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Immunization Corner
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Welcome to PSSNY's Immunization Corner

Recent Updates:

Shingrix recommendations during shortage (CDC)

National Foundation for Infectious Diseases Webinars

IAC's Ten Steps to Getting Started

Order an Immunization Techniques DVD

Pharmacists as Immunizers DOH Update October 2018

DOH Vaccines for Children Update

Vaccines for Children Program Update 10.29.18

Because immunizing children is new for us, it may be a challenge to estimate your product needs for this population, but that first step is crucial to the national success of the program.  Please contact me at pharmacist@pssny.org if you have a creative method to share.

Pharmacies in NYC are already up and running with VFC and you can be too:

Pharmacies outside NYC can now apply for the VFC program!

Children's vaccines and Medicaid

  • Medicaid eligible children are VFC eligible. Cannot bill flu vaccine product to any plan.
  • Product can be provided under VFC, free of charge by your pharmacy, or billed as cash **see below**
  • Administration fee can be billed to FFS and SOME Medicaid Managed Care plans.  See list below:
  • Covering administration fee for pharmacist administered children's flu: 
      • BCBS of Western NY
      • CDPHP
      • Crystal Run
      • Empire BCBS Health Plus
      • Fidelis
      • Independent Health
      • United Health Care
      • VNSNY
      • Wellcare
  • Not yet covering pharmacist administered children's flu:
    • Affinity (working with their PBM re: system issues)
    • Amida Care
    • Emblem Health
    • Excellus
    • Health First
    • MetroPlus
    • Molina (formerly Total Care)
    • MVP
    • Univera
    • Your Care

    **A NYS Medicaid provider MAY charge a patient if and only if both parties agree that it is a private pay transaction.** as described on page 10 of the NYS Medicaid General Policy Manual(page 11 of the pdf).

     

    Children's Flu Update (10.29.18)                                                                                         

  • Pharmacists may immunize children aged 2-18 for flu.
  • Need standing order specifically for pediatric vaccination and anaphylaxis.  This must be issued by a physician or nurse practitioner in your county or an adjacent county. (Same as adult rule.)  
  • Must be certified in pediatric CPR in order to immunize children.
  • In addition to the posting of the current ACIP immunization schedules, pharmacists who immunize children are required to post the following:

      NYC standing orders:

    • NYC pharmacies may obtain a flu standing order through the NY City Health Department if they are unable to obtain one on their own. Mandatory orientations are offered in summer and fall, with the next ones scheduled for 2019.

    • You can request more information by emailing nycflu@health.nyc.gov.

    • The NYC DOH standing order allows influenza immunization down to age 4 only.

    • NY City Department of Health has a dedicated webpage with information about obtaining a standing order within the five boroughs

    Reporting:

  • New York City – report to Citywide Immunization Registry (CIR).
  • All others – report to New York State Immunization Information System (NYSIIS).
  • MUST report to CIR or NYSISS within 14 days of administration immunizations for 19 yrs old and younger. No consent or opt out for reporting for this age group. 
  • For patients over 19 years of age, obtain consent and report to CIR or NYSIIS.
  • Pharmacists are now also required to report ALL vaccinations for all ages to the patient’s primary care provider electronically or via fax.  Discuss importance of having a PCP and the option to receive vaccinations from the PCP.
  • Consult the NY State Education Department’s FAQ page for more information
  • Complete the annual survey on Health Commerce System every year before the deadline,  even if all your vaccines are reported via NYSIIS or CIR. There's no penalty for failure to complete it, but the results demonstrate our value as healthcare providers and support the need for us to continue as immunizers.

       

NYS 2018 Budget Updates for Immunizations

  • Authorizes pharmacists to administer flu vaccine to children aged 2-18. Note that pharmacists are required to report all vaccines for patients 19 years old or younger to CIR (New York City) or NYSIIS (rest of state) within 14 days of administration
  • Clarifies the need to report all adult immunizations to both the patient’s primary care provider AND with patient consent to the state or citywide immunization registry
  • Extends the sunset date for the immunization bill to July 1, 2020
  • More details here: http://www.pssny.org/default.asp?page=ImmuUpdate2018

  

Shingrix – If vaccine is not available for the second dose on schedule (2 to 6 months after the first dose), give as soon as possible.

CDC Shingrix facts: https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/recommendations.html

Which vaccines can we administer…

In order for a pharmacist to administer a vaccination without a prescription, a non patient-specific standing order must be signed by a physician or certified nurse practitioner in the same or adjoining county as the pharmacy. The current standing order templates for pharmacist administered vaccines are linked below:

Who to Vaccinate…

HALO – Helps to make a decision about vaccinating a patient based on four factors, their Health condition, Age, Lifestyle, and Occupation

When to Vaccinate…

Immunization schedules

While you Vaccinate…

Additional Vaccine Information Statements as well as translations into multiple languages can be found at http://www.immunize.org/vis/

After Vaccination…
  • Pharmacists must report all immunizations administered to the New York State Immunization Information System (NYSIIS) or, if vaccinating in New York City, the Citywide Immunization Registry (CIR) within 14 days of administration. If the patient is 19 years or older then reporting to registries is only done with patient’s consent. If the patient is less than 19 years of age reporting is mandatory with no consent needed and no option to opt out.
  • New York Immunization Information System (NYSIIS)
  • NYSIIS FAQ
  • Citywide Immunization Registry (CIR)
  • Recommend that Patients keep and carry a vaccination card in order to keep track of their vaccination history. Links to vaccination card templates can be found here and here.
  • Notify patient’s primary care provider: http://www.immunize.org/catg.d/p3060.pdf
For more information:
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