Immunizations & Vaccines FAQs

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Quick Entry is used when you're entering historical vaccination information. In this case, the entry of the vaccination will not take a dose out of your inventory.

To add vaccines into your vaccine inventory click here to see the solution. 

For information on managing your vaccine inventory click here.

To see when you should use the Enter Immunization button for vaccines click here to see the solution.

To enter a vaccine that was ordered click here to see the solution.

There are multiple ways to pull up a consent form and electronically sign the form from a touchscreen tablet or a computer.

From Patient Demographics (for any consent, but particularly HIPAA forms, general consent forms, and financial acknowledgment forms):

1. In a patient's chart, under the Demographics header, choose Consent Forms.
2. In the Document Type dropdown, select the consent form you want to use.  
3. Optional: you may add to the Note, End Date, Exp(ires), Correspondent, and Consent mode fields, but these are optional. 
4. Click Attach Document.
5. A popup window listing consent forms you might want to attach appears.   To use a consent form from your practice's master library, select the Consent/directive form library radio button.  To re-issue a consent form that is already in the patient's chart, select the Existing patient consents/directives radio button.  To issue a consent form that is in a sibling's chart, select the Existing patient family consents/directives radio button.
6. Highlight the consent form you wish to use.  A thumbnail will appear to the right for verification.  Then click Use Selected Document at the bottom of the popup window.
7. A copy of the document appears in the Consent/Directive Document window.  Click the Sign button at the top.

• Have the parent electronically sign the consent form using his/her finger or a mouse.

1. Click OK in the Consent/Directive Document window.  
2. You can now see the signed form in the Attached Form pane (to the right of the main Consents/Directives table.)

From the Patient Chart (specifically for vaccine consents):

1. Open the Patient Chart by clicking on the Chart button.
2. Click Immunizations tab.
3. Click Consent Form.   
4. If one or more vaccine consent forms already exists for a patient, it/they will appear.   You can either simply amend one of the existing forms (by tabbing through the forms using the arrow keys on the bottom, then clicking Sign on the one you want to amend) or create a "fresh" vaccine consent form by clicking Choose Document.  
5. If a vaccine consent form does not already exist, you will be automatically prompted to choose a consent form template (see steps 5 and 6 in From Patient Demographics above)   Once the consent form loads, click Sign, then let the family complete the form.

• Have the parent electronically sign the consent form using his/her finger or a mouse.

1. Click Ok to save the signed consent form.

From Document Management (to add a custom consent form from your computer and sign it):

1. In the Clinical tab or the Practice Management tab, click on the Document Mgmt button.
2. Search for the patient.
3. Click Import Image Files in the Acquisition Panel. 
4. Choose an image file (e.g. a TIF or JPG) of the consent you want signed.
5. Drag the image from the Acquisition Panel to the main panel.  
6. Assign the patient ID, item type, and category in the Patient Information panel on the right side.
7. Click Edit button in the Document Controls Toolbar.
8. Click Sign button at bottom of window.

• Have the parent electronically sign the consent form using his/her finger or a mouse.

1. Click Save.  

1. Open Maintain Vaccine Inventory (Practice Management tab > Manage Vaccine Inventory button).
2. Locate the vaccine in the list and click the ellipses button in the Edit Vaccine Inventory Item Detail column ().
3. Click the dropdown arrow in the Inventory name field.
4. Locate and select the new inventory name.
5. Click Save.
6. Repeat steps 1-5 for all lots with the name change, this will include any lots that are Inactive.

The DTaP-IPV warning window provides a warning and conditions for administering the DTaP-IPV vaccine. It compares the patient's data with the requisites for administering DTaP-IPV and displays them in the window.

Warning:

• Status: Indicates the administration of DTaP-IPV (Kinrix) conditions
• PATIENT STATUS: Indicates the patient's vaccine administration data for DTaP and IPV compared to the DTaP-IPV status conditions.

In order to view past Vaccine Inventory, you must mark the "past" lots as Retired in the Availability field. The Retired lots must also contain a Retired Date. Once that has been confirmed, you may do the following to view past inventory:

1. Select the Retired radio button in the Availability section of the Vaccine Inventory window.
2. Add the Date Retired column to the grid.
3. Click the filter located in the Date Retired column header.
4. Set a Custom Filter to reflect the date range that you wish to view for the past inventory.

Two or more injectable or nasally administered live vaccines that are not administered on the same day should be separated by at least 4 weeks.

ACIP allows a grace period for vaccine doses administered up to 4 days before the recommended minimum interval age, excluding the rabies vaccine. Vaccines given in the grace period will be considered valid. If a vaccine was administered 5 or more days earlier than recommended it is not valid and must be repeated using the recommended minimum interval. 

With the new certification standards, users must be prevented from documenting an improper administration route. One of the common vaccines this may be occurring is with Rotavirus. Below is an image of the error message you will receive when an administration route is incorrect.

To correct the error follow the steps below.

1. Navigate to Practice Management tab > More (Reference Data group) > Vaccine Products.
2. Click the Vaccine to be edited.
3. Click the ellipsis button.
4. Select the correct Route from the Route of administration drop-down menu.

1. Click the Save button.
2. For complete information on Vaccine Products, click here.

If a vaccine was originally marked as deferred and you need to change to refused, follow the steps below.

1. Navigate to Clinical, Practice Management or Billing tab > Patient Chart.
2. Search for and select the patient.
3. Click Immunizations then Complete List tab.
4. Highlight the vaccine that is deferred and click the Delete button.
5. Click the Refuse/Defer button and complete the Refuse/Defer Vaccine window.

If a vaccine was originally marked as refused and you need to change to deferred, follow the steps below.

1. Navigate to Clinical, Practice Management or Billing tab > Patient Chart.
2. Search for and select the patient.
3. Click Immunizations then Complete List tab.
4. Highlight the vaccine that is refused and click the Delete button.
5. Click the Refuse/Defer button and complete the Refuse/Defer Vaccine window.

When Does OP update VIS Sheets?

OP will update the VIS Sheet Edition Dates and the corresponding barcode numbers in a release following the date when the CDC updates its Vaccine Information Statement (VIS) Lookup Table.

What is your responsibility with VIS Sheet management?

It is the practice’s responsibility to upload any URL link changes into their Local Content Library and/or Handouts associated with visit templates.

In OP, the VIS Sheets will be populated by OP with barcoded VIS Sheets from the CDC. You only have the ability to archive VIS Sheets that have been populated from the CDC. A VIS Sheet publish date may be changed if it does not contain information in the Barcode field.

From the Complete tab of a child's Immunization record you have the ability to create new vaccine records. The New button can be used to enter historic vaccine records, in place of Quick Entry. From this window you may enter detail information for a vaccine such as: route, body site, source of vaccine information, administering facility and adverse reaction, to name a few.

Vaccine logic and indicator capabilities were built before information regarding immunizations was shared with Immunization Registries. The specifications regarding immunization information exchange now require a finite way of describing this information for sharing, and it is associated with coded data sets. OP is now certified under this robust standard, and we must adhere to the certified pre-determined data specifications.

To review information about certification click here.

Practices have marked vaccines Series Complete even when it was against ACIP forecasting which includes, catch up and minimal intervals including the 4 day grace period rule. The immunizations sent to immunization registries follow ACIP guidance. There is an inherent conflict between what the immunization registries say the patient needs and what OP did. When we moved to the new certification standard, all vaccines were again processed through the updated vaccine logic. Using this logic, if the vaccine was complete, OP set the indicator to Series Complete. But, if in accordance with current best practice, the vaccine is not complete, the provider/practice will have to reaffirm they disagree with ACIP and best practice and choose not to give the patient an additional vaccine.

This is especially important since ACIP logic has evolved over time and years ago providers indicated a vaccine as Series Complete. With the new functionality, every user can see who over-rode the ACIP guidance and why. This makes the information transparent to the rest of the practice.

Below is a list of how the previous vaccine indicators are mapped on the Historical Status Indicators tab.

• Documented Disease (DD): Documented Disease, Other.
• Documented Immunity (DI): Documented Immunity, Other.
• Refused (R): Refused, Parent Decision (permanent, will no longer be forecast).
• Adverse Reaction (AR): Deferred, Medical Precaution.
• Deferred: vaccine not available (DNA): Deferred, Other, Out of Stock.
• All other statuses: (AS, SC, NR, NRL, DMC, DVH): are not valid reasons to adjust vaccine forecasting and will remain as historical references.

The choices of Refused or Deferred are the only valid selections according to the certifications standards. According to Best Practices, we encourage practices to think of the choices in this ways:

• Refused: If you do not want to ever forecast the vaccine, select Refused.
• Deferred: If you do not want the vaccine to be given today, some examples are listed below.
  • The parent/patient declined the flu vaccine today, but you want to ask again during the season and in the future.
  • The parent splits vaccines and you are giving 2 today and 2 in 1 month.
  • The child was ill at the well visit and you want the child to return when well.
  • There was no inventory at the visit to give the vaccine, but you want to recall them in a few weeks when you expect to have the vaccine in inventory.

To avoid confusion, think of a refusal as permanent. If a parent/patient declines to receive the vaccine, for any reason, but you intend to continue asking because the patient is due or you want to be able to find them during an outbreak, then the vaccine would be set to deferred. A vaccine that is set to deferred can remain in that status for an unknown period of time or indefinitely, but the vaccine is not permanently refused.

When selecting Deferral for a vaccine, the Defer until date defaults to 2 weeks. If you want the patient to return on a different date, click the Field and enter the date or select a date from the calendar. When a date is entered in the Defer until field a task is created. If there is no definitive return for the vaccine and you do not want to create the task, remove the date in the Defer until field. The vaccine will continue to forecast as due. When a vaccine is deferred there is no warning message that you are giving a vaccine that is deferred.

However, if you want to stop a vaccine from forecasting for a period of time, you will have to set the status of the vaccine to Refused. Once the period for the refusal has passed, the refused vaccine will be deleted. It is Best Practice to create a task for the staff to delete the vaccine refusal from the Immunizations Complete List after the forecast stop date has been reached.

Click here to open and print a PDF copy.

If you need to view or print when VIS Sheets were given for vaccines, follow the steps below.

1. Navigate to Patient Chart and search for a patient.
2. Select Immunizations.
3. Select the Complete List tab.
4. Click the Column Selection button and click the Date VIS Given checkbox.

1. To print, click the Print button.

Below you will find the dosing recommendations for Kinrix and Quadracel which are both DTaP-IPV.

Kinrix (GlaxoSmithKline):

Kinrix can be ordered and administered without error in children ages 4 through 6 years for the fifth dose of DTaP and the fourth dose of IPV in children who received DTaP (Infanrix) and/or  DTaP-HepB-IPV (Pediarix) as the first three doses and DTaP (Infanrix) as the fourth dose.

Quadracel (Sanofi Pasteur):

Quadracel can be ordered and administered without error in children 4 through 6 years for the fifth dose of DTaP and as the fourth and fifth dose of IPV in children who have received 4 doses of DTaP-IPV-Hib (Pentacel) and/or DTaP+ (Daptacel) vaccine.

The practice should not discard extra doses left in the vial for COVID-19 vaccines. To add extra doses of the COVID-19 vaccine, follow the instruction below.

1. Navigate to Practice Management > Manage vaccine inventory.
2. Select the edit button for the inventory item.

1. Increment the Total doses in lot with the number of additional doses in the vial.
2. Click the Save button.

For practices who have received the Vaxelis vaccine in their office, please be aware that the Vaccine Product (DTaP-HepB-IPV-HIB) that this represents already exists in your OP! 

Our practices in the Caribbean have been using the hexavalent product Infanhex for several years, which is the same combination of products and the same CVX code. Navigate to your Vaccine Product table, change the Inventory name, and add the Product Description, GTIN (if available), and NDCID.

Please refer to the below articles available on the Help Center to assist you with making the necessary changes.

• Changing the Inventory Name in OP
• Add GTIN and NDC numbers to a Vaccine Product