COVID-19 Vaccine Group (with Pfizer, Moderna, and Janssen Vaccines)

Note - The COVID-19 Vaccine Group is based on the interim recommendations from ACIP. As additional guidelines are published, the COVID-19 logic in ICE will be updated. This release includes support for the following COVID-19 vaccines:

  • Pfizer COVID-19 vaccine (CVX 208)
  • Moderna COVID-19 vaccine (CVX 207)
  • Janssen COVID-19 vaccine (CVX 212)
  • COVID-19, Unspecified Formulation (CVX 213)

Two Shot Same Day Exception Rules for COVID-19

The Duplicate Shot, Same Day rules do not apply for COVID-19 Vaccine Group, due to the fact that the absolute minimum intervals between dose 1 and dose 2 = 0 days in both the Pfizer COVID-19 2-dose Series and Moderna COVID-19 2-dose Series. 

Table of Contents

COVID-19 Vaccine Group Evaluation and Forecasting Rules

General Rules for COVID-19

General rules are not series-specific; general rules apply to the entire vaccine group.

Rules for Recommending at the CVX Code vs. Vaccine Group Level 

  • When recommending in the Pfizer COVID-19 2-dose Series, recommend CVX 208 for the next target dose.
  • When recommending in the Moderna COVID-19 2-dose Series, recommend CVX 207 for the next target dose.
  • When recommending in the Janssen COVID-19 1-dose Series, recommend CVX 212 for the next target dose. 
  • If patient has no doses on record, 
    • and is > = 12 years old, recommend at the vaccine group level at today's date. 
    • and is < 12 years old, recommend at the vaccine group level at 12 years old.

COVID-19 Vaccines

CVX Code

Name

Absolute Minimum Age
207

Moderna COVID-19 Vaccine

0 days

208

Pfizer COVID-19 Vaccine

0 days
210AstraZeneca COVID-19 Vaccine0 days
212Janssen COVID-19 Vaccine0 days
213SARS-COV-2 (COVID-19) vaccine, UNSPECIFIED0 days

(*) If a COVID-19 vaccine is administered before the vaccine's minimum age or series' recommended age (12y - 4d for Pfizer; 18y - 4d for Moderna), or below the series' minimum interval, supplemental text is returned to alert the user of this fact even though the may have been evaluated as Valid. See "Series Special Rules" for all series below for more details. (Notethe running distribution must have the output_supplemental_text option enabled for the supplemental text to be returned.)

(*) See note about exception logic for AstraZeneca below.

Combination Vaccines that Include COVID-19

No combination vaccines exist, at this time, that include COVID-19 and count toward completion of the Pfizer COVID-19 2-dose series.


CVX Code Specific Rules

CVX Code Absolute Minimum Age

  • 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 and the reason code is BELOW_MINIMUM_AGE_VACCINE

Rule for CVX 213

  • If the patient receives CVX 213 for:
    • Target Dose 1, evaluate the shot as Valid.
      • Recommend Target Dose 2 at Vaccine Group level
      • Recommended interval = 28 days
      • Recommended age = 18 years
    • Target Dose 2, evaluate the shot as Valid. 
  • If the patient receives CVX 213 for Target Dose 1 and CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,  
    • evaluate Target Dose 2 (CVX 212) as Valid
    • evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.
  • If the patient receives CVX 213 for Target Dose 1 and CVX 210 (AstraZeneca COVID-19 Vaccine) for Target Dose 2 or CVX 210 (AstraZeneca COVID-19 Vaccine) for Target Dose 1 and CVX 213 for Target Dose 2, then:
    • evaluate both shots as Valid. 
    • No additional doses of COVID-19 vaccine are needed; Recommendation: Not Recommended/ COMPLETE.

Rule for CVX 210 (AstraZeneca COVID-19 Vaccine)1

  • If the patient has received CVX 210 (AstraZeneca COVID-19 vaccine) for Target Dose 1 and Target Dose 2, then: 
    • Evaluate both shots as Valid. 
    • No additional doses of COVID-19 vaccine are needed; Recommendation: Not Recommended/ COMPLETE.
  • If the patient has received CVX 210 (AstraZeneca COVID-19 vaccine) for Target Dose 1 only, then:
    • Evaluate the shot as Accepted/ VACCINE_NOT_APPROVED_IN_US. (new reason code)
    • Recommendation:
      • If CVX 210 is the last COVID-19 shot administered, then recommend COVID-19 at the vaccine group level at last shot administered + recommended interval (28 days). 
        • Example #1: Patient has 1 shot of CVX 210 (AstraZeneca) on record.
          • Evaluate CVX 210 as Accepted/ VACCINE_NOT_APPROVED_IN_US.
          • Recommend COVID-19 at the vaccine group level at CVX 210 + recommended interval (28 days). 
        • Example #2: Patient has 1 shot of CVX 208 (Pfizer), then 1 shot of CVX 210 (AstraZeneca) on record. 
          • Evaluate CVX 208 as Valid and CVX 210 as Accepted/ VACCINE_NOT_APPROVED_IN_US.
          • Recommend COVID-19 at the vaccine group level at CVX 210 + recommended interval (28 days). 
      • If CVX 210 is not the last COVID-19 shot administered, recommend based on the series that applies for the last COVID-19 shot administered.
        • Example: If CVX 208 (Pfizer) is given after CVX 210 (AstraZeneca), then recommend based on the Pfizer COVID-19 2-dose Series.

Notes

  • 1CVX 210 (AstraZeneca COVID-19 Vaccine) has not yet been approved for use in the U.S. by the FDA, but it is approved by the WHO. The "Rule for CVX 210 (AstraZeneca COVID-19 Vaccine)" rules were created to handle AstraZeneca shots reported on patient records. The ICE rules were created and sourced from published guidance from the CDC, updated April 27, 2021 - Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. When the FDA approves the AstraZeneca COVID-19 vaccine (CVX 210) for use in the U.S., ICE will be updated as necessary.

Immunization Series and Selection Rules

Series Name

  • Pfizer COVID-19 2-dose Series
  • Moderna COVID-19 2-dose Series
  • Janssen COVID-19 1-dose Series

Series Selection Rules

There are three series for this vaccine group: the Pfizer COVID-19 2-dose series, Moderna COVID-19 2-dose series, and Janssen COVID-19 1-dose series. The rules for determining which series applies are:

  • If dose 1 is CVX 208, then the Pfizer COVID-19 2-dose series applies.
  • If dose 1 is CVX 207, then the Moderna COVID-19 2-dose series applies. 
  • If dose 1 is CVX 212, then the Janssen COVID-19 1-dose series applies. 
  • If dose 1 is CVX 210, reference the "Rule for CVX 210" rules above. 
  • If dose 1 is CVX 213, reference the "Rule for CVX 213" rule above. 
  • If no doses are on patient record, reference the "Rules for Recommending at the CVX Code vs. Vaccine Group Level" rules above. 

Immunization Series: Pfizer COVID-19 2-dose Series

The Pfizer COVID-19 2dose series is complete after 2 doses. 

Vaccine Dose Parameters - Minimum and Routine Ages 

Dose

Series Name

Absolute Minimum
 Age

Minimum Age

Routine
Age

Latest Recommended Age (less than)Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Pfizer COVID-19 2-dose Series

0 days

12 years12 yearsN/A208, 213N/A

2

Pfizer COVID-19 2-dose Series

0 days

12 years

12 years

N/A208, 207, 213N/A

Vaccine Dose Parameters - Minimum and Recommended Intervals

Doses

Series Name

Absolute Minimum Interval

Minimum Interval

Minimum Recommended Interval

Latest Recommended Interval (less than)

Dose 1 to 2

Pfizer COVID-19 2-dose Series

0 days

21 days

21 days

N/A

Series Special Rules

  • If the patient receives a shot at < 12 years - 4 days of age and/or < 21 days - 4 days interval between dose 1 and 2, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines of the EUA regarding the minimum age and/or minimum interval."

Rule for CVX 212 (Janssen COVID-19 Vaccine)

  • If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,  
    • evaluate Target Dose 2 (CVX 212) as Valid.
    • evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Immunization Series: Moderna COVID-19 2-dose series

The Moderna COVID-19 2-dose series is complete after 2 doses. 

Vaccine Dose Parameters - Minimum and Routine Ages 

Dose

Series Name

Absolute Minimum
 Age

Minimum Age

Routine
Age

Latest Recommended Age (less than)

Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Moderna COVID-19 2-dose Series

0 days

18 years

18 years

N/A207, 213

N/A


2

Moderna COVID-19 2-dose Series

0 days18 years18 yearsN/A207, 208, 213

N/A


Vaccine Dose Parameters - Minimum and Recommended Intervals

Doses

Series Name

Absolute Minimum Interval

Minimum Interval

Recommended Interval

Latest Recommended Interval (less than)

Dose 1 to 2

Moderna COVID-19 2-dose Series

0 days

28 days

28 days

N/A

Series Special Rules

  • If the patient receives a shot at < 18 years - 4 days of age and/or < 28 days - 4 days interval between dose 1 and 2, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines of the EUA regarding the minimum age and/or minimum interval."

Rule for CVX 212 (Janssen COVID-19 Vaccine)

  • If CVX 212 (Janssen COVID-19 Vaccine) is reported for Target Dose 2, the Janssen COVID-19 1-dose Series applies and the series is complete. Therefore,  
    • evaluate Target Dose 2 (CVX 212) as Valid.
    • evaluate Target Dose 1 as Accepted and the reason code is VACCINE_NOT_COUNTED_BASED_ON_MOST_RECENT_VACCINE_GIVEN.

Immunization Series: Janssen COVID-19 1-dose Series

The Janssen COVID-19 1-dose Series is complete after 1 dose.

Vaccine Dose Parameters - Minimum and Routine Ages 

Dose

Series Name

Absolute Minimum
 Age

Minimum Age

Routine
Age

Latest Recommended Age (less than)

Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Janssen COVID-19 1-dose Series

0 days

18 years

18 years

N/A212

N/A


Series Special Rules

  • If the patient receives a shot at < 18 years - 4 days of age, evaluate the shot as Valid, with reason code SUPPLEMENTAL_TEXT; Descriptive Text: "The timing of the administration of this shot does not follow the guidelines of the EUA regarding the minimum age and/or minimum interval."