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Immunization Corner
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Welcome to PSSNY's Immunization Corner

News and Updates:

CDC releases 10 updated Vaccine Information Statements
On October 30, CDC released new interim Vaccine Information Statements (VISs) for Hib, HPV, PCV13, polio, and rotavirus vaccines. CDC also released final VISs for cholera, PPSV23, typhoid, and zoster (both live and recombinant) vaccines. 
Access these VISs on their respective IAC web pages by clicking on the links below.

CDC publishes “Update: Influenza Activity—United States and Worldwide, May 19–September 28, 2019 and Composition of the 2020 Southern Hemisphere Influenza Vaccine” in this week’s MMWR

Volunteers Needed for NIH Study of Flu Vaccine and Heart Disease

NEW and Updated IAC Educational Materials:

CMS Special Edition Medicare Newsletter for Flu Season

2019-20 ACIP influenza recommendations - published in MMWR 8/22/19

Flu vaccine linked with lower risk of early death in patients with high blood pressure

Updates to the Varicella-Zoster Virus Disease Prevention Guidelines for HIV patients

CDC has released new interim VISs.  View them here

IAC recently revised Administering Vaccines: Dose, Route, Site, and Needle Size

Integrating Technicians into Your Immunization Program Free Webinar!!

CMS: Mass Immunizers and Roster Billing

Interns as Immunizers

Measles Vaccination Recommendations 2019

Report Vaccine Errors

Hepatitis A Outbreak guidelines Now Include Homeless

CDC Pink Book Webinar Series

Vaccinating Adults: A Step-by-Step Guide, IAC Guide available for free download

Shingrix recommendations during shortage (CDC)

National Foundation for Infectious Diseases Webinars

IAC's Ten Steps to Getting Started

Pharmacists as Immunizers DOH Update October 2018

>>>>>NY Pharmacists' immunization privileges sunset on July 1, 2020 if not extended<<<<<

>>>>Get involved in PSSNY's Advocacy Efforts to Expand RPh Immunization privileges<<<<

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Vaccines for Children Program Details

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 Carole Deyoe, Director of Pharmacy Practice at pharmacist@pssny.org if you have a creative method to share, or any questions about site content.

Pharmacies in NYC:

Pharmacies outside NYC:

Children's vaccines and Medicaid

  • Medicaid eligible children are VFC eligible so pharmacies cannot bill flu vaccine product for them 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 as of August 6,2019
        • BCBS of Western NY, HealthNow - Notify plan of your VFC status
        • CDPHP
        • Crystal Run
        • Emblem Health
        • Empire BCBS
        • Excellus
        • Fidelis Care
        • Independent Health
        • Metro Plus
        • MVP
        • United Health Care
        • Univera
        • VNSNY
        • Wellcare
        • Your Care
    • Plan to allow billing of pharmacist administered children's flu in the near future (working through systemic and operational details
      • Affinity 
      • Amida Care
      • Health First 
      • Molina (formerly Total 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).

  • Pharmacists may immunize children aged 2-18 for flu 
  • Patient specific prescription OR standing order
  • Standing order must be 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. You are required to attend an annual mandatory orientation.

    • 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 Legislative Updates for Immunizations

  • Adds flu for children aged 2-18
  • Establishes reporting for children's vaccinations to NYSIIS or CIR within 14 days 
  • 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

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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.  DO NOT start series again.

CDC Shingrix facts

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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:

Vaccine Manufacturer Contacts

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…

ACIP 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 as now required: http://www.immunize.org/catg.d/p3060.pdf
Need to get certified?

For more information:

PSSNY, 210 Washington Avenue Extension, Albany, NY 12203 * 800-632-8822 * staff@pssny.org