Immunizations

"Immunizations" listed as a data class and data element

"Immunizations" listed as a data class and data element 

This would be an issue if ASTP decided to transform USCDI into an ontology.

The data element should be more specific than the data class.

Data element example would be "Immunizations Details"  - subject to stakeholder feedback and working group committee decision.

Rename the data element Immunizations to Vaccine Code

The inclusion of the vaccine code in USCDI v6 is essential for enhancing the clarity and effectiveness of immunization data management across healthcare platforms. Currently, within the immunizations data class, there exists an immunizations data element that captures information about the type of vaccine administered, using CVX or NDC codes. However, the term immunizations has often led to confusion, as it does not intuitively refer to vaccine code for those working with vaccination data. 

 To address this issue, CDC proposes renaming the immunizations data element to vaccine code. This change will resolve the ambiguity associated with the term “Immunizations” and ensure that discussions about immunization data within USCDI are clear and precise.                                                                                                                                       

The vaccine code data element will provide a more descriptive and accurate representation of the type of vaccine administered, aligning with common terminology used in public health and healthcare settings. This adjustment will also eliminate the confusion caused by the duplicate use of the term immunizations, which currently refers both to a data class and a data element. 

By adopting vaccine code as the standardized term, we also ensure consistency with US Core, further promoting interoperability and clarity across different health information systems. 

In summary, renaming the data element immunizations to vaccine code will enhance the precision, understanding, and consistency of immunization data within USCDI, ultimately supporting better public health outcomes. 

Comment

Recommend adding Lot Number as a data element. This will ensure patient safety in the effect of a recall. This will also support FHIR resources, data exchange, and immunization registry tracking.

Data Class: Immunizations

Level 2 Data Element: Vaccination Administration Date

Level 2 Data Element: Vaccination Event Record Type

Level 2 Data Element: Immunization Status

Level 2 Data Element: Reason Immunization Not Performed

Level 2 Data Element: Immunization Code

IMO supports the inclusion of the proposed Level 2 data elements in USCDI V3.  Many technical specifications with a wide range of maturity were cited for inclusion of this data class and data elements. This information is routinely exchanged between clinical environments and state, tribal, local, or territorial (STLT) public health agencies, and are supported by ONC Certified HIT.

USCDI defines this as “the…

USCDI defines this as “the record of an administration of a vaccination or a record of a vaccination as reported by a patient, a clinician, or another party.” The HL7 Event code DE Immunization Status addresses a single visit that is fulfilled by the following value set:
• completed
• entered-in-error
• not-done
The last valid value “not-done” might benefit from having a reason why not done and offering ‘entered-in-error’ as one of the reasons. The expanded valid values in the HL7 Immunization Status Reason Codes for the reason immunization not performed does not capture most reasons why the patient might have declined the vaccine. The CDC message mapping guide (MMG) for case notifications uses a larger value set as seen in this here.  
Additionally, the USCDI Immunization Data Class does not capture critical information regarding a vaccine series or booster status which are available in immunization registries. MMGs with vaccine information captures a patient’s vaccine history including booster shots, dose number, and whether a series was completed by the appropriate date.  These vaccine data elements used by CDC for case notification include:
• Vaccine Dose Number
• Vaccine Manufacturer
• Vaccine Lot Number
• Vaccine Expiration Date
We recommend assessing if more information such as boosters and additional series information can be captured to fulfill a more complete use case for Immunization Status. The other DEs from this data class are compatible with the current DEs CDC requests for case notifications. 

This field is for general comments on this specific data class. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system: https://healthit.gov/ONDEC

USCDI_Version_2_DSAT_Comments_20210413.docx

a status reason why the vaccine was not given; When the vaccine

This field is for general comments on this specific data class. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system: https://healthit.gov/ONDEC

Hi,

My question is related to the Immunizations data class. If the "status" is - "not done". How do we find out the "date" when the vaccine was not given? I am asking this since both "Status" & "Date" are mandatory fields in the FHIR data model.

Thanks,

Priti