Rules Based on Patient's Age

•  There is no maximum age for this vaccine group.

Influenza Vaccine Season Rules

• Season Start and End Dates
  
  • The influenza current vaccine season default start date is July 1st and the default end date is June 30th. The default start date for the next season is July 1st.
    
    • Note: Rule Manager must provide a user the ability to set the influenza vaccine season start and end date for the current season, as well as the start date for the next season (for recommendation purposes).
• Recommendation and Recommended Due Date
  
  • Influenza vaccine is due only during the influenza vaccine season.
    
  • The day after the influenza vaccine season ends (e.g., July 1st) all previously recommendation dates must be reset to the 1st day of the next influenza vaccine season or the date that the patient becomes the routine recommended age, whichever date is later. 
    • There is a 4 week recommended interval between the last shot administered during the current influenza vaccine season and target dose 1 of the next influenza vaccine season.
  • If the recommended due date falls outside of the influenza vaccine season, no doses are recommended until the start of the next influenza vaccine season.¹
    
  • All patients >= the recommended age for dose 1 (i.e., 6 months of age) are due an influenza vaccine each influenza season. The series is never complete.
    
• Evaluation
  
  • Influenza shots administered outside the influenza vaccine season (e.g., during July, if the season has been defined as August 1st to June 30th) will be evaluated as Invalid with reason code OUTSIDE_FLU_VAC_SEASON.¹
  • There is a 4 weeks - 4 days absolute minimum interval between the last shot administered during the previous influenza vaccine season and target dose 1 of the current influenza vaccine season.
  • There is no absolute minimum interval between shots administered outside the influenza vaccine season and target dose 1 of the current influenza vaccine season, unless applying the Live Vaccine Interval rule.¹
  • Influenza shots administered after the series is complete for the current influenza vaccine season will be evaluated as Accepted with a reason code of EXTRA_DOSE.
  • Rules for Evaluating Doses Administered During Prior Influenza Seasons
    
    • If rules have been established for an influenza vaccine season, then shots administered during that influenza vaccine season are evaluated based on the rules in effect at the time the shot was administered.
    • If no rules have been established for a prior influenza vaccine season, then shots administered during that prior influenza vaccine season are evaluated based on the following default rules:
      • Absolute minimum age of 6 months - 4 days
      • Absolute minimum interval of 24 days
      • Shots administered after 2 doses are evaluated as Accepted with a reason code of EXTRA_DOSE.
      • Shots administered July 1st of that year to June 30th of the next year are evaluated as within the influenza vaccine season.
• If no rules have been established for the current influenza vaccine season, then use the rules from the preceding influenza vaccine season where rules have been defined unless otherwise noted.
  
• When determining the recommended age for dose 1 in the next influenza vaccine season while still in the current influenza vaccine season (or in the "off season" if there is one defined), if no rules have been defined for the next season, then use the current influenza vaccine season's rules.

Live Vaccine Interval Rule

• The Live Vaccine Interval rule (also referred to as the Live Virus rule) applies to intranasal influenza vaccines. For a list of applicable CVX codes, see the Influenza Vaccines section of this page. For rule details, see the Live Vaccine Interval rule on the General ICE Rules page.

Select Adjuvant Product Interval

• The Select Adjuvant Product Interval rule applies to CVX 168 and CVX 205. For rule details, see the Select Adjuvant Product Interval rule on the General ICE Rules page.

 

Notes

• ¹This rule applies if there is a defined "off season" for Influenza. For example, if the season start date is August 1st and the season end date is June 30th, then July 1 - July 31 would be considered the Influenza "off season".

CVX Code Specific Rules

• The Live Vaccine Interval rule applies to the CVX codes indicated with a star (). For rule details, see the Live Vaccine Interval rule on the General ICE Rules page.
• 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 with reason code BELOW_MINIMUM_AGE_VACCINE.
  
• CVX 161 (Influenza, injectable, quadrivalent, preservative free, pediatric) will be evaluated as:
  • Invalid (due to insufficient antigen) if administered to a patient who is >= 3 years old.
  • Valid (as long as minimum interval/minimum age requirements are met, where applicable) if administered to a patient who is < 3 years old.
• If CVX 194, 200, 201, 202, or 231 are administered, evaluate the shot as Invalid with reason code VACCINE_NOT_ALLOWED_IN_US.

Series Name

• Influenza 2-dose Series

• Influenza 1-dose Series
  

Series Selection Rules for 2015-2016, 2016-2017, 2017-2018, 2018-2019, 2019-2020, 2020-2021, 2021-2022, 2022-2023, 2023-2024, and 2024-2025 Season

• If the patient is >= 10 years of age then:

  • the 1-dose series applies.

• If the patient is >= 9 and < 10 years of age then:

  • The 2-dose series applies if all of the following conditions are met:
    

    1. The patient received a dose of influenza at < 9 years of age during the current influenza vaccine season
       

    2. The patient DID NOT receive at least 2 doses of seasonal influenza vaccine during any prior seasons.
       

  • Otherwise, the 1-dose series applies

• If the patient is < 9 years of age then

  • The 1-dose series applies if:

    • The child received at least 2 doses of seasonal influenza vaccine during any prior influenza seasons.  

  • Otherwise, the 2-dose series applies

Series Name

• Influenza 2-dose Series

• Influenza 1-dose Series
  

Series Selection Rules for 2014-2015 Season

• If the patient is >= 10 years of age then:

  • the 1-dose series applies.

• If the patient is >= 9 and < 10 years of age then:

  • The 2-dose series applies if all of the following three conditions are met:
    

    1. The patient received a dose of influenza at < 9 years of age during the current influenza vaccine season
       

    2. The patient DID NOT receive at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

    3. The patient DID NOT receive at least 2 doses of seasonal influenza vaccine prior to July 2010 and at least one dose of monovalent 2009 H1N1 vaccine
       

  • Otherwise, the 1-dose series applies

• If the patient is < 9 years of age then:

  • The 1-dose series applies if any of the following three conditions are met:

    1. The patient received at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

    2. The patient received at least 2 doses of seasonal influenza vaccine prior to July 2010 and at least one dose of monovalent 2009 H1N1 vaccine

    3. The patient received at least 1 dose of seasonal influenza vaccine during the 7/1/2013-6/30/2014 influenza vaccine season¹
       

  • Otherwise, the 2-dose series applies

Notes

• ¹This new rule is the only ACIP recommendation change from the 2013-2014 season to the 2014-2015 season. This rule applies specifically to the 2014-2015 influenza vaccine season and is not intended to be used as a default rule for subsequent, e.g. 2015-2016, influenza vaccine seasons.
  

Series Name

• Influenza 2-dose Series
• Influenza 1-dose Series
  

Series Selection Rules for 2012-2013 and 2013-2014 Seasons

• If the patient is >= 10 years of age then:

  • The 1-dose series applies.

• If the patient is >= 9 and < 10 years of age then:

  • The 2-dose series applies if all of the following three conditions are met:
    

    1. The patient received a dose of influenza at < 9 years of age during the current influenza vaccine season
       

    2. The patient DID NOT receive at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

    3. The patient DID NOT receive at least 2 doses of seasonal influenza vaccine prior to July 2010 and at least one dose of monovalent 2009 H1N1 vaccine
       

  • Otherwise, the 1-dose series applies

• If the patient is < 9 years of age then:

  • The 1-dose series applies if either of the following two conditions are met:

    1. The patient received at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

    2. The patient received at least 2 doses of seasonal influenza vaccine prior to July 2010 and at least one dose of monovalent 2009 H1N1 vaccine
       

  • Otherwise, the 2-dose series applies

Series Special Rules 

• There are no special rules for this series.

Series Special Rules 

• There are no special rules for this series.

Notes

• When creating test cases, note that the absolute minimum age¹ will never be violated while applying the 1-dose series; patients below the absolute minimum age would not meet the criteria (i.e., 2 prior doses of influenza vaccine) for selecting the 1-dose series.