Catch-up Calculator

Version 4.2.1

Inclusions

This version of the NICC caters to all people under 20 years of age including people who may have one or more medical at-risk conditions (as defined in the Australian Immunisation Handbook), and those who may have received one or more vaccinations overseas.

This version of the NICC includes catch-up recommendations for the following antigens:

• Diphtheria, Tetanus (dT)
• Diphtheria, Tetanus, Pertussis (DTPa, dTpa)
• Hepatitis A
• Hepatitis B
• Haemophilus Influenzae Type B (HIB)
• Human Papillomavirus (HPV)
• Meningococcal ACWY
• Meningococcal B
• Meningococcal C
• Measles, Mumps, Rubella (MMR, and MMRV)
• Pneumococcal Conjugate
• Pneumococcal Polysaccharide
• Polio
• Rotavirus
• Varicella (including MMRV)

In addition, this version 4.2.1 also includes the following:

• Bug fixes to address issues reported on the ‘production’ Under 20s release (v4.0.6).
• Reintroduction of Australian vaccine brand names to the catch-up schedule.
• Display of the catch-up schedule in a table format, including due vaccines, due antigens, dose counts/labels, and notes.
• Refinements to the business logic for antigen grouping, such as MMR+Varicella, DTP+Polio, and DTP+Polio+HepB+Hib.
• Refinements to the ‘at cost’ vaccine indicator, including a disclaimer for at-cost PCV vaccines ‘Prevenar 20’ and ‘Vaxneuvance’.
• Refinements to the business logic for specific scenarios where a birth dose of HepB should be counted as a valid primary dose.
• Minor refinements to the ‘Live vaccine’ status indicator.
• Minor refinements to the vaccine formulation and associated labels.
• Refinements and enhancements to automated tests. There are now approximately 450 automated test cases, each representing a scenario with an expected outcome. Tests are reviewed and updated when changes are made to the NICC, including when bugs are fixed.

Known issues

We are aware of, and are working on resolving the following known issues. All of these are being worked on, but haven't made it into this release.

• In some specific scenarios (where the dose schedules vary based on the specific vaccine administered in the past), this version of the NICC produces an incorrect Rotavirus schedule.
• In some specific scenarios (where the dose schedules vary based on the specific vaccine administered in the past), this version of the NICC produces an incorrect MenACWY schedule.
• In some specific scenarios, this version of the NICC does not schedule MMR and Varicella doses on the same day, when it should.
• In some specific scenarios, all available vaccine formulations (Paediatric, Adult) for Engerix and HBVaxII are displayed when only one of them should. For instance, if the child is <11y or between the ages of 15-19, and are recommended to receive a Hep B vaccine, then should receive the Paediatric formulation, but both the  formulations (Paediatric, Adult) may be displayed.
• Some issues have been reported regarding the scheduling of 'live' vaccines (to ensure they are either given on the same day or at least 4 weeks apart from each other). 

Exclusions

The following exclusions apply to this release:

• Influenza (antigen, and vaccines): Although NICC v4.2.1 includes messaging about ‘Annual Influenza vaccination’, Influenza vaccines/antigen is not included on the schedule.
• Contraindicated live vaccines: For some immunocompromising conditions, live vaccines are contraindicated. The decision to administer live vaccines depends on several factors, including but not limited to the individual’s level of immunocompromise, serology, risk-level based on recommended durations post-transplant (e.g. 6m after a solid organ transplant, etc.) and requires professional judgement. Therefore, live vaccines which may be contraindicated for people with certain at-risk conditions will be displayed on the schedule. They will be accompanied by an alert and highlighted in ‘red’ colour to increase visibility. (Further changes and refinements will be made in the upcoming releases).
• No vaccination periods before and after procedure or treatment: While the NICC enforces a no-vaccination period before/after certain procedures or treatments and adjusts schedules, this is only feasible when the timing of the calculation or treatment permits. As the NICC only captures dates, a person needing catch-up is considered to be ‘healthy’ until the date of the planned procedure (say HSCT or SOT) has lapsed.
• Grouping of HepA and HeB: If both Hepatitis A and Hepatitis B antigens are due on the same date, they are not grouped. Monovalent Hepatitis A and Hepatitis B vaccines will be displayed, instead of Twinrix (#39564).
• Funded and recommended vaccines: The NICC provides catch-up advice for vaccines that are both funded under the NIP and recommended as per the Australian Immunisation Handbook. Those incurring a cost to the patient (not funded under the NIP) with be indicated with a $ sign. Even though some vaccines may not be funded under the NIP, they may be funded by an individual state or territory. These vaccines will be marked as at-cost (with a $ sign) in the schedule generated by the NICC.

See also ‘General provisions’ section of NICC Under 20s BRS 4.2.1 (page 7).

Version 4.0.6

Following bugs have been fixed in this release:

• Fixed a bug with the incorrect DTPa recommendations for a healthy child >4years
• Fixed a bug with the incorrect DTP recommendations for healthy person ≥10 years
• Fixed a bug with the incorrect Hep B recommendations for a person with with chronic liver disease, including refinements to dose validity for certain conditions.

Version 4.0.5

Following refinements were made to the NICC to improve clarity and usability:

• Fixed a bug with incorrect PCV and PPV recommendations for a child over 10 years.

Version 4.0.4

Following refinements were made to the NICC to improve clarity and usability:

• Fixed a bug where PCV doses were marked as invalid when given 4 weeks apart.
• Updated minimum and maximum ages for various vaccines.

Version 4.0.3

Following refinements were made to the NICC to improve clarity and usability:

• Fixed a bug with incorrect Hep A recommendation for a healthy Indigenous child in NT, QLD, SA or WA.
• Fixed a bug with incorrect DTP recommendation when the 4th dose is after the age of 3 years and 6 months.

Version 4.0.2

Following refinements were made to the NICC to improve clarity and usability:

• Fixed a bug with the dose schedule for Men B doses for healthy non-Indigenous 2+ year olds.
• Fixed a bug with the dose schedule for Men ACWY doses for healthy non-Indigenous 10-15 year olds.
• Include vaccines H-B-Vax® II Adult and Vaxneuvance.
• Refinements to the At-risk condition labels and error messages.

Version 4.0.1

Following refinements were made to the NICC to improve clarity and usability:

• Fixed a bug with the dose schedule for Hep B doses for healthy adolescents over 15 years of age.
• Added a Back button to the top of the NICC pages to improve navigation between pages and overall usability.

Version 4.0.0

The new version (4.0.0) of the NICC includes catch-up recommendations for all infants, children, and adolescents under 20 years of age including people who may have one or more medical at-risk conditions (as defined in the Australian Immunisation Handbook), and those who may have received one or more vaccinations overseas.

Version (4.0.0) of the NICC includes catch-up recommendations for the following antigens:

• Diphtheria, Tetanus (dT).
• Diphtheria, Tetanus, Pertussis (DTPa, dTpa).
• Hepatitis A
• Hepatitis B
• Haemophilus Influenzae Type B
• Human Papillomavirus (HPV)
• Meningococcal ACWY
• Meningococcal B
• Meningococcal C
• Measles, Mumps, Rubella (MMR)
• Pneumococcal Conjugate
• Pneumococcal Polysaccharide
• Polio
• Rotavirus
• Varicella.

In addition, version (4.0.0) of the NICC also includes:

• Ability to ‘print’ the schedule (in addition to ‘Save PDF’).
• ‘Live vaccine’ indicator on the catch-up schedule to alert health professionals to proceed with caution. (The ‘Live vaccine’ indicator is displayed in ‘red’ colour for certain MAR conditions which may have contraindications. Otherwise, it is displayed in ‘black’ or neutral colour).
• Refinements to the medical at-risk conditions list, including but not limited to:
  • Inclusion of additional medical at-risk conditions (e.g. harmful use of alcohol, smoking), and condition specific catch-up recommendations.
  • Inclusion of additional sub-conditions (e.g. low birth baby and gestation period for a preterm infant).
  • Refinements to the labels to improve usability.
  • Alphabetised listing to improve usability.
  • Refinements to the date labels for the medical at-risk conditions to improve usability.
• Ability to select birth weight for a ‘low birth weight baby’, and condition specific catch-up recommendations.
  • Low birth weight <1500g, or
  • Low birth weight >1500g and <2000g.
• Ability to select gestation period for a pre-term infant, and condition specific catch-up recommendations.
  • <28 weeks
  • <32 weeks or
  • <37 weeks.
• Ability to select whether the person has ‘functional asplenia’ or ‘anatomical asplenia or splenectomy’. Ability to specify a date for splenectomy.
• Ability to specify dates, including those in the future, for planned procedures (e.g. HSCT, SOT, splenectomy), and allowances for a no-vaccination period pre and post procedure (e.g. 4 weeks before and 6m after HSCT).
• Refinements to the list of vaccines, including additional ‘Generic/Other’ variants, and alphabetised ordering of the ‘Generic/Other’ vaccines.
• Minor refinements to the antigen grouping logic (DTP-IPV, DTP-IPV-HepB-HIB, MMRV).
• Bug fixes
• Code refactoring to improve the internal structure, scalability, and maintainability without changing its functionality. Removal of legacy and redundant code.
• Updates/upgrades to the libraries in use.
• Refinements and enhancements to the automated test suite (added new, updated existing test cases). We have circa 380 automated test cases (think of them as a scenario with expected schedule) which have passed/cleared.

Exclusions:

• Influenza (antigen, and vaccines). NICC v4.0.0 includes messaging about Annual Influenza but does not include Influenza vaccines on the schedule.

The following features are on the product backlog and will be available in future releases.

• Reintroduce vaccine brand names on the catch-up schedule.
• Display catch-up schedule (due antigens, vaccines, and dose counts) as a table.
• Minor refinements to the ordering of antigens to improve consistency and usability.