Part of Influenza Vaccinations 2022-23: Cohort Identification Methodology
Rule logic
The table below displays the cohorts of clinical conditions that have been identified for call and recall for the flu season from 2022 to 2023. These conditions are detailed in Chapter 19 of the Green Book.
Chronic respiratory disease
| Description | Data used | Rulesets |
|---|---|---|
| Asthma that requires continuous or repeated use of inhaled steroids or systemic steroids. | GPES v4 and GDPPR | All people over 6 months of age on asthma treatment (inhaled steroids) in the previous 12 months. |
| Asthma with previous exacerbations requiring hospital admission. | GPES v4 and GDPPR | All people over 6 months of age with an emergency admission due to asthma between 1 September 2022 to 31 March 2023. |
| Chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD). | GPES v4 and GDPPR | All people over 6 months of age with a diagnosis of chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD). |
| Children who have previously been admitted to hospital for lower respiratory tract disease. | GPES v4 and GDPPR | All children under 17 years on 1 September 2023 and over 6 months of age who have previously been admitted to hospital for a lower respiratory tract disease. |
Chronic heart disease
| Description | Data used | Rulesets |
|---|---|---|
| Congenital heart disease, hypertension with cardiac complications, chronic heart failure, individuals requiring regular medication and/or follow-up for ischaemic heart disease. | GPES v4 and GDPPR | All people over 6 months of age with a diagnosis of congenital heart disease, hypertension with cardiac complications, chronic heart failure or ischaemic heart disease (regardless of medication/ hospital follow up). |
Chronic kidney disease
| Description | Data used | Rulesets |
|---|---|---|
| Chronic kidney disease at stage 3, 4 or 5, chronic kidney failure, nephrotic syndrome or kidney transplantation. | GPES v4 and GDPPR | All people over 6 months of age with a diagnosis of Chronic kidney disease stage 3, 4, 5 (where diagnosis has not been superseded by a CKD stage 1/2 diagnosis) or with a history of renal transplant, or dialysis for chronic kidney disease. |
Chronic liver disease
| Description | Data used | Rulesets |
|---|---|---|
| Cirrhosis, biliary atresia, chronic hepatitis. | GPES v4 and GDPPR | All people over 6 months of age with a diagnosis of cirrhosis, biliary atresia, chronic hepatitis. |
Chronic neurological disease
| Description | Data used | Rulesets |
|---|---|---|
| Conditions in which respiratory function may be compromised due to neurological disease (e.g. polio syndrome sufferers). Clinicians should offer immunisation, based on individual assessment, to clinically vulnerable individuals including those with cerebral palsy, learning disabilities, multiple sclerosis and related or similar conditions; or hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability. |
GPES v4 and GDPPR | All people over 6 months of age diagnosed with a neurological condition where respiratory compromise is often severe and occult, such as Motor Neuron Disease, Parkinson’s Disease and Huntington’s Chorea. |
| Stroke, transient ischaemic attack (TIA). | GPES v4 and GDPPR | All people over 6 months of age diagnosed with stroke or transient ischaemic attack (TIA). |
Diabetes and adrenal insufficiency
| Description | Data used | Rulesets |
|---|---|---|
| Type 1 diabetes, type 2 diabetes requiring insulin or oral hypoglycaemic drugs, diet controlled diabetes. Addison’s disease, secondary or tertiary adrenal insufficiency requiring steroid replacement. | GPES v4 and GDPPR | All people over 6 months of age diagnosed with type 1 or type 2 diabetes. |
Immunosuppression
| Description | Data used | Rulesets |
|---|---|---|
|
Immunosuppression due to disease leading to immunosuppression, bone marrow transplant, HIV infection at all stages, multiple myeloma or genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement disorder). It is difficult to define at what level of immunosuppression a patient could be considered to be at a greater risk of the serious consequences of influenza and should be offered influenza vaccination. This decision is best made on an individual basis and left to the patient’s clinician. |
GPES v4 and GDPPR | All people over 6 months of age with immunosuppression due to haematological disease (including multiple myeloma), bone marrow transplant, HIV infection at all stages, Down's syndrome, neutropenia and some genetic causes of immunosuppression (such as SCID) and acquired causes of immunosuppression. |
| Immunosuppression due to treatment leading to immunosuppression, including patients undergoing chemotherapy and individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day (any age), or for children under 20kg, a dose of 1mg or more per kg per day. | GPES v4 and GDPPR | All people over 6 months of age prescribed immunosuppressants by their GP (apart from oral steroids) and some people over 6 months of age on chemotherapy within the last 12 months. |
| Asplenia or dysfunction of the spleen. This also includes conditions such as homozygous sickle cell disease, hereditary spherocytosis, thalassemia major and coeliac syndrome that may lead to splenic dysfunction. |
GPES v4 and GDPPR | All people with a splenectomy or splenic damage, sickle cell anaemia, thalasaemia, spherocytosis, coeliac syndrome and some other diseases that cause asplenia or splenic dysfunction. |
Pregnancy
| Description | Data used | Rulesets |
|---|---|---|
| Pregnant people at any stage of pregnancy (1st, 2nd or 3rd trimesters). | GPES v4 and GDPPR |
Morbid obesity (class III obesity)
| Description | Data used | Rulesets |
|---|---|---|
| Adults with a Body Mass Index ≥40 kg/m² | GPES v4 and GDPPR | All people over 16 years with a BMI equal to or over 40 at any time between 1 September 2022 to 31 March 2023. If there is no BMI within this time frame, anyone over 16 years whose last recorded BMI within the last 3 years was equal to or over 40. |
Clinically coded eligibility
| Description | Data used | Rulesets |
|---|---|---|
| GP added code to indicate vaccination eligibility for flu. | GPES v4 and GDPPR | All people over 6 months with the SNOMED CT code 185903001 needs influenza immunization (finding) added to their GP record between 1 September 2022 to 31 March 2023. Or all people over 6 months of age with the SNOMED CT code 935351000000106 Long term indication for seasonal influenza vaccination (situation) added to their GP record at any time. |
Last edited: 4 July 2024 12:12 pm