VFC Vaccine Coordinator Education

1. VFC Vaccine CoordinatorEducation Valerie MacKenzie Provider Relations Specialist

2. Objectives • Learn the responsibilities of being a vaccine coordinator. • Know the eligibility criteria for Federally Vaccine-eligible children (VFC eligible) and State Vaccine-eligible children. • Understand the requirements of the program to maintain compliance. • Learn about preventable wastage and how to avoid having preventable wastage. Maine Center for Disease Control and Prevention

3. Vaccine Coordinator Role • What is the role of vaccine coordinator for Maine Immunization Program (MIP)? • It is required by federal. • Ensure program requirements are followed. • Point personal for contact. • Who can be a vaccine coordinator? Maine Center for Disease Control and Prevention

4. Provider Agreement • Every site must complete a Provider Agreement every other year. • Vaccine coordinators are responsible for completing and maintaining the information in the agreement. Maine Center for Disease Control and Prevention

5. Eligibility Categories • Federally Vaccine-eligible children (VFC eligible) are: • American Indian or Alaska Native; • Enrolled in Medicaid; • Uninsured (self pay); • Underinsured (insurance does not pay for vaccines) and; • Under the age of 19. • Every child at every visit must be screened and documented for Vaccine for Children eligibility. Paper screening (save for three years with all other VFC related documentation) or • Electronic screening (done in ImmPact). • State Vaccine-eligible children are: • Privately insured, • Under the age of 19 and, • Have a Maine residence. Maine Center for Disease Control and Prevention

6. Required Federal Documentation Elements • Address of clinic where vaccine was administered • Name, manufacturer, and lot number of vaccine administered • Date when the dose was administered • Name and title of the individual administering the vaccine • Date when VIS was given and VIS publication date Maine Center for Disease Control and Prevention

7. Requirements • Your site cannot charge an administration fee that exceeds $21.58. • Your site cannot deny administration of publicly purchased vaccine to an established patient due to inability to pay the administration fee. • Your site will distribute the current Vaccine Information Statements every time vaccine is administered. • Do not pre-draw vaccines. Maine Center for Disease Control and Prevention

8. Temperatures • Check temperatures every morning on every unit on days the practice is open. • The morning (practice opening) recording will be the min/max temperature for the last 12 hours. • All temperatures will be recorded onto a log for each month (a.k.a. temperature log). Maine Center for Disease Control and Prevention

9. Temperature Logs • There will be a temperature log for every storage unit. • All temperature logs will have on them: • Date • Min/max temperatures for the pervious 12 hours in the morning, • Time that each temperature was taken, • Days the practice are close will be indicated and, • Initials of the person taking down the temperature. Maine Center for Disease Control and Prevention

10. Sample Temperature Log Maine Center for Disease Control and Prevention

11. The To Do’s and Not to Do’s Maine Center for Disease Control and Prevention

12. Storage • Best practice is to use are stand-alone storage units. • If using a combination unit, only use the refrigerator section. • Must have adequate space around the vaccine for air flow. • Temperature probes should be as close to the center as possible. • Vaccines cannot be on the bottom of the unit. • Vaccines cannot be on the door of the unit. • Vaccines cannot be in vegetable/fruit draws in a unit. • Never store vaccines in a dorm style storage unit. • Do not unplug stickers are near the outlet/on unit. • Do no unplug sticker with breaker number on the breaker box. • Public stock of vaccine and private stock are clearly labeled Maine Center for Disease Control and Prevention

13. Thermometers • All Thermometers must be digital data loggers (primary and backup). • Active temperature display that can be easily read from the outside of the unit • Capacity for continuous monitoring and recording capabilities where the data can be routinely downloaded  • Alarm for out-of-range temperatures • Current, minimum, and maximum temperatures display • Low battery indicator • Accuracy of +/- 1°F (0.5°C) • Memory storage of at least 4,000 readings • User programmable logging interval (or reading rate) at maximum time interval of every 30 minutes • A probe that best reflects the temperature of the vaccine (such as a • buffered probe) • Have a primary and backup data logger for each unit. • Must be currently calibrated and have calibration certificates available Maine Center for Disease Control and Prevention

14. Temperature Excursions • Any temperature above 46° or below 36° Fahrenheit for a refrigerator unit. Any temperature above 5° or below -58° Fahrenheit for a freezer unit. • Quarantine vaccines and label the vaccines “Do Not Use". • Follow site’s emergency plan to move the vaccine to a stable storage unit. • Download data logger. • Call manufacturers of all vaccines in your unit(s). • Call Maine Immunization Program if vaccine needs to be wasted. Maine Center for Disease Control and Prevention

15. Data Entry • By law, administered State supplied vaccines must be entered into ImmPact within 5 business days. Maine Center for Disease Control and Prevention

16. Inventory Reconciliation • Compare what is in your site’s inventory in ImmPact to what is in your site’s units. • Unit count of stock • Rotate stock (and when vaccine is received) • Number of doses need to match • Administered (interfaced?) • Wastage Maine Center for Disease Control and Prevention

17. Expired Vaccine • All expired vaccines must be returned to the manufacturer. • If a vaccine expires remove it from your inventory by placing it into a paper/plastic bag. Clearly label the bag “Do Not Use”. You will continue the process by logging into ImmPact. • 1. Make sure your temperature logs are entered and saved within 24 hours of calling • us to return vaccine. • 2. You will need to click on Manage Transfer, then New Transfer. • 3. Choose the Inactive or Expired radio button. • 4. Find your vaccine that has expired. • 5. Enter the amount you are returning in the Transfer Quantity. • 6. Scroll up to your search string. • 7. Type Maine in the empty space and click search. • 8. In the Organization drop down, choose Maine Immunization Program. • 9. Click Save. • 10. Click the Packing List button. Open and close. (You do not have to print ) • 11. Click Ship • 12. Click Ship (again) • 13. You will see a message that transfer was successful. • Now call vaccine management at 287-3347 to go through the process to get return labels for the vaccine. Maine Center for Disease Control and Prevention

18. Educational Requirements • Every new vaccine coordinator needs to complete the Vaccines for Children and Storage & Handling “You Call the Shots” modules. • Every year the vaccine coordinators will need to meet an educational requirement by either; • completing “You Call the Shots Storage & Handling Module” or • completing a VFC Compliance site visit with MIP Staff. • https://www.maine.gov/dhhs/mecdc/infectious-disease/immunization/annual-education-requirement.shtml Maine Center for Disease Control and Prevention

19. Preventable Wastage • All sites have a 5% preventable Wastage Allowance. • 3% is a warning level and a warning letter will go to the site (if possible). • 5% is the level of when vaccine will need to be replaced dose for dose. • All sites receive a threshold report in the beginning of the year that notifies the site of it’s preventable wastage allowance. • How do I avoid having preventable wastage? Maine Center for Disease Control and Prevention

20. What do I do if I forget to write the temperatures on the temperature log and notice the next day? • Download the data logger and print out the Summery tab on the LogTag Analyzer for the date range in question. • Reading range is the min and max of temperatures for all of the dates that is in this range. • Average readings is the average temperature for all the reading in the date range which could be used as the current temperature when inputting data into ImmPact. • The last three categories will show if there has been a temperature excursion and for how long. Ideally these will show nothing. • Attach the summary print out to the temperature log. Document on the temperature log in comments to see the attached data logger summery for the date in question. Please make note of why the day is blank for temperatures. The blank dates can be left blank or could have a line through them to prevent accidently putting any data into these slots. Please make note of this in comments on the temperature log. Maine Center for Disease Control and Prevention

21. I download the data logger and it just says ‘Ready’, what do I do? • Hold down the start button and the word “Starting” will appear and will begin to blink. This may take a minute or two but continue to hold down the button. When “Starting” stops blinking release the button and the screen should return to the normal format of recording temperatures. Maine Center for Disease Control and Prevention

22. What do I do if the data loggers says stopped? • This means that the data logger’s memory is full and it can not record anymore temperatures until the memory has been cleared. • First down load the data logger. • Review the data to confirm the dates that the reports shows temperatures for. • If there are missing days of temperatures it can not be confirmed the vaccines cold chain has been in range. The stock of vaccine may be deemed not viable. • If this preventable wastage goes over the sites 5% preventable allowance than the site will be required to replace vaccines. • If the unit has a back up data logger or equivalent system recording temperature that meets MIP requirements, temperatures can be used. Maine Center for Disease Control and Prevention

23. Program Contacts • Maine Immunization Program • Maine line: 287-3746 • Fax line: 287-8127 • Email: ImmunizeME.DHHS@maine.gov • Website: https://www.maine.gov/dhhs/mecdc/infectious-disease/immunization • Educator line: 287-9972 • Vaccine Management line: 287-3347 • ImmPact Help Desk line: 287-3006 • ImmPact Help Desk email: ImmPact.Support@maine.gov • ImmPact website: https://immpact.maine.gov Maine Center for Disease Control and Prevention

24. AFIX • If your site is interested in immunization rate improvement please contact Clara Alvarez. • clara.alvarez@maine.gov • 287-4068 Maine Center for Disease Control and Prevention

25. Questions Maine Center for Disease Control and Prevention

26. Questions? Valerie MacKenzie Provider Relations Specialist Valerie.mackenzie@maine.gov 287-3862 Maine Department of Health and Human Services Center for Disease Control and Prevention