VA-PNEUMOCOCCAL IMMUNIZATION PCV13 (1599)    REMINDER DEFINITION (811.9)

Name Value
NAME VA-PNEUMOCOCCAL IMMUNIZATION PCV13
PRINT NAME Pneumococcal PCV13 (Prevnar13)
CLASS NATIONAL
SPONSOR VA National Center for Health Promotion and Disease Prevention (NCP)
USAGE CR
EDIT HISTORY
  1. EDIT DATE:   2016-05-23 13:06:00
    EDIT BY:   USER,FIFTYFOUR
    EDIT COMMENTS:   
    Exchange Install
    
DESCRIPTION
Pneumococcal vaccine-nave persons. ACIP recommends that adults aged >=19 
for adults at high risk. Specifically, a second PPSV23 dose is recommended
5 years after the first PPSV23 dose for persons aged 19-64 years with
functional or anatomic asplenia and for persons with immunocompromising
conditions. Additionally, those who received PPSV23 before age 65 years
for any indication should receive another dose of the vaccine at age 65
years, or later if at least 5 years have elapsed since their previous
PPSV23 dose. 
 
Previous vaccination with PPSV23. Adults aged >=19 years with 
immunocompromising conditions, functional or anatomic asplenia, CSF 
years with immunocompromising conditions, functional or anatomic 
leaks, or cochlear implants, who previously have received >=1 doses of 
PPSV23 should be given a PCV13 dose >=1 year after the last PPSV23 dose 
was received. For those who require additional doses of PPSV23, the first 
such dose should be given no sooner than 8 weeks after PCV13 (age <65 or 
immunocompromised) or no sooner than 1 year after PCV13 (age 65 or older 
and not immunocompromised) and at least 5 years after the most recent dose
of PPSV23. 
 
If meningococcal conjgate vaccine (diphtheria conjugate) is given, then 
PCV13 administration should be delayed 4 weeks due to possible reduced 
asplenia, CSF leaks, cochlear implants or age 65 and older, and who have
antibody response.
not previously received PCV13 or PPSV23, should receive a dose of PCV13
first, followed by a dose of PPSV23 at least 8 weeks later if age <65 or 
immunocompromised and at least 1 year later if age 65 or older AND not 
immunocompromised.
 
Subsequent doses of PPSV23 should follow current PPSV23 recommendations
FINDINGS
  1. FINDING ITEM:   VA-PNEUMOC PCV13 DX INCORRECT
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  2. FINDING ITEM:   VA-PNEUMOC PCV13 IMMUNIZATION
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
    BEGINNING DATE/TIME:   5/31/12
  3. FINDING ITEM:   VA-PNEUMOC DZ RISK - CHEMO/IMMUNOSUPP DRUGS
    OCCURRENCE COUNT:   4
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    BEGINNING DATE/TIME:   T-6M
  4. FINDING ITEM:   VA-PNEUMOC PCV13 DEFERRALS
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
    BEGINNING DATE/TIME:   T-3M
  5. FINDING ITEM:   VA-PNEUMOC DZ RISK - LONG TERM STEROIDS
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  6. FINDING ITEM:   VA-MENING VACCINES DIPHTHERIA CONJUGATE
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN PATIENT COHORT LOGIC:   AND NOT
    BEGINNING DATE/TIME:   T-28D
  7. FINDING ITEM:   VA-PNEUMOC DZ RISK - HIGH
    OCCURRENCE COUNT:   2
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    BEGINNING DATE/TIME:   T-4Y
  8. FINDING ITEM:   VA-PNEUMOC DZ RISK - IMMUNOCOMPROMISED
    OCCURRENCE COUNT:   2
    NO. OF FOUND TEXT LINES:   2
    NO. NOT FOUND TEXT LINES:   0
    FOUND TEXT:   
    Immunocompromised and at high risk of pneumococcal disease - vaccination 
    with both PCV13 and PPSV23 at appropriate intervals is needed.
    
    USE IN PATIENT COHORT LOGIC:   AND
    BEGINNING DATE/TIME:   T-2Y
  9. FINDING ITEM:   VA-PNEUMOC DZ RISK - HIGHEST/NOT IMMUNO COMP
    NO. OF FOUND TEXT LINES:   2
    NO. NOT FOUND TEXT LINES:   0
    FOUND TEXT:   
    Patients with cochlear implant or CSF leak should receive one dose of 
    PCV13 followed at least 8 weeks later by a dose of PPSV23.
    
    USE IN PATIENT COHORT LOGIC:   OR
    BEGINNING DATE/TIME:   T-10Y
  10. FINDING ITEM:   VA-PNEUMOC PPSV23 IMMUNIZATION
    OCCURRENCE COUNT:   2
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  11. FINDING ITEM:   VA-PNEUMOC PCV13 ORDERS
    ENDING DATE/TIME:   T+14
    STATUS LIST:
    1. STATUS:   ACTIVE
    2. STATUS:   PENDING
    3. STATUS:   SCHEDULED
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE START DATE:   YES
    USE IN RESOLUTION LOGIC:   OR
    BEGINNING DATE/TIME:   T-14
  12. FINDING ITEM:   VA-AGE
    CONDITION:   I V>64
    INTERNAL CONDITION:   I V>64
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  13. FINDING ITEM:   VA-PNEUMOC PCV13 CONTRAINDICATION
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   AND NOT
  14. FINDING ITEM:   VA-PNEUMOC PPSV23 IMMUNIZATION
    NO. OF FOUND TEXT LINES:   2
    NO. NOT FOUND TEXT LINES:   0
    FOUND TEXT:   
    The patient has a recorded dose of PPSV23 in the past one year.  Wait at 
    least one year after this dose before giving a dose of PCV13.
    
    BEGINNING DATE/TIME:   T-1Y
FUNCTION FINDINGS
  1. LOGIC:   FN(1)>FN(2)
    FUNCTION STRING:   MRD(3)>MRD(1)
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  2. LOGIC:   (FN(1)>0)!(FN(2)>0)!(FN(3)>0)!(FN(4)>0)
    FUNCTION STRING:   (NUMERIC(11,1,"CODE")>0)!(NUMERIC(11,2,"CODE")>0)!(NUMERIC(11,3,"CODE")>0)!(NUMERIC(11,4,"CODE")>0)
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   NUMERIC
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   CODE
    2. FUNCTION NUMBER:   2
      FUNCTION:   NUMERIC
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   CODE
    3. FUNCTION NUMBER:   3
      FUNCTION:   NUMERIC
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   CODE
    4. FUNCTION NUMBER:   4
      FUNCTION:   NUMERIC
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   CODE
  3. LOGIC:   ((FN(1)>0))&'(((FN(2)="INTRAVITREAL")!(FN(3)="INTRAVITREAL")!(FN(2)="TOPICALLY")!(FN(3)="TOPICALLY")))
    FUNCTION STRING:   ((VALUE(11,1,"START DATE")>0))&'(((VALUE(11,1,"MR")="INTRAVITREAL")!(VALUE(11,1,"MEDICATION ROUTE")="INTRAVITREAL")!(VALUE(11,1,"MR")="TOPICALLY")!(VALUE(11,1,"MEDICATION ROUTE")="TOPICALLY")))
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   START DATE
    2. FUNCTION NUMBER:   2
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MR
    3. FUNCTION NUMBER:   3
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MEDICATION ROUTE
    4. FUNCTION NUMBER:   4
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MR
    5. FUNCTION NUMBER:   5
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MEDICATION ROUTE
  4. LOGIC:   ((FN(1)>0))&'(((FN(2)="INTRAVITREAL")!(FN(3)="INTRAVITREAL")!(FN(2)="TOPICALLY")!(FN(3)="TOPICALLY")))
    FUNCTION STRING:   ((VALUE(11,2,"START DATE")>0))&'(((VALUE(11,2,"MR")="INTRAVITREAL")!(VALUE(11,2,"MEDICATION ROUTE")="INTRAVITREAL")!(VALUE(11,2,"MR")="TOPICALLY")!(VALUE(11,2,"MEDICATION ROUTE")="TOPICALLY")))
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   START DATE
    2. FUNCTION NUMBER:   2
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MR
    3. FUNCTION NUMBER:   3
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MEDICATION ROUTE
    4. FUNCTION NUMBER:   4
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MR
    5. FUNCTION NUMBER:   5
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MEDICATION ROUTE
  5. LOGIC:   ((FN(1)>0))&'(((FN(2)="INTRAVITREAL")!(FN(3)="INTRAVITREAL")!(FN(2)="TOPICALLY")!(FN(3)="TOPICALLY")))
    FUNCTION STRING:   ((VALUE(11,3,"START DATE")>0))&'(((VALUE(11,3,"MR")="INTRAVITREAL")!(VALUE(11,3,"MEDICATION ROUTE")="INTRAVITREAL")!(VALUE(11,3,"MR")="TOPICALLY")!(VALUE(11,3,"MEDICATION ROUTE")="TOPICALLY")))
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   START DATE
    2. FUNCTION NUMBER:   2
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MR
    3. FUNCTION NUMBER:   3
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MEDICATION ROUTE
    4. FUNCTION NUMBER:   4
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MR
    5. FUNCTION NUMBER:   5
      FUNCTION:   VALUE
      FUNCTION PARAMETER LIST:
      1. FUNCTION PARAMETER:   MEDICATION ROUTE
TECHNICAL DESCRIPTION
Add age 65 and older - update Fall 2014
ICD code, an outpatient medication or a chemotherapy drug that was not 
intravitreal (FI11 and FF11,12,13,14) 
   
3.  long term steroids (FI13) or 
   
   
4.  history of cochlear implant, CSF leak  (FI4) 
   
and no Pneumovax in the past year and no contraindication to PCV13 
   
 
5. No meningococcal immunization in the past month   
    
Resolved by immunization, deferral or an order 
 
Cohort 
 
1.  Immunocompromised (FI3) and no more recent entry of incorrect dx 
(FF1), 
   
2.  on chemotherapy or immunosuppressive medication and this entry is an 
CUSTOMIZED COHORT LOGIC ((FI(3)&FF(1))!(FI(11)&(FF(10)!FF(11)!FF(12)!FF(13)))!FI(4)!FI(13)!FI(7))&'FI(9)&'FI(8)&'FI(14)
INTERNAL PATIENT COHORT LOGIC ((FI(3)&FF(1))!(FI(11)&(FF(10)!FF(11)!FF(12)!FF(13)))!FI(4)!FI(13)!FI(7))&'FI(9)&'FI(8)&'FI(14)
PATIENT COHORT FINDINGS COUNT 13
PATIENT COHORT FINDINGS LIST 3;FF1;11;FF10;FF11;FF12;FF13;4;13;7;9;8;14
CUSTOMIZED RESOLUTION LOGIC FI(10)!FI(6)!FI(12)
INTERNAL RESOLUTION LOGIC FI(10)!FI(6)!FI(12)
RESOLUTION FINDINGS COUNT 3
RESOLUTION FINDINGS LIST 10;6;12
INFORMATION FINDINGS COUNT 3
INFORMATION FINDINGS LIST 1;2;5
WEB SITES
  1. URL:   http://www.cdc.gov/vaccines/vpd-vac/pneumo/vac-PCV13-adults.htm
    WEB SITE TITLE:   CDC Information on PCV13 for Adults
  2. URL:   http://www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv13.html
    WEB SITE TITLE:   PCV 13 (Prevnar) Vaccine Information Statement (VIS)
  3. URL:   http://immunize.us1.list-manage1.com/track/click?u=69948816469e0f4801f8647ee&id=d7eea44b5d&e=b8d57ee9b5
    WEB SITE TITLE:   CDC Recommendations on use of PCV13 for Adults (Oct 2012)
  4. URL:   http://vaww.prevention.domain.ext/Pneumococcal_Immunization.asp
    WEB SITE TITLE:   VHA Pneumococcal Immunization Guidance Statement
  5. URL:   http://vaww.prevention.domain.ext/docs/PneumococcalImmunizationsAlgorithm.pdf
    WEB SITE TITLE:   Pneumococcal Immunization Algorithm for PPSV23 and PCV13
# OF GEN. COHORT FOUND LINES 0
# GEN. COHORT NOT FOUND LINES 0
# GEN. RES. FOUND LINES 0
# GEN. RES. NOT FOUND LINES 0
BASELINE AGE FINDINGS
  1. REMINDER FREQUENCY:   99Y
    MINIMUM AGE:   19
    NO. OF AGE MATCH LINES:   0
    NO. OF AGE NO MATCH LINES:   0
  2. REMINDER FREQUENCY:   0Y
    MAXIMUM AGE:   18
    NO. OF AGE MATCH LINES:   0
    NO. OF AGE NO MATCH LINES:   0
# SUM. COHORT FOUND LINES 0
# SUM. COHORT NOT FOUND LINES 0
# SUM. RES. FOUND LINES 0
# SUM. RES. NOT FOUND LINES 0