To reduce financial barriers for patients and ensure that eligible patients will not incur additional costs outside of any routine copay for the clinic visit, program sites shall:

- Not charge eligible patients or third-party payers for the cost of VFA vaccines.

- Not charge a vaccine administration fee to eligible patients for VFA vaccines. 

- Prominently post a sign clearly visible to patients which states that:

“FREE vaccines are available to adult patients who are uninsured or have insurance that doesn’t cover (certain) vaccines. We do not charge these patients for getting the vaccine or for the cost of the vaccine.” 

Vaccine orders will be submitted during a two-week period at the beginning of each quarter. Each VFA site within a health organization should submit its own order. See the VFA Ordering & Distribution Calendar.

Ordering periods for Year 8*:

- January 11 – 25, 2024 

- April 15 – May 2, 2024

- July 15 – 26, 2024 

- September 25 – October 10, 2024

*These ordering periods are subject to change. Wait for official communication regarding actual start and end dates of the quarterly ordering period.

VFA program recertification occurs each year concurrently with VFC program recertification in December. Requirements change slightly each year. Providers will be notified regarding any additional reporting requirements for the year.

Providers must have a system in place to ensure all vaccine doses administered are documented electronically. The system must be designed to include options to access the data if the platform used for documentation is down. The backup plan may include entering doses administered in the 317 Adult Vaccine Daily Usage Log in addition to the patient’s electronic medical record. You may document VFA vaccine doses administered using one of the following options:

1. Enter doses directly into your Electronic Health Record (EHR) and transmit data to the immunization information system. Sites utilizing an EHR that exchanges data with an immunization registry must ensure that all VFA doses are captured in the immunization registry as “317 Eligible LHD or HDAs only”

- If your clinic is in one of the California Immunization Registry (CAIR) regions using CAIR software, consult with your EHR vendor and review the CAIR data exchange FAQs to learn about setting up electronic data exchange to automatically populate CAIR with EHR data.

- If you are NOT in a CAIR region, consult your EHR vendor and contact your local representative for instruction regarding electronic data exchange through Healthy Futures (San Joaquin and nearby counties).

OR

2. Enter doses directly into your immunization registry (in CAIR, as “317 Eligible LHD or HDAS only”). Contact your local CAIR representative if you have any questions.

Providers must review VFA doses reported in the immunization information system (CAIR/Healthy Futures) before every VFA ordering period or at minimum every six months to ensure VFA doses administered have been documented accurately.

As a best practice, patient declination of immunization should be documented in the form of a signed statement in the patient’s medical record. Here is an example of a prenatal immunization declination form.

Staff and providers with roles in implementing activities related to the VFA program should receive appropriate training. Should the VFA Vaccine Coordinator and VFC Vaccine Coordinator roles be fulfilled by different members of the site’s team, the clinic should ensure that the VFA Vaccine Coordinator’s training fulfill the same requirements.

VFA Providers and staff must document the patient’s eligibility at every immunization visit. The date of screening, whether the patient is eligible for VFA, and the eligibility criteria (317) must be documented in the patient’s Electronic Health Record (EHR) and in the California Immunization Registry (CAIR/Healthy Future). It is recommended that staff also document the specific eligiblity criteria (uninsured OR underinsured) in the patient’s record. Please refer to the 317 Eligiblity Screening Record for eligibility verification requirements. Sites utilizing an EHR that exchanges data with an immunization registry must ensure that all VFA doses are captured in the registry as “317 Eligible LHD or HDAs only.” 

Sites may only transfer VFA doses to another VFA site or a Local Health Department. Sites must contact their Senior Field Representative to request approval for transfers.

At least six months prior to the expiration of VFA vaccines which a site may not be able to use:

• Notify the Senior Field Representative for the region and follow up with an e-mail to my317vaccines@cdph.ca.gov.
• Place the short-dated vaccines towards the front of the vaccine storage unit to make sure that you use those doses first.
• To use the vaccine before it expires, implement strategies described in Take Action to Prevent Vaccine Loss. 
  

Providers: 

• Must manage their vaccine inventory effectively to prevent negligent vaccine loss. 
• Are accountable for all VFA vaccines upon receipt and must be able to provide documentation to support usage and current inventory. 
• Must report vaccine accountability numbers with each vaccine order to receive new vaccines. 
• May be held financially responsible for the dose for dose replacement of VFA vaccines that 
  - They cannot account for or 
  - Spoil or expire due to provider negligence.