Description: 

The percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (HepB), one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday. The measure calculates a rate for each vaccine and nine separate combination rates.


Denominator:

Product lines
Commercial, Medicaid (report each product line separately).
Age
Children who turn 2 years of age during the measurement year.
Continuous enrollment
12 months prior to the child’s second birthday.
Allowable gap
No more than one gap in enrollment of up to 45 days during the 12 months prior to the child’s second birthday. To determine continuous enrollment for a Medicaid beneficiary for whom enrollment is verified monthly, the member may not have more than a 1-month gap in coverage (i.e., a member whose coverage lapses for 2 months [60 days] is not continuously enrolled).
Anchor date
Enrolled on the child’s second birthday.
Benefit
Medical.
Event/ diagnosis
None.


Numerator:


Numerators
For MMR, hepatitis B, VZV and hepatitis A, count any of the following:
Evidence of the antigen or combination vaccine, or 
Documented history of the illness, or
A seropositive test result for each antigen.
For DTaP, IPV, HiB, pneumococcal conjugate, rotavirus and influenza, count only:
Evidence of the antigen or combination vaccine.
For combination vaccinations that require more than one antigen (i.e., DTaP and MMR), the organization must find evidence of all the antigens.



DTaP 

At least four DTaP vaccinations (DTaP Vaccine Administered Value Set), with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

IPV

At least three IPV vaccinations (Inactivated Polio Vaccine (IPV) Administered Value Set), with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

MMR

Any of the following on or before the child’s second birthday meet criteria:
At least one MMR vaccination (Measles, Mumps and Rubella (MMR) Vaccine Administered Value Set).
At least one measles and rubella vaccination (Measles/Rubella Vaccine Administered Value Set) and at least one mumps vaccination or history of the illness (Mumps Vaccine Administered Value Set; Mumps Value Set) on the same date of service or on different dates of service.
At least one measles vaccination or history of the illness (Measles Vaccine Administered Value Set; Measles Value Set) and at least one mumps vaccination or history of the illness (Mumps Vaccine Administered Value Set; Mumps Value Set) and at least one rubella vaccination or history of the illness (Rubella Vaccine Administered Value Set; Rubella Value Set) on the same date of service or on different dates of service.
Note: General Guideline 39 (i.e., the 14-day rule) does not apply to MMR.

HiB

At least three HiB vaccinations (Haemophilus Influenzae Type B (HiB) Vaccine Administered Value Set), with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

Hepatitis B

Any of the following on or before the child’s second birthday meet criteria:
At least three hepatitis B vaccinations (Hepatitis B Vaccine Administered Value Set), with different dates of service.
One of the three vaccinations can be a newborn hepatitis B vaccination (Newborn Hepatitis B Vaccine Administered Value Set) during the eight-day period that begins on the date of birth and ends seven days after the date of birth. For example, if the member’s date of birth is December 1, the newborn hepatitis B vaccination must be on or between December 1 and December 8.
History of hepatitis illness (Hepatitis B Value Set).

VZV

Either of the following on or before the child’s second birthday meet criteria:
At least one VZV vaccination (Varicella Zoster (VZV) Vaccine Administered Value Set), with a date of service on or before the child’s second birthday.
History of varicella zoster (e.g., chicken pox) illness (Varicella Zoster Value Set).

Pneumococcal conjugate

At least four pneumococcal conjugate vaccinations (Pneumococcal Conjugate Vaccine Administered Value Set), with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

Hepatitis A

Either of the following on or before the child’s second birthday meet criteria:
At least one hepatitis A vaccination (Hepatitis A Vaccine Administered Value Set), with a date of service on or before the child’s second birthday.
History of hepatitis A illness (Hepatitis A Value Set).


Rotavirus

Any of the following on or before the child’s second birthday meet criteria. Do not count a vaccination administered prior to 42 days after birth.
At least two doses of the two-dose rotavirus vaccine (Rotavirus Vaccine [2 Dose Schedule] Administered Value Set) on different dates of service.
At least three doses of the three-dose rotavirus vaccine (Rotavirus Vaccine
[3 Dose Schedule] Administered Value Set
) on different dates of service.
At least one dose of the two-dose rotavirus vaccine (Rotavirus Vaccine [2 Dose Schedule] Administered Value Set) and at least two doses of the three-dose rotavirus vaccine (Rotavirus Vaccine [3 Dose Schedule] Administered Value Set), all on different dates of service.

Influenza

At least two influenza vaccinations (Influenza Vaccine Administered Value Set), with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 6 months (180 days) after birth.
Combination rates
Calculate the following rates for Combination 2–Combination 10.


Exclusions (optional):

Exclude children who had a contraindication for a specific vaccine from the denominator for all antigen rates and the combination rates. The denominator for all rates must be the same.

Exclude contraindicated children only if administrative data do not indicate that the contraindicated immunization was rendered in its entirety.

Any of the following on or before the member’s second birthday meet optional exclusion criteria:

Any particular vaccine

  • Anaphylactic reaction to the vaccine or its components (Anaphylactic Reaction Due To Vaccination Value Set).

DTaP

Encephalopathy (Encephalopathy Due To Vaccination Value Set) with a vaccine adverse-effect code (Vaccine Causing Adverse Effect Value Set).

MMR, VZV and influenza

Immunodeficiency (Disorders of the Immune System Value Set).
HIV (HIV Value Set).
Lymphoreticular cancer, multiple myeloma or leukemia (Malignant Neoplasm of Lymphatic Tissue Value Set).
Anaphylactic reaction to neomycin.

IPV

Anaphylactic reaction to streptomycin, polymyxin B or neomycin.

Hepatitis B

Anaphylactic reaction to common baker’s yeast.