Table of Contents

Rules Based on Patient's Age

• If a patient is >=18 years old and has no shots on record:

  • the recommendation is Conditional, with recommendation reasons HIGH_RISK and SUPPLEMENTAL_TEXT; Descriptive Text: "Unless there are specific reasons to believe they were not vaccinated, most adults who were born and raised in the United States can assume they were vaccinated against polio as children. Refer to ACIP for additional information." 

• If a patient is >= 18 years old and has completed the series:

  • the recommendation is Conditional, with recommendation reasons COMPLETE_HIGH_RISK and SUPPLEMENTAL_TEXT; Descriptive Text: "Adults who completed their polio vaccination but who are at increased risk of exposure to poliovirus may receive one lifetime IPV booster. Refer to ACIP for additional information." 

  • and is administered shot(s) after series completion:

    • and those shot(s) are administered at <18 years old:

      • evaluate those shot(s) as Accepted/ EXTRA_DOSE. This evaluation applies regardless of CVX Code Specific Rules - Rule for CVX 178 and CVX 179 and Rule for CVX 02 and CVX 182 below.

    • and those shot(s) are administered at >= 18 years old:

      • evaluate the first shot administered as Valid / BOOSTER_DOSE (i.e., if CVX Code Specific Rules are met); Absolute Minimum interval (from previous shot) = 0 days.¹ 

      • evaluate all shot(s) administered afterwards as Accepted/ EXTRA_DOSE. This evaluation applies regardless of CVX Code Specific Rules - Rule for CVX 178 and CVX 179 and Rule for CVX 02 and CVX 182 below.

  • and has received one booster dose after series completion, recommendation = Not Recommended/ COMPLETE. 

Notes

• ¹ For shots administered at the Absolute Minimum interval (from previous shot) of 0 days, ICE General Rule #27 - Two Shots, Same Vaccine Group, Same Day applies.

CVX Code Specific Rules

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.

  • Ignore the reported shot when determining the recommended due date for the next target dose due and when evaluating the next shot based on the absolute minimum interval for that target dose. (Note - The ICE General Rule "Earliest, recommended, and past due dates must be on or after the last shot given" applies here.)

Rule for CVX 02 and CVX 182

• If a patient receives CVX 02 or CVX 182 administered >= 4/1/2016, these shots do not count towards the series. Evaluate these shots as Invalid with reason code MISSING_ANTIGEN.

  • If the shot administered is CVX 182, ignore the reported shot when determining the recommended due date for the next target dose due and when evaluating the next shot based on the absolute minimum interval for that target dose. (Note - The ICE General Rule "Earliest, recommended, and past due dates must be on or after the last shot given" applies here.)

Rule for CVX 89

• If CVX 89 was administered >= 4/1/2016, return reason code SUPPLEMENTAL_TEXT and descriptive text: “CVX 89 represents an unspecified formulation vaccine. Trivalent oral polio vaccine ceased to be used globally in April 2016. If the patient received bivalent or monovalent oral polio vaccine (bOPV or mOPV), additional protection is needed."

Series Name

• Polio 4-dose Series

• Polio fIPV Series

Series Selection Rules

• There are two series for this vaccine group: the Polio 4-dose Series and the Polio fIPV Series. The rules for determining which series applies are:

  • If CVX 324 is administered for dose 1 and dose 2, then the Polio fIPV Series applies.

    • Otherwise, the Polio 4-dose Series applies.

Series Special Rules

4-dose Series Exception Rules

The series is complete with 4 doses unless:

• Series complete with 3 doses:

  • If patient is >= 4 years old (or will be >= 4 years old at the dose 3 recommended due date), recommend target dose 3 (and final dose) at 4 years old; recommended interval = 6 months. (Minimum interval= 6 months; absolute minimum interval = 6 months - 4 days)

  • If dose 3 was administered when the patient was >= 4 years - 4 days old and was administered at least 6 months - 4 days after the previous dose, then the series is complete with 3 doses. 

• Series complete with 5 doses: (See also Installation Configuration Option)

  • For children who received target dose 4 at >= 8/7/2009 and before 4 years - 4 days of age:

    • Evaluate target dose 4 as Valid (i.e., if CVX per dose and CVX code specific rules are met), with reason code EXTRA_DOSE. Absolute minimum interval from dose 3 = 0 days.

    • An additional dose (target dose 5) is needed to complete the series. See rules in tables above for Dose 5 and Dose 4 to 5.

CVX 324 Rule

If a patient receives shots of CVX 324 administered, these shots do not count towards the series. Evaluate these shots as Invalid/VACCINE_NOT_PART_OF_THIS_SERIES.

Notes

• ² When calculating the target dose 4 Earliest Date in the Polio 4-dose Series:

  • If Execution Date < 8/7/2009:

    • Minimum Age: 126 days

    • Minimum Interval: 28 days

    • However, if the calculated Earliest Date is >= 8/7/2009, use Minimum Age and Minimum Interval below (4 years, 6 months)

  • If Execution Date >= 8/7/2009:

    • Minimum Age: 4 years

    • Minimum Interval: 6 months

• ³ The series may be completed with 5 doses for children who received target dose 4 at >= 8/7/2009 and before 4 years - 4 days of age.

• In rare circumstances, when the Overdue Date calculation results in a date that is earlier than the Recommended Due Date, ICE will set the Overdue Date to be equal to the Recommended Due Date. Here's an example test scenario:

  • Patient has 3 doses on record and Dose 3 was given on 1/1/2008 (at 8 years old).

  • Target Dose 4 Overdue Date would be calculated as Dose 3 + Latest Minimum Interval (28 days) = 1/29/2008.

  • Recommended Due Date would be calculated as Dose 3 + Recommended Interval (6 months) = 7/1/2008. 

  • Since the Overdue Date results in a date that is earlier than the Recommended Due Date, ICE will set the Overdue Date to be equal to the Recommended Due Date. So adjusted Overdue Date will be set to 7/1/2008. 

Series Special Rules 

fIPV Series Exception Rules

The series is complete with 5 doses unless:

• Series complete with 4 doses:

  • If patient is >= 4 years old (or will be >= 4 years old at the dose 4 recommended due date), recommend target dose 4 (and final dose) at 4 years old; recommended interval = 6 months. (Minimum interval= 6 months; absolute minimum interval = 6 months - 4 days)

  • If dose 4 was administered when the patient was >= 4 years - 4 days old and was administered at least 6 months - 4 days after the previous dose, then the series is complete with 4 doses.

• Series complete with 6 doses: (See also Installation Configuration Option)

  • For children who received target dose 5 at >= 8/7/2009 and before 4 years - 4 days of age: