Labels to Assist in the Documentation of Vaccination Administration

There are specific recordkeeping requirements when vaccines are administered, including the use and distribution of Vaccine Information Statements (VISs), as follows:
Health care providers shall make a notation in each patient's permanent medical record at the time vaccine information materials are provided indicating (1) the edition date of the materials distributed and (2) the date these materials were provided.

This recordkeeping requirement supplements the requirement of 42 U.S.C. Section 300aa-26 that all health care providers administering these vaccines must record in the patient's permanent medical record (or in a permanent office log) the name, address and title of the individual who administers the vaccine, the date of administration and the vaccine manufacturer and lot number of the vaccine used. (Source: http://www.cdc.gov/nip/publications/VIS/vis-instructions.txt)

The following tool allows you to generate a formatted sheet of labels, in Adobe PDF format, which includes the following information: Vaccine Name, Manufacturer, Lot Number, Expiration Date, and the VIS Edition Dates* for all components of the vaccine. These labels can then be applied to the medical record or log, covering all recordkeeping requirements but the date of administration and the name/address/title of the individual who administers the vaccine.

Please send any comments to Stuart T. Weinberg, MD at info@stwmd.com

1.-Select a Vaccine:
2.-Enter the Lot Number:
3.-Enter the Expiration Date (Month, Day, Year):
4.-Select a Label Format:

NOTE: This sheet of labels will be a PDF file and requires the Adobe Acrobat Reader to view.
To obtain this free Reader, click here

* As of 3/30/2007, the latest VIS Edition Dates are:

Diphtheria, Tetanus, Pertussis (DTaP/DT): 7/30/01
Hepatitis A: 3/21/06
Hepatitis B: 7/11/01
Haemophilus influenzae type b (Hib): 12/16/98
Human papillomavirus virus (HPV): 2/2/07
Inactivated Influenza Vaccine: 6/30/06
Live, Intranasal Influenza Vaccine: 6/30/06
Measles, Mumps, Rubella (MMR): 1/15/03
Meningococcal: 11/16/06
Pneumococcal Polysaccharide (PPV23): 7/29/97
Pneumococcal Conjugate (PCV7): 9/30/02
Polio: 1/1/00
Rotavirus: 4/12/06
Tetanus / Diphtheria (Td): 6/10/94
Tetanus / Diphtheria / Pertussis (Tdap): 7/12/06
Varicella (Chickenpox): 1/10/07

(Source: http://www.cdc.gov/nip/publications/VIS/vis-instructions.txt)