Rev. 9/21/2021
Vermont Immunization Registry: Vaccine Names and CPT/CVX Codes
A list that matches the vaccine names or codes in the Vermont Immunization Registry with the brand name/common names. Intended as a tool to guide accurate vaccine reporting for practices and organizations sending data from electronic medical records. For questions, contact Immunization Registry Manager at (802) 951-4094. State CVX CPT Vaccine Trade Name or Common Trade Name Best IMR Selection Supplied Licensed Age Range Route Manufacturer Code Code COVID-19 Vaccines COVID-19, mRNA Moderna COVID-19 Vaccine® LNP-S, PF, Moderna Y 18+yrs IM Moderna 207 91301 COVID-19, mRNA Pfizer COVID-19 Vaccine® LNP-S, PF, Pfizer Y 16+yrs IM Pfizer 208 91300 COVID-19 vaccine, AstraZeneca COVID-19 Vaccine® vector-nr, Y 18+yrs IM AstraZeneca 210 91302 AstraZeneca Janssen COVID-19 Vaccine® COVID-19 vaccine, Y 18+yrs IM Janssen 212 91303 vector-nr, Janssen Combined Vaccines Pediarix® DTaP-HepB-IPV Y 6 weeks - 6 yrs. IM GlaxoSmithKline - SKB 110 90723 Kinrix® Y 4-6 yrs. IM GlaxoSmithKline - SKB Quadracel® DTaP-IPV Y 4-6 yrs. IM Sanofi Pasteur - PMC 130 90696 Pentacel® DTaP-Hib-IPV Y 6 weeks - 4 yrs. IM Sanofi Pasteur - PMC 120 90698 Twinrix® HepA-HepB Y 18+ yrs. IM GlaxoSmithKline - SKB 104 90636 ProQuad® MMR-Varicella Y 1 yr. -12yrs. SC Merck - MSD 94 90710 Comvax® * HIB-HepB 6 weeks - 15 mos. IM Merck - MSD 51 90748 Diphtheria, Tetanus, Pertussis Decavac® * or Tenivac® Td Adult, Tetanus and Diphtheria Toxoids Adsorbed Preservative free 7+ yrs. IM Sanofi Pasteur - PMC 113 90714 Infanrix® Y 6 weeks - 6 yrs. IM GlaxoSmithKline - SKB Tripedia® * DTaP 6 weeks - 6 yrs. IM Sanofi Pasteur - PMC 20 DTaP, 5 pertussis Daptacel® antigens Y 6 weeks - 6 yrs. IM Sanofi Pasteur - PMC 106 90700 Diphtheria and Tetanus Toxoids Adsorbed DT Pediatric 6 weeks - 6 yrs. IM Sanofi Pasteur - PMC 28 90702 Massachusetts Biologic
Boostrix® Tetanus Diphtheria & Acellular Pertussis Tdap Y 7+ yrs. IM GlaxoSmithKline - SKB 115 90715 If DTaP was given and the brand name is unknown DTaP 20 90700 Diphtheria, Tetanus Toxoids, & Whole Cell Pertussis Vaccine * DTP 01 90701
Hepatitis A Vaqta® HepA, Adult Y 19+ yrs. IM Merck - MSD Havrix® Y 19+ yrs. IM GlaxoSmithKline - SKB 52 90632 Vaqta® HepA 2 dose-Ped, Y 1 yr. - 18 yrs. IM Merck - MSD Havrix® Adol Y 1 yr. - 18 yrs. IM GlaxoSmithKline - SKB 83 90633 HepA 3 dose Ped, Havrix® * Adol 1 yr. - 18 yrs. IM GlaxoSmithKline - SKB 84 90634 Hepatitis B Engerix-B® Ped/Adol Y Birth - 19 yrs. IM GlaxoSmithKline - SKB Recombivax HB® HepB Ped, Adol Y Birth - 19 yrs. IM Merck - MSD 08 90744 Engerix-B® for adults Y 20+ yrs. IM GlaxoSmithKline - SKB Recombivax HB® for adults HepB, Adult Y 20+ yrs. IM Merck - MSD 43 90746 Recombivax-DIALYSIS (4 dose schedule) HepB, Dialysis IM Merck - MSD 44 90747 HepB, adjuvanted
Heplisav-B Y 18+ yrs. IM Dynavax 189 90739 HIB ActHib® Y 2 mo. - 5 yrs. IM Sanofi Pasteur - PMC Hiberix® Y 6 weeks - 4 yrs. IM GlaxoSmithKline - SKB OmniHib® * Hib-PRP-T IM GlaxoSmithKline - SKB 48 90648 PedvaxHib® Hib-PRP-OMP Y IM Merck - MSD 49 90647 HibTITER® * Hib-Hboc 2 mo. - 5 yrs. IM Wyeth Ayerst - WAL 47 90645 Human Papilloma Virus Gardasil-9® HPV-9 Y 9-45 yrs. IM Merck - MSD 165 90651 Gardasil® * HPV, quadrivalent 9-26 yrs. IM Merck - MSD 62 90649 Cervarix™* HPV, bivalent 10-25 yrs. IM GlaxoSmithKline - SKB 118 90650 Japanese Encephalitis The Research Foundation for Microbial Japanese Diseases of Osaka Univ JE-VAX® - Japanese Encephalitis * Encephalitis 1+ yrs. SC (BIKEN) - JPN 39 90735 Japanese IXIARO® - Japanese Encephalitis Encephalitis - IM 2 mos. + IM Intercell Biomedical -INT 134 90738 Measles, Mumps, & Rubella MMR®II - Measles, Mumps, & Rubella MMR Y 1+ yrs. SC Merck - MSD 03 90707 Meningococcal (Serogroups A, C, Y, W-135) Meningococcal Menactra® Meningococcal Conjugate Vaccine MCV4 Y 9 mos-55 yrs. IM Sanofi Pasteur - PMC 114 2
Meningococcal Menveo® Meningococcal Conjugate Vaccine MCV4O Y 2 mos-55 yrs. IM GlaxoSmithKline - SKB 136 90734 Meningococcal polysaccharide 3-18 mos. (2 doses) Menomune® Meningococcal Polysaccharide Vaccine * MPSV4 19+mos. (1 dose) SC Sanofi Pasteur - PMC 32 90733
Meningococcal B Bexsero Meningococcal B 4C, OMV Y 10-25 yrs. IM GlaxoSmithKline - SKB 163 90620 Meningococcal B FHbp, Trumemba recombinant Y 10-25 yrs. IM Pfizer Inc - PFR 162 90621 Pneumococcal Pneumovax® 23 Pneumococcal, Polysaccharide Y 2 yrs. + SC/IM Merck - MSD Pnu-Imune® 23 * Pneumococcal 2 yrs. + SC/IM GlaxoSmithKline - SKB 33 90732 (PPV23) polysaccharide Prevnar® Pneumococcal Conjugate, 7 Valent * Pneumococcal PCV - 7 Y 6+ weeks IM Wyeth Ayerst - WAL 100 90669 Prevnar 13® Pneumococcal Conjugate, 13 Valent Pneumococcal PCV – 13 Y IM Pfizer Inc - PFR 133 90670 Polio IPOL® Poliovirus Vaccine, Inactivated IPV Y 6+ weeks SC/IM Sanofi Pasteur - PMC 10 90713 Poliovirus Vaccine, Live Oral * US ONLY OPV 02 90712 Poliovirus Vaccine, Live Oral * Non-United States monovalent OPV Monovalent, 179 none unspecified Poliovirus Vaccine, Live Oral * Non-United States bivalent OPV Bivalent 178 none Rabies Imovax® Rabies IM Sanofi Pasteur - PMC 175 Novartis Pharmaceutical Corp.- Rabavert® Rabies All ages IM NOV 176 90675 Rabies, ID * Rabies Intradermal ID 40 90676 Rotavirus Rotateq® Rotavirus, pentavalent Y 6-32 weeks Merck - MSD 116 90680 Rotarix® Rotavirus, monovalent Y 6-24 weeks Oral GlaxoSmithKline - SKB 119 90681 Respiratory Syncytial Virus Synagis® RSV- MAG IM MedImmune - MED 93 90378 Typhoid Vivotif Typhoid, Oral 6+ yrs. Oral Berna Products Corp. -BPC 25 90690 Typhim Vi Typhoid, ViCPs 2+ yrs. IM Sanofi Pasteur - PMC 101 90691 Varicella Varivax® Chicken Pox Vaccine Varicella Y 1+ yrs. SC Merck - MSD 21 90716 Yellow Fever VF - VAX Yellow Fever SC Sanofi Pasteur - PMC 37 90717 Stamaril Yellow Fever SC/IM Sanofi Pasteur - PMC 183
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Zoster ("Shingles") Zostavax® Zoster Live 50+ yrs. SC Merck - MSD 121 90736 Shingrix Zoster Recombinant Y 50+ yrs. IM GlaxoSmithKline -SKB 187 90750
*Discontinued, historical records only For questions, contact Immunization Registry Manager at (802) 951-4094
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