the new Hep B vaccine (HEPLISAV-B - CVX 189) has been added to ICE to mark administration of CVX 189 vaccine as "Not Evaluated" with reason code "VACCINE_NOT_SUPPORTED".  (The ICE team will work on a future release with further support for CVX 189 once more information is provided by national guidance sources such as ACIP, CDC, etc...)

Shots Administered "before" the Patient's DOB

• Improved handling of shots marked as administered before the patient's date of birth.

Overdue Date/Earliest Date

• Overdue Date/Earliest Date Functionality Added for Select Vaccine Groups (Hep A, MMR, Zoster)

3/9/2018: Release v1.11.1

Overdue Date/Earliest Date

• Overdue Date/Earliest Date Functionality Added for Select Vaccine Groups (Polio, Meningococcal ACWY, Rotavirus, Varicella)

General Rule Update

• Fixes a bug that resulted in the General Rule "Shots Administered Below Series Absolute Minimum Age for Dose 1" not triggering when there are 2 or more invalid shots given below the absolute minimum age for Dose 1.

12/19/2017: Release v1.10.1.0

DTP Update

• Fixes a bug that resulted in (under certain circumstances) the 4th dose to be evaluated as Accepted rather than Valid.

Influenza Update

• Fixes a bug that resulted in a 2nd dose being recommended during the 2017-2018 season, when only 1 dose is needed.

11/20/2017: Release v1.9.2.0

Hib/Meningococcal ACWY Update

• Fixes a bug that resulted in the vaccine Meningococcal C/Y-HIB PRP (CVX 148) to be incorrectly evaluated as a part of the Meningococcal vaccine group (in addition to the Hib vaccine group). Version 1.9.2.0 correctly evaluates this vaccine as a part of the Hib vaccine group only.

10/6/2017: Release v1.9.1.0

Meningococcal B Updates:

• Support has been added in ICE for Meningococcal B Vaccine Group. 

Hepatitis B Updates

• Updated and expanded upon the existing "Enough is Enough" rule:
  • Original: If the patient gets 3 or more shots prior to age 164 days and has a dose 2, there is no minimum interval between the next-to-last 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) and b.) meet the minimum age for the final dose in the series (164 days).
  • Updated: 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. 

HPV Updates:

• Fix to the HPV Series Selection Rules logic where if the HPV 3-dose series is triggered and applied, it cannot switch back to applying the HPV 2-dose series. 

DTP Updates:

• Support for CVX 170 has been added to DTP Vaccine Group. Note - This is a non-US vaccine. 

Hib Updates:

• Support for CVX 170 has been added to Hib Vaccine Group. Note - This is a non-US vaccine. 

8/2/2017: Release v1.8.2.0

Influenza Updates:

• Added CVX 186 to the Influenza Vaccines table.

8/1/2017: Release v1.8.1.0

Pneumococcal Updates:

• Combined vaccine groups Pneumococcal Conjugate (PCV) and Pneumococcal Polysaccharide (PPSV) into one vaccine group called "Pneumococcal Vaccine Group".

Meningococcal ACWY Updates:

• Removed the following rules:
  • If a patient's age at administration is >= 19 years and the patient did NOT complete the series before 19 years of age, then the Evaluation is Accepted and the reason code is ABOVE_REC_AGE.
  • Shots administered to a patient >= 19 years of age do NOT count toward completion of the series; the series can NOT be completed once the patient is >= 19 years old.
• And replaced with the following rules:
  • Shots administered to a patient who is >= 19 years and < 22 years of age will continue to be evaluated (based on minimum intervals) and, if valid, will count toward completion of the series.
  • If a patient's age at administration is >= 22 years and the patient did NOT complete the series before 22 years of age, then the Evaluation is Accepted and the reason code is ABOVE_REC_AGE_SERIES. (Shots administered to a patient >= 22 years of age do NOT count toward completion of the series; the series can NOT be completed once the patient is >= 22 years old.)
• Updated CVX 108 Absolute Minimum Age from 9 months - 4 days to 2 years minus 4 days.
• Updated Absolute Minimum Age for Dose 1 of MCV4 2-dose series from 10 years minus 4 days to 10 years.

Polio Updates:

• Added CVX 170 to Polio Vaccines table. 
• Removed the Series Complete with 5 doses rule
• Added rule - For children who received target dose 4 at >= 8/7/2010 and before 4 years - 4 days of age, evaluate target dose 4 as Accepted/ BELOW_MINIMUM_AGE_FINAL_DOSE (if absolute minimum interval is met). (An additional dose will be recommended at >= 4 years of age).
• Added rule - OPV Rule - If a patient receives shots of OPV administered >= 4/1/2016, these shots do not count towards the series. Evaluate these shots as Invalid with reason code MISSING_ANTIGEN.
• Added 3 new OPV vaccines (CVX 178, 179, 182) to the Polio Vaccines table.
• Added Rule for CVX 178 and CVX 179 - If a patient receives CVX 178 or CVX 179, evaluate these shots as Invalid with reason code MISSING_ANTIGEN.
• Updated the Series Complete with 3 doses rule to:
  
  • If all administered doses are IPVs (containing component CVX 10) or all administered doses are OPVs (containing component CVX 02 or CVX 182), and dose 3 was administered when the patient was >= 4 years and was administered at least 6 months - 4 days after the previous dose, then the series is complete with 3 doses.

Influenza Updates:

• Added CVX 185 to the Influenza Vaccines table. 

2/27/2017: Release v1.7.1.0

Polio Updates:

• Modifications for 5-dose series: restriction that child be born >= 1/1/2006 removed and 4th dose must be given before 8/7/2010 instead of 1/1/2010 to be recommended 5th dose.
• Change Cut-off date for Dose 4 Absolute Min Age/Min Age and Absolute Min Interval/Min Interval    

12/1/2016: Release v1.6.1.0

HPV Updates:

•  Added support for new 2-Dose Series; recommend according to 2- or 3-dose series accordingly
•  Ignore (HPV, bivalent (Cervarix)) shots administered to males
•  Remove minimum/absolute minimum age restriction for dose 2 and dose 3 

Meningococcal ACWY Updates:

•  Add absolute minimum age/minimum age of 16 years for Dose 2 
•  Change recommended interval between Dose 1 and Dose 2 from 3 years to 56 days 

9/23/2016: Release v1.4.1.0

Zoster Updates:

• Support for Zoster

Influenza Updates:

• Added rule to mark vaccine CVX 161 Invalid due to Insufficient Antigen if patient >= 3yrs

Meningococcal B Updates:

• Until supported by ICE, mark administration of Meningococcal B vaccines as "not supported" and include in "Other" vaccine group category of forecast.  (The ICE team is working on support for Meningococcal B in a future release.)

8/15/2016: Release v1.3.1.2

Influenza Updates:

• Influenza 2016-2017 season: added influenza vaccines CVX 168 and CVX 171

8/12/2016: Release v1.3.1.0

Hep A Updates:

• Hep A logic updates. To better accommodate twinrix, ICE is adding a second series selection rule for the Hep A 3-dose series. Please refer to the wiki for the most up-to-date documentation of the rules.

Meningococcal Updates:

• Meningococcal: Fixed a bug whereby in rare cases ICE recommends a 2nd dose when the series is complete was complete with 1-dose.

Other Updates:

• Support for ICD-10 and SNOMED-CT codes. Previous releases accepted ICD-9 diagnosis codes when reporting evidence of immunity (history of disease or serology). With this new enhancement, ICD-10 and SNOMED-CT codes are also accepted. Refer to the ICE Client Implementation Guide for details.