Representing Immunizations

General considerations:

• The list above includes any vocabulary used to record immunizations in any health IT system including IIS, pharmacy, billing, etc. 

• NDC has been used by pharmacies to report historical doses for billing purposes, so it is included here in that context.  

• The CDC's National Center for Immunization and Respiratory Diseases (NCIRD) developed and maintains the CVX and MVX code systems, and developed and maintains the NDC vaccine tables based on information published by the FDA.

• RxNorm is an acceptable alternative code set for use at the local level.

• RxNorm is not utilized for reporting of previous dispensing.

For Immunization Information System (IIS) consideration:

• The CDC's National Center for Immunization and Respiratory Diseases (NCIRD) developed and maintains the CVX and MVX code systems, and developed and maintains the NDC vaccine tables based on information published by the FDA.

• CVX codes are designed to represent administered and historical immunizations and will not contain manufacturer-specific information.

• If an MVX code is paired with a CVX (vaccine administered) code, the specific trade named vaccine may be indicated providing further specificity as to the vaccines administered.

• There is a potential issue with use of the National Drug Code regarding which code to use when there are multiple active ingredients in a single package or multiple separate ingredients that need to be mixed together. CDC has published guidance on NDC Unit of Use and Unit of Sale; it can be found at: https://www.cdc.gov/vaccines/programs/iis/2d-barcodes/downloads/guidance-documenting-ndc.pdf.

• The lot number is used in conjunction with the NDC when reporting immunizations to state registries. There is no standard codification for lot numbers.

• The IIS community does not utilize RxNorm as a code set and thus it may have limitations for interoperability across systems.