General Evaluation and Recommendation Rules

Rules Based on Date

• Shots administered prior to 9/12/2023 are evaluated according to the logic specified on COVID-19 Vaccine Group - Prior to September 12, 2023, with the following exceptions:
  • If an updated Sept 2023 Pfizer or Moderna COVID-19 vaccine (CVX 308, CVX 309, CVX 310, CVX 311, CVX 312) is administered prior to 9/12/2023, evaluate as Invalid with reason code VACCINE_NOT_YET_AVAILABLE_ON_DATE_SPECIFIED.
  • If an updated Sept 2023 Novavax (CVX 313) is administered prior to 10/4/2023, evaluate as Invalid with reason code VACCINE_NOT_YET_AVAILABLE_ON_DATE_SPECIFIED.

Recommendation Rules

• The recommended date for each of the series will be 9/12/2023 or later, following series intervals based on patient history.
• If the patient has no COVID-19 shots on record, recommend at 6 months of age or 9/12/2023, whichever date is later.

Prior Formulation of COVID-19 Vaccine Administered on or after 9/12/2023  

• If a prior formulation of a COVID-19 vaccine, excluding CVX 211, is administered on or after 9/12/2023, then the Evaluation is Invalid and the reason code is VACCINE_NOT_ALLOWED.
  
  • If administered as target dose 1 (for any Sept 2023 COVID-19 Series), recommended target dose 1 at shot date + 28 days, absolute minimum interval = 24 days.
  • If administered as other than target dose 1 (for any Sept 2023 COVID-19 Series), follow series intervals.
    
• If the prior formulation of Novavax (CVX 211) is administered on or after 10/4/2023, then the Evaluation is Invalid and reason code is VACCINE_NOT_ALLOWED.
• Notes: If applicable, evaluation reason codes in addition to VACCINE_NOT_ALLOWED will also be returned. Per ICE General Rule "Evaluation of Shots Administered after Series is Complete," shots administered after series completion will have an evaluation of Accepted / EXTRA_DOSE. 

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

• When recommending in the Sept 2023 COVID-19 Series (>= 5 years), the Sept 2023 Pfizer COVID-19 Series (< 5 years), the Sept 2023 Moderna COVID-19 Series (< 5 years), the Sept 2023 Mixed Product COVID-19 Series (< 5 years), or the Sept 2023 Novavax COVID-19 Series, recommend at the vaccine group level. 

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, per the ICE General Rule "Evaluation of Shots Below the Vaccine Code Absolute Minimum Age."

CVX Code Absolute Maximum Age

• If one of the CVX codes in the table above is administered above the absolute maximum age for that CVX code, then the Evaluation is Invalid and the reason code is ABOVE_MAXIMUM_AGE_VACCINE, per the ICE General Rule "Evaluation of Shots Above the Vaccine Code Absolute Maximum Age."

  • There is no interval required between the Invalid shot and the next target dose. 

Series Name

• Sept 2023 COVID-19 Series (>= 5 years)
• Sept 2023 Pfizer COVID-19 Series  (< 5 years)

• Sept 2023 Moderna COVID-19 Series  (< 5 years)

• Sept 2023 Mixed Product COVID-19 Series (< 5 years)

• Sept 2023 Novavax COVID-19 Series

Series Selection Rules

The rules for determining which series applies are: 

• To determine if a < 5 years series applies: 
  • If: 
    • the patient is < 5 years of age as of the evaluation date,
    • OR
    • the patient is >= 5 years of age as of the evaluation date and one of the following is true:
      • if there is a shot administered in the current season (i.e., 9/12/2023 or later) at < 5 years of age,
      • or in the prior season (i.e., before 9/12/2023): >= 1 dose was administered at < 5 years of age and the prior season primary series is not complete,
  • Then a < 5 years series applies. The rules for determining the < 5 years series are as follows: 
    • if all the prior season doses (if any) are a Moderna vaccine (CVX 207, CVX 221, CVX 227, CVX 228, CVX 229, CVX 230, CVX 519), and all shot(s) (if any) on or after 9/12/23 are a Moderna vaccine (CVX 207, CVX 221, CVX 227, CVX 228, CVX 229, CVX 230, CVX 311, CVX 312, CVX 519), then the Sept 2023 Moderna COVID-19 Series (< 5 years) applies.
    • if all the prior season doses (if any) are a Pfizer vaccine (CVX 208, CVX 217, CVX 218, CVX 219, CVX 300, CVX 301, CVX 302, CVX 520), and all shot(s) (if any) on or after 9/12/23 are a Pfizer vaccine (CVX 208, CVX 217, CVX 218, CVX 219, CVX 300, CVX 301, CVX 302, CVX 308, CVX 309, CVX 310, CVX 520), then the Sept 2023 Pfizer COVID-19 Series (< 5 years) applies.
    • if neither of the above two conditions is true, then the Sept 2023 Mixed Product COVID-19 Series (< 5 years) applies.

• If the above is not true (I.e., a < 5 years series does not apply), to determine if the Novavax or >= 5 years series applies:    
  
  • if the patient has >= 1 dose of Novavax COVID-19 vaccine (CVX 211, CVX 313) on or after 9/12/23, and no prior COVID-19 doses on record before 9/12/2023, then the Sept 2023 Novavax Series applies.
  • if the above condition is not true, then the Sept 2023 COVID-19 Series (>= 5 years) applies.

• If a series selected via one of the above conditions is not complete but another series is complete, select the complete series.
• If a series selected via one of the above conditions is complete but another series is also complete at an earlier date, select the series that completed at the earlier date.

Series Special Rules

CVX Code Absolute Maximum Age

• There is no absolute maximum age for CVX 308 for doses 2 and 3.

Skip Dose Rules 

• Target Dose 1
  • If the patient has 1 dose of any of the following prior Pfizer COVID-19 vaccines (CVX 208, CVX 217, CVX 218, CVX 219, CVX 300, CVX 301, CVX 302, or CVX 520) administered prior to 9/12/2023, target dose 1 is not needed. Skip to target dose 2.
    • Absolute minimum interval = 17 days 
    • Minimum interval = 21 days
    • Recommended interval = 21 days
    • Latest recommended interval (less than) = N/A
• Target Dose 1 and Target Dose 2
  • If the patient has >= 2 doses of any of the following prior Pfizer COVID-19 vaccines (CVX 208, CVX 217, CVX 218, CVX 219, CVX 300, CVX 301, CVX 302, CVX 520) administered prior to 9/12/2023, target dose 1 and target dose 2 are not needed. Skip to target dose 3.
    • Absolute minimum interval = 8 weeks - 4 days
    • Minimum interval = 8 weeks
    • Recommended interval = 8 weeks
    • Latest recommended interval (less than) = N/A

Intervals From COVID-19 Shots Administered Prior to 9/12/2023

• If the patient has >= 1 (invalid) COVID-19 shot(s) administered prior to 9/12/2023, but no doses on record, the intervals from the last shot, if prior to 9/12/2023, are:
  
  • Absolute Minimum Interval = 8 weeks - 4 days
  • Minimum Interval = 8 weeks  
  • Recommended Interval = 8 weeks  

Series Completion Rules

• If the patient has 1 dose of updated Sept 2023 Pfizer COVID-19 vaccine intended for patients age >= 5 years (CVX 309 or CVX 310) at age >= 5 years, then the series is complete. 

Series Special Rules

Skip Dose Rules 

• Target Dose 1
  • If the patient has 1 dose of any of the following prior Moderna COVID-19 vaccines (CVX 207, CVX 221, CVX 227, CVX 228, CVX 229, CVX 230, CVX 519) administered before 9/12/2023, target dose 1 is not needed. Skip to target dose 2. 
    • Absolute minimum interval = 24 days
    • Minimum interval = 28 days
    • Recommended interval = 28 days
    • Latest recommended interval (less than) = N/A 
  • If the patient has >= 2 doses of any of the following prior Moderna COVID-19 vaccines (CVX 207, CVX 221, CVX 227, CVX 228, CVX 229, CVX 230, CVX 519) administered before 9/12/2023, target dose 1 is not needed. Skip to target dose 2. 
    
    • Absolute minimum interval = 8 weeks - 4 days
    • Minimum interval = 8 weeks 
    • Recommended interval = 8 weeks 

Intervals From COVID-19 Shots Administered Prior to 9/12/2023

• If the patient has >= 1 (invalid) COVID-19 shot(s) administered prior to 9/12/2023, but no doses on record, the intervals from the last shot, if prior to 9/12/2023, are:
  
  • Absolute Minimum Interval = 8 weeks - 4 days
  • Minimum Interval = 8 weeks  
  • Recommended Interval = 8 weeks 

Series Special Rules

CVX Code Absolute Maximum Age

• There is no absolute maximum age for CVX 308 for doses 2 and 3.

Skip Dose Rules 

• Target Dose 1 
  • If the patient has 1 dose of prior COVID-19 vaccine (CVX 207, CVX 208, CVX 210, CVX 211, CVX 212, CVX 213, CVX 217, CVX 218, CVX 219, CVX 221, CVX 227, CVX 228, CVX 229, CVX 230, CVX 300, CVX 301, CVX 302, CVX 502, CVX 510, CVX 511, CVX 519, or CVX 520) administered prior to 9/12/2023, target dose 1 is not needed. Skip to target dose 2.
    
    • Absolute minimum interval = 24 days
    • Minimum interval = 28 days
    • Recommended interval = 28 days
    • Latest recommended interval (less than) = N/A

• Target Dose 1 and Target Dose 2
  • If the patient has >= 2 doses of prior COVID-19 vaccine (CVX 207, CVX 208, CVX 210, CVX 211, CVX 212, CVX 213, CVX 217, CVX 218, CVX 219, CVX 221, CVX 227, CVX 228, CVX 229, CVX 230, CVX 300, CVX 301, CVX 302, CVX 502, CVX 510, CVX 511, CVX 519, or CVX 520) administered prior to 9/12/2023, target dose 1 and target dose 2 are not needed. Skip to target dose 3.
    
    • Absolute minimum interval = 8 weeks - 4 days
    • Minimum interval = 8 weeks
    • Recommended interval = 8 weeks
    • Latest recommended interval (less than) = N/A

Intervals From COVID-19 Shots Administered Prior to 9/12/2023

• If the patient has >= 1 (invalid) COVID-19 shot(s) administered prior to 9/12/2023, but no doses on record, the intervals from the last shot, if prior to 9/12/2023, are: 
  
  • Absolute Minimum Interval = 8 weeks - 4 days
  • Minimum Interval = 8 weeks
  • Recommended Interval = 8 weeks

Intervals from Updated Novavax Vaccine  

• If CVX 313 is administered as target dose 1 or target dose 2, intervals from the CVX 313 shot to the next target dose are: 
  • Absolute Minimum Interval = 17 days 
  • Minimum Interval = 8 weeks
  • Recommended Interval = 8 weeks

Series Completion Rules 

• If the patient has 1 dose of updated Pfizer or Moderna Sept 2023 COVID-19 vaccine intended for patients age >= 5 years (CVX 309, CVX 310, CVX 311, or CVX 312) at age >= 5 years, then the series is complete. 
• If the patient has >= 1 dose of COVID-19 vaccine at age < 5 years and has 1 dose of updated Novavax Sept 2023 COVID-19 vaccine (CVX 313) at age >= 5 years, then the series is complete.
• If the patient has 2 doses of CVX 313, the series is complete. 

Series Special Rules

• If the patient has 2 doses of CVX 211 on or after 9/12/2023, but no doses of CVX 313, evaluate and recommend using the following intervals from the last shot: 
  • Absolute Minimum Interval = 8 weeks - 4 days 
  • Minimum Interval = 8 weeks
  • Recommended Interval = 8 weeks

• If a dose of CVX 313 is administered between age >= 5 years and < 12 years - 4 days, and the patient has no other valid doses on record, then the following evaluation and recommendation parameters apply: 
  
  • Absolute Minimum Interval = 17 days
  • Minimum Age = 5 years 
  • Minimum Interval = 8 weeks
  • Recommended Interval = 8 weeks