vaccine

Pneumococcal Vaccination Algorithm for Adults
[select name="Q1" value="-choose-|yes=1|no=0"] <-- Has the patient previously received PPSV23 (Pneumovax 23)?[conditional field="Q1" condition="(Q1).is('no=0')"]
[select name="Q2a" value="-choose-|yes=1|no=0"] <-- Is the patient at least 65 years of age?[/conditional][conditional field="Q1|Q2a" condition="(Q1).is('no=0')&&(Q2a).is('no=0')"]
[select name="Q3a" value="-choose-|yes=1|no=0"] <-- Does the patient have a PCV13 (Prevnar 13) qualifying condition?
High-risk patients in whom PCV13 is preferred include those with cochlear implants, chronic renal failure, congenital or acquired asplenia, congenital or acquired immunodeficiency, cerebrospinal fluid leak, generalized malignancy, human immunodeficiency virus infection, Hodgkin disease, leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease, and solid organ transplant; and those receiving long-term corticosteroids or radiation therapy.[/conditional][conditional field="Q1|Q2a" condition="(Q1).is('no=0')&&(Q2a).is('yes=1')"]
RECOMMENDATION --> Administer PCV13, then PPSV23 at least eight weeks later (one year later for patients covered by Medicare Part B)[/conditional][conditional field="Q1|Q2a|Q3a" condition="(Q1).is('no=0')&&(Q2a).is('no=0')&&(Q3a).is('no=0')"]
[select name="Q4a" value="-choose-|yes=1|no=0"] <-- Does the patient have a PPSV23 qualifying condition?
Patients with chronic illness in whom PPSV23 is preferred include those who smoke and those with alcoholism; diabetes mellitus or chronic heart, liver, or lung disease.[/conditional][conditional field="Q1|Q2a|Q3a|Q4a" condition="(Q1).is('no=0')&&(Q2a).is('no=0')&&(Q3a).is('no=0')&&(Q4a).is('no=0')"]
RECOMMENDATION --> No Vaccine Required.[/conditional][conditional field="Q1|Q2a|Q3a|Q4a" condition="(Q1).is('no=0')&&(Q2a).is('no=0')&&(Q3a).is('no=0')&&(Q4a).is('yes=1')"]
RECOMMENDATION --> Administer PPSV23.  Wait at least one year to give PCV13 if patient subsequently turns 65 years of age or develops a qualifying condition.[/conditional][conditional field="Q1|Q2a|Q3a" condition="(Q1).is('no=0')&&(Q2a).is('no=0')&&(Q3a).is('yes=1')"]
RECOMMENDATION --> Administer PCV13, then PPSV23 at least eight weeks later (one year later for patients covered by Medicare Part B)[/conditional][conditional field="Q1" condition="(Q1).is('yes=1')"]
[select name="Q2b" value="-choose-|yes=1|no=0"] <-- Was it administered more than one year ago?[/conditional][conditional field="Q1|Q2b" condition="(Q1).is('yes=1')&&(Q2b).is('no=0')"]
RECOMMENDATION --> Wait one year[/conditional][conditional field="Q1|Q2b" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')"]
[select name="Q4b" value="-choose-|yes=1|no=0"] <-- Does the patient have a PCV13 (Prevnar 13) qualifying condition?
High-risk patients in whom PCV13 is preferred include those with cochlear implants, chronic renal failure, congenital or acquired asplenia, congenital or acquired immunodeficiency, cerebrospinal fluid leak, generalized malignancy, human immunodeficiency virus infection, Hodgkin disease, leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease, and solid organ transplant; and those receiving long-term corticosteroids or radiation therapy.[/conditional][conditional field="Q1|Q2b|Q4b" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')&&(Q4b).is('no=0')"]
[select name="Q5" value="-choose-|yes=1|no=0"] <-- Is the patient at least 65 years of age?[/conditional][conditional field="Q1|Q2b|Q4b|Q5" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')&&(Q4b).is('no=0')&&(Q5).is('no=0')"]
RECOMMENDATION --> No Vaccine Required.[/conditional][conditional field="Q1|Q2b|Q4b|Q5" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')&&(Q4b).is('no=0')&&(Q5).is('yes=1')"]
[select name="Q6" value="-choose-|yes=1|no=0"] <-- Has it been at least five years since PPSV23 was administered if patient was younger than 65 years at the time?[/conditional][conditional field="Q1|Q2b|Q4b|Q5|Q6" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')&&(Q4b).is('no=0')&&(Q5).is('yes=1')&&(Q6).is('no=0')"]
RECOMMENDATION --> Administer PCV13 if it has been at least eight weeks since PPSV23 was received, repeat PPSV23 five years after prior PPSV23 dose.[/conditional][conditional field="Q1|Q2b|Q4b|Q5|Q6" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')&&(Q4b).is('no=0')&&(Q5).is('yes=1')&&(Q6).is('yes=1')"]
RECOMMENDATION --> Administer PCV13, then PPSV23 at least eight weeks later (one year later for patients covered by Medicare Part B).[/conditional][conditional field="Q1|Q2b|Q4b|Q5|Q6" condition="(Q1).is('yes=1')&&(Q2b).is('yes=1')&&(Q4b).is('yes=1')"]
RECOMMENDATION --> Administer PCV13.[/conditional] 
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
references:
[link url="https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html" memo="Centers for Disease Control and Prevention. Pneumococcal Vaccination: Summary of Who and When to Vaccinate.   https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html. Accessed January 8, 2017."][/conditional]