Vaccine Administration Guidelines
Proper vaccine administration is a critical component of a successful immunization program. It is a key part of ensuring that vaccination is as safe and effective as possible.
The patient’s immunization history should be reviewed at every healthcare visit. When the patient arrives, providers should obtain a complete immunization history, and compare the patient’s immunization record to the medical record and immunization information system or registry data, if available. Use the current immunization schedule based on the age of the patient to determine all recommended vaccines that are needed. Assess for all routinely recommended vaccines as well as any vaccines that may be indicated based on health status, occupation, or other risk factors.
If a documented immunization history is not available, administer the vaccines that are indicated based on the person’s age, medical condition and other risk factors. With the exception of influenza and pneumococcal polysaccharide vaccine (PPSV23), providers should only accept written, dated records as evidence of vaccination; self-reported doses of influenza vaccine and PPSV23 are acceptable. This prevents missing an opportunity to vaccinate while the patient or parent searches for the immunization record.
Vaccine Administration Reimbursement
Missouri Care’s system is configured to cover immunization administration completed within the CDC’s recommended immunization schedule, by age, or within the age range reflected on the CDC catch up schedule. The most up to date information on these schedules can be found here: https://www.cdc.gov/vaccines/schedules
Immunization administration for ages outside of the CDC guidelines will be denied as inappropriate for patient’s age. If a provider disagrees with this outcome, please file a claims payment policy dispute, with supporting documentation as to medical indications as to the need for providing the vaccination outside the CDC age category.