Immunization Program Update: COVID-19 Edition

Immunization Program Update: COVID-19 Edition

By now you are likely hearing that COVID-19 vaccine could be available as early as the end of 2020 and you may be wondering what the Philadelphia Immunization Program is doing to prepare. You may also be wondering when your site is likely to get vaccine. This update will address these questions.

The Philadelphia Immunization Program is working hard to be ready to distribute COVID-19 vaccine as soon as it is available. Initially, vaccine availability will be extremely limited. We are planning a 3 phase approach to COVID-19 vaccine rollout.

  • Phase 1 will concentrate on high-risk populations in controlled settings. PDPH anticipates distributing vaccine primarily through Health System and Hospital Occupational Health Departments, community-based clinics serving vulnerable populations and critical workforce, and registration-based mass vaccination events.
  • Phase 2, COVID-19 vaccine will remain somewhat limited. PDPH will prioritize vaccinating persons who were identified as prioritized in Phase 1 but were unable to receive vaccine. Additional Phase 2 groups may include moderate-risk essential workers and additional persons at high risk of severe morbidity and mortality, including people with chronic health conditions. Vaccine will be distributed in Phase 2 through pharmacies, medical clinics, occupational health offices, community-based clinics, and registration-based mass vaccination events.
  • Phase 3, COVID-19 vaccine supply will be sufficient for the entire population. PDPH will create a broad vaccine administration network to achieve sustainable and equitable vaccine access across the city, including pharmacies, clinics, hospitals, and mass vaccination events. Recruitment of private healthcare providers to administer COVID-19 vaccine will be key to integrating immunization into routine medical practice.

How can my site enroll to be a COVID-19 vaccine provider?

  1. Attend a Town Hall hosted by PDPH. Learn about the vaccine, important dates, eligibility details, roll out plans, etc. See schedule here!
  2. Complete and submit an enrollment form. Provide PDPH with your provider information so that your eligibility can be assessed. Missing information will delay your application review.
  3. Await confirmation of approval. PDPH will review all applicants and select COVID providers based on the information you provide. Providers will be selected to administer vaccine during a certain phase (see Phase detail above).

To learn more, and see updates, visit our COVID-19 page here.

Needle Shortage

Is your site running low on needles?

The Philadelphia Immunization Program has heard about shortages of needles for vaccine administration. Especially 25 gauge, 1 inch, needles. If you are experiencing shortages or having trouble acquiring an additional supply of needles to meet your practices needs, please complete our survey. We are working to better understand the need throughout the city and identify ways to address the need to avoid missed opportunities.

Thank you for all that you do to keep Philadelphia healthy. The Immunization Program is here to support you. Don’t hesitate to reach out to us.

VFAAR Vaccine is Available to Order

VFAAR vaccine is available to order.

In response to the unprecedented nature of this flu season, the Philadelphia Immunization Program is offering additional doses of flu to your site and our other FQHC partners. For this flu season only, both insured and uninsured adults would be eligible to receive these additional flu doses.

Contrary to our default policy of allowing only the truly uninsured to receive VFAAR flu doses, this year, the Centers for Disease Control and Prevention (CDC) is making an exception to the screening requirement for flu only.

Why is VFAAR flu vaccine available to everyone?

The intent of removing the eligibility requirements for these federally funded doses is to ensure that everyone has access to flu vaccine. However, as providers, we ask you to follow the ordering algorithm below to ensure that throughout the flu season, you continue to have doses on hand for all your patients – especially the uninsured:

  • Use your existing privately purchased vaccine to vaccinate insured individuals.
  • Order a supply of VFAAR vaccines to vaccinate uninsured patients.
  • Do not miss opportunities. Vaccinate your patients with the most appropriate supply you have in stock.

Which supply of vaccine should I use?

If private doses are not available (because you’re waiting for your shipment or your supply is depleted), do not miss an opportunity; remember everyone is eligible to receive a dose from the VFAAR supply. And the VFAAR vaccines you use on private patients do not have to be replaced.

  • Do not charge anyone’s insurance for the cost of the VFAAR flu doses. This is considered fraud and could affect your ability to receive VFAAR doses going forward. You can charge patients’ insurance an administration fee for doses of VFAAR flu that are administered to insured patients.
  • Use the flowchart below to assist you with identifying the correct supply:

Order Today!

Remember to order VFAAR doses as needed throughout the season. If you have any questions about your VFAAR supply contact Jillian Brown at for assistance.

Visit our Flu Hub for information on what vaccines are available and access flu resources.

To place your first order, visit the 2020-21 Ordering Page.

Pentacel Formula Updated

The Pentacel formula has changed.

The formulation of Pentacel® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjugate [Tetanus Toxoid Conjugate] Vaccine) has been updated. Sanofi changed the source of Inactivated Polio Virus (IPV) antigen from MRC-5-derived IPV (mIPV) to IPV that is derived from Vero cells (vIPV). This formulation of Pentacel retains the same dosing schedule, indication, safety, and immunogenicity data as the Pentacel formulation customers may use currently. Both formulations of Pentacel can be used to complete the series.

Pentacel formulated with Vero cell-derived IPV will include a different National Drug Code (NDC) number than the formulation you may use currently. It’s important to note the correct NDC number when receiving and administering the vaccine. The NDC number is listed on the outer carton, the vials, in the Prescribing Information, and on the shipment details you receive with your shipment.

Please work with your EHR/EMR to insure the that the new NDC is added to your system.

Pentacel (with (vIPV) 49281-0511-05 90698 120

Visit or contact Sanofi Pasteur at 1-800-VACCINE (1-800-822-2463) if you have additional questions about the prescribing information and formula changes.

If you have questions about ordering doses for your VFC patients, email our ordering specialists, Christine Wilson and Charma Miller.

How to order VFC/VFAAR flu vaccine for the 2020-21 season

How to order VFC/VFAAR flu vaccine for the 2020-21 season!

Please note, all flu vaccine from the 2019-2020 season must be accounted for before you can order flu for the 2020-2021 season. Guidance on accounting for remaining doses can be found here.

To place your first flu order…

  1. Complete a reconciliation. (If its been less then 2 weeks since your last reconciliation, email Christine and Charma to skip this step)
  2. Submit your temperature data since your last order.
  3. On the Vaccine Order page check the “Will this be an influenza order?” box.
  4. Order what your site needs for a 4 to 6-week period. Be sure that you have room in your fridge to store all of the flu and other vaccine you order.
  5. Check the status of your order 2 business days later in the PhilaVax IIS:
    • APPROVED: Your flu vaccine is on its way.
    • REJECTED: Click on view next to your order to review the notes from the VFC staff. Once all issues have been resolved, resubmit your order.

For additional flu orders, start with step 2. Additional flu orders do not require a completed reconciliation as long as a reconciliation has been completed in the last 60 days. Flu vaccine can be ordered as often as needed. There is no minimum time period between orders.

The Immunization Program will make every effort to fulfill your flu vaccine request. If flu product is available in limited quantity, your order may be reduced. If your order is reduced, a note will be added to the PhilaVax IIS comment box on the order page.

Flu vaccine may arrive separately from other vaccines even when ordered at the same time. The day you receive your flu order, log into PhilaVax IIS and electronically add the doses to your inventory. Contact us immediately if the temperature monitor indicates an out-of-range temperature when vaccines are delivered:


  • 8/17/2020 – Pediatric Flu Vaccine is Available to Order! A supply of FluLaval pre-filled syringes is now available to order for your VFC patients. In order to allow as many sites as possible to access flu vaccine at this time, initial orders will be limited to a max of 500 doses. Orders may be reduced based on usage in past years.
  • 8/20/2020 – A supply of FluMist intranasal sprayers is now available to order for your VFC patients.
  • 9/14/2020 – Adult Flu Vaccine is Available to Order! A supply of Fluarix and Flucelvax pre-filled syringes and Flumist intranasal sprayers is now available to order for your VFAAR patients.
  • 9/21/2020 – FluZone, prefilled syringes and multi-dose vials (MDVs), is now available to order for your VFC patients.

Have Questions?

Contact Christine Wilson at 215.685.6728 or, or Charma Miller at 215.685.6667 or for assistance.

Thank you for keeping Philadelphia healthy by fighting flu! For more information about influenza in Philadelphia, visit our flu hub.

Return All 2019/20 Influenza Vaccine

Return all unopened seasonal 2019/20 VFC/VFAAR influenza vaccine.

All VFC/VFAAR influenza vaccine supplied by the Philadelphia Immunization Program during this past flu season has expired.Please account for unused VFC/VFAAR flu vaccine at your site using PhilaVax:

  • Process a return for the unopened vials online in the Vaccines Returns module
  • Complete an adjustment to account for open vials in the Inventory on-hand page

More information about reporting expired VFC/VFAAR vaccines is on the Immunization Program website.

Return your vaccine before July 24th

Please complete these steps by July 24, 2020 to avoid delays in processing your site’s 2020-21 flu season orders. If you have questions, contact or call Mohan Najaraja (215-685-6872).

Vaccine available for the 2020-21 flu season


Product Manufacturer / NDC Eligibility Dose/ Presentation / Type CPT Code CVX Code Availability
FluLaval GlaxoSmithKline / 19515-0816-52 6 mos – 18 years 0.5 mL / single-dose syringe / inactivated, quadrivalent 90686 150 Yes
Fluzone Sanofi / 49281-0420-50 6 mos – 18 years 0.5 mL / single-dose syringe / inactivated, quadrivalent 90686 150 No
Fluzone Sanofi / 49281-0633-15 6 mos – 18 years 0.5 mL/ 5.0mL multi-dose vial / inactivated, quadrivalent 90688 158 No
FluMist1 AstraZeneca / 66019-0307-10 2 – 18 years 0.2 mL / intranasal sprayer / live, quadrivalent 90672 149 No


Product Manufacturer / NDC Eligibility Dose/ Presentation / Type CPT Code CVX Code Availability
Fluarix GlaxoSmithKline / 19515-0885-52 19 years & older 0.5 mL / single-dose syringe / inactivated, quadrivalent 90686 150 No
Flucelvax2 Sequirus/ 70461-0320-03 19 years & older 0.5 mL / single-dose syringe / inactivated, quadrivalent 90674 171 No

1 A limited supply of FluMist, the nasal spray, is available to order for your VFC eligible patients. Continue to order injectable flu products for most of your patients, and FluMist for your patients who refuse a shot.
2 A limited supply of Flucelvax is available to order for your VFAAR eligible patients who have egg allergies or requests an egg-free flu vaccine.

Don’t delay, return your expired vaccine now

It is difficult to anticipate exactly when flu vaccine will be available. However, the health department is committed to getting flu vaccine to our providers as soon as it arrives. To prevent delays, please complete your flu return today.

All communication about the availability of flu vaccine will be made via email and posted on our website. Keep you eyes open for upcoming messages! If you need to add more people to our mailing list, please contact us at

Thank you for helping to protect Philadelphians this past flu season! We look forward to working together to keep people safe from the flu next season.

COVID-19 Conference Call Follow Up

Thank you to all the providers who joined our conference calls last month. Please review this summary of the strategies and resources we discussed to address the decrease in vaccination that has been caused by the COVID-19 pandemic.

Vaccinating during the pandemic

A number of practices shared what they are doing to safely offer vaccines during this time that we thought would be helpful for other practices. These measures include:

  • Communicating cleaning and other preventative measures with parents and guardians when scheduling visits.
  • Having all family members wear a mask to the visit.
  • Limiting the number of persons who accompany a patient for the visit.
  • Bringing patients straight to the exam room, avoiding any time in the waiting room. Some practices asked families to wait outside the office and called parents and guardians when they were ready to see the patient.
  • Scheduling vaccine appointments in blocks in the morning, separate from sick and other visits.
  • Using separate entrances for well and sick visits.
  • Offering vaccines in spaces that better lend themselves to social distancing. Examples of measures that practices implemented include offering vaccination curbside in the parent’s vehicle and using other rooms in the clinic such as conference rooms for vaccination that are separate from the exam rooms.

New resources

Several new resources have been developed in response to the feedback that we got from providers.

  • Take a few minutes to review the new Safer at Home website, a hub of re-opening guidelines and resources for Philadelphia. It includes the Guidelines for Outpatient Health Care Facilities guide, a plain language summary of rules for reopening in the Yellow Phase.
  • Offering PhilaVax Reminder Recall webinars to train vaccine coordinators and office managers on how to use this tool to identify patients who are due for a vaccination. The reminder recall has the functionality to aid with mailings and automatic dialing programs. The first training is scheduled for Wednesday, June 17 at 10 am. Register for the training here.

Coming resources

Based on the feedback that we received during our conference calls, we are working on several resources to support immunization services in your clinics. These include:

  • Resources for reaching out to parents, guardians, and patients to encourage them to come in for well visits and vaccination.
  • Guidance on implementing vaccination clinics that also allows for COVID social distancing measures. If your practice is considering a vaccination clinic, it is important to start thinking about the logistics and space now.

Keep an eye out for emails with these resources and they will also be posted on our website, The Immunization Program looks forward to our continued partnership during this challenging time. See below for some steps you can take to keep your vaccine inventory stocked.

Ordering VFC vaccine

Please stay in communication with our program as changes that impact vaccination are implemented. Continue to do the following:

  • Let us know your plan for visits over the coming weeks when you place your order so that we can better match your current vaccine supply with projected usage.
  • Work with your staff who access vaccines to ensure that the vaccine coordinator is notified when you are running low on any vaccines in between orders.
  • Reach out to our program about vaccine needs as they arise. We can help ensure that you get the vaccines you need in a timely manner.

Our response to requests for vaccine is situation dependent. We consider many factors whenever a site requests vaccines. Do not hesitate to reach out because a previous request was denied.

Philadelphia COVID resources

Pediatric patients (0 – 18 yo) can be referred to CHOP for testing if you cannot offer testing at your practice. To refer a patient, your office should call Joani Schmeling at 215-685-6490 Monday through Friday between 8:30 am and 5:00 pm.

  • Have the following info available when you call: Patient name, Date of birth, Address, Parent / Guardian Contact information, Symptom and exposure information.

The city has several resources available to help providers during the pandemic.


Thank you for all you do to keep your patients safe and healthy!

Immunization Service Survey

Help us help you! Take our immunization service survey!

Dear VFC and VFAAR Providers

Thank you for your continuing service to your patients, especially during this COVID-19 pandemic. Our team continues to provide core immunization services as we respond to the pandemic.

In order to better support you during this time, please complete this survey so that we can better understand your immunization needs at this time.



We’re here to help!

If you have any questions regarding the following, we are here to help:

And, if there are changes at your office that will affect your ability to properly store and monitor your vaccines or your office will be closed in response to COVID-19, email for guidance.


The Philadelphia Immunization Program

Update for VFC & VFAAR Providers

Covid-19 Update for VFC/VFAAR Providers





To Our VFC and VFAAR Providers:

On behalf of the entire Immunization Program team, we want to thank you for your service to your patients, especially during this COVID-19 pandemic. We also want to thank all the doctors, nurses, medical assistants, office staff, laboratorians, and clinicians that are tirelessly working to keep Philadelphians healthy. Covid-19 update for vfc.vfaar providers


As your partners in public health, the Immunization Program is committed, alongside you, to ensure that safe and viable vaccines are available to children and adults. All our PDPH Immunization staff are considered ‘essential personnel’ and are reporting for duty at the health department. Our staff are here to answer your concerns regarding the Vaccines for Children Program and the Vaccines for Adults at Risk Program. Although some of our routine services are limited while we respond to COVID-19, our core immunization services are operational (see list below). However, all in-person VFC and IQIP visits are cancelled until further notice. Our team will be reaching out to sites with scheduled visits to discuss next steps given these changes. We do ask for your patience while we juggle our routine job duties and the COVID-19 response.


If you have any questions regarding the following, we are here to help:



And, if there are changes at your office that will affect your ability to properly store and monitor your vaccines or your office will be closed in response to COVID19, email for guidance.


Thank you for your ongoing confidence, partnership, and trust. The Immunization Program is committed to the well-being of Philadelphia’s residents and we are grateful for your support.




The Philadelphia Immunization Program

2020 Enrollment Is Open! Enroll Today!

2020 Enrollment Opens Today!

The Philadelphia Immunization Program’s Vaccines for Child (VFC) & Vaccines for Adults at Risk (VFAAR) enrollment opens today! Log into PhilaVax and begin your enrollment right now!

Annual enrollment is required to receive federally funded vaccines regardless of if it’s your first year or hundredth! Enrollment will be open until February 28th. Don’t wait – enroll today!

To help you through enrollment, we’ve created the following materials…

Clinic Information Changes Cheat Sheet

Your sites contact information (ie staff, delivery hours and address) populates to the enrollment form. Get a head start on enrollment by updating your clinic information now. Our Clinic Information Changes cheat sheet breaks these changes down into simple steps. You can download our Clinic Information Changes Cheat Sheet here.

Enrollment Cheat Sheet

You can download our Enrollment Cheat Sheet PDF here. Our enrollment cheat sheet breaks down the enrollment process step by step. It also provides useful tips that will make your 2020 enrollment much easier. The Enrollment Form will be available in PhilaVax starting on Monday, February 3. Review the instructions today so that you know what to expect next week.

Contact us!

Have questions about enrollment? Having difficulties accessing the cheat sheets? Contact our Immunization Education Coordinators! You can email them at or call 215.685.6872 or 215.685.6490.

Being enrolled in VFC/VFAAR helps keep vaccines available to all Philadelphians. We strongly encourage you to log into PhilaVax and re​-enroll today! Don’t wait until the 28th!

2020 Enrollment begins February 3rd

2020 Enrollment begins February 3rd

Happy new year! The Philadelphia Immunization Program annual Vaccines for Children (VFC) and Vaccines for Adults at Risk (VFAAR) enrollment opens on Monday, February 3rd.

Start the new year off on the right foot. Complete your VFC/VFAAR enrollment on time.

This year’s enrollment period runs from February 3rd to February 28th. During this time all VFC/VFAAR sites must log in and complete the online enrollment. Annual enrollment is required to receive federally funded vaccines regardless of if it’s your first year or hundredth! Don’t wait until the end of February. Login and get started on Monday, February 3rd!

Vaccine Shipment Delays During the Holiday Season

Please Submit Vaccine Orders by Monday, December 9

Don’t let delays in vaccine shipments during the holiday season leave you with no vaccine!

To ensure your office has sufficient vaccine in stock, please submit orders by 3:00 PM on Monday, December 9. Complete orders received by December 9th at 3pm will be processed and shipped as usual, without delay. Do not wait until the last minute to submit your order! Please check the status of your order no more than 2 days after submission.

Orders submitted between Tuesday, December 10 and Thursday, January 2 may not be delivered until the week of January 6. The distribution center will return to normal operations on January 2.
Contact the VFC/VFAAR Program if you Need Assistance

Provider Education Coordinator

Mohan Nagaraja, 215-685-6872,
Joani Schmeling, 215-685-6490

Vaccine Order Specialists

Christine Wilson, 215-685-6728,
Charma Miller, 215-685-6667, []

VFC & VFAAR Coordinator

Jillian Brown, 215-685-6424, []

The Philadelphia Immunization Program wants to thank you for all your hard work this year and for doing your part to keep Philadelphia healthy. We wish you good health and wellness during this holiday season!

Spring, Measles and Mumps

Medical Director Notes

Dr. Kristen Feemster

Dr. Kristen Feemster is the Medical Director of the Philadelphia Department of Public Health’s Immunization Program.

Spring, Measles and Mumps

2019 is on track to have the highest number of measles cases since the disease was declared eliminated from the U.S. in the year 2000. Why are we seeing these outbreaks and what can we do to protect our community?

This has been a busy spring for vaccine-preventable diseases! Temple University is experiencing a mumps outbreak among students and reported almost 150 cases as of mid-April. While, across the nation, the Centers for Disease Control and Prevention (CDC) reports more than 600 cases of measles so far this year. While we have not yet had any measles cases in Philadelphia, some of the largest outbreaks are right next door. The MMR vaccine prevents both measles and mumps, and most schools require it for entry. Despite that, 2019 is on track to have the highest number of measles cases since the disease was declared eliminated from the U.S. in the year 2000. Why are we seeing these outbreaks and what can we do to protect our community? 


Between January 2016 and July 2017, there were 150 mumps outbreaks (9,200 cases) across the country. Half of these outbreaks took place on college campuses despite the majority of students being vaccinated. Why? The effectiveness of two doses of MMR vaccine is 88% for mumps, meaning that out of 100 people, 12 may still get sick if exposed. Additionally, it appears that protection against mumps may decrease over time. How easy is it to be exposed to mumps? Mumps spreads through contact with saliva or respiratory droplets from an infected person. In a community like a college campus, where young students live in dormitories and socialize frequently, there are many opportunities for the mumps virus to spread. And, unfortunately, people with mumps can start spreading the virus before they know for sure that they are sick. The virus can be spread up to two days before developing the most common symptom, a swollen, painful jaw. The ability to spread the mumps virus before one knows that they are sick along with close personal contact inherit to dorm style living and college life, and a decreased protection from the MMR vaccine creates the ideal conditions for an outbreak. 


Unlike mumps, measles outbreaks are primarily occurring among unvaccinated individuals. The majority of our current measles cases are in New York City and state where returning travelers brought measles to some Orthodox Jewish communities where vaccination rates are low.  Large outbreaks have also occurred in Oregon where there are high rates of vaccine refusal among parents. The measles virus is so highly contagious, it is easy for it to spread quickly through a community if there are any unprotected people. How well does MMR vaccine work for measles? The effectiveness of 2 doses of MMR is 97% against measles AND immunity is lifelong. If we can maintain 95% or higher MMR vaccination rates we can prevent the spread of measles. 

Vaccine Hesitancy

While there is no explicit content barring vaccination in major religious texts and no evidence of any association between vaccines and autism, some parents still seek exemption on these grounds.

If MMR vaccine has been a part of the routine immunization schedule for decades, why do some communities have low MMR vaccination rates? In every state, MMR is one of the vaccines required for school attendance. And, nationally, MMR rates are greater than 90%. Yet, despite requirements, almost every state allows exemptions based upon personal or religious beliefs. And there are a wide range of reasons some parents refuse vaccination or choose to pursue an exemption. For example, some religious communities refuse vaccines based upon interpretation of religious teachings. And some parents refuse MMR vaccine because of vaccine safety concerns related to autism. While there is no explicit content barring vaccination in major religious texts and no evidence of any association between vaccines and autism, some parents still seek exemption on these grounds. 

Preventing Outbreaks

Simply, the best prevention tool that we have for both is the MMR vaccine.

What can we do to prevent or stop mumps and measles outbreaks? Simply, the best prevention tool that we have for both is the MMR vaccine. Be sure that your patients, whether children or adults, are up to date as per current recommendations. Early identification of cases of mumps and measles is also important. When we suspect cases, we can use appropriate isolation practices to prevent further spread. We can also identify contacts to make sure they are protected. 

For mumps specifically, it is time to implement requirements that all university and college students are up to date on their MMR vaccine and provide documentation of vaccine receipt. It is also important to consider a third MMR booster dose for people who are at risk of being exposed to mumps cases when there is an outbreak. At Temple, this has meant setting up vaccination clinics to provide MMR vaccine to students. 

For measles, we are encouraging providers to remain vigilant and consider measles when seeing patients with fever and a rash, especially if they have traveled domestically or internationally. Talk to your patients and their families about any vaccine-related concerns, especially if they have a history of vaccine refusal. Know about resources to help address specific questions, such as concerns about vaccine safety. And consider partnering with community leaders to communicate the importance of vaccination. 

Healthcare providers should also use our immunization registry, Philavax, to check your patients’ immunization histories and keep patients, especially students, up to date on their MMR. The Vaccines for Children (VFC) program can help you provide vaccines for publicly, under – or uninsured kids up to the age of 19. 

Working together we can keep measles and mumps from spreading any further this spring and keep everyone healthy to enjoy this wonderful weather. 

Staying Resilient: Controlling Hepatitis A Outbreak

Medical Director Notes

Dr. Kristen Feemster

Dr. Kristen Feemster is the Medical Director of the Philadelphia Department of Public Health’s Immunization Program.

Staying Resilient: Controlling Hepatitis A Outbreak

City personnel evacuated Kensington’s last homeless encampment during January’s polar vortex. Forty-five people left the Emerald City encampment and were referred for a combination of housing, medical or social services as a part of Mayor Kenney’s Philadelphia Resilience Project.

Launched in October 2018, the Philadelphia Resilience Project aims to bolster affected Philadelphia neighborhoods by uniting partners to address homelessness, drug addiction, violence, metal health challenges, and neighborhood clean-up. While these are all crucial needs, it is also important to remember that persons and communities affected by the opioid crisis are at higher risk for certain infectious diseases. Indeed, Philadelphia has seen increases in Hepatitis A, B and C, HIV and syphilis within neighborhoods most affected by the crisis. Hepatitis A has been particularly concerning.

Now is the time to immunize everyone who should get a Hepatitis A vaccine and the Immunization Program is here to support your efforts

Many states are experiencing outbreaks of Hepatitis A, especially among homeless persons. Hepatitis A spreads when stool from infected persons contaminates food, water or other surfaces. It is much easier for the virus to spread when it is difficult to wash hands or have regular access to a bathroom. Hepatitis A can also be spread through sexual activity or sharing needles. That is one of the reasons why there have been a rising number of outbreaks in communities affected by homelessness and injection drug use. Since March 2017, several states have declared Hepatitis A outbreaks for a total of more than 4,000 cases, the majority of whom have been hospitalized and over fifty have died. Pennsylvania joined the list of affected states in November 2018. Fortunately, there are things we can do to prevent the outbreak from escalating here…vaccinate!

Hepatitis A vaccines were first introduced in the U.S. in 1996. Since then they have been routinely recommended for all infants 12-23 months old and for anyone at increased risk for Hepatitis A exposure. Why vaccinate 12 month olds? When Hepatitis A was more common, it was often spread by young children who would be more likely to have asymptomatic infection and could spread virus without knowing it. This strategy helps reduce the amount of hepatitis A in the community – but it won’t stop all transmission. Only about 70% of infants get the vaccines. And there are many adolescent and adults who didn’t have a chance to get vaccinated as kids. Now is the time to immunize everyone who should get a Hepatitis A vaccine and the Immunization Program is here to support your efforts

  • If you see children and adolescents in your practice, check whether your patients have received Hepatitis A vaccine and catch them up if they haven’t. If you see adults, offer Hepatitis A vaccine to everyone but make sure you give it to your patients with a history of drug use or homelessness. Use our immunization registry, Philavax, to check your patients’ immunization histories.
  • The Vaccines for Children (VFC) and Vaccines for Adults at Risk (VFAAR) programs can help you provide vaccines for publicly, under- or uninsured kids and uninsured adults.
  • If any of your patients have signs of acute hepatitis (fever, jaundice, nausea, light colored stools), test for Hepatitis A and report any positive results. We can help make sure that the virus won’t spread to others.
  • Check the Health Information Portal for more information about Hepatitis A and other infections affecting persons who are homeless or use drugs.

In October and November, our team provided 222 Hepatitis A and over 200 influenza vaccines to people living in and around encampments in Kensington through street outreach. We have also collaborated with Prevention Point, Philadelphia’s needle exchange program, to provide vaccines to their clients. While we have been able to target a high risk community, let’s do what we can to increase Hepatitis A vaccination rates across the city.

Through partnership, we can contribute to resilient communities.

Update your Digital Data Logger software today

Update your Digital Data Logger (DDL) software today

 Please update to the latest version of the LogTag software, which makes small but important changes to how the digital data loggers (DDL) work and prevent future compatibility issues.

This update will not affect downloading processes or your daily responsibilities and will take about 1 minute to do. Please do this update by Friday, 1/25.


How to update your software

To update your software:

If you need administrative or IT permission to download software, please contact your IT department as soon as possible.


If you have any questions about this update please contact:

Alexis Bridges and Adam Howsare

Storage & Handling Coordinators

Phone: 215-685-6777

Holiday DDL Download Reminder

Digital Data Logger Download Reminder During the Holiday Season

To make sure that your vaccines stay properly monitored over the busy holiday season, please be aware of the date indicator on your digital data loggers (DDLs). To prevent any gaps in temperature monitoring, please download your DDL files if the date indicator is approaching the 30 day capacity. With many offices having adjusted holiday hours or staff members taking time off, the 30 day capacity on your DDL could be reached.

To prevent this, we suggest that you download your DDL files before they reach their 30 day memory capacity. This may mean downloading your DDL earlier than you normally would. This will ensure that they continue to record temperature readings for your storage units over the holidays.


After you download your DDL files, remember to:

1) Email both your LTD (yellow and blue) and CSV (green) files to

2) Upload your CSV files into the Clinic Tools module in PhilaVax


Contact the VFC or VFAAR program if you need assistance or have additional questions:

Storage and Handling Coordinators

Alexis Bridges       phone: 215-685-6777

Adam Howsare     phone: 215-685-6777


VFC & VFAAR Coordinator

Jillian Brown          phone: 215-685-6424


HPV vaccine for adults?

Notes from the Medical Director

Dr. Kristen Feemster
Dr. Kristen Feemster is the Medical Director of the Philadelphia Department of Public Health’s Immunization Program.

HPV vaccine for adults?

On October 5, 2018, the Food and Drug Administration expanded the age range for HPV vaccines to include 27-45 years old men and women. The change has gotten a lot of coverage in the media and perhaps you have been getting questions about the expanded age range from patients, family or friends. Why was this change made and what does this change mean for you?

FDA approval does not mean that recommendations have changed.
While the FDA has approved the expanded age range, the Advisory Commission on Immunization Practices (ACIP), who makes our recommendations about when and to whom to give approved vaccines, has not yet changed their recommendations about who should get HPV vaccines. So, for now, HPV vaccines recommendations still focus on 9-26 year old males and females.

The committee has been reviewing information about not only how well HPV vaccines work, but also how much of an impact it is likely to have on preventing HPV infections, in this older age group. Adding a new recommendation takes resources to make sure there is enough vaccine supply, raise awareness and get providers ready to stock and recommend a vaccine. The ACIP considers all of this before making changes to the program.

Why wouldn’t HPV vaccines be recommended for adults, especially since HPV is a sexually-transmitted infection?
Current recommendations for HPV vaccines target 11-12 years old adolescents for routine vaccination with catch up through age 26. Our current recommendation target younger age groups for several reasons:

  1. The goal of vaccination is to get everyone protected BEFORE exposure: HPV vaccines work by providing immunity before exposure to the HPV types covered by the vaccine. Since HPV is a sexually transmitted infection, that means before onset of sexual activity. The best way to make sure this happens is to get kids vaccinated just as they are entering adolescence, well before likely exposure. HPV is very common- almost all of us are exposed at some point during adolescence and adulthood.
  2. HPV vaccine can be given as a part of the adolescent vaccine platform: This approach also works well because young adolescents are coming in to get other vaccines, Tdap and MCV4, when they are 11 or 12 years old. This an excellent time to make sure adolescents have everything they need to keep them healthy as they enter middle and high school.
  3. We have data that shows how well the vaccines work in this age group: The immune response in younger adolescents is so good, only 2 doses of the HPV vaccine are needed if you start the series before age 15 years, compared to 3 doses for older teens.

Recommendations have not included adults because as we get older, we are more likely to be exposed to HPV. Since the vaccine protects us BEFORE exposure- it won’t help if we have already been infected by the types covered by the vaccine. So, for now, recommendations focus on early protection to get as much impact as possible.

If adults are more likely to already be exposed to HPV, why did the FDA approve the expanded age range?
Even though adults are more likely to be already exposed to HPV, adults are not likely to have been exposed to ALL the HPV types covered by the vaccine. That means that there may still be some benefit to vaccination. Let’s say you have a patient who has been exposed to types 6 and 16. Your patient would still be protected against the 7 other types covered by the vaccine.
To make its decision, the FDA considered benefit by reviewing studies that show how well the vaccine works in women and men ages 27-45 years old. These studies looked at two things: the immune response (antibody levels) and vaccine effectiveness (ability to prevent HPV disease) in this age group. These studies showed that there is a good immune response but effectiveness is not quite as high since adults may have already been exposed to HPV before vaccination. No studies showed any safety issues.

Does this mean that I should or shouldn’t vaccinate adults >27 years old?
Remember that recommendations from the ACIP still have not changed. Keep emphasizing routine vaccination for 11-12 year olds. This is the best and most cost-effective way to ensure good protection before exposure to any HPV and reduce the overall prevalence of HPV in the community. For this reason, it is difficult to know whether HPV vaccines will be recommended universally for adults aged 27-45 years old. But, there still may be room for individual decision making. While adolescents and young adults are at highest risk of first exposure to HPV once they become sexually active, that does not mean the exposure risk goes away. HPV vaccination for 27-45 year old adults could still provide protection against some HPV types, especially for adults who remain at risk of exposure (i.e. have a new partner). While our HPV vaccination rates have been improving, we are still below Healthy People 2020 goals so there are unvaccinated adults out there.

More to come…

Holiday Vaccine Shipping Delays

Vaccine Shipment Delays During the Holiday Season

Submit orders by December 7th

To make sure that you receive vaccines when you need them, submit orders by 3:00 PM on Friday, December 7. These will be processed and shipped out as usual. Be sure to check the status of your order 2 business days after submitting.

Orders submitted between Monday, December 10 and Friday, December 28 may not be delivered until the week of January 8th. The distribution center will return to normal operations on January 2.


During the holiday season – from mid-December to early January – the distribution center that ships vaccine provided through the Vaccines for Children (VFC) and Vaccines for Adults At Risk (VFAAR) programs will have reduced shipping capacity. Orders submitted during this time may take longer than usual to ship.


Contact the VFC or VFAAR program if you need assistance.

Provider Education Coordinators

Joani Schmeling      phone: 215-685-6490

Mohan Nagaraja      phone: 215-685-6872


VFC & VFAAR Coordinator

Jillian Brown          phone: 215-685-6424


Vaccine Order Specialists

Christine Wilson      phone: 215-685-6728   

Charma Miller         phone: 215-685-6667


How bad can the flu get?

Notes from the Medical Director

Dr. Kristen Feemster
Dr. Kristen Feemster is the Medical Director of the Philadelphia Department of Public Health’s Immunization Program.

How bad can the flu get?

Flu season is challenging. First, we need a new flu vaccine every year because the flu virus is always changing.  Before each flu season, a new flu vaccine is developed to match the flu strain that scientists expect will be dominant during the upcoming season. Then, vaccine producers start manufacturing the vaccine and distribute it all over the world. Finally, local public health professionals like us here in Philadelphia work hard to remind everybody to get a flu vaccine as early as September to make sure everyone is protected before flu arrives.

From vaccine development to vaccine delivery, it is a large amount of work. But it is important work because flu is serious, every year. During the height of a bad flu season, up to 8% of all emergency room visits in the USA – 1 out of every 12 – is somebody who’s sick with the flu and hundreds of thousands of people are hospitalized with illness caused by the flu. Last year’s flu season killed an estimated 80,000 people in the USA.

Despite flu’s severity every year, too few people get the flu vaccine – immunization rates hover around 40% in the USA. Why? Often, I think we underestimate how bad flu can be. We call lots of things ‘the flu,’ including milder infections like the common cold. That can lead us to think that the flu does not really make you very sick. But influenza can invade your lungs and make you feel horrible. In severe cases, your lungs can get so inflamed that they stop working.

The worst example of how bad the flu can get was the 1918 flu pandemic. It was so bad that “cities ran out of wood for coffins” as the virus killed 3 to 5 percent of the world’s population – an estimated 50 to 100 million people. The 1918 pandemic was caused by a new strain of influenza. We have had pandemics since that time and will probably have more the future. And we will continue to have flu epidemics every season. While we now have more tools to prevent and treat influenza, we need to keep being prepared and keep working to reduce the toll that the seasonal flu takes on our population.

To help, we’ve got a Flu Toolkit that health care providers can use to boost flu vaccination rates at their clinics this fall and winter – and, of course, resources for Philadelphia residents to Get Your Annual Flu Shot.