Brief Description of Measure:

​CMS117: Childhood Immunization Status:
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 or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday
Description of Issue:

While completing an internal review of the proposed header language in a change previously posted to CRP (CQM-4934) to align with the HEDIS measure for the MMR, Hepatitis A, and VZV vaccination requirement, the measure developer identified an opportunity to refine the specified logic to better align with the proposed header language.
 
​We are revising the logic timing requirement for the Hepatitis A, MMR, and VZV vaccination because the CDC’s 2021 Child and Adolescent Immunization Schedule for Ages 18 Years or Younger guidelines specifically mention that these vaccines should not be given before 12 months of age. Additionally, this change will align with NCQA's HEDIS parent measure and match the intent of the measure.

Proposed Solution:

Current logic:

One Hepatitis A Vaccinations

( ( ["Immunization, Administered": "Hepatitis A Vaccine"]

union ["Procedure, Performed": "Hepatitis A Vaccine Administered"] ) HepatitisAVaccination

where HepatitisAVaccination.relevantDatetime during "First Two Years"

)

One MMR Vaccination

( ( ["Immunization, Administered": "Measles, Mumps and Rubella (MMR) Vaccine"]

union ["Procedure, Performed": "Measles, Mumps and Rubella (MMR) Vaccine Administered"] ) MMRVaccination

where MMRVaccination.relevantDatetime during "First Two Years"

)

One Chicken Pox Vaccination

( ( ["Immunization, Administered": "Varicella Zoster Vaccine (VZV)"]

union ["Procedure, Performed": "Varicella Zoster Vaccine (VZV) Administered"] ) ChickenPoxVaccination

where ChickenPoxVaccination.relevantDatetime during "First Two Years"

)

First Two Years

Interval[date from Patient.birthDatetime, "Date of Second Birthday"]

Proposed logic:

"One MMR Vaccination":

( ( ["Immunization, Administered": "Measles, Mumps and Rubella (MMR) Vaccine"]

union ["Procedure, Performed": "Measles, Mumps and Rubella (MMR) Vaccine Administered"] ) MMRVaccination

where Global."ToDateInterval" ( Global."NormalizeInterval" ( MMRVaccination.relevantDatetime, MMRVaccination.relevantPeriod ) ) during "Date of First Birthday to Date of Second Birthday"

)

"One Chicken Pox Vaccination":

( ( ["Immunization, Administered": "Varicella Zoster Vaccine (VZV)"]

union ["Procedure, Performed": "Varicella Zoster Vaccine (VZV) Administered"] ) ChickenPoxVaccination

where Global."ToDateInterval" ( Global."NormalizeInterval" ( ChickenPoxVaccination.relevantDatetime, ChickenPoxVaccination.relevantPeriod ) ) during "Date of First Birthday to Date of Second Birthday"

)

"One Hepatitis A Vaccinations":

( ( ["Immunization, Administered": "Hepatitis A Vaccine"]

union ["Procedure, Performed": "Hepatitis A Vaccine Administered"] ) HepatitisAVaccination

where Global."ToDateInterval" ( Global."NormalizeInterval" ( HepatitisAVaccination.relevantDatetime, HepatitisAVaccination.relevantPeriod ) ) during "Date of First Birthday to Date of Second Birthday"

)

define "Date of First Birthday to Date of Second Birthday":

Interval["Date of First Birthday", "Date of Second Birthday"]

define "Date of First Birthday":

date from Patient.birthDatetime + 1 year

Rationale for Change:

Revising the logic timing requirement for the Hepatitis A, MMR, and VZV vaccinations because guidelines indicate these vaccines should not be given before 12 months of age. Additionally, this change will align with NCQA's HEDIS measure and match the intent of the measure.