TRICARE Retail Vaccination Program Vaccine List - September 2018*
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1 Diphtheria, tetanus and pertussis Diphtheria and tetanus toxoids adsorbed acellular pertussis adsorbed DT DTaP Diphtheria and tetanus toxoids adsorbed Daptacel, Infanrix Tetanus and diphtheria toxoids adsorbed (A) Td Tenivac 7 years none Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis, adsorbed Tdap Adacel, Boostrix 7 years none hepatitis B and inactivated poliovirus DTaP-HepB- IPV Pediarix acellular pertussis adsorbed and inactivated poliovirus DTaP-IPV Kinrix Quadracel 4 years inactivated poliovirus and conjugate DTaP-IPV/Hib Pentacel *This reference chart is intended to provide abbreviations and age limitations used in Recommendations and Policy
2 Haemophilus influenzae type b conjugate Hib PedvaxHIB; ActHIB Hiberix H. influenzae type b, diphtheria, tetanus, pertussis, and polio DTaP-IPV/Hib Pentacel Hepatitis Hepatitis A HepA Havrix Vaqta 1 year Hepatitis B HepB Engerix-B Recombivax HB none Hepatitis B-TLR HepB-CpG Heplisav-B 18 years Hepatitis A inactivated and hepatitis B HepA-HepB Twinrix 18 year hepatitis B and inactivated poliovirus DTaP-HepB- IPV Pediarix Herpes zoster Zoster Live ZVL Zostavax 60 years Zoster Recombinant, Adjuvanted RZV Shingrix 50 years *This reference chart is intended to provide abbreviations and age limitations used in Recommendations and Policy
3 Human papillomavirus Influenza Human papillomavirus (9-valent) types 6,11,16,18,31, 33,45,52,and 58 Live Attenuated Influenza, quadrivalent Trivalent inactivated influenza 9vHPV Gardasil-9 9 years <27 years LAIV4 Flumist 2 years <50 years IIV3 Afluria 5 years Fluad 65 years Fluzone High Dose 65 years Quadrivalent inactivated influenza IIV4 Afluria Quad 5 years Fluarix Quad 6 months FluLaval Quad 6 months Flucelvax Quad 4 years Fluzone Quad - MDV 6 months Fluzone Quad (Syringe/SDV) 3 years Fluzone Quad - Ped 6 months 35 months Recombinant Influenza, Trivalent RIV3 FluBlok 18 years *This reference chart is intended to provide abbreviations and age limitations used in Recommendations and Policy
4 Measles, mumps and rubella Measles, mumps, and rubella Measles, mumps, rubella, and varicella MMR M-M-R II 6 months MMRV ProQuad 1 year Meningococcal Quadrivalent MenACWY- CRM Menveo 2 months Quadrivalent MenACWY- D Menactra 9 months Serogroup B meningococcal MenB-FHbp MenB-4C Trumenba Bexsero 10 years *This reference chart is intended to provide abbreviations and age limitations used in Recommendations and Policy
5 Pneumococcal Pneumococcal conjugate (13- valent) Pneumococcal polysaccharide (23-valent) TRICARE Retail Vaccination Program PCV13 Prevnar 13 PPSV23 Pneumovax 2 years Poliovirus Inactivated poliovirus IPV Ipol acellular pertussis adsorbed and inactivated poliovirus DTaP-IPV Kinrix Quadracel 4 years inactivated poliovirus and conjugate DTaP-IPV/Hib Pentacel Rotavirus Rotavirus (monovalent) RV1 Rotarix Rotavirus (pentavalent) RV5 RotaTeq <9 months <9 months Varicella Varicella VAR Varivax 1 years Measles, mumps, rubella, and varicella MMRV ProQuad 1 years Varicella immune globulin VZV VariZIG none *This reference chart is intended to provide abbreviations and age limitations used in Recommendations and Policy
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An immunization that does not fall under one of the exclusions in the Certificate of Coverage is considered covered after the following conditions are satisfied: (1) FDA approval; (2) explicit ACIP recommendation
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