Re: [Gnumed-devel] one more vaccinations detail

[Karsten Hilbert]

> There seems to be no "restart" of vaccination schedules (see liz's comments)
This is what I am looking for. An intuitive term, BTW.

> mainly  *minimum number of doses*, possibly different in different age groups,
> and *minimum intervals*,  possibly different between different dose  number.
>
> The au guidelines  dropped the 18 month booster DTPa fairly recently,
> and have a 4 dose minimum  for DTPa with minimal intervals 1,1, 6 
> months.  Standard times is 2,4,6 mo, 4yrs.
> 10 yrs later, before leaving school, a  booster with lower antigen 
> content dTpa ; dTpa is for preventing neonatal pertussis,
> so also recommended pre-pregnancy or after delivery, or if involved 
> with child-care, or active grandparent.
>
> DTPa is not given over 8 years old, and the primary aim thereafter seems 
> to have dipth-tet immunization, so dT is used to make up
> at least 3 immunizations ( 3 to cover tet), min interval 1 month. Adults 
> with hx of min 3 tet containing vaccines, have 2 tet vaccines
> at 10 yr intervals, and finally at 50yrs.
>
> Polio ( now recommend inactivated IPV) is minimum 3 dose with 1 month 
> min interval, but recommended 4th dose,  at same time as DTPa.
> 
> MMr is 2 doses > 12mo, min interval 1month.
> 
> rubella is still pregnancy screened.
> 
> Meningicoccal conjugate is
>   2mo<= x < 4 , 3 doses;
>   4mo <= x < 12, 2 doses;
>                min interval 1 month
> 
>    x >=12mo , 1 dose.
>   
> varicella is
>  1yr <= x < 14 yrs, 1 dose
>   >14 yrs, 2 doses,  min interval 1 month.
> 
> Hep B is
>   if birth dose (< 1 wk ) given,
>        3 paed doses, min interval 1 month, 1 month
>   else
>        3 paed doses,  min intervals 1 month,  2 month
> 
> alternate adolescent (11-15yrs)
>  2  adult doses, min interval 4 months apart,
>    
> HIB  has 2 types , purified polysaccharide (PRP)
> outer membrane protein( -OMP), and other carrier ( -OC)
> PRP-OMP is more antigenic then PRP-OC
> catch-up start age:
> 0 < 6        : PRP-OMP  2 min doses, 1 mo min interval;  PRP-OC , 3 min 
> doses, 2 mo min interval; both  +booster min 2 months, pref at 12mo old
> 6 - < 12   : PRP-OMP same ; PRP-OC 2 min doses, then same
> 12 < 15   : PRP-OMP  and PRP-OC , 1 dose + 1 booster , min interval 2 
> mo, pref 18 mo old
> 15mo-5 yrs : single dose ( PRP -OMP or OC)
> 
> Comvax is PRP-OMP ( seems most common brand here)
> 
> Pneumococcal - deciding 3 , 2 , or 1 doses of 7-valent , and whether and 
> when to have 23-valent.
> 
> start 2-6 months is always 3 doses, min interval 2 months,
> start 7mo - 17mo is always 2 doses, min interval 2 months,
>  thereafter  ,
> lower , medium or high risk, is
>  lower -18mo -23mo,  1 dose  7 valent
>  medium - 18mo -  5yrsmo  1 dose,   
>  high  - 18 - 5 yrs,   2 doses , min interval 2 months.
> 
> medium and high - may follow with 23 valent , min interval 2 mon, pref 
> age 4 yrs.
> 
> In au,  high risk might be medical conditions, and medium living in 
> Central Australia when indigenous.
> 
> That's the easy part ( thanks for the motivation to read the schedule)  
> : reference ( 'catch-up schedules' pp42-52, 'pneumoccoccus' pp223- 234, 
> AIH 8th ed)
> 
> hope this helps in the task of encoding catch-up details.
Sure. We can (backend-wise) cover all that. The only missing
piece was/is whether there is any hard evidence on when to
re-start base immunization on a given indication. That's the
only part the current structure and code don't cover.

Karsten
-- 
GPG key ID E4071346 @ wwwkeys.pgp.net
E167 67FD A291 2BEA 73BD  4537 78B9 A9F9 E407 1346