Immunization Program Archive

Update on future availability of Tripedia and TriHIBit

In 2011, Sanofi Pasteur will discontinue the supply of Tripedia® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) and TriHIBit® (Haemophilus b Conjugate Vaccine [Tetanus Toxoid Conjugate]-ActHIB® reconstituted with Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed-Tripedia) in an effort to support their other DTaPa and Hibb products. Supplies are expected to last through Q2 2011 however, this is subject to change based on fluctuations in demand. Sanofi is sending Dear Doctor letters to communicate this information directly to providers (see attachment for draft of the Dear Provider letter).

Sanofi Pasteur continues to offer a full line of DTaP and Hib products, including Pentacel® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjugate [Tetanus Toxoid Conjugate] Vaccine), DAPTACEL® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed), and ActHIB® (Haemophilus b Conjugate Vaccine [Tetanus Toxoid Conjugate]).

Click here for more information (pdf)
Pre-book your Influenza Vaccine for 2011-2012
Please note that pre-booking of Vaccines for Children (VFC) influenza vaccine for the 2011-2012 flu season will not occur until Summer 2011. Please call (518) 474-4578 for any questions about the VFC Program.

Prebook Vaccine Info – Hospital (pdf)

Prebook Vaccine Info – All Other Providers (pdf) 
Immunize NY! February 2011
New Immunization Administration Codes


I’m contacting you to make you aware of new immunization administration codes for children and adolescents through 18 years of age that went into effect on January 1, 2011. These new codes  significantly increase reimbursement for the administration of vaccines by allowing for billing for each component of a vaccine using new codes 90460 and +90461.  Thus, for instance, with these new codes when billing for the administration of MMR vaccine, one would bill 90460, +90461, +90461 (essentially billing 3 times since there are 3 components to the vaccine).  Thus, one of our local commercial insurers has told us that they will be paying $277 for the administration of 5 vaccines at the 12 month check up instead of the $72 that they had been reimbursing previously for administration of these vaccines.  The only caveat for using the codes is that providers or RNs (not LPNs or medical assistants) must document that they educated the parent (or the patient if he/she is 18 years old) about the vaccinations being ordered, the most common side effects associated with the vaccines, and have answered any questions that they may have about the vaccinations.

All of the commercial insurers in the Rochester area have adopted use of the new codes, and I’m sure the same is the case throughout the rest of the state.  In our area, most Medicaid managed care plans have also adopted them.  However, because of a recent AAP alert (see below) regarding lack of adequate CDC funding to state VFC programs at the present time to support VFC payment of the enhance immunization administration fees, some Medicaid managed care and Child Health Plus plans and Fee-For-Service Medicaid have delayed adopting the use of the new codes.

Additional information about the new billing codes can be found here. 

Stanley J. Schaffer, M.D., M.S.
Associate Professor of Pediatrics
Director, WNY Lead Poisoning Resource Center - Rochester Office
Golisano Children's Hospital
University of Rochester Medical Center
601 Elmwood Ave., Box 777
Rochester, NY  14642
Phone: (585) 275-0267
Fax: (585) 273-1037
Immunization Toolkit

More info:
Letter from Commissioner Daines to all New York State regulated health facilities
Immunize NY!  Summer 2010 Edition
· Group Purchasing: Vaccine purchasing groups for physicians

This link lists information about vaccine purchasing groups, most of which provide discounted vaccine pricing. (xls)
· Manufacturers: Manufacturer discounts and return policies for practices
This link lists vaccine manufacturer’s discount and return policies. (xls)
· Medicare Vaccine Administration Fee Schedule:
Medicare annually publishes a vaccine administration fee schedule which is geographically adjusted. The Medicare vaccine administration fee schedule is considered one of the most accurate estimates of the cost of providing vaccinations. Practices should use it as a reference when they negotiate new contracts with payers.
2009 Medicare Vaccine Admin Rates (pdf)
· NYSIIS Compatible EMRs: EMR vendor products with NYSIIS compatibility
Before contracting with an EMR vendor, check to make sure that the EMR system that you are considering is NYSIIS-compatible.
· Helpful Immunization Links
AAP Vaccine Finance Resources for Physicians: Supplement in Pediatrics with resources for physicians

CDC Vaccine Price List: Vaccines prices for CDC and the private sector

Immunization Action Coalition: Resources and vaccine information for providers including up-to-date vaccine immunization statements in English and a host of other languages. IAC also distributes an informative weekly e-mail posting called IAC Express which contains the latest immunization information

MMWR: Morbidity and Mortality Weekly Report: Published weekly by the CDC, MMWR lists up-to-date vaccine information. On-line subscriptions to MMWR are available at:

NYSIIS Information for Providers: Information resources for providers about NYSIIS

Vaccine Education Center at Children’s Hospital of Philadelphia. Headed by Dr. Paul Offit, the center provides helpful information about vaccine safety, addresses special considerations related to vaccination and offers educational materials on vaccination.

Washington State Vaccine List: Vaccine and CPT codes list updated by Washington State. Washington State publishes the most up-to-date list of vaccines and vaccine CPT codes
Now You Can Help With Influenza Surveillance...In Only a Few Minutes a Week! (pdf)
Recommendation to Temporarily Suspend Usage of GlaxoSmithKline Rotarix (pdf)
CDC’s Advisory Committee on Immunization Practices (ACIP) Recommends Universal Annual Influenza Vaccination

Press Release
For Immediate Release: February 24, 2010
Contact: CDC Division of Media Relations
(404) 639-3286 (404) 639-3286

CDC’s Advisory Committee on Immunization Practices (ACIP) Recommends Universal Annual Influenza Vaccination

A panel of immunization experts voted today (February 24, 2010) to expand the recommendation for annual influenza vaccination to include all people aged 6 months and older. The expanded recommendation is to take effect in the 2010 – 2011 influenza season. The new recommendation seeks to remove barriers to influenza immunization and signals the importance of preventing influenza across the entire population.

The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC) on vaccine issues, voted on the new recommendation during its February 24, 2010 meeting in Atlanta. The vote took place against a backdrop of incremental increases in the numbers and groups of people recommended for influenza vaccination in years past, and lessons learned from the world’s still ongoing first flu pandemic in 40 years.

Prior to today’s vote, ACIP recommendations for seasonal influenza vaccination – which focused on vaccination of higher risk persons, children 6 months through 18 years of age and close contacts of higher risk persons – already applied to about 85 percent of the U.S. population.

Discussion at the ACIP meeting focused on the value of protecting all people 19 to 49 years of age, who have been hard hit by the 2009 H1N1 pandemic virus, which is likely to continue circulating into next season and beyond. Another reason cited in favor of a universal recommendation for vaccination is that many people in currently recommended “higher risk” groups are unaware of their risk factor or that they are recommended for vaccination. The ACIP discussion also recognized the practicality and value of issuing a simple and clear message regarding the importance of influenza vaccination in the hopes that this would remove impediments to vaccination and expand coverage. Finally, new data collected over the course of the 2009 H1N1 pandemic indicates that some people who do not currently have a specific recommendation for vaccination may also be at higher risk of serious flu-related complications, including those people who are obese, post-partum women and people in certain racial/ethnic groups.

More influenza vaccine doses will be required to vaccinate all adults. However, based on current projections, more licensed types and brands of seasonal influenza vaccines will be available in the 2010-11 influenza season than has ever been available before. Historically, uptake of seasonal influenza vaccine has been less than half of the number of persons with a specific recommendation for vaccination.

Annual influenza vaccination is a safe and preventive health action that benefits all age groups. However, certain people have a higher risk for influenza complications, including people aged 65 years and older, children younger than 6 months of age, pregnant women, and people of any age with certain chronic medical conditions.

These people, their household and close contacts, and all health care personnel should continue to be a primary focus for vaccination efforts as providers and programs transition to routinely vaccinating all people 6 months of age and older.

The composition of the Northern Hemisphere’s 2010-2011 seasonal influenza was announced at the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting yesterday in Bethesda, MD. Next season’s vaccine will be trivalent (with three different vaccine viruses) and include an A/California/7/2009 (H1N1)-like virus, an A/Perth/16/2009 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus. The H1N1 virus recommended for inclusion in the 2010-2011 seasonal influenza vaccine is a pandemic 2009 H1N1 virus and is the same virus used in the 2009 H1N1 monovalent vaccine.

Recommendations of the ACIP become recommendations of CDC once they are accepted by the director of CDC and the Secretary of Health and Human Services and are published in the Morbidity and Mortality Weekly Report.
Immunization Recommendations for Haitian Refugees

Dear NYSIIS Users and Stakeholders:


The purpose of these recommendations is to provide guidelines to those institutions providing services to Haitian child and adolescent refugees who will be attending school in New York State.

Thank you.
State Health Commission waives restrictions on the use of thimerosal free flu vaccines due to a shortage in seasonal and H1N1

NYS Health Commissioner Richard Daines has waived the restriction on use of use of influenza vaccines containing more than the mercury levels described in PHL § 2112 (2) and (3), due to insufficient amounts of vaccine because of the flu emergency declared yesterday by the Governor. This authorization shall continue until May 1, 2010. All vaccinations should be given with the informed consent of the patient or the patient’s parent or person otherwise authorized to consent.

The Commissioner’s letter states that supplies of both the 2009 seasonal trivalent and 2009 H1N1 monovalent vaccines are inadequate to meet the immediate need to vaccinate all persons who seek vaccination including young children and pregnant women. He notes that DOH has received numerous calls from physicians, advocacy groups and individuals regarding difficulties in obtaining vaccine. NYSAFP has been in regular communication with DOH regarding flu developments and preparations for emergency distribution of vaccine in the event of an outbreak. We surveyed family physicians and determined that few family physician practices had received any flu vaccine in the initial distribution of supply. In discussions with DOH officials earlier this week, we recommended redistribution of existing supply to assure that all physicians receive some amount of vaccine to administer to high risk patients, rather than focus on high volume practices in distribution of the limited supply available. We also recommended that the existing supply be stretched as widely as possible by waiving the statutory restriction on use of vaccine containing thimerosol. We will continue to report to you on developments and welcome any feedback you feel would be helpful to our efforts to assure that vaccine supplies are adequately and equitably distributed.

Click here for the full text of the Commissioner’s letter (pdf)
Dear NYSIIS Participants:


The advisory is attached to this email in pdf format and can also be accessed online at:

Effective immediately, the CDC, in consultation with the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP), is recommending reinstatement of the booster dose of Haemophilus influenzae type b (Hib) vaccine for children aged 12–15 months who have completed the primary 3-dose series. Infants should continue to receive the primary Hib vaccine series at ages 2, 4, and 6 months. Children aged 12–15 months should receive the booster dose on time. Older children for whom the booster dose was deferred should receive their Hib booster dose at the next routinely scheduled visit or medical encounter. Although supply is sufficient to reinstate the booster dose and begin catch-up vaccination, supply is not yet ample enough to support a mass notification (i.e. reminder-recall) process to contact ALL children with deferred Hib booster doses.

For more information, please see the full article in the CDC’s Morbidity and Mortality Weekly Report available at:

Also, CDC has posted "Hib Vaccine: Q&A for Providers about the Return to the Hib Booster Dose" available at:

We hope you find this information useful.
~The NYSIIS Team
Literature Review of Costs and Revenues Associated with Vaccination of Children and Adolescents (.doc)
Hib Booster Dose Reinstated
The CDC, in consultation with ACIP, the American Academy of Family Physicians, and the AAP, is recommending reinstatement of the booster dose of Haemophilus influenzatype b vaccine for children aged 12–15 months who have completed the primary 3-dose series. Infants should continue to receive the primary Hib vaccine series at ages 2, 4, and 6 months. Children aged 12–15 months should receive the booster dose on time. Older children, for whom the booster dose was deferred, should receive their Hib booster dose at the next routinely scheduled visit or medical encounter. Although supply is sufficient to reinstate the booster dose and begin catch-up vaccination, supply is not yet ample enough to support a mass notification and recall of all children with deferred Hib booster doses.

For more information, go to the July 23, 2009 New York State Health Advisory Updated Recommendations for the Use of Haemophilus Influenzae Type B (Hib) Vaccine: Reinstatement of the Booster Dose at 12-15 months at:
NYSIIS News - Winter 2010 (pdf)
Guidance for the vaccination of women of reproductive age (pdf)
Public Health Law 2112.
Click here for information sheet on Public Health Law 2112 and how providers can obtain influenza vaccine that complies with this new law.(.pdf)
NYSAFP and Atlantic Health Partners offer vaccine discount purchase program.
Click here for news regarding a sales promotion with Sanofi Pasteur.(.doc)

*This page contains information and links regarding vaccine safety and immunizations provided by the New York State Department of Health, Immunization Bureau and the Centers for Disease Control. We will also include information from other sources regarding vaccine safety and immunizations.

CDC's Vaccine Information Statements

CDC Email Updates