Vaccines for Children Program
Vaccines for Children (VFC) was established in 1993 to remove the barriers of cost and access to attaining childhood immunizations. The program is funded by the Centers for Disease Control and Prevention (CDC) and the State of Washington, and supplies vaccines to providers across the state. Almost 95% of public and private immunization providers in King County are currently enrolled. All children from birth up to the 19th birthday (hepatitis B up to the 20th birthday) are eligible to receive these vaccines; see below for vaccine-specific restrictions.
DT is offered as an option for children with a previous reaction to the pertussis antigen in DTAP. Order conservatively and monitor expiration dates carefully. Please remember to return expired, unopened vials of DT vaccine to the VFC Program. Refer to the VFC Provider Manual or call (206) 296-4774 for details.
We are currently shipping the Daptacel (Sanofi Pasteur) brand of vaccine. NOTE: Daptacel has now been licensed for the 5th dose in an all-Daptacel series. According to CDC, Daptacel may also be used as the 5th dose in a DTaP series that contained other brands of DTaP. For additional information visit the FDA site, product approval information. www.fda.gov/cber/products/daptacel.htm
DTaP-IPV-Hepatitis B (PediarixTM) |
DTaP/IPV/Hep B Combination: PediarixTM
Children from 2 months of age up to the 7th birthday:
- For the primary doses of DTaP, IPV, and Hep. B series at 2, 4 and 6 months of age.
- Pediarix may be used for catch up vaccination for children up to 7 years of age who have not completed the primary series.
DTaP-IPV/Hib (PentacelTM) |
DTaP/Hib/IPV Combination: PentacelTM
Children from 6 weeks of age of age up to the 5th birthday:
- Indicated for the primary doses of DTaP, IPV, and Hib series at 2, 4 and 6 and 15 - 18 months of age.
- May be used for any dose of the primary Hib series for children 6 weeks of age up to the 5th birthday.
Considerations: If PentacelTM is not available, single injection vaccines may replace any dose in the vaccination series.
DTaP-IPV/Hib is not licensed for children aged >5 years or for the booster dose at age 4 -- 6 years.
DTaP-IPV/Hib inadvertently administered to children aged >5 years should be counted as a valid dose MMWR on Pentacel: www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a5.htm Washington State VFC programs now provide the Havrix (GSK) brand of Hepatitis A vaccine, following supply issues with Merck's Vaqta brand. Pediatric Vaqta and Havrix are interchangeable and the routine schedule can be followed. Washington State VFC programs now provide the Engerix (GSK) brand of Hepatitis B vaccine, following supply issues with Merck's Recombivax brand. Pediatric Recombivax and Engerix are interchangeable and the routine schedule can be followed. Children 6 weeks of age up to the 5th birthday. The 4th (booster) doses, typically given at 15 - 18 months of age, can now be given. HOWEVER! Please do not recall children who had the 4th dose deferred. Catch up children at their next regularly scheduled appointment. Recall efforts will create an artificial vaccine shortage.
Human papillomavirus vaccine |
Please note: As of July 1, 2009, state-supplied HPV vaccine can be given only to uninsured, under-insured, Medicaid-enrolled or Native American/Alaska Native children. Unaccompanied minors without insurance information and teens enrolled in state-sponsored insurance plans such as BHP+, S-CHIP, and Apple are also eligible for state-supplied HPV vaccine. Regardless of when the vaccine was acquired, adolescent girls with private insurance coverage for HPV vaccine are no longer eligible for state-supplied HPV vaccine beginning on July 1st. Gardasil® is a quadrivalent vaccine that protects against four human papilloma virus types (6, 11, 16, 18), which are responsible for 70% of cervical cancers and 90% of genital warts. More information for parents and health care providers is available through the CDC Web site at www.cdc.gov/std/hpv/default.htm. The vaccine should be stored at 35-46F and protected from exposure to light. VFC Program usage guidelines: A 3-dose series for adolescent females from 9 years of age up to the 19th birthday:
- Adolescent females 11-12 years of age
- Adolescent females 13-18 years of age who have not been previously vaccinated or who have not completed the full series.
PLEASE NOTE: Young women who have reached their 19th birthday are no longer eligible for state-supplied vaccine, even when the 3-dose series is incomplete. Health care providers may be interested in signing up for the Merck Vaccines Patient Assistance Program, which helps provide reduced cost adult vaccines. Contact your Merck representative or visit www.merck.com/merckhelps/vaccines/home.html.
- Females as young as 9 years of age may be vaccinated
Recommended intervals:
- 1st dose: at initial visit
- 2nd dose: 2 months after the first dose
- 3rd dose: 6 months after the first dose
Influenza vaccine from 2008-2009 expired on June 30, 2009. Please return unopened vials and pre-filled syringes to McKesson Specialty using the 2009 Influenza Vaccine Return form (see link below). Sanofi-Pasteur's IPOL vaccine is available to all children from 6 weeks of age up to the 19th birthday. The recommended 4-dose schedule is 2 months, 4 months, 6-18 months, and a booster dose at 4-6 years of age.
First dose:
- children from 12 months up to the 19th birthday
- adults born in 1957 or later who are entering college
Second dose:
- children entering kindergarten or born on or after 9/1/1995
- children entering 6th grade
- transfer students in grades 7-12 who have not previously received a second dose
- adults born in 1957 or later who are entering college
NOTE: Please consult with Public Health regarding the appropriate use of MMR during measles outbreaks. MMR-V vaccine (ProQuad) is unavailable until further notice. Requests for MMR-V vaccine cannot be accepted. If you have questions, please speak with your Merck Representative or call the Merck National Service Center at 800-MERCK-90 (800-637-2590).
- A single dose of meningococcal vaccine (Menactra or MCV4) is recommended for adolescents 11-12 years of age
- A single dose for those adolescents who have not previously received MCV4, before high school entry (at approximately 15 years of age).
Other populations at increased risk for meningococcal disease:
- Who have terminal compliment component deficiencies
- Who have anatomic or functional asplenia
- Who travel to countries in which N. meningititidis is hyperendemic or epidemic, particularly if contact with the local population will be prolonged.
- Who are entering college as freshmen living in dormitories
- Military recruits
Children age 2 up to the 19th birthday meeting the following high risk criteria:
- children who travel to or reside in countries in which N. meningitidis is hyperendemic or epidemic, particularly if contact with the local population will be prolonged
- children who have terminal complement component deficiencies
- children who have anatomic or functional asplenia
- children previously vaccinated with MPSV4 who remain at increased risk for meningococcal disease
- providers may elect to vaccinate children infected with human immunodeficiency virus (HIV)
Wyeth Pharmaceuticals has begun supplying VFC Programs in the US with pneumococcal conjugate ("Prevnar") vaccine in boxes of 10 pre-filled syringes (only the packaging has changed). As more vaccine manufacturers switch to pre-filled syringes, the "dorm style" refrigerators may be too small to store vaccine supplies. Contact Public Health at (206) 296-4774 for refrigerator purchase information.
Pneumococcal polysaccharide |
This vaccine is recommended, in addition to the pneumococcal conjugate vaccine, for children aged 2 years up to the 19th birthday who meet the following high risk criteria: asplenia, sickle cell disease, nephritic syndrome; cerebral spinal fluid leaks; immunosuppression; children living in special environments or social settings with an identified increased risk of pneumococcal disease or its complications (e.g., certain Native American populations).
Tdap (adolescent pertussis booster) |
Depending on price and product availability, the VFC Program will ship either the Boostrix (Glaxo) or Adacel (Sanofi) brand of Tdap vaccine. Both vaccines are recommended and licensed for one dose only. In the VFC Program, the recommended age group is 11-18 years, although official licensure for the two vaccines is somewhat different. For providers in the VFC Program, both Boostrix and Adacel may be reported as one total number of doses rather than separated by brand. However, providers do not have the option of specifying the brand of Tdap vaccine they choose to order but will receive whatever is currently in stock at the VFC Program's distribution center. Regardless of the brand of vaccine provided, the VFC Program's Tdap usage guidelines are for children 11-18 years of age. Although Boostrix is licensed for 10 years and older, funding and vaccine supply are not intended to support vaccinating 10-year-olds in general.
- A single dose of Tdap instead of Td for booster immunization against tetanus, diphtheria and pertussis if they have completed the recommended childhood DTP/DTaP vaccination. The preferred age for Tdap vaccination is 11-12 years.
- A 5-year interval between Td and Tdap is encouraged to reduce the risk of local or systemic reactions. However, intervals shorter than 5 years can be used.
Tdap is also recommended in other special circumstances. Refer to the recent mailing from Public Health regarding the correct selection of tetanus-diphtheria-pertussis containing vaccines. The school requirement for Tdap vaccination is as follows: One dose Tdap IF student is 11 years old and IF it has been at least 5 years since the last DTaP, DT, or Td. Schools should not be requiring ten-year olds entering the 6th grade to be vaccinated with Tdap. Please note that Td will not satisfy the school requirement. Note that Td supplied by the VFC Program is for CHILDREN ages 7 years up to the 19th birthday ONLY. Adults needing Td shots for wound prophylaxis, travel risks or boosters should be immunized from purchased supplies. Using state-supplied vaccine outside the VFC Guidelines is a violation of the Provider Agreement. Washington State and King County's VFC Programs have begun supplying health care providers with Td vaccine in pre-filled syringes, 10 to a box ("Decavac"). This is the same vaccine as the more familiar, generic Td in multi-dose vials however, it is preservative-free. Although VFC will begin offering Tdap vaccine in July 2006, health care providers are advised to continue carrying a supply of Td vaccine. Tdap is licensed for only one dose and there are a number of situations where Td vaccine will be the recommendation. Rotavirus vaccine (RotaTeq®) has been shown to prevent 74% of all rotavirus gastroenteritis cases and 98% of severe cases. In addition, the rotavirus vaccine reduced the need for hospitalization for gastroenteritis due to rotavirus by 96 percent. More information for parents and health care providers is available through the CDC Web site. The vaccine should be stored at 35-46ºF and protected from light exposure. The VFC Program provides the RotaTeq brand, which follows a 3-dose schedule: Infants aged 6 weeks up to 32 weeks:
- First dose: children 6 weeks of age up to 14 weeks and 6 days
- Second dose: children 4 months of age (4 to 10 weeks after the first dose)
- Third dose: children 6 months of age (4 to 10 weeks after the second dose, no later than 8 months of age)
The first dose of rotavirus vaccine for infants should be given between 6 and 14 weeks of age because of insufficient data on the safety of the first dose in older infants. Rotavirus vaccine should not be administered on or after 32 weeks of age, even if fewer than 3 doses have been administered. Substitute House Bill 2475, regarding the scope of practice for Health Care Assistants (HCA), signed by Governor Gregoire on March 13, 2008, becomes effective June 12, 2008. This bill expands the scope of practice for HCAs by allowing them to administer all FDA approved vaccines given by "injection, orally, or topically, including nasal administration". As a result, HCAs may administer rotavirus (oral) and FluMist (intranasal) vaccines, in addition to injectable vaccines for children and adults. Also, physician assistants and osteopathic physician assistants are added to the list of professions that may assign specific duties, such as vaccine administration, to HCAs.
The usage guidelines for state-supplied varicella vaccine have been expanded:
- First dose: children 12-15 months of age, and children up to the 19th birthday who do not have varicella immunity.
- Second dose: children 4-6 years of age, and children up to the 19th birthday who do not have varicella immunity and who have not received two doses of varicella vaccine.
MMRV vaccine (ProQuad®) may be used when a child needs both MMR and varicella vaccination. Both MMRV (currently not available) and varicella vaccine are shipped directly to providers from the manufacturer; please allow 3 weeks between order date and vaccine delivery. IMPORTANT! Varicella vaccine must be kept frozen at +5º F (-15ºC) or colder and must be used within 30 minutes of reconstitution. Provider freezers must be "certified" to receive and store varicella vaccine. Contact Public Health at 206-296-4774 for certification requirements.
Forms and guidelines for King County health care providers |
If you need assistance with these items, please contact us using our online form or call 206-296-4774 and ask for the VFC program. FORMS:
- VFC Provider Manual (PDF, 3 Mb)
- Vaccine Information Statements (VIS) are available in English and over 30 other languages. Statements for the following vaccines have all been updated in 2006-7: chicken pox (varicella), DTaP, Hepatitis A, Hepatitis B, HPV, Meningococcal conjugate, Rotavirus, and Tdap. Make sure you are up-to-date!
QUESTIONS: Providers with questions about the status screening (VFC eligibility) process will find helpful information and printable forms at www.doh.wa.gov/cfh/Immunize/vaccine/vfcstatus.htm or call 206-296-4774 and ask for the VFC Program.
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