|
|
|
|
CONTENT OF THE GUIDE |
|
PAGE NO. |
|
|
|
|
Covers (front and back)
|
|
cov1–cov4 |
 |
|
|
|
|
|
|
Includes outside and inside covers; provides quick reference links for IAC, |
|
|
|
CDC, adult immunization partners, and vaccine manufacturers |
|
|
|
|
|
|
|
Front Matter
|
|
i–iv |
|
|
|
|
|
|
|
Includes title pages and acknowledgments |
|
|
|
|
|
|
|
Introductory Letter
|
|
v-vi |
|
|
|
|
Table of Contents
|
|
vii–xii |
|
|
|
|
Step 1: Getting Started
|
|
1–14 |
|
|
|
|
| |
• |
|
Why the emphasis on adult vaccination? |
|
|
|
|
| |
• |
|
How do I determine which vaccines adults need? |
|
|
|
|
| |
• |
|
The
Guide does not discuss vaccines for children or travelers |
|
|
|
|
| |
• |
|
Concluding thoughts |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
| |
• |
|
Key Resources |
|
|
|
|
|
|
| Step
2: Setting Up for Vaccination
Services |
|
15–28 |
|
|
|
|
| |
• |
|
Obtain support and cooperation
from clinic staff and management
|
|
|
|
|
| |
• |
|
Seek out community resources |
|
|
|
|
| |
• |
|
Assign a vaccination coordinator
and back-up for that person |
|
|
|
|
| |
• |
|
Plan workflow and workspace |
|
|
|
|
| |
• |
|
Determine how and where vaccines
will be stored, and purchase
appropriate |
|
|
|
|
|
|
|
vaccine storage and temperature monitoring equipment |
|
|
|
|
| |
• |
|
Purchase emergency response
supplies |
|
|
|
|
| |
• |
|
Determine who can provide
vaccinations in your setting |
|
|
|
|
| |
• |
|
Arrange for staff training |
|
|
|
|
| |
• |
|
Organize vaccination paperwork
and reference materials |
|
|
|
|
| |
• |
|
Create standing orders documents
for times when a supervising
clinician is |
|
|
|
|
|
|
|
not available to
write orders |
|
|
|
|
| |
• |
|
Order vaccines – Yes, do this
last! |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
| |
• |
|
Key Resources |
|
|
|
|
|
|
|
Step 3: Vaccine Storage and Handling |
|
29–42 |
|
|
|
|
| |
• |
|
Receive vaccine shipments
|
|
|
|
|
| |
• |
|
Monitor and record temperatures
at least twice each day |
|
|
|
|
| |
• |
|
If there’s a problem, take appropriate action right away; report power failures |
|
|
|
|
|
|
|
or other storage issues immediately! |
|
|
|
|
| |
• |
|
Transport vaccines properly (and
only when absolutely necessary) |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
| |
• |
|
Key Resources |
|
|
|
|
|
|
|
Step 4: Deciding Whom to Vaccinate |
|
43–66 |
|
|
|
|
|
• |
|
Determine the patient’s previous
vaccination history
|
|
|
|
|
| |
• |
|
Determine which vaccines are
needed |
|
|
|
|
| |
• |
|
Screen for contraindications and
precautions to vaccines |
|
|
|
|
| |
• |
|
Advise the patient if he or she
should be vaccinated |
|
|
|
|
| |
• |
|
Educate your patients about
diseases for which they may be
at risk and |
|
|
|
|
| |
|
|
the vaccines that
can prevent them |
|
|
|
|
| |
• |
|
Special section:
Vaccination of Special
Populations |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
| |
• |
|
Key Resources |
|
|
|
|
|
|
|
Step 5: Administering Vaccines |
|
67–86 |
|
|
|
|
| |
• |
|
Determine who can administer
vaccines (either independently
or under standing |
|
|
|
|
| |
|
|
orders) |
|
|
|
|
| |
• |
|
Always provide a Vaccine
Information Statement (VIS) |
|
|
|
|
| |
• |
|
Administer the vaccine properly |
|
|
|
|
| |
• |
|
Prepare and watch for an
allergic reaction (anaphylaxis)
after vaccination |
|
|
|
|
| |
• |
|
Always report anaphylaxis and
other adverse events after
vaccination to VAERS |
|
|
|
|
| |
• |
|
Prepare and watch for syncope
(fainting) |
|
|
|
|
| |
• |
|
Communicate about appointments
for subsequent doses |
|
|
|
|
| |
• |
|
Understand proper spacing of
doses |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
|
• |
|
Key Resources |
|
|
|
|
|
|
|
Step 6: Documentation and Related
Issues |
|
87–94 |
|
|
|
|
| |
• |
|
Record federally required
information about your patient’s
vaccinations in |
|
|
|
|
| |
|
|
the patient’s
permanent medical record or in
an office log |
|
|
|
|
| |
• |
|
Update your patient’s personal
vaccination record card or
provide a record |
|
|
|
|
| |
|
|
to your patient |
|
|
|
|
| |
• |
|
Update your patient’s
vaccination record in your state
or local Immunization |
|
|
|
|
|
|
|
Information System (IIS, or
registry), if one is available |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
| |
• |
|
Key Resources |
|
|
|
|
|
|
|
Step 7A: Financial Considerations |
|
95–106 |
|
|
|
|
| |
• |
|
Standards for Adult
Immunization Practice: How
it should work
|
|
|
|
|
| |
• |
|
Finding free or discounted
vaccines |
|
|
|
|
| |
• |
|
Investigating possible
third-party coverage for the
cost of vaccines and/or |
|
|
|
|
|
|
|
vaccine administration |
|
|
|
|
| |
• |
|
Finding your way through the
billing maze |
|
|
|
|
| |
• |
|
Materials and Resources You Can Use |
|
|
|
|
| |
• |
|
Key Resources |
|
|
|
|
|
|
|
Step 7B: How to Bill for Adult
Immunizations |
|
107–120 |
|
|
|
|
| |
• |
|
Health insurance coverage of
adult vaccines
|
|
|
|
|
| |
• |
|
Billing Medicare for
immunizations |
|
|
|
|
| |
• |
|
Billing third-party payers for
immunizations (not Medicare) |
|
|
|
|
|
|
|
Appendix A: Frequently Used Acronyms and Abbreviations |
|
121–122 |
|
|
|
|
Appendix B: Glossary |
|
123–126 |
ACIP Recommendations
Vaccine Information Statements 
