034D Eligible for RSV vaccination searches
This folder sits within Primary care IT - Reporting Group within folder 034 Eligibility.
The new vaccination programme against Respiratory Syncytial Virus (RSV) goes live in September 2024. In preparation for this new line of work, Primary Care IT has produced this folder of searches to support call and recall activities.
The majority of this work relates to older adults (over 75s) as this is the group that primary care is expected to manage. The other group of pregnant patients who are at least 28 weeks' gestation should be managed by midwifery services like the pertussis vaccination programme, although primary care is still expected to keep an eye on patients. See Pregnant patients cohort below for more information.
Primary Care IT strongly recommends that this article is understood before the searches are used in your Practice.
As of July 2024, there are no SNOMED concepts for RSV vaccination invitations. Primary Care IT submitted this request for codes to be created as invitation codes are a fundamental component of an effective recall programme.
Cohorts for RSV vaccination
There are 3 searches representing the cohorts who are eligible to receive an RSV vaccination according to the UKHSA guidance in July 2024. There are no exclusions in this folder for patients declining or vaccinations given, so they should not be used for call/recall purposes
- Age 75 routine cohort : those patients born on or after 1st September 1949 who have had their 75th birthday but not their 80th birthday. For 2024 this group will only include 75 year olds, but it should continue to grow significantly until 2029/2030.
- Age 75 to 79 catch-up cohort : patients born before 01/09/1949 who have had their 75th birthday but not their 80th birthday. This cohort should diminish in size until 2030 when the catch up programme is complete.
- Age 80 catch up cohort : this is a one-off cohort for patients aged 79 in August 2024 who may turn 80 before they can be offered a vaccination. These patients were born between 02/09/1944 and 31/08/1945, and remain eligible to receive an RSV vaccine until 31st August 2025.
Whilst a SNOMED concept exists, there are no apparent plans for "Requires RSV vaccination" qualifying a patient for the vaccine. This is unlikely to happen in the same way that the equivalent code for shingles was only introduced in September 2023 when eligibility was widened from simply age.
Patients who have been previously invited but have not accepted the offer of a vaccine remain eligible. Practices are contractually required to send a second invitation, although no timeframe is specified and could be a year or more. If a second invitation is desired, a child search could be added which looks at patients of a certain age - keep the age range relatively small to manage supply and demand.
The CQRS Enhanced Service business rules appear to exclude patients in the one-off cohort who turned 80 between 1st September 2024 and 31st August 2025. Practices should be aware that while we were informed that these patients are eligible, they may not be paid for the administration of the vaccine.
Eligible for RSV vaccination
This section describes the INVITE searches .
Patients over 75 eligible for RSV vaccination
All patients who can be sent an invitation for a RSV vaccination due to:
- age 75 or older
- born after 1st September 1945
- no previous record of vaccination
- no contraindication
- not having declined in the last 5 years
- not having been invited at least twice in the last 5 years
Targeted recall
These searches are available for those Practices who wish to send customised invitations for a specific cohort. All patients appearing in these searches will also appear in PA-344 or PA-349.
Turned 75 for RSV invitation
Patients who are aged between 70y0m and 70y2m. Patients who have already declined or received the vaccination are excluded. Regular running of this search and inviting patients accordingly will ensure they are invited and ready to receive their 1st dose soon after their 70th birthday.
Using a relative run date of a couple of weeks in the future will also capture patients who are technically not yet eligible (eg: if today is 01/09/2024, set the relative run date to 15/09/2024). This approach can be used to invite patients just prior to their 75th birthday, allowing time to generate the invitation, book the patient in for an appointment in a couple of weeks - assuming this is a typical lead time for routine vaccination appointments.
Turning 80 for final RSV recall
Patients who are aged between 79y6m and 79y11m who have not previously had a dose. For 2024-25 this also includes the one-off age 80 catch up cohort that must not be used after 31/08/2025.
In the early months of the vaccination programme in late 2024, consider using this search to target a subset of all eligible patients who have less time remaining to be vaccinated.
Data Admin
RSV vaccination contraindicated
If patients appear in this search, consider reviewing the patient record to establish when the code was added and if it is appropriate. Patients who have received a vaccination are removed from this search.
RSV vaccination declined in last 5 years
This search lists all patients who have declined an RSV vaccine in the last 5 years. Unlike shingles, 5 years is sufficient to hide a patient from recall for the remainder of their period of eligibility.
Patients who have declined remain eligible for a vaccine until their 80th birthday. They will not appear in the "All eligible patients" search in the top level folder. Practices may wish to consider adding a child search with their own threshold for sending a further invitation to those who have declined, perhaps to those who are 78 and declined more than 3 or 5 years ago.
Received RSV vaccination
All patients over the age of 75 who have received an RSV vaccination ever.
RSV invitation in last 6 months or 2 in last 5 years
Eligible patients who have been invited for an RSV vaccination in the last 6 months, or have received 2 invitations in the last 5 years.
This search is a placeholder in anticipation of official RSV concepts being made available. It will always return 0.
Pregnancy
The programme for pregnant patients is designed to protect infants in utero, conferring immunity before they are born to protect their early years. This is expected to be delivered primarily by maternity services, while GP Practices will opportunistically mop up or vaccinate upon request.
Unlike the programme for older adults, patients are eligible to receive an RSV vaccination during every pregnancy. Excluding patients who have declined or previously had a vaccination should not happen.
We have decided to keep pregnant patients separate for the recall programme as search capabilities cannot reliably filter to those patients of at least 28 weeks' gestation who are eligible.
Instead, this folder identifies patients who are pregnant but at any stage. This means some patients may only be 12 weeks along, while others may be 36 weeks or have even delivered. There are a number of challenges to creating an accurate register of pregnant patients:
- Not all patients present at a similar time
- Coding pregnancy might take place as early as 6 weeks, but more likely when the patient starts to see the midwife
- Not everybody adds the code of Estimated date of delivery - this is one of the few codes that can be recorded with a future date!
- Coding for the end of the pregnancy - whether termination, miscarriage, or delivery method - is variable and heavily dependent on when information is sent to the Practice.
DISCLAIMER - For the reasons stated above, always review each record prior to inviting a patient for vaccination. It is important that a clinician establishes how many weeks' pregnant the patient is to avoid any wasted invitations or appointments. Use the report to help identify likely candidates for vaccination, then double check the record.
Coding
As of July 2024 the following codes relating to RSV vaccination are available:
| SNOMED | Term |
| 1303503001 | Administration of RSV (respiratory syncytial virus) vaccine |
| 1853501000000105 | RSV (respiratory syncytial virus) vaccination declined |
| 1853511000000107 | RSV (respiratory syncytial virus) vaccination contraindicated |
2242701000000103 | RSV (respiratory syncytial virus) vaccination invitation letter |
2242691000000103 | RSV (respiratory syncytial virus) vaccination invitation SMS |
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