Record of vaccine administration.

Data Element

Immunization Code
Description

The code for the vaccine that was administered or was to be administered.

Comment

CDC's Consolidated Comment for USCDI v5

  • Since USCDI Version 1, within the “Immunizations” data class, there has been an “Immunizations” data element. The “Immunizations” data element captures information about the type of vaccine given with either CVX or NDC codes being used to represent the type of vaccine. Capturing the type of vaccine is one of the main pieces of information needed for immunization data, along with the date of vaccination administration, so there is definite support for the concept of the “Immunizations” data element. However, there has often been confusion about what this data element refers to and even confusion when discussing immunizations in regard to USCDI. Most individuals that work with vaccination data do not associate the word “Immunizations” with vaccine type, so individuals are not aware that the “Immunizations” data element refers to vaccine type. Second, it is hard to discuss Immunizations in regard to USCDI, as one must always specify whether you are discussing the data class or the data element. The duplicate naming has caused confusion in discussions around the “Immunization” data class and data elements. Because of the confusion, we suggest removing the “Immunizations” data element and renaming the Level 2 data element, “Immunization Code” to “Vaccine Code”. Renaming this data element thusly, will clarify the concept of the type of vaccine, so that individuals will have a better understanding of the data element due to a more descriptive name. Additionally, by using the “Vaccine Code" data element, the duplicate name issue will be resolved, so that “Immunizations” will refer to the data class, while “Vaccine Code” will refer to the data element. Finally, by renaming “Immunizations” to “Vaccine Code” the name will be in alignment with US Core.

** ADD THIS USE CASE TO SUBMISSION ** 

  • "Immunizations HPV": HPV is estimated to cause 70% of oropharyngeal cancers in the United States, although it is unclear if having HPV alone is enough to cause oropharyngeal cancers, or if other factors interact with HPV to cause these cancers. Because the HPV vaccine protects against the types of HPV that can cause oropharyngeal cancers, it may also prevent oropharyngeal cancers. The United States is struggling to achieve HPV vaccination goals because HPV vaccination policies vary greatly nationwide, making it hard to implement sustainable programs. Surveillance of HPV vaccination and risk factors can help to establish associations, identify at-risk populations, and better inform clinical decision-making guidelines and interventions. These activities can increase vaccination acceptance rates and may lower HPV-associated oropharyngeal cancer prevalence and incidence.

 

NACCHO Comment: This is a helpful clarification.

Unified Comment from CDC

  • Rename element  to Vaccine Code to align with US Core and with the other elements in the Immunizations Class.
     
  • Suggest replacing the V2 element of Immunizations with this Vaccine Code element that  includes a definition and descriptive name (keep the associated terminology).
     
  • Additional Use Case: Immunization elements are a major piece of public health control and mitigation. When combined with case reports to a jurisdiction or notification to CDC, it allows the jurisdiction or CDC to see where immunizations may be lacking. Immunization information may not directly provide disparity information, but it is needed together with other disparity-related data (e.g., race, ethnicity, location) to identify vaccine breakthroughs or problems with vaccination access/coverage which may also speak to broader health disparities related to general access to medical care and services.
    Immunization information including date of administration is collected as part of case based surveillance for Hepatitis A, Acute Hepatitis B and Perinatal Hepatitis B to understand hepatitis transmission patterns and ensure appropriate interventions are prioritized within impacted communities.
     
  • Number of stakeholders who capture, access, use or exchange this data element:  All US States and DC are funded through CDC’s Division of Viral Hepatitis flagship Notice of Funding Actions to perform surveillance activities, including collection of these data for surveillance purposes.
     
  • Support for healthcare aims:  Improving patient experience of care, Improving health of populations, Reducing cost of care, Improving provider experience of care
     
  • Use of data element:  Extensively used in production environments
     
  • Exchange of data element: CDC Message Mapping Guides (MMG) (e.g., COVID-19);
  • The Multiple Chronic Conditions eCare Plan project successfully tested this element at the Sep 2020 and Jan 2021 FHIR connectathons and has implemented it at the OHSU testing site.
  • This element is used by CMS Quality Reporting and is marked Required or MustSupport in the FHIR QI Core IG
     
  • CSTE supports inclusion of this measure into USCDI v3: supports information being shared with IIS across the country – should be captured for all IZ, not just children.

Suggest renaming to Vaccine Code

The MedMorph project recommends renaming this element to Vaccine Code which aligns with the FHIR US Core element Immunization.vaccineCode.

Also, will this element replace the V1 element of Immunizations?

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