Vaccines for Children Program

Initial Enrollment

Contact FloridaVFC@FLHealth.gov communicating that your provider office is interested in enrolling within the Vaccines for Children Program (VFC) and a representative will reply with the necessary information and paperwork required to participate.

Annual Enrollment

Login to Florida SHOTS to complete your Vaccines for Children Program annual enrollment process.

• If your VFC site needs to change its enrollee, primary coordinator or backup-coordinator, please complete the provider agreement form  and email the form to FloridaVFC@FLHealth.gov. This step may be needed as part of your annual enrollment process or as an update at some time during the year.

The VFC Program is not responsible for vaccine that is wasted due to incorrect delivery address or hours.

Reenrollment

Complete and submit the provider reenrollment form.

• If you have questions or encounter problems completing this form, contact the Florida VFC Program coordinator at 800-483-2543 or FloridaVFC@FLHealth.gov.

The VFC Program provides vaccines to both Medicaid and VFC Program eligible children.

The VFC Program follows federal law in qualifying practitioners as VFC Program providers. The term “authorized for administration of pediatric vaccines,” used in Section 1928(c)(1)(A) of the Social Security Act (42 U.S.C. 1396s (c)(1)(A)), is intended to mean authorized to prescribe vaccines. Therefore, any Florida-licensed medical doctor, doctor of osteopathy, nurse practitioner, physician assistant, or health care organization serving VFC Program-eligible children can become a provider.

Physician participation guidelines are simple. Providers continue to provide immunizations to VFC Program-eligible children, following normal practice guidelines. Providers do not have to accept a child into their practice based solely on the child’s VFC Program eligibility. The Florida Department of Health provides training and support to VFC Program providers.

Participation Guidelines

• Complete a vaccine report form and report the number of vaccine doses administered, lost and/or wasted and current vaccine inventory on hand within the designated reporting schedule
• Complete a yearly recertification application
• Screen each child’s eligibility
• Comply with the recommended immunization schedule
• Follow the Standards for Child and Adolescent Immunization Practices
• Maintain and retain a record of each child screened
• Provide access to records, as requested by the Florida Department of Health
• Provide current vaccine information statements to the child’s parent/guardian
• Return expired and unserviceable vaccines to the VFC Program vaccine distributor for accountability purposes and excise tax credit

Vaccines Available Through the VFC Program

Medical Record Recording

See the Vaccine Administration Record and Uniform Vaccine Record available in the VFC provider handbook for information to be included in the child’s medical record.

Use the VFC Usage Worksheet to record the children’s eligibility status and to account for the doses administered to children.

As the U.S. Food and Drug Administration (FDA) approves new vaccines or additional vaccine combinations and the ACIP recommends them, the VFC Program includes them in the program. Contact a program representative at 877-888-7468 for additional information.

Improperly stored vaccines result in wasted vaccine, and in some cases, suspension of providers from the VFC Program. When VFC Program providers do not maintain the recommended refrigerator/freezer temperatures, vaccines may lose their potency and result in children being inadequately immunized and required to get additional vaccinations.

• Vaccine Storage and Handling Guide
• Training Guides and Videos

Vaccine Storage Equipment

Providers must have appropriate vaccine storage equipment that can maintain proper temperature conditions.

The Florida Department of Health does not approve dormitory-style refrigerators for vaccine storage (defined as a small combination refrigerator/freezer unit that is outfitted with one external door, an evaporator plate, which is usually located inside an icemaker compartment within the refrigerator, and is void of a temperature alarm device). Its temperature control sensor reacts to the temperature of the evaporator, rather than the air in the storage compartment. When the compressor is on, the evaporator cools to lower the temperature in the refrigerator, in most cases to below 0° C.

• Must be an alarm-equipped, stand alone refrigerator and freezer.
• Refrigerator unit must maintain temperatures between 36-46° F (2-8° C) year-round.
• Freezer unit should maintain temperatures between -58° F and 5° F (-50° C and -15° C)
• Pharmaceutical-grade combination units are acceptable for vaccine storage (household combination units are unacceptable for vaccine storage).
• Both the refrigerator and freezer units must be large enough to hold the year’s largest supply of vaccine, without storing vaccine in the door.
• Providers must have certificate(s) of calibration (or report(s) of calibration) for all thermometers that are used to monitor temperatures where VFC Program vaccine is stored. These certificates must be available upon request by the Florida Department of Health. The certificates must include all the information as listed in either section A or B of the Checklist for Certificate of Calibration Reports. VFC providers certificates must match the examples of approved certificates. If your certificates are missing any required information, contact the thermometer’s manufacturer.
• Refrigerators and freezers must be dedicated to the storage of vaccines. Food and beverages must not be stored in a vaccine refrigerator or freezer.

Temperature Monitoring

Temperature monitoring should be the responsibility of the primary and back-up vaccine coordinators. If other staff must monitor temperatures, train them on how to respond to and document actions taken when temperatures are outside the appropriate range.

• Post a Fahrenheit or Celsius temperature log for vaccines on the storage unit door or in a readily accessible place.
• Keep, on-hand, at least one working and up-to-date back up digital data logger.
• Ensure that refrigerator temperatures are between 36-46° F (2-8° C).
• Keep the freezer temperature at 5°F or lower (-15° C or colder).
• Monitoring and recording temperature twice a day is required, even if a continuous graphing/recording thermometer or a digital data logger is used.
• Correct improper vaccine storage conditions immediately, including inappropriate exposure to light and storage temperatures outside the recommended ranges.
• Maintain and store the completed temperature log for vaccines for three years. Department staff will review this form when they conduct on-site visits.
• Monitor vaccine storage temperatures by using a digital data logger (DDL) in the refrigerator and freezer units. Follow the manufacturer’s recommended schedule for recalibration of the certified digital data loggers.

Because of the critical importance of administering safe and effective vaccines, we cannot guarantee continued participation in the VFC Program for providers who do not adhere to these requirements. If it is determined the vaccine is stored improperly and is not usable during an onsite review, providers will be instructed to immediately return it to the centralized national vaccine distributor. Vaccine shipments will be suspended until the provider meets the proper requirements. Be sure to:

1. Familiarize the appropriate staff with vaccine storage and handling requirements
2. Post the temperature log on the storage unit door or a readily accessible place
3. Record refrigerator and freezer temperatures twice daily, as indicated on the log
4. Adjust the thermostat if temperature is recorded outside the recommended range and contact the vaccine manufacturer for additional instructions

Two-week order window refers to either the first or second-half of the month. If your order frequency is monthly, you have a specific half of the month to place your VFC Program-funded vaccine order. If your order frequency is bimonthly or quarterly, we will give you a specific month and a specific window (first or second half of that specific month) during that month to place your vaccine order.

Ordering Tiers

Please use the chart below to determine when your scheduled VFC Program orders are due. If you do not know your assigned ordering tier, then please log on to your Florida SHOTS account and review your order history. Your assigned tier is on the previous order requests.

Tips for ordering VFC Program Vaccines

Additional Needs

Let us know if your office is experiencing rapid growth, if you are doing extra outreach clinics, or you want to have extra vaccines on hand for school physicals. Complete an additional information form, to request a specific number of doses for the next order.

National Vaccine Distributor

The Florida Vaccines for Children Program transitioned to the Vaccine Management Business Improvement Project, a centralized national vaccine inventory and distribution system, in April 2008. This initiative recommended several changes designed to enhance operating efficiency, improve vaccine inventory visibility, and reduce operating expenses. 

• McKesson Specialty currently ships vaccines for Florida from Memphis, Tennessee
• McKesson Specialty will distribute vaccines (with the exception of the varicella-containing vaccines) directly to the provider
• Merck & Co. ships varicella-containing vaccine in insulated containers containing ice directly to the provider
• The Florida Department of Health does not distribute VFC Program vaccines to providers
• Through VMBIP, the CDC selected McKesson Specialty as the distributor for publicly-purchased vaccines to providers enrolled in the VFC Program

Shipping Vaccines

After the VFC Program processes and approves the provider’s vaccine order, McKesson Specialty will process and ship their vaccine orders within 5-10 business days via commercial carrier. 

• Although FedEx® is their primary carrier, they may also use alternative carriers such as UPS®
• Shipping containers are recyclable. Do not return them to McKesson Specialty.
• To ensure that each container maintains the appropriate vaccine temperatures during shipment, McKesson will include temperature monitors, as well as a vaccine shipment packing slip outlining the vaccines received in the shipment
• We recommend providers keep 1-2 empty containers on hand to use for any vaccine returns

Vaccine Deliveries/Temperature Monitor Indicators Instructions

McKesson Specialty will carefully review orders with special handling instructions or limited delivery times to ensure they deliver the vaccines within the specified window of time (Monday through Friday, 9 a.m. to 5 p.m.). 

The 3M MonitorMark™ time temperature indicator and ColdMark™ freezer indicator are included in all vaccine shipments. These monitor indicators and accurately assess the exposure to temperature variants during the shipping process. Each monitor will be attached to a card that provides the recipient instructions as to how to read the monitor. 

Shipping containers are clearly marked “perishable” in order to alert clinic staff to refrigerate contents immediately upon arrival. In all cases, the recipient is instructed to do the following within 2 hours of shipment receipt:

1. Providers should train front staff signing for receipt of the shipment to alert the clinic’s vaccine manager immediately after arrival
2. Remove the indicator from the shipment container
3. Refrigerate vaccines between 36-46°F (2-8°C) – store varicella-containing vaccines in a freezer at 5°F (-15°C) or colder
4. After storing vaccines as instructed, recipients will read each of the indicators and verify that the temperature monitors have maintained the cold chain
5. If the monitor does not read “OK” contact McKesson Specialty’s vaccine-viability number at 877-836-7123 IMMEDIATELY and speak to a representative. Do not leave any voice messages.
6. Never reject vaccine delivery or discard vaccine shipments without prior consultation with the VFC Program

Procedure to Return Unserviceable Vaccine

McKesson Specialty accepts the return of all VFC Program-purchased nonviable (wasted or expired) vaccine from providers (including influenza and direct-ship vaccines) and arranges for return of nonviable vaccine at no cost to the provider.

• Contact your VFC Program representative at 877-888-7468 to request a postage-paid shipping label
• Include a copy of the Vaccine Return and Waste Form with all expired or unserviceable vaccines in the container: write “EXPIRED VACCINES” on the box
• Under no circumstances should providers return used syringes (with or without needles); open vials; broken vials; wasted products such as a syringe that was drawn up but not used; any multidose vial from which providers have withdrawn doses or expired diluents. These products are not available for federal excise tax credit and should be disposed properly by the provider and documented on the Vaccine Return and Waste Form, created in Florida SHOTS.

Patient Eligibility

Provider Enrollment Forms

Reporting Forms

Other Order Forms

• Varicella-Containing Order Form – Providers order through Florida SHOTS 

Vaccine Management