Skip directly to site content Skip directly to page options Skip directly to A-Z link


Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People
															Search
		×
			Vaccines site
			Vaccines site
				All CDC
				Submit
			For a full list of topics:A-Z Index
			Advanced Search
		Advanced Search


CoCASA (Comprehensive Clinic Assessment Software Application)


Facebook
        Twitter
        LinkedIn
        Syndicate





CoCASA Algorithm Reference										Related Pages
										On This Page
			DefinitionsRules for Each Antigen
		
This page describes the algorithms that CoCASA uses to produce reports.
**Note:** When running reports, the user can choose more or fewer than the number of doses that might be required by the algorithm for completeness. CoCASA will count the patient as complete for that particular antigen based on the lesser of the dose counts. For instance, if the algorithm requires 5 doses of an antigen, but the user chooses 2, then the patient will be counted as complete with 2 doses. Conversely, if the algorithm requires 2 doses but the user chooses 5, then the patient will still be counted as complete with 2 doses. Also note that when ACIP recommendations are applied, the intervals for compliance, missed opportunities, eligibility, and for coming due are calculated from the last valid or invalid dose.
Definitions
Note: Unless otherwise noted, the definitions listed below apply to all of the algorithms.
Complete and Up To Date:
The patient has received all of the selected vaccinations by either the compliance date or the compliance age as chosen by the user. If, when using compliance age, the patient’s date of birth causes his/her compliance age to fall after the assessment date, the patient is not included in the report, even if he/she falls within the age range chosen for the report. In other words, if you choose compliance by a specified age (e.g., 24 months), any patients that have not yet reached that age at the assessment date will be excluded from the report.
Complete But Late Up To Date:
The patient is not up to date at the compliance date or the compliance age requested for the report, but he/she becomes up to date according to the rules of the algorithm between the compliance date/age and the assessment date.
Bring Up To Date with One Visit:
The patient is not currently up to date by the assessment date, but is one dose shy of being complete for the particular antigen in question. If a report is run against a series of antigens and all of the remaining vaccinations could be given on the same day, then the patient could still be brought up to date with one visit.
Missed Opportunity On the Last Immunization Visit:
On the patient’s last visit for an immunization he/she received a dose of a different antigen than the antigen in question, or there was a reason a different antigen was not given, and at the time of that visit a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose.
Missed Opportunity On All Immunization Visits:
During any of the patient’s immunization visits he/she received a dose of a different antigen than the antigen in question, or there was a reason a different antigen was not given, and at the time of that visit a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose.
Missed Opportunity On All Previous Visits:
During any of the patient’s visits, not just immunization visits, he/she received a dose of a different antigen than the antigen in question, or there was a reason a different antigen was not given, or there was a non-immunization visit of some kind, and at the time of that visit a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose. Dates when only Influenza was given are not considered as a Missed Opportunity for other antigens.
Missed Opportunity On Only Non-Immunization Visits:
During any of the patient’s non-immunization visits, a valid dose of the antigen in question could have been administered in keeping with the patient’s age and the time interval from the previous valid or invalid dose.
**NOTE:**For the above missed opportunity calculations, influenza vaccinations are never considered to be a missed opportunity.  The reasoning behind this is that on many occasions influenza is administered as part of an immunization drive at locations like schools, clinics, or pharmacies where it would not be reasonable to expect other vaccinations to be given at the same time.
Eligible for Immunization:
Those patients who are not complete and up to date as of the assessment date and have no missed opportunities and, based on the rules of the antigen in question, could receive a valid dose of that antigen at the assessment date.
Last Visit < 12 Months Ago or Last Visit ≥= 12 Months Ago:
Only patients who are eligible for immunization are counted in these totals. Both immunization visits and non-immunization visits are counted.
Top of Page
Rules for Each Antigen
The rules listed below are applied for each antigen.DTaP | HepA | HepB | HIB | HPV | IIV or LAIV | IPV | MenACWY | MenB | MMR | PCV13 | RV | Tdap | VAR
DTaP—Diphtheria, tetanus, and acellular pertussis vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given at 6 weeks or later.
Dose 2 must be given at 10 weeks or later and at least 4 weeks after dose 1.
Dose 3 must be given at 14 weeks or later and at least 4 weeks after dose 2.
Dose 4 must be given at 12 months or later and at least 6 months after dose 3.
Dose 5 must be given at 4th birthday or later and at least 6 months after Dose 4.**Note:** DTwP, DTP and DT are all valid substitutes for DTaP.**Note:** If Dose 4 is given between 4 and 6 months after Dose 3 it will still be considered valid, but if Dose 4 has not been given yet, the patient will not be overdue until after a 6 month interval has passed.
4 valid doses were given and Dose 4 was given on or after the 4th birthday, or
5 valid doses were given and Dose 4 was given before the 4th birthday.List of Antigens
HepA—Hepatitis A vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given at 1 year or later.
Dose 2 must be given at 18 months or later and at least 6 months after dose 1.
There is a “reason not given” entry before the compliance date that specifies, “Lab evidence of positive serology”, or “MD diagnosis of previous disease”, or
2 valid doses were given.List of Antigens
HepB—Hepatitis B vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 can be given at birth.
Dose 2 must be given at 4 weeks or later and at least 4 weeks after the previous dose.
Dose 3 must be given at 24 weeks or later and at least 8 weeks after the previous dose and at least 16 weeks after Dose 1. If this dose is invalid, the minimum interval to the next dose is set to zero.**Note:** The use of combination vaccines may result in an extra (4th) dose of HepB. This algorithm accounts for a valid 4th dose but considers it Dose 3 if the 3rd dose does not meet the Dose 3 parameters above but the 4th dose does.
There is a “reason not given” entry before the compliance date that specifies, “Lab evidence of positive serology”, or “MD diagnosis of previous disease”, or
3 valid doses were given.List of Antigens
Hib—*Haemophilus influenza* type b vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given between 6 weeks and 5 years.
Dose 2 must be given between 10 weeks and 5 years and at least 4 weeks after Dose 1.
Dose 3 must be given between 14 weeks and 5 years and at least 4 weeks after Dose 2.
Dose 4 must be given between 12 months and 5 years and at least 8 weeks after Dose 3.
The patient has 4 valid doses, or
any valid dose was given after 15 months of age, or
the third dose was given after 12 months of age and more than 8 weeks after Dose 2, or
the patient’s first two doses were given after 12 months of age and Dose 2 was given more than 8 weeks after Dose 1.List of Antigens
HPV—Human papillomavirus vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status2-dose schedule
Dose 1 must be given on or after the 9th birthday and before the 15th birthday.
Dose 2 must be given at least 5 months after Dose 1.3-dose schedule
Dose 1 must be given on or after the 9th birthday.
Dose 2 must be given at least 4 weeks after Dose 1.
Dose 3 must be given at least 12 weeks after Dose 2 and at least 5 months after Dose 1.**Note:** CoCASA determines which schedule to use by examining the interval between valid Dose 1 and valid Dose 2. If the interval is greater than or equal to 5 months, the 2-dose schedule is used, otherwise the 3-dose schedule is used.
2 valid doses were given on the 2-dose schedule, or
3 valid doses were given on the 3-dose schedule.List of Antigens
IIV—Influenza vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDoses must be given between July 1 and June 30 of the succeeding year to be valid.
Dose 1 must be given at 6 months or later.
Dose 2, if required, must be given at 6 months plus 4 weeks or later and at least 4 weeks after Dose 1.
1 dose was given within the influenza season and either the patient was 9 years of age or more at the time of the dose or the patient was less than 9 years of age and this dose was greater than or equal to the third dose of the patient’s life, or
2 doses were given in the season and Dose 1 was the 1st or 2nd dose of the patient’s life, and the patient was less than 9 years of age at the time of Dose 1.List of Antigens
IPV—Inactivated poliovirus vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given at 6 weeks or later.
Dose 2 must be given at 10 weeks or later and at least 4 weeks after Dose 1.
Dose 3 must be given at 14 weeks or later and at least 4 weeks after Dose 2.
4 valid doses were given, or
3 valid doses were given and Dose 3 was given on or after the 4th birthday and at least 6 months after Dose 2.List of Antigens
MMR—Measles, mumps, and rubella vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given at 12 months or later and either on the same day as or at least 28 days after receiving varicella, smallpox, LAIV (Flumist), yellow fever, or monovalent measles, mumps, or rubella.
Dose 2 must be given at 13 months or later and either on the same day as or at least 28 days after receiving herpes zoster (shingles), varicella, smallpox, LAIV (Flumist), yellow fever, or monovalent measles, mumps, or rubella.
There is a “reason not given” entry before the compliance date that specifies, “Lab evidence of positive serology”, or “MD diagnosis of previous disease”, or
2 valid doses were given.List of Antigens
MenACWY—Meningococcal vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given greater than or equal to 10 years of age.
Dose 2, if needed, must be given at greater than or equal to 16 years of age and at least 8 weeks after Dose 1.
The patient was under 16 years of age at the compliance date, and 1 valid dose was given.
The patient was 16 years of age or greater at the time of compliance, and
2 valid doses were given, or
1 valid dose was given at 16 years or older.**Note:** the patient will not have any missed opportunities until on or after the 11th birthday.List of Antigens
MenB—Meningococcal serogroup B vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination status**Note:**CoCASA requires entry of brand name (Bexsero or Trumenba) for each MenB vaccine dose administered.
Bexsero
Dose 1 must be given greater than or equal to 10 years of age.
Dose 2 must be given at least 4 weeks after Dose 1.Trumenba
Dose 1 must be given greater than or equal to 10 years of age.
Dose 2 must be given at least 6 months after Dose 1, or, if the interval is less than 6 months, the minimum interval to the next dose is set to 4 months.**Note:** Administration of MenB vaccine for individuals aged 16–23 years is based on shared clinical decision making. Thus, MenB vaccine will not appear on any CoCASA missed opportunity reports.
2 valid doses were given.List of Antigens
PCV13—Pneumococcal conjugate vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given between 6 weeks and 5 years.
Dose 2 must be given between 10 weeks and 5 years and at least 4 weeks after Dose 1.
Dose 3 must be given between 14 weeks and 5 years and at least 4 weeks after Dose 2.
Dose 4 must be given between 12 months and 5 years and at least 8 weeks after Dose 3.
4 valid doses were given, or
the patient’s first, second, or third valid dose was given at 24 months or older, or
the patient’s first two doses were given after 12 months of age and Dose 2 was given 8 weeks or more after Dose 1, or
the patient’s third valid dose was given after 12 months and more than 8 weeks after Dose 2.List of Antigens
RV—Rotavirus vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given between 6 weeks and 15 weeks old.
Dose 2 must be given between 10 weeks and 8 months old and at least 4 weeks after Dose 1.
Dose 3 must be given between 14 weeks and 8 months old and at least 4 weeks after Dose 2.
2 valid doses of Rotarix were given, or
3 valid doses were given, and any dose in the series was RotaTeq or vaccine product is unknown for any vaccine in the series.List of Antigens
Tdap—Tetanus, diphtheria, and acellular pertussis vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given at 7 years of age or later.
1 valid dose was given.List of Antigens
VAR—Varicella vaccination
ACIP-recommended rules used by CoCASA to define valid doses
Rules used by CoCASA to assess complete or up-to-date (UTD) vaccination statusDose 1 must be given at 12 months or later and either on the same day as or at least 28 days after receiving herpes zoster (shingles), MMR, smallpox, LAIV (Flumist), yellow fever, or monovalent measles, mumps, or rubella.
Dose 2 must be given at least 4 weeks after dose 1 and either on the same day as or at least 28 days after receiving herpes zoster (shingles), MMR, smallpox, LAIV (Flumist), yellow fever, or monovalent measles, mumps, or rubella.
There is a “reason not given” entry before the compliance date that specifies “History of varicella”, “Lab evidence of positive serology for varicella”, or “Parent/patient report of disease”, or
2 valid doses were given.List of Antigens
Top of Page
							
					
						Page last reviewed:  January 17, 2019					Content source: 	National Center for Immunization and Respiratory Diseases CoCASA Home
Install CoCASA
Version History
Reports
Algorithm Reference
Core Assessment Reports nipcocasa@cdc.gov
800-803-5212
 Vaccines & ImmunizationsImmunization Quality Improvement for Providers (IQIP) ProgramImmunization Information Systems (IIS)Vaccines for Children Program (VFC)


About CDC
					Contact Us
					800-232-4636
 Facebook Twitter Instagram LinkedIn Youtube Pinterest Snapchat
 CONTACT CDC
				Contact Us
							Call 800-232-4636
							Email Us
			ABOUT CDC
				About CDC
							Jobs
							Funding
			POLICIES
				Accessibility
							External Links
							Privacy
							Policies
							No Fear Act
							FOIA
							OIG
							Nondiscrimination
							Vulnerability Disclosure Policy
			CONNECT WITH US
				Facebook
								Twitter
								Instagram
								LinkedIn
							Youtube
								Pinterest
								Snapchat
								Email
			LANGUAGES
				Español
							繁體中文
							Tiếng Việt
							한국어
							Tagalog
							Русский
							العربية
							Kreyòl Ayisyen
							Français
							Polski
							Português
							Italiano
							Deutsch
							日本語
							فارسی
							English


U.S. Department of Health & Human Services
			Accessibility
			External Links
			Privacy
			Policies
			No Fear Act
			FOIA
			Nondiscrimination
			OIG
			Vulnerability Disclosure Policy
			USA.gov


Exit Notification / Disclaimer Policy Close
 Links with this icon  indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
				Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
				You will be subject to the destination website's privacy policy when you follow the link.
				CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Website Disclaimers
 Cancel Continue