Appropriate orders
Code
<65 yo: quadrivalent vaccine (multidose vial with preservative): IMM155
65 or older: high dose trivalent (‘Flu vaccine HD 65+): IMM31
-EPIC will block you from ordering the high dose vaccine in patients <65 years old (even if immunosuppressed, not approved yet for this indication)
Pregnant or infants: preservative free quadrivalent: IMM42
The preservative is added to multi-dose vials to prevent bacterial growth (a source of deaths in the 1920s related to staph aureus growth in a multidose vial prior to the use of preservatives). Here is a Patient handout for preservative information.
Trivalent covers: 1) A/California/7/2009 (H1N1)pdm09-like virus | 2) A/Switzerland/9715293/2013 (H3N2)-like virus | 3) B/Phuket/3073/2013-like virus (Yamagata lineage)
Quadrivalent includes: the above and 4) B/Brisbane/60/2008-like virus (Victoria lineage)
**Please associate the order with ICD 10 code Z23 (found in common diagnosis drop down menu ‘need for prophylactic vaccination and inoculation against influenza’).**