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CHDP Influenza Vaccine Update for 2016 – 2017 Flu Season

September 15, 2016

Regarding the 2016 – 2017 flu season, below are key vaccination recommendations from the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP). Also included for the 2016 – 2017 flu season are Vaccines For Children (VFC) Program-approved influenza vaccines and current Child Health and Disability Prevention (CHDP) Program flu vaccine procedure codes.

For the 2016 – 2017 flu season, CHDP providers can administer VFC-approved influenza vaccines (CPT-4 codes 90674, 90685, 90686 and 90688) using CHDP procedure codes 53, 54 or 80, as appropriate. Additional guidance and payment updates regarding CHDP flu vaccines for the 2016 – 2017 flu season are forthcoming.

CDC ACIP has published the Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices for the 2016 – 2017 flu season. Following are vaccination recommendations for CHDP providers:

  • Routine annual influenza vaccinations for children 6 months of age and older, without contraindications, continues to be recommended.
  • ACIP recommends that children 6 months through 8 years of age receive two doses of influenza vaccine, administered four weeks apart, during their first season of vaccination. For children 6 months through 8 years of age who have previously received two or more doses of trivalent or quadrivalent influenza vaccine before July 1, 2016, ACIP recommends only one dose for the 2016 – 2017 flu season.
  • Due to low effectiveness against influenza A (H1N1) in the United States, ACIP has made the interim recommendation that live attenuated influenza vaccines (FluMist) are not to be used during the 2016 – 2017 flu season.
  • A quadrivalent formulation of Flucelvax was approved by the FDA in May 2016 for children 4 years of age and older. Flucelvax is an acceptable alternative to other influenza vaccines licensed for recipients in this age group.
  • Recommendations for influenza vaccination of recipients with an egg allergy have been modified:
    • Former recommendations suggested egg-allergic recipients should be observed for 30 minutes post vaccination for signs and symptoms of an allergic reaction. Providers should observe all patients for 15 minutes after vaccination to decrease the risk of injury if the patient experiences syncope, per the ACIP General Recommendations on Immunization.
    • Recipients with a history of severe allergic reaction to egg (such as any symptom other than hives) should be vaccinated in an inpatient or outpatient medical setting, including but not necessarily limited to hospitals, clinics, health departments and physician offices, under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.

2016 – 2017 Vaccines For Children (VFC) Program Flu Vaccines
For the 2016 – 2017 flu season, CHDP providers may administer VFC-approved influenza vaccines (CPT-4 codes 90674, 90685, 90686 and 90688) using CHDP procedure codes 53, 54 or 80, as appropriate (see table below). Recommended VFC influenza vaccines include:

Quadrivalent Influenza Vaccine

Vaccine Presentation Age CPT-4 Code
Flucelvax Quadrivalent 0.5 ml single-dose syringe 4 years and older 90674
Fluzone Quadrivalent 0.25 ml (single-dose syringe) 6 through 35 months 90685
Fluarix Quadrivalent 0.5 ml single-dose syringe 3 years and older 90686
Fluzone Quadrivalent 0.5 ml (single-dose syringe) 3 years and older 90686
Fluzone Quadrivalent 5 ml (multi-dose vial: 10 doses per vial) 3 years and older 90688

CHDP Flu Vaccine Payment Information

Vaccine Code Vaccine Source Age Rate
Influenza (Inactivated) 53 VFC or State 6 months thru 20 years, 11 months $9.00
54 Purchased 36 months thru 20 years, 11 months $13.76
Influenza (Inactivated) Preservative-Free 80 Purchased 6 months thru 35 months $18.71

For additional CHDP billing code and rates information, refer to the Rates: Maximum Reimbursement for CHDP section of the CHDP Provider Manual.

For additional details about VFC influenza vaccines, refer to the California VFC Program EZIZ Web page.

Note:

Additional guidance and payment updates regarding CHDP flu vaccines for the 2016 – 2017 flu season are forthcoming.

Providers with questions may also contact the Department of Health Care Services, Systems of Care Division at (916) 327-1400.