North Carolina Immunization

Program: Basics & Beyond

Presentation Overview Part I:

Vaccination Schedules Screening for VFC Eligibility

Part II: Vaccine Administration

Part III: Documentation Administration Fees Vaccine-Preventable Communicable Disease

Part I: Schedules and Screening for

VFC Eligibility

Objectives for Schedules and Screening

Participants will gain knowledge and enhance skills of current immunization issues by: Understanding the North Carolina

immunization requirements.

Describing how to determine which children are eligible for state-supplied vaccine

Vaccination Schedules

Video

Epidemiology and Prevention of Vaccine-Preventable Diseases Schedules

Catch-Up Immunization Schedule 4 Months Through 6 Years

Catch-Up Immunization Schedule 7 through 18 Years

Minimum Ages/Intervals

Antibody-Live Vaccine

Interval Table

Live Vaccine Rule Same day or

separated by 28 days

If time intervals not met, the live vaccines given second should be repeated in 28 days

Live Virus Vaccines:MMR/Varicella/LAIV/Zoster

Child, household member, or close contact of a: Pregnant woman

Person who is immunosuppressed

Live Virus Vaccines:MMR/Varicella/LAIV/Zoster

Minimum North Carolina Immunization Law

School Entry Requirements

Minimum North Carolina Immunization Law

School Entry RequirementsDTaP (diphtheria, tetanus & acellular pertussis)The last dose of DTaP must be given after age 4If child has had the 4th birthday you do not need to administer the 5th dose.

5 doses

PolioIf dose #3 is on or after 4th birthday dose 4 is not required.

4 doses

Hib (haemophilus influenzae type B)Children beyond their 5th birthday are not required to have any Hib vaccine

3-4 doses

Hepatitis B 3 doses

Measles, Mumps, RubellaSerological testing can replace the actual dose for only MMR and Varicella.

2 doses Measles2 doses Mumps1 dose Rubella

Varicella (chickenpox) Vaccination required unless documentation of disease historySerological testing can replace the actual dose for only MMR and Varicella.

1 dose

Minimum North Carolina Immunization Law

6th Grade School Entry Requirements Td/Tdap

All children required to have a booster dose of Tdap

• 6th grade public school

• 12 years of age for private school Boostrix - approved for 10-64 yrs Adacel - approved for 11-64 yrs

Td should only be used for:• Individuals 7 through 9 years,

• Individuals over 64 yrs, or

• Anyone over 7 years who is on a catch up schedule

NC College/University Vaccine Requirements

Diphtheria, tetanus &/or acellular pertussis 3 doses

Polio 3 doses

Hepatitis B 3 doses

Measles, Mumps, Rubella

2 doses Measles

2 doses Mumps

1 dose Rubella

Healthcare Personnel Vaccination Recommendations

Questions about

Vaccination Schedules?

Screening for VFC Eligibility

NCIP Coverage Criteria

Who should be aware of coverage criteria content?

NCIP Coverage Criteria

Nursing staff

Anyone who administers vaccines to patient

Office managers

Other administrative staff

Screening Requirements For compliance with VFC Program:

Screen all patients 0 through 18 years of age to determine VFC eligibility

• Record eligibility in NCIR or on Vaccines Administered Log (VAL) each time a state-supplied dose is administered or

• Retain copies of eligibility information for 3 years following the date the vaccine was administered.

May accept parent/guardian’s declaration of VFC eligibility status

Not required to verify VFC eligibility status

Determining VFC EligibilityWho is eligible for state-supplied vaccines

Children birth through 18 years of age who are in at least one of the following categories: Medicaid eligible

• Primary/Secondary

American Indian or Alaskan Native

Uninsured• Includes unaccompanied minors without proof of insurance

presenting to local health department Title X clinics

Underinsured

Determining VFC EligibilityDetermining who is underinsured:Underinsured children are those who have a commercial

health insurance plan, but the coverage: Does not include vaccines (that is, there is no

wellness plan on the policy), or

Caps the amount for vaccines (and that cap has been met), or

Covers only selected vaccines. For the vaccines not covered on the plan, the patient may be considered underinsured.

Determining who is considered insured, and therefore not VFC eligible: Children who have health insurance that fully

covers immunization services Children who have health insurance, but whose

insurance covers only a percentage of the cost of vaccines

Children who have an insurance plan with an unmet deductible or with co-pays

Health Choice children

Determining VFC Eligibility

Questions about screening?

Put Your Knowledge into Put Your Knowledge into Practice!Practice!

QuestionQuestion:: What vaccine(s) does this What vaccine(s) does this child need while at your practice today? child need while at your practice today? [By parent’s report, no contraindications][By parent’s report, no contraindications]