These requirements apply to all VFC providers including hospitals, pharmacies and large healthcare systems.
Screen for VFC Eligibility at Every Immunization Visit
Screen all children from birth through 18 years prior to administering VFC vaccines.
Determine Which VFC Eligibility Criterion Is Met
To be VFC-eligible, patients must meet at least one of these four criteria. Verification of a parent’s response or self-identification is not required.
Tip. If a child meets multiple criteria, select the one that requires the least amount of out-of-pocket expenses for the parent or guardian.
- Medicaid-eligible (or enrolled): Has Medi-Cal as primary or secondary coverage
- American Indian (AI) or Alaska Native (AN): As defined by the Indian Health Care Improvement Act
- Uninsured: Has no health insurance coverage
- Underinsured: Health insurance doesn’t cover vaccines; doesn’t cover all ACIP-recommended vaccines; covers vaccines but with a fixed dollar limit (or cap); or does not provide first-dollar coverage for vaccines including copays, coinsurance, or deductibles*; underinsured patients are only eligible to receive VFC vaccines at FQHC or RHC facilities.
* This applies even when the primary insurer would deny reimbursement for the cost of the vaccine and its administration because the family has not met the plan’s deductible.
Document VFC Eligibility in CAIR
Document patient eligibility in the California Immunization Registry (CAIR). Eligibility documentation must include these elements. Maintain patient eligibility screening records for a minimum of 3 years.
- Date of screening
- Whether or not the patient is VFC-eligible
- Which VFC eligibility criterion (or criteria) was met
Ensure Vaccinators Only Use VFC Vaccines for VFC Patients
Staff who conduct eligibility screening are not necessarily vaccinators. Update practice protocols so vaccinators know when to pull from VFC or private stock. Organize storage units (PDF) to prevent administration errors.
Reminder: By California law, all provider locations must report doses administered (including eligibility and funding sources) to the California immunization registry within 72 hours—for both private and publicly supplied vaccines.