Our federal funding agency, the Centers for Disease Control and Prevention (CDC), requires all NCIP Vaccines for Children (VFC) providers to designate a primary vaccine coordinator and at least one back-up vaccine coordinator who is able to perform the same responsibilities as the primary vaccine coordinator in the event that the primary person is unavailable.

These positions will be responsible for vaccine management and ensuring that all vaccines are stored and handled correctly. The primary and back-up vaccine coordinators must be fully trained regarding vaccine management, storage and handling. The primary coordinator is required to complete annual VFC requirements and vaccine storage and handling training.

CDC requires providers to notify the NCIP when there is a change in the Vaccine Coordinator. Vaccine Coordinator changes can be reported to the NCIP by accessing the report through this website link http://www.immunize.nc.gov.

Please complete this Contact Verification Report to ensure the NCIP has current and accurate information regarding the designated vaccine coordinator and back-up vaccine coordinator in your facility.

* 1. Facility Name and Address:

* 2. Fax Number:

* 3. Primary Vaccine Coordinator:

* 4. How long have you been functioning as the Vaccine Coordinator?

* 5. Back-up Vaccine Coordinator

Thank you for your response!