How to Administer the MnVFC Program

MnVFC eligibility criteria

Any child who is age 18 years or younger and meets at least one of eligibility criteria below can receive MnVFC vaccine at MnVFC-enrolled sites:

• Uninsured.
• Enrolled in a Minnesota Health Care Program (MHCP): Medical Assistance (MA), MinnesotaCare, and Prepaid Medical Assistance Plan (PMAP). For more information visit Minnesota Department of Human Services: MHCP member resources.
• American Indian or Alaskan Native: All American Indian or Alaska Native children who are age 18 years or younger are eligible for MnVFC vaccine. But those with insurance may not bill insurance if MnVFC vaccine is used. Ensure billing staff are aware.
• Underinsured:
  • The following two categories are considered underinsured and are only MnVFC-eligible at local public health (LPH), Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC), Indian Health Services (IHS), and tribal health clinics:
    • Has health insurance that does not cover one or more vaccines, as can be the case with newly licensed vaccines that are not yet covered (MnVFC-eligible for non-covered vaccines only), or does not provide first dollar coverage (which includes copays, coinsurance, or deductibles) for ACIP-recommended vaccines.
    • Has health insurance that caps vaccine coverage at a certain amount. Once that amount is reached, the person is MnVFC-eligible.

Healthcare sharing ministries

• Healthcare sharing ministries (HCSMs) are a form of health coverage whose members share a common belief system. Collectively, they “share” healthcare costs between its members.
• Although HCSMs, in general, are not recognized as insurance, their features strongly mimic traditional insurance plans.
  • If you are unsure if a HCSM is recognized as insurance, please call the plan directly.
• MnVFC-eligibility.
  • Children with a HCSM plan that is not recognized as insurance are considered uninsured and are MnVFC-eligible.
    • Use MnVFC vaccine and do not bill the patient for the cost of the vaccine. You may charge the patient up to $21.22 for the administration fee per dose (not per antigen). Waive the administration fee if the patient is unable to pay it.
    • However, if a HCSM is not recognized as insurance but has 100% vaccine coverage, you must use private vaccine and bill the HCSM plan.
  • Patients enrolled in HCSMs that are recognized as insurance are insured and are not MnVFC eligible.

Screen all patients for eligibility

Prior to immunizing each patient who is age 18 years and younger, you must inform the patient, parent, or legal representative of the MnVFC eligibility criteria and/or give them an eligibility screening form to complete. If a patient is eligible for more than one category, the provider must select the category that will require the least amount of out-of-pocket expense for the patient.

• Visit Free or Low-Cost Shots for Children for a self-screening form parents can fill out. The form is available in multiple languages.
• MnVFC vaccine must only be used for MnVFC-eligible patients.

Document the patient’s eligibility status

• Document eligibility screening at each visit in the patient’s medical record even if the patient is not eligible for MnVFC. Documentation may be done electronically or by using a paper form.
  • The MnVFC program provides screening record forms on MnVFC Program Resources. You do not have to use the MnVFC forms, but you do have to collect all the information that is on them.
• Separate stock sites are highly encouraged to submit your patients’ MnVFC eligibility status to the Minnesota Immunization Information Connection (MIIC). The MnVFC program also refers to this information as dose-level eligibility.
  • Reporting dose-level eligibility to MIIC for all vaccines administered to patients age 18 years or younger is strongly encouraged for all sites participating in the MnVFC program.
  • For more information, including how to submit dose-level eligibility information to MIIC (either electronically or by manually entering data), refer to Vaccine Ordering and Management in MIIC.
• Replacement method sites must submit your patients’ MnVFC eligibility status to the Minnesota Immunization Information Connection (MIIC).
• Keep a record of the patient’s eligibility for three years.

• You are required to give the current VIS (either paper or electronic) to the patient or their parent or legal representative before administering each dose of vaccine.
• It is acceptable to make a VIS available to be read before the immunization visit (e.g., giving the patient or parent a copy to take home during a prior visit or telling them how to download or view it on the web). We encourage this when possible. You must still offer a copy (which can be an electronic copy) of each appropriate VIS following the vaccination. However, the recipient may decline.
• An Immunization Information Statement (IIS) should be provided prior to administration of RSV monoclonal antibody products.
• Current VISs are available on Immunize.org: Vaccine Information Statements CDC: Vaccine Information Statements (VIS). Sign up to receive email updates when VISs change.
  • When possible, provide the VIS in the person’s native or preferred language. Translated VISs are available. You are encouraged to distribute the current English version at the same time as the translation.
  • Let the patient, parent, or legal representative keep a paper copy of the VIS, or if they prefer to view the VIS on a tablet or mobile device, direct them to CDC: Vaccine Information Statements (VIS) during the visit and make sure they have a chance to have their questions answered. Give them a phone number to call in case of any questions or unexpected symptoms after receiving a vaccine.
• You must document the publication date of the VIS (located on the bottom corner) in the patient’s medical record and the date the patient was given the VIS to review.
• You do not need to have the patient, parent, or legal representative sign anything to verify they have received the VIS, unless your site requires this.

Offer all ACIP-recommended vaccines for your patient population

• As a MnVFC-enrolled site, you must offer all ACIP-recommended vaccines for your patient population, including a plan for patients to access non-routine vaccines as appropriate. This plan must be documented in your Routine Vaccine Management Plan.
  • This includes RSV monoclonal antibody products, if appropriate for your population.
• Separate stock sites are not required to maintain a full stock of all ACIP-recommended vaccines for non-VFC-eligible patients if they do not plan to offer all ACIP-recommended vaccines to this population. This guidance includes, but is not limited to, RSV monoclonal antibody products. If a separate stock site VFC provider does not carry privately purchased stock, they are not permitted to use VFC stock on non-VFC-eligible patients.
• The current ACIP-recommended schedules are available on CDC: Vaccine Administration: Before Giving Vaccine.
• Use Immunize.org: Guide to Contraindications and Precautions to Commonly Used Vaccines for All Ages (PDF).
• The state laws related to vaccination requirements and acceptable vaccine exemptions can be found at Vaccines for Infants, Children, and Adolescents.

Train staff on how to administer vaccines correctly

• Comprehensive, competency-based staff training and education, including the “rights of medication administration,” patient care, vaccine preparation, and skill validation should occur for all personnel who administer vaccines based on their scope of practice. Sites may have their own internal training program. For those who do not, there are options available: Page 20 How to Administer the MnVFC Program 2027 MnVFC Policies and Procedures Manual
  • Vaccine Administration chapter in CDC: Chapter 6: Vaccine Administration.
    • CDC eLearn: Vaccine Administration.
  • Vaccine Administration lessons from California VFC Program EZIZ Training.
• To ensure competency, staff training should occur when: new staff are hired, new or different vaccines are added to the site’s usual inventory, new recommendations are published, and when old recommendations are revised. Annual updates and skill reviews are recommended for all staff.
• Encourage staff to ask questions about vaccine administration if they are unsure.

Immunization administration resources

• Immunization Best Practices.
• Reliable Sources of Immunization Information.
• CDC: Preventing Unsafe Injection Practices for safe injection practices.
• Immunization education and training: “You Call the Shots” modules, the Vaccine Administration e-Learn, and Pink Book Webinar Series.
• Immunize.org: Skills Checklist for Immunization (PDF).
• Immunize.org: Vaccination Tools for Administering Vaccines.
• Immunize.org: Vaccines with Diluents: How to use them (PDF).

• A patient’s medical record must include:
  • Site/facility address where the vaccine was administered.
  • Date vaccine was administered.
  • Vaccine type.
  • Vaccine manufacturer.
  • Vaccine lot number.
  • Signature and title of person(s) administering vaccine.
  • Publication date of VIS (located at the bottom of VIS).
  • Date VIS was given to the patient, parent, or legal representative (usually the same as the vaccine administration date but still needs to be documented).
• Best practice recommendations also include documenting the following information:
  • Dose.
  • Site and route of injection.
  • History of vaccine reaction, if the patient has experienced a clinically significant or unexpected event after an immunization (even if there is uncertainty that the vaccine caused the event).
  • Contraindications and precautions that may apply to this patient.
  • Serologic test results related to vaccine-preventable diseases.
• For combination vaccines, record the vaccine information in the spaces that correspond to each individual antigen in the combination product, indicating the combination type (for example, DTaP-IPV-HepB) and the name of the combination vaccine (for example, Pediarix).
• You should give patients/parents a record of each immunization.
• MIIC cannot serve as the permanent medical record.

MDH has started designing a new version of MIIC. We expect the new system to be able to do what you do now and be easier to use.

• The new system will include updated vaccine ordering, inventory, and related functionality.
• A comprehensive training plan is being developed to ensure provider organizations have the sources they need to efficiently and effectively use MIIC.
• The best way to get updates about the MIIC modernization effort is to sign up for email updates at MIIC Modernization.
  • Updates specific to vaccine ordering may also be sent out via MnVFC Announcements. Sign up for email updates at MnVFC Announcements.

*Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC), Indian Health Services (IHS).

Do not bill or charge for the cost of the vaccine

• You may not bill or charge for the cost of the vaccine for MnVFC-eligible patients.

Charge allowable office visit and administration fees

• You may bill or charge for the office visit.
• You may bill or charge an administration fee of up to $21.22 per dose (not per antigen) for administering MnVFC vaccine.
  • For patients who are not enrolled in an MHCP, you can bill them only one time (within 90 days of vaccine administration) for the administration fee. If the bill is not paid, the administration fee must be waived.
• To be reimbursed for the administration fee for pediatric patients enrolled in a Minnesota Health Care Program (MHCP), you must follow the billing procedures of each program. MHCPs include Medical Assistance (MA) and MinnesotaCare. For billing questions, call the health plan directly or call the Minnesota Department of Human Services (DHS) at 651-431-2700
• If a provider administers MnVFC vaccines to a Medicaid VFC-eligible child from a neighboring state, the provider must be Medicaid-enrolled for the child’s state of residency in order to receive administration fee reimbursement from that Medicaid program.

Waive the administration fee

• You may bill or charge patients an administration fee one time, but if they are unable to pay it, it must be removed from their bill. Having these bills go to collections is not acceptable.
• No MnVFC-eligible patient may be denied vaccine for inability or failure to pay an administration fee.

Remove vaccine charges from a MnVFC-eligible patient’s bill

• Make sure your billing department is prepared to respond to questions related to MnVFC eligibility and to adjust bills as needed; review Immunization Billing Guidance for MnVFC.

Vaccine Adverse Event Reporting System (VAERS)

• The Vaccine Adverse Event Reporting System (VAERS) is a national vaccine safety surveillance program co-sponsored by the CDC and the Food and Drug Administration (FDA). It collects information about adverse events that occur after the administration of vaccines licensed for use in the United States.
• VAERS provides a way for adverse events following immunization to be reported and analyzed.
• Adverse events are health effects that occur after immunization that may or may not be related to the vaccine. By reporting an event, you are not saying that the vaccine caused the event.

Reporting to VAERS

• The National Childhood Vaccine Injury Act (NCVIA) requires health care providers to report to VAERS:
  • Any adverse event listed by the vaccine manufacturer as a contraindication to further doses of vaccine.
  • Any event listed by the manufacturer in the VAERS Table of Reportable Events Following Vaccination (PDF) that occurs within the specified time period after vaccination.
• Healthcare providers are encouraged to report:
  • Any adverse event that occurs following the administration of a vaccine licensed in the U.S., whether or not it is clear that a vaccine caused the adverse event.
  • Vaccine administration errors.
• Anyone is able to file a VAERS report, including healthcare providers, manufacturers, vaccine recipients, or families.
• Submit the form as soon as possible after an adverse event following vaccination. Information about VAERS is on the back of every VIS. For more information or to report an event, visit the Vaccine Adverse Even Reporting System (VAERS) or call 800-822-7967.

• The following MnVFC records must be kept for at least three years:
  • Routine and emergency vaccine management plans, including the Policies and Procedures Manual as appropriate.
  • MnVFC eligibility screening information (forms or documentation in the electronic medical record).
  • Storage unit temperature documentation. Provider locations must maintain all paper temperature logs or a backup system of electronic data for a minimum of three years, unless state statutes or rules require longer retention. This requirement applies even in the case of provider retirement or provider location closure.
  • Certificate of Calibration for each continuous temperature monitoring device used including your backup device.
  • All forms related to vaccine management:
    • Temperature Excursion Incident Log.
    • Temperature Excursion Incident Checklist.
    • Minnesota Department of Health (MDH) Vaccine Transfer Record.
    • Minnesota Department of Health (MDH) Nonviable Vaccine Form. (If you submit the nonviable form via MIIC, you do not need to keep paper copies.)
    • Vaccine Borrowing Report or other borrowing documentation.
  • Monthly ordering records.
  • Packing lists of vaccine shipments.
  • Monthly inventory log.
  • MnVFC Program Annual Report of the Number of Immunized Pediatric Patients.
  • Minnesota Vaccines for Children (MnVFC) Program Provider Agreement.
  • Certificate of completion of the annual MnVFC online training.
• Check your own site’s policies about keeping records beyond three years.