Influenza Vaccine During Pregnancy

By, Mark LeDuc, DO

Immune system changes during pregnancy put women at an increased risk of serious illness and complications if they contract influenza (1).  These complications include preterm labor, preterm birth, and increased risk of dying (2).  Prior to the H1N1 epidemic in 2009, the influenza vaccination rates for pregnant women were only 15% (1).  During the 2009-2010 flu season, the vaccination rate increased to 50% (1).  This rate has been sustained due to strong recommendations by healthcare providers and other advocates. Strides continue to be made toward achieving the Healthy People 2020 goal of vaccinating 80% of pregnant women (3). 

The current CDC recommendations state that everyone 6 months of age and older - including pregnant women and women who are breastfeeding -  receive the flu vaccine each year (2).  It is recommended that pregnant women receive the vaccine early in the flu season (October – May (2)).  They can receive the vaccine any time during pregnancy (2) .  The nasal mist is not recommended by the CDC during the 2017-18 season. (2). 

Codes:

 

     VACCINE ADMINISTRATION
 Vaccine CPT  Typical Diagnosis Code Patient is 0-18 Years AND Qualified HCP Counseling Occurs  Patient is 19+ Years Regardless of Qualified Counseling, or Patient of Any Age Without Qualified Counseling
Choose correct code based on vaccine. Consult coding book and be cautious of trivalent vs. quadrivalent, dosage, route of administration, antigen content, manufacturing (egg, cell, recombinant DNA), etc.  Z23  

90460 - 1 Unit

(All influenza vaccines are single component vaccines)

  

90471 - 1 Unit

OR

90472 - 1 Unit

Resources:

  1. Centers for Disease Control and Prevention Vaccines and Immunizations Information Page, at http://www.cdc.gov/vaccines
  2. American College of Obstetricians and Gynecologists immunization web site, at http://www.immunizationforwomen.org
  3. Advisory Committee for Immunization Practices Recommendations, at http://www.cdc.gov/vaccines/pubs/ACIP-list.htm

References:

  1. http://www.acog.org/about-acog/news-room/news-releases/2014/all-pregnant-women-should-get-flu-vaccine
  2. http://www.acog.org/resources-and-publications/patient-education-pamphlets/files/the-flu-vaccine-and-pregnancy
  3. http://www.acog.org/resources-and-publications/committee-opinions/committee-on-abstetric-practice-and-immunization-expert-work-group/influenza-vaccination-during-pregnancy