Proof of Immunity Rules

• If a patient has immunity (reported as having a positive titer or serology) for all three antigens (measles, mumps, rubella), then the 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.
• If the series is not complete and the patient is administered a shot where the vaccine contains only the antigen(s), or a subset of the antigen(s) with previously reported proof of immunity, the shot is evaluated as Accepted with a reason code of PROOF_OF_IMMUNITY.²

Live Vaccine Interval Rule

• The Live Vaccine Interval rule (also referred to as the Live Virus rule) applies to all MMR vaccines. For rule details, see the Live Vaccine Interval rule on the General ICE Rules page.

Series Completion Special Rule

• Once a patient completes the MMR series the Recommendation is Not Recommended and the reason code is COMPLETE_HIGH_RISK. (MMR should never have a recommendation of Not Recommended/Complete.)

Notes

• ² For example, patient DOB = 1/1/2022. Patient receives proof of immunity for Mumps on 1/1/2023. 
  • Scenario #1 - MMR (CVX 03) administered on 2/1/2023 = Valid, OR
  • Scenario #2 - Mumps/ Rubella (CVX 38) administered on 2/1/2023 = Valid, OR
  • Scenario #3 - Mumps (CVX 07) administered on 2/1/2023 = Accepted / PROOF_OF_IMMUNITY
• ² For example, patient DOB = 1/1/2022. Patient receives proof of immunity for Mumps and Measles on 1/1/2023. 
  • Scenario #1 - Mumps (CVX 07) administered on 2/1/2023 = Accepted / PROOF_OF_IMMUNITY

CVX Code Specific Rules

Component Rules

• If components (measles, mumps, rubella, measles/rubella, mumps/rubella) are reported and are valid, and if there is at least one dose of each antigen (measles, mumps, and rubella), then this will be considered equal to a single dose of MMR. The MMR series is complete after 2 doses.

Notes

• CVX 94 (MMRV) is not licensed for patients >= 13 years old. This does not affect evaluation; however, see the rule Vaccine Administered Outside of Licensed Age Range on the General ICE Rules page.

Series Name

• MMR Series

Series Selection Rules

• There is only one series for this vaccine group.

Series Special Rules 

Shots Administered Below the Series Absolute Minimum Age

• If a CVX 03, CVX 04, or CVX 05 is administered at >= 6 months - 4 days and < the series absolute minimum age (i.e., < 1 year - 4 days), evaluate as Accepted with reason code OUTSIDE_ROUTINE_SERIES. (CVX 94 is not included in this special rule.²) Use the series table for intervals for target dose 1.³

DOB prior to 1/1/1957

• For persons born prior to 01/01/1957, if the series is NOT complete, then the Recommendation is Conditional and the reason code is HIGH_RISK.

Series Complete with 1 Dose

• If the recommended due date for Target Dose 2 is >= 19 years old, then that dose is not required; the series is complete with 1 dose. 

Notes

• ¹ Per the Live Vaccine Interval ICE General Rule, an absolute minimum interval of 28 days is required for CVX 94 (MMRV). 
• ² If CVX 94 is administered below the series absolute minimum age, ICE will evaluate the CVX 03 component as Invalid / BELOW_MINIMUM_AGE_SERIES.
• ³ The Live Vaccine Interval ICE General Rule applies to shots administered below the series absolute minimum age.