To support practices with the RSV (Respiratory Syncytial Virus) immunisation programme, Ardens has created a suite of useful searches to assist with invitations and monitoring.  The Ardens resources have also been updated to include template entries (via the Adult Immunisations template).  There is also a RSV vaccination administration protocol, and also a RSV Vaccine Eligibility Alert.

The RSV programme is effective from 1/9/2024 and eligible patients should not be vaccinated before this date.  

The programme offers a single dose of RSV vaccination to protect both newborns and seniors against severe respiratory disease.

Specifically, the patients who will be offered the RSV vaccination in the first year of the programme are:

• patients turning 75 years after 1/9/2024 ('routine' cohort)
• patients already aged 75-79 years after 1/9/2024 ('catch up' cohort)
• patients who are aged 79 years on 1/9/2024 and who will have their 80th birthday between then and 31/8/2025 ('catch up' cohort)
• pregnant patients who are at least 28 weeks pregnant

Government guidance for the older age groups advises that in order to give them the earliest protection against RSV disease, they should be vaccinated as soon as possible after the catch up campaign commences (1/9/2024).

Further information about the RSV Vaccination programme can be found in the Green Book Chapter 27a.  Information for healthcare practitioners for both the older adults and for pregnant women for infant protection, can be found on the Government website.

Also of note is the advice on the Government website regarding co-administration of RSV with other vaccines.

The Ardens searches can be found by navigating to Population Reporting > Ardens searches, and then locating folder 3.24 Vaccinations – RSV.

IMPORTANT - Please note:  THERE IS NO RSV INVITATION CODE.  We therefore recommend that you use the following code, adding descriptive text to show that this is an invitation for RSV vaccination.

On opening the main folder, you will see that there are sub-folders, invite searches and the other overview searches.

The Invite (RSV + Shingles OR Pneumo) folder contains reports to highlight patients that are due a shingles and pneumococcal vaccine, in additional to RSV. This will help practices that may consider scheduling all three together.

The Invite (RSV) folder contains a number of reports to run.  These reports will capture patients in different categories, who you will either send a standard invitation to, or who you might choose to invite via a different method.

We suggest that you run the Invite (RSV) folder as a whole, so that the sub-folder of searches on which the reports are based are also run and updated.

Once they have been run, you will see the results of the reports displayed in the Population Count column against each report.

You may wish to sort and/or filter this information from the reports, for example to list the patients in these reports by age or by date of birth.

To do this select each report in turn and click View Results on the ribbon. The report will be displayed on the screen.   Next, select Export from the ribbon, and then choose the Export format of CSV and click OK.   Choose a location to store this report outside of the clinical system, and then select Save.

Navigate to where you have stored the report and open the file. Select rows 1 to 8 using the row numbers on the left, and delete these rows as they are not needed for sorting and filtering.  Next press Ctrl and A on your keyboard to select all, and then select the Data tab.  Locate and select the Sort option from the Data tab.

This will open up a Sort box, on which you choose which column you wish to sort by from the drop down list.  For example, if Age is listed in column P, select this from the dropdown list on the left, and then select the Order, either Smallest to Largest or vice versa, again from the dropdown list on the right.

Select OK, and the list of patients will now be sorted accordingly, such as with the youngest patient at the top of the list and the oldest at the bottom.  You can perform a similar sorting function with any of the other columns such Date of Birth, Family Name, or EMIS Number.

You may find this support article helpful – it includes a short video which shows you how to export information from your EMIS system and then filter the data in Excel, to show for example mobile phone, email addresses, particular conditions or age. 

The Invite (RSV) reports are explained as follows:

The INVITE as age 75-79 + due RSV vac before 80th birthday report captures patients aged 75 to 79 years on 1/9/2024 who should receive the RSV vaccination, ideally before 31/8/25.

The INVITE as age 79-80y + due RSV vac before 31.8.2025 report finds those patients currently in the eligible age range and who will turn the age of 80 between 2/9/2024 and 31/8/2025.  You may wish to prioritise these patients early in the programme to give them greater protection over the winter months.

The INVITE as pregnant+ due RSV vaccine at 28/40 report lists pregnant patients who may be eligible for an RSV vaccination.  The report shows invite codes dated on or after 1/7/24, and also shows the latest EDD date.  It is not possible for the EMIS system to calculate when a pregnant patient reaches the eligible point of 28 weeks, but having the latest EDD on the report will help the practice to calculate when eligibility has been reached for the RSV vaccination.  You may find, however, that these patients are offered RSV vaccination during routine midwife appointments.  Please see important note below about pregnant patients before starting to invite this group. 

The VISIT as due RSV vac + housebound or care home report captures those patients who will need to be visited rather than invited.

Please note: A patient will be excluded from the recall process only if they have been coded with any of the following:

• Administration of RSV vaccination
• RSV vaccination contraindicated
• RSV vaccination declined

Please also note the following:

• patients should not be vaccinated before they enter the specified programme age range, or become the specified number of weeks pregnant.  So a patient who reaches their 75^th birthday on the 1^st December can only be vaccinated from that date, and a patient who is 20 weeks pregnant at the start of the programme should not be vaccinated until she reaches at least 28 weeks of pregnancy.  

The Overview searches are separated into the two main cohorts: Aged >=79y and <80y on 1/9/2024 and Pregnant.

For each cohort, the first search captures patients who are due an RSV vaccination because they have not had it already, or they have not declined the vaccine, or they have not been coded with a contraindication to the RSV vaccination.  

For the 75-79 year age group, as patients are vaccinated, you should expect the results in the 'Due' search to reduce to almost zero, due to patients entering the cohort on reaching their 75th birthday. However, the 'Due: Pregnant...' search will never reduce to zero as its parent search includes ALL pregnant patients, including those who are not (as yet) eligible. 

There are then three searches for each of the two cohorts, giving you lists of patients who have been vaccinated, patients who are contraindicated, and patients who have declined.

In the zSubreports folder, you will find the searches on which the Invite (RSV) and also the Invite (RSV + Shingles OR Pneumo) searches are based:

Also included here at the following searches and reports:

The INFO excluded as RSV vac contraindication code + age 75-79y report lists patients who have a contraindication code for RSV on their record.  This report is mainly for information only.

The INFO excluded as RSV vac contraindication code + pregnant report captures, for information purposes, pregnant patients who have either an adverse reaction or a contraindication to the RSV vaccination.

IMPORTANT NOTES REGARDING PREGNANT PATIENTS:

Before inviting the pregnant patient cohort, we recommend you run the 'For review/info: Patients currently coded as pregnant' search which you can find in folder 1.30 Administration - Misc > Info - Pregnancy folder. You can then use the report to determine the current pregnancy status of each patient prior to sending out RSV invitations.  If they are not currently pregnant, they can be coded with a pregnancy outcome code.

Ardens Adult Immunisation Template

You can use the Ardens Adult Immunisations template which has been updated to enable the recording of RSV vaccination, consent, contraindication, declines and aftercare information given.  

Important note regarding CQRS claims:

In order for the RSV vaccination to be correctly included in the CQRS extract, administration of the vaccine must be recorded as GMS.

Ardens has also provided an RSV Vaccination Administration protocol.  This is designed to be added to the F12 Protocol Launcher and used to record the administration of the vaccination in clinic.  This works very much like the Flu Vaccination Administration Protocol and will need to be edited for batch numbers etc.  When run, the protocol allows you to record a contraindication or a decline, or alternatively you can record eligibility and consent and proceed to record the vaccination details.

To alert practice staff to eligibility, Ardens has also produced the RSV Vaccine Eligibility Alert.  This is a medium priority pink box alert that will show if the patient's age determines their eligibility for the RSV vaccination, or that the patient may be pregnant and therefore may be eligible for the RSV vaccine.

You can double click on the pink box alert to access a template that allows you to record administration of the vaccine.

 If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk