ALERT Immunization Information System - Oregon
ALERT IIS Comma Delimited (csv) File Transfer SpecificationALERT Immunization Information SystemComma Delimited (csv) File Transfer SpecificationVersion 0.4Last Updated: April 23, 20131 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationIntroduction: .3Data Submission Frequency: .3Data Formats Accepted: .3Flat Files Defined: .4Required Data: .4Required Patient File Fields: .4Required Immunization File Fields: .4Required Comment File Fields: .5Required Event File Fields: .5Strongly Encouraged Data: .5Vaccines for Children (VFC) Accountability: .5Matching Records: .5Site identifiers (for clinics with multiple sites): .5Performance Measures: .5Vaccine Recalls: .5Field Order and Format Requirements: .6Patient File (Required) .7Immunization File (Optional File - Recommended) .9Comment File (Optional File – Not Required) .10Notes on Refusals:.10Event File (Optional File – Not Required) .10Examples: .11Patient Record .11Immunization Record .11Comment Record .12Event Record .12Custom File.12ALERT IIS Code Sets .14Change History .212 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationIntroductionThank you for your interest in electronic data exchange with the Oregon ALERT ImmunizationInformation System (IIS). Getting timely and accurate immunization data into ALERT IIS isimportant for your clinic and for the individuals you serve. While standardized Health Level Seven(HL7) messaging is the preferred format for exchanging data with ALERT IIS. the OregonImmunization Program is interested in finding the least burdensome method for your clinic tosubmit data to ALERT IIS.ALERT IIS has made available an interactive user interface on the World Wide Web for authorizedusers to enter, query, and update patient immunization records. The Web interface makes ALERTIIS information and functions available on desktops around the state. However, some immunizationproviders already store and process similar data in their own information systems and may wish tokeep using those systems while also participating in the ALERT IIS. Others may have differentneeds and may decide they do not want to enter data into two diverse systems. For these clinics,electronic transfer is the preferred method to accomplish this goal. ALERT IIS staff will work withyour team to identify the data exchange method, format, and frequency that makes the most sensefor your practice.Data Submission FrequencyTimely data submission to ALERT IIS benefits providers and the patients they serve by makingcomplete immunization records accessible through the system as soon as possible. This also assistspublic clinics with reporting requirements. ALERT IIS encourages, at a minimum, weekly datasubmissions whenever possible for all providers. Public clinics are required to submit data within 14days of administration, and regardless of the method of data submission you choose, you arerequired to send vaccine eligibility by dose.Data Formats AcceptedData is typically pulled from Electronic Medical Record (EMR) systems or from Practice Managementor billing systems. If you have both EMR and billing data systems, ALERT IIS encourages you to pulldata from the EMR, as we have found these data to be more complete (e.g., self-pay, history ofdisease, and historical immunizations are often in the EMR but not in billing databases).ALERT currently accepts the following electronic file types: Fixed length flat text files, specific to lengths specified by ALERT IIS spec Comma Delimited (csv) files Health Level Seven (HL7) Version 2.3.1, 2.1 and 2.5.1 batch files Health Level Seven (HL7) Version 2.4 and 2.5.1 Real Time TransferThis document defines requirements for Comma Delimited (csv) file submissions. Please share thisdocument with technical staff and your software vendor.1HL7 2.4 represents Oregon’s implementation of the June 2006 CDC HL7 2.3.1 specification.3 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationComma Delimited (csv) Files DefinedA csv file stores data in a plain text file. Each line of the text file holds one record, with fieldsseparated by delimiters, such as commas. ALERT IIS accepts comma delimited csv files.For example, the first two records of a file with First and Last Name fields in a csv file might looklike this:John,Doe,Roger,Smith,Note: There are no spaces between fields.ALERT IIS accepts four csv files for immunization data: Patient File (required), Immunization File(required for immunization updates), Comment File (optional), and Event File (optional). The PatientFile houses demographic information about the client. The Immunization File captures vaccinationdata for immunizations administered or reported as histories. The Comment File is used to reporthistory of disease, refusals, as well as allergies or adverse reactions. The Event File is used ifimmunizations are provided as part of a Countermeasure Response Administration (CRA) Eventwhich is used to prepare for, counteract, or offset a possible (preparedness) or actual (response)agent release or disease outbreak. The Event File describes the event and includes project areas,priority groups and event start and end dates.Required DataALERT IIS will accept and store data for patients sent in a Patient File. ALERT IIS needs to receivepatient and vaccination data for each individual that receives an immunization. These data can besent in two separate files: a Patient File and an Immunization File. The files will be linked via aunique Record Identifier supplied by the provider of the file. This identifier will uniquely identifyeach patient and will appear in each file submitted to link individual immunizations to theappropriate patient. A CSV file can also be created to contain all patient and immunization data in asingle file. .At a minimum, ALERT IIS requires the following data fields for each patient:Required Patient File Fields Record Identifier First Name Last Name Birth Date At least two additional identifying demographic fields, such as address, phone, etc. (seesection on matching under “Strongly Encouraged Data” below)ALERT IIS will need the following data fields for each patient receiving an immunization:Required Immunization File Fields Record Identifier Vaccine Code Vaccination Date Lot number and Vaccine Eligibility Code2 and therefore, the Immunization information Sourcefield2Providers participating in the Vaccines for Children (VFC) program must submit vaccine eligibilitycodes for all administered vaccines by January 1, 2013.4 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationWhen submitting one or more of the optional files (Comments File or Event File), the following fieldsare required:Required Comment File Fields Record Identifier Comment CodeRequired Event File Fields Record Identifier Event Code Priority GroupStrongly Encouraged DataVaccines for Children (VFC) AccountabilityClinics that receive state supplied vaccine will be required to provide vaccine eligibility codinginformation and lot number electronically by January 1, 2013. ALERT IIS strongly encouragesclinics to provide this data, prior to the mandate going into effect. This greatly simplifies federallyrequired vaccine accountability for your clinic. Submitting these data to ALERT IIS can savecountless hours to reconcile VFC reports every year, can assure you are eligible to receive all thevaccine you need for eligible children, and can make access to vaccines in short supply muchsimpler. Allow our staff to assist you in setting up this field now.Matching RecordsDue to the large volume of records ALERT IIS receives from various sources, additionaldemographic and immunization information is essential to ensure ALERT IIS matches immunizationrecords reported from multiple sources appropriately. If you are unable to supply this information,ALERT IIS will not be able to merge your data with other sources to compile a single completeimmunization record for each client. Complete records benefit your clinic by providing you with thebest possible client data. ALERT IIS encourages sites to send as many demographic elements aspossible (e.g., Address, Telephone number, Social Security Number, Mother's maidenname, Parent/guardian name, or Medicaid Number) to improve appropriate record matching.Site identifiers (for clinics with multiple sites)ALERT IIS highly recommends that clinics with multiple sites provide site-specific identifiers to bothdemographic and immunization records whenever possible. This will enable ALERT IIS staff toprovide recall reminders to appropriate clinics. Site-specific identifiers make it easier to match arecall report to a child's medical record. These identifiers also enable Immunization Program staff toprovide assessments for each clinic site. Clinics that receive state supplied vaccine must submit siteidentifiers if file contains data for multiple clinics.Performance MeasuresIn addition, your clinic may want to send elements that you can use for your own performancemeasurements. For example, you may want to consider sending provider identifiers, which wouldallow you to receive performance reports on individual providers in your practice. Please include asmuch information as possible.Vaccine RecallsEntering vaccine lot and manufacturer into ALERT IIS can save your clinic valuable time andresources in case of a vaccine recall or adverse event.5 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationField Order and Format RequirementsThe following tables describe the fields to include in each of the csv files discussed. Files need to begenerated using the American Standard Code for Information Interchange (ASCII) character set3.ASCII is a character-encoding scheme based on the ordering of the English alphabet. Specialcharacters should not be used in names. Records will be comma delimited and may be terminatedwith a carriage return/line feed. Text qualifiers should not be used.Each table contains Column, Data Type, R/SE, Default and Notes information. Column: The name of the data element. Data length: Maximum length ALERT IIS will accept for data in the field. Data exceeding thelength will be truncated. When the data in a field is numeric (e.g., dates, zip-code, telephonenumber, SSN, CVX code) only numeric digits should be entered. R/SE: R Required field. SE Strongly Encouraged field. (see ”Required Data” and“Strongly Encouraged Data” sections above) Default: Default value that will appear in ALERT IIS if the field is blank. Notes: Description of the column and code sets to use (where applicable).Character FieldsThese fields may contain letters, numbers, or blank spaces.Date FieldsDates must be entered in this format: MMDDYYYY, with leading zeroes (e.g., 01012001).Null ValuesWhen a site is unable to supply information for an optional field, null values are appropriate.Consecutive commas indicate a null value. For example, the first two records of a file in whichMiddle Name is part of the file format, but the site is unable to supply the middle name might looklike this:John,,Doe,Roger,,Smith,Extra CommasThese may be present in the data, but need special treatment. Since csv files are comma delimited,field data containing extra commas must be preceded by a backslash (\). Commas can instead bestripped from the data prior to submission if using a backslash is not possible.For example, a DTaP vaccine administered by Joe Q. Testdoctor, MD, would have an immunizationrecord that looks like this (fields with extra commas are bold):1772763,,DTaP\, NOS,90700,107,10132011,IM,LVL,10,PMC,00,abc123,JOE Q TESTDOCTOR\,MD,AL999,NALERT IIS recommends submitting as many of the elements listed below for maximumcompleteness. At a minimum, fields identified with an ‘R’ in the ‘R/SE’ in the required column mustbe submitted for ALERT IIS to process the file.While initial file set up and testing must be done, extracting these data from your system forsubmission to ALERT IIS relieves the burden of dual data entry efforts from your clinic. Due to thevariety of EMRs, Practice Management and billing systems in use, automating data extracts forroutine submission to ALERT IIS may require assistance from clinic technical staff or your softwarevendor. Please contact ALERT IIS technical staff at 800-980-9431 if you have questions regardingthis process.3http://www.asciitable.com/6 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationPatient File (Required)ColumnDataLength32R/SE1SEFirst Name50RMiddle NameLast Name5050SERName SuffixBirth DateDeath DateMother’s First Name108850SEMother’s MaidenLast NameMother’s HBsAgStatus50SERecord IdentifierPatient StatusDefaultRA11Social SecurityNumberContact Allowed9Supplied by sender, used to link a Patientto Immunization records.Use the IIS code set for Patient Status.(Note: Right click and select ‘OpenHyperlink’ to view corresponding codesets for all hyperlinks).Patients with no first name or who havespecial characters within the name willcause entire patient record not to importPatients with no last name or who havespecial characters within the name willcause entire patient record not to importJR, III, etc.MMDDYYYYMMDDYYYYALERT IIS will accept imported data butWILL NOT populate this field on export.ALERT IIS will accept imported data butWILL NOT populate this field on export.Code set for Mother’s HBsAg Status.ALERT IIS will accept imported data butWILL NOT populate this field on export.ALERT IIS code set for Sex (Gender).‘Y’ if YesR1Sex (Gender)American Indian orAlaska NativeAsianNative Hawaiian orOther PacificIslanderBlack or AfricanAmericanWhiteOther RaceEthnicityNotesR11‘Y’ if Yes‘Y’ if Yes1‘Y’ if Yes112‘Y’ if Yes‘Y’ if YesUse the ALERT IIS code set forEthnicity.ALERT IIS will accept imported data butWILL NOT populate this field on export.Controls whether notices are sent. Usethe ALERT IIS code set for Contact. If null default to ‘02’ - contact allowed.Must be provided for site specific patientId to be returned upon export. Typically,ID is a Chart Number, Medical RecordNumber, etc. It may be the same as theRecord Identifier. If provided here, it maybe used to facilitate access to thepatient’s records through the userinterface.SE202Patient ID32SEMedicaid ID20SE7 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationColumnResponsible PartyFirst NameDataLength50R/SENotesResponsible party would be a parent orguardian or someone responsible for thecare of this patient.Responsible PartyMiddle NameResponsible PartyLast NameResponsible PartyRelationshipStreet Address Line50Other Address Line55PO Box Route Line55CityStateZip onDefault50355Use the ALERT IIS code set forRelationship to the patient.Address is loaded for the patient and theresponsible person. Primary addressinformation (i.e. 100 TAFT ST.)Secondary address information (i.e. APT104, STE 530) Do not place a secondaryaddress in this field. Additional addressesfor the patient or responsible parties maybe added through the user interface.If patient has PO Box mailing address,enter here.SE2 character state abbreviation, ex. OR5 or 9 digits without separators (paddedwith blanks if 5) ex. 97123**** or971235678.Use the ALERT IIS code set for County.Format as digits only starting with thearea code, ex. 6081234567.Extension up to 7 digits allowed.The Organization Code of the providerorganization that owns these patient andcorresponding immunization records.Contact the ALERT IIS Help Desk for theappropriate Organization Code.* Optional if the org. is sending all of itsown records. This field is used if an org.other than the organization that owns therecord(s) is transmitting this file and/orwhen multiple providers are included in asingle file.8 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationImmunization File (Strongly cination DateAdministrationRoute CodeBody Site Code82RReaction Code8Manufacturer Code4SEImmunizationInformation Source2Please seenotesLot Number30SEProvider Name50Administered ByNameSendingOrganization50Record IdentifierNDC CodeTrade NameCPT CodeCVX CodeVaccine GroupDefaultR4801SE9 of 21NotesSupplied by sender, used to linkImmunizations to a Patients record.*One of these five vaccine codes isrequired. Multiple may be transmitted.See ALERT IIS Vaccine Codes PDF orSpreadsheet.NDC Formats: 99999-9999-9999999-*999-9999999-9999-*9MMDDYYYYUse the ALERT IIS code set forAdministration Route.Use the ALERT IIS code set for BodySite.Use the ALERT IIS code set forReaction. Do not place a secondaryreaction code in this field. Additionalreactions for the patient may be addedthrough the user interface.Use the ALERT IIS code set forManufacturers.Use 00 for an immunization which wasadministered by the sendingorganization. For historical doses fromthe patient’s record, use values 01through 07 or OU, for value descriptions,see ALERT IIS code set forImmunization Information Source.If left empty, default will be saved andadditional fields in the file such as Lotand Vaccine Eligibility will not be saved.FOR INVENTORY DEDUCTION: ‘00’ ismandatory.Converted records will be stored inALERT IIS as historical records, so theLot Number will not correspond toinventory tracked in ALERT IIS, but LotNumber can still be stored as historicalinformation.FOR INVENTORY DEDUCTION: Lot #is mandatory and must exactlymatch inventory list in IIS .If entering historical doses, enter thename of the provider or clinic thatadministered the vaccination, if known.The name of the person whoadministered the vaccination.The Organization Code of the providerorganization immunization records.Contact the ALERT IIS Help Desk for theappropriate Organization Code.* Optional if the org. is sending all of its
ALERT IIS Comma Delimited (csv) File Transfer SpecificationColumnVaccine EligibilityDataLengthR/SE1DefaultNotesown records. This field is used if an org.other than the organization that ownsthe record(s) is transmitting this fileand/or when multiple providers areincluded in a single file.FORINVENTORY DEDUCTION: Inventorydeduction will occur for the sendingorganization specified in this field.If empty, inventory deduction willoccur for the organizationtransmitting the file.Populate with Oregon VaccineEligibility Codes. MANDATORY FORINVENTORY DEDUCTION.SEComment File (Optional File – Not Required)ColumnDataLength32R/SEComment Code6RBegin Date8REnd Date8Record IdentifierDefaultRNotesSupplied by sender, used to linkComments to a Patients record.Use the ALERT IIS code set forComments.Begin date to which the commentapplies. MMDDYYYYEnd date to which the comment applies.MMDDYYYYNotes on Refusals:Refusals are sent in the optional Comment file. Please bear in mind the following when sending inrefusals or receiving output flat files from ALERT IIS:a) ALERT IIS will write out multiple refusals of the same vaccine on different dates for thosepatients who have them.b) ALERT IIS will accept incoming refusals of the same vaccine on different dates (BeginDate) and store them both; however, if the dates are the same, only one will be stored.Event File (Optional File – Not Required)ColumnDataLength32Pos#1R/SEEvent Code2033RPriority Group2053RRecord IdentifierDefaultR10 of 21NotesSupplied by sender, used to link Eventand Priority Group to a Patient’s recordCorresponds to alphanumeric EventCode as stored in ALERT IIS Contact theALERT IIS Help Desk for the appropriateEvent Code.Use the ALERT IIS code set for PriorityGroup. Contact the ALERT IIS HelpDesk for the appropriate Priority GroupCodes that are valid for the Event.
ALERT IIS Comma Delimited (csv) File Transfer SpecificationExamplesPatient RecordThis Information:Record ID:Status Active:Name:Birth Date:Death Date:Mother’s Maiden Name:Mother’s HbsAg Status:Gender:Race:Ethnicity:SSN:Contact Allowed:Patient ID:Medicaid ID:Responsible Party:Relationship:Address:PO Box:County:Phone:Sending Organization:17727736ACourtney Lee Brown, MD9/10/1994Anne GreenPositiveFemaleWhiteNot Hispanic111223333YesCHART33321MEDID11011Tim BrownFather1234 Test Street, Apt 491 Portland, OR 93221PO Box 740Clackamas4932227744AL9999Results in the following Patient EDID11011,TIM,,BROWN,FTH,1234 Test Street,Apt 491,PO munization RecordThis information:Record ID:17727736NDC Code:49281-0549-10Trade Name:ActHibCPT Code:90648CVX Code:48Vaccine Group:HibDate Administered:10/13/2003Admin Route:IntramuscularBody Site Code:Left Vastus LateralisReaction Code:NoneManufacturer:sanofi PasteurInformation Source: Administered by this clinicLot Number:abc123Provider Name:None, this is not historical informationAdministered by:Robert J. Test, MDSending Organization: AL9999Vaccine Eligibility:UninsuredResults in the following Immunization record:17727736, , , ,48, ,10132003,IM,LVL,,PMC,00,abc123,ROBERT J TEST\, MD,AL9999,N11 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationComment RecordThis information:Record ID:Comment Code:Begin Date:End Date:17727736Patient had Varicella10/1/1999not applicableResults in the following Comment record:17727736,33A,10011999Event RecordThis information:Record ID:Event Code:Priority Group:17727736DAX2008General Population, Tier 5Results in the following Event record:17727736,DAX2008,GPT5Custom CSV:Client and immunization data can be combined in a comma separated file. The required andstrongly encouraged elements need to be included in the file in the formats previously specified.A header should be included and the file extension must be .txt.This Information:Record ID:Name:Birth Date:Mother’s Maiden Name:Gender:Medicaid ID:Address:CVX Code:Date Administered:Information Source:Lot Number:Sending Organization:Vaccine Eligibility:17727736Courtney Lee Brown9/10/1994GreenFemaleMEDID110111234 Test Street, Portland, OR 932214810/13/2003Administered by this clinicabc123AL9999UninsuredResults in the following Event F,MEDID11011,1234 TestStreet, Portland, OR, 93221,48,10132003,00,abc123,AL9999,N12 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationNext StepsIf your site is a good candidate for electronic data transfer to ALERT IIS, please call and request tospeak to ALERT IIS technical staff at 800-980-9431. ALERT IIS staff will obtain some generalinformation about your site and data systems. If sending data via csv format is the appropriate nextstep, you’ll be asked to submit a test for review. Once data issues are resolved and a go-live date isagreed upon, you will be set up for routine data transfer. ALERT IIS and health education staff willwork with you to capture additional data not input into your system (immunization histories, etc).If electronic transfer is not a viable option for your clinic and you wish to explore entry of clientimmunization data directly using the online entry system, or you have any questions aboutsubmitting data to ALERT IIS, please do not hesitate to contact ALERT IIS technical staff at 800980-9431.Thank you for working with ALERT IIS on this important effort.13 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationALERT IIS Code SetsTable ralSubcutaneousTransdermalPercutaneous (multiple puncture – Small Pox)Body l NaresLeft ArmLeft DeltoidLeft Gluteous MediusLeft Lower ForearmLeft NaresLeft ThighLeft Vastus LateralisMouthRight ArmRight DeltoidRight Gluteous MediusRight Lower ForearmRight NaresRight ThighRight Vastus LateralisComments03Allergy to baker’s yeast (anaphylactic)04Allergy to egg ingestion (anaphylactic)05Allergy to gelatin (anaphylactic)06Allergy to neomycin (anaphylactic) MMR & IPV07Allergy to Streptomycin (anaphylactic)08Allergy to Thimerosal (anaphylactic)09Allergy to previous dose of this vaccine or to any of its unlistedvaccine components (anaphylactic)10Anaphylactic (life-threatening) reaction to previous dose of thisvaccine11Collapse or shock like state within 48 hours of previous dose ofthis vaccine12Convulsions (fits, seizures) within 3 days of previous dose ofDTP/DTaP13“Persistent, inconsolable crying lasting 3 hours within 48 hoursof previous dose of DTP/DTaP”14Current diarrhea, moderate to severe15Encephalopathy within 7 days of previous dose of DTP14 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationTable ItemCode16Description17Fever of 40.5 C (105 F) within 48 hours of previous dose ofDTP/DTaP18Guillain-Barre Syndrome (GBS) within 6 weeks after DTP/DTaP21Current acute illness, moderate to Chronic illnessImmune globulin (IG) administration, recent or simultaneousImmunity: DiphtheriaImmunity: Haemophilus Influenzae type BImmunity: Hepatitis AImmunity: Hepatitis BHepatitis B titer – immuneHepatitis B ANTIBODY to surface antigen, positive (immune)Immunity: MeaslesMeasles titer – immuneImmunity: MumpsMumps titer – immuneImmunity: PertussisHistory of PertussisImmunity: PoliovirusImmunity: RubellaHistory of RubellaRubella titer – immuneImmunity: TetanusImmunity: Varicella (chicken pox)Varicella titer – immuneHistory of Varicella/chicken poxImmunodeficiency (in recipient) OPV & MMR & VZVNeurologic disorders, underlying (seizure disorder)Otitis media (ear infection) moderate to severePregnancy (in recipient)ThrombocytopeniaThrombocytopenia purpura (history)Refusal of DTRefusal of DTaPRefusal of HepBRefusal of HibParental refusal of MMRRefusal of PneumococcalRefusal of PolioRefusal of TDRefusal of VaricellaRefusal of SmallpoxRefusal of HepARefusal of InfluenzaRefusal of Pertussis01No Contact Allowed – Notices are not to be sent.232425HEPA I2627282930313233ContactCurrent fever with moderate-to-severe illness15 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationTable ItemCode02DescriptionContact Allowed – Notices will be ouglasGilliamGrantHarneyHood illEthnicityNHHNot Hispanic or LatinoHispanic or LatinoImmunizationInformationSource00New Immunization Administered (by Sending Organization)010203Source UnspecifiedOther ProviderParent Written Record16 of 21
ALERT IIS Comma Delimited (csv) File Transfer SpecificationTable ItemCode04050607OUDescriptionParent RecallOther RegistryBirth CertificateSchool RecordOutside USAManufacturersABADAKRALPAVIBRRAbbott Laboratories (includes Ross Products Division)Adams LaboratoriesAkorn, Inc.Alpha Therapeutic CorporationAvironBarr LaboratoriesBaxter Heathcare Corporation (includes Hyland Immuno,Immuno International AG, and North American Vaccine, Inc.)Bayer (includes Miles, Inc., and Cutter
ALERT IIS Comma Delimited (csv) File Transfer Specification 3 of 21 Introduction Thank you for your interest in electronic data exchange with the Oregon ALERT Immunization Information System (IIS). Getting timely and accurate immunization data into ALERT IIS is important for your clinic and for the individuals you serve.
and Influenza Immunization Summit (NAIIS) is pleased to announce the recipients of the 2016 Immunization Excellence Awards. There are six categories of recognition: overall influenza season activities, influencer, "immunization neighborhood" champion, corpo-rate campaign, adult immunization champion, and adult immunization publication award.
The Kentucky Immunization Registry is an IIS Statewide Immunization Information System (IIS) Information system that houses immunization data on Kentucky residents across-the-lifespan record keeping (birth to death) Allows providers the ability to access and retrieve immunization records prior to or at the time of a scheduled appointment.
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The alert function is for the I2C-bus interface only. In interrupt mode (TM 1), the ALERT pin can be connected as an SMBus alert signal. When a controller detects an alert condition on the ALERT line, the controller sends an SMBus alert command (00011001) to the bus. The device acknowledges the SMBus alert command and responds by sending its
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immunization against α-syn can occur in one of two forms, active or passive immunity [18]. Active immunization involves stimulating the immune system to produce anti-bodies against toxic α-syn conformations, while passive immunization involves administering anti- α-syn antibodies to the patient, which confers temporary protection against the .
from our Club will show sUde a d taik about lapidary work made. by our lJI ery I[D me e s. ALERT, ALERT, ALERT, AL Please Uote end return enclosed balh'll RSRP Board Meeting: At Shop on: NQuember 10, 7:30 PM D
ASTROPHYSICS - PAPER 1 Candidates may attempt not more than six questions. Each question is divided into Part (i) and Part (ii), which may or may not be related. Candidates may attempt either or both Parts. The number of marks for each question is the same, with Part (ii) of each question carrying twice as many marks as Part (i). The approximate number of marks allocated to each component of a .
