If a client's immunization needs to be deferred, this can be done through the Vaccine Administration page (as part of In-Clinic Experience - ICE).
This article goes over the following scenarios:
The client does not consent to vaccination
1. In the Vaccine Administration chevron, scroll to Vaccine Agent Selection, and enter the appropriate agent. Warning: do not scroll past this step!
2. Under the Consent section, click Defer.
3. Click anywhere on this line to continue with the Deferral Process.
The client provides consent but needs to be deferred
Scenario: the client arrives the intention of receiving their vaccination, and consent is obtained by the clinician. However, it is later determined that the client needs to be deferred, and will not receive the immunization on that day.
1. Under Vaccine Agent Selection, enter the appropriate agent.
2. Complete the Informed Consent section for the agent selected above.
a. Click Record Consent.
b. In the Consent pop-up, click Grant, and continue filling all fields marked by asterisks (*). Click Next to proceed.
If Substitute Decision Maker / Parent / Guardian is selected, a secondary set of mandatory fields will show.
c. Review your consent entry. Tick the Confirmation box and click Create Consent Record.
3. Scroll past the Immunization Information section to the Deferrals section. Continue with the Deferral Process below.
Note: A record can still be deferred even if immunization information (trade name, lot #, dosage, route, injection site) has been previously entered.
Deferral Process
4. Click +Add to add a new deferral.
5. Complete the pop-up to Add New Deferral
- Confirm the agent (it should already be pre-populated)
- Important: the deferral agent must match the same agent selected at the top of the form!
- Enter the date of the appointment in the Effective From field
- For the Effective To field...
- In most cases, it is appropriate to use the next calendar day, or a later date as per clinician's discretion.
- Exception: the field can also be left blank under certain circumstances
(e.g. Clinic #1 ran out of a particular product, so the client will go to their local pharmacy on the same day.)
- Select a Reason for Deferral from the drop-down menu
- Add additional Comments to specify the reason for deferral, or any other relevant information provided by the client('s family).
6. Click Save. A green pop-up will confirm that the deferral was successfully created.
The newly created Deferral will display under the Deferrals section, and can be Viewed or Edited.
7. Navigate to the bottom of the page.
Select Defer Vaccination & Record Another Vaccine to chart a second antigen/product.
OR
Select Defer Vaccination & Save to end the client encounter.
8. After the form is submitted, the user will be returned to the Home Screen.
The client's record has now been deferred and taken out of vaccine_admin. The hidden record can be viewed under the Related tab > Immunization Records > Show Cancelled.
Tips & Troubleshooting
- If the Deferral button is greyed out, and not clickable, check the following:
- The deferral agent must match the agent selected at the top of the page
- The "effective to" date should be a FUTURE date. To save a new deferral, the "effective to" date cannot be the same day as the appointment.
- If a deferral was made for the incorrect agent (e.g. COVID-19), simply end-date the incorrect entry, and add a new deferral for the correct agent (e.g. COVID-19 mRNA)
- If the deferral button in the bottom right corner is not visible at all, your User Defaults may not be set to the same clinic location and/or date for the appointment you are trying to defer. Double check these values.