IIS Codes for Common Vaccines in Washington
Washington State Immunization Information System Quick Reference Guide
IIS Codes for Common Vaccines in Washington
This document provides the information needed to accurately document vaccines in electronic health records and manage vaccine inventory in the Washington State Immunization Information System (IIS). This document includes four sections: COVID (EUA approval), pediatric, influenza, adult, and travel & other vaccines.
Symbols/Colors *
Description Vaccines available through the Washington State Childhood Vaccine Program and Washington State COVID-19 Vaccine Program Vaccine is not available to order, but clinics may still have it in their inventory.
COVID-19 Monovalent Vaccines, Adult and Pediatric
IIS Vaccine Name
Trade Name
NDC Number
COVID-19, mRNA, LNP-S, PF, 100mcg/0.5 ml dose or 50mcg/0.25 ml dose (Mod 12+, red)
Moderna COVID-19 Vaccine
80777-0273-98*
COVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL dose (Mod 6y-11y, blue)
Moderna COVID-19 Vaccine
COVID-19, mRNA, LNP-S, PF, pediatric 25 mcg/0.25 mL dose (Mod 6m-5y, blue)
Moderna COVID-19 Vaccine
Comirnaty
COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 ml dose, tris-sucrose (Pfizer Tris-Sucrose 12+, grey)
COVID-19 Vaccine Pfizer COVID-19
Vaccine
COVID-19, mRNA, LNP-S, PF, 10 mcg/0.2 Pfizer
ml dose, tris-sucrose (Pfizer 5y-11y, orange)
COVID-19 Vaccine
COVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 Pfizer
mL dose, tris-sucrose (Pfizer 6m-4y,
COVID-19
maroon)
Vaccine
COVID-19 vaccine, vector-nr, rS-Ad26, PF, 0.5ml (Janssen ? J&J)
Janssen COVID-19 Vaccine
COVID-19 vaccine, Subunit, rS-
Novavax
nanoparticle+Matrix-M1 Adjuvant, PF, COVID-19
0.5ml (Novavax 12+)
Vaccine
80777-0275-99* 80777-0279-99* 00069-2025-10* 59267-1025-04* 59267-1055-04* 59267-0078-04* 59676-0580-15* 80631-0100-10
CPT CVX Code Code
Manufacturer Name - Code
91301 91306
207
Moderna US, Inc. ? MOD
91309
221
Moderna US, Inc. ? MOD
91311
228
Moderna US, Inc. ? MOD
91305 217 Pfizer-BioNtech ? PFR
91307 218 Pfizer-BioNtech ? PFR
91308 219 Pfizer-BioNtech - PFR
91303
212
Janssen Products, LP ? JSN
91304 211 Novavax, Inc. ? NVX
To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh..
DOH 348-580 June 2023
Washington State Immunization Information System Quick Reference Guide
IIS Codes for Common Vaccines in Washington
COVID-19 Bivalent Vaccines
COVID-19, mRNA, LNP-S, bivalent, PF, 50 mcg/0.5 mL or 25mcg/0.25 ml dose (Mod 6m+, blue)
Moderna COVID-19 Vaccine, Bivalent
Moderna COVID-19, mRNA, LNP-S, bivalent, PF, COVID-19 10mcg/0.2 mL (Mod 6m-5y, pink) Vaccine,
Bivalent
Pfizer COVID-19, mRNA, LNP-S, bivalent, PF, COVID-19 30 mcg/0.3 mL dose (Pfizer 12+, grey) Vaccine,
Bivalent
COVID-19, mRNA, LNP-S, bivalent, PF, 10 mcg/0.2 mL dose (Pfizer 5y-11y, orange)
Pfizer COVID-19 Vaccine, Bivalent
COVID-19, mRNA, LNP-S, bivalent, PF, 3mcg/0.2 mL dose (Pfizer 6m-4y, maroon)
Pfizer COVID-19 Vaccine, Bivalent
Pediatric Vaccines
IIS Vaccine Name
Trade Name
Diptheria
DT (Pediatric)
and Tetanus Toxoids Adsorbed Daptacel
DTaP
Infanrix
80777-0282-99
91314
229
Moderna US, Inc. ? MOD
80777-0283-99
91316
230
Moderna US, Inc. MOD
59267-0304-02 91312 300 Pfizer-BioNtech - PFR
59267-0565-02 91315 301 Pfizer-BioNtech - PFR
59267-0609-02 91317 302 Pfizer-BioNtech - PFR
NDC Number
CPT CVX Code Code
Manufacturer Name - Code
49281-0225-10* 90702 28 Sanofi-Pasteur ? PMC
49281-0286-10 58160-0810-52
90700
106 Sanofi-Pasteur ? PMC 20 GlaxoSmithKline ? SKB
DTaP/HepB/IPV
Pediarix
58160-0811-52 90723 110 GlaxoSmithKline ? SKB
DTaP/HIB/IPV
Pentacel
49281-0511-05 90698 120 Sanofi-Pasteur ? PMC
DTaP/HepB/HIB/IPV
Vaxelis
63361-0243-10 63361-0243-15
90697
MSP Vaccine Company 146 (partnership Merck and
Sanofi Pasteur) ? MSP
DTaP/IPV
Hep A 2 dose ? Ped/Adol
Hep B Ped/Adol ? Preservative Free (PF) Hib-PRP-OMP
Kinrix
Quadracel Vaqta Havrix Engerix-B
Recombivax
PedvaxHIB
58160-0812-52
49821-0562-10 00006-4095-02 58160-0825-52 58160-0820-52 00006-4981-00* 00006-4093-02 00006-4897-00
90696 90633 90744 90647
130 GlaxoSmithKline ? SKB
Sanofi Pasteur - PMC
83
Merck ? MSD GlaxoSmithKline ? SKB
GlaxoSmithKline ? SKB
08 Merck ? MSD
49 Merck ? MSD
To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh..
DOH 348-580 June 2023
Washington State Immunization Information System Quick Reference Guide
IIS Codes for Common Vaccines in Washington
IIS Vaccine Name
Trade Name
NDC Number
CPT CVX Code Code
Manufacturer Name - Code
Hib-PRP-T
ActHIB Hiberix
49281-0545-03 58160-0818-11
90648
48
Sanofi-Pasteur ? PMC GlaxoSmithKline ? SKB
HPV9
Gardasil 9
00006-4121-02 90651 165 Merck ? MSD
Influenza Vaccines ? see the separate Influenza Vaccines table below
IPV
IPOL
49281-0860-10 90713 10 Sanofi-Pasteur ? PMC
Meningococcal B, OMV
Bexsero
58160-0976-20 90620 163 GlaxoSmithKline ? SKB
Meningococcal B, Recombinant
Trumenba
00005-0100-10 90621 162 Pfizer ? PFR
Meningococcal Conjugate (MCV4P) Menactra Meningococcal Conjugate (MCV4O) Menveo
49281-0589-05* 58160-0955-09
90734
114 Sanofi-Pasteur ? PMC 136 GlaxoSmithKline ? SKB
Meningococcal Polysaccharide TT Conjugate
MenQuadfi
49281-0590-05 90619 203 Sanofi-Pasteur - PMC
MMR
M-M-RII Priorix
00006-4681-00 58160-0824-15
90707
03
Merck ? MSD GlaxoSmithKline - SKB
MMR/Varicella
ProQuad
00006-4171-00 90710 94 Merck ? MSD
PCV13
Prevnar 13
00005-1971-02 90670 133 Pfizer ? PFR
PCV15
Vaxneuvance 00006-4329-03 90671 215 Merck - MSD
PPSV23
Pneumovax 23
00006-4837-03 90732 33 Merck ? MSD
Rotavirus, Monovalent
Rotarix
58160-0854-52* 58160-0740-21
90681
119 GlaxoSmithKline ? SKB
Rotavirus, Pentavalent
RotaTeq
00006-4047-41 00006-4047-20
90680
116 Merck ? MSD
Td (adult), 5 Lf tetanus toxoid, PF, adsorbed
Tenivac
49281-0215-15 49281-0215-10
90714
113 Sanofi-Pasteur - PMC
Td (adult), 2 Lf tetanus toxoid, PF, adsorbed
TDVAX
13533-0131-01 90714 09 Grifols - GRF
Tdap
Adacel Boostrix
49281-0400 10* 49281-0400-20 58160-0842-11* 58160-0842-52
90715
Sanofi-Pasteur ? PMC 115
GlaxoSmithKline ? SKB
Varicella
Varivax
00006-4827-00 90716 21 Merck ? MSD
Influenza Vaccines
IIS Vaccine Name
Trade Name
NDC Number
CPT CVX Code Code
Manufacturer Name - Code
2022-2023 State Supplied Childhood Flu Vaccines
Influenza, injectable, quadrivalent, preservative free Influenza, injectable, quadrivalent
Influenza, injectable, quadrivalent, preservative free
Influenza, live, intranasal, quadrivalent
Fluzone 0.5 mL Syringe Fluzone 5.0 mL MDV FluLaval 0.5 mL Syringe FluMist 0.2 mL Spray
49281-0422-50 49281-0637-15 19515-0808-52 66019-0309-10
90686 150 Sanofi-Pasteur ? PMC 90688 158 Sanofi-Pasteur ? PMC 90686 150 GlaxoSmithKline ? SKB 90672 149 MedImmune ? ME
To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh..
DOH 348-580 June 2023
Washington State Immunization Information System Quick Reference Guide
IIS Codes for Common Vaccines in Washington
Influenza, injectable, MDCK, preservative free, quadrivalent
Influenza, high dose, quadrivalent
Influenza, Injectable, quadrivalent, preservative free
Influenza, Injectable, quadrivalent Influenza, injectable, MDCK, quadrivalent, preservative Influenza, Recombinant, quadrivalent, Injectable, preservative free Influenza vaccine, quadrivalent, adjuvanted
Flucelvax 0.5 mL Syringe
70461-0322-03 90674
Additional Influenza Vaccines
Fluzone High-Dose
Quadrivalent
49281-0122-65 90662
0.7 mL Syringe
Fluarix 0.5 mL Syringe
58160-0890-52
Fluzone 0.5 mL SDV
49281-0422-10 90686
Afluria 0.5 mL Syringe
33332-0322-03
Afluria 5.0 mL MDV
33332-0422-10 90688
Flucelvax 5.0 mL MDV
70461-0422-10 90756
Flublok Quadrivalent 0.5 mL Syringe
Fluad Quadrivalent 0.5 mL Syringe
49281-0722-10 90682 70461-0122-03 90694
171 Seqirus - SEQ
197 Sanofi-Pasteur - PMC GlaxoSmithKline ? SKB
150 Sanofi-Pasteur ? PMC Seqirus ? SEQ
158 Seqirus ? SEQ 186 Seqirus ? SEQ 185 Sanofi-Pasteur ? PMC 205 Seqirus - SEQ
Adult Vaccines
This table includes adult-specific vaccines. Additional vaccines are listed in the pediatric table.
IIS Vaccine Name
Trade Name
NDC Number
CPT CVX Code Code
Manufacturer Name - Code
Hep A, Adult
Hep B (Recombinant), CpG adjuvanted Hep A/Hep B ? Adult HebB recombinant, 3antigen, Al(OH)3
Havrix
Vaqta
Heplisav ? B Twinrix PreHevbrio
58160-0826-52 00006-4096-02 00006-4841-41 43528-0003-05 58160-0815-52 75052-0001-10
90632
GlaxoSmithKline ? SKB 52
Merck - MSD
90739 90636 90759
189 Dynavax, Inc - DVX 104 GlaxoSmithKline ? SKB 220 VBI Vaccines - VBI
Hep B, Adult
Engerix ? B
58160-0821-11 58160-0821-52
90746
43 GlaxoSmithKline ? SKB
To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh..
DOH 348-580 June 2023
Washington State Immunization Information System Quick Reference Guide
IIS Codes for Common Vaccines in Washington
Td (adult), 5 Lf tetanus toxoid, PF, adsorbed Td (adult), 2 Lf tetanus toxoid, PF, adsorbed
Zoster, Recombinant
Influenza Vaccines ? see the Influenza Vaccines table above
Tenivac
49281-0215-10 49281-0215-15
90714 113 Sanofi-Pasteur ? PMC
Tdvax
13533-0131-01 90714 09 Grifols - GRF
Shingrix
58160-0819-12 58160-0823-11
90750 187 GlaxoSmithKline - SKB
Travel & Other Vaccines
IIS Vaccine Name Anthrax
Cholera Japanese Encephalitis
Rabies
Vaccinia, smallpox monkeypox vaccine live PF, JYNNEOS Typhoid, Oral
Typhoid, ViCPs Yellow Fever
Trade Name BioThrax VaxChora
IXIARO
RabAvert Imovax Rabies
JYNNEOS
Vivotif Typhim Vi YF-Vax
NDC Number 64678-0211-01 70460-0001-01
42515-0002-01
58160-0964-12 49281-0252-51
50632-0001-02
69401-0000-02 50090-2292-00 49281-0790-51 49281-0915-01
CPT Code 90581 90625 90738
90675
CVX Code
24 174
134
Manufacturer Name - Code
Emergent BioSolutions ? MIP
PaxVax ? PAX Vetter Pharma Fertigung GmbH & Co. KG ? VET
18 GlaxoSmithKline ? SKB Sanofi-Pasteur ? PMC
90611 206 Bavarian Nordic A/S - BN
90690
90691 90717
25
PaxVax ? PAX A-s Medication
101 Sanofi-Pasteur ? PMC
37 Sanofi-Pasteur ? PMC
Questions? Contact the IIS Help Desk at 1-800-325-5599 or WAIISHelpDesk@doh.
To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh..
DOH 348-580 June 2023
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- directive of the governor 22 13 washington
- the supreme court of washington
- covid 19 safety protocols for higher education institutions
- office of management and budget
- proclamation by the governor amending proclamations 20 05 washington
- iis codes for common vaccines in washington
- department of health k 12 schools requirements
- state of washington office of financial management
- wa covid 19 return to work supervisor guidance
- other adult care facility covid related deaths statewide data through
Related searches
- becoming a teacher in washington state
- common vba codes for excel
- vaccines in europe vs usa
- required vaccines in the us
- history of vaccines in america
- new vaccines in development
- vaccines in public schools
- common cpt codes for pediatrics
- covid 19 vaccines in development
- common cpt codes for gastroenterology
- common icd 10 codes for occupational therapy
- most common icd 10 codes for labs