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Table of Contents

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CVX Code

Name

Absolute Minimum AgeAbsolute Maximum Age
15Influenza, split (incl. purified surface antigen)6 months - 4 days
16Influenza, whole6 months - 4 days
88Influenza, unspecified formulation6 months - 4 days
111 (star)Influenza, live, intranasal6 months - 4 days 50 years - 1 day
135Influenza, high dose, seasonal6 months - 4 days

140

Influenza, seasonal, injectable, preservative free6 months - 4 days
141Influenza, seasonal, injectable6 months - 4 days
144Influenza, seasonal, intradermal, preservative free12 years - 4 days65 years - 1 day
149 (star)Influenza, live, intranasal, quadrivalent6 months - 4 days 50 years - 1 day
150Influenza, injectable, quadrivalent, preservative free6 months - 4 days
151 (star)Influenza, nasal, unspecified formulation6 months - 4 days 50 years - 1 day
153Influenza, injectable, MDCK, preservative free6 months - 4 days
155Influenza, recombinant, injectable, preservative free6 months - 4 days
158Influenza, injectable, quadrivalent6 months - 4 days
161 Influenza, injectable, quadrivalent, preservative free, pediatric6 months - 4 days 3 years - 1 day
166 Influenza, intradermal, quadrivalent, preservative free, injectable12 years - 4 days65 years - 1 day
168

Influenza, trivalent, adjuvanted, preservative free 

6 months - 4 days
171

Influenza, injectable, MDCK, preservative free, quadrivalent 

6 months - 4 days
185Influenza, recombinant, quadrivalent, injectable, preservative free6 months - 4 days
186Influenza, injectable, MDCK, quadrivalent, preservative6 months - 4 days
194Influenza, Southern Hemisphere, unspecified formulationN/A N/A 
197Influenza, high dose, quadrivalent6 months - 4 days
200Influenza, Southern Hemisphere, pediatric, preservative freeN/A N/A 
201Influenza, Southern Hemisphere, preservative freeN/AN/A 
202Influenza, Southern Hemisphere, quadrivalent, with preservativeN/A N/A 
205Influenza vaccine, quadrivalent, adjuvanted6 months - 4 days
231Influenza, Southern Hemisphere, high-dose, quadrivalentN/AN/A
320Influenza, MDCK, trivalent, preservative6 months - 4 days

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Series Name

  • Influenza 2-dose Series

  • Influenza 1-dose Series

Series Selection Rules for 2014-2015 Season

  • If the patient is >= 10 years of age then:

    • the 1-dose series applies.

  • If the patient is >= 9 and < 10 years of age then:

    • The 2-dose series applies if all of the following three conditions are met:

      1. The patient received a dose of influenza at < 9 years of age during the current influenza vaccine season

      2. The patient

received <

      1. DID NOT receive at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

      2. The patient

received < 

      1. DID NOT receive at least 2 doses of seasonal influenza vaccine prior to July 2010

,

      1. and at least one dose of monovalent 2009 H1N1 vaccine

    • Otherwise, the 1-dose series applies

  • If the patient is < 9 years of age then:

    • The 1-dose series applies if any of the following three conditions are met:

      1. The patient received at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

      2. The patient received at least 2 doses of seasonal influenza vaccine prior to July 2010 and at least one dose of monovalent 2009 H1N1 vaccine

      3. The patient received at least 1 dose of seasonal influenza vaccine during the 7/1/2013-6/30/2014 influenza vaccine season1

    • Otherwise, the 2-dose series applies

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Series Name

  • Influenza 2-dose Series
  • Influenza 1-dose Series

Series Selection Rules for 2012-2013 and 2013-2014 Seasons

  • If the patient is >= 10 years of age then:

    • The 1-dose series applies.

  • If the patient is >= 9 and < 10 years of age then:

    • The 2-dose series applies if all of the following three conditions are met:

      1. The patient received a dose of influenza at < 9 years of age during the current influenza vaccine season

      2. The patient

received <

      1. DID NOT receive at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

      2. The patient

received < 

      1. DID NOT receive at least 2 doses of seasonal influenza vaccine prior to July 2010

,

      1. and at least one dose of monovalent 2009 H1N1 vaccine

    • Otherwise, the 1-dose series applies

  • If the patient is < 9 years of age then:

    • The 1-dose series applies if either of the following two conditions are met:

      1. The patient received at least 2 doses of seasonal influenza vaccine during prior influenza seasons, with at least one dose since July 2010

      2. The patient received at least 2 doses of seasonal influenza vaccine prior to July 2010 and at least one dose of monovalent 2009 H1N1 vaccine

    • Otherwise, the 2-dose series applies

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Dose

Series Name

Absolute Minimum
 Age

Minimum Age

Routine
Age 

Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Influenza 2-dose Series

 6 months - 4 days

6 months

6 months

15, 16,  88, 111, 135, 140, 141, 144, 149, 150, 151, 153, 155, 158, 161, 166, 168, 171, 185, 186, 197, 205, 320
N/A
2Influenza 2-dose SeriesN/AN/AN/A15, 16,  88, 111, 135, 140, 141, 144, 149, 150, 151, 153, 155, 158, 161, 166, 168, 171, 185, 186, 197, 205, 320N/A

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Dose

Series Name

Absolute Minimum
 Age

Minimum Age

Routine
Age 

Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Influenza 1-dose Series

 6 months - 4 days1

6 months

6 months

15, 16,  88, 111, 135, 140, 141, 144, 149, 150, 151, 153, 155, 158, 161, 166, 168, 171, 185, 186, 197, 205, 320N/A

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