Edit Immunization Screen

Patient Name(First - MI - Last)

Displays the patient's First Name, Middle Initial and Last Name.

DOB

Displays the patient's Date of Birth.

Gender

Displays the patient's Gender.

Tracking Schedule

Displays the patient's Immunization Tracking Schedule that is being used for the patient.

Patient ID

Displays the patient's Primary Patient ID for the organization that the user is logged in under.

Address

Displays the patient's Address.

Comments

Displays comments that have been entered for the patient that can be scrolled to view multiple comments if multiple comments are associated with the patient using the up and down buttons.

Vaccine Group

This field displays the vaccine group of the selected immunization and is a non-editable field.

 Vaccine Display Name

This field displays the vaccine group code of the selected immunization and is a non-editable field.

 Trade Name 

This field gives the trade name of the immunization received and is a non-editable field.

 Vaccine Lot Number 

This field displays the vaccine lot number from the site where the vaccine was taken from.  This is a non-editable field.

Dosage From Inventory

This field allows you to select the dosage from inventory for a particular immunization. This can be particularly helpful when for example you have given two pediatric doses to an adult. The default dosage from inventory is Full, with Half, 2, 3, 4 and 5 as other choices. Select an option from the list, and click the Save button to save your selection.

Subpotent Dose

This field allows you to specify whether the selected immunization was a "subpotent" immunization. "Subpotent" meaning something went wrong when the immunization was being given and was not administered entirely. Check the box to indicate that the dose was a "Subpotent" dose. Click on the Save button to save your changes.

 Date Provided 

This field displays the date which the selected immunization was given to the patient and is an editable field. Update this field by typing in a new date in the text box in the format MM/DD/CCYY, or click on the calendar icon to set the date.

Vaccine Eligibility

This is the vaccine eligibility for the immunization that was given. This field contains a drop down box of the vaccine eligibility descriptions.

 Ordering Authority 

This field names the clinician who had the ordering authority to let the patient have the selected immunization and is an editable field. Update this field by selecting a new clinician from the corresponding pick list. Click on the Save button to save your changes.

 Administered By 

This field names the clinician who actually gave the selected immunization to the patient and is an editable field. Update this field by selecting a new clinician from the corresponding pick list. Click on the Save button to save your changes.

 Body Site 

This field represents the patient's body site where he or she was given the immunization and is an editable field. Update this field by selecting a new body site from the pick list. Click on the Save button to save your changes.

 Administered Route 

This field represents the route with which the vaccine given takes effect and is an editable field. Update this field by selecting a new administered route from the pick list. Click on the Save button to save your changes.

Source of Immunization

This field contains a description of the Source of Immunization.

Disregard Primary Series

This field will only be editable when a Prerequisite Override is set for a vaccine. Otherwise it will by default display as not being checked.  Click the check box to enable the override or leave the check box as being unchecked to disable the override. This option when available will allow you to disregard the primary vaccine series for the vaccine.

VIS Date For:

This field is used to display the VIS date of the form given to the patient or parent by the provider organization. The system now allows the VIS date to be editable only on the day the immunization was administered. The appropriate VIS date for each antigen of a combination shot are also editable via the pick-list of VIS dates displayed. Only shots administered from inventory will display and have an editable VIS Date.

 Entered by Site 

This field denotes the site where the vaccine inventory came from for the selected immunization and is a non-editable field.

Input Source of Record

This field indicates how the immunization was entered into the system. The following descriptions explain the items that display:

Created Through User Interface: The immunization was manually entered by someone through the system.

Created Through Batch Load: The immunization was automatically added through a batch or data load through the system.

 Reactions 

The reactions field displays a table listing a CDC-specified list of possible reactions for the selected immunization. Previously selected reactions will be denoted by having bold red font, and the check box in the column next to the reaction will be checked. Update the reactions table by checking or un-checking the appropriate check boxes.

Anaphylactic Reaction

Hypotonic-hyporesponsive collapse within 48 hours of immunization

Seizure occurring within 3 days of immunization

Persistent crying lasting >= 3 hours within 48 hours of immunization

Temperature >= 105 (40.5 C) within 48 hours of immunization

Pertussis allergic reaction

Tetanus allergic reaction

Patient Died

Life threatening illness

Emergency room/doctor visit required

Hospitalization required

Resulted in prolongation of hospitalization

Resulted in permanent disability

When the Save button is clicked, all updates made to any of the editable information fields will be saved in the database for the selected immunization. After the edited information is saved, you will be returned to the Immunization History screen.

When the Delete button is clicked, you will be prompted to make sure you want to delete the selected immunization. Click the Ok button to continue with the delete or click the Cancel button to stop this process. After the system deletes the selected immunization from the patients history, you will be returned to the Immunization History screen.

NOTE: A new immunization can only be deleted if the user trying delete the selected immunization belongs to the provider organization that originally entered the selected new immunization. For all other users, the Delete button will be disabled.

When the Cancel button is clicked, any changes made to the selected immunization will be lost, and you will be returned to the Immunization History screen.