CDC Test Test Case DOB · Test 01/01/2013 07/09/2013: Recomme nded based on interval Past Due Date was missing. Added past due date per NIPInfo guidance. 1.1 2013-0019 1 Tdap, 2 Td

CDC Test Test Case DOB Gender Med Histo Med Histo Med Histo Series Sta Date Admini Vaccine N CVX_1 MVX_1 Evaluation Evaluation Date Adminis Vaccine N CVX_2 MVX_2 Evaluation Evaluation Date Adminis Vaccine N CVX_3 MVX_3 Evaluation Evaluation Date Adminis Vaccine N CVX_4 MVX_4 Evaluation Evaluation Date Admini Vaccine N CVX_5 MVX_5 Evaluation Evaluation Date Adm Vaccine N CVX_6 MVX_6 Evaluation Evaluation Date Adm Vaccine N CVX_7 MVX_7 Evaluation Evaluation Forecast # Earliest_Date Recommende Past Due Da Vaccine G Assessment D Evaluation Date_added Date update Forecast T Reason Fo Changed_In_Version

2013-0001Newborn Testing 02/01/2012 F Not Complete 1 03/14/2012 04/01/2012 05/28/2012 DTaP 02/01/2012

No Doses Administered 01/01/2013 01/01/2013

Recommended based on age

2013-0002

DTaP #2 at age 10 weeks-5 days 02/26/2011 F Not Comple 04/06/2011 DTaP Unsp 107 Valid 05/02/2011 DTaP Unsp 107 Not Valid

Age: Too Young 2 05/30/2011 06/26/2011 08/22/2011 DTaP 05/02/2011

Age: Below Absolute Minimum 01/01/2013 01/01/2013


2013-0003

DTaP #2 at 10 wks-4 days 02/26/2011 F Not Comple 04/09/2011 DTaP Unsp 107 Valid 05/03/2011 DTaP Unsp 107 Valid 3 06/04/2011 08/26/2011 10/23/2011 DTaP 05/03/2011

Age: At Absolute Minimum 01/01/2013 01/01/2013


2013-0004

DTaP # 2 at age 10 weeks 02/26/2011 F Not Comple 04/09/2011 DTaP Unsp 107 Valid 05/07/2011 DTaP Unsp 107 Valid 3 06/04/2011 08/26/2011 10/23/2011 DTaP 05/07/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0005

DTaP # 2 at age 4 months 08/01/2011 F Not Comple 10/01/2011 DTaP Unsp 107 Valid 12/01/2011 DTaP Unsp 107 Valid 3 12/29/2011 02/01/2012 03/28/2012 DTaP 12/01/2011

Age: At Recommended 01/01/2013 01/01/2013


2013-0007

# 2 (Tdap) to child age 7. DTaP # 1 given before age 12 months. Forecast # 3 (Td) in 4 weeks. 09/16/2003 F Not Comple 11/16/2003 DTaP Unsp 107 Valid 09/16/2010 BOOSTRIX 115 SKB Valid 3 10/14/2010 10/14/2010 10/14/2010 DTaP 09/16/2010

Age: At Minimum 01/01/2013 07/09/2013

Recommended based on minimum interval from previous dose (catch-up)

Past Due Date was missing and child is in catch-up. Past Due Date added to align with Recommended Date. 1.1

2013-0008

# 2 (Tdap) to child age 7. DTaP # 1 at ≥ 12 months. Forecast dose 3 for 6 months. 09/16/2004 F Not Comple 09/16/2005 DTaP Unsp 107 Valid 09/16/2011 BOOSTRIX 115 SKB Valid 3 03/16/2012 03/16/2012 03/16/2012 DTaP 09/16/2011

Age: At Minimum 01/01/2013 07/09/2013



2013-0010

# 1 (Td) to # 2 (Tdap) interval 28-4 days in child age > 7 years. Forecast # 3 in six months. 07/07/1998 F Not Comple 10/10/2006 TD(GENER 09 MBL Valid 11/03/2006 BOOSTRIX 115 SKB Valid 3 05/03/2007 05/03/2007 05/03/2007 DTaP 11/03/2006

Interval: At Absolute Minimum 01/01/2013 07/09/2013



2013-0011

#3 at age 14 weeks-5 days 01/06/2006 F Not Comple 02/17/2006 DTaP Unsp 107 Valid 03/17/2006 DTaP Unsp 107 Valid 04/09/2006 DTaP Unsp 107 Not Valid




2013-0012

Age 6. No vaccinations. Forecast DTaP. 12/01/2005 F Not Complete 1 01/12/2006 02/01/2006 03/28/2006 DTaP 12/01/2011



2013-0013

#3 at age 14 weeks-4 days 01/06/2006 F Not Comple 02/17/2006 DTaP Unsp 107 Valid 03/15/2006 DTaP Unsp 107 Valid 04/10/2006 DTaP Unsp 107 Valid 4 01/06/2007 04/06/2007 09/02/2007 DTaP 04/10/2006



2013-0014#3 at age 14 weeks 01/06/2006 F Not Comple 02/17/2006 DTaP Unsp 107 Valid 03/17/2006 DTaP Unsp 107 Valid 04/14/2006 DTaP Unsp 107 Valid 4 01/06/2007 04/06/2007 09/02/2007 DTaP 04/14/2006

Age: At Minimum 01/01/2013 01/01/2013


2013-0015#3 at age 6 months 02/01/2006 F Not Comple 04/01/2006 DTaP Unsp 107 Valid 05/01/2006 DTaP Unsp 107 Valid 08/01/2006 DTaP Unsp 107 Valid 4 02/01/2007 05/01/2007 09/28/2007 DTaP 08/01/2006



2013-0016

Doses # 2 and #3 at ≥ age 7 years; # 1 at age < 12 mo. Forecast # 4 in 6 mo. 03/16/2004 F Not Comple 11/16/2004 DTaP Unsp 107 Valid 03/16/2011 TD(GENER 09 MBL Valid 04/16/2011 BOOSTRIX 115 SKB Valid 4 10/16/2011 10/16/2011 10/16/2011 DTaP 04/16/2011

All Valid: Forecast Test 01/01/2013 01/01/2013


2013-0017

Doses # 2 and # 3 at ≥7 years old; dose # 1 at ≥ 12 months old. 05/13/2003 F Not Comple 07/15/2004 DTaP Unsp 107 Valid 05/21/2010 TD(GENER 09 MBL Valid 03/04/2011 BOOSTRIX 115 SKB Valid 4 03/04/2016 03/04/2021 03/31/2021 DTaP 03/04/2011


Recommended based on interval

Past Due Date was missing. Added past due date per NIPInfo guidance. 1.1

2013-0019

1 Tdap, 2 Td with appropriate intervals to child ≥ age 7 = UTD for 10 years 05/24/2004 F Not Comple 05/25/2011 BOOSTRIX 115 SKB Valid 06/24/2011 TD(GENER 09 MBL Valid 12/24/2011 TD(GENER 09 MBL Valid 4 12/24/2016 12/24/2021 01/20/2022 DTaP 12/24/2011




2013-0020

1 Tdap, 2 Td to child ≥ 7 years old with 6 mo-5 day interval between doses 2 and 3. 05/05/2003 F Not Comple 05/05/2011 BOOSTRIX 115 SKB Valid 06/05/2011 TD(GENER 09 MBL Valid 11/30/2011 TD(GENER 09 MBL Not Valid

Interval: Too Short 3 05/30/2012 05/30/2012 05/30/2012 DTaP 11/30/2011

Interval: Below Absolute Minimum 01/01/2013 07/09/2013

Recommended based on minimum interval from invalid dose


2013-0021

1 Tdap, 2 Td to child ≥ 7 years old with 6 mo-4 day interval between doses 2 and 3. 11/11/2003 F Not Comple 11/20/2010 TD(GENER 09 MBL Valid 02/06/2011 BOOSTRIX 115 SKB Valid 08/02/2011 TD(GENER 09 MBL Valid 4 08/02/2016 08/02/2021 08/29/2021 DTaP 08/02/2011




2013-0022

Age 7. Two DTaP˂ 12 months old. Needs Tdap. 01/06/2005 F Not Comple 04/04/2005 DTaP Unsp 107 Valid 07/10/2005 DTaP Unsp 107 Valid 3 01/06/2012 01/06/2012 01/06/2012 DTaP 01/06/2012



2013-0023

Age 7. No vaccinations. Forecast Tdap. 10/10/2004 F Not Complete 1 10/10/2011 10/10/2011 10/10/2011 DTaP 10/10/2011




2013-0024

Age 7. Two DTaP˂ 12 mos old & 1 ≥ 12 mo. Needs Tdap. 03/18/2005 F Not Comple 06/18/2005 DTaP Unsp 107 Valid 10/18/2005 DTaP Unsp 107 Valid 03/20/2007 DTaP Unsp 107 Valid 4 03/18/2012 03/18/2012 03/18/2012 DTaP 03/18/2012




2013-0025

#4 at age 12 mo-5 days 04/04/2010 F Not Comple 06/04/2010 DTaP Unsp 107 Valid 08/04/2010 DTaP Unsp 107 Valid 09/30/2010 DTaP Unsp 107 Valid 03/30/2011 DTaP Unsp 107 Not Valid



Recommended based on minimum interval from inValid dose

2013-0026

#4 at age 12 mo-4 days 06/01/2005 F Not Comple 08/01/2005 DTaP Unsp 107 Valid 10/01/2005 DTaP Unsp 107 Valid 11/28/2005 DTaP Unsp 107 Valid 05/28/2006 DTaP Unsp 107 Valid 5 06/01/2009 06/01/2009 05/31/2012 DTaP 05/28/2006



2013-0027

#4 at age ≥ 12 months old 04/04/2006 F Not Comple 06/04/2006 DTaP Unsp 107 Valid 08/04/2006 DTaP Unsp 107 Valid 10/04/2006 DTaP Unsp 107 Valid 04/04/2007 DTaP Unsp 107 Valid 5 04/04/2010 04/04/2010 04/03/2013 DTaP 04/04/2007



2013-0028

#4 at age 4 is UTD until age 11. 05/06/2006 F Not Comple 08/01/2006 DTaP Unsp 107 Valid 10/01/2006 DTaP Unsp 107 Valid 12/01/2006 DTaP Unsp 107 Valid 05/06/2010 DTaP Unsp 107 Valid 5 05/06/2017 05/06/2017 05/05/2019 DTaP 05/06/2010



V1.4: Updated past due date to shift 1 day earlier to align with business rule calculation and other similar tests in the DTaP/Tdap/Td forecasting at 11 years. 1.4


2013-0029

5 year old with no previous DTP product receives 4 vaccinations prior to age 7 years 02/25/2000 F Not Comple 02/25/2005 DTaP Unsp 107 Valid 04/25/2005 DTaP Unsp 107 Valid 10/27/2005 DTaP Unsp 107 Valid 04/30/2006 DTaP Unsp 107 Valid 5 02/25/2011 02/25/2011 02/24/2013 DTaP 04/30/2006




2013-0030

#5 at age 4 years-5 days 07/01/2006 F Not Comple 09/01/2006 DTaP Unsp 107 Valid 10/01/2006 DTaP Unsp 107 Valid 12/01/2006 DTaP Unsp 107 Valid 07/02/2007 DTaP Unsp 107 Valid 06/26/2010 DTaP Unsp 107 Not Valid




2013-0031

#5 at age 4 years-4 days 07/01/2006 F Not Comple 09/01/2006 DTaP Unsp 107 Valid 10/01/2006 DTaP Unsp 107 Valid 12/01/2006 DTaP Unsp 107 Valid 07/02/2007 DTaP Unsp 107 Valid 06/27/2010 DTaP Unsp 107 Valid 6 07/01/2017 07/01/2017 06/30/2019 DTaP 06/27/2010




2013-0032# 5 at age 4 years 07/01/2006 F Not Comple 09/01/2006 DTaP Unsp 107 Valid 12/14/2006 DTaP Unsp 107 Valid 03/03/2007 DTaP Unsp 107 Valid 09/19/2008 DTaP Unsp 107 Valid 07/01/2010 DTaP Unsp 107 Valid 6 07/01/2017 07/01/2017 06/30/2019 DTaP 07/01/2010

Age: At Minimum 01/01/2013 12/06/2013



2013-0033

DTaP #1 at age 6 weeks-5 days 05/01/2011 F Not Comple 06/07/2011 DTaP Unsp 107 Not Valid




2013-0034

# 6 DTaP before age 4. Nothing more until Tdap at age 11 even if some are invalid. 04/02/2008 F Not Comple 06/02/2008 DTaP Unsp 107 Valid 08/02/2008 DTaP Unsp 107 Valid 10/02/2008 DTaP Unsp 107 Valid 04/02/2010 DTaP Unsp 107 Valid 07/02/2010 DTaP Unsp 107 Not Valid

Age: Too Young ####### DTaP Unsp 107 Not Valid


Extra Doses 01/01/2013 02/23/2016


Updated due to new conditional skip logic which causes the next forecasted dose to be administered at age 7 rather than age 11. Updated due to Past Due Date was missing. Added past due date of 13 years - 1 day to be consistent with supporting data a logic specficiation 2.2

2013-0035

Adolescent with Td but no Tdap. 04/04/1998 F Not Comple 06/04/1998 DTaP Unsp 107 Valid 08/04/1998 DTaP Unsp 107 Valid 10/04/1998 DTaP Unsp 107 Valid 07/07/1999 DTaP Unsp 107 Valid 07/02/2003 DTaP Unsp 107 Valid ####### TD(GENER 09 MBL Valid 7 12/12/2010 12/12/2010 04/03/2011 DTaP 12/12/2010



New logic concerning Tdap 2.2

2013-0036

Invalid age for dose # 1 in first of series 08/01/2011 F Not Comple 09/01/2011 DTaP Unsp 107 Not Valid

Age: Too Young 12/01/2011 DTaP Unsp 107 Valid 02/01/2012 DTaP Unsp 107 Valid 3 02/29/2012 02/29/2012 03/28/2012 DTaP 02/01/2012



2013-0037

Invalid age for dose # 2 in midst of others 08/01/2011 F Not Comple 09/30/2011 DTaP Unsp 107 Valid 10/22/2011 DTaP Unsp 107 Not Valid

Interval: Too Short 02/01/2012 DTaP Unsp 107 Valid 3 02/29/2012 02/29/2012 03/28/2012 DTaP 02/01/2012



2013-0038

Invalid age for dose #3 in midst of others 06/01/2010 F Not Comple 07/13/2010 DTaP Unsp 107 Valid 08/07/2010 DTaP Unsp 107 Valid 09/01/2010 DTaP Unsp 107 Not Valid

Age: Too Young 06/02/2011 DTaP Unsp 107 Valid 4 12/02/2011 12/02/2011 01/28/2012 DTaP 06/02/2011



2013-0039

InValid age for dose # 4 in midst of others 05/01/2007 F Not Comple 07/01/2007 DTaP Unsp 107 Valid 09/01/2007 DTaP Unsp 107 Valid 10/25/2007 DTaP Unsp 107 Valid 04/25/2008 DTaP Unsp 107 Not Valid

Age: Too Young 05/01/2011 DTaP Unsp 107 Valid 5 05/01/2018 05/01/2018 04/30/2020 DTaP 05/01/2011




2013-0040

Invalid age dose 5 in midst of others 06/06/2000 F Not Comple 08/07/2000 DTaP Unsp 107 Valid 10/09/2000 DTaP Unsp 107 Valid 12/20/2000 DTaP Unsp 107 Valid 09/06/2001 DTaP Unsp 107 Valid 07/02/2003 DTaP Unsp 107 Not Valid

Age: Too Young ####### BOOSTRIX 115 SKB Valid 6 06/06/2016 06/06/2021 07/03/2021 DTaP 06/06/2011




2013-0041

Dose 1 to dose 2 interval 28-5 days 03/04/2006 F Not Comple 05/04/2006 DTaP Unsp 107 Valid 05/27/2006 DTaP Unsp 107 Not Valid




2013-0042

Dose 1 to dose 2 interval 28-4 days 02/01/2006 F Not Comple 04/01/2006 DTaP Unsp 107 Valid 04/25/2006 DTaP Unsp 107 Valid 3 05/23/2006 08/01/2006 09/28/2006 DTaP 04/25/2006



2013-0043

Dose 1 to dose 2 interval 28 days 04/07/2010 F Not Comple 07/01/2010 DTaP Unsp 107 Valid 07/29/2010 DTaP Unsp 107 Valid 3 08/26/2010 10/07/2010 12/04/2010 DTaP 07/29/2010

Interval: At Minimum 01/01/2013 01/01/2013


2013-0044

DTaP #1 at age 6 weeks-4 days 04/01/2006 F Not Comple 05/09/2006 DTaP Unsp 107 Valid 2 06/10/2006 08/01/2006 09/28/2006 DTaP 05/09/2006



2013-0045

Dose 2 to dose 3 interval 28-5 days 04/13/2011 F Not Comple 06/13/2011 DTaP Unsp 107 Valid 08/01/2011 DTaP Unsp 107 Valid 08/24/2011 DTaP Unsp 107 Not Valid




2013-0046

Dose 2 to dose 3 interval 28-4 days 12/01/2005 F Not Comple 01/10/2006 DTaP Unsp 107 Valid 02/17/2006 DTaP Unsp 107 Valid 03/13/2006 DTaP Unsp 107 Valid 4 12/01/2006 03/01/2007 07/28/2007 DTaP 03/13/2006



2013-0047

Dose 2 to dose 3 interval 28 days 12/01/2005 F Not Comple 01/10/2006 DTaP Unsp 107 Valid 02/08/2006 DTaP Unsp 107 Valid 03/08/2006 DTaP Unsp 107 Valid 4 12/01/2006 03/01/2007 07/28/2007 DTaP 03/08/2006



2013-0049

Dose 3 to dose 4 interval 6 months-4 days 08/09/2009 F Not Comple 10/10/2009 DTaP Unsp 107 Valid 12/10/2009 DTaP Unsp 107 Valid 02/15/2010 DTaP Unsp 107 Valid 08/11/2010 DTaP Unsp 107 Valid 5 08/09/2013 08/09/2013 08/08/2016 DTaP 08/11/2010



2013-0050

Dose 3 to dose 4 interval 6 months 08/09/2009 F Not Comple 10/10/2009 DTaP Unsp 107 Valid 12/10/2009 DTaP Unsp 107 Valid 02/15/2010 DTaP Unsp 107 Valid 08/15/2010 DTaP Unsp 107 Valid 5 08/09/2013 08/09/2013 08/08/2016 DTaP 08/15/2010




2013-0051

Dose 3 to dose 4 interval 4 months-1 day. 4 day grace does not apply to reduced intervals. 04/04/2010 F Not Comple 06/04/2010 DTaP Unsp 107 Valid 08/04/2010 DTaP Unsp 107 Valid 01/10/2011 DTaP Unsp 107 Valid 05/09/2011 DTaP Unsp 107 Not Valid




2013-0052

Dose 3 to dose 4 interval 4 months 11/10/2009 F Not Comple 01/10/2010 DTaP Unsp 107 Valid 03/10/2010 DTaP Unsp 107 Valid 07/10/2010 DTaP Unsp 107 Valid 11/10/2010 DTaP Unsp 107 Valid 5 11/10/2013 11/10/2013 11/09/2016 DTaP 11/10/2010



2013-0053

Invalid dose 1 to dose 2 interval in midst of other vaccines 02/11/2009 F Not Comple 04/11/2009 DTaP Unsp 107 Valid 05/01/2009 DTaP Unsp 107 Not Valid

Interval: Too Short 08/11/2009 DTaP Unsp 107 Valid 02/15/2010 DTaP Unsp 107 Valid 4 08/15/2010 08/15/2010 10/08/2010 DTaP 02/15/2010



2013-0054

Invalid dose 2 to dose 3 interval in midst of other vaccines. 02/02/2010 F Not Comple 04/02/2010 DTaP Unsp 107 Valid 05/30/2010 DTaP Unsp 107 Valid 06/21/2010 DTaP Unsp 107 Not Valid

Interval: Too Short 04/04/2011 DTaP Unsp 107 Valid 4 10/04/2011 10/04/2011 10/04/2011 DTaP 04/04/2011



2013-0055

DTaP #1 at age 6 weeks 11/01/2011 F Not Comple 12/13/2011 DTaP Unsp 107 Valid 2 01/10/2012 03/01/2012 04/28/2012 DTaP 12/13/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0056

Invalid dose 3 to dose 4 interval in midst of other vaccinations 03/18/2010 F Not Comple 08/18/2010 DTaP Unsp 107 Valid 10/18/2010 DTaP Unsp 107 Valid 12/10/2010 DTaP Unsp 107 Valid 03/18/2011 DTaP Unsp 107 Not Valid




2013-0057

Invalid dose 4 to dose 5 interval in midst of others 02/11/2000 F Not Comple 04/11/2000 DTaP Unsp 107 Valid 06/11/2000 DTaP Unsp 107 Valid 08/11/2000 DTaP Unsp 107 Valid 10/30/2003 DTaP Unsp 107 Valid 02/12/2004 DTaP Unsp 107 Not Valid

Interval: Too Short ####### BOOSTRIX 115 SKB Valid 6 02/12/2016 02/12/2021 03/11/2021 DTaP 02/12/2011



V1.4: Updated past due date to align with EIPB guidance clarification on past due date and other test cases. 1.4

2013-0058Tdap as dose #1 03/05/2010 F Not Comple 05/05/2010 BOOSTRIX 115 SKB Not Valid

Vaccine: Invalid Usage 07/07/2010 DTaP Unsp 107 Valid 09/09/2010 DTaP Unsp 107 Valid 04/04/2011 DTaP Unsp 107 Valid 4 10/04/2011 10/04/2011 11/01/2011 DTaP 04/04/2011

Vaccine: Invalid Usage 01/01/2013 01/01/2013


2013-0059Tdap as dose #2 03/05/2010 F Not Comple 05/05/2010 DTaP Unsp 107 Valid 07/07/2010 BOOSTRIX 115 SKB Not Valid

Vaccine: Invalid Usage 09/09/2010 DTaP Unsp 107 Valid 03/05/2011 DTaP Unsp 107 Valid 4 09/05/2011 09/05/2011 11/01/2011 DTaP 03/05/2011



2013-0060

Tdap as dose 3 to child under age 4=invalid as DTaP 3 02/01/2010 F Not Comple 05/01/2010 DTaP Unsp 107 Valid 07/01/2010 DTaP Unsp 107 Valid 11/01/2010 BOOSTRIX 115 SKB Not Valid

Vaccine: Invalid Usage 3 11/01/2010 11/01/2010 11/01/2010 DTaP 11/01/2010



2013-0061

Tdap as dose 4 to age 15 months=valid as DTaP 02/01/2010 F Not Comple 05/01/2010 DTaP Unsp 107 Valid 07/01/2010 DTaP Unsp 107 Valid 11/01/2010 DTaP Unsp 107 Valid 05/05/2011 BOOSTRIX 115 SKB Valid 5 02/01/2014 02/01/2014 01/31/2017 DTaP 05/05/2011

Vaccine: Off Label 01/01/2013 01/01/2013


2013-0062

Tdap as dose 5 to age 4 years-5 days=invalid as dose 5 of DTaP 02/11/2007 F Not Comple 05/01/2007 DTaP Unsp 107 Valid 07/01/2007 DTaP Unsp 107 Valid 11/01/2007 DTaP Unsp 107 Valid 06/06/2008 DTaP Unsp 107 Valid 02/06/2011 BOOSTRIX 115 SKB Not Valid




2013-0063

Tdap as dose 5 to age 4-4 days. Counts as valid DTaP. Child will need another Tdap in adolescence. 02/11/2007 F Not Comple 05/01/2007 DTaP Unsp 107 Valid 07/01/2007 DTaP Unsp 107 Valid 11/01/2007 DTaP Unsp 107 Valid 06/06/2008 DTaP Unsp 107 Valid 02/07/2011 BOOSTRIX 115 SKB Valid 6 02/11/2018 02/11/2018 02/10/2020 DTaP 02/07/2011




2013-0064

Tdap as dose 5 to age 4 years old=valid as DTaP 5. 02/11/2007 F Not Comple 05/01/2007 DTaP Unsp 107 Valid 07/01/2007 DTaP Unsp 107 Valid 11/01/2007 DTaP Unsp 107 Valid 06/06/2008 DTaP Unsp 107 Valid 02/11/2011 BOOSTRIX 115 SKB Valid 6 02/11/2018 02/11/2018 02/10/2020 DTaP 02/11/2011



Past Due Date was missing. Added past due date of 13 years - 1 day to be consistent with supporting data a logic specficiation business rule calculations. 1.1

2013-0065

Tdap as dose 1 at age 7 years old 01/01/2005 F Not Comple 01/01/2012 BOOSTRIX 115 SKB Valid 2 01/29/2012 01/29/2012 01/29/2012 DTaP 01/01/2012



2013-0066

DTaP # 1 at age 2 months 11/01/2011 F Not Comple 01/01/2012 DTaP Unsp 107 Valid 2 01/29/2012 03/01/2012 04/28/2012 DTaP 01/01/2012



2013-0067

Tdap as dose 2 at age ≥7 years 09/16/2004 F Not Comple 10/16/2011 TD(GENER 09 MBL Valid 11/13/2011 BOOSTRIX 115 SKB Valid 3 05/13/2012 05/13/2012 05/13/2012 DTaP 11/13/2011




2013-0068

Tdap as dose 3 to ≥ 7 years old 09/20/2004 F Not Comple 09/30/2011 DTaP Unsp 107 Valid 10/28/2011 DTaP Unsp 107 Valid 04/28/2012 BOOSTRIX 115 SKB Valid 4 04/28/2017 04/28/2022 05/25/2022 DTaP 04/28/2012




2013-0069

Tdap at age 7 years-5 days. Current age 7 years 03/08/2003 F Not Comple 03/03/2010 BOOSTRIX 115 SKB Not Valid

Vaccine: Invalid Usage 1 03/08/2010 03/08/2010 03/08/2010 DTaP 03/08/2010




2013-0070

Tdap at age 11 to child up-to-date with DTaP 03/03/2000 F Not Comple 05/05/2000 DTaP Unsp 107 Valid 07/07/2000 DTaP Unsp 107 Valid 09/09/2000 DTaP Unsp 107 Valid 04/04/2001 DTaP Unsp 107 Valid 05/09/2004 DTaP Unsp 107 Valid ####### BOOSTRIX 115 SKB Valid 7 05/09/2016 05/09/2021 06/05/2021 DTaP 05/09/2011




2013-0071

Encephalopathy within 7 days of DTaP. Further pertussis is contraindicated. 02/02/2001 F

encephalopathy within 7 days of previous dose of DTP or DTaP VXC22 CDCPHINVS Not Comple 04/02/2001 DTaP Unsp 107 Valid 06/02/2001 DT(GENER 28 PMC Valid 08/02/2001 DT(GENER 28 PMC Valid 05/02/2002 DT(GENER 28 PMC Valid 05/05/2006 DT(GENER 28 PMC Valid 6 02/02/2012 02/02/2012 02/01/2014 DTaP 05/05/2006





2013-0072

Encephalopathy within 7 days of DTaP # 5 08/01/2000 F

encephalopathy within 7 days of previous dose of DTP or DTaP VXC22 CDCPHINVS Not Comple 10/01/2000 DTaP Unsp 107 Valid 12/01/2000 DTaP Unsp 107 Valid 02/01/2001 DTaP Unsp 107 Valid 11/01/2001 DTaP Unsp 107 Valid 08/10/2004 DTaP Unsp 107 Valid 6 08/01/2011 08/01/2011 07/31/2013 DTaP 08/10/2004




2013-0073

Anaphylaxis to previous dose 10/10/2010 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 12/10/2010 DTaP Unsp 107 Valid - DTaP 12/10/2010


Not recommended: contraindication

2013-0074

4 doses of Tetramune to child 05/05/1995 F Not Comple 07/05/1995 TETRAMUN22 WAL Valid 09/05/1995 TETRAMUN22 WAL Valid 11/05/1995 TETRAMUN22 WAL Valid 10/05/1996 TETRAMUN22 WAL Valid 5 05/05/2002 05/05/2002 05/05/2002 DTaP 05/05/2002



Updated due to new conditional skip logic which caused the next forecast dose to be administered at age 7 rather than age 8 due to need Pertussis dose. V1.4: Updated past due date to shift 1 day earlier to align with business rule calculation and other similar tests in 2.2

2013-0075

4 doses of Tetramune with a DTaP booster. Forecast Tdap. 12/12/1999 F Not Comple 02/15/2000 TETRAMUN22 WAL Valid 04/15/2000 TETRAMUN22 WAL Valid 06/15/2000 TETRAMUN22 WAL Valid 02/15/2001 TETRAMUN22 WAL Valid 12/01/2004 DTaP Unsp 107 Valid 6 12/12/2010 12/12/2010 12/11/2012 DTaP 12/01/2004




2013-0076

4 Tetramune and Tdap at age 11=UTD for 10 years 03/03/1996 F Not Comple 05/05/1996 TETRAMUN22 WAL Valid 08/08/1996 TETRAMUN22 WAL Valid 01/04/1997 TETRAMUN22 WAL Valid 04/04/1998 TETRAMUN22 WAL Valid 03/18/2007 BOOSTRIX 115 SKB Valid 6 03/18/2012 03/18/2017 04/14/2017 DTaP 03/18/2007




2013-0077

DTaP #1 at age 6.5 years. 11/01/2005 F Not Comple 05/01/2012 DTaP Unsp 107 Valid 2 05/29/2012 05/29/2012 05/29/2012 DTaP 05/01/2012



2013-0078

TriHibit as primary dose. DTaP=valid. (Hib=invalid). 05/01/2011 F Not Comple 07/01/2011 TRIHIBIT 50 PMC Valid 2 07/29/2011 09/01/2011 10/28/2011 DTaP 07/01/2011



2013-0079

TriHibit as valid dose 4 of DTaP 02/02/2008 F Not Comple 04/04/2008 DTaP Unsp 107 Valid 06/06/2008 DTaP Unsp 107 Valid 08/08/2008 DTaP Unsp 107 Valid 05/19/2009 TRIHIBIT 50 PMC Valid 5 02/02/2012 02/02/2012 02/01/2015 DTaP 05/19/2009



2013-0080

TriHibit as valid dose 5 of DTaP 10/08/2006 F Not Comple 11/29/2006 PEDIARIX 110 SKB Valid 01/29/2007 PEDIARIX 110 SKB Valid 03/29/2007 PEDIARIX 110 SKB Valid 02/02/2008 PEDIARIX 110 SKB Valid 10/09/2010 TRIHIBIT 50 PMC Valid 6 10/08/2017 10/08/2017 10/07/2019 DTaP 10/09/2010



V1.4: Updated past due date to align with ACIP and other test cases to be 1 day before the 13th birthday. 1.4

2013-0081

Pentavalente (Mexico) DTP-Hib-Hep counts as valid. 10/18/2009 F Not Comple 02/18/2010 PENTAVAL 102 Valid 04/18/2010 PENTAVAL 102 Valid 06/18/2010 PENTAVAL 102 Valid 12/27/2010 PENTAVAL 102 Valid 5 10/18/2013 10/18/2013 10/17/2016 DTaP 12/27/2010



2013-0082

Kinrix at age 2 months as Dose 1 of DTaP. Off label but valid. 11/11/2011 F Not Comple 01/11/2012 KINRIX 130 SKB Valid 2 02/08/2012 03/11/2012 05/08/2012 DTaP 01/11/2012



2013-0083

Kinrix at age 4 months as dose 2 of DTaP. Off label but valid. 09/09/2011 F Not Comple 11/15/2011 DTaP Unsp 107 Valid 01/09/2012 KINRIX 130 SKB Valid 3 02/06/2012 03/09/2012 05/06/2012 DTaP 01/09/2012



2013-0084

Kinrix at age 6 months as dose 3 of DTaP. Off label but valid. 07/07/2011 F Not Comple 09/09/2011 DTaP Unsp 107 Valid 11/11/2011 DTaP Unsp 107 Valid 01/07/2012 KINRIX 130 SKB Valid 4 07/07/2012 10/07/2012 03/06/2013 DTaP 01/07/2012



2013-0085

Kinrix at age 12 months as dose 4 of DTaP=valid 07/07/2006 F Not Comple 09/09/2006 DTaP Unsp 107 Valid 11/11/2006 DTaP Unsp 107 Valid 12/30/2006 DTaP Unsp 107 Valid 07/07/2007 KINRIX 130 SKB Valid 5 07/07/2010 07/07/2010 07/06/2013 DTaP 07/07/2007

Age: At Minimum 01/01/2013 01/01/2013


2013-0086

Kinrix at age 4 to child with appropriate DTaP=UTD until adolescence 10/04/2006 F Not Comple 12/06/2006 PEDIARIX 110 SKB Valid 02/04/2007 PEDIARIX 110 SKB Valid 04/06/2007 PEDIARIX 110 SKB Valid 10/04/2007 PEDIARIX 110 SKB Valid 10/04/2010 KINRIX 130 SKB Valid 6 10/04/2017 10/04/2017 10/03/2019 DTaP 10/04/2010

Age: At Minimum 01/01/2013 12/06/2013



2013-0087

Kinrix at age 4 years-5 days 07/07/2007 F Not Comple 08/30/2007 PEDIARIX 110 SKB Valid 10/24/2007 PEDIARIX 110 SKB Valid 03/05/2008 PEDIARIX 110 SKB Valid 11/19/2008 PEDIARIX 110 SKB Valid 07/02/2011 KINRIX 130 SKB Not Valid




2013-0088

DTaP # 1 at age 7 years (off label but counts as valid). 02/01/2005 F Not Comple 02/01/2012 DTaP Unsp 107 Valid 2 02/29/2012 02/29/2012 02/29/2012 DTaP 02/01/2012



2013-0089

Kinrix at age 4 years -4 days 10/18/2007 F Not Comple 12/07/2007 PEDIARIX 110 SKB Valid 02/04/2008 PEDIARIX 110 SKB Valid 04/04/2008 PEDIARIX 110 SKB Valid 12/27/2008 PEDIARIX 110 SKB Valid 10/14/2011 KINRIX 130 SKB Valid 6 10/18/2018 10/18/2018 10/17/2020 DTaP 10/14/2011





2013-0090

Newborn forecasting 04/01/2012 F Not Complete 1 05/13/2012 06/01/2012 07/28/2012 DTaP 04/01/2012



2013-0091

# 2 Pediarix at 6 yrs 11.5 mo 01/01/2005 F Not Comple 12/16/2007 PEDIARIX 110 SKB Valid 12/15/2011 PEDIARIX 110 SKB Valid 3 01/12/2012 01/12/2012 01/12/2012 DTaP 12/15/2011



2013-0092

# 2 Pediarix at 7 yrs; # 1 at less than 12 mo. 09/16/2003 F Not Comple 12/16/2003 PEDIARIX 110 SKB Valid 09/16/2010 PEDIARIX 110 SKB Valid 3 10/14/2010 10/14/2010 10/14/2010 DTaP 09/16/2010




2013-0093

# 2 Pediarix at 7 yrs; # 1 ≥ 12 mo. Need 6 mo interval from 2 to 3. 09/16/2004 F Not Comple 10/16/2005 PEDIARIX 110 SKB Valid 09/16/2011 PEDIARIX 110 SKB Valid 3 03/16/2012 03/16/2012 03/16/2012 DTaP 09/16/2011




2013-0094

# 1 and 2 Pediarix at ≥7 yrs with 28 day interval. Off label but does not need repeating. 07/07/2002 F Not Comple 07/07/2009 PEDIARIX 110 SKB Valid 08/04/2009 PEDIARIX 110 SKB Valid 3 02/04/2010 02/04/2010 02/04/2010 DTaP 08/04/2009



2013-0095

# 3 Pediarix at 14 wks-5 days 06/01/2005 F Not Comple 07/09/2005 PEDIARIX 110 SKB Valid 08/06/2005 PEDIARIX 110 SKB Valid 09/02/2005 PEDIARIX 110 SKB Not Valid




2013-0096

# 3 Pediarix at 14 wks-4 days. 01/06/2006 F Not Comple 02/15/2006 PEDIARIX 110 SKB Valid 03/15/2006 PEDIARIX 110 SKB Valid 04/10/2006 PEDIARIX 110 SKB Valid 4 01/06/2007 04/06/2007 09/02/2007 DTaP 04/10/2006



2013-0097

#3 Pediarix at age 24 weeks- 5 days 05/13/2011 F Not Comple 06/24/2011 PEDIARIX 110 SKB Valid 08/24/2011 PEDIARIX 110 SKB Valid 10/23/2011 PEDIARIX 110 SKB Valid 4 05/13/2012 08/13/2012 01/09/2013 DTaP 10/23/2011



2013-0099

# 3 Pediarix at 6 yrs 11.5 mo 07/07/2004 F Not Comple 05/05/2007 PEDIARIX 110 SKB Valid 08/08/2008 PEDIARIX 110 SKB Valid 06/25/2011 PEDIARIX 110 SKB Valid 4 12/25/2011 12/25/2011 12/25/2011 DTaP 06/25/2011



2013-0100

# 4 Pediarix at 1 yr -5 days. 04/04/2010 F Not Comple 06/04/2010 PEDIARIX 110 SKB Valid 08/04/2010 PEDIARIX 110 SKB Valid 10/10/2010 PEDIARIX 110 SKB Valid 03/30/2011 PEDIARIX 110 SKB Not Valid




2013-0101

# 1 Pediarix at 6 wks-5 days 05/06/2011 F Not Comple 06/12/2011 PEDIARIX 110 SKB Not Valid




2013-0102

# 4 Pediarix at 1 yr -4 days 06/01/2005 F Not Comple 08/01/2005 PEDIARIX 110 SKB Valid 11/01/2005 PEDIARIX 110 SKB Valid 01/15/2006 PEDIARIX 110 SKB Valid 05/28/2006 PEDIARIX 110 SKB Valid 5 06/01/2009 06/01/2009 05/31/2012 DTaP 05/28/2006



2013-0103

# 4 Pediarix at 3 yrs 11.5 mo. 02/01/2008 F Not Comple 04/01/2008 PEDIARIX 110 SKB Valid 07/01/2008 PEDIARIX 110 SKB Valid 10/01/2008 PEDIARIX 110 SKB Valid 01/15/2012 PEDIARIX 110 SKB Valid 5 07/15/2012 07/15/2012 01/31/2015 DTaP 01/15/2012



2013-0104

# 4 Pediarix at 4 yrs=complete until age 11 05/06/2006 F Not Comple 09/09/2006 PEDIARIX 110 SKB Valid 03/03/2007 PEDIARIX 110 SKB Valid 07/10/2008 PEDIARIX 110 SKB Valid 05/06/2010 PEDIARIX 110 SKB Valid 5 05/06/2017 05/06/2017 05/05/2019 DTaP 05/06/2010




2013-0105

# 5 Pediarix at 4 yrs -5 days. 07/01/2006 F Not Comple 09/01/2006 PEDIARIX 110 SKB Valid 10/01/2006 PEDIARIX 110 SKB Valid 02/02/2007 PEDIARIX 110 SKB Valid 10/10/2007 PEDIARIX 110 SKB Valid 06/26/2010 PEDIARIX 110 SKB Not Valid




2013-0106

# 5 Pediarix at 4 yrs -4 days 07/01/2006 F Not Comple 09/01/2006 PEDIARIX 110 SKB Valid 10/01/2006 PEDIARIX 110 SKB Valid 02/02/2007 PEDIARIX 110 SKB Valid 10/10/2007 PEDIARIX 110 SKB Valid 06/27/2010 PEDIARIX 110 SKB Valid 6 07/01/2017 07/01/2017 06/30/2019 DTaP 06/27/2010




2013-0107

# 5 Pediarix at 6 yrs 11.5 mo 04/01/2005 F Not Comple 06/01/2005 PEDIARIX 110 SKB Valid 08/01/2005 PEDIARIX 110 SKB Valid 10/01/2005 PEDIARIX 110 SKB Valid 05/01/2006 PEDIARIX 110 SKB Valid 03/15/2012 PEDIARIX 110 SKB Valid 6 04/01/2016 04/01/2016 03/31/2018 DTaP 03/15/2012




2013-0108

# 5 Pediarix at 7 yrs. Off label but valid. 05/01/2005 F Not Comple 08/01/2005 PEDIARIX 110 SKB Valid 11/01/2005 PEDIARIX 110 SKB Valid 02/01/2006 PEDIARIX 110 SKB Valid 11/16/2006 PEDIARIX 110 SKB Valid 05/01/2012 PEDIARIX 110 SKB Valid 6 05/01/2017 05/01/2022 05/28/2022 DTaP 05/01/2012



V1.4: Updated to reflect 10 year recurring dose since the DTaP at age 7 can count as the adolescent (11 - 12 year) Tdap dose per conversation with EIPB and guidance in MMWRs 1.4

2013-0109

Invalid age dose 1 as first of others. 08/01/2011 F Not Comple 09/07/2011 PEDIARIX 110 SKB Not Valid

Age: Too Young 11/01/2011 PEDIARIX 110 SKB Valid 2 11/29/2011 12/01/2011 01/28/2012 DTaP 11/01/2011



2013-0110

Invalid age dose 2 in midst of others 10/18/2010 F Not Comple 11/25/2010 PEDIARIX 110 SKB Valid 12/21/2010 PEDIARIX 110 SKB Not Valid

Age: Too Young 04/18/2011 PEDIARIX 110 SKB Valid 3 05/16/2011 05/16/2011 06/14/2011 DTaP 04/18/2011



2013-0111

invalid age dose 3 in midst of others 06/01/2010 F Not Comple 07/15/2010 PEDIARIX 110 SKB Valid 08/10/2010 PEDIARIX 110 SKB Valid 09/01/2010 PEDIARIX 110 SKB Not Valid

Interval: Too Short 06/01/2011 PEDIARIX 110 SKB Valid 4 12/01/2011 12/01/2011 01/28/2012 DTaP 06/01/2011



2013-0112

# 1 Pediarix at 6 wks-4 days 04/04/2006 F Not Comple 05/12/2006 PEDIARIX 110 SKB Valid 2 06/13/2006 08/04/2006 10/01/2006 DTaP 05/12/2006




2013-0113

dose 1 to 2 Pediarix, interval 28-5 days 11/01/2010 F Not Comple 01/03/2011 PEDIARIX 110 SKB Valid 01/26/2011 PEDIARIX 110 SKB Not Valid




2013-0114

dose 1 to 2 Pediarix, interval 28-4 days 02/01/2006 F Not Comple 04/01/2006 PEDIARIX 110 SKB Valid 04/25/2006 PEDIARIX 110 SKB Valid 3 05/23/2006 08/01/2006 09/28/2006 DTaP 04/25/2006



2013-0115

dose 2 to 3 Pediarix, interval 28-5 days 04/01/2011 F Not Comple 06/01/2011 PEDIARIX 110 SKB Valid 08/01/2011 PEDIARIX 110 SKB Valid 08/24/2011 PEDIARIX 110 SKB Not Valid




2013-0116

dose 2 to 3 Pediarix, interval 28-4 days. 12/01/2005 F Not Comple 02/01/2006 PEDIARIX 110 SKB Valid 04/01/2006 PEDIARIX 110 SKB Valid 04/25/2006 PEDIARIX 110 SKB Valid 4 12/01/2006 03/01/2007 07/28/2007 DTaP 04/25/2006



2013-0117

dose 3 to 4 Pediarix, interval 6m-5 days 08/09/2009 F Not Comple 10/09/2009 PEDIARIX 110 SKB Valid 12/09/2009 PEDIARIX 110 SKB Valid 04/09/2010 PEDIARIX 110 SKB Valid 10/04/2010 PEDIARIX 110 SKB Valid 5 08/09/2013 08/09/2013 08/08/2016 DTaP 10/04/2010



2013-0118

dose 3 to 4 Pediarix, interval 6m-4 days 08/09/2009 F Not Comple 10/09/2009 PEDIARIX 110 SKB Valid 12/09/2009 PEDIARIX 110 SKB Valid 04/09/2010 PEDIARIX 110 SKB Valid 10/05/2010 PEDIARIX 110 SKB Valid 5 08/09/2013 08/09/2013 08/08/2016 DTaP 10/05/2010



2013-0119

dose 3 to 4 Pediarix, interval 4 mo-1 day. 04/04/2010 F Not Comple 06/04/2010 PEDIARIX 110 SKB Valid 08/04/2010 PEDIARIX 110 SKB Valid 02/04/2011 PEDIARIX 110 SKB Valid 06/03/2011 PEDIARIX 110 SKB Not Valid




2013-0120

dose 3 to 4 Pediarix, interval 4 mo 04/04/2010 F Not Comple 06/04/2010 PEDIARIX 110 SKB Valid 08/04/2010 PEDIARIX 110 SKB Valid 02/04/2011 PEDIARIX 110 SKB Valid 06/04/2011 PEDIARIX 110 SKB Valid 5 04/04/2014 04/04/2014 04/03/2017 DTaP 06/04/2011



2013-0121

invalid dose 1-2 interval in midst of others 02/11/2009 F Not Comple 04/11/2009 PEDIARIX 110 SKB Valid 04/30/2009 PEDIARIX 110 SKB Not Valid




2013-0122

invalid dose 2-3 interval in midst of others 02/02/2010 F Not Comple 04/02/2010 PEDIARIX 110 SKB Valid 06/02/2010 PEDIARIX 110 SKB Valid 06/25/2010 PEDIARIX 110 SKB Not Valid




2013-0123

# 1 Pediarix at 6 wks 11/01/2011 F Not Comple 12/13/2011 PEDIARIX 110 SKB Valid 2 01/10/2012 03/01/2012 04/28/2012 DTaP 12/13/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0124

inValid dose 3-4 interval in midst of others 03/18/2008 F Not Comple 05/18/2008 PEDIARIX 110 SKB Valid 07/18/2008 PEDIARIX 110 SKB Valid 02/12/2009 PEDIARIX 110 SKB Valid 06/10/2009 PEDIARIX 110 SKB Not Valid





2013-0125

Encephalopathy within 7 days of Pediarix. 02/02/2011 F

encephalopathy within 7 days of previous dose of DTP or DTaP VXC22 CDCPHINVS Not Comple 04/02/2011 PEDIARIX 110 SKB Valid 2 04/30/2011 06/02/2011 07/29/2011 DTaP 04/02/2011



2013-0126

Anaphylaxis to previous dose of Pediarix 10/10/2010 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 12/15/2010 PEDIARIX 110 SKB Valid - DTaP 12/15/2010



2013-0127

# 1 Pediarix at 6 yrs 11.5 mo 04/01/2005 F Not Comple 03/16/2012 PEDIARIX 110 SKB Valid 2 04/13/2012 04/13/2012 04/13/2012 DTaP 03/16/2012



2013-0128

# 1 Pediarix at 7 yrs 02/01/2005 F Not Comple 02/01/2012 PEDIARIX 110 SKB Valid 2 02/29/2012 02/29/2012 02/29/2012 DTaP 02/01/2012



2013-0129

# 2 Pediarix at 10 wks-5 days. 10/10/2011 F Not Comple 11/17/2011 PEDIARIX 110 SKB Valid 12/14/2011 PEDIARIX 110 SKB Not Valid




2013-0130

# 2 Pediarix at 10 wks-4 days 02/26/2011 F Not Comple 04/09/2011 PEDIARIX 110 SKB Valid 05/03/2011 PEDIARIX 110 SKB Valid 3 06/04/2011 08/26/2011 10/23/2011 DTaP 05/03/2011



2013-0131

# 2 Pediarix at 10 wks 02/26/2011 F Not Comple 04/09/2011 PEDIARIX 110 SKB Valid 05/07/2011 PEDIARIX 110 SKB Valid 3 06/04/2011 08/26/2011 10/23/2011 DTaP 05/07/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0132 Newborn 02/01/2012 F Not Complete 1 03/14/2012 04/01/2012 05/28/2012 DTaP 02/01/2012



2013-0133

# 2 Pentacel at 6 yrs 11.5 mo. Off label but counts. Current Age 7 years 01/01/2005 F Not Comple 09/22/2007 PENTACEL 120 PMC Valid 12/15/2011 PENTACEL 120 PMC Valid 3 01/01/2012 01/01/2012 01/01/2012 DTaP 01/01/2012



Past Due Date was missing and child is in catch-up. Past Due Date added to align with Recommended Date.Interval Priority Flag with Override allows for a vaccine to be given sooner than a previous date set by multiple vaccines. 2.2

2013-0134

# 2 Pentacel at 7 yrs; # 1 at age < 12 mo 09/16/2003 F Not Comple 02/25/2004 DTaP Unsp 107 Valid 09/20/2010 PENTACEL 120 PMC Valid 3 10/18/2010 10/18/2010 10/18/2010 DTaP 09/20/2010




2013-0135

# 2 Pentacel at 7 yrs; # 1 at age ≥ 12 mo. 09/16/2004 F Not Comple 11/19/2005 DTaP Unsp 107 Valid 09/20/2011 PENTACEL 120 PMC Valid 3 03/20/2012 03/20/2012 03/20/2012 DTaP 09/20/2011




2013-0136

# 3 Pentacel at 14 wks-5 days 06/01/2010 F Not Comple 07/09/2010 PENTACEL 120 PMC Valid 08/06/2010 PENTACEL 120 PMC Valid 09/02/2010 PENTACEL 120 PMC Not Valid




2013-0137

# 3 Pentacel at 14 wks-4 days 06/01/2010 F Not Comple 07/09/2010 PENTACEL 120 PMC Valid 08/06/2010 PENTACEL 120 PMC Valid 09/03/2010 PENTACEL 120 PMC Valid 4 06/01/2011 09/01/2011 01/28/2012 DTaP 09/03/2010



2013-0138

# 3 Pentacel at 6 yrs 11.5 mo 01/15/2005 F Not Comple 03/12/2005 DTaP Unsp 107 Valid 06/15/2008 DTaP Unsp 107 Valid 12/30/2011 PENTACEL 120 PMC Valid 4 06/30/2012 06/30/2012 06/30/2012 DTaP 12/30/2011




2013-0139

# 4 Pentacel at 1 yr -5 days. 04/04/2010 F Not Comple 06/04/2010 PENTACEL 120 PMC Valid 08/04/2010 PENTACEL 120 PMC Valid 10/04/2010 PENTACEL 120 PMC Valid 03/30/2011 PENTACEL 120 PMC Not Valid




2013-0140

# 4 Pentacel at 1 yr -4 days 04/04/2010 F Not Comple 06/04/2010 PENTACEL 120 PMC Valid 08/04/2010 PENTACEL 120 PMC Valid 10/04/2010 PENTACEL 120 PMC Valid 03/31/2011 PENTACEL 120 PMC Valid 5 04/04/2014 04/04/2014 04/03/2017 DTaP 03/31/2011



2013-0141

# 4 Pentacel at age 12 mo 04/04/2010 F Not Comple 06/04/2010 PENTACEL 120 PMC Valid 08/04/2010 PENTACEL 120 PMC Valid 10/04/2010 PENTACEL 120 PMC Valid 04/04/2011 PENTACEL 120 PMC Valid 5 04/04/2014 04/04/2014 04/03/2017 DTaP 04/04/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0142

# 4 Pentacel at 4 yrs 05/06/2006 F Not Comple 09/15/2006 PENTACEL 120 PMC Valid 04/28/2007 PENTACEL 120 PMC Valid 11/02/2009 PENTACEL 120 PMC Valid 05/06/2010 PENTACEL 120 PMC Valid 5 05/06/2017 05/06/2017 05/05/2019 DTaP 05/06/2010




2013-0143

# 5 Pentacel at ≥ 4 yrs 02/08/2008 F Not Comple 01/08/2009 PENTACEL 120 PMC Valid 04/08/2009 PENTACEL 120 PMC Valid 07/08/2009 PENTACEL 120 PMC Valid 12/09/2009 PENTACEL 120 PMC Valid 03/01/2012 PENTACEL 120 PMC Valid 6 02/08/2019 02/08/2019 02/07/2021 DTaP 03/01/2012




2013-0144

# 4 Pentacel at 5 yrs=off label but counts. 02/08/2007 F Not Comple 06/08/2007 PENTACEL 120 PMC Valid 12/05/2007 PENTACEL 120 PMC Valid 02/07/2008 PENTACEL 120 PMC Valid 02/08/2012 PENTACEL 120 PMC Valid 5 02/08/2018 02/08/2018 02/07/2020 DTaP 02/08/2012




2013-0145

invalid age dose 2 in midst of others 10/18/2010 F Not Comple 11/25/2010 PENTACEL 120 PMC Valid 12/22/2010 PENTACEL 120 PMC Not Valid

Age: Too Young 03/10/2011 PENTACEL 120 PMC Valid 10/20/2011 PENTACEL 120 PMC Valid 4 04/20/2012 04/20/2012 06/14/2012 DTaP 10/20/2011



2013-0146

invalid age dose 3 in midst of others 06/01/2010 F Not Comple 07/09/2010 PENTACEL 120 PMC Valid 08/06/2010 PENTACEL 120 PMC Valid 09/02/2010 PENTACEL 120 PMC Not Valid

Age: Too Young 07/07/2011 PENTACEL 120 PMC Valid 4 01/07/2012 01/07/2012 01/28/2012 DTaP 07/07/2011



2013-0147

dose 1 to 2 Pentacel, interval 28-5 days 11/09/2009 F Not Comple 01/03/2010 PENTACEL 120 PMC Valid 01/26/2010 PENTACEL 120 PMC Not Valid




2013-0148

dose 1 to 2 Pentacel, interval 28-4 days 11/01/2009 F Not Comple 01/03/2010 PENTACEL 120 PMC Valid 01/27/2010 PENTACEL 120 PMC Valid 3 02/24/2010 05/01/2010 06/28/2010 DTaP 01/27/2010



2013-0149

dose 2 to 3 Pentacel, interval 28-5 days 04/01/2008 F Not Comple 06/01/2008 PENTACEL 120 PMC Valid 08/01/2008 PENTACEL 120 PMC Valid 08/24/2008 PENTACEL 120 PMC Not Valid




2013-0150

dose 2 to 3 Pentacel, interval 28-4 days 04/01/2008 F Not Comple 06/01/2008 PENTACEL 120 PMC Valid 08/01/2008 PENTACEL 120 PMC Valid 08/25/2008 PENTACEL 120 PMC Valid 4 04/01/2009 07/01/2009 11/28/2009 DTaP 08/25/2008



2013-0152

# 1 Pentacel at 6 wks-4 days 04/04/2008 F Not Comple 05/12/2008 PENTACEL 120 PMC Valid 2 06/13/2008 08/04/2008 10/01/2008 DTaP 05/12/2008



2013-0153

dose 3 to 4 Pentacel, interval 6m-4 days 08/09/2009 F Not Comple 10/09/2009 PENTACEL 120 PMC Valid 02/09/2010 PENTACEL 120 PMC Valid 04/09/2010 PENTACEL 120 PMC Valid 10/05/2010 PENTACEL 120 PMC Valid 5 08/09/2013 08/09/2013 08/08/2016 DTaP 10/05/2010



2013-0154

dose 3 to 4 Pentacel, interval 4 mo-1 day. 04/04/2010 F Not Comple 06/04/2010 PENTACEL 120 PMC Valid 10/10/2010 PENTACEL 120 PMC Valid 01/15/2011 PENTACEL 120 PMC Valid 05/14/2011 PENTACEL 120 PMC Not Valid




2013-0155

dose 3 to 4 Pentacel, interval 4 mo. 04/04/2010 F Not Comple 06/04/2010 PENTACEL 120 PMC Valid 10/10/2010 PENTACEL 120 PMC Valid 01/15/2011 PENTACEL 120 PMC Valid 05/15/2011 PENTACEL 120 PMC Valid 5 04/04/2014 04/04/2014 04/03/2017 DTaP 05/15/2011



2013-0156

invalid dose 1-2 interval in midst of others 02/11/2009 F Not Comple 04/11/2009 PENTACEL 120 PMC Valid 05/04/2009 PENTACEL 120 PMC Not Valid

Interval: Too Short 08/01/2009 PENTACEL 120 PMC Valid 3 08/29/2009 08/29/2009 10/08/2009 DTaP 08/01/2009



2013-0157

invalid dose 2-3 interval in midst of others 02/02/2010 F Not Comple 04/02/2010 PENTACEL 120 PMC Valid 06/02/2010 PENTACEL 120 PMC Valid 06/23/2010 PENTACEL 120 PMC Not Valid




2013-0158

inValid dose 3-4 interval in midst of others 03/18/2008 F Not Comple 05/20/2008 PENTACEL 120 PMC Valid 07/25/2008 PENTACEL 120 PMC Valid 12/28/2009 PENTACEL 120 PMC Valid 03/22/2010 PENTACEL 120 PMC Not Valid





2013-0159

Encephalopathy on 8/3/10 (within 7 days of Pentacel) 06/06/2010 F

encephalopathy within 7 days of previous dose of DTP or DTaP VXC22 CDCPHINVS Not Comple 08/01/2010 PENTACEL 120 PMC Valid 2 08/29/2010 10/06/2010 12/03/2010 DTaP 08/01/2010



2013-0160

Anaphylaxis to previous dose of Pentacel 06/06/2010 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 08/02/2010 PENTACEL 120 PMC Valid - DTaP 08/02/2010



2013-0161

# 1 Pentacel at 6 wks 04/04/2008 F Not Comple 05/16/2008 PENTACEL 120 PMC Valid 2 06/13/2008 08/04/2008 10/01/2008 DTaP 05/16/2008

Age: At Minimum 01/01/2013 01/01/2013


2013-0162

# 1 Pentacel at 6 yrs 11.5 mo 01/15/2005 F Not Comple 01/02/2012 PENTACEL 120 PMC Valid 2 01/30/2012 01/30/2012 01/30/2012 DTaP 01/02/2012



2013-0163

# 1 Pentacel at 7 yrs. Off label use but counts as dose 1. 02/01/2005 F Not Comple 02/01/2012 PENTACEL 120 PMC Valid 2 02/29/2012 02/29/2012 02/29/2012 DTaP 02/01/2012




2013-0164

# 2 Pentacel at 10 wks-5 days 10/10/2010 F Not Comple 11/17/2010 PENTACEL 120 PMC Valid 12/14/2010 PENTACEL 120 PMC Not Valid




2013-0165

# 2 Pentacel at 10 wks-4 days 10/10/2010 F Not Comple 11/17/2010 PENTACEL 120 PMC Valid 12/15/2010 PENTACEL 120 PMC Valid 3 01/16/2011 04/10/2011 06/06/2011 DTaP 12/15/2010



2013-0166

# 2 Pentacel at 6 yrs . Off label but counts. 01/15/2005 F Not Comple 01/15/2006 PENTACEL 120 PMC Valid 01/15/2011 PENTACEL 120 PMC Valid 3 02/12/2011 02/12/2011 02/12/2011 DTaP 01/15/2011



2013-0167 Newborn 02/01/2015 F Not Complete 1 08/01/2015 08/01/2015 Flu 02/01/2015



Rolled test cases forward from 2014-15 season to 2015-16 season. 2.1

2013-0168

# 1 to # 2 interval 28 days 05/01/2014 F Not Comple 12/01/2014 Influenza U 88 Valid 12/29/2014 Influenza U 88 Valid 3 07/01/2015 07/01/2015 Flu 12/29/2014


Recommended based on seasonal start date


2013-0169

Child under 9 needs two in 1 first season 09/01/2008 F Not Comple 09/01/2015 FLUMIST 111 MED Valid 2 09/29/2015 09/29/2015 Flu 09/01/2015




2013-0170

Child under 9 received only one in first season 04/04/2009 F Not Comple 10/15/2015 Influenza U 88 Valid 2 11/12/2015 11/12/2015 Flu 10/15/2015




2013-0171

Child under 9 received two in first season 05/10/2008 F Not Comple 10/15/2014 Influenza U 88 Valid 11/27/2014 Influenza U 88 Valid 3 07/01/2015 07/01/2015 Flu 11/27/2014




2013-0172

Invalid dose 1st season 05/01/2015 F Not Comple 10/15/2015 Fluzone 141 PMC Not Valid

Age: Too Young 1 11/01/2015 11/01/2015 Flu 10/15/2015




2013-0175

LAIV given one week after MMR is invalid. 02/10/2014 F Not Comple 02/10/2016 M-M-R II 03 MSD Valid 02/17/2016 FLUMIST 111 MED Not Valid

Live Virus Conflict 1 03/16/2016 03/16/2016 Flu 02/17/2016

Live Virus: Below Minimum 01/01/2013 03/22/2016

Recommended based on minimum interval from live virus vaccine


2013-0176

Anaphylaxis following previous dose 07/04/2013 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 10/08/2014 Influenza U 88 Valid - Flu 10/08/2014




2013-0177# 1 at 6 mo-5 days 04/01/2015 F Not Comple 09/26/2015 FLUMIST 111 MED Not Valid

Age: Too Young 1 10/24/2015 10/24/2015 Flu 09/26/2015




2013-0178# 1 at 6 mo-4 days 04/01/2015 F Not Comple 09/27/2015 Influenza U 88 Valid 2 10/25/2015 10/25/2015 Flu 09/27/2015




2013-0179# 1 at 6 mo 04/01/2015 F Not Comple 10/01/2015 Influenza U 88 Valid 2 10/29/2015 10/29/2015 Flu 10/01/2015

Age: At Minimum 01/01/2013 03/22/2016



2013-0183

# 1 to # 2 interval 23 days 05/01/2015 F Not Comple 12/01/2015 Influenza U 88 Valid 12/24/2015 Influenza U 88 Not Valid

Interval: Too Short 2 01/21/2016 01/21/2016 Flu 12/24/2015




2013-0184

# 1 to # 2 interval 24 days 05/01/2014 F Not Comple 12/01/2014 Influenza U 88 Valid 12/25/2014 Influenza U 88 Valid 3 07/01/2015 07/01/2015 Flu 12/25/2014




2013-0185

Infant forecasting 07/10/2010 F Not Complete 1 07/10/2011 07/10/2011 08/06/2012 HepA 07/10/2010



2013-0186

Dose 1 to dose 2 interval 6 months. Series complete. 08/09/2009 F Complete 10/09/2010 Hep A Unsp 85 Valid 04/09/2011 Hep A Unsp 85 Valid - HepA 04/09/2011


Not recommended: series complete

2013-0187

Anaphylaxis to previous dose of Hep A. No forecast. 03/03/2003 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 03/04/2009 Hep A Unsp 85 Valid - HepA 03/04/2009



2013-0188

Adult dose mistakenly given to a child. Counts as valid. 02/02/2011 F Not Comple 02/02/2012 HAVRIX-AD 52 SKB Valid 2 08/02/2012 08/02/2012 03/01/2013 HepA 02/02/2012



Past Due Date was previously calculated based on an interval, but should have been calculated based on age of 24 months + 4 weeks - 1 day 1.1

2013-0189

Dose # 1 at age 12 months-5 days 12/01/2005 F Not Comple 11/26/2006 Hep A Unsp 85 Not Valid

Age: Too Young 1 12/01/2006 12/01/2006 12/28/2007 HepA 11/26/2006



2013-0190

Dose # 1 at age 12 months-4 days 06/01/2010 F Not Comple 05/28/2011 Hep A Unsp 85 Valid 2 12/01/2011 12/01/2011 06/28/2012 HepA 05/28/2011




2013-0191

Dose # 1 at age 12 months. 04/07/2010 F Not Comple 04/07/2011 Hep A Unsp 85 Valid 2 10/07/2011 10/07/2011 05/04/2012 HepA 04/07/2011

Age: At Minimum 01/01/2013 07/16/2013




2013-0192

Dose 1 to dose 2 interval 6 mo-5 days=invalid 11/10/2008 F Not Comple 11/10/2009 Hep A Unsp 85 Valid 05/05/2010 Hep A Unsp 85 Not Valid

Interval: Too Short 2 11/05/2010 11/05/2010 12/07/2010 HepA 05/05/2010




2013-0193

Dose 1 to Dose 2 interval 6 mo-4 days. Series complete. 04/04/2001 F Complete 04/04/2009 Hep A Unsp 85 Valid 09/30/2009 Hep A Unsp 85 Valid - HepA 09/30/2009



2013-0194

Dose # 2 at 18 months=series complete. 08/09/2009 F Complete 08/09/2010 Hep A Unsp 85 Valid 02/09/2011 Hep A Unsp 85 Valid - HepA 02/09/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0196

Dose 1 to dose 2 interval 6 mo-5 days 08/09/2009 F Not Comple 10/09/2010 Hep A Unsp 85 Valid 04/04/2011 Hep A Unsp 85 Not Valid

Interval: Too Short 2 10/04/2011 10/04/2011 10/04/2011 HepA 04/04/2011



Child is lapse enough that the Past Due Date should have been aligned with the earliest and recommended. 1.1

2013-0197

Dose 1 to dose 2 interval 6 months-4 days. Series complete. 08/09/2009 F Complete 10/09/2010 Hep A Unsp 85 Valid 04/05/2011 Hep A Unsp 85 Valid - HepA 04/05/2011



2013-0198

Newborn Testing. No vaccinations to date. 12/12/2011 F Not Complete 1 12/12/2011 12/12/2011 01/08/2012 HepB 12/12/2011



2013-0199

Dose 1 to dose 2 interval 28-5 days 04/01/2011 F Not Comple 05/01/2011 RECOMBIV 08 MSD Valid 05/24/2011 RECOMBIV 08 MSD Not Valid

Interval: Too Short 2 06/21/2011 06/21/2011 07/28/2011 HepB 05/24/2011



2013-0200

Dose 1 to dose 2 interval 28-4 days 04/01/2011 F Not Comple 04/01/2011 RECOMBIV 08 MSD Valid 04/25/2011 Hep B Unsp 45 Valid 3 09/16/2011 10/01/2011 11/28/2012 HepB 04/25/2011



2013-0201

Dose 1 to dose 2 interval 28 days 04/01/2011 F Not Comple 04/01/2011 RECOMBIV 08 MSD Valid 04/29/2011 RECOMBIV 08 MSD Valid 3 09/16/2011 10/01/2011 11/28/2012 HepB 04/29/2011



2013-0202

Dose 2 to dose 3 interval 8 wks-5 days. 4th dose needed. 06/01/2005 F Not Comple 09/01/2005 RECOMBIV 08 MSD Valid 12/01/2005 RECOMBIV 08 MSD Valid 01/21/2006 RECOMBIV 08 MSD Valid 4 03/18/2006 03/18/2006 01/28/2007 HepB 01/21/2006



v1.6: changed dose 3 from not valid to valid due to recent clarifications. Also changed test case name to reflect a 4th dose is required. 1.6

2013-0203

Dose 2 to dose 3 interval 8 wks-4 days. Series complete 02/11/2007 F Complete 03/01/2007 Hep B Unsp 45 Valid 08/01/2007 Hep B Unsp 45 Valid 09/22/2007 Hep B Unsp 45 Valid - HepB 09/22/2007



2013-0204

Dose 2 to dose 3 interval is 8 weeks. Series complete. 10/11/2006 F Complete 12/11/2006 Hep B Unsp 45 Valid 04/11/2007 Hep B Unsp 45 Valid 06/06/2007 Hep B Unsp 45 Valid - HepB 06/06/2007



2013-0205

Dose 1 to dose 3 interval 16 weeks-5 days. 4th dose needed 07/01/2004 F Not Comple 10/01/2004 Hep B Unsp 45 Valid 11/07/2004 RECOMBIV 08 MSD Valid 01/16/2005 RECOMBIV 08 MSD Valid 4 03/13/2005 03/13/2005 02/28/2006 HepB 01/16/2005



v1.6: changed dose 3 from not valid to valid due to recent clarifications. Also changed test case name to reflect a 4th dose is required.V1.1: Typo on Past Due Date by one day. 1.6

2013-0206

Dose 1 to dose 3 interval 16 weeks-4 days. Series complete. 07/04/2009 F Complete 10/01/2009 Hep B Unsp 45 Valid 11/24/2009 Hep B Unsp 45 Valid 01/17/2010 RECOMBIV 08 MSD Valid - HepB 01/17/2010



2013-0207

Dose 1 to dose 3 interval 16 weeks. Series complete. 08/01/2011 F Complete 11/01/2011 Hep B Unsp 45 Valid 12/17/2011 Hep B Unsp 45 Valid 02/21/2012 Hep B Unsp 45 Valid - HepB 02/21/2012



2013-0208

Recombivax Hep B ages 11-15. Dose 2 recommended in 4-6 months. 05/05/1999 F Not Comple 11/25/2011 RECOMBIV 43 MSD Valid 2 03/25/2012 03/25/2012 07/22/2012 HepB 11/25/2011



2013-0209

Dose # 1 at age 0 days. 04/01/2011 F Not Comple 04/01/2011 Hep B Unsp 45 Valid 2 04/29/2011 05/01/2011 07/28/2011 HepB 04/01/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0210

Doses 1 and 2 of Recombvx at ages 11-15 years with ≥ 4 mo interval = series complete. 04/07/1997 F Complete 10/13/2009 RECOMBIV 43 MSD Valid 02/13/2010 RECOMBIV 43 MSD Valid - HepB 02/13/2010



2013-0211

Dose 1 to dose 2 Recombvx interval 4 months-5 days. Two dose adolescent schedule no longer applies. 05/01/1996 F Not Comple 05/01/2007 RECOMBIV 43 MSD Valid 08/27/2007 RECOMBIV 43 MSD Valid 3 10/22/2007 10/22/2007 10/22/2007 HepB 08/27/2007



2013-0212

Dose 2 to dose 3 interval 8 wks-5 days in adolescent with two Recombvx not meeting rules for two dose adoles. 4th dose needed 05/01/1992 F Not Comple 09/01/2005 RECOMBIV 43 MSD Valid 12/01/2005 RECOMBIV 43 MSD Valid 01/21/2006 RECOMBIV 08 MSD Valid 4 03/18/2006 03/18/2006 03/18/2006 HepB 01/21/2006




2013-0213

Hep at birth. Comvax at 6 wks and 6 mo. Hep series complete. 02/04/2004 F Complete 02/04/2004 RECOMBIV 08 MSD Valid 03/13/2004 COMVAX 51 MSD Valid 08/04/2004 COMVAX 51 MSD Valid - HepB 08/04/2004



2013-0216

Hep B at birth. Comvax at 4 weeks and 6 months. Series complete for Hep B. 02/02/2006 F Complete 02/02/2006 Hep B Unsp 45 Valid 03/02/2006 COMVAX 51 MSD Valid 08/02/2006 COMVAX 51 MSD Valid - HepB 08/02/2006



2013-0219

Hep B at birth. Comvax at 5 mo and 8 wks-4 days later. Series complete for Hep B. 05/05/2006 F Complete 05/05/2006 RECOMBIV 08 MSD Valid 10/05/2006 COMVAX 51 MSD Valid 11/26/2006 COMVAX 51 MSD Valid - HepB 11/26/2006




2013-0220

Dose # 1 at age 1 day 04/01/2011 F Not Comple 04/02/2011 RECOMBIV 08 MSD Valid 2 04/30/2011 05/01/2011 07/28/2011 HepB 04/02/2011



2013-0221

Hep at birth. Comvax at 5 mo and 8 wks later. Series complete for Hep B. 06/06/2006 F Complete 06/06/2006 RECOMBIV 08 MSD Valid 11/06/2006 COMVAX 51 MSD Valid 01/01/2007 COMVAX 51 MSD Valid - HepB 01/01/2007



2013-0222

Dose 1 to dose 3 interval of Comvax 16 wks-5 days. 4th dose needed 05/15/2002 F Not Comple 08/01/2002 COMVAX 51 MSD Valid 09/20/2002 COMVAX 51 MSD Valid 11/16/2002 COMVAX 51 MSD Valid 4 01/11/2003 01/11/2003 01/11/2004 HepB 11/16/2002




2013-0223

Dose 1 to dose 3 interval of Comvax 16 wks-4 days=valid Hep B # 3. Hep B series complete. 07/07/2006 F Complete 10/18/2006 COMVAX 51 MSD Valid 12/09/2006 COMVAX 51 MSD Valid 02/03/2007 COMVAX 51 MSD Valid - HepB 02/03/2007



2013-0224

Dose 1 to dose 3 interval of Comvax is 16 weeks. Series complete for Hep B. 08/08/2006 F Complete 10/31/2006 COMVAX 51 MSD Valid 12/22/2006 COMVAX 51 MSD Valid 02/20/2007 COMVAX 51 MSD Valid - HepB 02/20/2007



2013-0225

Comvax given at birth. 10/10/2006 F Not Comple 10/10/2006 COMVAX 51 MSD Valid 2 11/07/2006 11/10/2006 02/06/2007 HepB 10/10/2006

Age: At Minimum 01/01/2013 01/01/2013


2013-0226

Anaphylaxis to previous dose of Hep B. No further forecast. 09/09/2006 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 11/11/2006 RECOMBIV 08 MSD Valid - HepB 11/11/2006



2013-0227

Dose # 2 at 28-5 days 08/01/2010 F Not Comple 08/01/2010 RECOMBIV 08 MSD Valid 08/24/2010 RECOMBIV 08 MSD Not Valid

Age: Too Young 2 09/21/2010 09/21/2010 11/28/2010 HepB 08/24/2010



2013-0228

Dose # 2 at 28-4 days 02/01/2011 F Not Comple 02/01/2011 Hep B Unsp 45 Valid 02/25/2011 RECOMBIV 08 MSD Valid 3 07/19/2011 08/01/2011 09/28/2012 HepB 02/25/2011



2013-0229Dose # 2 at 28 days 05/01/2011 F Not Comple 05/01/2011 Hep B Unsp 45 Valid 05/29/2011 Hep B Unsp 45 Valid 3 10/16/2011 11/01/2011 12/28/2012 HepB 05/29/2011



2013-0230

Dose # 3 at age 24 weeks-5 days. 4th dose needed. 01/01/2011 F Not Comple 01/01/2011 Hep B Unsp 45 Valid 02/01/2011 Hep B Unsp 45 Valid 06/13/2011 Hep B Unsp 45 Valid 4 08/08/2011 08/08/2011 08/28/2012 HepB 06/13/2011




2013-0231

Dose # 3 at age 24 weeks-4 days. Series complete. 12/01/2010 F Complete 12/01/2010 RECOMBIV 08 MSD Valid 01/01/2011 RECOMBIV 08 MSD Valid 05/14/2011 RECOMBIV 08 MSD Valid - HepB 05/14/2011



2013-0232

Dose # 3 at 24 weeks. Series complete. 04/01/2011 F Complete 04/01/2011 RECOMBIV 08 MSD Valid 06/01/2011 Hep B Unsp 45 Valid 09/16/2011 Hep B Unsp 45 Valid - HepB 09/16/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0233

Newborn forecasting 04/01/2012 F Not Complete 1 04/01/2012 04/01/2012 04/28/2012 HepB 04/01/2012



2013-0234

# 2 Pediarix at 6 yrs 11.5 mo 01/01/2005 F Not Comple 12/16/2007 PEDIARIX 110 SKB Valid 12/15/2011 PEDIARIX 110 SKB Valid 3 02/09/2012 02/09/2012 02/09/2012 HepB 12/15/2011



2013-0235

# 2 Pediarix at 7 yrs; # 1 at less than 12 mo. 09/16/2003 F Not Comple 12/16/2003 PEDIARIX 110 SKB Valid 09/16/2010 PEDIARIX 110 SKB Valid 3 11/11/2010 11/11/2010 11/11/2010 HepB 09/16/2010



2013-0236

# 2 Pediarix at 7 yrs; # 1 ≥ 12 mo. 09/16/2004 F Not Comple 10/16/2005 PEDIARIX 110 SKB Valid 09/16/2011 PEDIARIX 110 SKB Valid 3 11/11/2011 11/11/2011 11/11/2011 HepB 09/16/2011



2013-0237

# 1 and 2 Pediarix at ≥7 yrs with 28 day interval. 07/07/2002 F Not Comple 07/07/2009 PEDIARIX 110 SKB Valid 08/04/2009 PEDIARIX 110 SKB Valid 3 10/27/2009 10/27/2009 10/27/2009 HepB 08/04/2009



2013-0238

# 3 Pediarix at 14 wks-5 days 06/01/2005 F Not Comple 07/09/2005 PEDIARIX 110 SKB Valid 08/06/2005 PEDIARIX 110 SKB Valid 09/02/2005 PEDIARIX 110 SKB Valid 4 11/16/2005 12/01/2005 01/28/2007 HepB 09/02/2005



2013-0239

# 3 Pediarix at 14 wks-4 days 01/06/2006 F Not Comple 02/15/2006 PEDIARIX 110 SKB Valid 03/15/2006 PEDIARIX 110 SKB Valid 04/10/2006 PEDIARIX 110 SKB Valid 4 06/23/2006 07/06/2006 09/02/2007 HepB 04/10/2006



2013-0241

# 3 Pediarix at 24 weeks-4 days. Valid for dose 3 05/13/2011 F Complete 06/24/2011 Hep B Unsp 45 Valid 08/24/2011 Hep B Unsp 45 Valid 10/24/2011 PEDIARIX 110 SKB Valid - HepB 10/24/2011



2013-0243

# 4 Pediarix at 1 yr -5 days 04/04/2010 F Complete 06/04/2010 PEDIARIX 110 SKB Valid 08/04/2010 PEDIARIX 110 SKB Valid 10/10/2010 PEDIARIX 110 SKB Valid 03/30/2011 PEDIARIX 110 SKB Extraneous

Series Already Complete - HepB 03/30/2011

Extra Doses 01/01/2013 01/01/2013


2013-0244

# 1 Pediarix at 6 wks-5 days 05/06/2011 F Not Comple 06/12/2011 PEDIARIX 110 SKB Valid 2 07/10/2011 07/10/2011 09/02/2011 HepB 06/12/2011



2013-0245

# 4 Pediarix at 1 yr -4 days 06/01/2005 F Complete 08/01/2005 PEDIARIX 110 SKB Valid 11/01/2005 PEDIARIX 110 SKB Valid 01/15/2006 PEDIARIX 110 SKB Valid 05/28/2006 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0246

# 4 Pediarix at 3 yrs 11.5 mo. 02/01/2008 F Complete 04/01/2008 PEDIARIX 110 SKB Valid 07/01/2008 PEDIARIX 110 SKB Valid 10/01/2008 PEDIARIX 110 SKB Valid 01/15/2012 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0247

# 4 Pediarix at 4 yrs 05/06/2006 F Complete 09/09/2006 PEDIARIX 110 SKB Valid 03/03/2007 PEDIARIX 110 SKB Valid 07/10/2008 PEDIARIX 110 SKB Valid 05/06/2010 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0248

# 5 Pediarix at 4 yrs -5 days 07/01/2006 F Complete 09/01/2006 PEDIARIX 110 SKB Valid 10/01/2006 PEDIARIX 110 SKB Valid 02/02/2007 PEDIARIX 110 SKB Valid 10/10/2007 PEDIARIX 110 SKB Extraneous

Series Already Complete 06/26/2010 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0249

# 5 Pediarix at 4 yrs -4 days 07/01/2006 F Complete 09/01/2006 PEDIARIX 110 SKB Valid 10/01/2006 PEDIARIX 110 SKB Valid 02/02/2007 PEDIARIX 110 SKB Valid 10/10/2007 PEDIARIX 110 SKB Extraneous



Extra Doses 01/01/2013 01/01/2013


2013-0250

# 5 Pediarix at 6 yrs 11.5 mo 04/01/2005 F Complete 06/01/2005 PEDIARIX 110 SKB Valid 08/01/2005 PEDIARIX 110 SKB Valid 10/01/2005 PEDIARIX 110 SKB Valid 05/01/2006 PEDIARIX 110 SKB Extraneous



Extra Doses 01/01/2013 01/01/2013


2013-0251

# 5 Pediarix at 7 yrs 05/01/2005 F Complete 08/01/2005 PEDIARIX 110 SKB Valid 11/01/2005 PEDIARIX 110 SKB Valid 02/01/2006 PEDIARIX 110 SKB Valid 11/16/2006 PEDIARIX 110 SKB Extraneous



Extra Doses 01/01/2013 01/01/2013



2013-0255

# 1 Pediarix at 6 wks-4 days 04/04/2006 F Not Comple 05/12/2006 PEDIARIX 110 SKB Valid 2 06/09/2006 06/09/2006 07/31/2006 HepB 05/12/2006



2013-0256


Interval: Too Short 2 02/23/2011 02/23/2011 02/28/2011 HepB 01/26/2011



2013-0257

dose 1 to 2 Pediarix, interval 28-4 days 02/01/2006 F Not Comple 04/01/2006 PEDIARIX 110 SKB Valid 04/25/2006 PEDIARIX 110 SKB Valid 3 07/22/2006 08/01/2006 09/28/2007 HepB 04/25/2006



2013-0258

dose 2 to 3 Pediarix, interval 8 weeks-5 days. 4th dose needed. 04/01/2011 F Not Comple 05/25/2011 PEDIARIX 110 SKB Valid 07/27/2011 PEDIARIX 110 SKB Valid 09/16/2011 PEDIARIX 110 SKB Valid 4 11/11/2011 11/11/2011 11/28/2012 HepB 09/16/2011




2013-0259

dose 2 to 3 Pediarix, interval 8 weeks-4 days 12/01/2005 F Complete 01/25/2006 PEDIARIX 110 SKB Valid 03/27/2006 PEDIARIX 110 SKB Valid 05/18/2006 PEDIARIX 110 SKB Valid - HepB 05/18/2006



2013-0260

dose 3 to 4 Pediarix, interval 6m-5 days 08/09/2009 F Complete 10/09/2009 PEDIARIX 110 SKB Valid 12/09/2009 PEDIARIX 110 SKB Valid 04/09/2010 PEDIARIX 110 SKB Valid 10/04/2010 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0261

dose 3 to 4 Pediarix, interval 6m-4 days 08/09/2009 F Complete 10/09/2009 PEDIARIX 110 SKB Valid 12/09/2009 PEDIARIX 110 SKB Valid 04/09/2010 PEDIARIX 110 SKB Valid 10/05/2010 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0262

dose 3 to 4 Pediarix, interval 4 mo-1 day 04/04/2010 F Complete 06/04/2010 PEDIARIX 110 SKB Valid 08/04/2010 PEDIARIX 110 SKB Valid 02/04/2011 PEDIARIX 110 SKB Valid 06/03/2011 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0263

dose 3 to 4 Pediarix, interval 4 mo 04/04/2010 F Complete 06/04/2010 PEDIARIX 110 SKB Valid 08/04/2010 PEDIARIX 110 SKB Valid 02/04/2011 PEDIARIX 110 SKB Valid 06/04/2011 PEDIARIX 110 SKB Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0264


Interval: Too Short 06/11/2009 PEDIARIX 110 SKB Valid 3 08/06/2009 08/11/2009 10/08/2010 HepB 06/11/2009



2013-0266

# 1 Pediarix at 6 wks 11/01/2011 F Not Comple 12/13/2011 PEDIARIX 110 SKB Valid 2 01/10/2012 01/10/2012 02/28/2012 HepB 12/13/2011



2013-0267

# 1 Pediarix at 6 yrs 11.5 mo 04/01/2005 F Not Comple 03/16/2012 PEDIARIX 110 SKB Valid 2 04/13/2012 04/13/2012 04/13/2012 HepB 03/16/2012



2013-0268

# 1 Pediarix at 7 yrs 02/01/2005 F Not Comple 02/01/2012 PEDIARIX 110 SKB Valid 2 02/29/2012 02/29/2012 02/29/2012 HepB 02/01/2012



2013-0269

# 2 Pediarix at 10 wks-5 days 10/10/2011 F Not Comple 11/17/2011 PEDIARIX 110 SKB Valid 12/14/2011 PEDIARIX 110 SKB Valid 3 03/26/2012 04/10/2012 06/06/2013 HepB 12/14/2011



2013-0270

# 2 Pediarix at 10 wks-4 days 02/26/2011 F Not Comple 03/26/2011 PEDIARIX 110 SKB Valid 05/03/2011 PEDIARIX 110 SKB Valid 3 08/13/2011 08/26/2011 10/23/2012 HepB 05/03/2011



2013-0271

# 2 Pediarix at 10 wks 02/26/2011 F Not Comple 03/26/2011 PEDIARIX 110 SKB Valid 05/07/2011 PEDIARIX 110 SKB Valid 3 08/13/2011 08/26/2011 10/23/2012 HepB 05/07/2011



2013-0273

Child<2 months, no shots, #1 forecasted at 2 months of age 01/01/2010 F Not Complete 1 02/12/2010 03/01/2010 04/28/2010 Hib 01/01/2010



2013-0274

# 1 at 6 wks-5 days 01/01/2010 F Not Comple 02/07/2010 ACTHIB 48 PMC Not Valid

Age: Too Young 1 02/12/2010 03/01/2010 04/28/2010 Hib 02/07/2010



2013-0275

# 1 at 6 wks-4 days 01/01/2010 F Not Comple 02/08/2010 ACTHIB 48 PMC Valid 2 03/12/2010 05/01/2010 06/28/2010 Hib 02/08/2010



2013-0276

# 1 at 6 wks -3 days 01/01/2010 F Not Comple 02/09/2010 ACTHIB 48 PMC Valid 2 03/12/2010 05/01/2010 06/28/2010 Hib 02/09/2010



2013-0277# 1 at 3 months 01/01/2010 F Not Comple 04/01/2010 ACTHIB 48 PMC Valid 2 04/29/2010 05/01/2010 06/28/2010 Hib 04/01/2010



2013-0278

#1 at 3 months and 3 days-catchup- #2 recommended at +28 days 01/01/2010 F Not Comple 04/04/2010 ACTHIB 48 PMC Valid 2 05/02/2010 05/02/2010 06/28/2010 Hib 04/04/2010



2013-0279

#1 at 6 months - catchup- #2 recommended at +28 days 01/01/2010 F Not Comple 07/01/2010 ACTHIB 48 PMC Valid 2 07/29/2010 07/29/2010 07/29/2010 Hib 07/01/2010



2013-0280

#1 at 7 and <11 months - catchup- drop to 3 dose schedule 01/01/2010 F Not Comple 08/01/2010 ACTHIB 48 PMC Valid 2 08/29/2010 08/29/2010 08/29/2010 Hib 08/01/2010



2013-0281

#1 at 12 months, drop to 2-dose schedule 01/01/2010 F Not Comple 01/01/2011 ACTHIB 48 PMC Valid 2 02/26/2011 02/26/2011 02/26/2011 Hib 01/01/2011



Past Due Date was incorrect. Should be in alignment with the earliest and recommended. Child is in catch-up schedule. 1.1

2013-0282

#1 at 15m -drop to 1 dose schedule 01/01/2010 F Complete 04/01/2011 ACTHIB 48 PMC Valid - Hib 04/01/2011



2013-0283

#1 at 3 years -drop to 1 dose schedule 01/01/2008 F Complete 01/01/2011 ACTHIB 48 PMC Valid - Hib 01/01/2011




2013-0284#1 at 5 years 01/01/2006 F Aged Out 01/01/2011 ACTHIB 48 PMC Extraneous

Age: Too Old - Hib 01/01/2011

Age: Too Old 01/01/2013 11/07/2014

Not recommended: too old

v1.6: Updated Series Status from "Not Complete" to "Aged Out" to align with updated CDSi Logic Specification Series Statuses.

v1.2:Within the scope of the CDSi effort, Hib on or after 5 years is not recommended. The last administered dose was changed to Extraneou 1.6

2013-0285#1 at 7 years 01/01/2005 F Aged Out 01/01/2012 ACTHIB 48 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014



v1.2: Within the scope of the CDSi effort, Hib on or after 5 years is not recommended. The last administered dose was changed to Extraneou 1.6

2013-0286

# 2 at 10 wks-5 days 01/01/2010 F Not Comple 02/08/2010 ACTHIB 48 PMC Valid 03/07/2010 ACTHIB 48 PMC Not Valid

Age: Too Young 2 04/04/2010 05/01/2010 06/28/2010 Hib 03/07/2010



2013-0287

# 2 at 10 wks-4 days 01/01/2010 F Not Comple 02/08/2010 ACTHIB 48 PMC Valid 03/08/2010 ACTHIB 48 PMC Valid 3 04/09/2010 07/01/2010 08/28/2010 Hib 03/08/2010



2013-0288

# 2 at 10 wks -3 days 01/01/2010 F Not Comple 02/08/2010 ACTHIB 48 PMC Valid 03/09/2010 ACTHIB 48 PMC Valid 3 04/09/2010 07/01/2010 08/28/2010 Hib 03/09/2010



2013-0289# 2 at 4 months 01/01/2005 F Not Comple 03/01/2005 ACTHIB 48 PMC Valid 05/01/2005 ACTHIB 48 PMC Valid 3 05/29/2005 07/01/2005 08/28/2005 Hib 05/01/2005



2013-0290#2 at 5 months 01/01/2005 F Not Comple 03/01/2005 ACTHIB 48 PMC Valid 06/01/2005 ACTHIB 48 PMC Valid 3 06/29/2005 07/01/2005 08/28/2005 Hib 06/01/2005



2013-0291

#2 at 5 months and 3 days-catchup-#3 at +28 days 01/01/2005 F Not Comple 03/01/2005 ACTHIB 48 PMC Valid 06/04/2005 ACTHIB 48 PMC valid 3 07/02/2005 07/02/2005 08/28/2005 Hib 06/04/2005



2013-0292#2 at 12 m - 5 days 01/01/2005 F Not Comple 03/01/2005 ACTHIB 48 PMC Valid 12/27/2005 ACTHIB 48 PMC Valid 3 01/24/2006 01/24/2006 01/24/2006 Hib 12/27/2005



2013-0293

#2 at 12 m - 4 days drop to 3-dose schedule 01/01/2005 F Not Comple 03/01/2005 ACTHIB 48 PMC Valid 12/28/2005 ACTHIB 48 PMC Valid 3 02/22/2006 02/22/2006 05/28/2006 Hib 12/28/2005



2013-0294#2 at 15 months 01/01/2010 F Complete 03/01/2010 ACTHIB 48 PMC Valid 04/01/2011 ACTHIB 48 PMC Valid - Hib 04/01/2011



2013-0295#2 at 5 years 01/01/2007 F Aged Out 03/01/2007 ACTHIB 48 PMC Valid 01/01/2012 ACTHIB 48 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0296

dose 1 to 2, interval 4 weeks -5 days 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 03/24/2010 ACTHIB 48 PMC Not Valid

Interval: Too Short 2 04/21/2010 05/01/2010 06/28/2010 Hib 03/24/2010



2013-0297

dose 1 to 2, interval 4 weeks -4 days 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 03/25/2010 ACTHIB 48 PMC Valid 3 04/22/2010 07/01/2010 08/28/2010 Hib 03/25/2010



2013-0298

dose 1 to 2, interval 4 weeks -3 days 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 03/26/2010 ACTHIB 48 PMC Valid 3 04/23/2010 07/01/2010 08/28/2010 Hib 03/26/2010



2013-0299

#3 at 14 weeks-5 days 01/01/2010 F Not Comple 02/10/2010 ACTHIB 48 PMC Valid 03/08/2010 ACTHIB 48 PMC Valid 04/04/2010 ACTHIB 48 PMC Not Valid

Age: Too Young 3 05/02/2010 07/01/2010 08/28/2010 Hib 04/04/2010



Changed Doses 2 and 3 to be ACTHIB rather than PRP-OMP vaccines to avoid possible confusion with PRP-OMP product specific schedule 1.1

2013-0300#3 at 6 months 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 COMVAX 51 MSD Valid 07/01/2010 HIBTITER 47 WAL Valid 4 01/01/2011 01/01/2011 05/28/2011 Hib 07/01/2010



2013-0301

Dose 2 to 3, interval 4 weeks-5 days 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 COMVAX 51 MSD Valid 05/24/2010 ACTHIB 48 PMC Not Valid




2013-0302

Dose 2 to 3, interval 4 weeks -4 days 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 COMVAX 51 MSD Valid 05/25/2010 ACTHIB 48 PMC Valid 4 01/01/2011 01/01/2011 05/28/2011 Hib 05/25/2010



2013-0303

Dose 2 to 3, interval 4 weeks 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 HIBTITER 47 WAL Valid 05/29/2010 HIBTITER 47 WAL Valid 4 01/01/2011 01/01/2011 05/28/2011 Hib 05/29/2010



2013-0304

#4 at 360 days of age, interval between #3-4 >8 weeks 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 07/01/2010 ACTHIB 48 PMC Valid 12/27/2010 ACTHIB 48 PMC Not Valid

Age: Too Young 4 02/21/2011 02/21/2011 05/28/2011 Hib 12/27/2010



2013-0305

#4 at 361 days of age, interval between #3-4 >8 weeks 01/01/2010 F Complete 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 07/01/2010 ACTHIB 48 PMC Valid 12/28/2010 ACTHIB 48 PMC Valid - Hib 12/28/2010




2013-0306

#4 at 362 days of age, interval between #3-4 >8 weeks 01/01/2010 F Complete 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 07/01/2010 ACTHIB 48 PMC Valid 12/29/2010 ACTHIB 48 PMC Valid - Hib 12/29/2010



2013-0307

#4 at 15 months of age, interval between #3-4 > 8 weeks 01/01/2010 F Complete 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 07/01/2010 ACTHIB 48 PMC Valid 04/01/2011 ACTHIB 48 PMC Valid - Hib 04/01/2011



2013-0308

#4 at 365 days of age, interval between #3-4 8 weeks -5 days 01/01/2010 F Not Comple 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 11/11/2010 ACTHIB 48 PMC Valid 01/01/2011 ACTHIB 48 PMC Not Valid




2013-0309

#4 at 365 days of age, interval between #3-4 >8 weeks -4 days 01/01/2010 F Complete 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 11/10/2010 ACTHIB 48 PMC Valid 01/01/2011 ACTHIB 48 PMC Valid - Hib 01/01/2011



2013-0310

# 4 at 15 months of age 01/01/2010 F Complete 03/01/2010 ACTHIB 48 PMC Valid 05/01/2010 ACTHIB 48 PMC Valid 08/01/2010 ACTHIB 48 PMC Valid 04/01/2011 ACTHIB 48 PMC Valid - Hib 04/01/2011



2013-0313#4 at 5 years 01/01/2007 F Aged Out 03/01/2007 ACTHIB 48 PMC Valid 05/01/2007 ACTHIB 48 PMC Valid 08/01/2007 ACTHIB 48 PMC Valid 01/01/2012 ACTHIB 48 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0314#4 at 7 years 01/01/2005 F Aged Out 03/01/2005 ACTHIB 48 PMC Valid 05/01/2005 ACTHIB 48 PMC Valid 09/01/2005 ACTHIB 48 PMC Valid 01/01/2012 ACTHIB 48 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0315

Child<2 months, no shots, #1 forecasted at 2 months of age 01/01/2010 F Not Complete 1 02/12/2010 03/01/2010 04/28/2010 Hib 01/01/2010



2013-0317

# 2 at 10 wks-4 days, PRP-OMP series 01/01/2005 F Not Comple 02/08/2005 PEDVAXHIB 49 MSD Valid 03/08/2005 PEDVAXHIB 49 MSD Valid 3 01/01/2006 01/01/2006 05/28/2006 Hib 03/08/2005



2013-0318

# 2 at 10 wks-3 days, PRP-OMP series 01/01/2005 F Not Comple 02/08/2005 PEDVAXHIB 49 MSD Valid 03/09/2005 PEDVAXHIB 49 MSD Valid 3 01/01/2006 01/01/2006 05/28/2006 Hib 03/09/2005



2013-0319# 2 at 12 months 01/01/2005 F Not Comple 03/01/2005 ACTHIB 48 PMC Valid 01/01/2006 ACTHIB 48 PMC Valid 3 02/26/2006 02/26/2006 05/28/2006 Hib 01/01/2006



2013-0320

#3 at 5m (#1, #2 at 2 and 4m) 01/01/2010 F Not Comple 03/01/2010 COMVAX 51 MSD Valid 05/01/2010 PEDVAXHIB 49 MSD Valid 06/01/2010 ACTHIB 48 PMC Valid 4 01/01/2011 01/01/2011 05/28/2011 Hib 06/01/2010



2013-0321

#3 at 10 months and 9 days (#1,2 at 2 and 4 m) 01/01/2010 F Not Comple 03/01/2010 COMVAX 51 MSD Valid 04/01/2010 COMVAX 51 MSD Valid 11/10/2010 PEDVAXHIB 49 MSD Valid 4 01/05/2011 01/05/2011 05/28/2011 Hib 11/10/2010



2013-0322#3 at 11 months 01/01/2010 F Not Comple 03/01/2010 COMVAX 51 MSD Valid 05/01/2010 PEDVAXHIB 49 MSD Valid 12/01/2010 ACTHIB 48 PMC Valid 4 01/26/2011 01/26/2011 05/28/2011 Hib 12/01/2010



2013-0323

#3 at 12 months -5 days 01/01/2010 F Not Comple 03/01/2010 COMVAX 51 MSD Valid 05/01/2010 COMVAX 51 MSD Valid 12/27/2010 HIBTITER 47 WAL Valid 4 02/21/2011 02/21/2011 05/28/2011 Hib 12/27/2010



2013-0324

#3 at 12 months - 3 days 01/01/2005 F Complete 03/01/2005 ACTHIB 48 PMC Valid 05/01/2005 ACTHIB 48 PMC Valid 12/29/2005 ACTHIB 48 PMC Valid - Hib 12/29/2005



This patient should have been marked complete for Hib. No Further Doses Needed. 1.1

2013-0325#3 at 15 months 01/01/2005 F Complete 03/01/2005 ACTHIB 48 PMC Valid 05/01/2005 ACTHIB 48 PMC Valid 04/01/2006 ACTHIB 48 PMC Valid - Hib 04/01/2006



2013-0326#3 at 59 months 01/01/2007 F Complete 03/01/2007 COMVAX 51 MSD Valid 05/01/2007 PEDVAXHIB 49 MSD Valid 12/31/2011 Hib Unspec 17 Valid - Hib 12/31/2011



2013-0327

#1 at 7 months-5 days 01/01/2010 F Not Comple 07/27/2010 ACTHIB 48 PMC Valid 2 08/24/2010 08/24/2010 08/24/2010 Hib 07/27/2010



2013-0328

#1 at 7 months- 3 days 01/01/2005 F Not Comple 07/29/2005 ACTHIB 48 PMC Valid 2 08/26/2005 08/26/2005 08/26/2005 Hib 07/29/2005




2013-0329

Dose 2 to 3, interval 8 weeks -3 days, #3 after 12 months of age 01/01/2005 F Complete 03/01/2005 ACTHIB 48 PMC Valid 11/09/2005 ACTHIB 48 PMC Valid 01/01/2006 ACTHIB 48 PMC Valid - Hib 01/01/2006





2013-0330

# 1 at 7 months -4 days 01/01/2005 F Not Comple 07/28/2005 ACTHIB 48 PMC Valid 2 08/25/2005 08/25/2005 08/25/2005 Hib 07/28/2005




2013-0331

# 1 at 12 months minus 5 days 01/01/2010 F Not Comple 12/27/2010 ACTHIB 48 PMC Valid 2 01/24/2011 01/24/2011 01/24/2011 Hib 12/27/2010



2013-0332





2013-0333





2013-0334

#2 at 7 m and 23 days (#1 at 7 m) 01/01/2005 F Not Comple 08/01/2005 ACTHIB 48 PMC Valid 08/24/2005 ACTHIB 48 PMC Not Valid




2013-0335

#2 at 7 m and 24 days (#1 at 7 m) 01/01/2005 F Not Comple 08/01/2005 ACTHIB 48 PMC Valid 08/25/2005 ACTHIB 48 PMC Valid 3 01/01/2006 01/01/2006 05/28/2006 Hib 08/25/2005



2013-0336

#2 at 11 m (#1 at 7 m) 01/01/2005 F Not Comple 08/01/2005 ACTHIB 48 PMC Valid 12/01/2005 ACTHIB 48 PMC Valid 3 01/26/2006 01/26/2006 05/28/2006 Hib 12/01/2005



2013-0337

#2 at 12 m (#1 at 7 m) 01/01/2005 F Not Comple 08/01/2005 ACTHIB 48 PMC Valid 01/01/2006 ACTHIB 48 PMC Valid 3 02/26/2006 02/26/2006 05/28/2006 Hib 01/01/2006



2013-0338

#3 at 365 d -5 days (#1 at 7m, #2 at 8m) 01/01/2005 F Not Comple 08/01/2005 ACTHIB 48 PMC Valid 09/01/2005 ACTHIB 48 PMC Valid 12/27/2005 ACTHIB 48 PMC Not Valid

Age: Too Young 3 02/21/2006 02/21/2006 05/28/2006 Hib 12/27/2005



Dose 3 was too young by 1 day according to the cath-up schedule. Evaluation of dose 3 was changed from valid to not valid with a reason of Age: Too Young which aligns with original test case evaluation test type and forecast test type 1.2

2013-0339

#3 at 365 d -4 days (#1 at 7m, #2 at 8m) 01/01/2005 F Complete 08/01/2005 ACTHIB 48 PMC Valid 09/01/2005 ACTHIB 48 PMC Valid 12/28/2005 ACTHIB 48 PMC Valid - Hib 12/28/2005



2013-0340

#3 at 365 days - 3 days (#1 at 7m, #2 at 8m) 01/01/2005 F Complete 08/01/2005 ACTHIB 48 PMC Valid 09/01/2005 ACTHIB 48 PMC Valid 12/29/2005 ACTHIB 48 PMC Valid - Hib 12/29/2005



2013-0341

#3 at 59 months (#1 at 7m, #2 at 8m) 01/01/2005 F Complete 08/01/2005 ACTHIB 48 PMC Valid 09/01/2005 ACTHIB 48 PMC Valid 12/01/2009 ACTHIB 48 PMC Valid - Hib 12/01/2009



2013-0342

#3 at 5 years (#1 at 7m, #2 at 8m) 01/01/2005 F Aged Out 08/01/2005 ACTHIB 48 PMC Valid 09/01/2005 ACTHIB 48 PMC Valid 01/01/2010 ACTHIB 48 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0343

Dose 2 to 3, interval 8 weeks-5 days, #3 after 12 months of age 01/01/2010 F Not Comple 03/01/2010 COMVAX 51 MSD Valid 12/15/2010 PEDVAXHIB 49 MSD Valid 02/04/2011 PEDVAXHIB 49 MSD Not Valid




Dose 3 should be invalid due to an interval violation 1.1

2013-0344

Dose 2 to 3, interval 8 weeks -4 days, #3 after 12 months of age 01/01/2010 F Complete 03/01/2010 COMVAX 51 MSD Valid 12/15/2010 PEDVAXHIB 49 MSD Valid 02/05/2011 PEDVAXHIB 49 MSD Valid - Hib 02/05/2011



2013-0345

Dose 2 to 3, interval 8 weeks -3 days, #3 after 12 months of age 01/01/2010 F Complete 03/01/2010 COMVAX 51 MSD Valid 12/15/2010 PEDVAXHIB 49 MSD Valid 02/06/2011 PEDVAXHIB 49 MSD Valid - Hib 02/06/2011



2013-0346

#1 at 15 months -5 days 01/01/2010 F Not Comple 03/27/2011 ACTHIB 48 PMC Valid 2 05/22/2011 05/22/2011 05/22/2011 Hib 03/27/2011




2013-0347

#1 at 15 months -4 days 01/01/2010 F Complete 03/28/2011 ACTHIB 48 PMC Valid - Hib 03/28/2011



2013-0348

Dose 1 to 2 at 8 weeks -5 days (#1 at 1 year) 01/01/2010 F Not Comple 01/01/2011 ACTHIB 48 PMC Valid 02/21/2011 PEDVAXHIB 49 MSD Not Valid




Condensed the past due date to align with the earliest and recommended date since this child is in catch-up 1.2


2013-0349

Dose 1 to 2 at 8 weeks -4 days (#1 at >=1 year) 01/01/2010 F Complete 01/01/2011 COMVAX 51 MSD Valid 02/22/2011 HIBTITER 47 WAL Valid - Hib 02/22/2011



2013-0350

Dose 1 to 2 at 8 weeks - 3 days (#1 at >=1 year) 01/01/2010 F Complete 01/01/2011 ACTHIB 48 PMC Valid 02/23/2011 COMVAX 51 MSD Valid - Hib 02/23/2011



2013-0351

# 3 (#1 at one year, #2 at 15 months) 01/01/2005 F Complete 01/01/2006 ACTHIB 48 PMC Valid 04/01/2006 ACTHIB 48 PMC Valid 05/27/2006 ACTHIB 48 PMC Extraneous

Series Already Complete - Hib 05/27/2006

Extra Doses 01/01/2013 01/01/2013


2013-0352# 1 at 15 m - 3 days 01/01/2010 F Complete 03/29/2011 ACTHIB 48 PMC Valid - Hib 03/29/2011



2013-0353

# 1 at 5 years - 1 day 01/01/2006 F Complete 12/31/2010 ACTHIB 48 PMC Valid - Hib 12/31/2010



2013-0354

#2 at 2 years, #1 at 15 m 01/01/2005 F Complete 04/01/2006 ACTHIB 48 PMC Valid 01/01/2007 ACTHIB 48 PMC Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0355#2 at 5 months 01/01/2012 F Not Comple 03/01/2012 ACTHIB 48 PMC Valid 06/01/2012 ACTHIB 48 PMC Valid 3 06/29/2012 07/01/2012 08/28/2012 Hib 06/01/2012



2013-0356

# 2 Pentacel at 6 yrs 11.5 mo. 01/01/2005 F Complete 09/22/2007 PENTACEL 120 PMC Valid 12/15/2011 PENTACEL 120 PMC Extraneous




2013-0357


Age: Too Young 3 09/30/2010 12/01/2010 01/28/2011 Hib 09/02/2010



Past Due Date was incorrectly calculated as it was missing the 4 week buffer for overdue. 1.1

2013-0358

invalid age dose 1 as first of others 08/01/2011 F Not Comple 09/05/2011 PENTACEL 120 PMC Not Valid

Age: Too Young 12/01/2011 PENTACEL 120 PMC Valid 02/01/2012 PENTACEL 120 PMC Valid 3 02/29/2012 02/29/2012 03/28/2012 Hib 02/01/2012



2013-0359

dose 1 to 2 Pentacel, interval 28-4 days 11/01/2009 F Not Comple 01/03/2010 PENTACEL 120 PMC Valid 01/27/2010 PENTACEL 120 PMC Valid 3 02/24/2010 05/01/2010 06/28/2010 Hib 01/27/2010




2013-0360






2013-0365

# 1 Pentacel at 6 wks 04/04/2008 F Not Comple 05/16/2008 PENTACEL 120 PMC Valid 2 06/13/2008 08/04/2008 10/01/2008 Hib 05/16/2008

Age: At Minimum 01/01/2013 01/01/2013


2013-0366

# 1 Pentacel at 6 wks-4 days 04/04/2008 F Not Comple 05/12/2008 PENTACEL 120 PMC Valid 2 06/13/2008 08/04/2008 10/01/2008 Hib 05/12/2008



2013-0367

# 1 Pentacel at 6 wks-5 days. 05/06/2010 F Not Comple 06/12/2010 PENTACEL 120 PMC Not Valid

Age: Too Young 1 06/17/2010 07/06/2010 09/02/2010 Hib 06/12/2010



2013-0368

# 2 Pentacel at 10 wks-4 days 10/10/2010 F Not Comple 11/17/2010 PENTACEL 120 PMC Valid 12/15/2010 PENTACEL 120 PMC Valid 3 01/16/2011 04/10/2011 06/06/2011 Hib 12/15/2010



2013-0369


Age: Too Young 2 01/11/2011 02/10/2011 04/06/2011 Hib 12/14/2010



2013-0370

# 3 Pentacel at 14 wks-4 days 06/01/2010 F Not Comple 07/09/2010 PENTACEL 120 PMC Valid 08/06/2010 PENTACEL 120 PMC Valid 09/03/2010 PENTACEL 120 PMC Valid 4 06/01/2011 06/01/2011 10/28/2011 Hib 09/03/2010



Past Due Date was incorrect based on recommendations. 1.1

2013-0371

# 4 Pentacel ≥ age 12 mo 04/04/2010 F Complete 06/04/2010 PENTACEL 120 PMC Valid 08/04/2010 PENTACEL 120 PMC Valid 10/04/2010 PENTACEL 120 PMC Valid 04/04/2011 PENTACEL 120 PMC Valid - Hib 04/04/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0372

# 4 Pentacel at 1 yr -4 days 04/04/2010 F Complete 06/04/2010 PENTACEL 120 PMC Valid 08/04/2010 PENTACEL 120 PMC Valid 10/04/2010 PENTACEL 120 PMC Valid 03/31/2011 PENTACEL 120 PMC Valid - Hib 03/31/2011



2013-0373


Age: Too Young 4 05/25/2011 05/25/2011 08/31/2011 Hib 03/30/2011




2013-0374

# 4 Pentacel at 4 yrs 05/06/2006 F Complete 09/15/2006 PENTACEL 120 PMC Valid 04/28/2007 PENTACEL 120 PMC Valid 12/12/2009 PENTACEL 120 PMC Valid 05/10/2010 PENTACEL 120 PMC Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0375

# 4 Pentacel at 5 yrs=off label but counts. 02/08/2007 F Aged Out 06/08/2007 PENTACEL 120 PMC Valid 12/05/2007 PENTACEL 120 PMC Valid 02/03/2008 PENTACEL 120 PMC Valid 02/08/2012 PENTACEL 120 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014



v1.1: Changed Dose 3 vaccination date from 2/7/08 to 2/3/08 to avoid completion of series on dose 3 to properly test off-label usage on 1.6

2013-0376

# 5 Pentacel at ≥ 4 yrs is off label but counts 02/08/2008 F Complete 01/08/2009 PENTACEL 120 PMC Valid 04/08/2009 PENTACEL 120 PMC Valid 07/08/2009 PENTACEL 120 PMC Valid 12/09/2009 PENTACEL 120 PMC Extraneous

Series Already Complete 03/01/2012 PENTACEL 120 PMC Extraneous


Extra Doses 01/01/2013 01/01/2013


2013-0377

Anaphylaxis to previous dose of Pentacel 06/06/2010 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 08/02/2010 PENTACEL 120 PMC Valid - Hib 08/02/2010



2013-0378





2013-0379

dose 2 to 3 Pentacel, interval 28-4 days 04/01/2008 F Not Comple 06/01/2008 PENTACEL 120 PMC Valid 08/01/2008 PENTACEL 120 PMC Valid 08/25/2008 PENTACEL 120 PMC Valid 4 04/01/2009 04/01/2009 08/28/2009 Hib 08/25/2008




2013-0380

invalid age dose 2 in midst of others 10/18/2010 F Complete 11/25/2010 PENTACEL 120 PMC Valid 12/22/2010 PENTACEL 120 PMC Not Valid

Age: Too Young 03/10/2011 PENTACEL 120 PMC Valid 10/20/2011 PENTACEL 120 PMC Valid - Hib 10/20/2011





2013-0381

invalid age dose 3 in midst of others 06/01/2010 F Complete 07/09/2010 PENTACEL 120 PMC Valid 08/06/2010 PENTACEL 120 PMC Valid 09/02/2010 PENTACEL 120 PMC Not Valid

Age: Too Young 07/07/2011 PENTACEL 120 PMC Valid - Hib 07/07/2011




2013-0382


Interval: Too Short 08/01/2009 PENTACEL 120 PMC Valid 3 08/29/2009 08/29/2009 10/08/2009 Hib 08/01/2009



2013-0383 Newborn 02/01/2012 F Not Complete 1 03/14/2012 04/01/2012 05/28/2012 Hib 02/01/2012



2013-0384

Pentacel at 7 yrs; # 1 at age < 12 mo for DTaP and Hib 1. 09/16/2003 F Aged Out 02/25/2004 PENTACEL 120 PMC Valid 09/16/2010 PENTACEL 120 PMC Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0392

#1 @ 9 yrs - 4 days, female, gardisil 05/01/2002 F Not Comple 04/27/2011 GARDASIL 62 MSD Valid 2 05/25/2011 06/22/2011 08/16/2011 HPV 04/27/2011



Removal of Age requirements to allow for a more aligned dosing schedule based on intervals rather than age. 2.1

2013-0394


Age: At Minimum 01/01/2013 09/17/2015



2013-0395





2013-0396

#1 @ 9 yrs - 4 days, male, gardisil 05/01/2002 M Not Comple 04/27/2011 GARDASIL 62 MSD Valid 2 05/25/2011 06/22/2011 08/16/2011 HPV 04/27/2011




2013-0398


Age: At Minimum 01/01/2013 09/17/2015



2013-0399





2013-0400

#2 @ 9 yrs, 4 wks - 4 days, female, gardisil 05/01/2002 F Not Comple 04/27/2011 GARDASIL 62 MSD Valid 05/25/2011 GARDASIL 62 MSD valid 3 10/12/2011 10/12/2011 11/21/2011 HPV 05/25/2011




2013-0401

#2 @ 9 yrs, 4 wks - 5 days, female gardisil 05/01/2002 F Not Comple 04/27/2011 GARDASIL 62 MSD Valid 05/24/2011 GARDASIL 62 MSD Valid 3 10/12/2011 10/12/2011 11/20/2011 HPV 05/24/2011




2013-0402

#2 @ 9 yrs, 4 wks - 0 days, female gardisil 05/01/2002 F Not Comple 05/01/2011 GARDASIL 62 MSD Valid 05/29/2011 GARDASIL 62 MSD valid 3 10/16/2011 10/16/2011 11/25/2011 HPV 05/29/2011




2013-0403

#2 @ 11 yrs + 2 mo, female, gardisil 05/01/2000 F Not Comple 05/01/2011 GARDASIL 62 MSD Valid 07/01/2011 GARDASIL 62 MSD valid 3 10/16/2011 10/16/2011 12/28/2011 HPV 07/01/2011

Interval: At Recommended 01/01/2013 09/17/2015



2013-0404

#2 @ 9 yrs, 4 wks - 4 days, male, gardisil 05/01/2002 M Not Comple 04/28/2011 GARDASIL 62 MSD Valid 05/25/2011 GARDASIL 62 MSD valid 3 10/13/2011 10/13/2011 11/21/2011 HPV 05/25/2011




2013-0405

#2 @ 9 yrs, 4 wks - 5 days, male gardisil 05/01/2002 M Not Comple 04/27/2011 GARDASIL 62 MSD Valid 05/24/2011 GARDASIL 62 MSD Valid 3 10/12/2011 10/12/2011 11/20/2011 HPV 05/24/2011





2013-0406

#2 @ 9 yrs, 4 wks - 0 days, male gardisil 05/01/2002 M Not Comple 05/01/2011 GARDASIL 62 MSD Valid 05/29/2011 GARDASIL 62 MSD valid 3 10/16/2011 10/16/2011 11/25/2011 HPV 05/29/2011




2013-0407

#2 @ 11 yrs + 2 mo, male, gardisil 05/01/2000 M Not Comple 05/01/2011 GARDASIL 62 MSD Valid 07/01/2011 GARDASIL 62 MSD valid 3 10/16/2011 10/16/2011 12/28/2011 HPV 07/01/2011




2013-0409

#3 @ 9 yrs, 16 weeks - 1 days, female, gardisil 05/01/2002 F Complete 04/30/2011 GARDASIL 62 MSD Valid 05/28/2011 GARDASIL 62 MSD Valid 08/20/2011 GARDASIL 62 MSD Valid - HPV 08/20/2011




2013-0410

#3 @ 9 yrs, 24 weeks, 0 days, female, gardisil 05/01/2002 F Complete 05/01/2011 GARDASIL 62 MSD Valid 05/29/2011 GARDASIL 62 MSD Valid 10/16/2011 GARDASIL 62 MSD Valid - HPV 10/16/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0411

#3 @ 11 yrs + 6 mo, female, gardisil 05/01/2000 F Complete 05/01/2011 GARDASIL 62 MSD Valid 07/01/2011 GARDASIL 62 MSD Valid 11/01/2011 GARDASIL 62 MSD Valid - HPV 11/01/2011



2013-0413

#3 @ 9 yrs, 16 weeks - 1 days, male, gardisil 05/01/2002 M Complete 04/30/2011 GARDASIL 62 MSD Valid 05/28/2011 GARDASIL 62 MSD Valid 08/20/2011 GARDASIL 62 MSD Valid - HPV 08/20/2011




2013-0414

#3 @ 9 yrs, 24 weeks, 0 days, male, gardisil 05/01/2002 M Complete 05/01/2011 GARDASIL 62 MSD Valid 05/29/2011 GARDASIL 62 MSD Valid 10/16/2011 GARDASIL 62 MSD Valid - HPV 10/16/2011

Age: At Minimum 01/01/2013 06/26/2013


Dose 1 must be Gardisil for it to be valid and match test case purpose. 1.1

2013-0415

#3 @ 11 yrs + 6 mo, male, gardisil 05/01/2000 M Complete 05/01/2011 GARDASIL 62 MSD Valid 07/01/2011 GARDASIL 62 MSD Valid 11/01/2011 GARDASIL 62 MSD Valid - HPV 11/01/2011



2013-0416

Any dose ≥ 27 yrs, female, gardisil 05/01/1985 F Aged Out 05/02/2012 GARDASIL 62 MSD Extraneous

Age: Too Old - HPV 05/02/2012

Age: Too Old 01/01/2013 11/07/2014



v1.1: Changed test case name to better reflect the test case and align with other test case names. 1.6

2013-0417

Any dose ≥ 27 yrs, male, gardisil 05/01/1985 M Aged Out 05/02/2012 GARDASIL 62 MSD Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0418

#1 @ 9 yrs - 4 days, female, Cervarix 05/01/2002 F Not Comple 04/27/2011 CERVARIX 118 SKB Valid 2 05/25/2011 06/22/2011 08/16/2011 HPV 04/27/2011




2013-0421


Age: At Minimum 01/01/2013 09/17/2015



2013-0422





2013-0423

#1 @ 9 yrs - 4 days, male, Cervarix 05/01/2002 M Not Comple 04/28/2011 CERVARIX 118 SKB Not Valid

Gender: Invalid Administration 1 05/01/2011 05/01/2013 05/28/2015 HPV 04/28/2011

Gender: Invalid Administration 01/01/2013 01/01/2013


2013-0424





2013-0425





2013-0426





2013-0427

#2 @ 9 yrs, 4 wks - 4 days, female, Cervarix 05/01/2002 F Not Comple 04/28/2011 CERVARIX 118 SKB Valid 05/25/2011 CERVARIX 118 SKB Valid 3 10/13/2011 10/13/2011 11/21/2011 HPV 05/25/2011





2013-0428

#2 @ 9 yrs, 4 wks - 0 days, female Cervarix 05/01/2002 F Not Comple 05/01/2011 CERVARIX 118 SKB Valid 05/29/2011 CERVARIX 118 SKB Valid 3 10/16/2011 10/16/2011 11/25/2011 HPV 05/29/2011




2013-0429

#2 @ 11 yrs + 2 mo, female, Cervarix 05/01/2000 F Not Comple 05/01/2011 CERVARIX 118 SKB Valid 07/01/2011 CERVARIX 118 SKB Valid 3 10/16/2011 10/16/2011 12/28/2011 HPV 07/01/2011




2013-0430

#2 @ 9 yrs, 4 wks - 4 days, male, Cervarix 05/01/2002 M Not Comple 04/28/2011 CERVARIX 118 SKB Not Valid

Gender: Invalid Administration 05/22/2011 CERVARIX 118 SKB Not Valid




Past Due Date was wrong by 2 years. 1.1

2013-0433

#3 @ 9 yrs, 24 weeks, 0 days, female, Cervarix 05/01/2002 F Complete 05/01/2011 CERVARIX 118 SKB Valid 05/29/2011 CERVARIX 118 SKB Valid 10/16/2011 CERVARIX 118 SKB Valid - HPV 10/16/2011



2013-0434

#3 @ 11 yrs + 6 mo, female, Cervarix 05/01/2000 F Complete 05/01/2011 CERVARIX 118 SKB Valid 07/01/2011 CERVARIX 118 SKB Valid 11/01/2011 CERVARIX 118 SKB valid - HPV 11/01/2011



2013-0437

#3 @ 9 yrs, 24 weeks, 0 days, male, Cervarix 05/01/2002 M Not Comple 05/01/2011 CERVARIX 118 SKB Not Valid






2013-0438

#3 @ 11 yrs + 6 mo, male, Cervarix 05/01/2000 M Not Comple 05/01/2011 CERVARIX 118 SKB Not Valid






2013-0439

Any dose ≥ 27 yrs, female, Cervarix 05/01/1985 F Aged Out 05/02/2012 CERVARIX 118 SKB Extraneous


Age: Too Old 01/01/2013 11/07/2014




2013-0440

#2 with interval of 4 weeks from #1 05/01/2000 F Not Comple 05/01/2011 HPV Unspe 137 Valid 05/29/2011 HPV Unspe 137 Valid 3 10/16/2011 10/16/2011 11/25/2011 HPV 05/29/2011




2013-0441

#2 with interval of 4 weeks - 4 days from #1 05/01/2000 F Not Comple 05/01/2011 HPV Unspe 137 Valid 05/25/2011 HPV Unspe 137 Valid 3 10/16/2011 10/16/2011 11/21/2011 HPV 05/25/2011




2013-0442

#2 with interval of 4 weeks - 5 days from #1 05/01/2000 F Not Comple 05/01/2011 HPV Unspe 137 Valid 05/24/2011 HPV Unspe 137 Not Valid

Interval: Too Short 2 06/21/2011 07/19/2011 09/12/2011 HPV 05/24/2011




2013-0443

#2 with interval of 2 mo from #1 05/01/2000 F Not Comple 05/01/2011 HPV Unspe 137 Valid 07/01/2011 HPV Unspe 137 Valid 3 10/16/2011 10/16/2011 12/28/2011 HPV 07/01/2011




2013-0444

#3 with interval of 12 weeks from #2 05/01/2002 F Complete 05/01/2011 HPV Unspe 137 Valid 05/29/2011 HPV Unspe 137 Valid 08/21/2011 HPV Unspe 137 Valid - HPV 08/21/2011



2013-0445

#3 with interval of 12 weeks - 4 days from #2 05/01/2000 F Complete 05/01/2011 HPV Unspe 137 Valid 06/06/2011 HPV Unspe 137 Valid 08/25/2011 HPV Unspe 137 Valid - HPV 08/25/2011



2013-0446

#3 with interval of 12 weeks - 5 days from #2 05/01/2000 F Not Comple 05/01/2011 HPV Unspe 137 Valid 06/06/2011 HPV Unspe 137 Valid 08/24/2011 HPV Unspe 137 Not Valid


Interval: At Below Absolute Minimum 01/01/2013 09/17/2015



2013-0447

#3 with interval of 4 mo from #2 05/01/2000 F Complete 05/01/2011 HPV Unspe 137 Valid 07/01/2011 HPV Unspe 137 Valid 11/01/2011 HPV Unspe 137 Valid - HPV 11/01/2011



2013-0448




2013-0450




2013-0451

#1 @ 8 yrs - 5 days, #2 @ 9 yrs - 5 days 05/01/2002 F Not Comple 04/26/2010 HPV Unspe 137 Not Valid

Age: Too Young 04/26/2011 HPV Unspe 137 Not Valid

Age: Too Young 1 05/01/2011 05/01/2013 05/28/2015 HPV 04/26/2011



2013-0452

#1 @ 9 yrs - 5 days, #2 @ 9 yrs - 4 days 05/01/2002 F Not Comple 04/26/2011 HPV Unspe 137 Not Valid

Age: Too Young 04/27/2011 HPV Unspe 137 Valid 2 05/25/2011 06/22/2011 08/16/2011 HPV 04/27/2011




2013-0453

#1 @ 9 yrs, #2 @ 9 yrs + 2 weeks 05/01/2002 F Not Comple 05/01/2011 HPV Unspe 137 Valid 05/15/2011 HPV Unspe 137 Not Valid





2013-0454

#1 @ 9 yrs, #2 @ 12 yrs, 2 mo, 3 days 05/01/1998 F Not Comple 05/01/2007 HPV Unspe 137 Valid 07/04/2010 HPV Unspe 137 Valid 3 09/26/2010 09/26/2010 12/31/2010 HPV 07/04/2010





2013-0455

#1 @ 9 yrs, #2 @ 11 yr, 6 mo 05/01/1998 F Not Comple 05/01/2007 HPV Unspe 137 Valid 11/01/2009 HPV Unspe 137 Valid 3 01/24/2010 01/24/2010 04/28/2010 HPV 11/01/2009




2013-0456

#1 @ 8 yrs - 5 days, #2 @ 9 yrs - 6 days, #3 @ 9 yrs - 5 days 05/01/2002 F Not Comple 04/26/2010 HPV Unspe 137 Not Valid



Age: Too Young 1 05/01/2011 05/01/2013 05/28/2015 HPV 04/26/2011



2013-0457

#1 @ 8 yrs - 5 days, #2 @ 9 yrs - 6 days, #3 @ 9 yrs - 0 days 05/01/2002 F Not Comple 04/26/2010 HPV Unspe 137 Not Valid


Age: Too Young 05/01/2011 HPV Unspe 137 Valid 2 05/29/2011 06/26/2011 08/20/2011 HPV 05/01/2011




2013-0458

#1 @ 9 yrs - 5 days, #2 @ 9 yrs + 4 weeks, #3 @ 9 yrs, 8 weeks 05/01/2002 F Not Comple 04/26/2011 HPV Unspe 137 Not Valid

Age: Too Young 05/29/2011 HPV Unspe 137 Valid 06/26/2011 HPV Unspe 137 Valid 3 11/13/2011 11/13/2011 12/23/2011 HPV 06/26/2011




2013-0459

#1 @ 9 yrs - 5 days, #2 @ 9 yrs + 4 weeks, #3 @ 9 yrs, 8 weeks, #4 @ 9 yrs, 24 weeks 05/01/2002 F Complete 04/26/2011 HPV Unspe 137 Not Valid

Age: Too Young 05/29/2011 HPV Unspe 137 Valid 06/26/2011 HPV Unspe 137 Valid 10/19/2011 HPV Unspe 137 Valid - HPV 10/19/2011



2013-0460

Adolescent male, no HPV yet given. 04/04/1999 M Not Complete 1 04/04/2008 04/04/2010 05/01/2012 HPV 03/01/2008



2013-0461

# 2 at age 9 years 4 weeks-5 days 12/01/2001 F Not Comple 11/30/2010 HPV Unspe 137 Valid 12/24/2010 HPV Unspe 137 Valid 3 05/17/2011 05/17/2011 06/20/2011 HPV 12/24/2010




2013-0462

# 2 at age 9 years 4 weeks-4 days 12/01/2001 F Not Comple 11/30/2010 HPV Unspe 137 Valid 12/25/2010 HPV Unspe 137 Valid 3 05/17/2011 05/17/2011 06/21/2011 HPV 12/25/2010




2013-0463

# 2 at age 9 years 4 weeks 12/01/2001 F Not Comple 12/01/2010 HPV Unspe 137 Valid 12/25/2010 HPV Unspe 137 Valid 3 05/18/2011 05/18/2011 06/21/2011 HPV 12/25/2010




2013-0465

# 3 at age 9 years 16 weeks-1 days. 12/01/2001 F Complete 11/30/2010 HPV Unspe 137 Valid 12/28/2010 HPV Unspe 137 Valid 03/22/2011 HPV Unspe 137 Valid - HPV 03/22/2011




2013-0466

# 3 at age 9 years 16 weeks 12/01/2002 F Complete 12/01/2011 HPV Unspe 137 Valid 12/29/2011 HPV Unspe 137 Valid 03/22/2012 HPV Unspe 137 Valid - HPV 03/22/2012



2013-0467

# 2 at age 26 yrs 11 months 15 days; forecast # 3; female 04/04/1985 F Not Comple 04/04/2010 HPV Unspe 137 Valid 03/19/2012 HPV Unspe 137 Valid 3 06/11/2012 06/11/2012 09/15/2012 HPV 03/19/2012




2013-0468

Dose 1 to dose 2 interval 28-5 days 04/04/1999 F Not Comple 07/01/2011 HPV Unspe 137 Valid 07/24/2011 HPV Unspe 137 Not Valid





2013-0469

Dose 1 to dose 2 interval 28 days 04/04/1999 F Not Comple 07/01/2011 HPV Unspe 137 Valid 07/29/2011 HPV Unspe 137 Valid 3 12/16/2011 12/16/2011 01/25/2012 HPV 07/29/2011




2013-0470

Adolescent female, no HPV yet given. 12/25/1999 F Not Complete 1 12/25/2008 12/25/2010 01/21/2013 HPV 06/01/2008



2013-0471

Dose 2 to dose 3 interval 12 weeks-5 days 09/16/2000 F Not Comple 09/20/2010 HPV Unspe 137 Valid 11/20/2010 HPV Unspe 137 Valid 02/07/2011 HPV Unspe 137 Not Valid





2013-0472

Dose 2 to dose 3 interval 12 weeks-4 days 09/16/2000 F Complete 09/20/2010 HPV Unspe 137 Valid 11/20/2010 HPV Unspe 137 Valid 02/08/2011 HPV Unspe 137 Valid - HPV 02/08/2011



2013-0473

Dose 2 to dose 3 interval 12 weeks 09/16/2000 F Complete 09/20/2010 HPV Unspe 137 Valid 11/20/2010 HPV Unspe 137 Valid 02/12/2011 HPV Unspe 137 Valid - HPV 02/12/2011



2013-0474

Dose 1 to dose 3 interval 16 weeks -1 days 03/21/1996 F Not Comple 04/18/2008 HPV Unspe 137 Valid 05/16/2008 HPV Unspe 137 Valid 08/07/2008 HPV Unspe 137 Not Valid





2013-0475

Dose 1 to dose 3 interval 16 weeks=valid 03/21/1996 F Complete 04/18/2008 HPV Unspe 137 Valid 05/16/2008 HPV Unspe 137 Valid 08/08/2008 HPV Unspe 137 Valid - HPV 08/08/2008



2013-0476

# 2 to # 3 interval 12 wks-4 days 01/01/1997 F Complete 07/01/2010 HPV Unspe 137 Valid 09/23/2010 HPV Unspe 137 Valid 12/12/2010 HPV Unspe 137 Valid - HPV 12/12/2010




2013-0477

Invalid dose 1 of three doses given 07/21/2001 F Not Comple 07/01/2010 HPV Unspe 137 Not Valid

Age: Too Young 10/21/2010 HPV Unspe 137 Valid 05/05/2011 HPV Unspe 137 Valid 3 07/28/2011 07/28/2011 11/01/2011 HPV 05/05/2011




2013-0478

Invalid dose 2 in midst of others 12/25/1998 F Not Comple 02/25/2010 HPV Unspe 137 Valid 03/18/2010 HPV Unspe 137 Not Valid

Interval: Too Short 08/25/2010 HPV Unspe 137 Valid 3 11/17/2010 11/17/2010 02/21/2011 HPV 08/25/2010




2013-0479

Anaphylaxis to previous dose 05/19/2000 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 06/19/2011 HPV Unspe 137 Valid - HPV 06/19/2011



2013-0480

Adult female age 27 years, No Doses 03/30/1985 F Aged Out - HPV 03/30/2012



v1.6: Updated Series Status from "Not Complete" to "Aged Out" to align with updated CDSi Logic Specification Series Statuses. 1.6

2013-0481

Male age 27. HPV not recommended. 04/01/1985 M Aged Out - HPV 04/01/2012




v1.1: Gender should be M rather than F based on test case name; Also changed birth date to make patient 27 years old based on MMWR language 1.6

2013-0482

Female, age 14. HPV recommended 04/01/1998 F Not Complete 1 04/01/2007 04/01/2009 04/28/2011 HPV 04/01/2012



2013-0483

HPV bivalent to male adolescent. Not valid. Forecast quadrivalent 06/18/2000 M Not Comple 06/20/2011 CERVARIX 118 SKB Not Valid




2013-0484

# 1 at age 9 years-5 days 12/08/2001 F Not Comple 12/03/2010 HPV Unspe 137 Not Valid

Age: Too Young 1 12/08/2010 12/08/2012 01/04/2015 HPV 12/03/2010



2013-0485

# 1 at age 9 years-4 days 12/08/2001 F Not Comple 12/04/2010 HPV Unspe 137 Valid 2 01/01/2011 01/29/2011 03/25/2011 HPV 12/04/2010




2013-0486# 1 at age 9 years 12/08/2001 F Not Comple 12/08/2010 HPV Unspe 137 Valid 2 01/05/2011 02/02/2011 03/29/2011 HPV 12/08/2010

Age: At Minimum 01/01/2013 09/17/2015



2013-0487

#1 @ 11 yrs, 0 days, MCV4 05/01/2000 F Not Comple 05/01/2011 MENACTRA 114 PMC Valid 2 05/01/2016 05/01/2016 05/28/2017 MCV 05/01/2011

Age: At Minimum 01/01/2013 11/07/2014


v1.6: An EIPB clarification has resulted in a change to when dose 2 of MCV should be forecasted and validated. The second dose must come on or after 16 years (- 4 days) of age to be considered valid. 1.6

2013-0488

#2 @ 16 yr - 4 days, MCV4 05/01/1995 F Complete 05/01/2006 MENACTRA 114 PMC Valid 04/27/2011 MENACTRA 114 PMC valid - MCV 04/27/2011



v1.6: Updated Test case to reflect new absolute minimum age on dose 2 based on EIPB clarification 1.6

2013-0489

#2 @ 10 16 yr - 5 days, MCV4 05/01/1995 F Not Comple 05/01/2006 MENACTRA 114 PMC Valid 04/26/2011 MENACTRA 114 PMC Not Valid

Age: Too Young 2 06/21/2011 06/21/2011 05/28/2012 MCV 04/26/2011



v1.6: Updated Test case to reflect new absolute minimum age on dose 2 based on EIPB clarification 1.6

2013-0491

#2 @ 16 years, MCV4 05/01/1990 F Complete 05/01/2001 MENACTRA 114 PMC Valid 05/01/2006 MENACTRA 114 PMC Valid - MCV 05/01/2006



2013-0495

#2 with interval of 5 years of #1 05/01/1990 F Complete 05/01/2003 MENACTRA 114 PMC Valid 05/01/2008 MENACTRA 114 PMC Valid - MCV 05/01/2008



Test case was set to have the first dose at age 16 and second dose at 21 years. Test case was adjusted to be at 13 years and 18 years to avoid the 16 year age skip dose which is tested in another test 1.2


2013-0497

#1 @ 10 yrs - 1 day, #2 @ 10 yrs + 8 weeks - 5 days 05/01/2000 F Not Comple 04/30/2010 MENACTRA 114 PMC Not Valid

Age: Too Young 06/21/2010 MENACTRA 114 PMC Valid 2 05/01/2016 05/01/2016 05/28/2017 MCV 06/21/2010



v1.6: An EIPB clarification has resulted in a change to when dose 2 of MCV should be forecasted and validated. The second dose must come on or after 16 years (- 4 days) of age to be considered valid.v1.2: Same test case as previous version rolled younger to allow for the 10 1.6

2013-0498

#1 @ 10 yrs - 1 day, #2 @ 10 yrs + 8 weeks 05/01/2000 F Not Comple 04/30/2010 MENACTRA 114 PMC Not Valid





2013-0499#1 @ 10 yrs, MCV4 05/01/2000 F Not Comple 05/01/2010 MENACTRA 114 PMC Valid 2 05/01/2016 05/01/2016 05/28/2017 MCV 05/01/2010




2013-0500

#1 @ 10 yrs - 1 day, MCV4 05/01/2000 F Not Comple 04/30/2010 MENACTRA 114 PMC Not Valid

Age: Too Young 1 05/01/2011 05/01/2011 05/28/2013 MCV 04/30/2010



Same test case as previous version rolled younger to allow for the 10 year clarification by NIPInfo 1.2

2013-0501

#1 @ 10 yrs - 1 day, #2 @ 10 yrs, 8 weeks - 4 days 05/01/2000 F Not Comple 04/30/2010 MENACTRA 114 PMC Not Valid





2013-0502 Newborn 02/01/2012 F Not Complete 1 02/01/2023 02/01/2023 02/28/2025 MCV 02/01/2012



2013-0503

Dose 1 to dose 2 interval 8 wks-5 days 01/06/1995 F Not Comple 03/27/2006 Meningoco 147 Valid 05/17/2006 Meningoco 147 Not Valid

Interval: Too Short 2 01/06/2011 01/06/2011 02/02/2012 MCV 05/17/2006




2013-0504

Dose 1 to dose 2 interval 8 wks-4 days 04/01/1995 F Complete 03/18/2011 Meningoco 147 Valid 05/09/2011 Meningoco 147 Valid - MCV 05/09/2011



v1.6: updated to reflect interval without also testing age attributes. Simply made the patient older 1.6

2013-0505

Dose 1 to dose 2 interval 8 weeks 06/01/1995 F Complete 05/20/2011 Meningoco 147 Valid 07/15/2011 Meningoco 147 Valid - MCV 07/15/2011



v1.6: updated to reflect interval without also testing age attributes. Simply made the patient older 1.6

2013-0506

Anaphylaxis to previous dose of MCV 02/26/2000 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 03/15/2011 Meningoco 147 Valid - MCV 03/15/2011




2013-0507# 1 at age 11 years 09/06/1996 F Not Comple 09/06/2007 Meningoco 147 Valid 2 09/06/2012 09/06/2012 10/03/2013 MCV 09/06/2007

Age: At Minimum 01/01/2013 11/07/2014



2013-0508

age 22. No doses; No forecast 01/07/1990 F Aged Out - MCV 01/07/2012




2013-0509# 1 at age 15 years 04/21/1995 F Not Comple 04/29/2010 Meningoco 147 Valid 2 04/21/2011 04/21/2011 05/18/2012 MCV 04/29/2010




2013-0510

# 1 at age 16 years -5 days 08/22/1994 F Not Comple 08/17/2010 Meningoco 147 Valid 2 10/12/2010 10/12/2010 09/18/2011 MCV 08/17/2010



2013-0511

# 1 at age 16 years -4 days 08/22/1994 F Complete 08/18/2010 Meningoco 147 Valid - MCV 08/18/2010



2013-0512# 1 at age 16 years 08/22/1994 F Complete 08/22/2010 Meningoco 147 Valid - MCV 08/22/2010



2013-0523#1 at 15 months 03/14/2000 F Not Comple 06/14/2001 M-M-R II 03 MSD Valid 2 07/12/2001 03/14/2004 04/10/2007 MMR 06/14/2001



Renamed to better reflect test case. 1.1

2013-0524#2 at 4 years 03/14/2000 F Complete 06/14/2001 M-M-R II 03 MSD Valid 03/14/2004 M-M-R II 03 MSD Valid - MMR 03/14/2004




2013-0525#1 at 7 years 03/14/2000 F Not Comple 03/14/2007 M-M-R II 03 MSD Valid 2 04/11/2007 04/11/2007 04/11/2007 MMR 03/14/2007




2013-0528

5 single antigen doses: 1 Measles; 2 Mumps; 2 Rubella 03/05/1999 F Not Comple 03/05/2000 MUMPSVAX07 MSD Valid 04/02/2000 MERUVAX 06 MSD Valid 04/30/2000 ATTENUVA 05 MSD Valid 04/02/2004 MERUVAX 06 MSD Valid 05/02/2004 MUMPSVAX07 MSD Valid 2 05/30/2004 05/30/2004 04/01/2006 MMR 05/02/2004

Single Antigen Administration 01/01/2013 07/08/2013



2013-0530

4 single antigen doses: 1 Measles; 2 Mumps; 1 Rubella 03/05/1999 F Not Comple 03/05/2000 MUMPSVAX07 MSD Valid 04/02/2000 MERUVAX 06 MSD Valid 04/30/2000 ATTENUVA 05 MSD Valid 03/05/2004 MUMPSVAX07 MSD Valid 2 04/02/2004 04/02/2004 04/01/2006 MMR 03/05/2004




2013-0531

1 single antigen dose at 12M: 1 Measles 03/05/2000 F Not Comple 03/05/2001 ATTENUVA 05 MSD Valid 1 04/05/2001 04/05/2001 08/01/2001 MMR 03/05/2001



Renamed to better reflect test case. V1.4: Updated Earliest and Recommended date to adjust dates out 3 days. Previous recommendation was 4 weeks from single dose administration, but this would result in the dose being forecasted too early for the second Measles at 13 1.4

2013-0534

2 single antigen doses: 1 Measles; 1 Mumps 03/05/2000 F Not Comple 03/05/2001 ATTENUVA 05 MSD Valid 04/13/2001 MUMPSVAX07 MSD Valid 1 05/11/2001 05/11/2001 08/01/2001 MMR 04/13/2001




2013-0535

7 single antigen doses: 2 Measles; 3 Mumps; 2 Rubella 03/05/1999 F Complete 03/05/2000 MUMPSVAX07 MSD Valid 04/02/2000 MERUVAX 06 MSD Valid 04/30/2000 ATTENUVA 05 MSD Valid 03/05/2004 MUMPSVAX07 MSD Valid 04/02/2004 MERUVAX 06 MSD Valid ####### MUMPSVAX07 MSD Extraneous

Series Already Complete ####### ATTENUVA 05 MSD Valid - MMR 06/04/2004




2013-0536

3 single antigen doses: 1 Measles; 1 Mumps; 1 Rubella 03/05/2000 F Not Comple 03/05/2001 MUMPSVAX07 MSD Valid 04/05/2001 MERUVAX 06 MSD Valid 06/28/2001 ATTENUVA 05 MSD Valid 2 07/26/2001 03/05/2004 04/01/2007 MMR 06/28/2001




2013-0537

3 single antigen doses on same day: 1 Measles; 1 Mumps; 1 Rubella 03/05/1999 F Not Comple 03/05/2000 MUMPSVAX07 MSD Valid 03/05/2000 MERUVAX 06 MSD Valid 03/05/2000 ATTENUVA 05 MSD Valid 2 04/05/2000 03/05/2003 04/01/2006 MMR 03/05/2000



V1.1: Renamed to better reflect test case. V1.4: Updated Earliest date to reflect the earliest date of 13 months and not 12 months + 4 weeks to align with ACIP. 1.4

2013-0538

6 single antigen doses: 2 Measles; 2 Mumps; 2 Rubella 03/05/1999 F Complete 03/05/2000 MUMPSVAX07 MSD Valid 04/02/2000 MERUVAX 06 MSD Valid 04/30/2000 ATTENUVA 05 MSD Valid 03/05/2004 MUMPSVAX07 MSD Valid 04/02/2004 MERUVAX 06 MSD Valid ####### ATTENUVA 05 MSD Valid - MMR 04/30/2004




2013-0539

3 single antigen doses: 2 Measles; 1 Rubella 03/05/2000 F Not Comple 04/13/2001 ATTENUVA 05 MSD Valid 09/30/2001 MERUVAX 06 MSD Valid 02/17/2002 ATTENUVA 05 MSD Valid 1 03/17/2002 03/17/2002 03/17/2002 MMR 02/17/2002




2013-0540

MMR # 1 at 12 months-5 days 03/14/2000 F Not Comple 03/09/2001 M-M-R II 03 MSD Not Valid

Age: Too Young 1 04/06/2001 04/06/2001 08/10/2001 MMR 03/09/2001



2013-0541

MMR # 1 at 12 months-4 days 03/14/2000 F Not Comple 03/10/2001 M-M-R II 03 MSD Valid 2 04/14/2001 03/14/2004 04/10/2007 MMR 03/10/2001




2013-0542

MMR # 1 at 12 months 03/14/2000 F Not Comple 03/14/2001 M-M-R II 03 MSD Valid 2 04/14/2001 03/14/2004 04/10/2007 MMR 03/14/2001

Age: At Minimum 01/01/2013 01/01/2013


2013-0543

Newborn forecasting 02/01/2012 F Not Complete 1 02/01/2013 02/01/2013 06/28/2013 MMR 02/01/2012



2013-0544

Dose 1 to dose 2 interval 28 days 05/01/2004 F Complete 05/01/2006 M-M-R II 03 MSD Valid 05/29/2006 M-M-R II 03 MSD Valid - MMR 05/29/2006



2013-0545

MMR and VZ given at age 12 months 08/08/2004 F Not Comple 08/08/2005 M-M-R II 03 MSD Valid 08/08/2005 VARIVAX 21 MSD Valid 2 09/08/2005 08/08/2008 09/04/2011 MMR 08/08/2005

Age: At Minimum 01/01/2013 01/01/2013


2013-0546

Doses 1 and 2 of MMR and VZ at ages 12 and 13 months 06/14/2010 F Complete 06/14/2011 M-M-R II 03 MSD Valid 06/14/2011 VARIVAX 21 MSD Valid 07/14/2011 M-M-R II 03 MSD Valid 07/14/2011 VARIVAX 21 MSD Valid - MMR 07/14/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0547

VZ to MMR interval 28-1 day = invalid MMR 12/01/2010 F Not Comple 12/03/2011 VARIVAX 21 MSD Valid 12/30/2011 M-M-R II 03 MSD Not Valid

Live Virus Conflict 1 01/27/2012 01/27/2012 04/28/2012 MMR 12/30/2011



2013-0548

VZ given at age 12 mo; MMR at age 12 mo+28 days 10/13/2009 F Not Comple 10/13/2010 VARIVAX 21 MSD Valid 11/10/2010 M-M-R II 03 MSD Valid 2 12/08/2010 10/13/2013 11/09/2016 MMR 11/10/2010

Live Virus: At Minimum 01/01/2013 01/01/2013


2013-0549

Dose 1 MMRV at 12 m-5 days 11/10/2009 F Not Comple 11/05/2010 PROQUAD 94 MSD Not Valid

Age: Too Young 1 12/03/2010 12/03/2010 04/06/2011 MMR 11/05/2010



2013-0550

Dose 1 MMRV at 12 m-4 days 07/01/2005 F Not Comple 06/27/2006 PROQUAD 94 MSD Valid 2 08/01/2006 07/01/2009 07/28/2012 MMR 06/27/2006



2013-0551

Dose 1 to dose 2 MMRV interval 28 days age < 15 months old= valid MMR 05/01/2004 F Complete 05/01/2005 PROQUAD 94 MSD Valid 05/29/2005 PROQUAD 94 MSD Valid - MMR 05/29/2005



2013-0552

Dose 1 to 2 MMRV interval 28 days in child ≥ 15 months old=valid MMR 05/01/2004 F Complete 05/01/2007 PROQUAD 94 MSD Valid 05/29/2007 PROQUAD 94 MSD Valid - MMR 05/29/2007



2013-0554

Dose 1 to 2 MMRV interval 28-4 days=neither MMR nor VZ valid as second dose 09/06/2004 F Not Comple 10/06/2005 PROQUAD 94 MSD Valid 10/30/2005 PROQUAD 94 MSD Not Valid




Shifted dates of administration and forecast to strictly test the Live Virus conflict only. Previously it was testing a couple conditions 1.1

2013-0555

MMR to MMRV interval 28 days=valid MMR # 2 02/02/2005 F Complete 02/02/2006 M-M-R II 03 MSD Valid 03/02/2006 PROQUAD 94 MSD Valid - MMR 03/02/2006



2013-0556

MMR to MMRV interval 24 days=not valid MMR # 2 01/02/2005 F Not Comple 02/02/2006 M-M-R II 03 MSD Valid 02/26/2006 PROQUAD 94 MSD Not Valid




V1.4: Final Guidance for MMRV live virus spacing is 28 days. Grace period can't be applied. 1.4

2013-0557

MMRV to MMR interval 28 days=valid MMR dose 2 02/02/2005 F Complete 03/02/2006 PROQUAD 94 MSD Valid 03/30/2006 M-M-R II 03 MSD Valid - MMR 03/30/2006



2013-0558

Dose 1 to dose 2 interval 4 wks between VZ and MMRV in any age child=valid MMR 05/22/2005 F Not Comple 06/01/2006 VARIVAX 21 MSD Valid 06/29/2006 PROQUAD 94 MSD Valid 2 07/27/2006 05/22/2009 06/18/2012 MMR 06/29/2006



2013-0559

28 day interval between invalid VZ and subsequent MMRV=valid MMR and VZ 05/22/2005 F Not Comple 05/17/2006 VARIVAX 21 MSD Not Valid

Age: Too Young 06/14/2006 PROQUAD 94 MSD Valid 2 07/12/2006 05/22/2009 06/18/2012 MMR 06/14/2006



2013-0562

Interval of < 24 days between an invalid MMR and a subsequent MMRV=no valid MMR's 07/16/2005 F Not Comple 07/11/2006 M-M-R II 03 MSD Not Valid

Age: Too Young 08/03/2006 PROQUAD 94 MSD Not Valid




2013-0563

Interval of < 24 days between an invalid VZ and a subsequent MMRV=no valid MMR or VZ 07/16/2005 F Not Comple 07/11/2006 VARIVAX 21 MSD Not Valid





2013-0565

Correctly administered single antigen M, M and R followed by MMR=series complete 09/09/2004 F Complete 11/15/2005 MUMPSVAX07 MSD Valid 01/15/2006 MERUVAX 06 MSD Valid 09/15/2006 ATTENUVA 05 MSD Valid 09/15/2007 M-M-R II 03 MSD Valid - MMR 09/15/2007



2013-0566

Hx of measles. Child still needs MMR 04/07/2010 F

History of measles infection 371111005 SCT Not Complete 1 04/07/2011 04/07/2011 09/03/2011 MMR 01/01/2011



2013-0567

Anaphylactic reaction to dose 1 of MMR. No forecast for additional dose. 08/13/2010 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 09/02/2011 M-M-R II 03 MSD Valid - MMR 09/02/2011



2013-0568

Diagnosis of severe immunodeficiency. No forecast for MMR. 09/10/2011 F

immunodeficiency due to any cause, including HIV (hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive therapy, including steroids) VXC27 CDCPHINVS Contraindicated - MMR 09/10/2011



2013-0570

Dose 2 at age 13 mo -5 days 08/01/2007 F Not Comple 07/29/2008 M-M-R II 03 MSD Valid 08/27/2008 M-M-R II 03 MSD Not Valid

Age: Too Young 2 09/24/2008 08/01/2011 08/28/2014 MMR 08/27/2008



2013-0571

Dose 2 at age 13 mo - 4 days 08/01/2007 F Complete 08/01/2008 M-M-R II 03 MSD Valid 08/28/2008 M-M-R II 03 MSD Valid - MMR 08/28/2008



2013-0572Dose 2 at age 13 mo 08/01/2007 F Complete 08/01/2008 M-M-R II 03 MSD Valid 09/01/2008 M-M-R II 03 MSD Valid - MMR 09/01/2008

Age: At Minimum 01/01/2013 01/01/2013



2013-0573

Dose 1 to dose 2 interval 28 days-5 days 04/13/2004 F Not Comple 07/05/2006 M-M-R II 03 MSD Valid 07/28/2006 M-M-R II 03 MSD Not Valid

Interval: Too Short 2 08/25/2006 04/13/2008 05/10/2011 MMR 07/28/2006



2013-0574

Dose 1 to dose 2 interval 28-4 days 04/01/2004 F Complete 05/01/2005 M-M-R II 03 MSD Valid 05/25/2005 M-M-R II 03 MSD Valid - MMR 05/25/2005



2013-0575Newborn Testing 02/01/2012 F Not Complete 1 03/14/2012 04/01/2012 05/28/2012 PCV 02/01/2012



2013-0576

Dose # 1 PCV 13 at age 18 months 10/10/2009 F Not Comple 04/10/2011 PREVNAR 1 133 PFR Valid 2 06/05/2011 06/05/2011 06/05/2011 PCV 04/10/2011



2013-0577

Dose # 1 of PCV 7 at age 24 months. Need one dose PCV 13. 03/01/2008 F Not Comple 03/01/2010 PREVNAR 7 100 WAL Valid 2 04/26/2010 04/26/2010 04/26/2010 PCV 03/01/2010



V1.3: The first dose was PCV7 and was marked as not valid. This dose is valid, but the patient still needs a valid PCV13. 1.3

2013-0578

Dose # 1 of PCV 13 at age 24 months. Series complete. 07/10/2009 F Complete 07/10/2011 PREVNAR 1 133 PFR Valid - PCV 07/10/2011



2013-0579

Dose # 2 PCV 13 at age 10 weeks-5 days 09/10/2010 F Not Comple 10/18/2010 PREVNAR 1 133 PFR Valid 11/14/2010 PREVNAR 1 133 PFR Not Valid

Age: Too Young 2 12/12/2010 01/10/2011 03/09/2011 PCV 11/14/2010



2013-0580

Dose # 2 PCV 13 at age 10 weeks-4 days 02/26/2011 F Not Comple 04/06/2011 PREVNAR 1 133 PFR Valid 05/03/2011 PREVNAR 1 133 PFR Valid 3 06/04/2011 08/26/2011 10/23/2011 PCV 05/03/2011



2013-0581

Dose PCV 13 # 2 at age 10 weeks 02/26/2011 F Not Comple 04/09/2011 PREVNAR 1 133 PFR Valid 05/07/2011 PREVNAR 1 133 PFR Valid 3 06/04/2011 08/26/2011 10/23/2011 PCV 05/07/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0582

Dose # 2 PCV 13 at age 4 months 08/01/2011 F Not Comple 10/01/2011 PREVNAR 1 133 PFR Valid 12/01/2011 PREVNAR 1 133 PFR Valid 3 12/29/2011 02/01/2012 03/28/2012 PCV 12/01/2011



2013-0583

Dose # 1 PCV 13 at age7 months, dose # 2 at age 8 mos and current age ≥ 12 mos. 02/01/2011 F Not Comple 09/01/2011 PREVNAR 1 133 PFR Valid 10/01/2011 PREVNAR 1 133 PFR Valid 3 02/01/2012 02/01/2012 06/28/2012 PCV 02/01/2012



2013-0584

Dose # 1 PCV 13 at 12 mo; dose # 2 at 1 yr 8 wks-5 days 02/01/2010 F Not Comple 02/01/2011 PREVNAR 1 133 PFR Valid 03/24/2011 PREVNAR 1 133 PFR Not Valid

Interval: Too Short 2 05/19/2011 05/19/2011 05/19/2011 PCV 03/24/2011



Condensed the past due date to align with the earliest and recommended date since this child is in catch-up 1.2

2013-0585

Dose # 1 PCV 13 at age 12 mos; # 2 at 1 yr 8 wks-4 days 02/01/2010 F Complete 02/01/2011 PREVNAR 1 133 PFR Valid 03/25/2011 PREVNAR 1 133 PFR Valid - PCV 03/25/2011



2013-0586

Healthy child, age ≥ 5 years. No forecast 05/05/2006 F Not Complete 1 05/05/2071 05/05/2071 PCV 05/05/2011



The series is not complete since one final dose of the vaccine is recommended at age 65+ 2.2

2013-0587

Dose # 1 PCV 13 at age 12 months; # 2 at age 14 mos. Series complete. 01/01/2010 F Complete 01/01/2011 PREVNAR 1 133 PFR Valid 03/01/2011 PREVNAR 1 133 PFR Valid - PCV 03/01/2011



2013-0588

Dose # 1 PCV 13 at 24 mo-5 days. Valid but child needs another. 03/18/2010 F Not Comple 03/13/2012 PREVNAR 1 133 PFR Valid 2 05/08/2012 05/08/2012 05/08/2012 PCV 03/13/2012



2013-0589

Dose 1 PCV 13 at 24 m-4 days. Series complete. 03/18/2010 F Complete 03/14/2012 PREVNAR 1 133 PFR Valid - PCV 03/14/2012



2013-0590

Dose # 3 PCV 13 at age 14 weeks-5 days. 07/06/2011 F Not Comple 08/14/2011 PREVNAR 1 133 PFR Valid 09/11/2011 PREVNAR 1 133 PFR Valid 10/07/2011 PREVNAR 1 133 PFR Not Valid

Age: Too Young 3 11/04/2011 01/06/2012 03/04/2012 PCV 10/07/2011



2013-0591

Dose # 3 PCV 13 at age 14 weeks-4 days. 07/06/2011 F Not Comple 08/14/2011 PREVNAR 1 133 PFR Valid 09/11/2011 PREVNAR 1 133 PFR Valid 10/08/2011 PREVNAR 1 133 PFR Valid 4 07/06/2012 07/06/2012 12/03/2012 PCV 10/08/2011



2013-0592

Dose # 3 PCV 13 at age 14 weeks 07/06/2011 F Not Comple 08/17/2011 PREVNAR 1 133 PFR Valid 09/14/2011 PREVNAR 1 133 PFR Valid 10/12/2011 PREVNAR 1 133 PFR Valid 4 07/06/2012 07/06/2012 12/03/2012 PCV 10/12/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0593

Dose # 3 PCV 13 at 6 mo. 02/01/2011 F Not Comple 04/01/2011 PREVNAR 1 133 PFR Valid 06/01/2011 PREVNAR 1 133 PFR Valid 08/01/2011 PREVNAR 1 133 PFR Valid 4 02/01/2012 02/01/2012 06/28/2012 PCV 08/01/2011



2013-0594

Mixed vaccines: dose # 1 PCV 7 at 6 mo; # 2 PCV 13 at 8 mo; # 3 PCV 13 at 12 months. Series complete. 03/04/2010 F Complete 09/04/2010 PREVNAR 7 100 WAL Valid 11/04/2010 PREVNAR 1 133 PFR Valid 03/04/2011 PREVNAR 1 133 PFR Valid - PCV 03/04/2011



2013-0595

Mixed vaccines: dose # 1 PCV 7 at 7 mo; # 2 PCV 7 at 8 mo; #3 PCV 13 at 12 months. Series complete. 06/01/2009 F Complete 01/01/2010 PREVNAR 7 100 WAL Valid 02/01/2010 PREVNAR 7 100 WAL Valid 06/01/2010 PREVNAR 1 133 PFR Valid - PCV 06/01/2010



Minor typo in test case name corrected. 1.1

2013-0596

Dose # 1 PCV 13 at age 6 weeks-5 days 11/10/2010 F Not Comple 12/17/2010 PREVNAR 1 133 PFR Not Valid

Age: Too Young 1 12/22/2010 01/10/2011 03/09/2011 PCV 12/17/2010



2013-0597

Dose # 1 PCV 13 at 6 mo; # 2 at 11 mo, # 3 at 12 mo 08/01/2010 F Not Comple 02/01/2011 PREVNAR 1 133 PFR Valid 07/01/2011 PREVNAR 1 133 PFR Valid 08/01/2011 PREVNAR 1 133 PFR Not Valid




At 12 Months of age and after the spacing must be 8 weeks or more. Dose 3 was given on 12 Months, but wasn't spaced 8 weeks. The forecast in this case remains unchanged. 1.2

2013-0598

Dose # 4 PCV 13 at age 12 mo-5 days 06/01/2010 F Not Comple 08/01/2010 PREVNAR 1 133 PFR Valid 10/01/2010 PREVNAR 1 133 PFR Valid 12/01/2010 PREVNAR 1 133 PFR Valid 05/27/2011 PREVNAR 1 133 PFR Not Valid

Age: Too Young 4 07/22/2011 07/22/2011 10/28/2011 PCV 05/27/2011



2013-0599

Dose # 4 PCV 13 at age 1 year-4 days. Series complete. 06/01/2010 F Complete 08/01/2010 PREVNAR 1 133 PFR Valid 10/01/2010 PREVNAR 1 133 PFR Valid 12/01/2010 PREVNAR 1 133 PFR Valid 05/28/2011 PREVNAR 1 133 PFR Valid - PCV 05/28/2011



2013-0600

Dose # 4 PCV 13 at 1 year. Series complete. 06/01/2009 F Complete 08/01/2009 PREVNAR 1 133 PFR Valid 10/01/2009 PREVNAR 1 133 PFR Valid 12/01/2009 PREVNAR 1 133 PFR Valid 06/01/2010 PREVNAR 1 133 PFR Valid - PCV 06/01/2010

Age: At Minimum 01/01/2013 01/01/2013



2013-0601

4 doses of PCV 7, no PCV 13. Needs one PCV 13. 06/01/2009 F Not Comple 08/01/2009 PREVNAR 7 100 WAL Valid 10/01/2009 PREVNAR 7 100 WAL Valid 12/01/2009 PREVNAR 7 100 WAL Valid 07/01/2010 PREVNAR 7 100 WAL Valid 5 08/26/2010 08/26/2010 08/26/2010 PCV 07/01/2010



The fourth dose of PCV7 was marked as Not Valid. In fact this was a valid administration with a need for a subsequent PCV13 in 8 weeks time. V1.3: Updated Eval and Forecast Test Type and adjusted the past due date to align with the earliest and recommended date per the 1.3

2013-0602

Dose 1 invalid (age) as first of others 08/01/2011 F Not Comple 09/01/2011 PREVNAR 1 133 PFR Not Valid

Age: Too Young 11/15/2011 PREVNAR 1 133 PFR Valid 02/01/2012 PREVNAR 1 133 PFR Valid 3 02/29/2012 02/29/2012 03/28/2012 PCV 02/01/2012



2013-0603

Dose 2 invalid (age) in midst of others. 09/01/2011 F Not Comple 10/11/2011 PREVNAR 1 133 PFR Valid 11/05/2011 PREVNAR 1 133 PFR Not Valid

Age: Too Young 02/01/2012 PREVNAR 1 133 PFR Valid 3 02/29/2012 03/01/2012 04/28/2012 PCV 02/01/2012



2013-0604

Dose # 3 invalid (age) in midst of others. Four valid doses not required in this scenario. 12/12/2009 F Complete 01/22/2010 PREVNAR 1 133 PFR Valid 02/18/2010 PREVNAR 1 133 PFR Valid 03/01/2010 PREVNAR 1 133 PFR Not Valid

Age: Too Young 12/24/2010 PREVNAR 1 133 PFR Valid - PCV 12/24/2010



2013-0605

Dose 1 to dose 2 interval 28-5 days. 08/01/2011 F Not Comple 10/01/2011 PREVNAR 1 133 PFR Valid 10/24/2011 PREVNAR 1 133 PFR Not Valid




2013-0606

Dose 1 to dose 2 interval 28-4 days 08/01/2011 F Not Comple 10/01/2011 PREVNAR 1 133 PFR Valid 10/25/2011 PREVNAR 1 133 PFR Valid 3 11/22/2011 02/01/2012 03/28/2012 PCV 10/25/2011



2013-0607

Dose # 1 PCV 13 at age 6 weeks-4 days 04/01/2011 F Not Comple 05/09/2011 PREVNAR 1 133 PFR Valid 2 06/10/2011 08/01/2011 09/28/2011 PCV 05/09/2011



2013-0608

Dose 1 PCV 13 to dose 2 interval 28 days 08/01/2011 F Not Comple 10/01/2011 PREVNAR 1 133 PFR Valid 10/29/2011 PREVNAR 1 133 PFR Valid 3 11/26/2011 02/01/2012 03/28/2012 PCV 10/29/2011



2013-0609

Dose 2 to dose 3 interval 28-5 days 04/13/2011 F Not Comple 06/13/2011 PREVNAR 1 133 PFR Valid 08/13/2011 PREVNAR 1 133 PFR Valid 09/05/2011 PREVNAR 1 133 PFR Not Valid




2013-0610

Dose 2 to dose 3 PCV 13 interval 28-4 days 12/01/2010 F Not Comple 02/01/2011 PREVNAR 1 133 PFR Valid 04/17/2011 PREVNAR 1 133 PFR Valid 05/11/2011 PREVNAR 1 133 PFR Valid 4 12/01/2011 12/01/2011 04/28/2012 PCV 05/11/2011



2013-0611

Dose 2 to dose 3 PCV 13 interval 28 days 12/01/2010 F Not Comple 02/01/2011 PREVNAR 1 133 PFR Valid 04/17/2011 PREVNAR 1 133 PFR Valid 05/15/2011 PREVNAR 1 133 PFR Valid 4 12/01/2011 12/01/2011 04/28/2012 PCV 05/15/2011



2013-0612

Dose 3 PCV 13 to dose 4 interval 8 weeks-5 days 04/01/2010 F Not Comple 10/01/2010 PREVNAR 1 133 PFR Valid 02/01/2011 PREVNAR 1 133 PFR Valid 03/01/2011 PREVNAR 1 133 PFR Valid 04/21/2011 PREVNAR 1 133 PFR Not Valid




2013-0613

Dose 3 PCV 13 to dose 4 interval 8 wks-4 days. Series complete. 04/01/2010 F Complete 10/01/2010 PREVNAR 1 133 PFR Valid 02/01/2011 PREVNAR 1 133 PFR Valid 03/01/2011 PREVNAR 1 133 PFR Valid 04/22/2011 PREVNAR 1 133 PFR Valid - PCV 04/22/2011



2013-0614

Dose 3 PCV 13 to dose 4 interval 8 weeks. Series complete. 04/01/2010 F Complete 10/01/2010 PREVNAR 1 133 PFR Valid 02/01/2011 PREVNAR 1 133 PFR Valid 03/01/2011 PREVNAR 1 133 PFR Valid 04/26/2011 PREVNAR 1 133 PFR Valid - PCV 04/26/2011



2013-0615

Invalid dose 2 (interval) in midst of others 02/11/2009 F Complete 03/31/2009 PREVNAR 1 133 PFR Valid 04/23/2009 PREVNAR 1 133 PFR Not Valid

Interval: Too Short 08/11/2009 PREVNAR 1 133 PFR Valid 02/11/2010 PREVNAR 1 133 PFR Valid - PCV 02/11/2010



2013-0616

Invalid dose 3 (interval) in midst of others 02/02/2010 F Complete 06/02/2010 PREVNAR 1 133 PFR Valid 09/10/2010 PREVNAR 1 133 PFR Valid 10/02/2010 PREVNAR 1 133 PFR Not Valid

Interval: Too Short 03/02/2011 PREVNAR 1 133 PFR Valid - PCV 03/02/2011



2013-0617

InValid dose 4 (interval) in midst of others 03/18/2010 F Complete 05/18/2010 PREVNAR 1 133 PFR Valid 09/18/2010 PREVNAR 1 133 PFR Valid 03/10/2011 PREVNAR 1 133 PFR Valid 04/10/2011 PREVNAR 1 133 PFR Not Valid

Interval: Too Short 06/05/2011 PREVNAR 1 133 PFR Valid - PCV 06/05/2011



2013-0618

Dose # 1 PCV 13 at age 6 weeks 11/01/2011 F Not Comple 12/13/2011 PREVNAR 1 133 PFR Valid 2 01/10/2012 03/01/2012 04/28/2012 PCV 12/13/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0619

4 doses of PCV 7 and 1 dose of PCV 13=series complete 06/06/2008 F Complete 08/06/2008 PREVNAR 7 100 WAL Valid 10/06/2008 PREVNAR 7 100 WAL Valid 12/06/2008 PREVNAR 7 100 WAL Valid 12/06/2009 PREVNAR 7 100 WAL Valid 03/05/2012 PREVNAR 1 133 PFR Valid - PCV 03/05/2012



The fourth dose of PCV7 was marked as Not Valid. In fact this was a valid administration. The PCV13 which followed completed the series. V1.3 updated Evaluation Test Type 1.3

2013-0620

Four doses PCV 7, no PCV 13 child ≥ 5 years old. No forecast. 06/06/2006 F Not Comple 08/08/2006 PREVNAR 7 100 WAL Valid 10/10/2006 PREVNAR 7 100 WAL Valid 12/12/2006 PREVNAR 7 100 WAL Valid 09/06/2007 PREVNAR 7 100 WAL Valid 5 06/06/2071 06/06/2071 06/06/2071 PCV 06/06/2011



v2.2 updated based on ACIP recommendations for individuals 65+v2.0 Updated series status from Age Out to Not Complete since an vaccine dose is recommended at age 65+ v1.6: Updated Series Status from "Not Complete" to "Aged Out" to align with updated 2.2

2013-0621

Anaphylaxis to previous dose of PCV. No forecast. 07/11/2007 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 09/11/2007 PREVNAR 7 100 WAL Valid - PCV 09/11/2007



2013-0622




2013-0624





2013-0625





2013-0626Newborn Testing 02/01/2012 F Not Complete 1 03/14/2012 04/01/2012 05/28/2012 POL 02/01/2012



2013-0627

Dose # 2 at age 10 weeks 02/26/2011 F Not Comple 04/09/2011 IPOL 10 PMC Valid 05/07/2011 IPOL 10 PMC Valid 3 06/04/2011 08/26/2011 10/23/2012 POL 05/07/2011

Age: At Minimum 01/01/2013 06/26/2013


Typo on Past Due Date by one year. 1.1

2013-0628

Dose # 2 at age 4 months 08/01/2011 F Not Comple 10/01/2011 IPOL 10 PMC Valid 12/01/2011 IPOL 10 PMC Valid 3 12/29/2011 02/01/2012 03/28/2013 POL 12/01/2011




2013-0629

Dose # 2 at age 3 years 9 months 07/08/2011 F Not Comple 09/08/2011 IPOL 10 PMC Valid 04/08/2015 IPOL 10 PMC Valid 3 05/06/2015 05/06/2015 05/06/2015 POL 04/08/2015



Rolled all birth dates forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. 1.5

2013-0630

Dose # 2 at age 4 years 0 months 12/12/2011 F Not Comple 12/12/2013 IPOL 10 PMC Valid 12/12/2015 IPOL 10 PMC Valid 3 01/09/2016 01/09/2016 01/09/2016 POL 12/12/2015



Rolled birth date forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. V2.2

Polio should continue to be recommended in 4 weeks. The dose 1.5

2013-0631

Dose # 3 at age 14 weeks-5 days 06/01/2011 F Not Comple 07/09/2011 IPOL 10 PMC Valid 08/06/2011 IPOL 10 PMC Valid 09/02/2011 IPOL 10 PMC Not Valid

Age: Too Young 3 09/30/2011 12/01/2011 01/28/2013 POL 09/02/2011



Rolled birth date forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. 1.5

2013-0632

Dose # 3 at age 14 weeks -4 days 01/06/2011 F Not Comple 02/17/2011 IPOL 10 PMC Valid 03/17/2011 IPOL 10 PMC Valid 04/10/2011 IPOL 10 PMC Valid 4 01/06/2015 01/06/2015 02/02/2018 POL 04/10/2011




2013-0633

Dose # 3 at age 14 weeks 01/06/2011 F Not Comple 02/17/2011 IPOL 10 PMC Valid 03/17/2011 IPOL 10 PMC Valid 04/14/2011 IPOL 10 PMC Valid 4 01/06/2015 01/06/2015 02/02/2018 POL 04/14/2011

Age: At Minimum 01/01/2013 11/19/2015



2013-0634

Dose # 3 at age 6 months 02/01/2011 F Not Comple 04/01/2011 IPOL 10 PMC Valid 06/01/2011 IPOL 10 PMC Valid 08/01/2011 IPOL 10 PMC Valid 4 02/01/2015 02/01/2015 02/28/2018 POL 08/01/2011




2013-0635

Dose # 3 at age 3 yrs 11.5 years old. 06/23/2011 F Not Comple 08/23/2011 IPOL 10 PMC Valid 10/23/2011 IPOL 10 PMC Valid 06/07/2015 IPOL 10 PMC Valid 4 12/07/2015 12/07/2015 07/20/2018 POL 06/07/2015





2013-0636

Dose # 3 at age 4 years-5 days. Is valid as a dose but child will need another. 08/22/2011 F Not Comple 10/22/2011 IPOL 10 PMC Valid 12/22/2011 IPOL 10 PMC Valid 08/17/2015 IPOL 10 PMC Valid 4 02/17/2016 02/17/2016 09/18/2018 POL 08/17/2015




2013-0637

# 1 and # 2 at ≥ 4 years. 02/11/2011 F Not Comple 02/11/2015 IPOL 10 PMC Valid 03/11/2015 IPOL 10 PMC Valid 3 04/08/2015 04/08/2015 04/08/2015 POL 03/11/2015




2013-0638

Dose # 3 at 4 years-4 days but not six months after dose 2. Child will need another. 08/22/2011 F Not Comple 08/22/2012 IPOL 10 PMC Valid 03/22/2015 IPOL 10 PMC Valid 08/18/2015 IPOL 10 PMC Valid 4 02/18/2016 02/18/2016 09/18/2018 POL 08/18/2015




2013-0639

Dose # 3 at 4 years-4 days and ≥ 6 months since dose 2. Series complete. 08/22/2011 F Complete 08/22/2012 IPOL 10 PMC Valid 01/22/2015 IPOL 10 PMC Valid 08/18/2015 IPOL 10 PMC Valid - POL 08/18/2015




2013-0640

Dose # 3 at age 4 years but < 6 months after dose 2. Valid but child will need a dose # 4. 02/11/2011 F Not Comple 02/11/2012 IPOL 10 PMC Valid 10/11/2014 IPOL 10 PMC Valid 02/11/2015 IPOL 10 PMC Valid 4 08/11/2015 08/11/2015 03/10/2018 POL 02/11/2015




2013-0641

Dose # 3 at 4 years 0 months and ≥ 6 mo since dose 2. Series complete. 03/18/2011 F Complete 05/18/2011 IPOL 10 PMC Valid 07/18/2011 IPOL 10 PMC Valid 03/18/2015 IPOL 10 PMC Valid - POL 03/18/2015




2013-0642

Dose # 4 at age 18 months. InValid as dose 4. 06/01/2011 F Not Comple 08/01/2011 IPOL 10 PMC Valid 10/01/2011 IPOL 10 PMC Valid 12/01/2011 IPOL 10 PMC Valid 12/01/2012 IPOL 10 PMC Not Valid

Age: Too Young 4 06/01/2015 06/01/2015 06/28/2018 POL 12/01/2012




2013-0643

Dose # 4 at age 4 yrs-5 days 12/25/2011 F Not Comple 03/25/2012 IPOL 10 PMC Valid 07/25/2012 IPOL 10 PMC Valid 12/26/2014 IPOL 10 PMC Valid 12/20/2015 IPOL 10 PMC Not Valid

Age: Too Young 4 06/20/2016 06/20/2016 01/21/2019 POL 12/20/2015




2013-0644

Dose # 4 at age 4 years-4 days. Series complete. 12/25/2011 F Complete 03/25/2012 IPOL 10 PMC Valid 07/25/2012 IPOL 10 PMC Valid 12/26/2014 IPOL 10 PMC Valid 12/21/2015 IPOL 10 PMC Valid - POL 12/21/2015





2013-0645

Dose # 4 at age 4 years 0 days. Series complete. 06/01/2011 F Complete 08/01/2011 IPOL 10 PMC Valid 10/01/2011 IPOL 10 PMC Valid 02/02/2012 IPOL 10 PMC Valid 06/01/2015 IPOL 10 PMC Valid - POL 06/01/2015

Age: At Minimum 01/01/2013 11/20/2015



2013-0646

Invalid dose 1 (age) as first of others 08/01/2011 F Not Comple 09/01/2011 IPOL 10 PMC Not Valid

Age: Too Young 12/01/2011 IPOL 10 PMC Valid 02/01/2012 IPOL 10 PMC Valid 3 02/29/2012 02/29/2012 03/28/2013 POL 02/01/2012



2013-0647

Invalid dose # 2 (age) in midst of others 08/01/2011 F Not Comple 09/08/2011 IPOL 10 PMC Valid 10/05/2011 IPOL 10 PMC Not Valid

Age: Too Young 02/01/2012 IPOL 10 PMC Valid 3 02/29/2012 02/29/2012 03/28/2013 POL 02/01/2012



2013-0648

Invalid dose 3 (age) in midst of others. No additional dose required. The next dose was at age 4 and ≥ 6 months since previous dose. Series complete. 06/01/2011 F Complete 07/13/2011 IPOL 10 PMC Valid 08/07/2011 IPOL 10 PMC Valid 09/02/2011 IPOL 10 PMC Not Valid

Age: Too Young 06/01/2015 IPOL 10 PMC Valid - POL 06/01/2015




2013-0649

Dose 1 to dose 2 interval 28-5 days 06/01/2011 F Not Comple 08/01/2011 IPOL 10 PMC Valid 08/24/2011 IPOL 10 PMC Not Valid

Interval: Too Short 2 09/21/2011 10/01/2011 11/28/2011 POL 08/24/2011




2013-0650

Dose 1 to dose2 interval 28-4 days 02/01/2011 F Not Comple 04/01/2011 IPOL 10 PMC Valid 04/25/2011 IPOL 10 PMC Valid 3 05/23/2011 08/01/2011 09/28/2012 POL 04/25/2011




2013-0651

Dose 1 to dose 2 interval 28 days 02/01/2011 F Not Comple 04/01/2011 IPOL 10 PMC Valid 04/29/2011 IPOL 10 PMC Valid 3 05/27/2011 08/01/2011 09/28/2012 POL 04/29/2011




2013-0652

Dose 2 to dose 3 interval 28-5 days 04/01/2011 F Not Comple 06/01/2011 IPOL 10 PMC Valid 08/01/2011 IPOL 10 PMC Valid 08/24/2011 IPOL 10 PMC Not Valid





2013-0653

Dose 2 to dose 3 interval 28-4 days 12/01/2011 F Not Comple 01/10/2012 IPOL 10 PMC Valid 02/13/2012 IPOL 10 PMC Valid 03/09/2012 IPOL 10 PMC Valid 4 12/01/2015 12/01/2015 12/28/2018 POL 03/09/2012




2013-0654

Dose 2 to dose 3 interval 28 days 12/01/2011 F Not Comple 02/01/2012 IPOL 10 PMC Valid 04/01/2012 IPOL 10 PMC Valid 04/29/2012 IPOL 10 PMC Valid 4 12/01/2015 12/01/2015 12/28/2018 POL 04/29/2012





2013-0655

Dose 3 to dose 4 interval 6 m-5 days 11/15/2011 F Not Comple 11/15/2012 IPOL 10 PMC Valid 11/15/2013 IPOL 10 PMC Valid 05/20/2015 IPOL 10 PMC Valid 11/15/2015 IPOL 10 PMC Not Valid





2013-0656

Dose 3 to dose 4 interval 6 months-4 days. Series complete. 11/15/2011 F Complete 11/15/2012 IPOL 10 PMC Valid 11/15/2013 IPOL 10 PMC Valid 05/19/2015 IPOL 10 PMC Valid 11/15/2015 IPOL 10 PMC Valid - POL 11/15/2015




2013-0657

Dose 3 to dose 4 interval 6 months. Series complete. 11/15/2011 F Complete 11/15/2012 IPOL 10 PMC Valid 11/15/2013 IPOL 10 PMC Valid 05/19/2015 IPOL 10 PMC Valid 11/19/2015 IPOL 10 PMC Valid - POL 11/19/2015




2013-0658

Dose # 1 at age 6 weeks-5 days 11/10/2011 F Not Comple 12/17/2011 IPOL 10 PMC Not Valid

Age: Too Young 1 12/22/2011 01/10/2012 03/08/2012 POL 12/17/2011




2013-0659

Invalid dose 1 to dose 2 interval in midst of others. 02/11/2011 F Not Comple 04/11/2011 IPOL 10 PMC Valid 05/03/2011 IPOL 10 PMC Not Valid

Interval: Too Short 08/11/2011 IPOL 10 PMC Valid 3 09/08/2011 09/08/2011 10/08/2012 POL 08/11/2011




2013-0660

Invalid dose 3 (interval) in midst of others makes no difference in forecasting if # 4 is ≥ 4 years old and ≥ 6 months after previous dose. Series complete. 02/02/2011 F Complete 04/02/2011 IPOL 10 PMC Valid 06/02/2011 IPOL 10 PMC Valid 06/25/2011 IPOL 10 PMC Not Valid

Interval: Too Short 02/04/2015 IPOL 10 PMC Valid - POL 02/04/2015




2013-0661

Mixed OPV/IPV require 4 doses even if # 3 is after age 4 and ≥ 6 months after previous dose. 10/16/2011 F Not Comple 12/16/2011 ORIMUNE 02 WAL Valid 02/16/2012 ORIMUNE 02 WAL Valid 10/16/2016 IPOL 10 PMC Valid 4 04/16/2017 04/16/2017 11/12/2018 POL 10/16/2016




2013-0662

4 doses of mixed OPV/IPV with one after age 4=polio series complete 04/13/2011 F Complete 06/13/2011 ORIMUNE 02 WAL Valid 08/13/2011 ORIMUNE 02 WAL Valid 04/13/2014 IPOL 10 PMC Valid 04/17/2016 IPOL 10 PMC Valid - POL 04/17/2016




2013-0663

Anaphylaxis to previous dose. No forecast. 07/24/2011 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 09/24/2011 IPOL 10 PMC Valid - POL 09/24/2011





2013-0664

Dose 1 given as Kinrix at age 2 mos. Off-label but valid as IPV # 1. 11/11/2011 F Not Comple 01/11/2012 KINRIX 130 SKB Valid 2 02/08/2012 03/11/2012 05/08/2012 POL 01/11/2012



2013-0665

Dose 2 given as Kinrix at age 4 mo. Off label but valid as IPV 2. 09/09/2011 F Not Comple 11/15/2011 IPOL 10 PMC Valid 01/09/2012 KINRIX 130 SKB Valid 3 02/06/2012 03/09/2012 05/06/2013 POL 01/09/2012



2013-0666

Dose 3 given as Kinrix at age 6 mos. Off label but valid. 07/07/2011 F Not Comple 09/09/2011 IPOL 10 PMC Valid 11/11/2011 IPOL 10 PMC Valid 01/07/2012 KINRIX 130 SKB Valid 4 07/07/2015 07/07/2015 08/03/2018 POL 01/07/2012



2013-0667

Kinrix at 12 months old. Not Valid as dose 4 of IPV 07/07/2011 F Not Comple 09/09/2011 IPOL 10 PMC Valid 11/11/2011 IPOL 10 PMC Valid 12/30/2011 IPOL 10 PMC Valid 08/01/2012 KINRIX 130 SKB Not Valid

Age: Too Young 4 07/07/2015 07/07/2015 08/03/2018 POL 08/01/2012




2013-0668

Kinrix at age 4 years as dose 4=polio series complete 10/04/2011 F Complete 12/06/2011 PEDIARIX 110 SKB Valid 02/04/2012 PEDIARIX 110 SKB Valid 04/06/2012 PEDIARIX 110 SKB Valid 10/04/2015 KINRIX 130 SKB Valid - POL 10/04/2015

Age: At Minimum 01/01/2013 11/23/2015



2013-0669

Dose # 1 at age 6 weeks-4 days 04/01/2011 F Not Comple 05/09/2011 IPOL 10 PMC Valid 2 06/10/2011 08/01/2011 09/28/2011 POL 05/09/2011




2013-0670

Kinrix as dose 4 at age 4 years-5 days 07/07/2011 F Not Comple 08/30/2011 PEDIARIX 110 SKB Valid 10/24/2011 PEDIARIX 110 SKB Valid 03/05/2012 PEDIARIX 110 SKB Valid 07/02/2015 KINRIX 130 SKB Not Valid

Age: Too Young 4 01/02/2016 01/02/2016 08/03/2018 POL 07/02/2015




2013-0671

Kinrix as dose 4 at age 4 years-4 days= polio series complete 10/18/2011 F Complete 12/07/2011 PEDIARIX 110 SKB Valid 02/04/2012 PEDIARIX 110 SKB Valid 04/04/2012 PEDIARIX 110 SKB Valid 10/14/2015 KINRIX 130 SKB Valid - POL 10/14/2015




2013-0672

Dose # 1 at age 6 weeks 11/01/2011 F Not Comple 12/13/2011 IPOL 10 PMC Valid 2 01/10/2012 03/01/2012 04/28/2012 POL 12/13/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0673

Dose # 1 at age 2 months 11/01/2011 F Not Comple 01/01/2012 IPOL 10 PMC Valid 2 01/29/2012 03/01/2012 04/28/2012 POL 01/01/2012



2013-0674

Dose # 2 at age 10 weeks-5 days 09/10/2011 F Not Comple 10/18/2011 IPOL 10 PMC Valid 11/14/2011 IPOL 10 PMC Not Valid

Age: Too Young 2 12/12/2011 01/10/2012 03/08/2012 POL 11/14/2011




2013-0675

Dose # 2 at age 10 weeks-4 days 02/26/2011 F Not Comple 04/09/2011 IPOL 10 PMC Valid 05/03/2011 IPOL 10 PMC Valid 3 06/04/2011 08/26/2011 10/23/2012 POL 05/03/2011




2013-0676

Newborn forecasting 04/01/2012 F Not Complete 1 05/13/2012 06/01/2012 07/28/2012 POL 04/01/2012



2013-0677

# 2 Pediarix at 6 yrs 11.5 mo 01/01/2011 F Not Comple 12/16/2013 PEDIARIX 110 SKB Valid 12/15/2017 PEDIARIX 110 SKB Valid 3 01/12/2018 01/12/2018 01/12/2018 POL 12/15/2017



Rolled birth date forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. Polio should continue to be recommended in 4 weeks. The dose should not be 1.5


2013-0678

# 2 Pediarix at 7 yrs; # 1 at less than 12 mo. 09/16/2011 F Not Comple 12/16/2011 PEDIARIX 110 SKB Valid 09/16/2018 PEDIARIX 110 SKB Valid 3 10/14/2018 10/14/2018 10/14/2018 POL 09/16/2018




2013-0679

# 2 Pediarix at 7 yrs; # 1 ≥ 12 mo. 09/16/2011 F Not Comple 10/16/2012 PEDIARIX 110 SKB Valid 09/16/2018 PEDIARIX 110 SKB Valid 3 10/14/2018 10/14/2018 10/14/2018 POL 09/16/2018




2013-0680

# 1 and 2 Pediarix at ≥7 yrs with 28 day interval. Off label 07/07/2011 F Not Comple 07/07/2018 PEDIARIX 110 SKB Valid 08/04/2018 PEDIARIX 110 SKB Valid 3 09/01/2018 09/01/2018 09/01/2018 POL 08/04/2018



Rolled birth date forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. Original forecast were suggesting skipping dose 3 to the final dose at 6 months. EIPB 1.5

2013-0681

# 3 Pediarix at 14 wks-5 days 06/01/2011 F Not Comple 07/09/2011 PEDIARIX 110 SKB Valid 08/06/2011 PEDIARIX 110 SKB Valid 09/02/2011 PEDIARIX 110 SKB Not Valid

Age: Too Young 3 09/30/2011 12/01/2011 01/28/2013 POL 09/02/2011



Rolled birth date forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. Typo on Past Due Date by one year. V2.1 1.5

2013-0682

# 3 Pediarix at 14 wks-4 days. 01/06/2011 F Not Comple 02/15/2011 PEDIARIX 110 SKB Valid 03/15/2011 PEDIARIX 110 SKB Valid 04/10/2011 PEDIARIX 110 SKB Valid 4 01/06/2015 01/06/2015 02/02/2018 POL 04/10/2011




2013-0683

# 3 Pediarix at 24 weeks-5 days. 05/13/2011 F Not Comple 06/24/2011 PEDIARIX 110 SKB Valid 08/24/2011 PEDIARIX 110 SKB Valid 10/23/2011 PEDIARIX 110 SKB Valid 4 05/13/2015 05/13/2015 06/09/2018 POL 10/23/2011



2013-0684

# 3 Pediarix at 24 weeks-4 days. 05/13/2011 F Not Comple 06/24/2011 PEDIARIX 110 SKB Valid 08/24/2011 PEDIARIX 110 SKB Valid 10/24/2011 PEDIARIX 110 SKB Valid 4 05/13/2015 05/13/2015 06/09/2018 POL 10/24/2011



2013-0685

# 3 Pediarix at 6 yrs 11.5 mo 07/07/2011 F Complete 05/05/2014 PEDIARIX 110 SKB Valid 08/08/2015 PEDIARIX 110 SKB Valid 06/25/2018 PEDIARIX 110 SKB Valid - POL 06/25/2018




2013-0686

# 4 Pediarix at 1 yr -5 days. 04/04/2011 F Not Comple 06/04/2011 PEDIARIX 110 SKB Valid 08/04/2011 PEDIARIX 110 SKB Valid 10/10/2011 PEDIARIX 110 SKB Valid 03/30/2012 PEDIARIX 110 SKB Not Valid

Age: Too Young 4 04/04/2015 04/04/2015 05/01/2018 POL 03/30/2012




2013-0687

# 1 Pediarix at 6 wks-5 days 05/06/2011 F Not Comple 06/12/2011 PEDIARIX 110 SKB Not Valid

Age: Too Young 1 06/17/2011 07/06/2011 09/02/2011 POL 06/12/2011




2013-0688

# 4 Pediarix at 1 yr -4 days 06/01/2011 F Not Comple 08/01/2011 PEDIARIX 110 SKB Valid 11/01/2011 PEDIARIX 110 SKB Valid 01/15/2012 PEDIARIX 110 SKB Valid 05/28/2012 PEDIARIX 110 SKB Not Valid

Age: Too Young 4 06/01/2015 06/01/2015 06/28/2018 POL 05/28/2012




2013-0689

# 4 Pediarix at 3 yrs 11.5 mo. 02/01/2011 F Not Comple 04/01/2011 PEDIARIX 110 SKB Valid 07/01/2011 PEDIARIX 110 SKB Valid 10/01/2011 PEDIARIX 110 SKB Valid 01/15/2015 PEDIARIX 110 SKB Not Valid

Age: Too Young 4 07/15/2015 07/15/2015 02/28/2018 POL 01/15/2015




2013-0690

# 4 Pediarix at 4 yrs 05/06/2011 F Complete 09/09/2011 PEDIARIX 110 SKB Valid 03/03/2012 PEDIARIX 110 SKB Valid 07/10/2013 PEDIARIX 110 SKB Valid 05/06/2015 PEDIARIX 110 SKB Valid - POL 05/06/2015

Age: At Minimum 01/01/2013 11/23/2015



2013-0691

# 5 Pediarix at 4 yrs -5 days. 07/01/2011 F Not Comple 09/01/2011 PEDIARIX 110 SKB Valid 10/01/2011 PEDIARIX 110 SKB Valid 02/02/2012 PEDIARIX 110 SKB Valid 10/10/2012 PEDIARIX 110 SKB Not Valid

Age: Too Young 06/26/2015 PEDIARIX 110 SKB Not Valid

Age: Too Young 4 12/26/2015 12/26/2015 07/28/2018 POL 06/26/2015




2013-0692

# 5 Pediarix at 4 yrs -4 days 07/01/2011 F Complete 09/01/2011 PEDIARIX 110 SKB Valid 10/01/2011 PEDIARIX 110 SKB Valid 02/02/2012 PEDIARIX 110 SKB Valid 10/10/2012 PEDIARIX 110 SKB Not Valid

Age: Too Young 06/27/2015 PEDIARIX 110 SKB Valid - POL 06/27/2015




2013-0693

# 5 Pediarix at 6 yrs 11.5 mo 04/01/2011 F Complete 06/01/2011 PEDIARIX 110 SKB Valid 08/01/2011 PEDIARIX 110 SKB Valid 10/01/2011 PEDIARIX 110 SKB Valid 05/01/2012 PEDIARIX 110 SKB Not Valid





2013-0694

# 5 Pediarix at 7 yrs. Off label 05/01/2011 F Complete 08/01/2011 PEDIARIX 110 SKB Valid 11/01/2011 PEDIARIX 110 SKB Valid 02/01/2012 PEDIARIX 110 SKB Valid 11/16/2012 PEDIARIX 110 SKB Not Valid





2013-0695

Invalid age dose 1 as first of others. 08/01/2011 F Not Comple 09/06/2011 PEDIARIX 110 SKB Not Valid

Age: Too Young 11/01/2011 PEDIARIX 110 SKB Valid 2 11/29/2011 12/01/2011 01/28/2012 POL 11/01/2011



2013-0696

Invalid age dose 2 in midst of others 10/18/2011 F Not Comple 11/25/2011 PEDIARIX 110 SKB Valid 12/21/2011 PEDIARIX 110 SKB Not Valid






2013-0697

invalid age dose 3 in midst of others 06/01/2011 F Not Comple 07/15/2011 PEDIARIX 110 SKB Valid 08/10/2011 PEDIARIX 110 SKB Valid 09/01/2011 PEDIARIX 110 SKB Not Valid





2013-0698

# 1 Pediarix at 6 wks-4 days 04/04/2011 F Not Comple 05/12/2011 PEDIARIX 110 SKB Valid 2 06/13/2011 08/04/2011 10/01/2011 POL 05/12/2011




2013-0699






2013-0700

dose 1 to 2 Pediarix, interval 28-4 days 02/01/2011 F Not Comple 04/01/2011 PEDIARIX 110 SKB Valid 04/25/2011 PEDIARIX 110 SKB Valid 3 05/23/2011 08/01/2011 09/28/2012 POL 04/25/2011




2013-0701

dose 2 to 3 Pediarix, interval 28-5 days 04/01/2011 F Not Comple 06/01/2011 PEDIARIX 110 SKB Valid 08/01/2011 PEDIARIX 110 SKB Valid 08/24/2011 PEDIARIX 110 SKB Not Valid





2013-0702

dose 2 to 3 Pediarix, interval 28-4 days 12/01/2011 F Not Comple 02/01/2012 PEDIARIX 110 SKB Valid 04/01/2012 PEDIARIX 110 SKB Valid 04/25/2012 PEDIARIX 110 SKB Valid 4 12/01/2015 12/01/2015 12/28/2018 POL 04/25/2012




2013-0704

dose 3 to 4 Pediarix, interval 6m-4 days 08/09/2011 F Not Comple 10/09/2011 PEDIARIX 110 SKB Valid 12/09/2011 PEDIARIX 110 SKB Valid 04/09/2012 PEDIARIX 110 SKB Valid 10/05/2012 PEDIARIX 110 SKB Not Valid

Age: Too Young 4 08/09/2015 08/09/2015 09/05/2018 POL 10/05/2012




2013-0707


Interval: Too Short 06/11/2011 PEDIARIX 110 SKB Valid 3 07/09/2011 08/11/2011 10/08/2012 POL 06/11/2011




2013-0708

invalid dose 2-3 interval in midst of others 02/02/2011 F Not Comple 04/02/2011 PEDIARIX 110 SKB Valid 06/02/2011 PEDIARIX 110 SKB Valid 06/25/2011 PEDIARIX 110 SKB Not Valid

Interval: Too Short 02/02/2012 PEDIARIX 110 SKB Valid 4 02/02/2015 02/02/2015 03/01/2018 POL 02/02/2012




2013-0709

# 1 Pediarix at 6 wks 11/01/2011 F Not Comple 12/13/2011 PEDIARIX 110 SKB Valid 2 01/10/2012 03/01/2012 04/28/2012 POL 12/13/2011

Age: At Minimum 01/01/2013 01/01/2013



2013-0712

# 1 Pediarix at 6 yrs 11.5 mo 04/01/2011 F Not Comple 03/16/2018 PEDIARIX 110 SKB Valid 2 04/13/2018 04/13/2018 04/13/2018 POL 03/16/2018




2013-0713

# 1 Pediarix at 7 yrs 02/01/2011 F Not Comple 02/01/2018 PEDIARIX 110 SKB Valid 2 03/01/2018 03/01/2018 03/01/2018 POL 02/01/2018




2013-0714

# 2 Pediarix at 10 wks-5 days 10/10/2011 F Not Comple 11/17/2011 PEDIARIX 110 SKB Valid 12/14/2011 PEDIARIX 110 SKB Not Valid

Age: Too Young 2 01/11/2012 02/10/2012 04/06/2012 POL 12/14/2011



2013-0715

# 2 Pediarix at 10 wks-4 days 02/26/2011 F Not Comple 04/07/2011 PEDIARIX 110 SKB Valid 05/03/2011 PEDIARIX 110 SKB Valid 3 06/04/2011 08/26/2011 10/23/2012 POL 05/03/2011




2013-0716

# 2 Pediarix at 10 wks 02/26/2011 F Not Comple 04/07/2011 PEDIARIX 110 SKB Valid 05/07/2011 PEDIARIX 110 SKB Valid 3 06/04/2011 08/26/2011 10/23/2012 POL 05/07/2011

Age: At Minimum 01/01/2013 06/26/2013



2013-0717 Newborn 02/01/2012 F Not Complete 1 03/14/2012 04/01/2012 05/28/2012 POL 02/01/2012



2013-0718

# 2 Pentacel at 6 yrs 11.5 mo. Off label but counts. 01/01/2011 F Not Comple 09/22/2013 PENTACEL 120 PMC Valid 12/15/2017 PENTACEL 120 PMC Valid 3 01/12/2018 01/12/2018 01/12/2018 POL 12/15/2017




2013-0719

Pentacel at 7 yrs; # 1 at age < 12 mo. Off label use. 09/16/2011 F Not Comple 02/25/2012 IPOL 10 PMC Valid 09/16/2018 PENTACEL 120 PMC Valid 3 10/14/2018 10/14/2018 10/14/2018 POL 09/16/2018




2013-0720

# 2 Pentacel at 7 yrs; # 1 at age ≥ 12 mo. 09/16/2011 F Not Comple 11/19/2012 IPOL 10 PMC Valid 09/16/2018 PENTACEL 120 PMC Valid 3 10/14/2018 10/14/2018 10/14/2018 POL 09/16/2018



Rolled birth date forward to 2011 to ensure test was relevant to when ACIP recommendations were made. Previous dates were before the ACIP recommendations were published. Original forecast were suggesting skipping dose 3 to the final dose at 6 months. EIPB 1.5

2013-0721


Age: Too Young 3 09/30/2011 12/01/2011 01/28/2013 POL 09/02/2011




2013-0722

# 3 Pentacel at 14 wks-4 days 06/01/2011 F Not Comple 07/09/2011 PENTACEL 120 PMC Valid 08/06/2011 PENTACEL 120 PMC Valid 09/03/2011 PENTACEL 120 PMC Valid 4 06/01/2015 06/01/2015 06/28/2018 POL 09/03/2011





2013-0723

# 3 Pentacel at 6 yrs 11.5 mo 01/15/2011 F Complete 03/15/2011 IPOL 10 PMC Valid 05/15/2011 IPOL 10 PMC Valid 12/30/2017 PENTACEL 120 PMC Valid - POL 12/30/2017




2013-0724


Age: Too Young 4 04/04/2015 04/04/2015 05/01/2018 POL 03/30/2012




2013-0725

# 4 Pentacel at 1 yr -4 days 04/04/2011 F Not Comple 06/04/2011 PENTACEL 120 PMC Valid 08/04/2011 PENTACEL 120 PMC Valid 10/04/2011 PENTACEL 120 PMC Valid 03/31/2012 PENTACEL 120 PMC Not Valid

Age: Too Young 4 04/04/2015 04/04/2015 05/01/2018 POL 03/31/2012




2013-0726

# 4 Pentacel ≥ age 12 mo 04/04/2011 F Not Comple 06/04/2011 PENTACEL 120 PMC Valid 08/04/2011 PENTACEL 120 PMC Valid 10/04/2011 PENTACEL 120 PMC Valid 04/04/2012 PENTACEL 120 PMC Not Valid

Age: Too Young 4 04/04/2015 04/04/2015 05/01/2018 POL 04/04/2012




2013-0727

# 4 Pentacel at 4 yrs 05/06/2011 F Complete 09/15/2011 PENTACEL 120 PMC Valid 04/28/2012 PENTACEL 120 PMC Valid 11/06/2014 PENTACEL 120 PMC Valid 05/06/2015 PENTACEL 120 PMC Valid - POL 05/06/2015

Age: At Minimum 01/01/2013 11/25/2015



2013-0728

# 1 Pentacel at 6 wks-5 days 05/06/2011 F Not Comple 06/12/2011 PENTACEL 120 PMC Not Valid

Age: Too Young 1 06/17/2011 07/06/2011 09/02/2011 POL 06/12/2011




2013-0729

# 5 Pentacel at ≥ 4 yrs 02/08/2011 F Complete 01/08/2012 PENTACEL 120 PMC Valid 04/08/2012 PENTACEL 120 PMC Valid 07/08/2012 PENTACEL 120 PMC Valid 12/09/2012 PENTACEL 120 PMC Not Valid

Age: Too Young 03/01/2015 PENTACEL 120 PMC Valid - POL 03/01/2015




2013-0730

# 4 Pentacel at 5 yrs=off label 02/08/2011 F Complete 06/08/2011 PENTACEL 120 PMC Valid 12/05/2011 PENTACEL 120 PMC Valid 02/07/2012 PENTACEL 120 PMC Valid 02/10/2016 PENTACEL 120 PMC Valid - POL 02/10/2016




2013-0731

invalid age dose 1 as first of others 08/01/2011 F Not Comple 09/05/2011 PENTACEL 120 PMC Not Valid

Age: Too Young 12/01/2011 PENTACEL 120 PMC Valid 02/01/2012 PENTACEL 120 PMC Valid 3 02/29/2012 02/29/2012 03/28/2013 POL 02/01/2012





2013-0732

invalid age dose 2 in midst of others 10/18/2011 F Not Comple 11/25/2011 PENTACEL 120 PMC Valid 12/22/2011 PENTACEL 120 PMC Not Valid

Age: Too Young 03/10/2012 PENTACEL 120 PMC Valid 10/20/2012 PENTACEL 120 PMC Valid 4 10/18/2015 10/18/2015 11/14/2018 POL 10/20/2012




2013-0733

invalid age dose 3 in midst of others 06/01/2011 F Not Comple 07/09/2011 PENTACEL 120 PMC Valid 08/06/2011 PENTACEL 120 PMC Valid 09/02/2011 PENTACEL 120 PMC Not Valid

Age: Too Young 07/07/2012 PENTACEL 120 PMC Valid 4 06/01/2015 06/01/2015 06/28/2018 POL 07/07/2012




2013-0734






2013-0735

dose 1 to 2 Pentacel, interval 28-4 days 11/01/2011 F Not Comple 01/03/2012 PENTACEL 120 PMC Valid 01/27/2012 PENTACEL 120 PMC Valid 3 02/24/2012 05/01/2012 06/28/2013 POL 01/27/2012




2013-0736






2013-0737

dose 2 to 3 Pentacel, interval 28-4 days 04/01/2011 F Not Comple 06/01/2011 PENTACEL 120 PMC Valid 08/01/2011 PENTACEL 120 PMC Valid 08/25/2011 PENTACEL 120 PMC Valid 4 04/01/2015 04/01/2015 04/28/2018 POL 08/25/2011




2013-0739

# 1 Pentacel at 6 wks-4 days 04/04/2011 F Not Comple 05/12/2011 PENTACEL 120 PMC Valid 2 06/13/2011 08/04/2011 10/01/2011 POL 05/12/2011




2013-0740

dose 3 to 4 Pentacel, interval 6m-4 days 08/09/2011 F Not Comple 10/09/2011 PENTACEL 120 PMC Valid 02/09/2012 PENTACEL 120 PMC Valid 04/09/2012 PENTACEL 120 PMC Valid 10/05/2012 PENTACEL 120 PMC Not Valid

Age: Too Young 4 08/09/2015 08/09/2015 09/05/2018 POL 10/05/2012




2013-0743


Interval: Too Short 08/01/2011 PENTACEL 120 PMC Valid 3 08/29/2011 08/29/2011 10/08/2012 POL 08/01/2011





2013-0744

invalid dose 2-3 interval in midst of others 02/02/2011 F Not Comple 04/02/2011 PENTACEL 120 PMC Valid 06/02/2011 PENTACEL 120 PMC Valid 06/23/2011 PENTACEL 120 PMC Not Valid

Interval: Too Short 02/05/2012 PENTACEL 120 PMC Valid 4 02/02/2015 02/02/2015 03/01/2018 POL 02/05/2012




2013-0747

# 1 Pentacel at 6 wks 04/04/2011 F Not Comple 05/16/2011 PENTACEL 120 PMC Valid 2 06/13/2011 08/04/2011 10/01/2011 POL 05/16/2011

Age: At Minimum 01/01/2013 11/25/2015



2013-0748

# 1 Pentacel at 6 yrs 11.5 mo 01/15/2011 F Not Comple 01/02/2018 PENTACEL 120 PMC Valid 2 01/30/2018 01/30/2018 01/30/2018 POL 01/02/2018




2013-0749

# 1 Pentacel at 7 yrs. Off label 02/01/2011 F Not Comple 02/01/2018 PENTACEL 120 PMC Valid 2 03/01/2018 03/01/2018 03/01/2018 POL 02/01/2018




2013-0750


Age: Too Young 2 01/11/2012 02/10/2012 04/06/2012 POL 12/14/2011




2013-0751

# 2 Pentacel at 10 wks-4 days 10/10/2011 F Not Comple 11/17/2011 PENTACEL 120 PMC Valid 12/15/2011 PENTACEL 120 PMC Valid 3 01/16/2012 04/10/2012 06/06/2013 POL 12/15/2011




2013-0752

# 2 Pentacel at 6 yrs . Off label 01/15/2011 F Not Comple 01/15/2012 PENTACEL 120 PMC Valid 01/15/2017 PENTACEL 120 PMC Valid 3 02/12/2017 02/12/2017 02/12/2017 POL 01/15/2017




2013-0753Newborn forecast 04/01/2012 F Not Complete 1 05/13/2012 06/01/2012 Rota 04/01/2012



2013-0754

Dose # 3 Rotateq at age 14 weeks 11/01/2011 F Complete 12/13/2011 ROTATEQ 116 MSD Valid 01/10/2012 ROTATEQ 116 MSD Valid 02/07/2012 ROTATEQ 116 MSD Valid - Rota 02/07/2012

Age: At Minimum 01/01/2013 01/01/2013


2013-0755

Dose # 3 Rotateq at age 6 months 11/01/2011 F Complete 01/01/2012 ROTATEQ 116 MSD Valid 03/01/2012 ROTATEQ 116 MSD Valid 05/01/2012 ROTATEQ 116 MSD Valid - Rota 05/01/2012



2013-0756

Dose 1 to dose 2 Rotateq interval 28-5 days 02/05/2012 F Not Comple 03/25/2012 ROTATEQ 116 MSD Valid 04/17/2012 ROTATEQ 116 MSD Not Valid

Interval: Too Short 2 05/15/2012 06/05/2012 08/01/2012 Rota 04/17/2012



2013-0757

Dose 1 to dose 2 Rotateq interval 28-4 days 02/05/2012 F Not Comple 03/25/2012 ROTATEQ 116 MSD Valid 04/18/2012 ROTATEQ 116 MSD Valid 3 05/16/2012 08/05/2012 10/02/2012 Rota 04/18/2012



2013-0758

Dose 1 to dose 2 Rotateq interval 28 days 02/05/2012 F Not Comple 03/25/2012 ROTATEQ 116 MSD Valid 04/22/2012 ROTATEQ 116 MSD Valid 3 05/20/2012 08/05/2012 10/02/2012 Rota 04/22/2012



2013-0759

Dose 2 to dose 3 Rotateq interval 28-5 days 11/01/2011 F Not Comple 12/28/2011 ROTATEQ 116 MSD Valid 02/02/2012 ROTATEQ 116 MSD Valid 02/25/2012 ROTATEQ 116 MSD Not Valid




2013-0760

Dose 2 to dose 3 Rotateq interval 28-4 days 11/01/2011 F Complete 12/28/2011 ROTATEQ 116 MSD Valid 02/02/2012 ROTATEQ 116 MSD Valid 02/26/2012 ROTATEQ 116 MSD Valid - Rota 02/26/2012



2013-0761

Dose 2 to dose 3 Rotateq interval 28 days 11/01/2011 F Complete 12/28/2011 ROTATEQ 116 MSD Valid 02/02/2012 ROTATEQ 116 MSD Valid 03/01/2012 ROTATEQ 116 MSD Valid - Rota 03/01/2012



2013-0762

Dose # 1 Rotarix at age 6 weeks-5 days 01/02/2012 F Not Comple 02/08/2012 ROTARIX 119 SKB Not Valid

Age: Too Young 1 02/13/2012 03/02/2012 Rota 02/08/2012




2013-0763

Dose # 1 Rotarix at age 6 weeks-4 days 01/02/2012 F Not Comple 02/09/2012 ROTARIX 119 SKB Valid 2 03/12/2012 05/02/2012 06/29/2012 Rota 02/09/2012



2013-0764

Dose # 1 Rotateq at age 6 weeks-5 days 01/01/2012 F Not Comple 02/07/2012 ROTATEQ 116 MSD Not Valid

Age: Too Young 1 02/12/2012 03/01/2012 Rota 02/07/2012



2013-0765

Dose # 1 Rotarix at age 6 weeks 01/02/2012 F Not Comple 02/13/2012 ROTARIX 119 SKB Valid 2 03/12/2012 05/02/2012 06/29/2012 Rota 02/13/2012

Age: At Minimum 01/01/2013 01/01/2013


2013-0766

Dose # 2 Rotarix at age 10 weeks-5 days 12/01/2011 F Not Comple 01/10/2012 ROTARIX 119 SKB Valid 02/04/2012 ROTARIX 119 SKB Not Valid

Age: Too Young 2 03/03/2012 04/01/2012 05/28/2012 Rota 02/04/2012



2013-0767

Dose # 2 Rotarix at age 10 weeks-4 days 12/01/2011 F Complete 01/12/2012 ROTARIX 119 SKB Valid 02/05/2012 ROTARIX 119 SKB Valid - Rota 02/05/2012



2013-0768

Dose # 2 Rotarix at age 10 weeks 12/01/2011 F Complete 01/12/2012 ROTARIX 119 SKB Valid 02/09/2012 ROTARIX 119 SKB Valid - Rota 02/09/2012

Age: At Minimum 01/01/2013 01/01/2013


2013-0769

Dose 1 to dose 2 Rotarix interval 28-5 days 12/01/2011 F Not Comple 02/01/2012 ROTARIX 119 SKB Valid 02/24/2012 ROTARIX 119 SKB Not Valid




2013-0770

Dose 1 to dose 2 Rotarix interval 28-4 days 12/01/2011 F Complete 02/01/2012 ROTARIX 119 SKB Valid 02/25/2012 ROTARIX 119 SKB Valid - Rota 02/25/2012



2013-0771

Dose 1 to dose 2 Rotarix interval 28 days 12/01/2011 F Complete 02/01/2012 ROTARIX 119 SKB Valid 02/29/2012 ROTARIX 119 SKB Valid - Rota 02/29/2012



2013-0772

≥15 weeks old with no rota vax: no forecast for rotavirus 01/01/2012 F Aged Out - Rota 04/15/2012




2013-0773

Dose # 1 ≥ 15 weeks old 12/28/2011 F Not Comple 04/15/2012 ROTARIX 119 SKB Valid 2 05/13/2012 05/13/2012 06/24/2012 Rota 04/15/2012



2013-0774

8 months old with only one rota vax 08/17/2011 F Not Comple 11/17/2011 ROTARIX 119 SKB Valid 2 12/15/2011 12/17/2011 02/13/2012 Rota 04/17/2012



Child is exactly 8 months old based on the Assessment Date and should still be recommended for administration. 1.1

2013-0775

Dose # 1 Rotateq at age 6 weeks-4 days 01/01/2012 F Not Comple 02/08/2012 ROTATEQ 116 MSD Valid 2 03/11/2012 05/01/2012 06/28/2012 Rota 02/08/2012



2013-0776

Rotateq at 2 months; rotarix at 4 mo 01/06/2012 F Not Comple 03/06/2012 ROTATEQ 116 MSD Valid 05/06/2012 ROTARIX 119 SKB Valid 3 06/03/2012 07/06/2012 09/02/2012 Rota 05/06/2012



2013-0777

Rotatrix at 2 mo; rotateq at 4 mo 01/06/2012 F Not Comple 03/06/2012 ROTARIX 119 SKB Valid 05/06/2012 ROTATEQ 116 MSD Valid 3 06/03/2012 07/06/2012 09/02/2012 Rota 05/06/2012



2013-0778

Unspecified rotavirus at 2 and 4 mo 12/06/2011 F Not Comple 02/06/2012 Rotavirus U 122 Valid 04/06/2012 Rotavirus U 122 Valid 3 05/04/2012 06/06/2012 08/02/2012 Rota 04/06/2012



2013-0779

Severe combined immunodeficiency (SCID)=no rotavirus vaccine 02/01/2012 F

immunodeficiency due to any cause, including HIV (hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive therapy, including steroids) VXC27 CDCPHINVS Contraindicated - Rota 03/01/2012



2013-0780


allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 04/01/2012 ROTARIX 119 SKB Valid - Rota 04/01/2012



2013-0781

Dose # 1 Rotateq at age 6 weeks 01/01/2012 F Not Comple 02/12/2012 ROTATEQ 116 MSD Valid 2 03/11/2012 05/01/2012 06/28/2012 Rota 02/12/2012

Age: At Minimum 01/01/2013 01/01/2013


2013-0782

Dose # 2 Rotateq at age 10 weeks-5 days 12/01/2011 F Not Comple 01/10/2012 ROTATEQ 116 MSD Valid 02/04/2012 ROTATEQ 116 MSD Not Valid




2013-0783

Dose # 2 Rotateq at age 10 weeks-4 days 12/01/2011 F Not Comple 01/12/2012 ROTATEQ 116 MSD Valid 02/05/2012 ROTATEQ 116 MSD Valid 3 03/08/2012 06/01/2012 07/28/2012 Rota 02/05/2012



2013-0784

Dose # 2 Rotateq at age 10 weeks 12/01/2011 F Not Comple 01/12/2012 ROTATEQ 116 MSD Valid 02/09/2012 ROTATEQ 116 MSD Valid 3 03/08/2012 06/01/2012 07/28/2012 Rota 02/09/2012

Age: At Minimum 01/01/2013 01/01/2013


2013-0785

Dose # 3 Rotateq at age 14 weeks-5 days 11/01/2011 F Not Comple 12/10/2011 ROTATEQ 116 MSD Valid 01/07/2012 ROTATEQ 116 MSD Valid 02/02/2012 ROTATEQ 116 MSD Not Valid




2013-0786

Dose # 3 Rotateq at age 14 weeks-4 days 11/01/2011 F Complete 12/13/2011 ROTATEQ 116 MSD Valid 01/10/2012 ROTATEQ 116 MSD Valid 02/03/2012 ROTATEQ 116 MSD Valid - Rota 02/03/2012



2013-0787


allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 04/01/2012 ROTATEQ 116 MSD Valid 05/01/2012 ROTARIX 119 SKB Valid - Rota 05/01/2012



2013-0789#1 at 15 months 03/14/2000 F Not Comple 06/14/2001 VARIVAX 21 MSD Valid 2 09/06/2001 03/14/2004 04/10/2007 Var 06/14/2001



Improved test case name and forecast test type to acurately reflect what was being tested 1.1

2013-0795

No doses of Varicella: current age 13Y -1D 06/02/1991 F Not Complete 1 06/02/1992 06/02/1992 10/29/1992 Var 06/01/2004



2013-0798#1 at 1 year 01/01/2005 F Not Comple 01/01/2006 VARIVAX 21 MSD Valid 2 04/01/2006 01/01/2009 01/28/2012 Var 01/01/2006

Age: At Minimum 01/01/2013 01/01/2013


2013-0803

# 1 at 12 months-5 days 01/01/2005 F Not Comple 12/27/2005 VARIVAX 21 MSD Not Valid

Age: Too Young 1 01/24/2006 01/24/2006 05/28/2006 Var 12/27/2005



2013-0804

VAR # 1 at 12 months-4 days 01/01/2005 F Not Comple 12/28/2005 VARIVAX 21 MSD Valid 2 04/01/2006 01/01/2009 01/28/2012 Var 12/28/2005



2013-0806

Newborn forecasting 04/01/2012 F Not Complete 1 04/01/2013 04/01/2013 08/28/2013 Var 04/01/2012




2013-0807

# 2 at age 13 years + 28 days 10/18/1998 F Complete 10/18/2011 VARIVAX 21 MSD Valid 11/15/2011 VARIVAX 21 MSD Valid - Var 11/15/2011

Age: At Minimum 01/01/2013 01/01/2013


2013-0808

Dose 1 to dose 2 interval 28-1 days in child < 13 years 11/11/2009 F Not Comple 11/12/2010 VARIVAX 21 MSD Valid 12/09/2010 VARIVAX 21 MSD Not Valid

Interval: Too Short 2 03/03/2011 11/11/2013 12/08/2016 Var 12/09/2010



v1.6: Incorrect Forecast Test Type was used and has been updated to reflect how the recommended date was forecasted. 1.6

2013-0809

Dose 1 to dose 2 interval 28 days in child < 13 yrs old 01/01/1997 F Complete 03/01/2006 VARIVAX 21 MSD Valid 03/29/2006 VARIVAX 21 MSD Valid - Var 03/29/2006



2013-0810

Dose 1 to dose 2 interval 28-5 days in child ≥ 13 yrs old 01/01/1997 F Not Comple 04/01/2010 VARIVAX 21 MSD Valid 04/24/2010 VARIVAX 21 MSD Not Valid

Interval: Too Short 2 05/22/2010 05/22/2010 05/22/2010 Var 04/24/2010



2013-0811

Dose 1 to dose 2 interval 28-4 days in child ≥ 13 years old 01/01/1997 F Complete 04/01/2010 VARIVAX 21 MSD Valid 04/25/2010 VARIVAX 21 MSD Valid - Var 04/25/2010



2013-0812

Dose 1 to dose 2 interval 28 days in child ≥ 13 years old 01/01/1997 F Complete 06/01/2010 VARIVAX 21 MSD Valid 06/29/2010 VARIVAX 21 MSD Valid - Var 06/29/2010



2013-0813

VZ and MMR given on same day at age 12 months 08/08/2008 F Not Comple 08/08/2009 M-M-R II 03 MSD Valid 08/08/2009 VARIVAX 21 MSD Valid 2 11/08/2009 08/08/2012 09/04/2015 Var 08/08/2009

Age: At Minimum 01/01/2013 01/01/2013


2013-0814

Doses 1 and 2 of VZ and MMR given at ages 12 and 13 months 09/09/2009 F Complete 09/09/2010 M-M-R II 03 MSD Valid 09/09/2010 VARIVAX 21 MSD Valid 10/07/2010 M-M-R II 03 MSD Valid 10/07/2010 VARIVAX 21 MSD Valid - Var 10/07/2010



2013-0815

MMR to VZ interval 28-1 day = invalid VZ. 07/07/2005 F Not Comple 07/07/2006 M-M-R II 03 MSD Valid 08/03/2006 VARIVAX 21 MSD Not Valid

Live Virus Conflict 1 08/31/2006 08/31/2006 12/04/2006 Var 08/03/2006



2013-0816

MMR given at age 12 mo; VZ at age 12 mo+28 days 10/10/2010 F Not Comple 10/10/2011 M-M-R II 03 MSD Valid 11/07/2011 VARIVAX 21 MSD Valid 2 01/30/2012 10/10/2014 11/06/2017 Var 11/07/2011



2013-0817

# 1 at age 12 mo-5 days 11/10/2009 F Not Comple 11/05/2010 VARIVAX 21 MSD Not Valid

Age: Too Young 1 12/03/2010 12/03/2010 04/06/2011 Var 11/05/2010



2013-0818

# 1 MMRV at 12 m-5 days 11/10/2009 F Not Comple 11/05/2010 PROQUAD 94 MSD Not Valid

Age: Too Young 1 12/03/2010 12/03/2010 04/06/2011 Var 11/05/2010



2013-0819

# 1 MMRV at 12 m-4 days 07/01/2005 F Not Comple 06/27/2006 PROQUAD 94 MSD Valid 2 10/01/2006 07/01/2009 07/28/2012 Var 06/27/2006



2013-0820

# 1 MMRV at 12 months 07/01/2009 F Not Comple 07/01/2010 PROQUAD 94 MSD Valid 2 10/01/2010 07/01/2013 07/28/2016 Var 07/01/2010

Age: At Minimum 01/01/2013 01/01/2013


2013-0821

Dose 1 to dose 2 MMRV interval 28 days in child < 15 months 05/01/2008 F Complete 06/01/2009 PROQUAD 94 MSD Valid 06/29/2009 PROQUAD 94 MSD Valid - Var 06/29/2009



2013-0822

Dose 1 to dose 2 MMRV interval 28 days in child ≥ 15 months old=valid VZ 05/01/2004 F Complete 07/15/2005 PROQUAD 94 MSD Valid 08/12/2005 PROQUAD 94 MSD Valid - Var 08/12/2005



2013-0823

Dose 1 to dose 2 MMRV interval 28-1 days 09/06/2004 F Not Comple 10/01/2008 PROQUAD 94 MSD Valid 10/28/2008 PROQUAD 94 MSD Not Valid




2013-0824

MMR to MMRV interval 28 days=valid VZ # 1 02/02/2005 F Not Comple 02/02/2006 M-M-R II 03 MSD Valid 03/02/2006 PROQUAD 94 MSD Valid 2 05/25/2006 02/02/2009 02/29/2012 Var 03/02/2006



2013-0825

MMR to MMRV interval 27 days=invalid as VZ # 1 02/01/2011 F Not Comple 02/02/2012 M-M-R II 03 MSD Valid 02/29/2012 PROQUAD 94 MSD Not Valid




2013-0826

Dose 1 to dose 2 MMRV interval 12 weeks in child < 13 years old 02/02/2005 F Complete 08/13/2008 PROQUAD 94 MSD Valid 11/05/2008 PROQUAD 94 MSD Valid - Var 11/05/2008



2013-0827

Dose 1 to dose 2 interval of 4 wks between VZ and MMRV in any age child=both valid 05/22/2005 F Complete 06/01/2006 VARIVAX 21 MSD Valid 06/29/2006 PROQUAD 94 MSD Valid - Var 06/29/2006



2013-0829

28 day interval between invalid VZ and subsequent MMRV=valid VZ 05/22/2005 F Not Comple 05/17/2006 VARIVAX 21 MSD Not Valid

Age: Too Young 06/14/2006 PROQUAD 94 MSD Valid 2 09/06/2006 05/22/2009 06/18/2012 Var 06/14/2006



2013-0831

Interval of < 24 days between an invalid VZ and a subsequent MMRV=not valid VZ 07/16/2005 F Not Comple 07/11/2006 VARIVAX 21 MSD Not Valid





Forecast Dates were forecasting Dose 2, but the patient is still trying to satisfy target dose #1. Dates were updated to reflect a forecast for dose 1 based on live virus spacing. 1.1

2013-0832

LAIV given at age 3 years; VZ at age 3 years + 27 days 10/14/2008 F Not Comple 10/14/2011 FLUMIST 111 MED Valid 11/10/2011 VARIVAX 21 MSD Not Valid




2013-0833

LAIV given at age 3 years; VZ at age 3 years + 28 days 10/14/2008 F Not Comple 10/14/2011 FLUMIST 111 MED Valid 11/11/2011 VARIVAX 21 MSD Valid 2 02/03/2012 10/14/2012 11/10/2015 Var 11/11/2011



2013-0834

History of VZ=series complete or exempt by hx of disease 05/01/2004 F

History of varicella infection 38907003 SCT Immune - Var 04/01/2005


Not recommended: immune

2013-0835

Titer of immunity to VZ=series complete or exempt 06/01/2005 F

History of varicella infection 38907003 SCT Immune - Var 06/01/2006




2013-0836

Anaphylactic reaction to dose 1 of VZ 12/12/2010 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindic 03/15/2012 VARIVAX 21 MSD Valid - Var 03/15/2012



2013-0837

Diagnosis of severe immunodeficiency. No second dose. 12/12/2009 F

immunodeficiency due to any cause, including HIV (hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive therapy, including steroids) VXC27 CDCPHINVS Contraindic 12/20/2010 VARIVAX 21 MSD Valid - Var 12/20/2010



2013-0839

Diagnosis of severe immunodeficiency before administration of any VZ. No VZ to be given. 11/18/2010 F

immunodeficiency due to any cause, including HIV (hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive therapy, including steroids) VXC27 CDCPHINVS Contraindicated - Var 10/18/2011



2013-0840

# 1 MMR at 12.5 mo; VZ not given=need 28 day interval for VZ 03/17/2011 F Not Comple 04/01/2012 M-M-R II 03 MSD Valid 1 04/29/2012 04/29/2012 08/13/2012 Var 04/01/2012



2013-0842

# 2 at age 12 mo+ 4 Weeks 11/28/2007 F Complete 11/28/2008 VARIVAX 21 MSD Valid 12/26/2008 VARIVAX 21 MSD Valid - Var 12/26/2008



2013-0843# 2 at age 15 mo. 11/28/2007 F Complete 11/28/2008 VARIVAX 21 MSD Valid 02/28/2009 VARIVAX 21 MSD Valid - Var 02/28/2009

Age: At Minimum 01/01/2013 01/01/2013


2013-0844

# 1 at age ≥ 13 years old 01/01/1997 F Not Comple 01/04/2010 VARIVAX 21 MSD Valid 2 02/01/2010 02/01/2010 02/01/2010 Var 01/04/2010




2015-0001

Varicella: Zoster dose in lieu of first dose of Varicella for adult patient 06/16/1979 F Not Comple 06/16/2015 ZOSTAVAX 121 MSD Valid 2 07/14/2015 07/14/2015 07/14/2015 Var 06/16/2015



New test case for version 2.0 which expanded scope into Adult recommendations 2.0

2015-0002

Varicella: Adult patient has received 2 doses of the Varicella Vaccine at least 4 weeks apart 02/18/1992 F Complete 03/28/2015 VARIVAX 21 MSD Valid 5/2/2015 VARIVAX 21 MSD Valid - Var 05/02/2015




2015-0003

Varicella: Patient is U.S. born before 1/1/1980 06/16/1977 F Immune - Var 06/19/2015




2015-0004

Varicella: Patient was born in Mexico and born before 01/01/1980 05/28/1974 F Not Comple 05/28/2015 VARIVAX 21 MSD Valid 2 06/25/2015 06/25/2015 06/25/2015 Var 05/28/2015




2015-0005

Varicella: Patient has laboratory evidence of immunity for Varicella 06/16/1990 F

Laboratory Evidence of Immunity or confirmation of Varicella Disease 371113008 SCT Immune - Var 06/16/2015




2015-0006

Varicella: Patient has a Varicella verifiable diagnosis by a healthcare provider. 06/16/1983 F

Healthcare provider verified history of or diagnosis of Varicella 38907003 SCT Immune - Var 06/16/2015




2015-0007

Varicella: Patient has a Herpes Zoster verifiable diagnosis by a healthcare provider. 06/19/1972 F

Healthcare provider verified history of or diagnosis of Herpes Zoster 4740000 SCT Immune - Var 06/19/2015




2015-0008

Varicella: Patient is a healthcare worker without evidence of immunity for Varicella. 03/28/1968 F

Healthcare Personnel 223366009 SCT Not Comple 05/28/2015 VARIVAX 21 MSD Valid 2 06/25/2015 06/25/2015 06/25/2015 Var 05/28/2015




2015-0011

Varicella: Patient is pregnant, and has not been found to have evidence of immunity for Varicella. 06/19/1977 F

Patient currently Pregnant 77386006 SCT Contraindicated - Var 06/19/2015




2015-0012

Varicella: Zoster dose administered at 50 years - 1 day 05/29/1965 F Not Comple 05/28/2015 ZOSTAVAX 121 MSD Valid 2 06/25/2015 06/25/2015 06/25/2015 Var 05/28/2015




2015-0013

Zoster: Zoster Dose administered at 50 years of age 06/12/1965 F Complete 06/12/2015 ZOSTAVAX 121 MSD Valid - Zoster 06/12/2015




2015-0014

Zoster: Zoster Dose administered at 60 years of age 01/20/1955 F Complete 02/03/2015 ZOSTAVAX 121 MSD Valid - Zoster 02/03/2015




2015-0015

Zoster: Patient is 60 years of age and pregnant 06/12/1955 F

Patient currently Pregnant 77386006 SCT Contraindicated - Zoster 06/12/2015





2015-0016

Zoster: Patient is overdue at 62 years of age for Zoster dose 03/16/1953 F Not Complete 1 03/16/2013 03/16/2013 Zoster 04/01/2015




2015-0017

Zoster: Anaphylactic reaction to Zoster vaccine components (Gelatin or neomycin). 06/16/1955 F

allergy to previous dose of this vaccine or to any of its unlisted vaccine components (anaphylactic) VXC20 CDCPHINVS Contraindicated - Zoster 06/16/2015




2015-0018

Zoster: MMR to Zoster interval 28 days 05/12/1962 F Complete 05/12/2015 M-M-R II 03 MSD Valid 6/9/2015 ZOSTAVAX 121 MSD Valid - Zoster 06/09/2015




2015-0019

Zoster: MMR to Zoster interval 28 - 1 days 05/12/1964 F Not Comple 05/12/2015 M-M-R II 03 MSD Valid 6/8/2015 ZOSTAVAX 121 MSD Not Valid

Live Virus Conflict 1 05/12/2024 05/12/2024 Zoster 06/08/2015




2015-0020

Pneumococcal: Patient has no history of PCV 13 or PPSV 23 06/08/1950 F Not Complete 1 06/08/2015 06/08/2015 PCV 06/08/2015




2015-0021

Pneumococcal: Patient has received PCV13 and PPSV23 02/18/1950 F Complete 02/24/2015 PREVNAR 1 133 PFR Valid 2/24/2016 PNEUMOVA 33 MSD Valid - PCV 02/24/2016



New test case for version 2.0 which expanded scope into Adult recommendations. Update due to MMWR (9/4/2015 / Vol.64 / No. 34) changing the minimal and recommended interval from PCV13 to PPSV23 in adults 65+ from 6-12 months to 1 year. 2.1

2015-0022

Pneumococcal: Patient has received PCV13 but has no history of PPSV23 05/28/1950 F Not Comple 05/28/2015 PREVNAR 1 133 PFR Valid 2 05/28/2016 05/28/2016 PCV 05/28/2015



New test case for version 2.0 which expanded scope into Adult recommendations. Update due to MMWR (9/4/2015 / Vol.64 / No. 34) changing the minimal and recommended interval from PCV13 to PPSV23 in adults 65+ from 6-12 months to 1 year. 2.1

2015-0023

Pneumococcal: Patient has received PPSV23 at age 65 but has no history of PCV13. 04/12/1950 F Not Comple 04/28/2015 PNEUMOVA 33 MSD Valid 2 04/28/2016 04/28/2016 PCV 04/28/2015




2015-0024

MMR: Patient is born before 01/01/1957 06/12/1956 F Immune - MMR 03/23/2015




2015-0025

MMR: Patient is a healthcare worker, born before 1957, without laboratory evidence of immunity. 08/12/1955 F

Healthcare Personnel 223366009 SCT Not Comple 04/30/2015 M-M-R II 03 MSD Valid 2 05/28/2015 05/28/2015 05/28/2015 MMR 04/30/2015




2015-0027

Zoster: Patient has received a dose of Varicella vaccine 05/12/1955 F Not Recom 05/23/2015 VARIVAX 21 MSD Valid - Zoster 05/23/2015


Not recommended


2016-0001

Dose #1 received at 4 months, dose #2 received at 8 months, dose #3 received at 2 years, and dose #4 received at 3 years. Current Age is 7 yrs. 06/08/2009 F Not Comple 10/08/2009 DTaP 20 PMC Valid 02/08/2010 DTaP 20 PMC Valid 06/08/2011 DTaP 20 PMC Valid 06/08/2012 DTaP 20 PMC Valid 4 06/08/2016 06/08/2016 06/08/2016 DTaP 06/08/2016




2016-0002

Dose #1 received at 2 years, dose #2 received at 3 years, and dose #3 received at 4 years. Current age 7 yrs 03/02/2009 F Not Comple 05/02/2011 DTaP 20 PMC Valid 05/16/2012 DTaP 20 PMC Valid 08/01/2013 DTaP 20 PMC Valid 4 03/02/2016 03/02/2016 03/02/2016 DTaP 03/02/2016




2016-0003

3 Dose received at < 12 months. Current age is 7 years. 11/12/2009 F Not Comple 01/12/2010 DTaP 20 PMC Valid 03/12/2010 DTaP 20 PMC Valid 07/12/2010 DTaP 20 PMC Valid 4 11/12/2016 11/12/2016 11/12/2016 DTaP 11/12/2016




2016-0004

Dose #1 given at < 12 months. Current age is 7. 02/01/2009 F Not Comple 07/01/2009 DTaP 20 PMC Valid 2 02/01/2016 02/01/2016 02/01/2016 DTaP 02/01/2016




2016-0005

Dose #1 given at 3 months, dose #2 given at 1 year, dose #3 given at 2 years, and dose # 4 given at 3years. Current age is 7 yrs 02/17/2009 F Not Comple 05/17/2009 DTaP 20 PMC Valid 02/17/2010 DTaP 20 PMC Valid 02/17/2011 DTaP 20 PMC Valid 02/17/2012 DTaP 20 PMC Valid 5 02/17/2016 02/17/2016 02/17/2016 DTaP 02/17/2016





2016-0006

Dose #1 given at 5 months, dose #2 given at 1 year, dose #3 given at 2 years. Current age is 7 yrs 05/14/2009 F Not Comple 10/14/2009 DTaP 20 PMC Valid 05/04/2010 DTaP 20 PMC Valid 05/14/2011 DTaP 20 PMC Valid 4 05/14/2016 05/14/2016 05/14/2016 DTaP 05/14/2016




2016-0007

Dose #1 at 9 months, dose #2 at 2 years, and dose #3 at 5 years. Current Age is 7 yrs 01/31/2009 F Not Comple 10/31/2009 DTaP 20 PMC Valid 01/31/2011 DTaP 20 PMC Valid 01/31/2014 DTaP 20 PMC Valid 4 01/31/2016 01/31/2016 01/31/2016 DTaP 01/31/2016




2016-0008

Dose 1 given at < 12 mo Dose 2 given at 2 yrs Current age 7 yrs 04/02/2009 F Not Comple 06/02/2009 DTaP 20 PMC Valid 04/02/2011 DTaP 20 PMC Valid 3 04/02/2016 04/02/2016 04/02/2016 DTaP 04/02/2016




2016-0009

3 doses at < 12 mos, 1 dose at 1.5 yrs. Current Age is 7 yrs. 03/01/2009 F Not Comple 05/01/2009 DTaP 20 PMC Valid 09/01/2009 DTaP 20 PMC Valid 11/01/2009 DTaP 20 PMC Valid 08/01/2010 DTaP 20 PMC Valid 5 03/01/2016 03/01/2016 03/01/2016 DTaP 03/01/2016




2016-0010

Dose 1 and 2 given at < 12 months of age. Dose # 3 given at 2 years and dose #4 given at 3 years. Current age is 7 years. 04/04/2009 F Not Comple 07/04/2009 DTaP 20 PMC Valid 01/04/2010 DTaP 20 PMC Valid 04/16/2011 DTaP 20 PMC Valid 05/18/2012 DTaP 20 PMC Valid 4 04/04/2016 04/04/2016 04/04/2016 DTaP 04/04/2016




Documents

CDC Test Test Case DOB · Test 01/01/2013 07/09/2013: Recomme nded based on interval Past Due Date was missing. Added past due date per NIPInfo guidance. 1.1 2013-0019 1 Tdap, 2 Td