PRE-REGISTRATION FOR PROVIDERS INTERESTED IN ADMINISTERING THE NOVEL H1N1 INFLUENZA VACCINE
The U.S. Government will provide federally funded vaccine against the 2009 Novel H1N1 influenza virus. Details of this planned
vaccination effort are still being decided but it is expected that enough vaccine will be available within six months of the beginning of
vaccine distribution to meet U.S. demand. At this time, vaccination will be restricted to the following populations, per recommendations
of the CDC Advisory Committee on Immunization Practices: pregnant women, people who live with or care for children younger than 6 months
of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25
through 64 years of age who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.
All Delaware facilities that provide immunizations and intend to receive and administer this vaccine should pre-register at http://www.dhss.delaware.gov/dhss/dph/dpc/files/h1n1providerpreregform.pdf.
Key Points on Vaccine Registration:
- The Delaware Division of Public Health (DPH) is establishing a pre-registration process for all licensed immunization providers
interested in administering the H1N1 vaccine.
Providers are cautioned that the pre-registration process as outlined here may be subject to change depending on unforeseen
factors affecting the distribution of H1N1 vaccine. Any change(s) to the proposed plan will be communicated through various methods
including the DPH website.
- Pre-registration is free and registered providers are not committed to order or administer the vaccine, but may receive updates and
vaccine planning information. Depending on the final distribution plan, they will have theopportunity to order vaccine as outlined by the
final terms of the H1N1 vaccine distribution program.
- Pre-registration will collect the shipping and contact information necessary for the shipment of vaccine to providers. In addition,
providers will be asked to estimate the number of persons they realistically intend to vaccinate and the type of vaccine they expect to
use (nasal or injectable). Only providers with active licenses and in good standing in the state of Delaware need register.
- Providers already enrolled in the Vaccines for Children (VFC) Program will be expected to make the H1N1 vaccine available to their
VFC clients that seek it. Their estimates should therefore include both their VFC and non VFC (private) clients.
- Registered providers will receive email and/or fax updates to assist with pandemic vaccine administration planning.
- The Pre registration form is currently posted to the State of Delaware web-site at http://www.dhss.delaware.gov/dhss/dph/dpc/files/h1n1providerpreregform.pdf.
Forms should be returned by September 8, 2009.
Below is a non-exhaustive list of the providers that may pre-register. If your facility does not fit under any of these categories, you
may indicate that under the “other” on the form.
- Pediatric Practice
- Family Practice
- Internal Medicine
- Obstetric / Gynecology
- Long Term Care / Assisted Living
- Occupational Health
- School or College
- Urgent Care Center
- Federally Qualified Health Center
- Community Vaccinator
Please call 1-800-282-8672 if you have any questions regarding the pre-registration process.
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