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Depending on circumstances, you could also use: Z28.03 ( Immunization not carried out because of immune compromised state of patient ) Z28.04 ( Immunization not carried out because of patient allergy to vaccine or component ) Z28.81 ( Immunization not carried out due to patient having had the disease ) Unvaccinated due to philosophical/religious reasons: Your application of Z28.82 ( Immunization not carried out because of caregiver refusal ) and Z28.21 ( Immunization not carried out because of patient refusal ) if your patient is old enough to make their own wishes known is also pretty straightforward