CoCASA Algorithm Reference
This page describes the algorithms that CoCASA uses to produce reports.
Note: When running reports, the user can choose more or fewer than the number of doses that might be required by the algorithm for completeness. CoCASA will count the patient as complete for that particular antigen based on the lesser of the dose counts. For instance, if the algorithm requires 5 doses of an antigen, but the user chooses 2, then the patient will be counted as complete with 2 doses. Conversely, if the algorithm requires 2 doses but the user chooses 5, then the patient will still be counted as complete with 2 doses. Also note that when ACIP recommendations are applied, the intervals for compliance, missed opportunities, eligibility, and for coming due are calculated from the last valid or invalid dose.
Definitions
Note: Unless otherwise noted, the definitions listed below apply to all of the algorithms.
Complete and Up To Date:
The patient has received all of the selected vaccinations by either the compliance date or the compliance age as chosen by the user. If, when using compliance age, the patient’s date of birth causes his/her compliance age to fall after the assessment date, the patient is not included in the report, even if he/she falls within the age range chosen for the report. In other words, if you choose compliance by a specified age (e.g., 24 months), any patients that have not yet reached that age at the assessment date will be excluded from the report.
Complete But Late Up To Date:
The patient is not up to date at the compliance date or the compliance age requested for the report, but he/she becomes up to date according to the rules of the algorithm between the compliance date/age and the assessment date.
Bring Up To Date with One Visit:
The patient is not currently up to date by the assessment date, but is one dose shy of being complete for the particular antigen in question. If a report is run against a series of antigens and all of the remaining vaccinations could be given on the same day, then the patient could still be brought up to date with one visit.
Missed Opportunity On the Last Immunization Visit:
On the patient’s last visit for an immunization he/she received a dose of a different antigen than the antigen in question, or there was a reason a different antigen was not given, and at the time of that visit a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose.
Missed Opportunity On All Immunization Visits:
During any of the patient’s immunization visits he/she received a dose of a different antigen than the antigen in question, or there was a reason a different antigen was not given, and at the time of that visit a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose.
Missed Opportunity On All Previous Visits:
During any of the patient’s visits, not just immunization visits, he/she received a dose of a different antigen than the antigen in question, or there was a reason a different antigen was not given, or there was a non-immunization visit of some kind, and at the time of that visit a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose. Dates when only Influenza was given are not considered as a Missed Opportunity for other antigens.
Missed Opportunity On Only Non-Immunization Visits:
During any of the patient’s non-immunization visits, a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose.
NOTE: For the above missed opportunity calculations, influenza vaccinations are never considered to be a missed opportunity. The reasoning behind this is that on many occasions influenza is administered as part of an immunization drive at locations like schools, clinics, or pharmacies where it would not be reasonable to expect other vaccinations to be given at the same time.
Eligible for Immunization:
Those patients who are not complete and up to date as of the assessment date and have no missed opportunities and, based on the rules of the antigen in question, could receive a valid dose of that antigen at the assessment date.
Last Visit < 12 Months Ago or Last Visit ≥= 12 Months Ago:
Only patients who are eligible for immunization are counted in these totals. Both immunization visits and non-immunization visits are counted.
Rules for Each Antigen
The rules listed below are applied for each antigen.
DTaP | HepA | HepB | HIB | HPV | IIV or LAIV | IPV | MenACWY | MenB | MMR | PCV13 | RV | Tdap | VAR
DTaP—Diphtheria, tetanus, and acellular pertussis vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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Note: DTwP, DTP and DT are all valid substitutes for DTaP. |
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HepA—Hepatitis A vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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HepB—Hepatitis B vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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Note: The use of combination vaccines may result in an extra (4th) dose of HepB. This algorithm accounts for a valid 4th dose but considers it Dose 3 if the 3rd dose does not meet the Dose 3 parameters above but the 4th dose does. |
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Hib—Haemophilus influenza type b vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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HPV—Human papillomavirus vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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2-dose schedule
3-dose schedule
Note: CoCASA determines which schedule to use by examining the interval between valid Dose 1 and valid Dose 2. If the interval is greater than or equal to 5 months, the 2-dose schedule is used, otherwise the 3-dose schedule is used. |
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IIV—Influenza vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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IPV—Inactivated poliovirus vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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MMR—Measles, mumps, and rubella vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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MenACWY—Meningococcal vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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Note: the patient will not have any missed opportunities until on or after the 11th birthday. |
MenB—Meningococcal serogroup B vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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Note: CoCASA requires entry of brand name (Bexsero or Trumenba) for each MenB vaccine dose administered.
Bexsero
Trumenba
Note: Administration of MenB vaccine for individuals aged 16–23 years is based on shared clinical decision making. Thus, MenB vaccine will not appear on any CoCASA missed opportunity reports. |
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PCV13—Pneumococcal conjugate vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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RV—Rotavirus vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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Tdap—Tetanus, diphtheria, and acellular pertussis vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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VAR—Varicella vaccination
ACIP-recommended rules used by CoCASA to define valid doses | Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status |
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