[PDF] EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, POLICY NUMBER: 2.01.

1 MEDICAL POLICY SUBJECT: IMMUNIZATIONS PAGE: 1 OF: 10 If a product excludes coverage for a service, it is not covered, ...

MEDICAL POLICY SUBJECT: IMMUNIZATIONS

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, POLICY NUMBER: 2.01.42 07/18/13, 07/17/14, 07/16/15, 07/21/16 CATEGORY: Vaccines/Biologics PAGE: 1 OF: 10 • If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. • If a commercial product, including an Essential Plan product, covers a specific service, medical policy criteria apply to the benefit. • If a Medicare product covers a specific service, and there is no national or local Medicare coverage decision for the service, medical policy criteria apply to the benefit. POLICY STATEMENT: Childhood and adult immunizations are eligible for coverage when: I. administered according to the official recommendations of the Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control and Prevention (CDC), and II. the services are covered by a member’s contract/benefit design. ACIP recommendations are effective on the date of the ACIP meeting at which the recommendations were made and are considered official when publicized by the CDC. POLICY GUIDELINES: I.

Refer to the member’s subscriber contract and/or the Customer (Member/Provider) Service Department for specific contract age limitations for dependents.

II. Coverage criteria are adjusted when national guidelines are revised to address new vaccines or changes in vaccine indications or the CDC makes recommendations for changes in administration schedules related to national vaccine shortages. III. Coverage for vaccines related to or required only as a condition of work, travel or school are strictly contract dependent. DESCRIPTION: Immunization is the process of stimulating the body’s immune system to protect against a specific infection. Minute amounts of the specific bacteria or virus, in whole or part, are specially treated so that when given to the patient, they will stimulate the body’s immune system without actually causing disease. Some immunizations require “boosters,” or repeat doses of the same vaccine, to keep up the body’s protection against a specific bacteria or virus. Recommended Pediatric and Adult immunizations are addressed as part of the Health Plan’s Preventive Health Guidelines. The “Recommended Childhood Immunization Schedule – Birth to 18 years and “Catch-up” that is part of Preventive Health Services: Healthy Children to Age 19 guidelines is produced by the American Academy of Pediatrics (AAP), the ACIP of the CDC, and the American Academy of Family Physicians and can be referenced at: https://www.excellusbcbs.com/wps/portal/xl/prv/pc/cpg. The Childhood & Adolescent Immunization Schedules are also available at: http://www.cdc.gov/vaccines/. The following immunizations are included in the recommendations: • Diphtheria-Tetanus-Pertussis • Influenza (Seasonal) • Hepatitis A • Measles, Mumps, Rubella • Hepatitis B • Meningococcal • Haemophilus Influenza Type B (HiB) • Pneumococcal • Human Papillomavirus (HPV) (Cervarix [HPV2], Gardasil [HPV4, HPV9])

Proprietary Information of Excellus Health Plan, Inc. A nonprofit independent licensee of the BlueCross BlueShield Association

• Poliovirus • Rotavirus • Varicella

SUBJECT: IMMUNIZATIONS

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, 07/18/13, 07/17/14, 07/16/15, 07/21/16 PAGE: 2 OF: 10

POLICY NUMBER: 2.01.42 CATEGORY: Vaccines/Biologics

The Preventive Care of Adults Ages 19 Years and Older guidelines include immunization schedules and information for both persons at “usual risk” and “at risk”. These guidelines are based primarily on recommendations from the Report of the US Preventive Services Task Force and the Department of Health and Human Services Centers for Disease Control and Prevention Recommended Adult Immunization Schedule and can be referenced at: https://www.excellusbcbs.com/wps/portal/xl/prv/pc/cpg. The Adult Immunization Recommendations Schedule is also available at: http://www.cdc.gov/vaccines/. The following immunizations are included in the recommendations: • Diphtheria-Tetanus-Pertussis • Human Papillomavirus (HPV) (Cervarix [HPV2], Gardasil [HPV4, HPV9]) • Hepatitis A • Influenza (Seasonal) • Pneumococcal • Hepatitis B • Measles, Mumps, Rubella • Varicella • Haemophilus Influenza Type B (HiB) • Meningococcal • Varicella Zoster (Shingles) According to New York State Law, every health insurance policy providing medical, major medical or similar comprehensive type coverage must provide coverage for necessary immunizations as recommended by the Advisory Committee on Immunization Practices (ACIP) to the CDC. CODES:

Number

Description

Eligibility for reimbursem*nt is based upon the benefits set forth in the member’s subscriber contract. CODES MAY NOT BE COVERED UNDER ALL CIRc*msTANCES. PLEASE READ THE POLICY AND GUIDELINES STATEMENTS CAREFULLY. Codes may not be all inclusive as the AMA and CMS code updates may occur more frequently than policy updates. Code Key: Experimental/Investigational = (E/I), Not medically necessary/ appropriate = (NMN). CPT:

90460

90461

Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered each additional vaccine or toxoid component administered

90620

Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB), 2 dose schedule, for intramuscular use

90621

Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB), 3 dose schedule, for intramuscular use

90630

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use

90632

Hepatitis A vaccine (Hep A), adult dosage, for intramuscular use

90633

Hepatitis A vaccine (Hep A), pediatric/adolescent dosage-2 dose schedule, for intramuscular use

90634

Hepatitis A vaccine (Hep A), pediatric/adolescent dosage-3dose schedule, for intramuscular use

90636

Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use

90644

Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type vaccine (Hib-MenCY), 4 dose schedule, when administered to children 2-18 months of age, for intramuscular use

90647

Hemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use Proprietary Information of Excellus Health Plan, Inc.

SUBJECT: IMMUNIZATIONS

POLICY NUMBER: 2.01.42 CATEGORY: Vaccines/Biologics

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, 07/18/13, 07/17/14, 07/16/15, 07/21/16 PAGE: 3 OF: 10

90648

Hemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use

90649

Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramuscular use

90650

Human Papillomavirus vaccine, types 16, 18, bivalent (2vHPV), 3 dose schedule, for intramuscular use

90651

Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 3 dose schedule, for intramuscular use

90653

Influenza virus vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use

90654

Influenza virus vaccine, split virus, preservative free, for intradermal use

90655

Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use (revised 1/1/17)

90656

Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use (revised 1/1/17)

90657

Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use (revised 1/1/17)

90658

Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use (revised 1/1/17)

90660

Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use Note: Not covered for 2016-2017 influenza season as is not recommended for use by the CDC.

90661

Influenza virus vaccine trivalent (ccIIV3), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use (revised 1/1/17)

90662

Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use

90664

Influenza virus vaccine, live (LAIV), pandemic formulation, for intranasal use

90666 (E/I)

Influenza virus vaccine (IIV), pandemic formulation, split virus, preservative free, for intramuscular use (pending FDA approval)

90667 (E/I)

Influenza virus vaccine (IIV), pandemic formulation, split virus, adjuvanted, for intramuscular use (pending FDA approval)

90668 (E/I)

Influenza virus vaccine (IIV), pandemic formulation, split virus, for intramuscular use (pending FDA approval)

90670

Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use

90672

Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use Note: Not covered for 2016-2017 influenza season as is not recommended for use by the CDC.

90673

Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use

90674

Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use (effective 1/1/17) Proprietary Information of Excellus Health Plan, Inc.

SUBJECT: IMMUNIZATIONS

POLICY NUMBER: 2.01.42 CATEGORY: Vaccines/Biologics

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, 07/18/13, 07/17/14, 07/16/15, 07/21/16 PAGE: 4 OF: 10

90680

Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use

90681

Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use

90682 (E/I)

Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use (effective 1/1/17, pending FDA approval)

90685

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use (revised 1/1/17)

90686

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use (revised 1/1/17)

90687

Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use (revised 1/1/17)

90688

Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use (revised 1/1/17)

90696

Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), when administered to children 4 years through 6 years of age, for intramuscular use

90697 (E/I)

Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use (pending FDA approval)

90698

Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine (DTaP-IPV/Hib), for intramuscular use

90700

Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use

90702

Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use

90707

Measles, mumps, and rubella vaccine (MMR), live, for subcutaneous use

90710

Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use

90713

Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use

90714

Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use

90715

Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use

90716

Varicella virus vaccine (VAR), live, for subcutaneous use

90723

Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DtaP-HepB-IPV), for intramuscular use

90732

Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use

90733

Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use Proprietary Information of Excellus Health Plan, Inc.

SUBJECT: IMMUNIZATIONS

POLICY NUMBER: 2.01.42 CATEGORY: Vaccines/Biologics

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, 07/18/13, 07/17/14, 07/16/15, 07/21/16 PAGE: 5 OF: 10

90734

Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 quadrivalent (MCV4 or MenACWY), for intramuscular use (revised 1/1/17)

90736

Zoster (shingles) vaccine (HZV), live, for subcutaneous injection

90738

Japanese encephalitis virus vaccine, inactivated, for intramuscular use

90739 (E/I)

Hepatitis B vaccine (HepB), adult dosage, 2 dose schedule, for intramuscular use (pending FDA approval)

90740

Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use

90743

Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use

90744

Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use

90746

Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use

90747

Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use

90748

Hepatitis B and Haemophilus influenzae type b vaccine (Hib-HepB), for intramuscular use

90750 (E/I)

HCPCS:

G0008

Administration of influenza virus vaccine

G0009

Administration of pneumococcal vaccine

G0010

Administration of hepatitis B vaccine

Q2034

Influenza virus vaccine, split virus, for intramuscular use (Agriflu) Sipuleucel-t, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF, including leukopheresis and all other preparatory procedures, per infusion

Q2035

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (AFLURIA)

Q2036

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (FLULAVAL)

Q2037

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (FLUVIRIN)

Q2038

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)

Q2039

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (not otherwise specified)

ICD9:

Numerous

ICD10:

Numerous

Proprietary Information of Excellus Health Plan, Inc.

SUBJECT: IMMUNIZATIONS

POLICY NUMBER: 2.01.42 CATEGORY: Vaccines/Biologics

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, 07/18/13, 07/17/14, 07/16/15, 07/21/16 PAGE: 6 OF: 10

REFERENCES: American Academy of Pediatrics. 2016 Immunization schedules. Last updated 2016 Feb [http://redbook.solutions.aap.org/SS/Immunization_Schedules.aspx] accessed 6/14/16. American Academy of Pediatrics. Immunization. Last updated 2016 [http://www2.aap.org/immunization/index.html] accessed 6/14/16. American Academy of Pediatrics Committee on Infectious Diseases. Immunization for Streptococcus pneumoniae infections in high-risk children. Pediatrics 2014 Dec;134(6):1230-3. American Academy of Pediatrics. Recommendations for prevention and control of influenza in children, 2013-2014. Policy statement. Pediatrics 2013 Oct;132(4):1-16. American Academy of Pediatrics Committee on Infectious Diseases. Meningococcal conjugate vaccines policy update: booster dose recommendations. Pediatrics 2011 Dec;128(6):1213-8. American Academy of Pediatrics Committee on Infectious Diseases. Poliovirus. Pediatrics 2011 Oct;128(4):805-8. *American Academy of Pediatrics. Committee on Infectious Diseases. Prevention of rotavirus disease: updated guidelines for use of rotavirus vaccine. Pediatrics 2009 May;123(5):1412-20. American Academy of Pediatrics Committee on Infectious Diseases. Policy statement—Prevention of varicella: update of recommendations for use of quadrivalent and monovalent varicella vaccines in children. Pediatrics 2011 Sep;128(3):6302. American Academy of Pediatrics. Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2012-2013. Pediatrics 2012 Oct;130(4):780-92. American Academy of Pediatrics Committee on Infectious Diseases. Updated recommendations on the use of meningococcal vaccines. Pediatrics 2014 Aug;134(2):400-3. American College of Obstetricians and Gynecologists. Committee on Adolescent Health; Immunization Expert Work Group of the American College of Obstetricians and Gynecologists. Committee opinion no. 641: human papillomavirus vaccination. Obstet Gynecol 2015 Sep [http://www.acog.org/-/media/Committee-Opinions/Committee-on-AdolescentHealth-Care/co641.pdf?dmc=1&ts=20150706T0701411210] published online ahead of print 6/26/15. American College of Obstetricians and Gynecologists. Committee on Obstetric Practice and Immunization Expert Work Group; Centers for Disease Control and Prevention’s Advisory Committee on Immunization, United States; American College of Obstetricians and Gynecologists. Committee opinion no. 608: influenza vaccination during pregnancy. Obstet Gynecol 2014 Sep;124(3):648-51. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 566: Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Obstet Gynecol 2013 Jun;121(6):1411-4. Baxter R, et al. Immunogenicity and safety of an investigational quadrivalent meningococcal ACWY tetanus toxoid conjugate vaccine in healthy adolescents and young adults 10 to 25 years of age. Pediatr Infect Dis J 2011 Mar;30(3):e418. *Centers for Disease Control and Prevention (CDC). Addition of severe combine immunodeficiency as a contraindication for administration of rotavirus vaccine. MMWR 2010 Jun 11;59(22):687-8. Centers for Disease Control and Prevention (CDC).Robinson CL; Advisory Committee on Immunization Practices (ACIP), ACIP Child/Adolescent Immunization Work Group. Advisory Committee on Immunization Practices recommended immunization schedules for persons aged 0 Through 18 years--United States, 2016. MMWR Morb Mortal Wkly Rep 2016 Feb 5;65(4):86-7. Centers for Disease Control and Prevention (CDC). Kim DK, et al; Advisory Committee on Immunization Practices. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older: United States, 2016. MMWR Morb Mortal Wkly Rep 2016 Feb 2;65(4):88-90. Proprietary Information of Excellus Health Plan, Inc.

SUBJECT: IMMUNIZATIONS

POLICY NUMBER: 2.01.42 CATEGORY: Vaccines/Biologics

EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, 07/18/13, 07/17/14, 07/16/15, 07/21/16 PAGE: 7 OF: 10

Centers for Disease Control and Prevention (CDC). Advisory Committee on Immunization Practices (ACIP). Vaccines for Children Program. Vaccines to prevent meningococcal disease. Resolution 6/15-1. 2015 Jun 24 [http://www.cdc.gov/vaccines/programs/vfc/downloads/resolutions/2015-06-15-mening.pdf] accessed 6/16/16. *Centers for Disease Control and Prevention (CDC). FDA licensure of bivalent human Papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR 2010 May 28;59(20):626-9. *Centers for Disease Control and Prevention (CDC). Hepatitis A vaccination coverage among children aged 24 – 35 months --- United States, 2006 and 2007. MMWR 2009 Jul 3;58(25):689-94. Centers for Disease Control and Prevention (CDC). Markowitz LE, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2014 Aug 29;63(RR-05):1-30 [http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6305a1.htm?s_cid=rr6305a1_w]. Erratum in: MMWR Recomm Rep. 2014 Dec 12;63(49):1182 [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6349a11.htm] accessed 6/3/15. *Centers for Disease Control and Prevention (CDC). Licensure of a diphtheria and tetanus toxoids and acellular pertussis adsorbed, inactivated poliovirus, and haemophilus B conjugate vaccine and guidance for use in infants and children. MMWR 2008 Oct 3;57(39):1079-80. *Centers for Disease Control and Prevention (CDC). Licensure of a diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine and guidance for use as a booster dose. MMWR 2008 Oct 3;57(39):1078-9. Centers for Disease Control and Prevention (CDC). Briere EC, et al; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases. Prevention and control of haemophilus influenzae type b disease: recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 2014 Feb 28;63(RR-01):1-14. Centers for Disease Control and Prevention (CDC). Recommendation of the Advisory Committee on Immunization Practices (ACIP) for use of quadrivalent meningococcal conjugate vaccine (MenACWY-D) among children aged 9 through 23 months at increased risk for invasive meningococcal disease. MMWR Morb Mortal Wkly Rep 2011 Oct 14;60(40):1391-2. Centers for Disease Control and Prevention (CDC). Recommendations on the use of quadrivalent human papillomavirus vaccine in males--Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep 2011 Dec 23;60(50):1705-8. *Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR 2010 Sep 3;59(34):1102-6. *Centers for Disease Control and Prevention (CDC). Updated recommendations for use of haemophilus influenzae Type b (Hib) Vaccine: reinstatement of the booster dose at ages 12-15 months. MMWR 2009 Jun 26;58(24):673-4. *Centers for Disease Control and Prevention (CDC). Updated recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding routine poliovirus vaccination. MMWR 2009 Aug 7;58(30):829-30. Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged

[PDF] EFFECTIVE DATE: 09/16/04 REVISED DATE: 10/20/05, 09/21/06, 07/19/07, 08/21/08, 07/16/09, 07/15/10, 07/21/11, 07/19/12, POLICY NUMBER: 2.01. - Free Download PDF (2024)