Vaccine Cheat Sheet
Vaccine Trade name or Common Name Select this vaccine name/code in ImmuNet Manufacturer Manu.Code in ImmuNet CPT Codes from CDC 90748 90723 90636 90721
Combination Vaccines Comvax® HepB.Hib Merck Pediarix® DTAP/HepB/IPV GlaxoSmithKline Twinrix® HepA/HepB GlaxoSmithKline Trihibit® DTAP/Hib Aventis Pasteur (Sanofi Pasteur) DTAP/DTP/DT/Td/Tdap DTAP Aventis Pasteur for Daptacel, Tripedia, Daptacel Aventis Infanrix, and whenever you Pasteur for know that DTap was given Tripedia even if you don’t know the GlaxoSmithKline brand name for Infanrix Diphtheria and tetanus DT (Pediatric) Aventis Pasteur toxoids adsorbed-DT (Sanofi Pasteur) Td – Adult Aventis Pasteur Tetanus and diphtheria (Sanofi Pasteur) toxoids adsorbed for adult use for 7+ age group Adult Td – Preserv Free Aventis Pasteur DecavacTM(Tetanus and (Sanofi Pasteur) Diphtheria Toxoids Adsorbed for age 7+ and Adult – preservative free) Aventis Pasteur Adacel (Tetanus, Diphteria Tdap (Sanofi Pasteur) & Acellular Pertussis) for use in age 11-64 Tdap GlaxoSmithKline Boostrix (Tetanus, Diphtheria & Acelluar Pertussis) for use in age 10-18 Diphtheria, tetanus toxoids, DTP and whole cell pertussis vaccine (DTP), for intramuscular use (will be from historical record) DTP-unspecified Historical – when you can’t tell if it was DTP or DTaP-given during transition years, 1991-1997 Page 1 of 4
MSD SKB SKB PMC
PMC PMC SKB
90700
PMC PMC PMC
90702 90718 90714
PMC SKB
90715 90715
90700
Vaqta®1 ml 2 doses for adults (19 years and older) Vaqta® .5 ml 2 doses for pediatric/adolscents Havrix® 1 ml 2 doses for adults Havrix® .5 ml (720 EL.U) 2 doses for pediatric/adolescent (1-18 years) Historical data entry -don’t know type Engerix-B® Ped/Adol Engerix-B® for adults Recombivax HB® (pediatric/adol formulation) Recombivax HB® (2 dose) for age 11-15 Recombivax HB® for adults Comvax® Various dosages depending on individual, such as highrisk & dialysis Historical data entry-don’t know type ActHib® PedvaxHib® HibTITER® ProHIBit®(discontinued) OmniHib®(discontinued) Historical data entry-don’t know type Gardasil®
Hepatitis A Hep A 2 dose-Adult Merck Hep A 2 dose-Ped/Adol Hep A 2 dose-Adult Hep A 2 dose-Ped/Adol Merck GlaxoSmithKline GlaxoSmithKline
MSD MSD SKB SKB
90632 90633 90632 90633
Hep A-- Unspecified Hepatitis B HepB Ped/Adol PreservGlaxoSmithKline free Hep B Adult GlaxoSmithKline HepB Ped/Adol PreservMerck free HepB 2 dose-Adol/Adult Hep B Adult HepB/Hib Note there are various choices available to reflect the specific situation Hep B-unspecified Hib Hib-PRP-T Hib-PRP-OMP Hib-Hboc Hib-PRP-D Hib-PRP-T Hib-unspecified Aventis Pasteur (Sanofi Pasteur) Merck WyethLederle Pasteur-Merieux GlaxoSmithKline PMC MSD WAL (Inactive) SKB Merck Merck Merck
90730
SKB SKB MSD MSD MSD MSD
90744 90746 90744 90646 90746 90748
90731
90648 90647 90645 90645 90648 90737 90649
Human Papilloma Virus (HPV) HPV, quadrivalent Merck
MSD
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Fluzone PF® - For children 635 months old-pre-filled syringes-.25 ml-Preservative free Fluzone® - For Children 36 mos. and older – contains preservative – Dosage - .5 ml age 3 & up (Multi-dose vials) Fluzone® age 6-35 mos. Dosage .25 ml contains preservative – (Multi-dose vials) FluzonePF®-For individuals 3yrs. and above – single dose syringes - .5 ml Preservative free Fluvirin® - multidose .5 ml age 48+ months Fluvirin® - multidose, .5 ml age 48+ months Preservative Free Fluarix®-single-dose, .5ml preservative free Flumist®-Live Attenuated Influenza Vaccine Measles, Mumps, Rubella ProQuad®(Measles, Mumps, Rubella, Varicella) Menomune® A/C/Y/W-135 Meningococcal polysaccharide vaccine, (Serogroups A, C, Y and W-135(not available from VFC) Manactra® Meningococcal Conjugate Vaccine, (Serogroups A,C,Y and W-135
Influenza Influenza Split, 6-35 mos, presv free Influenza split, 36 mos. and older
Aventis Pasteur (Sanofi Pasteur) Aventis Pasteur (Sanofi Pasteur)
PMC
90655
PMC
90658
Influenza split, 6-35 mos. Aventis Pasteur (Sanofi Pasteur) Influenza split, 36 mos. and older, preservative free To be determined To be determined Influenza Split, 18+ yrs. preservative free Influenza Nasal Spray Aventis Pasteur (Sanofi Pasteur) Novartis Novartis GlaxoSmithKline MedImmune
PMC
90657
PMC
90656
NOV NOV SKB MED MSD MSD PMC 90656 90660 90707 90710 90733
Measles, Mumps, Rubella MMR Merck MMR/Varicella Merck Meningococcal Meningococcal Aventis Pasteur (MPSV4) (Sanofi Pasteur)
Meningococcal Conjugate (MCV4)
Aventis Pasteur (Sanofi Pasteur)
PMC
90734
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Prevnar®(Pneumococcal Conjugate, 7 valent) Pneumovax® 23 (Pneumococcal vaccine polyvalent) (not available from VFC) Pnu-Imune® 23(discontinued) Historical data entry – don’t know type RotaTeq® (live, Oral, Pentavalent) IPOL®-poliovirus vaccine, inactivated Poliovirus vaccine, live, oral Historical data entry – don’t know type, ≥ Year 2000 IPV Varivax® Chickenpox vaccine
Pneumonia Pneumococcal (PCV7) Pneumococcal (PPV23) Pneumococcal (PPV23) Pneumococcalunspecified Rotavirus Rotavirus, pentavalent Polio IPV OPV Polio – Unspecified Varicella Varicella
WyethLederle Merck
WAL MSD
90669 90732
GlaxoSmithKline
SKB
90732
Merck Aventis Pasteur (Sanofi Pasteur) No longer administered in U.S.
MSD PMC
90680 90713 90712
Merck
MSD
90716
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