Eligibility and administration
Who is eligible to receive state-supplied vaccine?
State-supplied vaccine can be used for all children and adolescents through the age of 18 (up to the 19th birthday) regardless of their insurance status.
Can I administer state-supplied vaccine to adults?
Select state-supplied vaccines can only be used for uninsured adults seen at public sector sites (ex. Boards of health, community health centers, free community-based clinics, etc.). See the Availability Table - Adult (PDF) l (DOC) for more information.
What childhood and adolescent vaccines are supplied by MDPH?
See the Childhood and Adult Vaccine Availability Tables located on the Vaccine Management webpage.
What are common examples of improperly using state-supplied vaccine?
The most common example is administering state-supplied vaccine to an adult in a private office. Other examples are failing to store vaccine correctly upon shipment, not using a pharmaceutical grade refrigerator, or failing to read temperatures twice a day.
What about adolescents that start a vaccine series at age 18, but the subsequent doses would be administered at age 19 or older?
State-supplied vaccine can be administered when the adolescent is 18 years of age, but not 19 years of age or older. For example, if a patient started the three dose series of HPV at 18 years and 9 months, that patient could be given state supplied vaccine at dose 1 and dose 2 (if given at the recommended 1-2 month interval). The third dose at 6 months would fall outside of the state-supplied vaccine age limit. The third dose would have to be privately purchased and billed through insurance. (Please note that this example is just a case study, the recommended age for HPV vaccination is 11-12 years old.)
What if the patient is a student 19 years or older and the vaccine is required for school?
If the patient has insurance and is 19 or older, vaccine should be privately purchased and billed through insurance. MDPH does provide some vaccine to uninsured adults, review the Adult Availability Table for more information.
Vaccine ordering and shipments
Why are you cutting my inventory?
Vaccine order approval is based on the number of vaccines administered since the last order. Using vaccine administration information from a site’s reconciliation, the Vaccine Management Unit may reduce your order. If you need more than the recommended amount of vaccine (2.5 month supply) or are worried about your order being reduced, add a note in the order explaining why the increase is needed and the Vaccine Management Unit will consider your request when approving the order.
Is a signature needed for delivery of vaccine?
Yes, a signature is required for delivery.
I received my vaccine shipment and there is a problem?
Whenever you receive a vaccine shipment:
- Compare the contents of the container to the packing list, including number of doses ordered vs. shipped, lot numbers, and that you received the correct amount of diluent.
- Check cold chain monitors for any indication of a temperature excursion during transit. The frozen vaccine packing list will show the acceptable transit time.
- If there is a problem, call the vaccine unit immediately.
Expired/wasted vaccine returns
How do I handle expired vaccine?
- Expired vaccine should be removed from storage unit immediately.
- Sites should initiate a vaccine return in the MIIS by using the Storage/Handling Issue function or at the beginning of a new order in the MIIS as soon as possible.
- Then, package the vaccine and wait for a packing slip.
- All sites have the option to have the mailing label emailed or brought to the site by the mail carrier. If the label is emailed, attach it to the package and give it to the mail carrier. If the mailing label is brought by the mail carrier, then the delivery person from UPS will come to the site with a label and take the package. All sites should decide which option works best for them.
How long do I have to ship expired or wasted vaccine back to the distributor?
Expired/wasted vaccine should be processed as soon as possible. Once a ‘Storage/Handling Issue’ has been processed for the vaccine, if you select email, you have 30 days to return the vaccine. If you select pick up, vaccine will be picked up by UPS within 3-5 business days. If you missed your scheduled pick-up or haven’t sent back you return within 30 days you will need to contact the vaccine unit. The Vaccine Unit will put the vaccine back into your MIIS inventory so that a new ‘Storage/Handling Issue’ can be created.
What’s the difference between a secondary and a back-up storage unit?
- A secondary storage unit is a unit that stores vaccines normally.
- ex. A small refrigerator in an exam room or a refrigerator for flu over-flow
- A back-up storage unit stores vaccines only in cases of emergency. Back-up units are primarily off-site, but possibly on site if it is the only unit that can be connected to a generator. Back-ups do not need to be pharma grade.
Should water bottles be kept in a storage unit?
According to the most recent version of the CDC Storage and Handling Toolkit, water bottles are not recommended for use with certain pharmaceutical-grade and purpose-built units. Sites should follow manufacturer’s guidance when it comes to placing water bottles in these units.
I’m getting a new storage unit for my state-supplied vaccines, what do I do?
Contact the Vaccine Unit when you are planning to get a new unit. New units need to be monitored for at least 48 hours before moving state-supplied vaccines into the unit. Once the temperatures are showing in range for 48 hours, you can move your vaccine into the new unit. Make sure to note on the data logger report when the new unit was installed.
How do I get a new digital data logger (DDL)?
All sites should have received new data loggers by April 2019 which should last 2 years. If your site has not received a new data logger, please contact the Vaccine Unit. MDPH Immunization Division replaces expired data loggers for sites that provide pediatric vaccines.
What do I do with my old DDL?
Download the data report from the old digital data logger. Leave the probe in the refrigerator so it’s always conditioned. Store the old data logger in a place you will remember for use as a back-up data logger. The old data logger should not be kept on the storage unit.
Am I supposed to call the vaccine unit every time I see an X on the DDL?
Yes. An ‘X’ appears when there is an out of range temperature. Every time you see an out of range temperature you should call, this includes when you notice that minimum and maximum temperatures are outside of the recommended range.
How do I order flu vaccine?
An email will be sent to the primary and back-up vaccine coordinators when flu vaccine is available to order. Sites should enter in a flu order for the number of vaccines they need and can safely store in their storage units. Sites can order flu vaccine as often as they need.
How do you determine how much flu vaccine is needed?
MDPH relies on sites to account for the vaccine accurately. MDPH uses the number of administered doses in the MIIS to forecast the number of doses your site may need. MDPH gives sites the option to change this allocation. Change allocation emails are sent to the Primary and Back-up Vaccine Coordinator in the summer.
What do I do with the flu vaccine that I don’t use?
Flu vaccine should continue to be stored in the appropriate storage unit until it expires. Once flu vaccine expires, it can be processed out of your inventory by submitting a storage and handling issue.
I ran out of Flu vaccine, I need more.
If you need more flu vaccine, please call the Vaccine Unit and we will see how we can accommodate you.