BackPage September/October 2018

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The BackPage
Vaccine News Alert

Sept/Oct 2018

Flu VIS


The current influenza VIS, dated 8/7/15, is still valid for the 2018-19 influenza season. It will remain valid through upcoming flu seasons unless there are significant changes to CDC’s recommendations, in which case subscribers will be notified of any change.


Flu Borrowing

For seasonal influenza vaccine, providers may use private-stock seasonal influenza vaccine to vaccinate VFC-eligible children if VFC seasonal influenza stock is not yet available. Those private stock doses used on VFC-eligible children can later be replaced when VFC stock becomes available. This one directional borrowing exception is unique to seasonal influenza vaccine.


Flu Vaccine is Available

The first shipments of flu vaccine have arrived at the CDC depots. Please notify Susan Kocen if you are ready to begin administering flu vaccine.


FluLaval and Fluarix Vaccine

The dose for FluLaval and Fluarix for this flu season is (0.5-mL) for all children in the indicated age range of 6 months and older.


Vaccine Storage Unit Assessment

Because vaccine borrowing occurs, a private dose of vaccine is occasionally administered to a VFC-eligible patient. A private storage unit may be used to store VFC vaccine when a storage unit fails. Because these types of events occur, storage units that contain only private stock must be reviewed during compliance visits. Private storage units that don’t meet CDC storage and handling requirements will require follow up.


Vaccine Supply

Hep B - To ensure equitable access to hepatitis B vaccines, CDC is placing Recombivax HB and Engerix B under allocation. The recommendations for hepatitis B vaccination of infants have NOT changed. To expedite order approval, please indicate if you have no preference for Hep B on the order form until supply improves. If you indicate “no preference” we will substitute brands only if necessary. Orders may be reduced, but providers can re-order as necessary. Sample schedules are posted on the CDC Current Vaccine Shortages and Delays web page located here: https://www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html


New Vaccine NDCs

HPV – A new NDC for Gardasil syringes will be available soon and will be added to the vaccine order form. Tdap – A new latex free NDC for Adacel will be available soon and will been added to the vaccine order form.


 

Adult Vaccine Update

Shingrix Supply - Due to high levels of demand for Shingrix vaccine, GSK has implemented order limits and providers have experienced shipping delays. It is anticipated these order limits and shipping delays will continue throughout 2018. In response, GSK has increased the US supply available for 2018 and plans to release doses to all customer types on a consistent and predictable schedule for the rest of 2018.Ask the Experts Q&A

Q: I want to begin providing vaccines for my adult patients but reimbursement for these vaccines is confusing. Can you provide guidance?

A: In 2017, the Immunization Action Coalition revised its comprehensive 142-page guide titled Vaccinating Adults: A Step-by-Step Guide. The guide was written to assist medical practices to improve their adult vaccination services. Two of the chapters (7A and 7B) address financial considerations and provide guidance on how to obtain reimbursement for adult vaccines. The guide is available free of charge on the IAC website at www.immunize.org/guide. In addition, the National Adult and Influenza Immunization Summit has created a web section on this topic at www.izsummitpartners.org/naiis-workgroups/access-provider-workgroup/coding-and-billing.


Gold Star Awards (June/July)

Outstanding VVFC Compliance
Bon Secours Hanover Pediatrics, Mechanicsville
Bon Secours Pediatrics, Mechanicsville
Centerville Family Practice, Manakin Sabot
Century Pediatrics, Fredericksburg
Century Pediatrics, Garrisonville
Century Pediatrics, Woodbridge
Children’s Health, Fredericksburg
Family Care Pediatrics, Galax
Infant, Child, & Adolescent Clinic, Alexandria
MWMG Family & Internal Med., Bowling Green
Practice of Carolyn Boone, Richmond
Valley Health-Page Memorial Hosp., Luray
Woodbridge Pediatrics, Woodbridge

Process Improvement
The Practice of Carlos Cruz in Alexandria uses a pharmaceutical grade refrigerator and has a back-up data logger. Their EMR interface exchanges data with the immunization registry and includes patient eligibility.


109 Governor Street, 6th Floor
Richmond, Virginia 23218
Toll Free:800-568-1929 or Richmond 804-864-8055
vvfc@vdh.virginia.gov
https://www.vdh.virginia.gov/immunization/vvfc/


Developed by the Division of Immunization 2017

July/August 2018

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Vaccine News Alert

July/August 2018

FAMIS Plus vs FAMIS


FAMIS Plus is Medicaid for children. Children with FAMIS Plus are VFC-eligible. FAMIS is Virginia’s health insurance program for children. Children with FAMIS are insured and not VFC-eligible.


Flu Vaccine

It is time to return last year’s expired flu vaccine. Please notify the order center of any circumstances that should be considered for distribution planning for the upcoming flu season.


Flu Borrowing

For seasonal influenza vaccine, providers may use private-stock seasonal influenza vaccine to vaccinate VFC-eligible children if VFC seasonal influenza stock is not yet available. Those private stock doses used on VFC-eligible children can later be replaced when VFC stock becomes available. This one directional borrowing exception is unique to seasonal influenza vaccine.


CDC Webinar Series on "The Pink Book"

CDC is again presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of weekly 1-hour webinars that will start June 6 and run through September 26. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 a.m. (ET). Continuing education will be available for each event.


CE Credit

To receive continuing education for CDC’s You Call the Shots training follow the steps located here: https://tceols.cdc.gov/Home/Steps


Safe Removal of Fridge Tag 2L

Instructions to safely remove a Fridge Tag 2L from a PC can be found here: https://www.vdh.virginia.gov/content/uploads/sites/11/2018/05/RemoveFT2LSafely.pdf


Catch Up Job Aids

CDC recently developed several new job aids to help providers figure out exactly what is needed for children who are behind schedule with PCV13, Hib, DTaP, and/or Tdap vaccines. Although this information is available in the annual U.S. Catch-Up Immunization Schedule for Persons Aged 4 Months through 18 Years Who Start Late or Who Are More Than 1 Month Behind, the format of these resources makes it easier to determine what is needed (number of doses and timing) in a particular situation. The job aids are located here: https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html


Hepatitis A and Hepatitis B Vaccine Resource

Hep A outbreaks are occurring in multiple states across the U.S. increasing awareness of the importance of protection through Hep A vaccine. IAC recently revised its resource for healthcare professionals
titled Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose. Changes were made to incorporate the recently licensed 2-dose Heplisav-B vaccine. http://www.immunize.org/catg.d/p2081.pdf


Hep B Supply

To ensure equitable access to hepatitis B vaccines, CDC is placing Recombivax HB and Engerix B under allocation. The recommendations for hepatitis B vaccination of infants have NOT changed. Providers should continue to follow the recommended schedule outlined in the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger. Updates for vaccine supply (and sample schedules) are posted on the CDC Current Vaccine Shortages and Delays web page located here: https://www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html

Tip: To expedite order approval, please indicate if you have no preference for Hep B on the order form until supply improves. If you indicate “no preference” we will substitute brands only if necessary. Orders may be reduced, but providers can re-order as necessary.


 

Adult Vaccine Update

Recombinant Zoster Vaccine Administration Errors

CDC published Notes from the Field: Vaccine Administration Errors Involving Recombinant Zoster Vaccine—United States, 2017–2018 in the May 25 issue of MMWR (pages 585–6). The complete article is located here: https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6720a4-H.pdf

Gold Star Awards (April/May)

Outstanding VVFC Compliance
Carilion Family Medicine-Giles, Pearisburg
Fall Hill Pediatrics, Fredericksburg
Lewis Gale Clinic, Salem
Metropolitan Pediatrics, Arlington
Practice of Jacqueline Hoang, Springfield
Practice of Jocelyn Trent, Woodbridge
Richeson Drive Pediatrics, Lynchburg
Winchester Family Health Center, Winchester


109 Governor Street, 6th Floor
Richmond, Virginia 23218
Toll Free:800-568-1929 or Richmond 804-864-8055
vvfc@vdh.virginia.gov
https://www.vdh.virginia.gov/immunization/vvfc/


Developed by the Division of Immunization 2017

May/June 2018

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Vaccine News Alert

May/June 2018

Guidance for the Hepatitis B Series during a Recombivax HB® Shortage

The manufacturing issue related to hepatitis B vaccine that Merck began experiencing in 2017 is expected to continue throughout 2018. As a result, Merck’s supply of pediatric hepatitis B vaccine will be intermittent during 2018 and Merck will not be distributing its adult hepatitis B vaccine. GSK has confirmed that it can continue to support full demand for pediatric hepatitis B vaccine in the United States throughout 2018, using a combination of monovalent pediatric hepatitis B vaccine and its DTaP-HepB- IPV pediatric combination vaccine (Pediarix). The expected monovalent supply will provide sufficient vaccine to cover the hepatitis B birth dose for all children as well as additional pediatric hepatitis B vaccine for second and third doses. CDC has developed guidance for providers that is available at the link provided below. The recommendations for hepatitis B vaccination of infants have NOT changed. Providers should continue to follow the recommended schedule outlined in the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger. Updates for vaccine supply (and sample schedules) are posted on the CDC Current Vaccine Shortages and Delays web page located here: https://www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html


 

National Infant Immunization Week (NIIW)

National Infant Immunization Week (NIIW), observed from April 21–28 this year, started on Saturday! NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. As part of this week, CDC announced the winners of its CDC Childhood Immunization Champion Award, found here:

https://www.cdc.gov/vaccines/events/niiw/champions/profiles-2018.html

This annual award recognizes individuals who make a significant contribution toward improving public health through their work in childhood immunization.  The following are recognized for their stellar work in childhood immunizations in Virginia:

  • Donna Deadrick, BSNCarilion
    Children’s Pediatric Medicine
  • Cyrelda Fermin, M.D.
    Infant, Child & Adolescent Clinic
  • Cathie Harrington, PNP FNP
    Wythe Physicians Practices

 

Eligibility: Clarification for Underinsured

Eligibility for the VFC Program as “underinsured” is rare.  Unless insurance coverage for vaccines is verified by the provider prior to administration of vaccine, for the purposes of the VFC Program, these children are considered insured and are not eligible to receive vaccines at that immunization encounter.  Note: Children whose health insurance covers the cost of vaccinations are not eligible for federally purchased vaccines, even when a claim for the cost of the vaccine and its administration would be denied for payment by the insurance carrier because the plan’s deductible has not been met. A child verified as underinsured is VFC eligible ONLY at a Federally Qualified Health Center/Rural Health Center (FQHC/RHC).  Private providers cannot use VFC vaccine on underinsured children.  Health Departments provide immunizations to underinsured and insured clients using vaccine purchased with other funding (not VFC funded vaccine).


 

IAC posts 19 translations of the MMR, MMRV, varicella, zoster-recombinant, and zoster-live VISs

As part of its cooperative agreement with CDC, IAC recently posted updated or new translations of the MMR, MMRV, varicella, zoster-recombinant (Shingrix), and zoster-live (Zostavax) VISs in Arabic, Burmese, Cambodian (Khmer), Chinese-Simplified, Chinese-Traditional, Farsi, French, Haitian-Creole, Hmong, Indonesian, Japanese, Korean, Portuguese, Russian, Somali, Tagalog, Thai, Turkish, and Vietnamese.


 

New VISs

CDC has released updated VISs.  They are available at: https://www.cdc.gov/vaccines/hcp/vis/current-vis.html

  • DTaP (5/17/07)
  • Hepatitis A (7/20/16)
  • Hepatitis B (7/20/16)
  • Hib (Haemophilus Influenzae type b) (4/2/15)
  • HPV – Gardasil-9 (12/2/16)
  • Influenza – Live, Intranasal (8/7/15)
  • Influenza – Inactivated (8/7/15)
  • Measles/Mumps/Rubella (MMR) (2/12/18)
  • Measles/Mumps/Rubella & Varicella (MMRV) (2/12/18)
  • Meningococcal ACWY (MenACWY & MPSV4) (3/31/2016)
  • Serogroup B Meningococcal (MenB) (8/9/16)
  • Pneumococcal Conjugate (PCV13) (11/5/15)
  • Pneumococcal Polysaccharide (PPSV23) (4/24/15)
  • Polio (7/20/16)
  • Rotavirus (2/23/18)
  • Tdap (Tetanus, Diphtheria, Pertussis) (2/24/15)
  • Td (Tetanus, Diphtheria) (4/11/17)
  • Varicella (Chickenpox) (2/12/18)
  • Zoster / Shingles (Live) (2/12/18)
  • Zoster / Shingles (Recombinant) (2/12/18)

 

Gold Star Awards (Feb/Mar)

Image Exceptional Immunization Rates
Pediatric Associates of Charlottesville
Outstanding VVFC Compliance
Pediatric Associates of Charlottesville


109 Governor Street, 6th Floor
Richmond, Virginia 23218
Toll Free:800-568-1929 or Richmond 804-864-8055
vvfc@vdh.virginia.gov
https://www.vdh.virginia.gov/immunization/vvfc/


Developed by the Division of Immunization 2017

March/April 2018

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Vaccine News Alert

March/April 2018

In this Newsletter:

New VISs

Shingrix – Refrigerate the Antigen and Adjuvant!

CDC Policy for Federally Purchased Vaccine

2018 Immunization Schedules

Email Return Label “Tip”

Borrowing Influenza Vaccine

2018-19 Flu Pre-Book

Gold Star Awards (Dec 2017 to Jan 2018)

New VISs

(Back to Top)

There is a new VIS for Recombinant Zoster. The MMR, MMRV, Varicella, and Live Zoster VISs have recently been updated and are now available. Providers are encouraged to begin using the updated MMR, MMRV, and varicella VISs immediately, but existing stocks may be used until exhausted.


Shingrix – Refrigerate the Antigen and Adjuvant!

(Back to Top)

Shingrix is a vaccine indicated for prevention of herpes zoster (shingles) in adults aged 50 years and older. Shingrix is not indicated for prevention of primary varicella infection (chickenpox). Administer 2 doses of Shingrix (0.5 mL each) at 0 and 2 to 6 months intramuscularly. Suspension for injection is supplied as a single-dose vial of lyophilized varicella zoster virus glycoprotein E (gE) antigen component to be reconstituted with the accompanying vial of adjuvant suspension component. Store the Lyophilized gE antigen AND adjuvant suspension components in the refrigerator between 2° and 8°C (36° and 46°F). Protect vials from light. Do NOT Freeze. Providers will be notified when Shingrix is available to order through the Division of Immunization.


CDC Policy for Federally Purchased Vaccine

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To ensure federally purchased vaccine is used for those who are least able to pay for them, vaccines purchased with federal funds are not intended for insured individuals. Federally purchased vaccines are funded with VFC and Section 317 funds. VFC funded vaccine must be used only for VFC eligible children. Section 317 funded vaccine is used to support adult programs for public providers serving uninsured and underinsured adults.


2018 Immunization Schedules

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The Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Immunization Schedules for Children and Adults. Changes in the 2018 schedules can be found here: https://www.cdc.gov/vaccines/schedules/easy-to-read/
A “16-year-old” column brings attention to several CDC-recommended vaccinations due to be administered at 16 years of age. These include:

  • MenACWY dose #2 — recommended at age 16
  • MenB dose #1 — recommended (category B) at age 16
  • HPV “catch-up” — needed for those who have not yet completed their series
  • Influenza vaccine — recommended seasonally
  • Other vaccines — the 16-year-old platform provides a “catch-up” opportunity for patients who have fallen behind on other recommended vaccines

Email Return Label “Tip”

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UPS return labels are emailed to providers when they have vaccine to send back to McKesson for the federal excise tax credit. When emailed, a unique UPS return label will be sent from UPS Quantum View [pkginfo@ups.com] to the contact email address. The subject of the email with the return label will be titled “UPS Label Delivery, .” Return labels may be available by email in about 15-30 minutes after the return is entered. If a return label is not received via email check your spam folder. Adding the email address pkginfo@ups.com to your address book will prevent the label from going to your spam folder. The return form has been updated and is located here:

https://www.vdh.virginia.gov/content/uploads/sites/11/2016/04/return_form.pdf


Borrowing Influenza Vaccine

(Back to Top)

Influenza vaccine purchased with VFC funds must be administered to VFC-eligible clients only. If VFC seasonal influenza vaccine in not available, providers may use private-stock seasonal influenza vaccine to vaccinate VFC-eligible children, then private stock doses used on VFC-eligible children may be replaced subsequently, when VFC stock becomes available. This one-directional borrowing is unique to seasonal influenza vaccine. VFC seasonal influenza stock cannot be used to vaccinate non-VFC eligible clients.


2018-19 Flu Pre-Book

(Back to Top)

If you have not already done so, please reserve Influenza vaccine for the next flu season.


Gold Star Awards (Dec 2017 to Jan 2018)

(Back to Top)

ImageExceptional Immunization Rates
Crestwood Pediatric Associates, Gainesville
Crestwood Pediatric Associates, Manassas

Outstanding VVFC Compliance
Crestwood Pediatric Associates, Gainesville
New River Valley Pediatrics, Blacksburg
Sentara Pratt Medical Group, Fredericksburg
Wythe Physicians Practices, Fort Chiswell

Immunization Champion Nominees
The CDC Childhood Immunization Champion Award is an annual award that recognizes individuals who make a significant contribution toward improving public health through their work in childhood immunization. The following are recognized for their stellar work in childhood immunizations in Virginia:

Donna Deadrick, BSN
Carilion Children’s Pediatric Medicine

Cyrelda Fermin, M.D.
Infant, Child & Adolescent Clinic

Cathie Harrington, PNP FNP
Wythe Physicians Practices


109 Governor Street, 6th Floor
Richmond, Virginia 23218
Toll Free:800-568-1929 or Richmond 804-864-8055
vvfc@vdh.virginia.gov
https://www.vdh.virginia.gov/immunization/vvfc/

Developed by the Division of Immunization 2017

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Nov/Dec 2017

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Vaccine News Alert
Nov/Dec 2017

 

In this Newsletter:

New Requirements

New for 16-year-olds! “You’re 16 . . . We recommend these vaccines for you!”

Holiday Preparations

HPV Quality Improvement Initiative

HPV Champion

Flu Vaccine for 2017-18

Vaccine Supply Update

Gold Star Awards (Aug/Sep)

 

New Requirements

(Back to Top)

Effective January 1, 2018, all VVFC providers will be required to use continuous temperature monitoring devices (data loggers) to monitor vaccines that will be administered to VFC-eligible children during routine onsite storage of vaccine, transport of vaccine, and mass vaccination clinics. Beginning January 1, 2018, data loggers will be required as back-up thermometers and providers will be required to assess and record minimum and maximum temperatures at the start of each clinic day.


New for 16-year-olds! “You’re 16 . . . We recommend these vaccines for you!”

(Back to Top)

To assist providers in communicating the important vaccines recommended at the 16-year-old immunization visit, IAC and the Society for Adolescent Health and Medicine (SAHM) have partnered to develop a 1-page handout that can be given to your teen patients or their parents. Navigate to the handout by clicking here.


Holiday Preparations

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Vaccine shipments from McKesson will be HELD November 10th, November 22-24th, and December 22-26th. The Order Center will not enter direct-ship orders to avoid deliveries from Merck during these time periods. However, a few direct-shipments might arrive from Merck since they cannot be HELD as done with refrigerated vaccines shipped by McKesson. Providers should indicate any changes to routine hours on the order form and should order vaccine mindful of their Holiday closures.

 


HPV Quality Improvement Initiative

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Earn CE credit by participating in a Learning Collaboration between National Improvement Partnership Network (NIPN) and the Academic Pediatric Association (APA). This collaborative effort is funded by the Centers for Disease Control and Prevention to improve adolescent HPV immunization rates through strong provider recommendations, and the reduction of missed opportunities. The National Immunization Partnership with the APA (NIPA) is a large-scale, Quality Improvement (QI) initiative designed to prioritize HPV vaccination at every adolescent visit. The global aim for this project is to improve HPV vaccine initiation and series completion rates by 10% from baseline to the end of the project. Recruitment for Year 4 is underway. The deadline to enroll is December 15, 2017. The enrollment link (cohort 4) is here. Details on educational credits are included on the enrollment survey. For more information contact Rachel Wallace-Brodeur at Rachel.Wallace-Brodeur@med.uvm.edu or (757) 484-1856.


HPV Champion

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The Office of Sein Win has been selected as a 2017 HPV Vaccine Is Cancer Prevention Champion. Led in partnership by the Centers for Disease Control and Prevention (CDC), Association of American Cancer Institutes, and the American Cancer Society, the HPV Vaccine Is Cancer Prevention Champion Award Program recognizes clinicians, clinics, practices, groups, and health systems that are effectively working to protect their adolescent patients against HPV cancers by achieving high HPV vaccination rates. This year, the award program honored one Champion from each of the 10 U.S. Department of Health and Human Services (HHS) regions. After a rigorous review and data validation process of all submissions, the Office of Sein Win stood out as the Champion from HHS region 3.


Flu Vaccine for 2017-18

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All injectable flu vaccine presentations are available. Please notify the Order Center if you need additional doses. Current VISs can be found on CDC’s website. Influenza Vaccine Labels can be found here.


Vaccine Supply Update

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To expedite vaccine orders, substitutions may be made for Recombivax, Havrix, and Vaqta presentations. Providers will be notified of brand substitutions.


Gold Star Awards (Aug/Sep)

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Image

Outstanding VVFC Compliance
Bayview Community Health Center, Cheriton
Carilion Childrens Pediatric Med., Roanoke
Carilion Clinic Adolescent Health, Roanoke
Clinch Valley Physician Associates, Richlands
CMG Pediatric Specialists, Norfolk
CMG Pediatric Specialists, Chesapeake
Commonwealth Pediatrics, Richmond
Cornerstone Pediatrics, Chesapeake
General Booth Pediatrics, Virginia Beach
Kids First Pediatrics of Stafford, Stafford
Pedsplus Primary Care, Fredericksburg
Royal Oak Pediatric Associates, Marion
Seven Corners Pediatrics, Falls Church
SEVHS East End Physicians, Newport News

Process Improvement
The following providers are recognized for excellence in vaccine storage, vaccine transport, inventory management, and/or taking extra care to overcome vaccine hesitancy:
Associates in Pediatric Care, Hampton
Children First, Inc., Dumfries
Family Medical Center of Smithfield, Smithfield
Kenneth J. Kim Pediatrics, Fairfax
PATHS Community Medical Center, Danville
Practice of Sameera Nasser Rentia, Falls Church
Prince William Pediatric Care, Inc., Manassas
Tidewater Pediatrics, Portsmouth

 


109 Governor Street, 6th Floor
Richmond, Virginia 23218

Toll Free:800-568-1929 or Richmond 804-864-8055
vvfc@vdh.virginia.gov
https://www.vdh.virginia.gov/immunization/vvfc/

Developed by the Division of Immunization 2016

 

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