VaccineHistoricalNameCode

Historic Vaccines

This content is designed for use when populating an immunization history when the client and/or the provider do not have the detail of the trade name of the vaccine administered OR the product has been discontinued and/or never licensed in Canada. Currently licensed products, described generically, are also included on this list as an immunization history may include products still available in Canada. It consists mainly of concepts from the Medicinal Entity class and from the SNOMED CT Pharmaceutical / biologic product hierarchy that are described using a “generic name”. With time, additional concepts represented by the trade name may be found in this subset when they are no longer licensed for use in Canada but are required to capture historic data.

Scope definition:

The scope of this subset is vaccines that are currently licensed for use in Canada (generic description, i.e. no trade name), those obtained through special access programs (generic description), and vaccines that have been discontinued and/or never licensed in Canada (with trade name). This content is intended to be used when populating an immunization history when the client and /or provider does not have the detail of the trade name (brand name) of the vaccine administered OR the product has been discontinued and/or never licensed in Canada. This subset will include concepts represented by a generic description for a vaccine that was previously administered to the client as may be expressed by the client or provider for an immunization history and concepts represented by the trade name for products that have been discontinued and/or never licensed in Canada.

General rules applied to this section

• A Canadian Edition concept may be created if the concept does not exist or if the existing concept in the international version is ambiguous.
• A ‘generic’ code is created (when appropriate) when there is not enough information to create a ‘trade name vaccine product’. This may happen when there is missing information or because the product monograph is no longer available.
• It is expected that over time, additional discontinued trade name products which have the ADMINISTRABLE VACCINES format will be found in this subset. In such a case the trade name product format will be kept.
• The preventable disease as described in the Canadian Immunization Guide is the term used for FSN/PS where different options are possible.
  • For example: polio vs poliovirus vs poliomyelitis. Decision: use poliomyelitis.

Modifiers/Qualifiers

• SNOMED CT international terminology is known to be ‘inconsistent’ with the use of modifiers for active ingredient substances when used in the generic name for a product. Here are some rules applied to the Canadian Edition content as workarounds, until acceptance of an RFC to SNOMED International to change the SNOMED CT international terminology content:
  • For vaccines such as tetanus and diphtheria, “toxoid” is not used in the FSN in the international version. For the existing international concepts in SNOMED CT, a request for change will be sent to SNOMED International to make this change (this is to be confirmed);
  • The word “adsorbed” is not included in FSN/PS of CA Edition concept, as the absence or presence does not materially change the meaning (unless the term is part of the trade name);
  • If a modifier, such as "inactivated” or "live and / or attenuated", is required, it will be placed after the antigen within the description. e.g. Influenza trivalent inactivated (product);
  • For concepts with multiple antigens and no qualifier for (adult vs pediatric) dosage on the international concept descriptions: it will not be assumed it is a standard dose (= pediatric). Two (2) CA descriptions will be created under the international concept for both the adult and pediatric dose: EN CA PS description will include the ‘pediatric’ or ‘adult’ qualifier
    • For example: [DPT] Diphtheria, pertussis and tetanus pediatric vaccine
  • If the concept is a Canadian Edition concept the FSN description including the ‘low dose’ (=for adult) or ‘standard dose’ (=for pediatric) will be added to each antigen, where appropriate to identify unambiguously the audience targeted by the vaccine.
    • For example: [DPT] Diphtheria, pertussis and tetanus pediatric vaccine

Case

• Upper-case letters in these vaccine abbreviations denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and pertussis (P) vaccine used in the pediatric formulations. Lower-case “d” and “p” denote reduced doses of diphtheria and pertussis used in the adolescent/adult-formulations. The “a” in DTaP and Tdap stands for “acellular”, meaning that the pertussis component contains only a part of the pertussis organism. Reference: http://www.vaccines.gov/diseases/pertussis/

Antigens

• On CA Edition concepts when there is more than one active antigen in a vaccine, use "," with a space after the ‘,’, for each agent e.g. Diphtheria,tetanus and acellular pertussis.
• When many antigens are listed, they follow PHAC abbreviation order (for all descriptions).
  • For example: DTaP = Diphtheria,tetanus and acellular pertussis.

Vaccine Abbreviation Code

• The same vaccine abbreviation code (on the EN Preferred Synonym or the French Preferred Synonym) may be used to represent different variations of vaccine products.
  • For example: “Inf”; which is used to represent Influenza vaccine products; include the different types of vaccine products:
    • [Inf] Influenza vaccine
    • [Inf] Influenza A virus subtype H1N1 vaccine
    • [Inf] Influenza A monovalent vaccine
    • [Inf] Influenza A monovalent H1N1 adjuvanted vaccine
    • [Inf] Influenza A monovalent H1N1 unadjuvanted vaccine
    • [Inf] Influenza trivalent vaccine
    • [Inf] Influenza quadrivalent vaccine
      
      
  • Some concepts are part of a group of similar concepts.
    • When the subset is sorted to group the similar concepts together, the user can select a more detailed concept when available. For example, it is possible to select an adult dose or a child dose, when that information is available. If there is not enough information to select such a detailed code, the user can then select a more generic code. 
      
      For example, the Diphtheria group: 

• For example, the Pertussis Group: 

*These descriptions do not have a current abbreviation assigned by PHAC (to avoid confusion with discontinued codes)

•      For example, the HPV Group: 

• Other groups are:
  • Poliomyelitis Group
  • Rota Group
  • Meningococcal Group 
  • Pneumococcal Group

The Vaccine Historical Subset may list additional vaccine codes than those found in the CIG or the vaccine abbreviation list. This is to allow the data capture of generic products or trade name products that might not be available in Canada or are discontinued products of different formulation, strength and dosage.

For example:

Fully Specified Name

The format for the Fully Specified Name (FSN) is as follows:

1. For generic concepts

Vaccine Name (strength) vaccine (product)

E.g.: Diphtheria standard dose + tetanus vaccine (product) 

FSN Components

Vaccine Name

• Usually reflects the preventable disease for which the vaccine is administered.
• The word “vaccine” is not always included in the FSN of an international concept, but must be included for all CA Edition concepts for generic terms. 

For example: attenuated Bacillus Calmette Guerin (product) (This is an international concept)

• The word “vaccine” may be found next to the vaccine name in some cases:

For example: Hepatitis B virus vaccine regular strength (product) (This is a Canadian Edition concept) 

(Strength)

• There is a requirement to specify the dose form for some vaccines since this allows the differentiation between adult and pediatric doses.

For example:   Acellular pertussis low dose vaccine (product) is for adults, and Acellular pertussis standard dose is for children

• When more than one (1) ingredient is listed, the dose form will be specified for each of the ingredients where more than one (1) dose form is available.

For example: Diphtheria standard dose + tetanus + acellular pertussis standard dose vaccine (product)

Vaccine

• ‘Vaccine’ is added to the FSN description of the ‘historic vaccine’ concepts

(medicinal product)

• This is the semantic tag representing the context of use within SNOMED CT: for any concept that is within the Pharmaceutical / biologic product hierarchy.

1. For concepts that include a Trade Name

• Refer to the VaccineAdministeredTradeNameCodesubset, Fully Specified Name section.
• For example: Arepanrix 3.75 micrograms per 0.5 milliliter suspension and emulsion for injection GlaxoSmithKline Inc. (product)

Preferred Synonym (English)

For further information on PS editorial guidelines, please refer to Picklists Editorial Guidelines

The format for the Preferred Synonym (PS) is as follows:

 For generic concepts

• [PHAC Abbreviation] Vaccine Name (qualifier) vaccine   
  • [HA] Hepatitis A vaccine 
  • [fIPV] Poliomyelitis inactivated fractional vaccine 
  • [IPV] Poliomyelitis inactivated standard dose vaccine

PS Components

• The word ‘vaccine’ will be present in the Preferred Synonym to align with the new guidelines as requested for the Clinician Picklists.

PHAC Abbreviation

• The PHAC abbreviation is used at the beginning of the PS and is in square brackets.
• There are some descriptions where there is no PHAC abbreviation, generally where historic abbreviations have been discontinued due to similarity to new ones.  To avoid confusion the discontinued abbreviation will not be re-used nor will be included in the historic concepts’ name.
• For example: Pertussis vaccine; was not allocated with the ‘P’ abbreviation because ‘P’ has been used as the abbreviation for Polio, and for Pertussis (discontinued for both)
• Exception to the PHAC ingredient order ONLY FOR THE HISTORIC VACCINE SUBSET
• In order to present the antigen in alpha order at the user interface, the type is presented after the antigen
  • For example: wP = pertussis whole cell

Vaccine Name

• The active ingredients will be listed as per PHAC’s vaccine abbreviation.
• The word “vaccine” is included in PS description.

Qualifier

• A qualifier may be added to the PHAC abbreviation to avoid two (2) PS being duplicated.
  • Adult and pediatric qualifiers will be used to differentiate same product and same strength (same concentration) given to the different populations
    • For example: [d] Diphtheria adult vaccine and [D] Diphtheria pediatric vaccine

For concepts that include a Trade Name

Trade name products may be retired from the Canadian market due to decreased demand, replacement by another product, etc. When this happens, the trade name concept will be inactivated from the Administrable subset and activated in the historic subset.

Refer to the VaccineAdministeredTradeNameCode subset, Preferred Synonym section

• For example: [Inf] Arepanrix

Preferred Synonym (French) 

• Pour plus d’information concernant le Preferred Synonym (french), veuillez consulter la page sur les règles éditoriales des “Picklists”. Différents mots peuvent être utilisés pour représenter la maladie, le virus ou le vaccin. Dans le cas de la poliomyélite, le terme retenu entre polio vs poliovirus vs poliomyélite est ‘poliomyélite, comme décidé par le groupe de travail sur les Picklists.
• L’abréviation VPO est traduite sur les sites de l’Agence de la santé publique du Canada (ASPQ) comme : vaccin antipoliomyélitique oral.
  • Le vaccin vivant contre la polio est seulement disponible en formule orale.
• La traduction des expressions suivantes ‘regular strength’, ‘dialysis strength’et ‘pediatric strength’ est la même que celle trouvée dans le sous-ensemble des antigènes.
  • Par exemple: [HB] Hepatitis B virus X strength vaccine (product)
    • regular strengthtraduit par: formulation régulière
    • dialysis strengthtraduit par: formulation pour dialyse
    • pediatric strengthtraduit par: formulation pédiatrique
  • Les termes privilégiés ci-dessous avec un (*) ne comportent pas d’abréviation afin d’éviter la confusion avec les codes similaires.

Additional information :

Varicella and herpes zoster vaccines 

Varicella disorder and herpes zoster disorder are caused by the same organism: human alphaherpesvirus 3 (“varicella-zoster virus” is the historical name of this organism). The base antigen substance for both vaccine groups is the same: Antigen of human alphaherpesvirus 3. 

As varicella and herpes zoster vaccines concepts cannot be differentiated by the active ingredient, the specific target disease must be stated in the FSN.  

Define naming convention for the target disorder pattern in the FSN 

<Vaccine for X disorder prevention> was applied in 2020 (CA vaccines remodeling project) 

Examples: 

• FSN: Vaccine product containing only Human alphaherpesvirus 3 antigen for varicella prevention(medicinal product)| 
• FSN: Vaccine product containing only Human alphaherpesvirus 3 antigen for herpes zoster prevention(medicinal product)| 

<Vaccine against X ORGANISM> was applied in 2021 (Int Edition) to resolve COVID-19 vaccine 

Example: 

• FSN: Vaccine product againstsevere acute respiratory syndrome coronavirus 2 (medicinal product)| 

Order of patterns: 

Vaccine product containing <active ingredient pattern> <target disease pattern> 

Examples: 

• FSN: Vaccine product containing Human alphaherpesvirus 3 antigen for herpes zoster prevention (medicinal product) 
• FSN: Vaccine product containing Human alphaherpesvirus 3 antigen against herpes zoster (medicinal product) 

Define the level of granularity for the recombinant vaccine (new parent for Shingrix) 

Pattern: 

• FSN: Vaccine product containing only Human alphaherpesvirus 3 recombinant surface glycoprotein E antigen for herpes zoster prevention (medicinal product) 

This allows aligning with the already existing: Antigen of Human alphaherpesvirus 3 recombinant surface glycoprotein E (substance) concept. 

Define CA PT for herpes zoster vaccines. 

For the previously existing concept with the Zos vaccine abbreviation, a change was implemented to specify this is a herpes zoster vaccine as follows:  

• FSN: Vaccine product containing only Human alphaherpesvirus 3 antigen for herpes zoster prevention (medicinal product) 
• New English PT:  [Zos] herpeszoster vaccine
• Additional English Syn:  Zos zoster unspecified* 
• Additional English Syn: HZ herpes zoster unspecified ** 

* This description will be kept for historical and data search options. 

** The HZ abbreviation has also been added for reference, since it is on the CIG page, although HZ is not listed in the VVWG. 

A new vaccine was created to distinguish the live attenuated herpes zoster vaccine. 

• FSN: Vaccine product containing only live attenuatedHuman alphaherpesvirus 3 antigen for herpes zoster prevention (medicinal product)  
• English PT: [LZV]Live attenuated herpes zoster vaccine

A new vaccine was created to distinguish the recombinant herpes zoster vaccine. 

• FSN: Vaccine product containing only Human alphaherpesvirus 3 recombinantsurface glycoprotein E antigen for herpes zoster prevention (medicinal product) 

English PT: [RZV] Recombinant herpes zoster vaccine