Immunizations/ Vaccinations 1

(Version: 4/16/04)

Definition: Vaccination is the administration of a preparation intended for active immunological prophylaxis.

Introduction: Although SNOMED lists seems to imply that Vaccination and immunization are synonyms, this is not technically true. (e.g., Immunization of a puppy for distemper requires a series of vaccinations, starting with Distemper-Measles). Vaccination has, in veterinary medicine, also come to mean administration of either vaccines or bacterins. The solution proposed here would also cover administration of antibodies. To avoid confusion and provide a consistent approach, we recommend the use of a SNOMED concept - "Administration of substance to produce immunity, either active or passive (procedure)" to which concepts representing the antigens or antibodies may be appended. However, you can use the pre-coordinated concepts that are children of veterinary immunization procedure if one currently exists for the concept you required. If not, use the approach outlined above.

Example:

• Administration of substance to produce immunity, either active or passive (procedure) ( 127785005)
• Direct Substance (attribute) (363701004)
• Tetanus toxoid, animal (product) (76293001)

Root Concept (Disorders):

• Administration of substance to produce immunity, either active or passive (procedure) 127785005
• Veterinary immunization procedure (procedure) 85749001*

(*This concept is a child of immunization 127785005)

Comments:

• You can use a pre-coordinated "veterinary immunizations" concept if the concept you require currently exists in SNOMED (see example 1).
• For Vaccinations ONLY, “products” and “substances” can be used as a value for the “Direct substance” attribute. This is an exception to the standard rule that only a “substance” can be the value for this attribute (see example 2).
• Much work needs to be done on the hierarchy parented by Veterinary proprietary drug AND/OR biological (substance) 102272007 as these agents have not been properly classified as devices, medicinal, insecticides, etc. (see example 3)

Examples:

Case 1: “Vaccination for Distemper-Measles”

Immunization for measles/distemper (procedure) 3121007

Case 2: “Vaccination for DA2PLP”

Administration of substance to produce immunity, either active or passive (procedure) 127785005

• Direct Substance (attribute) 363701004

• Canine distemper - adenovirus type 2 - parainfluenza - parvovirus vaccine - leptospira bacterin (product) 19150007

Case 3: “Vaccination with BOVISHIELD 4”

Administration of substance to produce immunity, either active or passive (procedure) 127785005

• Direct Substance (attribute) 363701004
• BOVISHIELD 4 (product) 100041005

*Note: this is an example of an immunization using the specific veterinary branded name product.

Case 4: Equine 5 way combination vaccine (e.g. Prestige 5 way)

Administration of substance to produce immunity, either active or passive (procedure) 127785005

• Direct Substance (attribute) 363701004
• Equine rhinopneumonitis - influenza vaccine - tetanus toxoid (product) 1144004
• Direct Substance (attribute) 363701004
• encephalomyelitis vaccine (product) 31494003

1Written by the VMDB Taskforce on Development of SNOMED Guidelines. The committee wishes to recognize contributions provided by Dr. Jeff Wilcke and Dr. Penny Livesay.