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.

CVX Code Specific Rules

CVX Code Absolute Minimum Age

• If one of the CVX codes in the table above is administered below the absolute minimum age for that CVX code, then the Evaluation is Invalid and the reason code is BELOW_MINIMUM_AGE_VACCINE 

Rule 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.
  

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.)

Series Special Rules

Rule 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.

Series Special Rules

Rule 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.

Series Special Rules

Rule 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.