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CDC Working to Improve VFC Program After OIG Report Highlights Vaccine Management Deficiencies
By Matt Brown
According to one family physician who participates in the VFC program, adhering to the program's requirements is no mean feat. His recommendation: Physicians who wish to administer the free vaccines this program provides for uninsured and underinsured children and adolescents should be prepared to make a firm commitment to complying with the program's dictates.
Report's Findings Point to Administrative Challenges
- A June 5 report by the HHS Office of the Inspector General (OIG) indicates inadequate storage and handling of vaccines is all too common among participants in the CDC's Vaccines for Children (VFC) program.
- In response, the CDC has pledged to work with its VFC grantees and providers to tighten up their processes.
- Ninety percent of U.S. children are vaccinated by a provider that participates in the VFC program.
- vaccine storage equipment,
- vaccine storage practices,
- temperature monitoring,
- vaccine storage and handling plans,
- vaccine personnel,
- vaccine waste,
- vaccine security and equipment maintenance,
- vaccine ordering and inventory management,
- receiving vaccine shipments, and
- vaccine preparation.
"CDC is in the process of implementing substantial improvements in vaccine ordering and inventory management systems, which will support improvements in vaccine management at the provider office," CDC Director Thomas Frieden, M.D., M.P.H. wrote in a letter (page 49 of 52-page PDF; About PDFs) responding to the OIG report.
"Because VFC providers generally manage their public and private stock vaccines in a similar manner, and 90 percent of U.S. children are vaccinated by a provider that participates in the VFC program, CDC believes that efforts to strengthen storage and handling practices will help improve vaccination services nationally and benefit children vaccinated with both publicly and privately purchased vaccines."
FP Explains Nuts and Bolts of Vaccine Storage and Handling
"Once a week, we go through and check our inventory to look for two things: Are any vials getting close to expiring, and do we need to order any more vaccine?" he said. "We are a small practice, so we order small amounts more frequently so that we don't have to have such a large burden in our refrigerator/freezer."
Loehr said he and his staff have had their share of headaches managing the vaccines, but the office is committed to safe handling.
"It is my job to manage these vaccines, and I take that seriously," he said. "We recently bought a new refrigerator/freezer and found out that the freezer was not performing to expectations, so we pulled the old freezer back into service until we either replace the new one or find a better way to store the frozen vaccine."
Loehr stressed the importance of having temperature alarms on both the refrigerator and freezer, adding that the alarm tipped him off the freezer was getting too warm. Now, with the vaccines stored safely in the old unit, he is experimenting with the new freezer to see if he can get it in line.
"The new fridge is keeping the temperature range fairly narrow, but the new freezer has to go up to 25 degrees farenheit four times a day in order to stay frost free, which is out-of-range for frozen vaccines," Loehr said. "So I have been looking at CDC suggestions on how to better manage the temperature by putting cold packs in there to maintain the range. If we can't make it work, we'll just have to return it and find another option."
Members Can Look to the AAFP for Help
"The AAFP applauds the CDC's efforts to continue to improve the VFC program for the benefit of patients," Young told AAFP News Now. Many of our members are a part of the VFC program providing these needed immunizations. We have links from the AAFP Immunization Resources Web page to CDC information that can help aid practices on such procedures as handling and storage of vaccine."