Maryland Vaccines for Children Program
    REVISED - VFC Vaccine Inventory Form 
                          July 24, 2015

PLEASE PRINT AND GIVE TO ALL STAFF WHO HANDLE VFC VACCINE
 

 

The Maryland VFC Program has revised the VFC Vaccine Inventory Form (DHMH 4499; Rev. July 2015) to include HPV 9 (Gardasil 9 Vials) and instructions on how to request serogroup B meningococcal vaccine (MenB). Additional details on HPV 9 and MenB can be found at www.MarylandVFC.org (VFC Email Archives - 2015). 

 
PLEASE DISCONTINUE USE OF ALL PREVIOUS VERSIONS OF THE VFC VACCINE INVENTORY FORM (DHMH 4499). 

Helpful tips for completing the VFC Vaccine Inventory Form (DHMH 4499) include:
  • Write "0" next to a vaccine if you do not have any on-hand
     
  • Include all lot numbers, expiration dates, and vaccine doses on-hand
     
  • If you have additional lot numbers or need more space make copies of this form
     
  • Do not report expired vaccine(s) on this form; list it on the Vaccine Return and Wastage Form 
     
  • Write neatly and clearly
     
  • Incomplete inventory form submissions will NOT be processed
     

The VFC Vaccine Inventory Form (DHMH 4499; Rev. July 2015) can be printed by clicking the links above or from the VFC website at  www.MarylandVFC.org (VFC Program Documents).

 

 

Please call the VFC Contact Center if you have any questions.


 

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Maryland VFC Program