1. Vaccinating During COVID-19
The COVID-19 pandemic is changing rapidly and is affecting communities across the United States in different ways. Despite changing circumstances, clinicians must continue to provide their patients with access to clinical services in environments that are safe for all. Some strategies used to slow the spread of disease in communities include postponing or cancelling non-urgent elective procedures and using telemedicine instead of face-to-face encounters for routine medical encounters. Delivery of some clinical preventive services, such as immunizations, requires face-to-face encounters. In areas with community transmission of COVID-19, these visits should be postponed except when:
- An in-person visit must be scheduled for some other purpose and the clinical preventive service can be delivered during that visit with no additional risk; or
- An individual patient and their clinician believe that there is a compelling need to receive the service based on an assessment that the potential benefit outweighs the risk of exposure to the virus that causes COVID-19.
2. What is VFAAR
The Vaccines for Adults at Risk (VFAAR) Program makes vaccine available to providers throughout Philadelphia who serve uninsured adults at high-risk for vaccine preventable diseases. VFAAR provides enrolled providers with federally purchased vaccine at no cost. Enrolled health care providers then administer these vaccines to eligible individuals at no out-of-pocket cost.
The VFAAR program started in 1994, providing at-risk adults in shelters with Hepatitis A & B, influenza, and Td vaccines. The program has since expanded to include more community partners and vaccines, with the continuing goal of serving uninsured adults in Philadelphia.
Currently there are 33 facilities enrolled in the program. In 2012, the Philadelphia Immunization Program distributed 13,295 doses of vaccines to VFAAR sites.
In addition to Philadelphia’s nine Ambulatory Health Service (AHS) Health Centers, a diverse range of providers participate in the VFAAR program in the city. VFAAR Program sites include HIV treatment centers, FQHCs, health clinics in methadone maintenance programs, medical clinics that work with social service organizations, family planning, STD clinics, and primary care clinics.
3. Who is Eligible for VFAAR vaccines?
Individuals are eligible to receive VFAAR vaccines if they are:
- 19 years of age or older
Adults with any type of insurance – Medicaid, Medicare, or privately-insured – are not eligible to receive VFAAR vaccines. Additionally, anyone younger than 19 years of age is not eligible for VFAAR
4. What Vaccines are Available Through VFAAR?
VFAAR providers order a subset of the available VFAAR vaccines based on the population of VFAAR eligible patients they serve. The following vaccines are available through the VFAAR program:
5. Why Should My Clinic Enroll in VFAAR?
By removing financial barriers to immunization for both patients and providers, VFAAR:
- Facilitates timely immunizations for eligible adults
- Reduces referrals to public clinics for immunizations
- Allows patients to choose where they go for comprehensive care
- Makes it easier to provide high quality care to patients
6. How Do I Enroll My Clinic in VFAAR?
Before your clinic can be enrolled in the VFC/VFAAR Program, you’ll need to ensure that your office meets these qualifications:
- Serve VFAAR-eligible adults
- Have appropriate refrigeration and freezer units that can maintain appropriate temperatures for vaccine storage (no dorm style units) Find more information on vaccine storage requirements here
- Have access to the internet to order vaccines online
- Electronically report all administered vaccines to PhilaVax IIS
- Can meet the requirements of the VFAAR Provider Agreement
If your office meets these qualifications, you’ll complete the enrollment process:
- Complete the electronic enrollment form
- Determine which vaccines your site will offer through VFAAR
- Attend the VFAAR site visit
- Submit 7 days of vaccine storage temperature data showing in range temperatures before receiving VFAAR vaccine
All providers enrolled in VFAAR are required to complete the VFAAR enrollment form annually, due each June.
7. What is Required of Enrolled Providers?
Below is an overview of the requirements for enrolled providers. Detailed information about how to meet these requirements can be accessed through the links included below.
Comply with the ACIP Immunization Schedule
VFAAR providers must comply with current immunization schedules, dosages, and contraindications as established by the Advisory Committee on Immunization Practices (ACIP).
The U.S. Recommended Adult Immunization Schedule indicates the recommended ages for routine administration of currently licensed vaccines for adults older than 18 years. Click here to review the schedule.
Take Financial responsibility for the VFAAR vaccine at your clinic
Even though VFAAR vaccine is supplied free of charge to enrolled providers, the doses are not provided to the program at no cost. VFAAR vaccine is purchased from vaccine manufacturers under contract using federal taxpayer dollars. To ensure the continuation of the VFAAR Program, vaccine wasted through negligence must be replaced on a dose-per-dose basis.
Given the goal of the VFAAR program to remove financial barriers to vaccination for eligible patients, enrolled providers must adhere to the capped vaccine administration fees for eligible patients. By enrolling in the VFAAR Program your office agrees to not:
- Charge for VFAAR vaccine
- Impose a vaccine administration fee higher than the fee cap established by the Center for Medicaid and Medicare Services (CMS) and the Commonwealth of Pennsylvania, which is currently $23.14 per vaccine
- Deny access to federally purchased vaccines to an established patient who is unable to pay the vaccine administration fee
Allow Immunization Program Staff Access to Your Site
The Philadelphia VFAAR Program conducts site visits with enrolled provider sites to ensure compliance with VFAAR Program requirements. Providers should expect a visit from VFAAR staff at least once per year, but these may occur more frequently. Depending on the type of visit, some preparation may be required of the provider/staff prior to the visit.
Maintain a Supply of Vaccines On-hand
Providers enrolled in the VFAAR Program are responsible for ordering appropriate amounts of vaccine and maintaining proper vaccine inventory. Vaccine needed for a practice is based on the number of VFAAR-eligible patients seen in a practice. The vaccine inventory is tracked by the completion of monthly reconciliations. Reconciliation means keeping track of your vaccine inventory in PhilaVax – documenting vaccine doses that have been administered, returned, or adjusted due to wastage.
Providers are required to order VFAAR vaccine and document their inventory in the PhilaVax online ordering system. Find more information on the system here.
Separate Vaccines by Funding Source
Private, VFC, and VFAAR vaccine can’t be used interchangeably. Clearly label VFAAR vaccine to distinguish it from privately-purchased vaccine.
When you receive vaccine shipments, label them as you unpack and store them. You can request VFAAR stickers at no cost from us on our Materials Page.
Store Vaccines & Monitor Temperatures
All VFAAR vaccines need to be stored in a precise temperature range – some need to be in the fridge and some need to be in the freezer. In addition, all VFAAR vaccine must be constantly monitored to ensure that correct temperature storage is maintained until it is administered to patients.
Learn more about storing vaccines and maintaining correct temperature ranges on our Storage and Handling or within our Complete Storage and Handling Guide.
VFAAR Documents, Files, & Forms
Guides & Tips for VFC/VFAAR Providers
Online Ordering: Inventory Management Job Aid
Online Ordering: Accepting Shipments Guide
Online Ordering: Ordering Vaccines Guide
Online Ordering: Adjusting Wasted Vaccine
Online Ordering: COVID-19 Vaccine
Tracking Vaccine Shipments Job Aid
PhilaVax Recall Report Guide