Brief Description of Measure: CMS127: Pneumococcal Vaccination Status for Older Adults Percentage of patients 66 years of age and older who have received a pneumococcal vaccine Description of Issue: ​Due to recent ACIP guideline updates to the pneumococcal vaccination schedule, the numerator age criteria for the pneumococcal vaccine will be expanded to lookback to age 19.  The measure developer proposes to continue focusing the initial population on adults aged 66 and older by the start of the measurement period, but recommends extending the numerator lookback period to age 19, as opposed to age 60, as the measure currently does. The measure already references the updated ACIP guideline within the specification, therefore, expanding the numerator age will be further alignment with the ACIP guideline. Goal of Review: Obtain clinical feedback

Proposed Solution: Numerator header before: Patients who received a pneumococcal vaccination on or after their 60th birthday and before the end of the measurement period Numerator header after: Patients who received a pneumococcal vaccination on or after their 19th birthday and before the end of the measurement period Numerator definition before: define "Has Adult Pneumococcal Vaccine Administered":   exists ( ( ["Immunization, Administered": "Adult Pneumococcal Vaccine"]       union ["Procedure, Performed": "Adult Pneumococcal Vaccine Administered"] ) PneumococcalVaccination       where AgeInYearsAt(date from start of Global."NormalizeInterval"(PneumococcalVaccination.relevantDatetime, PneumococcalVaccination.relevantPeriod))>= 60         and Global."NormalizeInterval" ( PneumococcalVaccination.relevantDatetime, PneumococcalVaccination.relevantPeriod ) on or before day of          end of "Measurement Period"  ) Numerator definition after: define "Has Adult Pneumococcal Vaccine Administered":   exists ( ( ["Immunization, Administered": "Adult Pneumococcal Vaccine"]       union ["Procedure, Performed": "Adult Pneumococcal Vaccine Administered"] ) PneumococcalVaccination       where AgeInYearsAt(date from start of Global."NormalizeInterval"(PneumococcalVaccination.relevantDatetime, PneumococcalVaccination.relevantPeriod))>= 19         and Global."NormalizeInterval" ( PneumococcalVaccination.relevantDatetime, PneumococcalVaccination.relevantPeriod ) on or before day of          end of "Measurement Period"  ) Rationale for Change: This change would align with recent updates to the ACIP guidelines, which recommend pneumococcal vaccination for patients 19-64 years of age who have underlying conditions or risk factors. The updated numerator would capture adults who may have received the vaccine at a younger age due to a chronic illness or immunocompromising condition.