BACKGROUND:
Colorado VFC Program staff has traditionally targeted private provider offices for site visits due to concerns about vaccine storage/handling and VFC eligibility screening. Staff assumed that birthing hospitals stored Hepatitis B vaccine correctly in onsite pharmacies. During 2003, visits were expanded to include VFC enrolled birthing hospitals.

OBJECTIVE:
Birthing hospital site visit objective: to identify models for successfully implementing the VFC program as part of an overall plan to reinstate routine administration of the Hepatitis B birth dose.

METHOD:
During a site visit at one of Colorado's largest birthing hospitals, staff discovered that vaccine had been routinely stored at temperatures below freezing between February 2002-October 2003. Out of range temperatures had been logged daily but not corrected. Compromised VFC vaccine had been administered to 4400 VFC eligible and non-eligible infants.

RESULT:
The hospital and the Colorado Immunization Program developed a reimmunization plan:
-Parents were notified via first class mail and the media.
-Local public health used Colorado Immunization Program supplied vaccine to reimmunize both VFC and non-VFC eligible children and received administration fee reimbursement from the hospital.
-Private providers used VFC vaccine to reimmunize Medicaid patients and received administration fee reimbursement from Medicaid.
-Babies born to HBsAg-positive women continue to receive on-going follow up from the Colorado Viral Hepatitis Program.
Note: Revaccination must be completed by May 2004. Results will be presented at NIC.

CONCLUSION:
Don't assume that vaccine is stored correctly at sites with pharmacies. There are reasons (additional to program requirements) to ensure that only VFC eligible children receive VFC vaccines.

LEARNING OBJECTIVES:
to identify components:
-of a successful re-immunization plan;
-essential to successful implementation of the VFC Program in birthing hospitals.