Rules Based on Patient's Age

• If a patient is >= 19 years of age and did NOT receive a shot of Hep A, then the Recommendation is Conditional and the reason code is HIGH_RISK.
• Shots administered to a patient who is >= 19 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; Recommendation is Not Recommended and the reason code is PROOF_OF_IMMUNITY.
• 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 unless the series is COMPLETE.

CVX Code Specific Rules

CVX Code Absolute Maximum Age

• If one of the CVX codes in the table above is administered above the absolute maximum age for that CVX code, then the Evaluation is Invalid and the reason code is ABOVE_MAXIMUM_AGE_VACCINE, per the ICE General Rule "Evaluation of Shots Above the Vaccine Code Absolute Maximum Age."

  • There is no interval required between the Invalid shot and the next target dose. 

Series Name

• Hep A 2-dose Series
  
• Hep A 3-dose Series^1,2

Series Selection Rules

The Hep A 3-dose series applies only if the following is true:

1. CVX 104 (Twinrix) is given to a patient >= 18 years - 4 days old as dose 1 and/or dose 2.¹
2. If the 3-dose series is selected via the above condition but the 2-dose series completed before the 3-dose series, change the selection to the 2-dose complete series. Furthermore, for each previously Invalid shot in the 2-dose series that was marked Valid in the 3-dose series, change the evaluation for the shot to Accepted / VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Otherwise, the Hep A 2-dose series applies.

Notes

• ¹The Hep A adult 3-dose series is used to accommodate Twinrix administered to patients > = 18 years - 4 days of age.
• ²There is a 4-dose Twinrix series (as well as a 4-dose Hep B series) that is an accepted, accelerated schedule (used often at treatment facilities). This is currently not supported by ICE.
  

Series Special Rules 

• Target dose 2 will be evaluated as valid if administered >= 6 months - 4 days from dose 1, even if there have been invalid shots administered. 
  
  • Example: If dose 1 is administered at 1 year, invalid shot 2 is administered at 1 year 5 months, and target dose 2 is administered at 1 year 6 months, then target dose 2 is evaluated as valid and counts as dose 2, completing the 2-dose series.
• If CVX 104 is administered for target dose 2 at >= 18 years - 4 days of age, then switch this series to the Hep A 3-dose Series starting with target dose 2.

Series Special Rules 

• If CVX 104 is administered at >= 18 years - 4 days, there is no maximum age for the Hep A vaccine component (CVX 83).
• If dose 1 and dose 2 are administered at < 19 years and the interval between dose 1 and dose 2 is >= 6 months - 4 days, the series is complete.