Vaccine composition for the 2026-2027 U.S. influenza season
The Food and Drug Administration (FDA) and the Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommend which influenza viruses should compose the vaccines for the U.S. influenza season.
The seasonal influenza vaccines for the 2026-2027 U.S. season include two influenza A viruses (H1N1 and H3N2) and one influenza B virus. The selected influenza virus strains are based on the vaccine production method: egg-based and cell- or recombinant-based.
The egg-based vaccine contains the following:
- A/Missouri/11/2025 (H1N1)pdm09-like virus.
- A/Darwin/1454/2025 (H3N2)-like virus.
- B/Tokyo/EIS13-175/2025 (B/Victoria lineage)-like virus.
The cell- or recombinant-based vaccine contains the following:
- A/Missouri/11/2025 (H1N1)pdm09-like virus.
- A/Darwin/1415/2025 (H3N2)-like virus.
- B/Pennsylvania/14/2025 (B/Victoria lineage)-like virus.
VFC program
The Vaccines for Children (VFC) program is a federally funded program that provides vaccines at no cost to eligible children who might not otherwise get vaccinated due to an inability to pay.
To be eligible for the VFC program, children must be under 19 years of age and any of the following:
- Medicaid eligible.
- Uninsured.
- Underinsured.
- American Indian/Native American.
VFC providers
When using VFC stock, append modifier SL to the vaccine code. The SL modifier indicates that VFC stock was used and allows reimbursement only for the vaccine administration.
Per Medi-Cal guidelines: “Medi-Cal vaccine injection codes billed for recipients eligible to receive VFC program vaccines will be reimbursed only in documented cases of vaccine shortage, disease epidemic, vaccine delivery problems, or instances when the recipient does not meet the special circumstances required for VFC special-order vaccines. A provider’s non-enrollment in the VFC program is not a justified exception.”
In the event of a VFC vaccine shortage, or if VFC stock is out, indicate this on the claim and add reason “VFC out of stock” in box 19 of the CMS claim form or box 80 of the UB-04 claim form.
Non-VFC providers
The Alliance makes an exception for non-VFC providers.
To bill as a non-VFC provider:
- Do not bill the CPT code with the SL modifier.
- Add “non-VFC” in box 19 of the CMS claim form or box 80 of the UB-04 claim form.
All claims must be billed on UB-04, CMS-1500 or the electronic equivalent.
| Influenza vaccine guidance for all Alliance lines of business (Effective September 1, 2026 through June 30, 2027) |
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| Applies to members linked to your practice, non-linked members (no referral required) or administrative members. |
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| Vaccine Name | Dosage | Age Group | CPT Code |
| Fluad® (IIV) | 0.5 mL PFS 10-bx* | 18 years and older | 90653 |
| Fluarix® (IIV3) | 0.5 mL PFS 10-bx* | 3 years and older | 90656 |
| Flublok® | 0.5 mL PFS 10-bx* | 9 years and older | 90673 |
| Flucelvax® (ccIIV3)
|
0.5 mL PFS 10-bx* | 6 months and older | 90661 |
| 5 mL MDV
.25 mL/dose |
6 months and older | 90661 | |
| FluLaval® (IIV3) | 0.5 mL PFS 10-bx* | 6 months and older | 90656 |
| FluMist®(LAIV3) | 0.2 mL spray 10-bx* | 2 to 49 years | 90660 |
| Fluzone® (IIV)
|
0.5 mL PFS 10-bx* | 6 months and older | 90656 |
| 5 mL MDV
.5 mL/dose |
3 years and older | 90658 | |
| 0.25-mL dose taken from 5-mL multi-dose vial | 6-35 months | 90657 | |
| Fluzone® High-Dose (IIV) | 0.5 mL PFS 10-bx* | 18 years and older | 90662 |
| mFLUSIVA | .38 mL PFS 10-bx | 50 years and older | 90616 |
| Immunization Registries | |
| Vaccine Name | Immunization Service Name with CVX* |
| Fluad® | Influenza, injectable, subunit, adjuvanted, pres free (168) |
| Fluarix® | Influenza, injectable, trivalent, pres free (140) |
| Flublok® | Influenza, recombinant, trivalent, injectable, pres free (155) |
| Flucelvax®
|
Influenza, injectable, MDCK, pres free, trivalent (153) |
| Influenza, injectable, MDCK, trivalent (320) | |
| FluLaval® | Influenza, injectable, trivalent, pres free (140) |
| FluMist® | Influenza, live, intranasal, trivalent (111) |
| Fluzone®
|
Influenza, injectable, split virus, trivalent, pres free (140) |
| Influenza, injectable, split virus, trivalent (141) | |
| Fluzone® High-Dose | Influenza, injectable, high dose split virus, pres free (135) |
| mFLUSIVA | Influenza, mRNA, trivalent, PF (338) |
*Correct CVX code for immunization registries is needed for Care Based Incentives (CBI).
For vaccine information to be available, patients/parents must not “opt out” of immunization registry sharing. A patient/parent may request to change their sharing status at any time and get updates through the registry website. For more information, please see disclosures on registry websites:
