Immunization Information for Providers

A systematic approach to vaccination is necessary to ensure that every adult is appropriately protected against vaccine-preventable diseases. Every visit by an adult to a health-care provider should be an opportunity to review and update immunization status. Health-care providers and individuals should maintain detailed records about each person's vaccination history.

Pneumonia and influenza are the fifth leading cause of death in older adults in the U.S. While vaccines are available to prevent and reduce complications from these diseases, their use is suboptimal. African Americans and Hispanics have significantly lower influenza and pneumococcal immunization rates compared to the rest of the population. While influenza vaccination coverage rates for whites age 65 and older is 68 percent, it is only 48 percent for African Americans, and 54 percent for Hispanics. The gap for pneumococcal vaccination coverage is even wider: 60 percent of whites report they ever have received this vaccine, compared with 38 percent for African-Americans and 36 percent for Hispanics. (Source: CDC Behavioral Risk Factor Surveillance System, 1999 and 2001).

This page provides information, resources, and tools to help support clinicians, including community vaccinators, in administering vaccines for influenza, pneumococcal and hepatitis B vaccinations.

Vaccines For Children Program

The Vaccines For Children (VFC) program helps families by providing free vaccines to doctors who serve eligible children. The program is administered nationally through the CDC National Immunization Program which contracts with vaccine manufacturers to buy vaccines at reduced rates.

State and eligible U.S. projects enroll physicians who serve eligible patients through age 18, providing routine immunizations with little to no out-of-pocket costs.

 VFC Provider Agreement

Legislation and Regulations

Immunization Schedules and Certificates

School and Child Care Facilities



Long-Term Care Facilities


Updated Day Care and School Immunization Requirements

New requirements for Kentucky children entering child day care, Head Start programs, public and private preschool programs and public and private elementary and secondary schools were approved  in February 2011.  Read the updated requirements.

These regulatory changes go into effect July 1, 2011. Any immunization certificate presented on or after July 1, 2011, for a child entering child day care, preschool Head Start, kindergarten or sixth grade should comply with the new requirements.

Since the requirements had not been revised since 2002, several updates were made in order to assure improved vaccine coverage for children in these settings. The following is a summary of the changes.

Newly Required Vaccinations

Pneumococcal conjugate vaccine (PCV)

Age-appropriate immunization with PCV is required for children younger than 5. Children 5 and older are not required to receive PCV, as it is not licensed for healthy children in that age range.

Meningococcal conjugate vaccine (MCV)

One dose of meningococcal vaccine for sixth grade entry, 11 or 12 years old or older, is required. 

The use of meningococcal conjugate vaccine is preferred, but meningococcal polysaccharide vaccine (MPSV) may be used if the conjugate vaccine is unavailable.

Tetanus-diphtheria-acellular pertussis  vaccine (Tdap)

One dose of Tdap regardless of interval since last dose of tetanus-containing vaccine is required for students at sixth grade entry, 11 or 12 years old or older, with option for Td for individuals who cannot receive pertussis containing vaccines.

Changes in Varicella Immunization and Documentation Requirements

Additional dose of varicella vaccine

A second dose of varicella vaccine, or proof of disease, is required for children at least 48 months old and younger than 5 years of age and for children entering the sixth grade, 11-12 years of age or older, if these children have not already been vaccinated with two doses of varicella.

More stringent documentation of varicella or herpes zoster disease

In lieu of immunization against varicella, the immunization certificate now requires that proof of disease be in the form of verification of a history of varicella or herpes zoster infection by a healthcare provider

Changes that Allow Greater Flexibility in Vaccine Administration

Flexibility in use of  different brands of Haemophilus influenzae type b (Hib) vaccine

Children at least 5 months and younger than 7 months old now are required to have two doses of Hib vaccine instead of three. Some brands of Hib vaccine or combination Hib-containing vaccines permit doses at 2 months and 4 months, but do not require a dose at 6 months as described in the 2011 Advisory Committee on Immunization Practices (ACIP) recommended schedule. This amendment gives providers more flexibility in choosing Hib-containing vaccine brands for their practices.

Flexibility in timing of Hepatitis B vaccination

The third dose of hepatitis B vaccine is now required for children 19-48 months old. This amendment allows providers the flexibility to administer the third dose of hepatitis B vaccine as late as 18 months while maintaining compliance with requirements for child day care entry. This timing is in compliance with 2011 ACIP recommendations for hepatitis B vaccine administration.

Other changes

Polio (IPV) vaccine

The final dose of IPV vaccine should be administered at age four years or older regardless of the number of previous doses and the minimum interval between this final dose and the previous dose should be at least six months.

Measles-mumps-rubella (MMR) vaccine

Since MMR is the only measles-containing vaccine licensed in this country, the language for age appropriate vaccination against measles with a measles-containing vaccine was replaced with language requiring a second dose of MMR.

Providers should particularly focus immunization efforts through the fall of 2011 on immunizations for school age children, especially those children entering kindergarten and sixth grade, in order to meet the new school entry requirements. However, immunization records should be reviewed at every patient encounter and age-appropriate immunizations should be administered at any visit unless medically contraindicated.