CDPH created the California Vaccines for Adults (VFA) Program to increase adult vaccination rates and decrease disparities in immunization coverage. Program goals are to help centers integrate the standards for adult immunization practice into routine clinical care and provide no-cost vaccine for uninsured or underinsured adults 19 years of age and older.

VFA vaccines are purchased with limited federal funds called Section 317 funding and are sometimes referred to as Section 317-funded VFA vaccines. Most vaccines routinely recommended for adults by the federal Advisory Committee on Immunization Practices (ACIP) are available.

The VFA Program runs from January 1 through December 31 and may be extended as funding permits. Clinics may continue using VFA vaccines through each vaccine’s expiration date.

• Federally Qualified Health Centers (FQHCs)
• FQHC Look-Alikes
• Rural Health Centers (RHCs)
• Tribal Health Centers
• Indian Health Services (IHS) Centers
• Community Health Centers (CHCs)

• Operating funds may not be available.
• Vaccines must be ordered through the California VFA Program.
• Redistribution of VFA vaccine is not allowed.
• Not all recommended adult vaccines are available.

Adults 19 years of age and older may receive VFA vaccines if they are uninsured (no public or private health insurance coverage) or underinsured (has public or private health insurance but coverage does not include vaccines, covers only select vaccines, covers vaccines but with a fixed dollar limit, or does not include first-dollar coverage including copay, co-insurance or deductible). Refer to 317 Eligibility Based on Insurance Status (PDF).

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 Futures). It is recommended that staff also document the specific eligibility criteria (uninsured OR underinsured) in the patient’s record. Please refer to 317 Eligibility Screening & Documentation 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.”

Adults are not eligible to receive vaccines if they have 

• public or private insurance that covers vaccines,
• plans that deny payment for the cost or administration of vaccines when the deductible requirement has not been met, or
• full-scope Medi-Cal coverage, whether fee-for-service or managed care.

This depends on the type of coverage. An individual who has both Medicare Part B and Part D is not eligible for VFA vaccines. Patients with Medicare Part B but without Medicare Part D may receive VFA Zoster, Tdap and other vaccines that are otherwise covered by Part D, but not the routine pneumococcal and hepatitis B vaccines, which are covered by Part B. Refer to 317 Eligibility Based on Insurance Status (PDF).

No, the eligibility criteria for the VFA Program will remain the same.The Inflation Reduction Act (IRA) included key provisions that address longstanding gaps in vaccination coverage for Medicare and Medicaid beneficiaries by eliminating out-of-pocket expenses for recommended adult vaccines. Refer to 317 Eligibility Based on Insurance Status (PDF).

Most adults enrolled in Medi-Cal are NOT eligible to receive VFA vaccines, including:

• Adults with full scope Medi-Cal coverage.
• Pregnant women with Presumptive Eligibility (also known as Pregnancy-only/Emergency MediCal), as this program covers influenza and Tdap vaccinations recommended during pregnancy.
• Adults with share of cost Medi-Cal.

Only non-pregnant adults on restricted-scope Medi-Cal are considered eligible for routine (non–emergency) VFA vaccines. See Vaccines Eligibility Guidelines (PDF). Providers should verify if each plan’s preventive healthcare services cover immunizations. If immunizations are not covered, the patient under that plan is eligible to receive VFA vaccines.

Recent changes in California law have gradually expanded access to full-scope Medi-Cal for adult ages 19 years and older  regardless of immigration status. All other Medi-Cal eligibility rules apply, including income limits.

It depends. Family PACT is not insurance coverage, so patients who are enrolled in Family PACT and are uninsured/underinsured are eligible for VFA vaccines. However, patients are not eligible if they have public or private insurance that covers vaccines and be enrolled in Family PACT.

Effective July 1, 2022, HPV vaccine will be added as a covered benefit for Family PACT patients ages 19 through 45 years. We strongly encourage you to utilize this benefit for VFA-eligible, Family PACT patients where HPV vaccination is recommended. Please contact the Family PACT program (Family.Pact@dhcs.ca.gov or 916-650-0414) with questions.

It depends. ADAP is not insurance coverage, so patients who are enrolled in ADAP and are uninsured/underinsured are eligible for VFA vaccines. However, patients are not eligible if they have public or private insurance that covers vaccines and be enrolled in ADAP.

The ADAP formulary includes many ACIP-recommended vaccines, and we strongly encourage you to utilize these vaccines for VFA-eligible patients enrolled in ADAP. Please see the ADAP Formulary for more information regarding vaccines covered by ADAP.

No. No-cost health programs that provide health care services to uninsured individuals such as My Health LA (MHLA), Healthy San Francisco, County Medical Services Program (CMSP), etc. are not health insurance. Patients in these programs are eligible to receive VFA vaccines.

It depends. Program sites should determine each person’s healthcare benefits. Those who do not have coverage for immunizations through the State Refugee Program or health insurance may be vaccinated with VFA vaccines.

Patients can utilize the public-facing My Turn Vaccine Locator.  Offices can utilize the My Turn Vaccine Locator tool via myCAvax (login required).

Yes, if they meet the 317 eligibility based on insurance status (PDF).

CDC’s General Best Practice Guidelines state that “adults should receive a vaccine if the dose is recommended and no record of previous administration exists,” unless they:

• Remember being vaccinated with influenza or pneumococcal polysaccharide vaccines; this may be accepted as evidence of vaccination.
• Served in the US military and does not have immunization records available. Providers can assume that the adult has received all vaccines recommended by the military at the time-ofservice entry.

Log in to myCAvax account and follow instructions in the “Placing Vaccine Order Requests” job aid that is available in the myCAvax Knowledge Center (login required).

See Vaccine Eligibility Guidelines (PDF).

The VFA program usually does not offer 317-funded flu vaccine to VFA providers. VFA providers should work with their Local Health Department to request state-funded flu doses.

Participating clinics can order VFA vaccines during a two-week period at the beginning of each quarter. Ordering periods are subject to change. Wait for official communication from the VFA Program regarding actual start and end dates of the quarterly ordering period. Refer to Ordering & Distribution Calendar.

No. The VFA Program does not offer supplemental orders.

Prior to ordering, participating clinics must thoroughly assess the number of doses needed for their VFA-eligible population. Approval of orders is based on available funding and supplies, the number of doses your clinic has in inventory, and the number administered since your last order. Please avoid vaccine waste from expiration.

Each VFA clinical site within a health organization needs to submit its own VFA order.

Yes.

If the data needed to complete the Vaccine Usage Log (PDF) and the Physical Inventory Form (PDF) is entered into CAIR and is easily retrievable, then CAIR may be used to track VFA inventory. For sites exchanging EHR data, the inventory function must be turned on.

Yes. VFA sites may only transfer doses to another VFA site or a Local Health Department 317 site. Sites must contact their Field Representative or Provider Call Center to request approval for transfers.

At least six months prior to the expiration of VFA vaccines which your practice may not be able to use, please:

• Notify the Provider Call Center (833) 502 – 1245 and follow up with an email to my317vaccines@cdph.ca.gov.
• Note all attempts to relocate any short-dated vaccines.
• 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 (PDF).
• Contact VFA prior to making any decisions regarding the viability of VFA vaccines.

VFA program 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 their numbers.
• Must report vaccine accountability numbers with each vaccine order to receive new vaccines.
• May be held financially responsible for the replacement of VFA vaccines that they cannot account for or spoil or expire due to provider negligence.
• All VFA vaccines must be documented in CAIR with the correct NDC Eligibility Code and Funding Source.

Yes. As outlined in the Provider Agreement (PDF) and Agreement Addendum (PDF), authorized representatives of the VFA Program will be permitted to visit your facility in order to review compliance with program policies and procedures.

Please email us at my317vaccines@cdph.ca.gov with any questions!