Immunization Content Development 

Source of Truth  

Source of truth has been updated for creating new vaccine and passive immunizing agent content in SNOMED CT CA: 

 1. Market Authorization Holder

The MAH is the organization who distributes the vaccine in Canada. It may be different from manufacturing company. The MAH is the organization displayed in the COMPANY element in the Health Canada Drug Product Database (DPD) .

Exception:    

For Immunizing Agents not licenced in Canada i.e. Special Access Products (SAP) and International Vaccines being recorded for administrations outside of Canada, the   MAH is not added to the FSN or the Preferred term as these products are not licensed in Canada and as such 1.  there is no Canadian MAH. 

 2. MAH Abbreviation 

Is taken from the web provided Table 1: Vaccine List

    • Note there is sometimes more than one (1) name used by a company. The abbreviation list provides one recognized abbreviation for similar companies. 
    • The source of truth for the MAH abbreviation is the Table 1: Vaccine List
      • For example: The manufacturer abbreviation is SP for any of the following: Sanofi Pasteur Inc. or Sanofi Pasteur SA or Sanofi Pasteur Limited
      • The MAH (Supplier in SNOMED CT) concept will be created based on the DPD COMPANY name, but the MAH abbreviation will be the one that is part of the Vaccine list.

Exception: 

The VVWG does not provide abbreviations for MAH for passive agents. For those MAH without a VVWG abbreviation: Infoway assigns an abbreviation, using VVWG guidelines. 

3. Trade Name 

Source if truth is the Product Monograph for vaccines and passive immunizing agents 


Content abbreviation

If an abbreviation is required as the guidelines, but is not currently being used by the Public health surveillance experts, the abbreviation should not be created.

Example:

  • ImmunizationRouteofAdministrationCode subset
    • If the route of administration does not have a commonly used abbreviation (once checked with CIRC, CCDD, VVWG to see if an abbreviation exists – we validate with expert advice before reaching out to the community at large or adding an abbreviation) it will not be created. 

New RFCs

All new immunization requests for change can be found on the Immunization RFC Dashboard. InfoRMS access, obtained via an InfoCentral account, is required.

The below sections are currently under review due to the Immunization Redesign

If you have questions or need information, please contact us

Introduction

The current pages form the SNOMED CT Content Development Canadian Editorial Guidelines for Immunization. 

The September 2020 release of the Canadian Edition of SNOMED CT included major changes to the Immunization content especially around the concepts that are generic.

COVID-19 vaccines:

  • The Public Health Surveillance Community expressed the need to access SNOMED CT codes for COVID-19 vaccine tradenames that are not marketed in Canada. This request has been approved, and those concepts will be created in the Canadian Edition of SNOMED CT. Different editorial guidelines have been applied to these concepts because of the challenge associated with referring to a single source of truth. It was agreed to create these as generic tradename concepts that would become potential parent concepts for concepts with variance in strength, dose form or manufacturer/market authorization holder, of the same vaccine that would be available internationally.  

  • These editorial guidelines are available on the VaccineAdministeredTradeNameCode page.

The AstraZeneca vaccine, the Pfizer-BioNTech vaccine and the Moderna vaccine that were already published have been renamed (FSNs have been updated) and additional synonyms added to reflect formal approval from Health Canada.

The technology has also been added to all COVID-19 Tradenames. Additional information can be found on the VaccineAdministeredTradeNameCode page.

Vaccine Redesign

Between July 30 and September 3, 2020, Infoway hosted 5 presentations on different topics of importance: the Kick off meeting, the Influenza vaccines, the combined Diphtheria, Pertussis, Tetanus, HB, Hib and Polio vaccines, the Subset (refset) requirements and the naming conventions.

The Immunization redesign work was supported by different reference documents:

A working document was provided to the Public Health and the Health Terminologies Communities: Vaccines changes for review

A Summary of changes and questions pending answers - SNOMED CT Immunization Redesign Project was also shared with the communities.

We welcome feedback, comments and concerns. They can be posted on the PHS or HTC Forums or sent to [email protected]


English Generic Editorial Guidelines

Canada Health Infoway (Infoway) publishes Canadian Editorial Guidelines. These guidelines should be consulted, along with the guidelines in the following pages prior to creating any new content for submission to Infoway.

Implementers should be familiar with the SNOMED International Editorial Guidelines prior to creating submissions for new content.


Immunization Content Development

The development of the Immunization content is based on different documents such as:

  1. The product monograph found on the Health Canada Drug Product Database web site has been used as the source of truth for the product’s description.  When the product monograph information is either missing or unclear, other sources are consulted such as:  RxNorm, FDA DailyMed and the NHS drug dictionary terms, which handle similar products. 
  2. The Canadian Immunization Guide, published by Public Health Agency of Canada (PHAC) (and on-line updates) was the initial main reference document for most of the decisions around business requirements. The information can be found online at:

Main Reference Documentation - UPDATED

Other references, available in French and English, were used as part of this work. It is expected that any future development will consider these:

A) Canadian Products

1- Product monograph

a) For the current vaccine tradename

    • The product monograph is available through the Health Canada Drug Product Database Online Query Tool. 

b) For discontinued vaccine tradename

    • When a product is discontinued the product monograph is removed from the manufacturer site and from the Health Canada Drug product database
    • If the requestor does not have the product monograph, Infoway can reach out to the proper Health Canada department to obtain an archived copy.

c) For the current passive immunizing agent tradename

    • The product monograph is available through the Health Canada Drug Product Database Online Query Tool. 

d) For discontinued passive immunizing agent tradename

    • When a product is discontinued the product monograph is removed from the manufacturer site and from the Health Canada Drug product database
    • If the requestor does not have the product monograph, Infoway can reach out to the proper Health Canada department to obtain an archived copy.

2- Vaccines and Passive Agents Abbreviations List

a) For the current vaccine

    • The vaccine abbreviation is created by the Vaccine Vigilance Working Group (VVWG).

b) For the current passive immunizing agent

    • The passive immunizing agent abbreviation is created by Infoway based on the Canadian Immunization Guide.
    • Infoway seeks guidance from the National Advisory Committee on Immunization (NACI) representative. 

c) Discontinued vaccine 

d) Discontinued passive immunizing agent

    • The current passive immunizing agent abbreviation list created by Infoway can be used for discontinued passive immunizing agent

3- Marketing Authorization Holder (MAH) vs Manufacturer's abbreviation list  

NOTE: Most of the Vaccine tradename and passive immunizing agent tradename product concepts have been developed using the Manufacturer's name and abbreviation. In the April 2019 release, some concepts have been updated to display the MAH instead of the Manufacturer. For details, refer to the Informs tickets BSCT-8425.

In some reference documentation, the Marketing Authorization Holder (MAH) is referred to as the manufacturer. This may not be true in all cases. 

a) For the current vaccine tradename - Updated as described above

    • see guidance in Whats New in this Release - Source of Truth  section above
    • Thei manufacturer’s abbreviation is created by the Vaccine Vigilance Working Group (VVWG

b) For the current passive immunizing agent tradename

    • The passive agent manufacturer’s abbreviation is created by Infoway, based on the VVWG principles.
    • Infoway seeks guidance from the Vaccine Supply Working Group (VSWG) representative. 


B) Non-Canadian Products

  • Content Subject to Future Discussion

This logo   is used throughout the guide to identify areas that will require future clarification from the community of practice.

Acknowledgement

Thank you to the Ontario representatives for their participation in the initial subsets development.

Thank you to the Public Health Agency of Canada (PHAC), Ontario and Manitoba for the French Preferred Terms submissions and review.

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