=Paper=
{{Paper
|id=Vol-3302/paper20
|storemode=property
|title=Decision-Making Support for Necessity/Optionality/Contraindication of Vaccination against COVID-19 Considering Legal Norms
|pdfUrl=https://ceur-ws.org/Vol-3302/paper12.pdf
|volume=Vol-3302
|authors=Yelyzaveta Hnatchuk,Tetiana Hovorushchenko,Andrii Misiats,Alla Herts,Artem Boyarchuk
|dblpUrl=https://dblp.org/rec/conf/iddm/HnatchukHMHB22
}}
==Decision-Making Support for Necessity/Optionality/Contraindication of Vaccination against COVID-19 Considering Legal Norms==
https://ceur-ws.org/Vol-3302/paper12.pdf
Decision-Making Support for Necessity/Optionality/
Contraindication of Vaccination against COVID-19 Considering
Legal Norms
Yelyzaveta Hnatchuka, Tetiana Hovorushchenkoa, Andrii Misiatsa, Alla Hertsb, and Artem
Boyarchukc
a
Khmelnytskyi National University, Institutska str., 11, Khmelnytskyi, 29016, Ukraine
b
Ivan Franko National University of Lviv, Universytetska str., 1, Lviv, 79000, Ukraine
c
Tallinna Tehhnikaülikool, Ehitajate tee 5, Tallinn, 12616, Estonia
Abstract
The conducted review of known methods and systems showed that there are currently no
tools for decision-making support for necessity/optionality/contraindication of vaccination
against COVID-19. The paper models the process of decision-making support for
necessity/optionality/contraindication of vaccination against COVID-19, which is a
theoretical basis for the formation of questionnaires for gathering information about the
person who plans to be vaccinated, for organizing the analysis of this person's answers, as
well as for decision-making support for necessity/optionality/contraindication of vaccination
against COVID-19. Questionnaires for determining the necessity/optionality of vaccination
against COVID-19 and for determining the contraindication of vaccination against COVID-
19 were developed taking into account the current legal norms of Ukraine, as well as rules for
analyzing the answers to questions of questionnaires for determining the necessity/optionality
of vaccination against COVID-19 and the answers to the questions of questionnaires for
determining the contraindication of vaccination against COVID-19. The developed rules
make it possible to form a set of work’s categories of the person, for whom the
necessity/optionality of vaccination against COVID-19 is determined, and a set of medical
diagnoses-contraindications of a person, for whom a contraindication of vaccination against
COVID-19 is determined, which are grounds for making a decision about the
necessity/optionality/contraindication of vaccination against COVID-19. The scheme of
process of decision-making support for necessity/optionality/contraindication of vaccination
against COVID-19 has been developed, according to which a person who plans to be
vaccinated can automatically and free of charge determine the necessity/optionality of
vaccination against COVID-19, as well as the possibility/contraindication of vaccination
against COVID-19 based on the legal norms in force in Ukraine, i.e. can independently make
a reasoned decision regarding vaccination against COVID-19.
Keywords 1
Necessity of vaccination against COVID-19, optionality of vaccination against COVID-19,
contraindication of vaccination against COVID-19, decision-making support.
1. Introduction
Today, health care decision-making by both doctors and patients requires considerable attention,
because the health care industry has high risks and stakes, and the health and life of the patient
IDDM’2022: 5th International Conference on Informatics & Data-Driven Medicine, November 18–20, 2022, Lyon, France
EMAIL: liza_veta@ukr.net (Ye. Hnatchuk); tat_yana@ukr.net (T. Hovorushchenko); misiatc@khnu.km.ua (A. Misisatc); agerc@ukr.net
(A. Herts); a.boyarchuk@taltech.ee (A. Boyarchuk)
ORCID: 0000-0003-2989-3183 (Ye. Hnatchuk); 0000-0002-7942-1857 (T. Hovorushchenko); 0000-0002-0003-6340 (A. Misiats); 0000-
0002-3310-3159 (A. Herts); 0000-0001-7349-1371 (A. Boyarchuk)
©️ 2022 Copyright for this paper by its authors.
Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
CEUR Workshop Proceedings (CEUR-WS.org)
depends on the decision made. When making medical decisions, there is a lack of time, high
dynamics of the course of diseases, high cost of medical errors, etc. Medical errors cause tens of
thousands of deaths in hospitals each year. Medical errors threaten the quality of health care, increase
health care costs, and threaten a crisis in the health care industry. Even simple medical decisions can
affect the subsequent quality of life of patients and the success and speed of their recovery. Most
often, decision-making comes down to the experience of a medical worker who has to take into
account a lot of different factors, often insufficient or imperfect information under strict time
constraints and psychological pressure [1-3].
The problem of providing the automated support for decision-making in the field of health care is
becoming more and more urgent with the increase in the information load on the doctor and the
development of computer technologies. Clinical decision support systems provide decision makers
with the functionality to use a variety of information to inform decision making. Exactly clinical
decision support systems that can help alleviate the pressure felt by healthcare professionals,
minimize the potential for medication errors, and help provide effective care regardless of the current
workload of the healthcare facility. The clinical decision support system significantly saves money,
time and reputation of the medical institution and its employees [1-5]. But the clinical decision
support system is the most difficult to design and implement, because when designing such a system,
information from two or more subject areas should be taken into account (at least the field of
information technology, the field of health care, and often also the field of medical law, etc.) [6, 7].
Since the beginning of 2020, the health care industry has faced a serious challenge - the COVID-
19 pandemic, which is causing considerable mortality in the population, as well as destroying the
economies of countries around the world. Vaccination against COVID-19 has become the most
effective tool for containing the pandemic. For August 10, 2022, 67.2% of the world population has
received minimum one dose of a COVID-19 vaccine, but only 20.2% of people in low-income
countries have received minimum one dose [8]. High speed of vaccine manufacturing and accelerated
approval, poor and weak laboratory testing of vaccines, lack of clinical trial data on vaccine safety
and efficacy, unwell feeling of many people after receiving the vaccine, unknown long-term health
effects of vaccination, uncertainty about efficacy against various strains of COVID-19, inadequate
information and representation of vaccination in social networks are factors that inhibit vaccination of
the population and make it difficult to make a decision about the
necessity/optionality/contraindication of vaccination against COVID-19, especially for people with
chronic diseases, despite even a high mortality rate from COVID-19.
When making a decision on the necessity/optionality/contraindication of vaccination against
COVID-19, it is important for Ukrainians to understand that for people of certain professions,
vaccination against COVID-19 is mandatory in accordance with the order of the Ministry of Health of
Ukraine dated 04.10.2021 No. 2153, registered in the Ministry of Justice on 16.12.2021 under No.
1624/37246 (categories of employees, for whom vaccination is mandatory, are defined by the authors
in [9]). For everyone else, vaccination is optional but desirable, again given the high mortality rate of
people from COVID-19. In addition, when making a decision about the
necessity/optionality/contraindication of vaccination against COVID-19, Ukrainians should know the
medical contraindications on vaccination against Covid'19 established by the current legislation of
Ukraine (medical contraindications are also defined by the authors in [9]).
Therefore, when making a decision about the necessity/optionality/contraindication of vaccination
against COVID-19, a person can independently study the relevant legislative acts and make such a
decision or turn to a family doctor, who must again be familiar with the norms of the law and take
responsibility for making a decision about necessity/optionality/contraindication of vaccination against
COVID-19. The third way is the use of a clinical decision-making support system about vaccination
against COVID-19, the concept of which is proposed by the authors in [9], which provides a conclusion
about the necessity/optionality/contraindication of vaccination against COVID-19 on the basis of
existing legal norms and thereby contributes to independent decision-making by a person and reducing
the burden on the family doctor (at least eliminating the need for the family doctor to study the current
legal norms regarding vaccination). Based on the truthful answers of the person, who plans to be
vaccinated, to the questions of the system about the profession and place of work of the person planning
to be vaccinated, about his medical history, the proposed system forms conclusions about the mandatory
or optional vaccination, about the possibility or contraindications to vaccination.
The main task in designing the clinical decision support system about vaccination against COVID-
19 is the formation of questionnaires to gathering the information about a person who plans to be
vaccinated, as well as the analysis of this person's answers to the questions of the questionnaires, on
the basis of which the decision about necessity/optionality/contraindication of vaccination against
COVID-19 is made. This research is dedicated to the solution of such task.
2. Review of the Known Methods and Systems
Let's review the known methods and systems for decision-making support for
necessity/optionality/contraindication of vaccination against COVID-19.
ProMES is the Covasim-based multiagent pandemic simulator, which evaluates and compares
strategies for reducing Covid-19 transmissions (vaccinations, tests, combinations of
nonpharmaceutical individual and state interventions). This tool is a part of data/knowledge intensive
decision support system, preventing the spread of the coronavirus [10].
In [11] the general linear and logistic regression methods researched factors (demographic
characteristics, health-related characteristics, knowledge about vaccination against COVID-19, and
determinants of decisions to vaccinate), associated with vaccine acceptance and vaccine hesitancy
respectively. COVID-19 vaccine acceptance groups were defined and multivariable models were
constructed.
The study [12] proposes a decision support system that integrates geoinformatic systems,
simulation methods, analytics to develop a tool for priority-based distribution of COVID-19 vaccines
in a large urban setting.
In [13] Bayesian network is developed for combination and effectively communication of evidence
on the risks versus benefits of the AstraZeneca vaccine, for consolidation of evidence on benefits and
risks of the AstraZeneca vaccine, on the assessment of risk of developing from Thrombosis and
Thrombocytopenia Syndrome after AstraZeneca vaccine. This model can be used as a decision-
support tool for generating the vaccination scenarios based on sex, age, community transmission rates,
virus variant. It is useful for individuals, doctors and researchers for assessing the different health
outcomes.
Paper [14] develops a multi-criteria decision support system for analysis of the previous studies
about similar virus infections and available data about COVID-19 and for ranking the main
approaches and alternatives in confronting the pandemic of COVID-19 considering the feasibility,
sustainability, and success rate of possible approaches.
Shared decision making and use of patient decision aids help patients overcome vaccination
against COVID-19 hesitancy. In [15] an overview of shared decision making and use of patient
decision aids is conducted and the effect of shared decision making interventions on vaccine uptake is
determined - significantly increase of the decision confidence and decrease of the decisional conflict.
Authors of [16] propose the shared decision-making, based on tools associated with patient
decision aids, which help patients make an informed choice about vaccination with Comirnaty from
Pfizer-BioNTech in France, but such instruments can easily be extended to the population of any
other country.
In the paper [17] the decision support system is presented that focuses on the capacity planning of
the process of vaccination against COVID-19 in the Netherlands based on the Dutch national
vaccination priority list, and is ideally suited for providing the support in the dynamic of process of
vaccination against COVID-19.
The paper [18] proposes the prototype of multi-criteria decision support model based on goal
programming that can effectively support vaccination plans considering minimizing the risk of
spreading the disease and the number of fatalities.
Paper [19] develops a tool for decision support to improve vaccine against COVID-19 uptake
among HCWs in the early phase of vaccination rollout on the basis of multifactorial influences
underpinning a decision on vaccination, that features use of platform for sharing of experience,
provides plans and communications in case of unforeseen situations and positive outlook associated
with vaccination.
The main contribution of the study [20] is proposition of a machine learning algorithm
Hierarchical Priority Classification eXtreme Gradient Boosting for administration and priority
classification of vaccination against COVID-19, for the prediction of priorities of COVID-19 vaccine.
Authors of [21] proposes a decision support system used multi-agent programmable modeling
environment NetLogo. This system is based on the adoption of artificial intelligence techniques,
simulation of the different vaccination strategies, use of genetic algorithms for evolving the best
vaccination criteria and for provision of suggestions about more effective policies.
The paper [22] develops community-oriented COVID-19 vaccination program RapidVax based on
Health IT and big data analysis, which provides security of data gathering, quality of data and
validations of rule, preserves privacy, customizes interactive user interfaces, visualizes outcomes, and
generates reporting, and supports the vaccination task efficiently.
In the paper [23] the particle-based SEIR epidemic simulator is proposed as a tool for modeling
the effective immunization outcomes and for assessing the impact of different vaccination strategies
on viral propagation based on the prioritization of certain age groups or randomly vaccinating
individuals across all age groups.
Authors of [24] implemented optimized decision-support system for ambulatory care for four case
studies: problem of positioning centers for vaccination against COVID-19 and emergency doctors, the
out-of-hours pharmacy planning problem, and the route planning of patient transport services.
In the paper [25] the decision-making supporting system is proposed as an epidemiological
prediction tool including vaccination against COVID-19 and restrictions on population migration both
within the country and between countries.
The conducted review of known methods and systems showed that there are currently no tools for
decision-making support for necessity/optionality/contraindication of vaccination against COVID-19.
Although the known methods and systems have considerable potential for the field of health care and
in the fight against the COVID-19 pandemic, these methods and systems do not take into account the
legal norms of any country and do not ensure the formation of a conclusion about the
necessity/optionality/contraindication of vaccination against COVID- 19 on the basis of existing legal
norms.
3. Modeling the Process of Decision-Making Support for
Necessity/Optionality/ Contraindication of Vaccination against COVID-19
In order to form questionnaires for gathering the information about a person who plans to be
vaccinated and for analyzing this person's answers to the questions, it is necessary to first model the
process of decision-making support for necessity/optionality/ contraindication of vaccination against
COVID-19.
Let RPFQS is a set of work’s categories of the person, for whom the necessity/optionality of
vaccination against COVID-19 is determined (such a set may consist of one element or be empty).
In order to form a conclusion about the necessity of vaccination against COVID-19, it is a
mandatory condition to belong to the categories of employees who are subject to mandatory
vaccination, defined in [9], therefore the criterion of necessity of vaccination against COVID-19 will
have the following form:
• if RPFQS = , then vaccination against COVID-19 is optional;
• if RPFQS ≠ , then vaccination against COVID-19 is necessary.
Taking into account the defined in [9] categories of employees who are subject to mandatory
vaccination, the set of categories of employees, who are subject to mandatory vaccination, has the
following form:
, (1)
where cebe – central executive authorities’ employees, lsae – local state administrations’ employees,
erie – educational and scientific institutions’ employees, lge – local self-government bodies’
employees, hcie – healthcare institutions’ employees, uioe – communal enterprises’, institutions’ and
organizations’ employees.
Taking into account the developed criterion of necessity of vaccination against COVID-19 and the
set of categories of employees, who are subject to mandatory vaccination (formula (1)), let's perform
modeling the process of decision-making support for necessity/optionality of vaccination against
COVID-19.
If RPFQS is a set of work’s categories of the person, for whom the necessity/optionality of
vaccination against COVID-19 is determined (such a set may consist of one element or be empty),
then the general rule for making a decision on the necessity/optionality of vaccination against
COVID-19 is as follows:
. (2)
Let RCIQS is a set of medical diagnoses-contraindications of a person, for whom a
contraindication of vaccination against COVID-19 is determined (such a set may consist of one
element or be empty).
In order to form a conclusion about contraindication of vaccination against COVID-19, the
presence of medical contraindications defined in [9] is a mandatory condition, so the criterion of
contraindication of vaccination against COVID-19 will look like this:
• if RCIQS = , then vaccination against COVID-19 is possible;
• if RCIQS ≠ , then there are contraindication on vaccination against COVID-19.
Taking into account the available medical contraindications to vaccination against COVID-19
defined in [9], the set of contraindications to vaccination against COVID-19 has the following form:
, (3)
where ails – an acute illness with an increase in temperature above 38.0 °C, cdhs – COVID-19 in
history, macp – treatment with monoclonal antibodies or convalescent plasma, pgnt – pregnancy, lctn
– lactation, vcid – recent administration of vaccines against other infectious diseases, tbif – tuberculin
test or interferon-γ release blood test, hidv – human immunodeficiency virus, hepatitis C virus,
hepatitis B virus, ttcp – thrombosis and/or thrombocytopenia, mcpc – myocarditis and/or pericarditis,
opct – oncopathology with allogeneic or autogenous transplantation or cell therapy, opic –
oncopathology with a course of intensive cytotoxic chemotherapy, imdy – immunodeficiency, arar –
allergic and/or anaphylactic reaction to vaccine components in history, aics – autoimmune conditions.
Taking into account the developed criterion of contraindication of vaccination against COVID-19
and the set of contraindications to vaccination against COVID-19 (formula (3)), let's perform modeling
the process of decision-making support for contraindication of vaccination against COVID-19.
If RCIQS is a set of medical diagnoses-contraindications of a person, for whom a contraindication of
vaccination against COVID-19 is determined (such a set may consist of one element or be empty), then the
general rule for making a decision about contraindication of vaccination against COVID-19 is as follows:
. (4)
The scientific novelty of the paper is the model of the process of decision-making support for
necessity/optionality/contraindication of vaccination against COVID-19 is conducted, which is a
theoretical basis for the formation of questionnaires for gathering information about the person who
plans to be vaccinated, for organizing the analysis of this person's answers, as well as for decision-
making support for necessity/optionality/contraindication of vaccination against COVID-19.
4. Questionnaires for Determining the Necessity/Optionality/
Contraindication of Vaccination against COVID-19 and Rules for Analyzing
the Answers to Questions of Questionnaires
Taking into account the results of the conducted in [9] analysis of the legal norms of vaccination
against COVID-19, as well as modeling the process of decision-making support for
necessity/optionality/contraindication of vaccination against COVID-19, let's develop questionnaires
for gathering the information about a person, who plans to be vaccinated , and let's describe the
process of forming the sets of work’s categories of the person, for whom the necessity/optionality of
vaccination against COVID-19 is determined, and of medical diagnoses-contraindications of a person,
for whom a contraindication of vaccination against COVID-19 is determined.
Questionnaire for determining the necessity/optionality of vaccination against COVID-19:
1. Are you an employee of central executive authorities?
2. Are you an employee of local state administrations?
3. Are you an employee of educational and scientific institutions?
4. Are you an employee of local self-government bodies?
5. Are you an employee of healthcare institutions?
6. Are you an employee of communal enterprises, institutions and organizations?
Each of the questions in the questionnaire for determining the necessity/optionality of vaccination
against COVID-19 requires "yes" or "no" answer.
Rules for analyzing the answers to questions of questionnaire for determining the
necessity/optionality of vaccination against COVID-19:
1. If the answer "yes" is chosen to the first question of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19, then the element cebe is put in the set
RPFQS
2. If the answer "yes" is chosen to the second question of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19, then the element lsae is put in the set
RPFQS
3. If the answer "yes" is chosen to the third question of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19, then the element erie is put in the set
RPFQS
4. If the answer "yes" is chosen to the fourth question of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19, then the element lge is put in the set
RPFQS
5. If the answer "yes" is chosen to the fifth question of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19, then the element hcie is put in the set
RPFQS
6. If the answer "yes" is chosen to the sixth question of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19, then the element uioe is put in the set
RPFQS
7. If none of the six questions of the questionnaire for determining the necessity/optionality of
vaccination against COVID-19 is answered in the affirmative (“yes” answer), then the set
RPFQS remains empty
Questionnaire for determining the contraindication of vaccination against COVID-19:
1. Do you currently have an acute illness with an increase in temperature over 38.0 °C?
2. Do you have COVID-19 in history?
3. Are you being treated with monoclonal antibodies or convalescent plasma?
4. Are you currently pregnant?
5. Are you currently lactating?
6. Have you had a recent administration of vaccines against other infectious diseases?
7. Have you recently had a tuberculin test or a blood test for the release of interferon-γ?
8. Do you have human immunodeficiency virus, hepatitis C virus, hepatitis B virus?
9. Do you suffer from thrombosis and/or thrombocytopenia?
10. Do you suffer from myocarditis and/or pericarditis?
11. Do you have oncopathology with allogeneic or autogenous transplantation or cell therapy?
12. Do you have oncopathology and are on a course of intensive cytotoxic chemotherapy?
13. Do you have an immunodeficiency?
14. Do you have a history of allergic and/or anaphylactic reaction to vaccine components?
15. Do you have autoimmune conditions?
Each of the questions in the questionnaire for determining the contraindication of vaccination
against COVID-19 requires "yes" or "no" answer.
Rules for analyzing the answers to questions of questionnaire for determining the contraindication
of vaccination against COVID-19:
1. If the answer "yes" is chosen to the first question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element ails is put in the set
RCIQS
2. If the answer "yes" is chosen to the second question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element cdhs is put in the set
RCIQS
3. If the answer "yes" is chosen to the third question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element macp is put in the set
RCIQS
4. If the answer "yes" is chosen to the fourth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element pgnt is put in the set
RCIQS
5. If the answer "yes" is chosen to the fifth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element lctn is put in the set
RCIQS
6. If the answer "yes" is chosen to the sixth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element vcid is put in the set
RCIQS
7. If the answer "yes" is chosen to the seventh question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element tbif is put in the set
RCIQS
8. If the answer "yes" is chosen to the eighth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element hidv is put in the set
RCIQS
9. If the answer "yes" is chosen to the ninth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element ttcp is put in the set
RCIQS
10. If the answer "yes" is chosen to the tenth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element mcpc is put in the set
RCIQS
11. If the answer "yes" is chosen to the eleventh question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element opct is put in the set
RCIQS
12. If the answer "yes" is chosen to the twelfth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element opic is put in the set
RCIQS
13. If the answer "yes" is chosen to the thirteenth question of the questionnaire for determining
the contraindication of vaccination against COVID-19, then the element imdy is put in the set
RCIQS
14. If the answer "yes" is chosen to the fourteenth question of the questionnaire for determining
the contraindication of vaccination against COVID-19, then the element arar is put in the set
RCIQS
15. If the answer "yes" is chosen to the fifteenth question of the questionnaire for determining the
contraindication of vaccination against COVID-19, then the element aics is put in the set
RCIQS
16. If none of the fifteen questions of the questionnaire for determining the contraindication of
vaccination against COVID-19 is answered in the affirmative ("yes" answer), then the set
RCIQS remains empty
Therefore, questionnaires for determining the necessity/optionality of vaccination against COVID-
19 and for determining the contraindication of vaccination against COVID-19 were developed taking
into account the current legal norms of Ukraine, as well as rules for analyzing the answers to
questions of questionnaires for determining the necessity/optionality of vaccination against COVID-
19 and the answers to the questions of questionnaires for determining the contraindication of
vaccination against COVID-19. The developed rules make it possible to form a set of work’s
categories of the person for whom the necessity/optionality of vaccination against COVID-19 is
determined, and a set of medical diagnoses-contraindications of a person for whom a contraindication
of vaccination against COVID-19 is determined, which are grounds for making a decision about the
necessity/optionality/contraindication of vaccination against COVID-19according to rules (2) and (4).
5. Decision-Making Support for Necessity/Optionality/Contraindication of
Vaccination against COVID-19
Process of decision-making support for necessity/optionality/ contraindication of vaccination
against COVID-19 is represented on Fig. 1.
Figure 1: Scheme of process of decision-making support for necessity/optionality/contraindication of
vaccination against COVID-19
Therefore, the main source of information for making a decision about the
necessity/optionality/contraindication of vaccination against COVID-19 is the questionnaires for
determining the necessity/optionality of vaccination against COVID-19 and for determining the
contraindication of vaccination against COVID-19. The information streams are, respectively, the
answers of a person, who plans to be vaccinated, to questions of questionnaires. In the process of
analyzing the answers of a person, who plans to be vaccinated, to the questions of the questionnaire,
forming the set RPFQS of work’s categories of the person, for whom the necessity/optionality of
vaccination against COVID-19 is determined, on the basis of the rules for analyzing the answers to
questions of questionnaire for determining the necessity/optionality of vaccination against COVID-
19, as well as forming the set RCIQS of medical diagnoses-contraindications of a person, for whom a
contraindication of vaccination against COVID-19 is determined, on the basis of the rules for
analyzing the answers to the questions of questionnaire for determining the contraindication of
vaccination against COVID-19.
Next, it is checked whether the set RPFQS of work’s categories of the person, for whom the
necessity/optionality of vaccination against COVID-19 is determined, is empty. If the set RPFQS is
empty, then a decision is made about optionality of vaccination against COVID-19, if the set RPFQS
is not empty, then a decision is made about the necessity of vaccination against COVID-19.
The next step is checking whether the set RCIQS of medical diagnoses-contraindications of a
person, for whom a contraindication of vaccination against COVID-19 is determined, is empty. If the
set RCIQS is empty, then the decision is made about the possibility of vaccination against COVID-19,
if the set RPFQS is not empty, then the decision is made about the contraindication of vaccination
against COVID-19.
So, the scheme of process of decision-making support for necessity/optionality/contraindication of
vaccination against COVID-19 has been developed, according to which a person who plans to be
vaccinated can automatically and free of charge determine the necessity/optionality of vaccination
against COVID-19, as well as the possibility/contraindication of vaccination against COVID-19 based
on the legal norms in force in Ukraine, i.e. can independently make a reasoned decision regarding
vaccination against COVID-19. The currently presented scheme of process of decision-making
support for necessity/optionality/contraindication of vaccination against COVID-19 is based on the
current legal norms of Ukraine, but it can be adapted to the legal norms of any other country by
analyzing these legal norms, supplementing or changing the questionnaires for determining the
necessity/optionality of vaccination against COVID-19 and for determining the contraindication of
vaccination against COVID-19, as well as supplementing or changing the rules for analyzing the
answers to questions in the questionnaires for determining the necessity/optionality of vaccination
against COVID-19 and for determining contraindication of vaccination against COVID-19.
The developed rules for analyzing the answers to questions of questionnaire for determining the
necessity/optionality of vaccination against COVID-19, rules for analyzing the answers to questions
of questionnaire for determining the contraindication of vaccination against COVID-19, and the
formalization of the process of decision-making support for necessity/optionality/contraindication of
vaccination against COVID-19, which provides the conclusions about the
necessity/optionality/contraindication of vaccination against COVID-19, are also the scientific
novelty of this paper.
6. Results & Discussion
Let's consider the example of decision-making support for necessity/optionality/contraindication of
vaccination against COVID-19. Two people, who plan to be vaccinated, gave truthful answers to the
questions of questionnaires for determining the necessity/optionality of vaccination against COVID-
19 and for determining the contraindication of vaccination against COVID-19.
Person1 gave the following answers to the questions of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19: 1) No; 2) No; 3) Yes; 4) No; 5) No; 6) No.
Person1 gave the following answers to the questions of the questionnaire for determining the
contraindication of vaccination against COVID-19: 1) No; 2) No; 3) No; 4) No; 5) No; 6) No; 7) No;
8) Yes; 9) No; 10) No; 11) No; 12) No; 13) No; 14) Yes; 15) No.
Therefore, considering the given answers, the sets RPFQS1 = {erie}, RCIQS1 = {hidv, arar}. Since
the set RPFQS1 ≠ , a decision is made about the necessity of vaccination against COVID-19. At the
same time, since the set RCIQS1 ≠ , a decision is made about contraindication of vaccination against
COVID-19. Person 1, after analyzing the received conclusions, decided to postpone vaccination
against COVID-19.
Person2 gave the following answers to the questions of the questionnaire for determining the
necessity/optionality of vaccination against COVID-19: 1) No; 2) No; 3) No; 4) No; 5) No; 6) No.
Person2 gave the following answers to the questions of the questionnaire for determining the
contraindication of vaccination against COVID-19: 1) No; 2) No; 3) No; 4) No; 5) No; 6) No; 7) No;
8) No; 9) No; 10) No; 11) No; 12) No; 13) No; 14) No; 15) No.
Therefore, considering the given answers, the sets RPFQS2 = , RCIQS2 = . Since the set
RPFQS2 = , a decision is made about optionality of vaccination against COVID-19. Since the set
RCIQS2 = , a decision is made about possibility of vaccination against COVID-19. Person 2, after
analyzing the received conclusions, decided to undergo vaccination against COVID-19.
As the conducted in Section 2 analysis showed, the known methods and systems do not take into
account the legal norms of any country and do not ensure the formation of a conclusion about the
necessity/optionality/contraindication of vaccination against COVID- 19 on the basis of existing legal
norms. Instead, we proposed a solution, according to which a person who plans to be vaccinated can
automatically and free of charge determine the necessity/optionality of vaccination against COVID-
19, as well as the possibility/contraindication of vaccination against COVID-19 based on the legal
norms in force in Ukraine, i.e. can independently make a reasoned decision regarding vaccination
against COVID-19.
The proposed scheme of process of decision-making support for
necessity/optionality/contraindication of vaccination against COVID-19 was tested on the data of 580
real patients (the information was provided by the family doctor of the outpatient clinic of family
medicine of the southwestern district of Khmelnytskyi), correct conclusions about the
necessity/optionality/contraindication of vaccination against COVID-19 were obtained on all test
data, which gives reasons to assert 100% veracity of the work of the proposed solution.
7. Conclusions
The main task in designing the clinical decision support system about vaccination against COVID-
19 is the formation of questionnaires to gathering the information about a person who plans to be
vaccinated, as well as the analysis of this person's answers to the questions of the questionnaires, on
the basis of which the decision about necessity/optionality/contraindication of vaccination against
COVID-19 is made. This research is dedicated to the solution of such task.
The conducted review of known methods and systems showed that there are currently no tools for
decision-making support for necessity/optionality/contraindication of vaccination against COVID-19.
Although the known methods and systems have considerable potential for the field of health care and
in the fight against the COVID-19 pandemic, these methods and systems do not take into account the
legal norms of any country and do not ensure the formation of a conclusion about the
necessity/optionality/contraindication of vaccination against COVID- 19 on the basis of existing legal
norms.
The scientific novelty of the paper is the developed model of the process of decision-making
support for necessity/optionality/contraindication of vaccination against COVID-19, which is a
theoretical basis for the formation of questionnaires for gathering information about the person who
plans to be vaccinated, for organizing the analysis of this person's answers, as well as for decision-
making support for necessity/optionality/contraindication of vaccination against COVID-19.
Questionnaires for determining the necessity/optionality of vaccination against COVID-19 and for
determining the contraindication of vaccination against COVID-19 were developed taking into
account the current legal norms of Ukraine, as well as rules for analyzing the answers to questions of
questionnaires for determining the necessity/optionality of vaccination against COVID-19 and the
answers to the questions of questionnaires for determining the contraindication of vaccination against
COVID-19. The developed rules make it possible to form a set of work’s categories of the person for
whom the necessity/optionality of vaccination against COVID-19 is determined, and a set of medical
diagnoses-contraindications of a person for whom a contraindication of vaccination against COVID-
19 is determined, which are grounds for making a decision about the
necessity/optionality/contraindication of vaccination against COVID-19.
The scheme of process of decision-making support for necessity/optionality/contraindication of
vaccination against COVID-19 has been developed, according to which a person who plans to be
vaccinated can automatically and free of charge determine the necessity/optionality of vaccination
against COVID-19, as well as the possibility/contraindication of vaccination against COVID-19 based
on the legal norms in force in Ukraine, i.e. can independently make a reasoned decision regarding
vaccination against COVID-19. Such scheme was tested on the data of 580 real patients, correct
conclusions about the necessity/optionality/contraindication of vaccination against COVID-19 were
obtained on all test data, which gives reasons to assert 100% veracity of the work of the proposed
solution.
The scientific novelty of the paper is also the developed rules for analyzing the answers to
questions of questionnaire for determining the necessity/optionality of vaccination against COVID-
19, rules for analyzing the answers to questions of questionnaire for determining the contraindication
of vaccination against COVID-19, and the formalization of the process of decision-making support
for necessity/optionality/contraindication of vaccination against COVID-19, which provides the
conclusions about the necessity/optionality/contraindication of vaccination against COVID-19.
The currently presented scheme of process of decision-making support for
necessity/optionality/contraindication of vaccination against COVID-19 is based on the current legal
norms of Ukraine, but it can be adapted to the legal norms of any other country by analyzing these
legal norms, supplementing or changing the questionnaires for determining the necessity/optionality
of vaccination against COVID-19 and for determining the contraindication of vaccination against
COVID-19, as well as supplementing or changing the rules for analyzing the answers to questions in
the questionnaires for determining the necessity/optionality of vaccination against COVID-19 and for
determining contraindication of vaccination against COVID-19.
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