Laserfiche WebLink
Vaccine A. Ensure that all vaccine shipments are promptly received and stored immediately and report <br />Shipments any problems with vaccine shipments immediately to the LHJ. <br />B. Make sure all staff who receive mail at the provider location know how to handle shipments <br />of vaccine. <br />Vaccine Wastage A. Implement written procedures for reporting and respond i ng to losses resulting from vaccine <br />expiration, wastage, and compromised cold cha in. <br />B. Notify your LHJ promptly (within 24 hours) of vaccine incidents where vaccine has been <br />exposed to temperatures above or below the recommended range for vaccine storage. <br />Follow state and LHJ guidance on how to document and report the incident. <br />C. Bag affected vaccine, mark it do not use, and store it at appropriate temperatures until <br />viability is confirmed by the manufacturer. <br />D. Create a written report including the reasons for the vaccine loss . Note the measures taken <br />to correct the cause of the loss and to prevent reoccurrence. This report must be submitted <br />to the LHJ . <br />E. If the vaccine is deemed non-viable, remove wasted/expired vaccine from storage conta iners <br />with viable vaccine to prevent Inadvertent admin istration . Return all unopened spoiled or <br />expired publicly purchased vaccines following the state returns process . <br />F, Vaccine losses determined to be the result of negligent vaccine storage and handling <br />practices, or failure to comply with the storage and handling requirements in this agreement <br />may result in corrective act ion. Corrective action may include restitution for the value of all <br />federal-and state-supplied vaccine loss resulting from the incident . <br />Vaccine A. Make immunization records available to your LHJ and the state Department of <br />Accountability Health Immunization Program (if requested). <br />B. Participate in a site visit by your LHJ or state Depa rtment of Health , wh i ch may include an <br />immunization assessment (AFIX). <br />C. Provide data on the number, age and VFC status of children seen in the practice by <br />completing the annual data request for the provider profile . <br />D. Complete a provider satisfaction survey (ifrequested). <br />E. Complete the Private Provider's Report of Vaccine Usage form provided by your LHJ, which <br />includes : the doses of vaccine administered by vaccine type and age group of each patient; <br />doses of vaccine wa sted, lost or expired; inventory of vaccine by vac cine type and number of <br />doses. <br />Vaccine Security A. Post "Do Not Disconnect" signs at both the electrical outlet where your storage unit is <br />and Equipment plugged in and the circuit breaker to prevent storage units losing power . <br />Maintenance <br />By initialing this form, I agree to the Washington State-specific requirements listed above and understand I am <br />accountable (and each listed provider is individually accountable) for compliance with these requireme