# IBD Vaccine Navigator

A responsive, therapy-first vaccine discussion guide for **adult U.S. GI/IBD clinics**. The page follows the requested workflow: select the current or planned IBD therapy, then show vaccine priorities, live-vaccine restrictions, timing, therapy-specific caveats, and a pre-treatment checklist.

## Files

- `index.html` — interactive patient/clinician-facing page
- `references.html` — full OpenEvidence and added-source reference page, evidence reconciliation, and source map
- `styles.css` — responsive, accessible, print-friendly styling
- `app.js` — all client-side recommendation logic; no backend and no data storage
- `favicon.svg` — site icon
- `CLINICAL_REVIEW.md` — clinical governance checklist, logic summary, and test scenarios

## Open locally

Double-click `index.html`, or serve the folder locally:

```bash
python -m http.server 8000 --directory .
```

Then open `http://localhost:8000/`.

## Deploy to Cloudflare Pages

This is a no-build static site.

1. Rename the folder if desired.
2. In Cloudflare Pages, create a project and upload the entire folder, or connect a Git repository containing these files.
3. Use no framework preset and no build command. Set the output directory to the repository root.
4. Confirm that both `/` and `/references.html` load after deployment.
5. Replace the placeholder brand name and footer language only after local clinical, legal, accessibility, and privacy review.

The same folder also works on GitHub Pages, Netlify, an intranet web server, or most static hosting services.

## Privacy and security

- The form runs entirely in the browser.
- It does not submit data, use analytics, create cookies, or write to local storage.
- It intentionally asks only for age, treatment class/timing, steroid dose/duration, and a few non-identifying modifiers.
- Do not add names, dates of birth, medical record numbers, or other identifiers without a formal privacy and security design review.
- External links appear only on the references page and open in a new tab.

## Clinical scope

- Adults age 19 and older
- United States CDC/ACIP schedule
- Crohn's disease and ulcerative colitis clinic workflow
- Counseling and screening support, not autonomous prescribing
- Does not calculate exact catch-up schedules from dose history
- Does not replace product labeling, an immunization registry, CDC PneumoRecs, or a validated immunization forecasting engine

## Required review before clinical use

Assign named owners for:

1. GI clinical content
2. Vaccination/pharmacy content
3. Infection-prevention or infectious-disease review
4. Accessibility and patient-language review
5. Legal/risk review
6. Update monitoring after ACIP meetings, annual influenza/COVID changes, drug-label changes, and new IBD guidelines

The current content review date displayed in the site is **September 4, 2026**. See `CLINICAL_REVIEW.md` for the exact logic and known evidence differences.

## Customization points

Search these files for:

- `IBD Vaccine Navigator` — replace with the clinic or health-system name
- `Reviewed September 4, 2026` — update only after a documented clinical review
- `Adult, U.S.-focused` — change only if the schedule and references are rebuilt for another jurisdiction
- `therapyLabels` and `advancedTherapies` in `app.js` — medication taxonomy and logic
- `buildVaccineCards()` in `app.js` — age/risk recommendation logic
- `determineLiveStatus()` in `app.js` — live-vaccine timing logic

## Accessibility notes

- Semantic headings, fieldsets, labels, status text, and ARIA live results
- Keyboard-accessible therapy and modifier cards
- Visible focus states
- Responsive table region with keyboard scrolling
- Reduced-motion support
- Print-only layout for the generated discussion summary

A production deployment should still undergo formal WCAG testing with keyboard-only navigation, screen readers, zoom to 200–400%, and mobile devices.

## Source transparency

`references.html` separates:

1. References contained in the uploaded OpenEvidence documents
2. Current official sources added during web review
3. Explicit reconciliation decisions where current CDC guidance and IBD specialty guidance differ
4. A recommendation-to-source map

Do not remove the reconciliation section unless local clinical governance has replaced it with an equivalent update and version-control process.