[Gnumed-devel] Re: Vaccinations tables/questions

[Ian Haywood]

Karsten Hilbert wrote:

> I will take your word for it here and draw from your
> experience. Let's perhaps not think of
> vacc_indication.description as "disease to be vaccinated
> against" but rather "agreed-upon human-comprehensible
> indication identifier".
This is complex, as all vaccine epitopes do target a single disease entity,
the point is that not usually the way we use them (at least here)

Currently about the only time a vaccine is given by disease is
when we want to give hep b vaccine to an injecting drug user or health-care 
worker.
Oh, and Q-fever for meatworkers (do you have Q-fever in germany?)

The rest of the time we are giving according to a schedule,
either because the patient has reached a certain age, or
they wish to travel to a certain country.

Personally I think we should aim for a "fully automatic" system:
the vaccine dialogue computes the outstanding vaccinations based on the 
patient's
age, plus a short list of "high-level" indications such as
- meatworker
- blood-borne disease risk (currently == hepB, but when we get hepC vax this 
means we will have a formal "schedule" for these people)
- travel to africa
- travel to S.E asia
- travel to South America
- Indigenous (they get pneumococcal and influenza at an eariler age, from 50 
IIRC)

Oh, asthmatics and a few others get pneumo+flu as well, so there is a good case 
for linking
vaccine indications to disease codes.

The means we *do* need schedule_max_age, so we don't try to vaccinate the 
75-year-old Sudanese refugee grandmother against whooping cough.

ian