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1-800-821-5821

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Health Care Provider Toolkit for Vaccine Clinics

The purpose of this Toolkit is to provide information related to influenza and conducting immunization clinics. The following information and links to information should enable a successful clinic to be conducted.

Influenza Phone Bank number: 1-888-257-0990
Deaf and Hard of Hearing phone number: 1-800-606-0215
Influenza Phone Bank Hours: 9 AM – 5 PM 
 
Additional Information for Health Care Providers

 On this page 

• Frequently Asked Questions
• Governor's Declaration
• H1N1 Influenza Vaccine
• Seasonal Influenza Vaccine
• Vaccine Clinic Information
  • Billing
  • Guidelines for Clinic Layout and Set-up
  • Maintenance/Storage/Transportation of Vaccine
  • Are You Ready?

Frequently Asked Questions

• For Health Care Providers and Clinicians (Word* | PDF*)
• For School-based Clinics (Word*| PDF*)
• Vaccine Information for Health Care Providers

Governor's Declaration

Governor John E. Baldacci on September 1, 2009 signed a Proclamation of Civil Emergency Due (PDF*) to a Highly Infectious Agent to allow the State to better respond to the potential dangers of H1N1 flu and to facilitate a statewide vaccination campaign.

Many school districts reported that a concern about potential liability was putting at risk their ability to participate in vaccination clinics. The proclamation protects school districts and other vaccination clinic participants from liability.  The Proclamation also will provide immunity from tort liability for approved health care workers who administer the flu vaccines.  The Maine CDC, DOE, and MEMA will coordinate and facilitate the implementation of school supported vaccine clinics for both the seasonal flu and H1N1.

See the Governor's Press Release

H1N1 Influenza Vaccine

Anyone interested in offering H1N1 vaccine must complete and submit the H1N1 Provider Agreement (even those that are already registered Maine Immunization Program providers and who have already completed paperwork to offer seasonal flu vaccine).

• Vaccine Information Statements
• Vaccine Order form (Online Order form) (Word* | PDF*) – a health care provider must have completed the H1N1 Provider Agreement and received an H1N1 PIN from the Maine Immunization Program before submitting an order
• Weekly vaccine reporting form (Online Reporting Form) (Word* | PDF*) – required for reporting on all H1N1 doses administered (Instructions)
• H1N1 Vaccine Q&A from US CDC
• Additional H1N1 Vaccine Information, including Vaccine Coordinators by Public Health District

Seasonal Influenza Vaccine

• Pediatric Vaccine Usage Reporting Form (PDF*)
• Vaccine Information Statements

  Vaccine Clinic Information  

(Several of the below links will take you outside of maine.gov)

Billing

• MaineCare billing instructions for schools offering seasonal and H1N1 vaccines
• Vaccine Billing Information

Vaccine Administration

• Influenza Vaccine Administration (Seasonal) (Word*)
• PHN Vaccine Worksheet (xls*)
• Refusal to Stay After Receiving a Vaccine (Word*)
• Needle Length and Injection Site for Inactivated Influenza Vaccine (PDF*)

Guidelines for Clinic Layout and Set-up

• Guidelines for Setting Up Clinics
• Immunization Clinic Guidelines (Word*)
• Sample Vaccine POD Layout (Word*)
• Sample Medication POD Layout (Word*)
• Federal Clinic Guidance Layout (PDF*)

Maintenance/Storage/Transportation of Vaccine

• Proper Maintenance and Storage of Vaccine in Public Health Nursing (PHN) Offices (Word*)
• Policy: The Role of Public Health Nursing (PHN) in the Proper Storage of Vaccines in PHN Offices (Word*)
• Transportation of Small Quantities of Vaccine (except for Varicella and Measles, Mumps, Rubella [MMR] Vaccines) from Public Health Nursing Offices to Another Location (Word*)
• Transportation of Large Quantities of Vaccine (except for MMR and Varicella vaccines) from Public Health Nursing Offices to Another Location (Word*)
• Record of Transportation of Vaccines/Biologicals to a Facility for Emergency Cold Storage (Word*)
• US CDC Vaccine Storage and Handling Toolkit
• Refrigerator Storage Capacity (PDF*)
• Handling Instructions for H1N1 Vaccine (Word*)

Are You Ready?

• Seasonal Flu Clinic Checklist (Word*) or (PDF*)

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*free viewer or to request a hard copy

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