VA-TETANUS/DIPHTHERIA (TD) IMMUNIZATION (103)    REMINDER DEFINITION (811.9)

Td (Tetanus and Diphtheria Toxoids) should be given to adults every 10 
 
 - A history of serious allergic reaction (i.e., anaphylaxis) to any 
   component of the vaccine.
 - A history of a neurologic or severe hypersensitivity reaction 
   following a previous dose.
years as booster doses after the primary series of three vaccinations 
against diphtheria, tetanus, and pertussis that was received during 
infancy and childhood. If a dose is given sooner as part of wound 
management, the next booster is not needed until 10 years thereafter. 
 
CONTRAINDICATIONS: A contraindication is a condition in a recipient that 
increases the risk for a serious adverse reaction. A vaccine should not 
be administered when a contraindication is present.

The reminder will apply to all adults aged 19 and older. 
locally created immunizations that were used for Tdap vaccines. 
 
Reminder Term, "VA-TD IMMUNIZATION" includes the standardized 
immunization for Td.  Sites should also include the immunizations that
were used for Td vaccines.
 
Reminder Term, "VA-TD DEFERRALS" should include any Health Factors that 
have been in use at a VAMC to indicate the following items:
  Td Immunication Refusal
  Acute Febrile Illness
A Td Vaccine is recommended every 10 years.  
Any finding in this reminder term will resolve the reminder for 
predetermined amount of time.
 
Reminder Term, "VA-TETANUS/DIPHTHERIA CONTRAINDICATION" contains 
computed findings looking for allergies to Tetanus or Diphtheria that 
have been documented in the Allergy/Adverse Drug Reaction package.  If 
found, the reminder will not apply - AND NOT Cohort Logic.  Health 
Factors in use locally to document allergy to Td should also be included 
in the reminder term.
 
 
Reminder Term, "VA-TETANUS/DIPHTHERIA ORDERS" should contain any orders 
for the Td vaccine.  Sites should map any orders that are used for the Td 
immunization.  The reminder will be resolved for 28 days by the order for 
Td vaccine.
 
COHORT:
-Due for patient that have had the Tdap Immunization
-Not applicable for patients with a Td Contraindication
 
RESOLUTION:
This reminder is applicable only if a prior Tdap has been administered.  
-Td immunization
-Td Deferrals
-Td Order
This prevents both the Tdap reminder and this reminder from displaying at
the same time in the same patient's record.
 
Reminder Term, "VA-TDAP IMMUNIZATION" includes the 
standardized immunization for Tdap.  Sites should also include any 

• REMINDER FREQUENCY:   10Y
  MINIMUM AGE:   19
  NO. OF AGE MATCH LINES:   0
  NO. OF AGE NO MATCH LINES:   0