HealthFrame Discussion

Re: Tdap Vaccine & Td Vaccine missing from vaccine list

support@RecordsForLiving.com — Thu, 14 Feb 2013 08:21:42 GMT

Thank you so much for your help!

I believe we have this fixed for the next HealthFrame v3 beta (b9).

The current list of immunizations in HealthFrame that contain the word tetanus are:
C0039620 Tetanus Vaccine
C0058773 Diphtheria-Tetanus (DT) Vaccine
C1314123* Tetanus, Diphtheria Toxoids and acellular Pertussis Vaccine (Tdap)
C0535644 Diphtheria-Tetanus-Acellular Pertussis (DTaP) Vaccine
C0012559 Diphtheria-Tetanus-Pertussis Vaccine
C0215600 Diphtheria + Pertussis + Tetanus + Haemophilus Influenzae Type B Vaccine
C2054267* Tetanus-Diphtheria Vaccine (Td)

The two with the '*' after the concept id are additions in HealthFrame v3.

Re: Tdap Vaccine & Td Vaccine missing from vaccine list

mike08 — Fri, 08 Feb 2013 17:59:01 GMT

Here is a link to the CDC's page that explains the difference between DTaP, Tdap, and Td vaccines: http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm You can also see an explanation on Wikipedia here: http://en.wikipedia.org/wiki/DPT_vaccine#Combination_vaccines_with_acellular_pertussis I'm not sure if this will help you with your mapping problem or not, but hopefully it will. Also, I don't know how up to date the UMLS mappings are, but Tdap wasn't developed and approved for use until 2005 (DTaP was developed in the 1980's). It is possible that Tdap isn't in the UMLS system yet, or if it is, it may have been hastily added by people who didn't fully understand the difference. In a nutshell, DTaP and Tdap are very similar, but the dosages of the three various components are different. DTaP has full dosages of everything and is typically given to children under age 7. It is usually given several times over a period of a few months. After that, booster shots use the Tdap vaccine, which has reduced dosages of everything except the Tetanus component (Tetanus dosage remains unchanged).

Re: Tdap Vaccine & Td Vaccine missing from vaccine list

support@RecordsForLiving.com — Fri, 08 Feb 2013 12:51:01 GMT

Thank you so much for your valuable feedback!

We are working right now to finalize the reference content for HealthFrame v3 ,and it will be based on the contents of UMLS 2012AB (there most recently release).

If you are unfamiliar with UMLS, you might be interested to look into it.
https://uts.nlm.nih.gov

It's free, but you do need to sign up and get an account.

I'm having a hard time mapping what you are saying to the UMLS database contents. This is in NO WAY meant to contradict you. The UMLS database - though valuable, is unclean and inconsistent, and riddled with mixups like this.

What HealthFrame v3 is using currently (as of our last beta) - related to 'tetanus and diptheria immunizations' etc.. would be:

C0012551 -
MAIN UMLS NAME: 'diphtheria toxoid vaccine, inactivated'
HEALTHFRAME NAME: 'Diphtheria Vaccine'
(The formaldehyde-inactivated toxin of Corynebacterium diphtheriae. It is generally used in mixtures with TETANUS TOXOID and PERTUSSIS VACCINE; (DTP); or with tetanus toxoid alone (DT for pediatric use and Td, which contains 5- to 10-fold less diphtheria toxoid, for other use). Diphtheria toxoid is used for the prevention of diphtheria; DIPHTHERIA ANTITOXIN is for treatment.)

C0039620 -
MAIN UMLS AND HELATHFRAME NAMES: 'Tetanus Vaccine'

C0535644 -
MAIN UMLS NAME: 'Diphtheria-Tetanus-Acellular Pertussis Vaccines'
HEALTHFRAME NAME: 'Diphtheria-Tetanus-Acellular Pertussis (DTaP) Vaccine'
(Combined vaccines consisting of DIPHTHERIA TOXOID; TETANUS TOXOID; and an acellular form of PERTUSSIS VACCINE. At least five different purified antigens of B. pertussis have been used in various combinations in these vaccines.)

C0058773 -
MAIN UMLS NAME: 'Diphtheria-Tetanus Vaccine'
HEALTHFRAME NAME: 'Diphtheria-Tetanus (DT) Vaccine'
(A combined vaccine used to prevent infection with diphtheria and tetanus toxoid. This is used in place of DTP vaccine (DIPHTHERIA-TETANUS-PERTUSSIS VACCINE) when PERTUSSIS VACCINE is contraindicated)

My first guess as how to interpret your suggested additions (and how to integrate them with the UMLS database) would be to add:
[C2054270] tdap vaccine
(renaming to Tdap for HealthFrame)

C0542570 Td (adult)
Renamed for HealthFrame to ‘Tetanus – Diphtheria– Adult Vaccination (Td)

But the problem I have is that UMLS lists C0535644 as mapping to the concept named ‘Tdap - Tetanus + diphtheria + acellular pertussis vaccine in SNOMED_CT). Perhaps this is just a bad mapping, and I should ignore it?

Anyhow - I have no idea if any of this UMLS stuff makes sense or not, but I welcome your feedback, and want to provide the very best, most accurate and useful enumeration of immunizations I can.

Thank you for your help!

Tdap Vaccine & Td Vaccine missing from vaccine list

mike08 — Wed, 16 Jan 2013 17:47:12 GMT

The current version of HealthFrame does not have the Tdap vaccine in it's list of vaccine options. It does have the DTaP vaccine, but that vaccine is not the same has Tdap. While both vaccines are for Diphtheria, Tetanus, and Pertussis, the DTaP is given to infants and young children. Tdap is a booster, and contains smaller dosages of the three components.

In addition, the Td vaccine is not in the current vaccine list. There is the DT vaccine, but they are not the same thing. Td is a Tetanus/Diphtheria booster given after a person gets a Tdap booster (Tdap is usually only given once. Then you get Td booster every 10 years). In contrast, the DT vaccine that is in the current list, while also for Diphtheria and Tetanus, is NOT a booster. It is used for children under 7 who, for various reasons, cannot get the normal DTaP vaccine.

Just FYI, capitalization of the letters in vaccine abbreviations is not arbitrary. The lower-case 'd' in 'Td' indicates that the Diphtheria component of the Td vaccine is a reduced dosage. The DT vaccine has a full dosage of both components, which is indicated by both letters being capitalized. The lower case 'a' in both 'DTaP' and "Tdap' indicates that the Pertussis component is acellular.