North Carolina Immunization Program Coverage Criteria

This page provides information related to the North Carolina Immunization Program's (NCIP) Coverage Criteria.

The purpose of the coverage criteria is to distinguish which individuals, present in North Carolina, are eligible for state-supplied vaccine from the North Carolina Immunization Program (NCIP). NCIP state-supplied vaccine is generally available for children through the age of 18 in compliance with recommendations made by the Advisory Committee for Immunization Practices (ACIP) and the Vaccines for Children (VFC) program. ACIP recommends certain vaccines for certain individuals who are not covered by NCIP state-supplied vaccine.  Health care providers must use privately-purchased vaccine for those individuals who wish to have vaccine and are not covered by this coverage criteria.  For the current recommendations for each vaccine, please see the ACIP statements found at: http://www.cdc.gov/nip/publications/acip-list.htm.

Providers should use this coverage criteria document for all federally-funded, state-supplied vaccine (that is not part of the transition plan) recieved on or after July 1, 2010. This document has been updated. Version 2 was posted on 8-9-10, and updated on 8-26-10 to include universal coverage of the Hepatitis B birth dose, however the effective date remains 7-1-10.

NCIP Coverage Criteria (Effective: 7-1-10) Version 2(8/26/10)

NCIP Coverage Criteria (Effective: 7-1-10) Version 2 with changes highlighted (8/26/10)

Providers participating in the transition program should use this coverage criteria document for all state-funded, state-supplied vaccine recieved on or after July 1, 2010. This is vaccine purchased with one-time funding from the state. The vaccine is intended for Kindergarten through 8th grade school entry.

NCIP Coverage Criteria Transition Vaccine Only (8/23/10)

Local Health Departments particpating in the additional transition vaccine program should use this coverage criteria document. This vaccine is purchased with one-time funding from the the state and the Centers for Disease Control and Prevention. The vaccine is intended for non-VFC-eligible patients.

NCIP Coverage Criteria Transition Vaccine Only - For LHDs only (8/26/10)

Providers may continue to use the state-funded, state-supplied vaccines on hand on June 30, 2010 following the June 14, 2010 NCIP Coverage Criteria.  Any federally-funded, state-supplied vaccine (that is not part of the transition plan) received on or after July 1, 2010 must be used only for VFC-eligible children.

NCIP Coverage Criteria (Effective: 6-14-10)

NCIP Coverage Criteria (Effective: 6-14-10) with changes highlighted

Recent Updates to the NCIP Coverage Criteria:

Hepatitis B Birth Dose Available Universally: Federal funding has been identified to resume offering hepatitis B vaccine to birthing hospitals.  The hepatitis B vaccine for hospitals is to ensure that a birth dose of the vaccine is available for newborns, regardless of the family’s insurance status.  Please refer to the memo dated August 27, 2010 for more information.

Additional Transition Vaccine Available - For LHDs only We have been notified by the Centers for Disease Control and Prevention that additional vaccine funding is available that will allow us to offer additional DTaP, IPV, MMR, and Tdap, as well as varicella, MMRV, and Hib vaccines.   These vaccines are for all children through 18 years of age who are not eligible for Vaccines for Children (VFC), making these vaccines universally available until your allocation is depleted.  Please refer to the memo dated August 26, 2010 for more information.

Coverage Criteria for Transition Vaccine: This coverage criteria is to be used with vaccine purchased with one-time funding from the N.C. General Assembly. Please refer to the memo dated August 2, 2010 for practices that will recieve transition vaccine and the memo dated August 2, 1010 for practices that will not recieve transition vaccine.

Td and DT Universal: DT and Td are available universally only when pertussis-containing vaccine is medically contraindicated. Td is available universally for those indivduals who need to complete the DTaP series after age 7. This edit was made on August 9, 2010, however the effective date is July 1, 2010.

Program Change: Effective July 1, 2010, NCIP providers may no longer order state-supplied vaccine for non-VFC-elgible children. Please refer to the memo dated June 28, 2010 and the program changes webpage for more information.

Menveo Availability: Effective June 14, 2010, NCIP providers may choose to order Menveo® for their Vaccines for Children (VFC) eligible patients who are 11 through 18 years of age.  The NCIP will continue to offer the meningococcal conjugate vaccine, MCV4, Menactra®, manufactured by Sanofi, for VFC eligible children 2 through 18 years of age. Please refer to the memo dated June 14, 2010 for more information. 

MMRV Vaccine: Available for LHDs and updated recommendations:  Effective immediately, local health departments may order MMR-V vaccine to administer universally, that is, for all children 12 months through 12 years of age, regardless of insurance status. The ACIP has updated its recommendations for use of MMRV. Please refer to the memo dated May 12, 2010 for more information.

Updated Recommendations for Rotavirus Vaccine: The U.S. Food and Drug Administration (FDA) has revised its recommendations for rotavirus vaccine, including that providers resume the administration of Rotarix vaccine and continue administering RotaTeq. Please refer to the memo dated May 17, 2010 for more information.

Two doses of varicella vaccine are available universally: a note was added to clarify the universal availability of two doses of varicella vaccine.

Formatting Change: Formatting of the coverage criteria was changed on May 1, 2010 to streamline the document. A column including CPT® codes was added. The ACIP Recommendations column changed to the ACIP Recommendation Highlights. Information in this section is abbreviated and NOT inclusive of all recommendations, precautions, or contraindications.

New HPV Vaccine Availability: Effective May 1, 2010 an additional HPV product (Cervarix®) is now availalbe for NCIP participants to order. Please refer to the memo dated April 19, 2010 for more information.

Hib Vaccine Availability: Supplies of Hib-containing vaccines have returned to normal market levels. Effective March 1, 2010, Pentacel® will no longer be available universally. Please refer to the memo dated March 31, 2010 for more information.

Changes in the North Carolina Immunization Program: Several significant changes were made to the program, effective April 1, 2010. Some changes effective April 1, 2010 will rescind changes made December 1, 2009.

• Seasonal influenza vaccine (pediatric use) for the 2010-2011 influenza season is available only for VFC-eligible children through 18 years of age.  
•  Tdap vaccine (pediatric use) is available universally (that is, for all children) 10 through 18 years of age. (This rescinds the December 1, 2009 change that stated children 10 through 18 years of age can receive one dose of state-supplied Tdap ONLY to fulfill the 6th grade entry requirement.)
• Varicella vaccine (two doses) is available universally (that is, for all children) 12 months through 18 years of age. (This rescinds the December 1, 2009 change that stated only VFC eligible children could receive two doses of state supplied varicella vaccine).
• Tdap vaccine (adult use)—a single dose is available for two populations:
• Any person of any age entering a North Carolina college/university (where Tdap is required by NC Immunization Law) for the first time who has never received Tdap.(This rescinds the December 1, 2009 change that stated children 10 through 18 years of age can receive one dose of state-supplied Tdap ONLY to fulfill the 6th grade entry requirement.)
• Post partum women seen at local health departments if no documentation of Tdap vaccine exists. (This has not changed).

Please refer to the memo dated February 26, 2010 for more information.

Switch to PCV13: The NCIP switched from pneumococcal conjugate 7-valent (PCV7) vaccine to pneumococcal conjugate 13-valent (PCV13) vaccine effective March 18, 2010. PCV13 provides protection against thirteen strains of pneumococcal bacteria, including the seven strains in PCV7, and will replace PCV7 in all provider practices. Please refer to the memo dated March 12, 2010 for more information.

PPSV23 Language Update: Language was updated in the ACIP Recommendations column for PPSV23 to bring the NCIP Coverage Criteria in line with the most recent ACIP recommendations.

HPV Vaccine Coverage Criteria: Males from age 9 years through 18 years who meet Vaccines for Children (VFC) eligibility criteria, may be administered state-supplied human papillomavirus (HPV) vaccine, Gardasil®. Please refer to the memo dated February 4, 2010 for more information.