| Data Element Name |
Data Element Description |
Value Set Code |
CDC Priority (Legacy) |
CDC Priority (New) |
| Vaccine administered product type |
Indicates which product (vaccine) was administered
|
PHVS_VaccinesAdministered_VZ
|
|
|
| Vaccine administered date |
Indicates the date that the vaccine was administered.
|
N/A |
|
|
| Vaccine dose number |
Indicates the dose number in series
|
N/A |
|
|
| Vaccine product manufacturer |
Indicates the company which manufactured the vaccine |
PHVS_ManufacturersOfVaccinesMVX_CDC_NIP |
|
|
| Vaccine Lot Number |
Indicates the lot number for the vaccine administered |
N/A |
|
|
| Vaccine Lot Expiration Date |
Indicates the expiry date for the vaccine administered |
N/A |
|
|
| Vaccine Event information source |
Indicates whether the vaccine was administered by the provider organization recording the immunization or obtained from a historical record |
PHVS_VaccineEventInformation Source_NND |
|
|
| Immunization Schedule used |
Identifies the schedule used for immunization evaluation and forecast. |
N/A |
|
|
| Exemption/refusal reason |
Indicates the reason the patient is either exempt from the immunization or refuses the immunization |
N/A |
|
|
| National Drug Code (NDC) |
NDC from the vaccine's bar code can be used to obtain vaccine brand name and manufacturer. |
N/A |
|
|
| Vaccination Record Identifier |
Vaccination record identifier |
N/A |
|
|
| Did the Subject Ever Receive a Vaccine Against This Disease |
Did the subject ever receive a vaccine against this disease? |
PHVS_YesNoUnknown_CDC |
|
1 |
| Vaccination Doses Prior to Onset |
Number of vaccine doses against this disease prior to illness onset |
N/A |
|
1 |
| Date of Last Dose Prior to Illness Onset |
Date of last vaccine dose against this disease prior to illness onset |
N/A |
|
3 |
| Vaccinated per ACIP Recommendations |
Was subject vaccinated as recommended by the Advisory Committee on Immunization Practices (ACIP)? |
PHVS_YesNoUnknown_CDC |
|
1 |
| Reason Not Vaccinated Per ACIP Recommendations |
Reason subject not vaccinated as recommended by ACIP |
PHVS_VaccineNotGivenReasons_CDC |
|
1 |
| Vaccine History Comments |
Comments about the subject's vaccination history |
N/A |
|
3 |
| Number of Doses Received Before 1st Birthday |
The number of vaccine doses against this disease which the subject received before their first birthday. |
N/A |
|
1 |
| Number of Doses Received On or After 1st Birthday |
The number of vaccine doses against this disease which the subject received on or after their first birthday |
N/A |
|
1 |
| Did Mother Ever Receive a Vaccine Against This Disease |
Was the mother immunized with Rubella vaccine? |
PHVS_YesNoUnknown_CDC |
|
1 |
| Source of Mother's Vaccine Information |
Source of mother's Rubella-containing vaccine information |
PHVS_ImmunizationInformationSource_CRS |
|
1 |
|
|
|
|
|
| 12/28/2020 |
|
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