State of California Health and Human Services Agency California Department of Public Health

Transcription

1 State of California Health and Human Services Agency Ron Chapman, MD, MPH Director and State Health Officer EDMUND G. BROWN JR. Governor DATE: February 5, 213 TO: FROM: SUBJECT: Public and Private Health Care Providers Immunization Branch Vaccines for Children (VFC) Program Enrollment in the Vaccines for Children (VFC) Program Thank you for your interest in enrolling in the State of California's Vaccines for Children (VFC) Program. The Vaccines for Children (VFC) Program is a federally-funded program that supplies publicly purchased vaccines for immunizing eligible children- at no cost to participating public and private health care providers. Eligible patients include children through the age of 18 who are: Medi-Cal/CHDP eligible; or Uninsured (child has no health insurance coverage); or American Indian/Alaskan Native NOTES: Under-insured (child s health insurance does not cover immunizations or only covers selected vaccines) may not be immunized with VFC vaccines at private offices. They may be immunized with VFC vaccines only at a Federally Qualified Health Center (FQHC), Rural Health Center (RHC) or local health department clinic. Children with commercial (private) insurance, including Healthy Family subscribers, are NOT eligible to receive VFC-supplied vaccines. Enrollment Steps: 1. REVIEW AND COMPLETE ENROLLMENT FORMS Carefully review and complete the 6 page VFC Program Enrollment Application: o The first two pages of the application request information about your practice s profile, e.g., Name and address, vaccine delivery information, number of VFCeligible to be served, personnel with prescription privileges to administer VFC vaccines, and communication contacts for the practice. California Vaccines for Children (VFC) Program 85 Marina Bay Parkway, Bldg P, Richmond, CA or

2 o o o o Provider Enrollment Agreement (Page 3-4) and Certification of Capacity to Store Vaccines (Page 5-6) outline participation terms for all practices enrolling in the Program. The two documents must be reviewed and signed by the physician-in chief or the clinic s medical director (Must be a licensed Medical Doctor, Doctor of Osteopathy, Nurse Practitioner, Physician Assistant, or a Certified Nurse Midwife with prescription privileges in the State of California). Other providers authorized to administer vaccines can operate under the supervision of a prescribing VFC provider and should be listed under the Healthcare Providers with Prescription Privilege section (page 2). Organizations with multiple facilities or satellite clinics must complete enrollment forms for each site. Organizations self identifying as a Federally Qualified Health Center (FQHC) or Rural Health Center (RHC), must include a copy of the federal FQHC/RHC license/certification. Similarly, clinics self identifying as a State-licensed Community Health Center in the State of California must also submit a copy of the certification issued by the State s Bureau of Primary Care. In addition to VFC Provider Enrollment Forms, your New Provider Enrollment packet includes materials that outline program requirements for vaccine storage. All prospective VFC Program participants MUST comply with outlined requirements prior to enrolling in the program. Specific requirements about acceptable vaccine storage unit types used for the storage of VFC-supplied vaccines include: o o o A refrigerator-only unit(s) for the storage of all refrigerated vaccines (with a minimum capacity of 11 cubic feet) and A separate stand-alone freezer unit for the storage of frozen vaccines. Under-the-counter units for the storage of a small vaccine supply must be purposely built for the storage of biologics (pharmacy or biologic grade). NOTE: Bar or dormitory style units and household refrigerator/freezer combination units are NOT acceptable for the storage of VFC Supplied vaccines. If you are in the process of purchasing vaccine storage units for your practice, please ensure they meet requirements outlined in the enclosed guidelines or consult with your local VFC Field Representative during your new provider site visit. 2. MAIL ENROLLMENT FORMS Please mail the completed application to the following address and keep a copy for your records. Incomplete applications cannot be processed. California Vaccines for Children (VFC) Program Attn: New Enrollments 85 Marina Bay Parkway, Building P, Second Floor Richmond, CA 9484

3 3. COMPLETE REQUIRED TRAININGS Clinic staff handling vaccines and the clinic s vaccine manager must complete a series of trainings focused on VFC program requirements and vaccine management. Trainings must be completed prior to enrollment and annually thereafter. A copy of the certificate of completion must be presented during the New Provider Site Visit. 4. SCHEDULE A NEW PROVIDER SITE VISIT Once your enrollment forms are received at the VFC office, they will be checked for completeness and then sent to your local VFC Field Representative (See VFC Field Representative Phone List). Your VFC Field Representative will contact the point person listed on your enrollment forms to schedule a New Provider site visit and go over the program s administrative requirements, ensure proper storage and handling of vaccines, and approve your facility for participation in our program. 5. PRACTICE APPROVAL AND UNIQUE PROVIDER IDENTIFICATION NUMBER (PIN) ASSIGNMENT Upon completion of your site visit, the VFC Field Representative will notify the VFC Office that your practice is ready and approved to be enrolled in VFC. The VFC office will issue a unique six-digit Provider Identification Number (PIN) for your practice. You will receive a VFC Welcome letter that will include your new VFC PIN, which you will need for the submission of your vaccine orders and for all interactions with the VFC Program. 6. QUESTIONS? If you have any questions, please contact VFC Customer Service at ( GET-VFC). Thank you again for your interest in participating in the State of California's VFC Program. For current forms or more information about the VFC Program please visit our website Please allow up to 3 days from the receipt of your forms for the enrollment to be completed. Enclosures- VFC Provider Enrollment Application CDPH IMM-99 (5/212) VFC Regional Field Representative List

4 State of California Health and Human Services Agency VACCINES FOR CHILDREN (VFC) PROGRAM PROVIDER ENROLLMENT FORM PROVIDER PROFILE When finished, print, sign, and mail to the CA VFC Program, 85 Marina Bay Parkway, Richmond CA 9484 It is a federal requirement that each enrolled site to which VFC Program vaccines will be delivered to must complete and submit this form upon enrollment and at least once a year to receive VFC-supplied vaccine. Each enrolled site must also re-submit this enrollment form whenever (1) the estimated number of eligible children to be served changes; (2) the status of the facility changes (e.g. a private provider becomes an agent of a federally qualified health center, etc.), or the (3) the persons with prescription-writing privileges changes. Practice Information/Shipping Practice Name PIN Practice Information/Shipping Address (No P.O. Box) City ZIP Shipping Address, Part 2 County Employer Identification Number (EIN) National Provider Identifier (NPI) Phone Fax Contact Person Address CHDP Provider? Provider Type PUBLIC TYPES: Public Health Department Public Health Department/FQHC Public Hospital Federal Qualified Health Center (FQHC)/ Rural Health Center (RHC) Other Public Heath State Licensed Community Health Center (non-federal) Contact Person MEDI-CAL Provider? Would you like to be on Yes No Yes No the VFC online locator? Yes No American Indian/ Tribal Health Clinic Youth Correctional Facilities School-Based Clinic College/University Family Planning/STD Clinic *If you marked FQHC or RHC you must submit a photocopy of your FQHC or RHC license/certification. Mailing Address or PRIVATE TYPES: Private Practice (Individual or Group) Private Hospital City Pharmacy Private Other SPECIALTY or 'SPECIALTY CLINIC' TYPES: Pediatrics Family Practice Internal Medicine Adolescent Health Multi-Specialty Ob/Gyn Family Planning American Indian/ Native American Health Clinic Mailing Address ZIP Mailing Address, Part 2 Provider of Record Last Name First Name Title Specialty National Provider ID (NPI) Medical License Number Provider of Record Address for Official VFC Letters and Memos Vaccine Coordinator Please provide the name, phone number, and address of the Vaccine Coordinator, or the person that is authorized to order vaccines on behalf of your practice, below. is the main mode of communication from VFC. Program communications and vaccine order confirmations are automatically ed to the Vaccine Coordinator and the Provider of Record. You may also provide additional address(es) to receive vaccine order confirmations and program communications. Vaccine Coordinator Name Phone Vaccine Coordinator Address Additional Addresses to Receive Vaccine Order Confirmation and Program Communications (Optional) Page 1 of 6 IMM-99 (1/13)

5 State of California Health and Human Services Agency VACCINES FOR CHILDREN (VFC) PROGRAM PROVIDER ENROLLMENT FORM PROVIDER SUPPLEMENTAL INFORMATION Vaccine Storage Units INDICATE YOUR REFRIGERATOR STORAGE UNIT TYPES BELOW: Type: Small/under counter* Stand alone refrigerator Type: Small/under counter* Stand alone refrigerator Patient Estimates Number of Units: Combination Commercial/pharmacy grade Number of Units: Combination Commercial/pharmacy grade *Dormitory style units are not acceptable units. Under-counter units must be pharmacy or laboratory grade. Estimated number of children who will receive immunizations at your practice or clinic for a 12-month period, by category: TOTAL VFC-ELIGIBLE a. CHDP/Medi-Cal Eligible b. Without Private Insurance c. American Indian or Alaskan Native d. Underinsured (FQHCs RHCs only) NON-VFC ELIGIBLE ALL CHILDREN List of Health Care Providers with Prescription Writing Privileges INDICATE YOUR FREEZER STORAGE UNIT TYPES BELOW: Type: Number of Units: Small/under counter Combination Stand alone freezer Commercial/pharmacy grade Type: Small/under counter Stand alone freezer Number of Units: Combination Commercial/pharmacy grade Ages (Note: Do not count a child in more than one category.) <1 yr 1 6 yrs 7 18 yrs Instructions: Use this form to list all health care providers at your facility with prescription writing privileges who will administer VFC Program-provided vaccines. Note: It is not necessary to include the names of all staff who may administer VFC vaccine, but rather only those who possess a medical license or are authorized to write prescriptions. # Last Name First Name National Provider ID (NPI) Medical License Number Title Specialty code TOTAL Page 2 of 6 IMM-99 (1/13)

6 State of California Health and Human Services Agency VACCINES FOR CHILDREN (VFC) PROGRAM VFC PROVIDER ENROLLMENT AGREEMENT To participate in the Vaccines for Children (VFC) Program and receive publicly funded vaccine provided to my facility at no cost, I agree to the following conditions, upon enrollment and annually thereafter, on behalf of myself and all the practitioners, nurses and others associated with this medical practice, group practice, managed care organization, community/migrant/rural clinic, hospital, health department, or other health delivery facility of which I am the physician-in-chief or equivalent: 1) Screen patients and document eligibility status at each immunization encounter for VFC eligibility and administer VFC-purchased vaccine only to children who are 18 years of age or younger who meet one or more of the following categories: i) are an American Indian or Alaska Native ii) are enrolled in Medicaid iii) have no health insurance iv) are underinsured: A child who has health insurance, but the coverage does not include vaccines; a child whose insurance covers only selected vaccines (VFC-eligible for non-covered vaccines only). Underinsured children are eligible to receive VFC vaccine only through a Federally Qualified Health Center (FQHC), or Rural Health Clinic (RHC) or under an approved deputization agreement 2) Comply with immunization schedules, dosages, and contraindications that are established by the Advisory Committee on Immunization Practices (ACIP) and included in the VFC program unless: i) In the provider's medical judgment, and in accordance with accepted medical practice, the provider deems such compliance to be medically inappropriate; ii) The particular requirements contradict state law, including laws pertaining to religious and other exemptions. 3) Maintain all paper-based or electronic records related to the VFC program (including but not limited to patient screening/eligibility verification and documentation, temperature logs, etc.) for a minimum of three years, or longer if required by state law, and make these records available to public health officials, including the state or Department of Health and Human Services, (DHHS) upon request. 4) Immunize eligible children with VFC-supplied vaccine at no charge to the patient for the vaccine. 5) Not charge a vaccine administration fee to non-medicaid VFC-eligible children that exceed the administration fee cap of $26.3 per vaccine dose. For Medicaid VFC-eligible children, accept the reimbursement for immunization administration set by the state Medicaid agency or the contracted Medicaid health plans. 6) Not deny administration of a federally purchased vaccine to an established patient because the child's parent/guardian/individual of record is unable to pay the administration fee. Pharmacies, urgent care and other specialty providers enrolling in the VFC program agree to vaccinate all walk-in VFC-eligible children and not refuse to vaccinate VFC-eligible children based on a parent s inability to pay the administration fee. 7) Distribute the most current Vaccine Information Statements (VIS) each time a vaccine is administered and maintain records in accordance with the National Childhood Vaccine Injury Compensation Act (NCVIA), which includes reporting clinically significant adverse events to the Vaccine Adverse Event Reporting System (VAERS). 8) Comply with the requirements for vaccine ordering and vaccine accountability. Agree to operate within the VFC program in a manner intended to avoid fraud and abuse. Upon request, provide information and documentation related to the purchase of private vaccine supply (if applicable to clinic s population), including purchase invoices. Be financially responsible for the replacement cost of any VFC-provided vaccines that I receive for which I cannot account or that spoil or expire because of negligence. 9) Comply with the requirements for vaccine management in accordance with CDPH Certification of Capacity to Store and Manage Vaccines, and the manufacturer's specifications. I will store VFC supplied vaccines only at the facility stipulated in this agreement, and may not transfer vaccines to another VFC program provider without approval of the VFC program. I may be required to purchase a new refrigerator or freezer unit if equipment at my practice is deemed inappropriate for vaccine storage or not able to maintain appropriate temperature. Page 3 of 6 IMM-99 (1/13)

7 State of California Health and Human Services Agency VACCINES FOR CHILDREN (VFC) PROGRAM VFC PROVIDER ENROLLMENT AGREEMENT 1) Participate in VFC program compliance site visits, storage and handling unannounced visits, and other educational opportunities associated with VFC program requirements. 11) Should my staff, representative, or I access the VFC Program s On-line Vaccine Ordering System, I agree to be bound by the terms of use for interacting with the online ordering system. I further agree to be bound by any applicable federal laws, regulations or guidelines related to accessing a state and federal system and ordering publically funded vaccines. 12) I will identify a vaccine coordinator in my practice and each member of my staff who is authorized to order vaccines on my behalf. In addition, I will maintain a record of each staff member who is authorized to order vaccines on my behalf. If changes occur, I will inform the VFC Program within 24 hours of any change in status of current staff members or representatives who are no longer authorized to order vaccines, or the addition of any new staff authorized to order on my behalf. I certify that my identification is represented correctly on this provider enrollment form. 13) This agreement may be terminated at any time for personal reasons or the State may terminate this agreement at any time for failure to comply with these requirements. Should this agreement be terminated, I must follow program procedures for disenrollment and the return of all unused (viable and non-viable) VFC vaccine to the VFC Program. To agree to these federal requirements, type your name, your medical license number, today's date, and sign in the boxes below. Provider of Record Name (print) Medical License Number Date Provider of Record (signature) Page 4 of 6 IMM-99 (1/13)

8 State of California Health and Human Services Agency VACCINES FOR CHILDREN (VFC) PROGRAM CERTIFICATION OF CAPACITY TO STORE AND MANAGE VACCINES I, on behalf of myself and any and all practitioners associated with this medical office, group practice, Health Maintenance Organization (HMO), health department, community/migrant/rural clinic, hospital, or other entity of which I am the physician-inchief, medical director or equivalent, agree to comply with each of VFC's requirements listed below. 1. Comply with Vaccine Storage Equipment Requirements Providers must have appropriate equipment that can store vaccine and maintain proper conditions. Equipment must comply with VFC vaccine storage equipment requirements ( New providers must have separate refrigerator only and freezer only units for storage of vaccines. Dormitory refrigerators are not allowed for vaccine storage, under any circumstance. Vaccine storage units must be dedicated to the storage of vaccines. (Food and beverages must not be stored in a vaccine storage unit because this practice results in frequent opening of the door and destabilization of the temperature). 2. Designate a Vaccine Coordinator Designate one fully trained staff member to be the primary vaccine coordinator and at least one back-up person able to perform the same responsibilities as the primary vaccine coordinator in the event that the primary person is unavailable. Responsibilities are outlined in the Vaccine Coordinator Guide. The Provider of Record is responsible for maintaining compliance with annual training requirements for the vaccine manager, back-up and other clinic staff handling and storing vaccines. Documentation of training must be maintained in each staff member s personnel file. The VFC Program shall be contacted immediately to report a change in the primary vaccine manager. 3. Follow Established Vaccine Storage Guidelines Refrigerator and freezer units will be set up properly. Vaccine shall be stored in its original packaging and positioned 2-3 inches away from walls, floor, and with space for air circulation. VFC vaccine and private vaccine will be kept separate and clearly labeled. Within each supply, vaccines will be grouped by type and clearly labeled in designated spaces for each vaccine type. Vaccine will not be stored in the doors, drawers or bins. Thermometers or their probes will be placed in the center of both the refrigerator and freezer. Signs to prevent interruption of power to the vaccine storage units ("Do Not Unplug" warning signs) will be posted on the electrical outlets, and circuit breakers. The refrigerator and freezer will be plugged into separate wall outlets that are not controlled by a light switch. No food or drinks will be stored in the units. Water bottles shall be placed in the refrigerator and ice packs in the freezer to stabilize the temperatures. 4. Use Certified, Calibrated Thermometers Each storage unit must have a NIST certified and calibrated primary thermometer and a back-up thermometers centrally located within each unit. Each device is to be covered by a Certificate of Traceability and Calibration Testing (also known as Report of Calibration). Thermometer calibration must be tested annually by a laboratory with accreditation from an ILAC MRA signatory. Providers are responsible for maintaining Certificates of Traceability and Calibration Testing (also known as Report of Calibration) and available for review. Thermometer deemed no longer accurate within, +/-1 F (+/-.5 C) upon calibration shall be replaced. At minimum, the primary thermometer must be digital and have a biosafe glycol-encased probe. The digital display shall be placed on the outside of the unit to allow temperature monitoring without opening the doors. Batteries, if required, will be replaced every 6 months. 5. Store Vaccines at Recommended Temperatures Vaccines will be maintained at all times within the recommended ranges. Vaccines stored in freezer (MMR, MMRV, and Varicella) will be maintained at 5 F or below (aim for F or lower to keep temperatures from getting too warm). All other vaccines will be stored in a refrigerator maintained at a temperature above 35 F and below 46 F (Aim for 4 F to keep temperatures from getting too warm or cold). 6. Monitor and Record Refrigerator and Freezer Temperatures Twice a Day The Vaccine Manager shall monitor and record the temperatures (including the minimum and maximum temperatures since the last reading) in the refrigerator and freezer twice each day. If other staff will be assigned to monitor the temperatures, they must be trained on use of the thermometer and how to respond to and document out of range temperatures. The current temperature and minimum/maximum temperatures will be recorded on the VFC-provided temperature logs. The logs will be posted on the vaccine storage unit door or in a nearby, readily assessable location and maintained for review for three years. Temperatures shall be taken and recorded twice each day, at the beginning and end of the day, even if a continuously recording/graphing thermometer or data logger is in use. If the temperature is identified as out of range, immediate action will be taken to prevent spoilage of the vaccine and correct improper vaccine storage condition. This action will be documented on the temperature log and the VFC Program will be contacted immediately. Page 5 of 6 IMM-99 (1/13)

9 State of California Health and Human Services Agency VACCINES FOR CHILDREN (VFC) PROGRAM CERTIFICATION OF CAPACITY TO STORE AND MANAGE VACCINES 7. Clearly Identify VFC Vaccine from Privately Purchased Vaccine VFC vaccine and private vaccine will be kept separate and clearly labeled to allow easy identification and prevent use on ineligible patients. Vaccines will be labeled either VFC or private for clear identification and ideally, kept on different shelves to minimize potential for confusion. Accurate and separate stock records (purchase invoices) of privately purchased vaccines must be maintained and be available for review upon request. 8. Maintain and Rotate Stock Inventory management shall be conducted by the practice s vaccine coordinator or designee at least once a month and before ordering vaccine. VFC vaccine stock must be maintained in accordance with actual vaccine need. An additional two weeks of safety stock may be maintained to prevent vaccine shortage in the event of shipment delays. Vaccine stock will be rotated to place the vaccine with the shortest expiration date for use first. The VFC Program will be notified of any vaccine that will expire within the next 6 months that will not be used. Vaccine will be maintained in its original packaging until it is used. Spoiled and expired vaccine will be removed from the vaccine storage unit immediately to prevent inadvertent use. A report of all expired or spoiled, VFC supplied vaccines will be submitted to the VFC program prior to submitting a new vaccine request. Affected vaccines will be returned to the program s vaccine distributor for excise tax credit within 3 months of expiration/spoilage. 9. Monitor Vaccine Storage Unit Capacity to Store Vaccines-especially during flu season The Vaccine Manager shall continuously monitor the capacity of the vaccine storage units to ensure adequate space for Inventory, especially during flu season. Additional vaccine storage units may be purchased if the size of the current unit cannot accommodate the inventory in a manner consistent with VFC requirements. 1. Immediate Notification of the VFC Program for Storage and Handling Incidents or Vaccine Shipment Issues If the refrigerator or freezer units experience out of range temperatures, immediate action will be taken to prevent spoilage of the vaccine. This includes extended power outages and vaccine storage unit malfunctions. Depending on the situation, this may necessitate transporting the vaccines as outlined in the emergency plan. Vaccines exposed to out of range temperatures will be marked Do Not Use until direction is received from the VFC Program. Contact the VFC Program within two hours of identification of the out of range temperatures. Shipment issues will be reported to the VFC Program within 2 hours of receiving the shipment. 11. Order and Account for all VFC Vaccines in Accordance with Practice s Patient Estimates and VFC Guidelines Vaccines will be ordered in accordance with practice-based eligibility data, assigned order frequency, vaccine usage, and inventory on-hand at the time of order placement. Practice shall order all vaccines at one time. An accurate report of each VFC vaccine dose administered within each ordering period will be maintained. A summary of vaccine administration and on-hand inventory shall be submitted with each vaccine request. All VFC vaccine doses will be accounted for. Vaccine doses not accounted for or lost due to negligence will be replaced at the expense of the Provider of Record for the site. 12. Receive and Unpack Vaccine Shipments Immediately Upon Arrival Vaccine shipments will not be rejected. All staff who may accept packages for the clinic must be aware that vaccine shipments require immediate attention. When new shipments arrive, vaccines should be unpacked immediately. Immediately upon receipt, vaccine shipments will be inspected to verify the temperature during transport has not been out of range and that the vaccines included in the shipment match those listed on the invoice. Any shipment discrepancies or issues must be reported to the VFC program within 2 hours of shipment delivery. Any change in the practice availability to receive vaccine shipments will be immediately reported to the VFC Program. Practice will assume responsibility for all VFC vaccine shipped to the site. To receive VFC Vaccines, you must confirm acknowledgement of this agreement. You may be held financially responsible for replacing vaccines doses lost due to negligence if you do not comply with the above requirements. Provider of Record Name (print) Date Provider of Record (signature) Page 6 of 6 IMM-99 (1/13)

10 The VFC Programs was created to meet the vaccination needs of children from birth through 18 years of age. Who s Eligible * Children eligible to receive VFC provided vaccines are:?medicaid (Medi-Cal) Child Health & Disability Prevention (CHDP) Program No Health Insurance* Under-Insured** American Indian Alaskan Native State of California VFC Program Phone: (877) 2GET-VFC Fax: (877) FAXX-VFC Providers may charge cash patients who have no health insurance an administrative fee up to a maximum of $26.3 per dose. * * Underinsured means your patient has health insurance, but it won t cover vaccine(s), only covers selected vaccines, or it has a fixed dollar limit for vaccines. These children are eligible for the non-covered vaccines or after the cap/dollar limit has been reached. Under-insured children are eligible to receive VFC-supplied vaccines only at Federally Qualified Health Center (FQHC) or Rural Health Center (RHC). IMM-188 (2/13)

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12 Vaccine Freezer Setup Preparing for Vaccine Storage 1 Put cold packs in areas where vaccines should not be stored, including the freezer door and on the top shelf of the freezer. Co Pa k Co d Pack Co d Pa k Co d Pack Co d Pack Co d Pack Co d Pack C ld P ck C ld P ck 2 Co d Pa C ck Co d Pack Co d Pack C ld Pack Two thermometers are needed to ensure accurate temperatures. Many practices use a digital thermometer as the primary thermometer and a liquid-filled or dial thermometer as the back-up. In a stand-alone freezer, place the digital thermometer probe and the back-up thermometer in the center of the freezer, next to the vaccine. 3 Attach the display of the digital thermometer to the outside of refrigerator, either on the door or on the side. 4 Plug in the freezer. Secure with plug guard/cover. Post Do Not Unplug sign. WARNING! Do Not Unplug Set the temperature modes. 5 Cold Normal temp display Colder Set the freezer temperature. If the freezer has a thermostat, set it at -5ºF. If it has a dial with a range of numbers, set it in the middle. The next morning, check the temperature and adjust it until it stabilizes below ºF. 6 Once the temperature has stabilized, start recording temperatures on the temperature log twice a day. Do not store vaccines in the freezer until the temperature stays below ºF for 3 5 days. F º Freezer Temperature Log *Write in temperature if above 5 F Then take action! Danger! Temperatures above 5ºF are too w 5ºF 4ºF 3ºF 2ºF 1ºF A m for ºF or below) 1ºF 2ºF 3ºF 4ºF < 5ºF Acceptab e Temperatu es Staff Initials Day of Month Time am pm am pm am pm am pm am Immunization Branch IMM-965 (3/12)

13 F 2 Vaccine Refrigerator Setup Storing Vaccines Carefully organizing vaccines in a refrigerator helps protect vaccine and facilitates vaccine inventory management. Refrigerate all vaccines except MMRV, Varicella, and Zoster. Refrigerator-only Unit Almost all of the space is usable (inside dashed lines). Place vaccine in breathable plastic mesh baskets and clearly label baskets by type of vaccine. DTaP Hep B Hib IPV No vaccine in doors. Group vaccines by pediatric, adolescent, and adult types. VFC Vaccine PCV Rota Rota Hep A VFC Vaccine No vaccine in solid plastic trays or containers. Separate the VFC vaccine supply from privately purchased vaccine. 4º MCV Tdap HPV Flu VFC Vaccine No food in refrigerator. DTaP Hep B Hib IPV Keep baskets 2-3 inches from walls and other baskets. Privately purchased vaccine No vaccine in drawers or on floor of refrigerator. Keep vaccines in their original boxes until you are ready to use them. H Store only vaccine and other medication in vaccine storage units. Keep vaccines with shorter expiration dates to front of shelf. If you have vaccine that will expire in 3 months or less that you will not be able to use, notify the VFC Program. Expires in 9 months Expires in 3 months Keep temperatures between 35ºF to 46ºF. Below 35ºF is too cold! Call VFC. Aim for 4º F Above 46ºF is too warm! Call VFC. If you have any problems with your refrigerator, keep the refrigerator door shut and notify the California VFC Program. VFC Program Office (877) VFC Field Representative Immunization Branch IMM-963 (12/9)

14 F Vaccine Freezer Setup Storing Vaccines Carefully organizing vaccines in a refrigerator helps protect vaccine and facilitates vaccine inventory management. Freeze MMR, MMRV, Varicella, and Zoster vaccines. Stand-alone freezer Place vaccine in breathable plastic mesh baskets and clearly label baskets by type of vaccine. Do not block air vents with vaccine. Cold ack Cold Cold Pa MMRV MMRV VFC Vaccine MMRV MMRV Separate the VFC vaccine supply from privately purchased vaccine. MMR MMR Varicella Varicella VFC Vaccine Cold Pac MMR MMR Varicella Varicella Keep vaccines with shorter expiration dates to front of shelf. Privately purchased vaccine If you have vaccine that will expire in 3 months or less that you will not be able to use, notify the VFC Program. Expires in 9 months Expires in 3 months Chest freezer Keep temperatures 5ºF or colder. Aim for º F and below MMR shortdated shortdated VFC vaccine Varicella Colder is better. Above 5ºF is too warm! Call VFC. If you have any problems with your refrigerator, keep the refrigerator door shut and notify the California VFC Program. VFC Program Office (877) VFC Field Representative Immunization Branch IMM-966 (3/12)