IWeb User Guide

View/Add/Edit Vaccinations

Before you can view or add vaccinations for a patient, you must first search for that patient, then click the Vaccinations > View/Add menu link. A page opens with information about the patient, along with the patient's vaccination forecast and a Vaccination View/Add section for seeing past vaccinations and adding new ones. In fact, authorized users can perform these actions on this page:

View additional details about vaccinations, including comments
Edit and/or delete vaccination information
Add new vaccinations (shot administration)
Add historical vaccination information
Add smallpox history prior to 1990
Add chickenpox disease (this is a state-configurable option)
Add contraindications (Special Considerations)
Add exemptions
View vaccination forecast (if the option is enabled)

If the system administrator has configured vaccines to appear in alphabetical order, they appear in alphabetical order on this page. Administered vaccinations appear first, followed by unadministered vaccinations.

Note that patient vaccinations are re-forecasted before the Vaccination View/Add page opens. This eliminates problems encountered after an upgrade or before the registry forecast is complete. It also eliminates the need for users to force a forecast by editing a vaccination.

Regarding the rabies vaccine, an exception for the vaccine level deduplication for rabies post-exposure vaccine series has been created to apply special logic that differs from the registry-wide setting established through Administration > Settings > Properties > Deduplication > Dedup Vaccination Threshold. The rabies series that needs to be accommodated regardless of the threshold setting is 0, 3, 7, 14, and 21-18 days. The exception is for the 0 and 3-day doses.

For Montana Users: The Bypass Consent permission and OPT_IN status both have an impact on whether the Vaccination Add/Edit/Forecast menu options are available when a patient has been selected. The table below shows the relationship. Y indicates that the menu items for Adding/Editing vaccinations and Forecasting are enabled. N indicates that these menu items are not accessible.

	Consented Patient Menu Items Available	Undetermined Patient Menu Items Available	Non-Consented Patient Menu Items Available
User does not have the bypass consent permission	Y	N	N
User has the bypass consent permission	Y	Y	N

The first section on the page contains the patient demographic information in the following fields:

Field	Description
Name	The name of the patient whose vaccinations appear on this page.
Date of Birth	The patient's birthdate.
Guardian	The name of the patient's guardian.
SIIS Patient ID	The SIIS patient ID number.
Age	The patient's age in weeks, months, and years.
Status	The patient's status: Active, Inactive, etc.
Print Page	Click this link to open the patient information in a separate browser tab/window. Use the browser's print function to print the page.

The next section is the Vaccination Forecast section. See the Vaccination Forecasts topic for more information.

The third section is the Vaccination View/Add section, containing the following fields, columns, options, and buttons:

Field

Description

Special Considerations on Record for Patient, Please Review Notes Below

This red Special Considerations message appears when one or more fields contain information related to contraindications, exemptions, precautions, allergies, or comments. If chickenpox history was added for the patient, the message The patient was reported to have had the chickenpox disease appears.

Vaccination Notification Symbols

Special symbols representing specific information may appear next to vaccination dates. The symbols and their meanings are:

X - Indicates a vaccination outside of the ACIP schedule where revaccination is required.
* - Historicals
# - Adverse Reaction
!1 - Warning (setting configured in Administration > Properties > Vaccination Settings > Warning Group 1 Indicator and Warning Group 1 Indicator Description)
!2 - Warning (setting configured in Administration > Properties > Vaccination Settings > Warning Group 2 Indicator and Warning Group 2 Indicator Description)
!3 - Warning (setting configured in Administration > Properties > Vaccination Settings > Warning Group 3 Indicator and Warning Group 3 Indicator Description)
+ - Unverified Historicals (information about the vaccination was provided, but not verified) Note that this symbol is set in the Administration > Properties > Vaccination Settings.
^ - Compromised Vaccination
C - Confidential Services (vaccine was given as part of confidential services for a teen patient and should not be disclosed to parent without patient consent)
Blue text indicates the vaccination was administered or recorded in the user's facility.

Documented By

Select the name of the facility where the shot was administered.

Barcode Scanner

Displays depending on configuration settings. If a barcode scanner is installed and the Administration > Settings > Properties > Registry Settings > Enable Barcode Tools option is enabled (selected), this field will display Ready in green if the barcode is ready to be used.

Service Type (Louisiana)

A state-configurable option representing the vaccination service type. This is a setting entered by the administrator that appears on the Vaccination View/Add, Edit, and Detail pages. Select a valid choice from the drop-down list. The selection remains valid for the duration of the session. To use it as a default, configure the setting as a User Default .

(enter default date for vaccination)

Double-click in any date field next to a vaccine name to enter the default date. The date can be changed.

Vaccine Name

The name of the vaccine. The vaccines listed on this page are known as vaccine shortcuts. If the vaccine you need is not listed on the page, select it from the drop-down list at the bottom of the list of vaccines.

Note icon If the patient has a history of varicella reported, the word History appears in the first cell in the Varicella row of the vaccination shot grid. In addition, a History of Chickenpox message replaces the contraindication message at the top of the page.

If you attempt to give a patient an administered shot of an unspecified vaccine type, a warning message appears at the top of the page and you need to do one of the following:

Cancel the vaccine type and select a specific administered type
Mark the vaccination as historical versus administered
Select the checkbox to Ignore warning and add the unspecified vaccination

If you attempt to add an administered vaccination with an active deferral, a warning message appears and the vaccination is rejected.

A state-configurable option is available that displays a footnote and an exclamation symbol (!) when the 4th DTaP is between the 4th and 6th month (but not after the 6th month). The footnote message displays, The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months; however, DTaP-4 need not be repeated if administered at least four months after DTaP-3.

Date/Dose Administered

Dates and dose number of the shot given (e.g., 1-6). Note that depending on state configuration, you may not be able to enter more than one vaccination from the same vaccine family. Click on a date previously entered to view the details about that vaccination. Click on the field for the vaccine and dose (column number) to enter the default date; change it if necessary. Click Add Administered to open the Vaccination/Medical Detail page. See the Vaccination/Medication Detail section for more information about this page.

History to the right of the Varicella vaccine indicates the patient has a history of varicella.

School Nurse users with the Vaccine Administrator permission are able to administer vaccines and record historical vaccinations from their School Nurse login. They also have full edit/delete permissions on vaccines entered by their Organization (IRMS) and vaccinations they enter do not appear as unverified.

Do not take ownership when adding vaccinations

By default, the facility takes ownership of the patient record when they administer a vaccination. Select this option to prevent the Organization (IRMS) from taking ownership if the record. Instead, ownership remains with the previous owning IRMS. Note that this option does not appear on the patient if the user does not have permission to make changes to records, if the IRMS is blocked from ownership, or if the logged-in user already owns the patient record.

Add Administered

After entering the date for a vaccine, click this button to open the Vaccination Detail Add page. See the Vaccination Detail Add Page section for more information about the fields on this page.

Add Historicals

After entering the date for a vaccine, click this button to add the vaccination as a historical one (previously administered).

Clear

Click this button to clear the selections made and dates entered you entered, to start over.

Add Smallpox History

If available, click this button to mark this patient as having had smallpox.

Add Chickenpox History

Click this button to mark the patient as having had chickenpox. The message, The patient was reported to have had the Chickenpox disease, appears on the page to indicate the patient's history of chickenpox. If you need to remove the chickenpox history for the patient (for example, if it was entered in error), click the Remove Chickenpox History button. Note that whether or not this button appears is state-configurable, as is the option of having the information be public or private.

Special Considerations

Click this button to add vaccination contraindications, exemptions, and precautions. The button turns red if the patient has any previously entered contraindications. See the Contraindications section below for more information about the fields on this page. To remove a contraindication from this section, click the Delete button for the specific contraindication in the list.

The last section on the page is the Vaccine Contraindications / Exemptions / Precautions section, containing the following information:

Section	Description
Contraindications	If the patient has any contraindications, they are listed in this section and the Special Considerations button turns red. To view the specifics of or add a new contraindication, click the Special Considerations button. In the Add Special Consideration section on the page that opens, select either Contraindication, Exemption or Precautions, then select a vaccine and the contraindication/exemption/precaution from the drop-down lists. Optionally, select the facility where the special consideration was documented, select the Permanent option if the contraindication is a permanent one, enter the date the contraindication was noted, and/or add the patient's age when the contraindication first occurred. Click Save to save the information, then click Back to return to the Vaccination View/Add page. The new contraindication appears in the list. To remove a contraindication from the list, click the Delete button for that contraindication, either on the Vaccination View/Add page or on the page where contraindications are entered.
Exemptions	If the patient has any exemptions, they are listed in this section.
Precautions	If the patient has any precautions, they are listed in this section.
Allergies	If the patient has any allergies, they are listed in this section.
Comments	If there is any other relevant information about the patient or vaccinations, they are listed in this section. For example, if a campaign is incorrectly configured in MISA and the MISA data is imported via HL7 into IWeb, the campaign and tier information is appended to the Vaccination Comments in IWeb if they were not previously defined in IWeb.

To add new vaccination information, you can select from the Documented By list and/or change the default date as needed. Double-click in the empty field next to a vaccine, in the correct column related to the dose number, to automatically add the date.

Vaccination/Medicine Detail Page

The Vaccination/Medicine Detail page opens after you click on a previously entered vaccination date to view the details of that vaccination, or when you enter a date into a blank field and click Add Administered. Only authorized users can edit and delete vaccination information, so some users may not see all of the buttons on this page.

Only authorized users can edit vaccination records, and only the patient records owned by the user's Organization (IRMS) can be edited or deleted unless the IRMS Registry Client user has the Delete Administered and Historical Vaccinations permission assigned.

The fields on this page are as follows (and can be edited after clicking Edit Record):

Field

Description

Vaccine

The administered vaccine.

Smallpox is included only for historical use. Forecasting does not display the smallpox vaccine until a historical vaccination has been given to the patient. The smallpox vaccination appears on the Patient Detail report.

Date Administered

The date the vaccination was administered at the facility.

Invalid Vaccination

If an entered vaccination is invalid, the invalid reason message appears here.

Historical

Indicates the shot was recorded by a facility or vaccinator but was administered elsewhere, by someone else. When editing the record, select Yes or No.

Confidential

This is a state-configurable option. Displays Yes or No depending on whether the vaccination is confidential or not. This setting impacts the Certificate of Immunizations report by either displaying all vaccinations (confidential setting = No) or not displaying the confidential vaccinations (confidential settings = Yes).

Manufacturer
Lot Number
Lot Facility
Funding Source

These fields work together. To edit the Manufacturer, click the Click to select link, then click the arrow button in the Select column in the Manufacturer pop-up window next to the name of the manufacturer. Otherwise, enter the information in the fields manually.

Manufacturer - Name of the vaccine manufacturer
Lot Number - Number of the vaccine lot
Lot Facility - Location of the vaccine
Funding Source - Indicates whether the vaccine was publicly supplied (public) or not (private). This is retrieved from the lot number information unless imported with a vaccination sent via batch with the data translation tool

There is a state-configurable option that prevents publicly supplied vaccines from being administered to VFC-ineligible patients. If the option is enabled and a user attempts this, a warning message appears, stating to either modify the VFC status or administer a privately supplied vaccine. Also, when the VFC eligibility date update is enabled for a state and a vaccination is added or edited, the updated VFC eligibility and lot publicly supplied (funding source) status is stored in the Vaccination tables. This allows a detailed history of VFC status changes to be kept for each patient.

Vaccinator

Name of the person giving the vaccination. Select the name from the drop-down list.

Note icon

For Facility Client users, the Vaccinator list displays only vaccinators associated with the user's facility and doesn't include additional vaccinators from the Organization (IRMS) that do not have a facility defined. For Organization (IRMS) Client users, the list displays all vaccinators (assigned and not assigned).
If configured, this may be a required field.
If using barcode tools, the appropriate settings must be configured in order to see the scanning fields. When enabled, an extra field displays in order to scan the barcode. Click the field, point the scanner to the vaccinator barcode, and scan. After scanning, <scan barcode here> reappears in the field.

Organization (IRMS)

The Organization (IRMS) that owns the patient record. Automatically populated on the main Vaccination/Medicine page and not editable.

Facility

The Facility that owns the patient record. Automatically populated on the main Vaccination/Medicine page and not editable.

Anatomical Site

The location of the injection. Select from the drop-down list. When adding vaccinations for DTaP, MMR, IPV, and Varicella, this field may be automatically populated. It is also a setting in Personal Settings to allow for an optional minimum and maximum age, so the field may be prepopulated. Barcode scanning can be used if the appropriate settings are configured.

Anatomical Route

The placement of the injection. Select from the drop-down list. Examples: Intramuscular, nasal. This is configured in Personal Settings.

Service Type (Louisiana)

The vaccination service type. (State-configurable option). Select from the drop-down list. May be prepopulated if configured in Personal Settings.

Dose Size

When enabled, indicates the dose size provided. Examples:

Full - default setting; equal to 1 dose
Double - equal to 2 doses
Half - equal to 0.5 dose

Volume (CC)

Vaccine amount administered. May be prepopulated if configured in Personal Settings, but can be modified.

Revaccination Reason

This is a state-configurable option. When a patient is revaccinated because the prior vaccination was compromised, this field allows the user to document the reason the vaccination was compromised. Select from the drop-down list. This field also appears on the patient's immunization history and on any reports that show the patient's complete vaccination record. In addition, the original vaccination that the revaccination replaced is not counted in the patient's vaccination forecast.

VFC /PASPORT ID (Louisiana) /WyVIP (Wyoming) Status

The patient's VFC (PASPORT ID) (WYVIP) status. If the lot number is not WyVIP eligible, the message "Program Eligibility Status" will be ignored if lot number is not WyVIP eligible appears in the field.

Adverse Reaction

Indicates a reason for the adverse reaction to the vaccine. Select an option from the drop-down list, if displayed. To add or edit an adverse reaction, click the Add/Edit Adverse Reactions button toward the bottom of the main Vaccination/Medicine Detail page. Select the appropriate option on the page that opens, enter any comments, and click Save and Continue to return to the previous page. The newly edited or added adverse reaction appears in the field. Note that in some states, adverse reaction recording is not available because it is considered a violation of privacy.

Tennessee: Toward the top of the page, click the link to VAERS to report the adverse reaction.

District/Region

The district or region where the vaccination was administered.

Dates of VIS Publications

The publication dates of the vaccine information sheet (VIS). This field may be required.

Date VIS Form Given

The date the VIS form was given to the patient. It is assumed that this form is given at the time of the vaccination if another date is not explicitly specified. This may be a required field.

Ordering Provider

The ordering provider associated with the administered vaccine. Select from the drop-down list.

Comments

Notes regarding the vaccination.

Entered By

State-configurable field used when entering historical vaccinations; indicates the person who entered the information.

Entry Date

State-configurable field that shows the date and timestamp for when the historical information was entered.

Last Updated By

State-configurable field that indicates the username of the person who last updated the vaccination record.

Last Update

State-configurable field that shows the date and timestamp the vaccination record was lasted updated.

Validate Vaccination

Indicates whether or not the vaccination was verified. Displays when a vaccination is entered as Unverified, such as through the School Nurse module (School Nurse or School Nurse Coordinator). Authorized users can validate the vaccination by selecting this option. Also displays when validating a vaccination.

Validating Facility

Displays when the vaccination was entered as Unverified, such as through the School Nurse module (School Nurse or School Nurse Coordinator). Authorized users can validate the vaccination by selecting the option and selecting a facility from the drop-down list.

Decline ownership when saving this vaccination

When editing the vaccination record, select this option to maintain the patient record ownership with the previous Organization (IRMS) and Facility.

Click one of these buttons on the main Vaccination/Medicine Detail page to continue:

Cancel - To return to the previous page without continuing.
Edit Record - To edit the vaccination record.
Delete Record - To delete the vaccination record.
Add/Edit Adverse Reactions - To add or edit any adverse reactions the patient had to the vaccination.

On the Vaccination Detail Edit page, click:

Cancel - To return to the previous page without saving any changes.
Reset Values - To clear all of the fields and start over.
Submit Changes - To submit the changes and add the vaccination information to the patient's vaccination record.

Lead Blood Draw (Indiana)

Lead Blood Draw was added to the list of available vaccines and is flagged as a test result. It does not display on the Lot Number pages, but does display on reports that previously displayed PPD test results. This option is NOT related to the Lead Screenings entries populated by the laboratories. Lead Blood Draws are deleted as other vaccinations are. Note that when entering a Lead Blood Draw, only the date is required.

VFC Eligibility Update (Wyoming)

Depending on administrative settings, the VFC Eligibility Update page may open instead of the Vaccination Detail add/edit page. If the patient is older than 19 years, the Current VFC Status displays as ineligible. Either select the Update VFC Eligibility option from the drop-down list (Medicaid, Uninsured, Nat Amer or Alaskan, Underinsured, KidsCare, State Vaccine, Ineligible), or select the Health Plan, and optionally enter the Enroll Date. Click Continue. The Vaccination Detail Add page opens.

V FC Eligibility Update (Alaska)

Smallpox

Smallpox has been added to the vaccination list and can be used for administration or to enter historical smallpox vaccinations. Forecasting does not display the smallpox vaccine until a historical vaccination has been given to the patient. The Administration > Settings > Properties > Vaccination Settings > Display "Add Smallpox History" button option must be enabled for the button to appear on the Vaccination View/Add page for authorized users. When added, the smallpox vaccination appears on the Patient Detail report.

To add a smallpox vaccination history, on the Vaccination View/Add page, click the Add Smallpox History button. The Smallpox Vaccination History page opens, with the following fields and options. Enter the information and click Add History Now.

Field	Description
Name	The name of the patient.
Date of Birth	The patient's birthdate.
Facility where history documented	Select the facility that documented the patient's smallpox history from the drop-down list.
Smallpox Vaccination History	This information is required. Select one of the options to indicate the smallpox history: Patient received vaccination in childhood Patient received vaccination in adulthood Patient received vaccination and remembers data (enter the undocumented date in MM/DD/YYYY format) Patient received vaccination and has a documented date (enter the documented date in MM/DD/YYYY format)

Smallpox Take Responses

There are three possible Smallpox Take Responses:

Smallpox Major Take - indicates the smallpox vaccination took
Smallpox Equivocal Take - indicates it cannot be determined if the vaccination took
Smallpox No Take - indicates the smallpox vaccination did not take

Adding Smallpox Take Responses is similar to adding vaccinations. On the Vaccination View/Add page, select the appropriate take response for the responder by selecting the checkbox to the left of the take response description.

Notes about Vaccine Contraindications, Global Exemptions, and Precautions

In some states, contraindication recording is not available because it is considered a violation of privacy. To prevent patients who opt out of a specific vaccine from being forecasted and appearing on the reminder/recall list on the Contraindications page, the message Parent or Patient Refusal: Personal or Laboratory Evidence of Immunity appears instead of the actual contraindication text (or Vaccination Refusal).

Mississippi: The ability to record personal and religious exemptions has been removed specifically for the following: All vaccinations, both Parent or Patient Refusal: Personal and Parent or Patient Refusal: Religious were removed; Laboratory Evidence of Immunity was removed from all vaccinations except Varicella, Measles, Mumps, and Rubella; and Laboratory Evidence of Suppression was removed from Hep A and Hep A/Hep B.

Washington: Religious contraindications cannot be marked as permanent.

A patient's forecast updates immediately when adding or deleting contraindications. However, if global exemptions are enabled, the patients do not forecast.

When adding contraindications, the selected vaccine determines which valid reasons are listed.

In order for the Special Considerations button to display on the pages, the Administration > Settings > Properties > Vaccination Settings > Display Contraindications on Vacc View/Add Screen and Display Contraindications on Vacc Summary Screen options must be enabled (selected).

CASA only assesses coverage levels. Permanent contraindications and refusals are assessed as incomplete coverage for the specific antigen.

Medical Exemption Requests (West Virginia)

To add medical exemption requests, the Organization (IRMS) must have the Enable Exemption Form option enabled on the Organization (IRMS) Maintenance page. Search for and select the patient, then click the Vaccinations > View/Add menu link. The Vaccination View/Add page opens. Scroll down the page and click the Medical Exemption Request button, which opens Medical Exemption Request page.

Scroll down to the CDC Recognized Contraindications and Precautions section, enter the required and optional information for each vaccine (clicking Add Vaccine for each one), then click Submit. The fields and buttons on this page are as follows:

Field/Button	Description
Vaccine	Select the vaccine from the drop-down list. This field is required.
Contraindication	Select the contraindication for that vaccine from the drop-down list. This field is required.
Explanation of Exemption	Enter an explanation describing the reason for the exemption. This field is required.
Is Temporary/Permanent?	Select Temporary (default) or Permanent from the drop-down list to indicate whether this exemption is a temporary one or a permanent one. If the exemption is a temporary one, also enter a date for re-evaluation.
If Temporary, date of re-evaluation	If the exemption is temporary, enter a date for re-evaluation of the exemption. This field is required if Temporary is selected.
Add Vaccine	Click this button to add the vaccine exemption. Add as many vaccine exemptions as necessary and click this button to add each one. The vaccine exemptions are then added to the list.
Physician's Name	Select the physician from the drop-down list. This field is required.
Email Address	Enter the email address for the physician or a contact person at the provider's office for verification purposes. This field is required.
Submit	When all of the vaccine exemption information has been added, click Submit to submit the information.

After clicking Submit, the user is returned to the Vaccinations > View/Add page and the exemption request is submitted for approval. Click the Reports > Exemption Forms menu link to see the list of medical exemption requests and their current status. After the exemption request has been approved, it appears in the Exemption lists on the Vaccination pages and reports.

Mass Immunizations Module - Antivirals

The Vaccination/Medication table in the Mass Immunizations module is populated with antivirals that are available for selection as an administered countermeasure in Mass Immunizations and the Mass Immunizations stand-alone modules. An administrative setting (Administration > Settings > Properties > Mass Immunizations > Mass Immunizations Vaccine Display Label) is used to enable antivirals - select Vaccines and Medicines from the drop-down list. Antivirals/medications are not included on the list of available vaccines to administer in the core IWeb application, but they appear on the Vaccination View/Add page if they have been administered in Mass Immunizations. Both the Patient Detail Report and the Daily Patient Immunization List in Mass Immunizations include antivirals in their output.

School Nurse Vaccinations - Important Notes

When the Administration > Settings > Properties > School Nurse > Enable Vaccine Administration Permission option is enabled (selected), users with the School Nurse Vaccine Administrator permission can record administered vaccines and historical vaccinations from the School Nurse login. They also have full edit/delete permissions on vaccines entered by their Organization (IRMS). In addition, vaccinations administered by School Nurses with this permission do not appear as unverified.

Child Care Users (Arizona)

Child Care users can enter multiple exemptions on the Vaccination View/Add page. Enter the information and click Add Exemptions for each exemption.

Invalid and Warning Vaccination Reasons

The table below lists the Invalid or Warning reason descriptions. There are three groups of warnings:

Group #1: Existing Warnings
Group #2: All warnings not in Group 1 or 3
Group #3: Dose not required type warnings

All three warnings are state-configurable in the Administration > Properties > Vaccination Settings > Warning Group [#] Indicator and Warning Group [#] Indicator Description settings.

If the vaccination is both invalid and incorrectly administered, only the invalid reason displays.

#	Reason Description	Invalid or Warning
1	Minimal interval from previous dose not met	Invalid
2	Minimum age for this does not met	Invalid
3	Minimal interval from dose 1 not met	Invalid
4	Live vaccines not administered on same date must be separated by 28 days	Invalid
5	Antigen not found for this schedule	Invalid
6	Vaccine marked as compromised	Invalid
7	Patient age outside of recommended schedule	Invalid
8	Antigen not recommended for primary series	Invalid
9	Antigen recommended for booster dose only	Invalid
14	Vaccine not licensed in U.S.	Invalid
26	HPV Bivalent vaccine is not appropriate for male vaccination	Invalid
11	Minimum interval from previous dose not met but CDC does not recommend repeating this dose (Group 1)	Warning 1
12	Antigen administered off-label but CDC does not recommend repeating dose (Group 1)	Warning 1
22	The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months. However, DTaP-4 need not be repeated if administered at least 4 months after DTaP-3 (Group 1)	Warning 1
23	The minimum recommended interval between TD and TDAP is 5 years. However, shorter intervals may be counted as valid (Group 1)	Warning 1
24	This patient is on the twinrix accelerated schedule (Group 1)	Warning 1
25	Seasonal influenza nasal and novel influ-H1N1-09 nasal should not be administered at same visit but CDC does not recommend repeating the doses	Warning 1
32	Rotavirus dose 1 administered at age greater than recommended age. CDC recommends completing series	Warning 1
33	PCV13 is recommended for children ages 14-59 mos. Previously complete for PCV7	Warning 1
15	TD administered at < 7 years of age (Group 2)	Warning 2
16	PPV23 Administered at < 24 months of age (Group 2)	Warning 2
17	DTaP administered at >= 7 years of age (Group 2)	Warning 2
18	TDAP administered at < 10 years of age (Group 2)	Warning 2
19	TDAP administered at > 64 years of age (Group 2)	Warning 2
20	Influenza, 36+ months administered at < 36 months of age (Group 2)	Warning 2
21	Influenza, 6-35 months administered at < 6 months of age or > 35 months of age (Group 2)	Warning 2
30	Influenza, 48+ months administered at < 48 months of age	Warning 2
31	Influenza, 18+ years administered at < 18 years of age (Group 2)	Warning 2
34	TIV (flu) high-dose administered at < 65 years of age	Warning 2
10	This additional dose not required (group 3)	Warning 3
13	Antigen not recommended for primary HIB series and CDC recommends disregarding in forecast	Warning 3
27	Multiple doses administered for single dose series. One does of TDAP is recommended (Group 3)	Warning 3
28	Multiple doses administered for single dose series. Revaccination for meningococcal recommended for high risk only (Group 3)	Warning 3
29	Multiple doses administered for single dose series (Group 3)	Warning 3

Deferrals

A patient can be deferred for a vaccination on the Vaccination View/Add page. Adding a vaccine deferral affects the reminder/recall. If a patient is not forecasted to receive the vaccine, they do not receive a reminder/recall for it. A report is available to retrieve all deferrals.

If a patient receives an administered vaccination in the family of the shot that was deferred, the deferral is automatically removed. If an administered vaccination matches a historical vaccination, the deferral is left in place.

Click the Deferrals button on the Vaccination View/Add page. The Vaccine Deferrals page opens. Enter the vaccine deferral information and click Save. Once a deferral is added, it can be deleted by clicking the Delete button for it.

The available fields on this page are:

Field	Description
Vaccine	Select the vaccine from the drop-down list. This field is required.
Dose Number	Enter the dose number. This field is required.
Documented By	Select the facility that is documenting the deferral from the drop-down list.
Reason	Select a reason for the deferral from the drop-down list. Examples: Vaccine Shortage Patient/Parent Choose to Wait (Washington) Patient/Parent Choose Alternate Schedule (Washington) Temporary Acute Illness
Start Date	Enter the deferral start date. The start date appears in the Date column on the Vaccine Deferral - Detail report.
End Date	Enter the deferral end date.