Novel H1N1 Influenza

Pre-Registration for Vaccine Administration Sites in Kanawha County

The Kanawha Charleston Health Department has established a pre-registration process for immunization providers in Kanawha County to identify their facilities as possible vaccine administration sites for the 2009 novel H1N1 influenza vaccine. Pre-registered sites are not committed to administering vaccine; however they will receive periodic updates and vaccine planning information. Prior to receiving vaccine, your site will need to complete a Provider Agreement that outlines the specific terms and conditions of vaccine use and accountability as defined by federal and state authorities.

We would like to thank those of you who have pre-registered your facility to be an H1N1 vaccination site with the Bureau of Public Health. You do not need to re-register. Pre-registered sites will soon be receiving an email outlining steps to complete the registration process. If you have not yet pre-registered, you can do so thru the links below. Please continue to monitor the Kanawha Charleston Health Department (KCHD) website for updated information.

Sites that may wish to pre-register include healthcare provider offices, hospitals, and other private settings, such as pharmacies. Facilities with multiple locations should submit a separate pre-registration form for each vaccination site. Please contact the KCHD at (304) 348-6494 if your business has centralized distribution for multiple sites and would like to discuss pre-registering as one site. Please ensure that information is provided on the authorized prescriber (e.g., M.D., D.O.) under whose authority vaccinations will be administered at your site. To start, click on the link below:

Pre-Registration Key Points
Why Pre-Registration?
What to Expect When Vaccine is Available
Pre-Registration for Provider and Clinics
Pre-Registration for Hospital and Pharmacies

Pre-Registration Key Points

There is no cost to pre-register.
Pre-registered providers are not obligated to order vaccine once it is available.
Providers will be required to sign an H1N1 Vaccine Provider Agreement outlining the final terms before vaccine can be ordered.
Pre-registration is not a guarantee that you will receive H1N1 vaccine. Final decisions on which providers will receive vaccine will be made by each local health jurisdiction.
Pre-registered providers will receive periodic e-mail updates with H1N1 information including vaccine.
Providers will work with their local health jurisdiction to submit vaccine orders once vaccine becomes available.

Why Pre-Registration?

Pre-registration is the first step to becoming an approved H1N1 vaccine provider. Final federal requirements may be different. Final terms will be included in the H1N1 Vaccine Provider Agreement, which will require a signature. Shipping and contact information is being collected for vaccine ordering planning and will be used to assign provider identification numbers for providers who pre-register.

What to Expect When Vaccine is Available

When vaccine is available, the department will e-mail or blast fax the required H1N1 Vaccine Provider Agreement to pre-registered providers who are approved by local health jurisdictions. Providers will be required to notify their local health jurisdiction immediately if the vaccine delivery address, shipping days, or shipping time information changes. No guarantees will be made about the timing or size of individual vaccine shipments.

Providers will agree to regularly report the following information to local health jurisdictions:

Number of doses administered.
Number of doses still on hand.
Any requests for additional doses.

Subsequent orders will be filled based on this information. Provider orders will be reviewed and possibly limited by local health jurisdictions because of how much vaccine is allocated to the state.

If you are a Provider or Clinic

If you are a Hospital or Pharmacy

2009 H1N1 Vaccination Recommendations