Rules Based on Patient's Age

• If a patient is >= 5 years and did NOT complete the series before 5 years of age, then the Recommendation is Conditional and the reason code is HIGH_RISK.
  
• If a patient's age at administration is >= 5 years and the patient did NOT complete the series before 5 years of age, then the shot is evaluated as Accepted and the reason code is ABOVE_REC_AGE_SERIES.
• Shots administered to a patient >= 5 years of age do not count toward completion of the series; the series can NOT be completed once the patient is >= 5 years old. 

Series Name

• Hib 4-dose Series

• Hib OMP Series

Series Selection Rules

There are two series for this vaccine group: the Hib 4-dose series and the Hib OMP series. The rules for determining which series applies are:

• The Hib OMP series applies if:
  
  • A patient has only one dose, CVX 49 (Hib OMP), given at < 7 months
  • The first two doses are CVX 49 (Hib OMP), at least one dose was given at < 7 months, and both doses were given at <12 months
• Otherwise, the Hib 4-dose series applies.

Series Special Rules

Hib 4-dose Series Exception Rules

Follow the Hib 4-dose series tables (above) unless one of the following exceptions applies:

• Exception 1:If a child is >= 7 months and < 12 months at time of execution and
  
  • A.  Has received 0 doses prior to 7 months then:
    
    • 3 doses are indicated (dose 2, 3, and 4) at => 7 months.
    • Routine age is 7 months for target dose 2.
    • Recommended interval is 28 days between doses 2 and 3; recommended interval is 56 days between doses 3 and 4.
    • For dose 4, absolute minimum age is 1 year - 4 days and recommended age is 12 months.
      
      • If target dose 4 is administered at < 1 year - 4 days the shot is Invalid and the reason code is BELOW_MINIMUM_AGE_FINAL_DOSE.

- Or -

• • B. Has received 1 dose prior to 7 months and 1 dose at <= 28 days prior to 12 months then:
    • 3 doses are indicated (doses 1, 3, 4 or doses 2, 3, 4).
      
    • Recommended interval is 56 days between the final 2 doses.
      

• Exception 2: If a child is >= 12 months and < 15 months at time of execution and
  
  • A. Has received < 2 doses administered at < 12 months of age then:
    
    • 2 doses are indicated (dose 3 and 4) at >= 12 months.
    • Routine age is 12 months for target dose 3.
    • Recommended interval is 28 days between doses 2 and 3; recommended interval is 56 days between doses 3 and 4.

                      - Or -

• • B. Has received 2 doses administered at < 12 months of age then:
    • 1 dose is indicated (dose 4) at >= 12 months.
    • Routine age is 12 months for target dose 4.
    • Recommended interval is 56 days between doses 3 and 4.

• Exception 3: If a child is >= 15 months and < 5 years at time of execution and has not completed the series prior to the age of 15 months then:
  
  • 1 dose is indicated (dose 4) at >= 15 months.
  • Routine age is 15 months for target dose 4.
  • Recommended interval is 56 days between doses 3 and 4.

Hib 4-dose Series Rule for CVX 50

• The Hib component of CVX 50 (which is CVX 48) is evaluated as Valid only when it is the final dose of the series, follows a previous dose of Hib, and patient is => 1 year - 4 days; otherwise, the Hib component of CVX 50 (which is CVX 48) is Invalid and the reason code is BOOSTER_ONLY).¹
  
• This rule applies only to CVX 48 when it is the Hib component of the combination vaccine CVX 50; this rule does not apply when CVX 48 is given by itself or as part of any other combination vaccine. 

Notes

While the CDC CDSi rules allow a 4-day grace period for the skip dose trigger ages, the ICE Workgroup has decided not to allow grace periods for skip dose trigger ages. The ICE Workgroup has made this decision because:

• Grace periods should not be permitted to reduce the total number of doses (e.g., in skip dose/catch-up schedules).
• Catch-up schedules should not be made additionally lenient by including grace periods.
• The ICE algorithm should steer providers toward the schedule that most closely approximates the routine schedule.

Series Special Rules  

• There are no special rules for this series.