034A Eligible for pneumococcal vaccination searches
This folder (v3.2) now sits within 034 Eligibility. It was previously found in 020 Practice Administration.
These searches are provided to help Practices call and recall patients based on the criteria specified by the PPV Enhanced Service. A separate folder of CQRS searches is provided to ensure coding is correct for receiving full payment.
Searches in the top level folder are designed to support Practices regularly inviting patients for a pneumococcal vaccination. All searches have been built with the ability to be run on different dates using the Relative Run Date function.
Eligible for pneumo vaccination
This section describes searches found in the top level folder.
Patients who have been previously invited but have not accepted the offer of a vaccine remain eligible although there is no requirement for Practices to send a second invitation. 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.PA-323a) Patients over 65 eligible for pneumo invitation
Patients who have not previously received a pneumo vaccination, have not declined a vaccination in the last 5 years, and have not been invited in the last 12 months.
PA-323b) Patients 18-64 eligible for pneumo invitation
At-risk patients who have not previously received a pneumo vaccination, have not declined a vaccination in the last 5 years, and have not been invited in the last 12 months.
PA-323c) Clinically reviewed patients for booster vaccination
Patients with a history of splenic dysfunction or chronic kidney disease whose last pneumo vaccination was more than 5 years ago, who have been reviewed by a clinician to confirm that they would be eligible to receive a booster dose. See next item for details on how this search is populated.
PA-323e) Patients 2-17 eligible for pneumo vaccination
At-risk patients who have not previously received a pneumo vaccination, have not declined a vaccination in the last 5 years, and have not been invited in the last 12 months.
PA-326) Consider patients for booster vaccination
Patients with a history of splenic dysfunction or chronic kidney disease whose last pneumo vaccination was more than 5 years ago, have not declined a vaccination in the last 5 years, and have not been invited in the last 12 months. This search comes with a report to help understand why the patient may be eligible for a booster dose, and when their last dose was.
It is expected that few patients will appear in this search if it is run and actioned regularly. PCIT recommends the list of patients is reviewed by a clinician to confirm whether the patient is eligible to receive a 5 yearly booster; the clinician can then add the code Requires a pneumococcal vaccination to show that the patient record has been checked and they can have a vaccination. This code would need to be added once every 5 years to maintain eligibility (ie: as and when the patient re-appears on this search). Re-running PA-326 Clinically reviewed patients for booster vaccination will add the patient to a list that admin staff can use for inviting the patients.
Practices may prefer to manually invite these patients as they appear.
Cohorts for pneumo vaccination
This folder contains searches representing the cohorts who are eligible to receive a flu vaccination according to the Green Book and Enhanced Service specification. There are no exclusions in this folder for patients declining or vaccinations given, so they should not be used for call/recall purposes
PA-323) INFO ONLY - Invite for pneumococcal PPV vaccine
This overarching search represents the total number of patients who are currently eligible to receive a vaccine who have not previously received a pneumococcal PPV vaccine. We do not recommend using this search to invite patients. Patients who have previously declined are still technically eligible but are not included - reference the declined search in Data Admin for these patients.
PA-320a) Age 65 and above : those patients who have had their 65th birthday. There is no upper age limit.
PA-320b) At risk conditions : any patient who has a code on their record for a specified condition indicating they are at-risk and eligible to receive a pneumococcal vaccination.
PA-320c) Age 2-64 at risk : patients aged between 2 and 64 who appear in the above At risk conditions search.
PA-320d) High-risk patients for booster pneumo vaccinations : patients aged 2 or more who have a code on their record indicating they have splenic dysfunction / asplenia or chronic renal disease*. These codes are defined by the Pneumococcal Vaccination Enhanced Service.
PA-320e) Requires pneumo vaccination : patients aged 2-64 who are otherwise not eligible and have been clinically reviewed and given a code indicating they require a pneumo vaccination (much like equivalent codes for flu vaccination).
* Using the reference set CKDATRISK1_COD (CKD stage 4 & 5) - patients with eGFR below 30 but without up to date CKD staging may not be included.
We are aware of an issue where certain codes are being picked up as a reason for a patient to be at risk. This is due to EMIS adding additional steroid adverse reaction codes to IMTEMP, a nationally defined reference set. We have raised a case with EMIS to investigate (February 2024).
Data Admin
PA-321) Declined pneumococcal vaccine in last 5 years
All patients who have declined a pneumo vaccine in the last 5 years. The 5 year window has been chosen by PCIT to provide a balance between not recalling more frequently and reflecting how a patient remains eligible for the remainder of their life.
PA-322) Received pneumococcal vaccination
This search simply counts the patients in the 3 main cohorts (Age 65+; Age 2-64 at risk; those coded with Requires pneumococcal vaccination) who have at least one pneumo vaccination code on their record when from when they were at least 2 years old.
PA-325) Invited for pneumococcal vaccination in last 12 months
All patients who have been invited in the last 12 months regardless of eligibility or vaccination given or declined.
PA-327) Contraindicated to pneumococcal vaccine in last 5 years
All patients who have been coded with pneumococcal vaccination contraindicated or not indicated in the last 5 years without subsequently receiving a dose of the vaccine.
PA-328) Pneumococcal vaccination in last 6 months or 2 in last 5 years
This search lists patients who have been invited but there has been no response (ie: patients who received their vaccine are not included). This search helps to drive the INVITE searches.
An approach has been taken to reduce the burden on sending invitations too frequently where no action is taken by the patient, particularly where patients are likely to be eligible for their lifetime. Anybody who received an invitation in the previous 6 months will not appear in INVITE searches, and then a second invitation (at least 6 months after the first) will remove the patient from further INVITE searches.
It would be possible for additional invitations to be sent to patients included in this search, although there is no control over when the last invitation was sent to them.
PA-329) DATA QUALITY - PCV code added when PPV may have been given
This is a data quality search to help identify patients who may have received a PPV (Pneumococcal Polysaccharide Vaccine) vaccination but have been coded with PCV (Pneumococcal Conjugate Vaccine) . Incorrectly coded vaccinations may mean patients are identified for recall when they have already received a pneumococcal vaccination.
This search looks for patients who had a PCV vaccination coded with an age at event of >2 years. The code term "Pneumococcal conjugated vaccination" may not be visible if another term has been mapped from another system (eg: Pneumococcal 1).
PCIT recommends running this search if patients are coming up on the practice's invite list when it appears they have already been vaccinated. It checks for patients previously coded with PCV vaccination rather than PPV vaccination.
The PCV vaccine is currently given to infants as part of the childhood vaccination schedule and is only offered up to the age of 2. The PPV vaccine is given to at risk patients aged 2 and over as part of the PPV Enhanced Service.
Targeted recall
PA-323d) Target patients over 65 with at-risk condition
Patients aged 65 or older who have not previously received a pneumo vaccination, have not declined a vaccination in the last 5 years, and have not been invited in the last 12 months. Their age is a risk factor, but they also have a specified condition which may increase their risk factors.
If patients do not respond to a coded recall they will continue to appear in this search, in a frequency which will be exaggerated for those immunocompromised patients who would appear every 8 weeks. If Practices feel that this frequency is too much, it would be possible to amend the 'Exclude' feature in each rule to a longer timeframe.
PA-324) Turned 65 for pneumo invitation
Patients who are aged between 65y0m and 65y2m. Regular running of this search and inviting patients accordingly will ensure they are invited to receive their 1st dose soon after their 65th 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 65th 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.
Coding
Relevant coding for vaccination administration is provided below. Vaccination codes themselves can be found on PCIT templates, and in other articles on this support centre.
Invitation
Pneumococcal vaccination invitation letter sent [415118009]
Pneumococcal vaccination invitation first letter sent [200811000000103]
Pneumococcal vaccination invitation second letter sent [200821000000109]
Pneumococcal vaccination invitation third letter sent [200841000000102]
Pneumococcal vaccination verbal invitation [340801000000104]
Pneumococcal vaccination invitation SMS sent [950331000000105]
Declined
Pneumococcal vaccination declined [401086001]
Pneumococcal vaccination declined by caregiver [139731000119106]
Requires pneumo vaccination
Requires a pneumococcal vaccination [247951000000102]
References
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