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

DTaP (diphtheria, tetanus & acellular pertussis)  The last dose of DTaP must be given after age 4  If child has had the 4 th birthday you do not need to administer the 5 th dose. 5 doses Polio  If dose #3 is on or after 4 th 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 B3 doses Measles, Mumps, Rubella  Serological testing can replace the actual dose for only MMR and Varicella. 2 doses Measles 2 doses Mumps 1 dose Rubella Varicella (chickenpox)  Vaccination required unless documentation of disease history  Serological testing can replace the actual dose for only MMR and Varicella. 1 dose

Minimum North Carolina Immunization Law 6 th 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 yrs Adacel - approved for 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 pertussis3 doses Polio3 doses Hepatitis B3 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 Eligibility Who 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 Eligibility Determining 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 Practice!  Question: What vaccine(s) does this child need while at your practice today? [By parent’s report, no contraindications]