See Who is on the Provider Honor Roll
VFC Topics for Providers
Provider Quality Assurance Unit
In New York City, the Provider Quality Assurance (PQA) Unit oversees the review and evaluation of VFC provider practices and is implemented through VFC and AFIX (Assessment, Feedback, Incentives, and eXchange) site visits, chart reviews, and analysis of electronic immunization records, vaccine ordering, and vaccine utilization through NYC's Citywide Immunization Registry (CIR).
What are the benefits of participating in the VFC Program?
- It will enhance your ability to provide government purchased vaccine to your eligible patients and reduce your out-of-pocket costs.
- You can fully vaccinate all children with ACIP recommended vaccines
- No longer have to refer patients for immunizations.
- Increased community immunization coverage levels.
- For most vaccines VFC offers a choice of manufacturers.
- Medicaid provides a vaccine administration fee of $25.10 per VFC vaccination.
- Provider enrollment is easy and vaccines are delivered directly to your private office or health care facility within two weeks of placing your order.
- You will receive excellent customer service to address your questions.
back to top
How to enroll in the VFC Program
Download the Provider Enrollment Form/Provider Profile directly or contact the NYC DOHMH Bureau of Immunization Vaccine Management Unit (VMU) by calling (347) 396-2404.
Complete the forms and return them by fax to (347) 396-2559.
Prepare your office and staff for a site visit to review both the administrative requirements of the program and the proper storage and handling guidelines for the vaccines.
back to top
What to expect during your site visit
Providers new to VFC should expect to set aside one hour for the site visit in order to meet with a representative from the VFC Program to review the following topics:
- VFC eligibility screening procedures;
- Verification of information in the Provider Profile;
- the VFC Site Visit Questionnaire;
- VFC vaccine administration, storage and handling;
- VFC program policies and implementation;
- Feedback and correction of any identified problems.
Previously enrolled providers should expect to set aside one hour for the site visit in order to meet with a representative from the VFC Program to review the topics outlined above and present a number of patient charts for review. Based on the volume of patients seen at your practice, the number of charts reviewed may vary and should be randomly selected by VFC or by your staff.
Most of the materials provided in the enrollment package may be downloaded directly from the VFC website. See the “forms, charts, and handouts” section.
back to top
Provider Vaccine Management Requirements
All providers must be able to meet the following requirements in order to participate in New York City's VFC program:
- Designate one staff member to be the primary vaccine coordinator and at least one back-up vaccine coordinator who is able to perform the same responsibilities as the primary vaccine coordinator in the event that the primary person is unavailable. These positions will be responsible for all vaccine management within the office.
- The designated vaccine coordinator and backup will be responsible for the following vaccine management activities:
- Adjusting the temperature of a vaccine storage unit, and -
- Documenting the temperature on the temperature logs for each storage unit.
- The primary vaccine coordinator should review temperature logs weekly if daily monitoring is being conducted by the backup person. The backup staff should monitor the temperature logs weekly if the primary coordinator is recording the daily temperatures.
- The primary and backup vaccine coordinators are responsible for training other staff who are responsible for administering vaccines or who may be required to transport vaccine in an emergency situation. A simple log sheet with the staff member's name and date of training should be kept as documentation.
- Unless otherwise noted, the vaccine coordinator and/or backup should be the VFC contacts for the office.
Storage and Handling Plans
Providers may develop their own written routine and emergency storage and handling plans or use CDC’s Checklist for Safe Vaccine Handling and Storage (PDF). Both the routine and the emergency plans should be simple, and the processes outlined in the plan should be presented in a clear and concise manner. Both plans should be reviewed and updated as necessary.
- The routine vaccine storage and handling plan should include guidance on the following aspects of routine vaccine management:
- Ordering vaccines
- Controlling inventory
- Storing vaccines and monitoring storage conditions
- Minimizing vaccine wastage
- Vaccine shipping, including receiving, packing and transporting
- The emergency vaccine storage and handling plan should include guidance on what to do in the event of refrigerator or freezer malfunctions, power failures, natural disasters, or other emergencies that might compromise appropriate vaccine storage conditions The emergency plan should include the following:
At a minimum the emergency plan must be reviewed and updated annually (or as necessary) or when there is a change in staff that have responsibilities specified in the emergency plan.
- Person(s) responsible for preparing and transporting vaccine, including contact information
- How this person will be notified that vaccine needs to be moved
- Location that will receive vaccine
- How receiving location will be notified of transport
- How to pack vaccine for transport
- Worksheet to document vaccine involved in power or equipment failure
Vaccine Storage Equipment
Providers must have appropriate equipment that can store vaccine and maintain proper conditions. If a provider does not have the appropriate storage units, the Provider Quality Assurance (PQA) Unit will work with providers to obtain storage units that are acceptable.
The minimum requirements for types of storage units are:
1. A refrigerator that has a separate freezer compartment with a separate exterior door, or
2. Stand-alone refrigerators and freezers.Dormitory style refrigerator/freezer units and single door refrigerator/freezer units are NOT acceptable for the permanent storage of vaccines. Any frozen vaccines (e.g. varicella-containing vaccines) should NEVER be stored in these types of storage units.
Refrigerators or freezers used for vaccine storage must comply with the following requirements:
- Be able to maintain required vaccine storage temperatures year-round;
- Be large enough to hold the year's largest inventory;
- Have a working thermometer certified in accordance with National Institute of Standards and Technology (NIST) or the American Society for Testing and Materials (ASTM) standards placed in a central area inside each storage compartment;
- 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.).
Storing bottles of water (labeled “do not drink”) in the refrigerator and ice packs in the freezer will help maintain the internal temperature(s) of the unit(s). Vaccines should be stored with air space between the stacks and the sides/backs of the unit to allow cold air to circulate freely around the vaccine. Never store vaccines on the door or in the crisper compartments, as these areas may be warmer than the recorded temperatures.
Providers are required to have working certified and calibrated thermometers in all storage refrigerator and freezer compartments. Standard fluid filled or dial thermometers are acceptable as are digital thermometers and continuous read units. When using digital thermometers remember to change the batteries regularly and to use non digital thermometers in each unit as back up thermometers for added protection in ensuring vaccines stay viable and potent.
Providers should monitor and log temperatures of both the refrigerator and freezer sections of all vaccine storage units twice a day. In addition, VFC recommends that you document all corrective actions taken (thermostat adjustment, calling the vaccine manufacturers, etc.) for each occurrence that a storage unit is out of temperature range.
Vaccine Storage Practices
The vaccine storage practices listed below can be the responsibility of the vaccine coordinator or can be delegated to another staff member. If the practices are delegated, the vaccine coordinator should monitor these activities periodically.
- Rotate vaccine stock by placing vaccines with shorter expiration dates in front of those with longer expiration dates; check for short-dated vaccine.
- Notify the PQA Unit of any vaccine doses that will expire before they can be administered. Only with the approval and direct guidance of the PQA Unit and only if the cold chain can be ensured, redistribute short-dated vaccines to high-volume providers who are able to administer it before it expires.
- Store vaccines that require refrigeration in the middle of the refrigerator compartment away from the coils, walls, floor, and cold air vent.
- Store vaccines that require freezer storage in the middle of the freezer compartment, away from the walls, coils, and peripheral areas.
- Space stored vaccine to allow for cold air circulation around the vaccine.
- Do not store vaccines in the door of the storage unit.
Temperature monitoring should be the primary responsibility of the vaccine coordinator and backup. If other staff must monitor temperatures, those persons must be trained on how to respond to and document actions taken when temperatures are outside the appropriate range.
- Post a temperature log on the vaccine storage unit door or nearby in a readily accessible place.
- Record refrigerator and freezer temperatures twice each day (in the morning and afternoon) ensuring that refrigerator temperatures are between 35° and 46° F (2° and 8°C). The freezer temperature must be between -58��F and +5��F (-50��C and -15��C). Twice-daily temperature monitoring and recording is required even if a continuous graphing/recording thermometer or a digital data logger is used.
- Take immediate action to correct improper vaccine storage conditions, including inappropriate exposure to light and inappropriate exposure to storage temperatures outside the recommended ranges. Document actions taken on the temperature log.
- Maintain an ongoing file of temperature logs, and store completed logs for 3 years.
- Immediately check vaccine cold chain monitors and document the temperature inside the transport unit when vaccine arrives at office or clinic. The cold chain monitors are single-use devices that come in three basic types: those that indicate whether packages have reached temperatures that are too warm, those that indicate whether packages have reached temperatures that are too cold, and those that continuously record the temperature. These types of monitors are designed to be irreversible indicators of inappropriate temperatures.
- Take proper action if cold chain monitor was activated.
- Develop a policy, complete with protocols and procedures, for maintaining the vaccine cold chain during transport to off-site clinics or emergency storage locations. See guidelines: Maintaining the Cold Chain During Transport (PDF).
- Notify the PQA Unit of vaccine cold chain failure/wastage incidents involving publicly funded vaccines promptly after discovery of the incident. Follow PQA guidance on how to document and report the incident.
- Implement written procedures for reporting and responding to losses resulting from vaccine expiration, wastage, and compromised cold chain.
- Remove wasted/expired vaccine from storage containers with viable vaccine to prevent inadvertent administration.
- Return, as directed by PQA, all spoiled or expired publicly-purchased vaccines for excise tax credit.
It is not acceptable clinical practice to pre-draw vaccines into syringes. Providers should draw vaccine only at the time of administration to ensure that the cold chain is maintained and the vaccine is not inappropriately exposed to light.
Vaccine Ordering and Inventory Management
- Order vaccine in accordance with actual vaccine need; avoid stockpiling or build-up of excess vaccine inventory.
- Develop and maintain complete, accurate and separate stock records for both public and private vaccines. The requirement to keep separate records does not necessitate having separate storage units for public and private vaccines. Providers must be able to distinguish between their public and private vaccine stock.
Vaccine Security and Equipment Maintenance
Post warning notices at both the electrical outlet and the circuit breaker to prevent power from being disconnected.
For more information on vaccine storage and handling, visit the CDC’s Recommendations and Guidelines for Vaccine Storage and Handling.
back to top
How to order your vaccines
All Vaccine Orders are done online using the Vaccine Ordering & Management Tool in the Citywide Immunization Registry (CIR) Online Registry.
To access the tool, go to www.nyc.gov/health/cir and click on the Online Registry button. After logging in, go to the VFC icon on the toolbar and tab on ‘Order VFC Vaccine’ to begin placing your order.
For questions regarding your online vaccine order, please call 347-396-2405.
back to top
Vaccine shipments will arrive directly to your office or health care facility through our distributor, McKesson Specialties, via UPS or Federal Express.
All packing material is recyclable and should be recycled according to your local sanitation rules.
Note: Varicella shipments will arrive separately and should be unpacked and stored in the freezer immediately upon delivery.
The VFC program recommends keeping one or two of the shipping boxes on hand should an emergency occur and the vaccines need to be moved to another storage unit or stored temporarily in the case of defrosting a storage unit. Remember to document such activities and call the VFC program (347) 396-2405.
back to top
Returning spoiled or expired VFC vaccines
All spoiled and expired vaccines must be reported to the VFC Program by completing the Spoiled/Expired Vaccine Return Form. The VFC Program receives excise tax credit for vaccine that is returned.
Spoiled or expired vaccines should be packed into a shipping box so that they can be returned to the shipping distributor at no cost to you. Complete a Spoiled/Expired Vaccine Form to include with the spoiled vaccines. Keep a copy for your records and fax a copy to the VFC program so that the doses and the incident can be recorded under your VFC PIN. Call the VFC Program to request a postage-paid mailing labeling for returning the vaccines.
Excessive spoilage or expired vaccine instances may result in additional visits from the PQA VFC Program to determine the problem and to offer recommendations to reduce the number of instances of vaccine wastage. If mismanagement is determined your practice may need to reimburse the VFC Program for the vaccine.
back to top
Accountability and usage
The amount of vaccine ordered and administered will be tracked by the VFC program in conjunction with the CIR. Such monitoring ensures that VFC vaccines are administered only to eligible children, that mandatory CIR requirements are met, and that providers order vaccines in accordance with the number of children seen on a yearly basis.
back to top
VFC Vaccine Fraud and Abuse and Non-Compliance Procedures
To prevent, identify and investigate any suspected cases of fraud and abuse of VFC vaccine, the NYC Bureau of Immunization follows “The NYC VFC Vaccine Fraud and Abuse Policy” provided below. To report suspected cases of fraud or abuse of the VFC Program, call the Bureau of Immunization, Provider Quality Assurance Unit at 347-396-2404 or the New York State Office of the Medicaid Inspector General Fraud Hotline at 877-873-7283. Complaints may also be filed on-line.
back to top
Letters to Providers/NYCDOHMH Bureau of Immunization Publications
To search for current and past letters, click on the link below for the NYC DOHMH Archive of Letters to Providers. These letters may be used by you and your staff for reference on how best to administer the vaccines, read about program changes, and about vaccine shortages and delays.
back to top
Additional Links and Resource Materials
back to top
For more information about the Vaccines for Children program or to enroll in the program, call (347) 396-2405.
back to top