November/December 2019

VFC Administration Fee Change

Effective January 1, 2020, providers who choose to bill for the vaccine administration fee of a non-Medicaid, VFC-eligible child after the date of service may issue only a single bill to the patient within 90 days of vaccine administration. This policy does not apply to vaccine administration fees billed to Medicaid for children who meet the Medicaid eligibility criteria for the VFC program. Unpaid administration fees may not be sent to collections, and the provider may not refuse to vaccinate an eligible child whose parents have unpaid vaccine administration fees.

Adolescent Vaccine Coverage Data

On August 23, CDC published National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years – 2018. In 2018:
  • 1% of adolescents age 13–17 years were up to date with the HPV vaccine series, and 68.1% had received more than 1 dose of HPV vaccine.
  • Coverage with more than 1 MenACWY dose increased by 1.5 percentage points to 86.6%. Among persons age 17 years, coverage with more than 2 MenACWY doses increased by 6.5 percentage points to 50.8%.
  • Coverage with more than 1 dose of MenB among persons age 17 years was 17.2% (95% confidence interval=14.9%–19.9%).
CDC has a number of resources to assist clinicians to improve adolescent vaccination rates, including information about how to make an effective vaccine recommendation and/or effective vaccine referral. Access the MMWR article and resources below. https://www.cdc.gov/mmwr/volumes/68/wr/mm6833a2.htm

Flu Vaccine Buttons and Stickers

Wearing these, your patients will be letting their communities know that influenza vaccination is important. Suitable for clinic staff, too! These send a powerful reminder to get vaccinated.

Flu Vaccine for 2019-20

Injectable and intranasal flu vaccine presentations are available. Please notify the Order Center if you need additional doses.

Holiday Preparations

Holiday Preparations
Vaccine shipments from McKesson will be HELD:
  • November 11th, and November 27th-29th.
  • December 23rd-31st. Orders entered by noon on December 13th should arrive before the break.
  • January 1st, 2020.
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.


Outstanding VVFC Compliance
Carilion Childrens Pediatric Med., Roanoke
Children First Inc., Dumfries
Valley Pediatric Group, Waynesboro

“Keys to Storing and Handling Your Vaccine Supply” Video

Two of the most important safeguards for the nation’s vaccine supply are proper vaccine storage and handling. An updated web-on-demand video, titled “Keys to Storing and Handling Your Vaccine Supply,” is designed to decrease vaccine storage and handling errors by demonstrating recommended best practices and addressing frequently asked questions. Continuing Education (CE) is available.

CDC Clinician Outreach and Communication Activity (COCA), 2019-2020 Recommendations for Influenza Prevention and Treatment in Children

COCA subject matter experts from the American Academy of Pediatrics (AAP) and CDC will discuss strategies providers can use to improve influenza prevention and control in children for the 2019–2020 influenza season. Continuing Education (CE) is available.

Adult Vaccine Update

Gardasil 9 for Adults: Updated Recommendations of the Advisory Committee of Immunization Practices (ACIP)
The FDA announced approval of expanded use of Gardasil 9 to include adults 27 through 45 years old. In June 2019, ACIP recommended catch-up HPV vaccination for all persons through age 26 years. ACIP did not recommend catch-up vaccination for all adults age 27 through 45 years, but recognized that some persons in this age range who are not adequately vaccinated might be at risk for new HPV infection and might benefit from vaccination. Therefore, ACIP recommended shared clinical decision-making regarding potential HPV vaccination for these persons. Although the vaccine is approved by the FDA for males and females through age 45 years, ACIP does not recommend routine vaccination of persons older than 26 years.