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User’s Guide to
Florida SHOTS:
Immunization Registry
(State Health On-line Tracking System)
Version 10.3.8
Florida Department of Health
Bureau of Immunization - 5/25/2012
Table of Contents
1.0
1.1
1.2
1.3
2.0
2.1
2.2
2.3
3.0
3.1
4.0
4.1
4.2
4.3
5.0
5.1
5.2
5.3
5.4
6.0
6.1
6.2
7.0
Introduction......................................................................................................4
Registry Participation—Parents and Children ................................................................ 4
Using This Guide ............................................................................................................ 5
Service Site Information ................................................................................................. 6
Gaining Access to Florida SHOTS..................................................................6
Florida SHOTS Main Menu (Logging In) ...................................................................... 7
Password Expiration and Grace Login ........................................................................... 9
Forgot your password?.................................................................................................. 10
Navigation......................................................................................................12
Today’s Patient List ...................................................................................................... 16
Patient Search ................................................................................................17
Extended Search............................................................................................................ 19
Patient Load Warning Message .................................................................................... 21
Invalid Names ............................................................................................................... 21
Patient Registration........................................................................................22
Patient Identification..................................................................................................... 23
Patient Information ....................................................................................................... 27
Parent/Guardian Information ........................................................................................ 29
HMS Demographics...................................................................................................... 30
Immunization Status ......................................................................................32
Immunization Status Notes ........................................................................................... 35
New Immunization Status............................................................................................. 36
Entering Vaccinations....................................................................................36
7.1
7.2
7.3
7.4
7.5
7.6
7.7
Vaccination List Overview ........................................................................................... 37
Add Vaccinations.......................................................................................................... 38
Entering Vaccinations using Inventory......................................................................... 43
Changing / Deleting Vaccinations When Using Inventory........................................... 45
Historical Vaccinations................................................................................................. 46
Additional functions...................................................................................................... 47
Invalid doses and alternate schedules ........................................................................... 50
8.0
9.0
10.0
11.0
12.0
13.0
Adverse Events ..............................................................................................52
Contraindications...........................................................................................53
Contact Attempts ...........................................................................................56
Exclude From Recall .....................................................................................57
Merge History................................................................................................58
Religious Exemption .....................................................................................64
13.1
13.2
13.3
13.4
Viewing the DH 681: Religious Exemption Form ....................................................... 64
Creating a DH 681: Religious Exemption ................................................................... 67
Rescinding the DH 681 Form: Religious Exemption ................................................... 69
Viewing a Rescinded DH 681 and a Parent’s Proof of Rescission............................... 71
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page i
14.0 Reminder Recall ............................................................................................73
15.0 Immunization History Report........................................................................78
16.0 Form 680 – Certificate of Immunizations .....................................................80
16.1
16.2
16.3
16.4
16.5
Electronically Certifying a Form 680 ........................................................................... 83
Working with previously certified Form 680s.............................................................. 87
Search for Certified Form 680 ...................................................................................... 88
Form 680 Rules for View Only Users .......................................................................... 92
DH 680 Variations ........................................................................................................ 93
17.0 Form 687 – Immunization Clinic Record Card.............................................93
18.0 Assess Immunization Levels .........................................................................96
18.1
18.2
18.3
18.4
18.5
18.6
18.7
18.8
18.9
Create Assessment File ................................................................................................. 97
Assessment Reports and Extract Overview .................................................................. 98
Immunization Survey Report........................................................................................ 99
Immunization Summary Report.................................................................................. 101
Late Up-To-Date Report ............................................................................................. 102
Not Complete Report .................................................................................................. 104
No Immunizations Report........................................................................................... 106
Patient List Report ...................................................................................................... 107
Create CASA Extract File........................................................................................... 109
19.0 Reports ........................................................................................................ 110
19.1
19.2
19.3
19.4
19.5
19.6
19.7
Vaccine Utilization Report ......................................................................................... 110
Physical Inventory Reports ......................................................................................... 112
Doses Administered Report ........................................................................................ 116
Vaccine Return Form.................................................................................................. 117
Vaccine Accountability Report................................................................................... 119
Vaccine Demand Forecast Report .............................................................................. 123
Religious Exemptions ................................................................................................. 126
20.0 Working with Inventory ............................................................................. 128
20.1
20.2
20.3
20.4
20.5
20.6
20.7
20.8
20.9
Maintain Locations ..................................................................................................... 128
Receive Inventory ....................................................................................................... 130
List Receipts................................................................................................................ 133
Adjust Inventory ......................................................................................................... 135
Transfer Inventory ...................................................................................................... 139
Archive Inventory ....................................................................................................... 144
Transaction History..................................................................................................... 145
Unarchive Inventory ................................................................................................... 147
Correcting Inventory................................................................................................... 148
21.0 System Administration ............................................................................... 157
21.1
21.2
21.3
21.4
21.5
21.6
Organization Edit Information.................................................................................... 158
Viewing Site Information ........................................................................................... 160
Site Maintenance......................................................................................................... 161
Adding Personnel........................................................................................................ 166
Managing Site Responsibilities................................................................................... 172
User Account Maintenance......................................................................................... 175
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page ii
Appendices:
Appendix A – Florida SHOTS Notification & Opt Out Form…………………………….. 176
Appendix B – Florida SHOTS Glossary…………………………………………………….. 179
Appendix C – Florida SHOTS Valid Contraindications…………………………………… 183
Appendix D – Example Florida Certification of Immunization (Form 680)……………… 187
Appendix E - Allowing Parents Access to Download Certified Form 680s……..………… 189
Appendix F – Vaccine Type Information…………………………………………………… 199
Appendix G – Selected Resources…………………………………………………………….202
Contact Information:
Toll Free Help Line: 1-877-888-7468
Primary Fax: (850) 412-5801
Secondary Fax: (850) 922-4195
www.flshots.com
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page iii
1.0 Introduction
The Florida SHOTS (State Health On-line Tracking System) is a statewide, computerized
immunization registry, which houses immunization records for children and adults. The
system provides up to date algorithms, which evaluate patients’ vaccination records with
the most recent recommendation for immunizations. Florida SHOTS is authorized
under s. 381.003, F.S. and administrative rule 64D-3.011, F.A.C., which indicate that
health care providers licensed under ss. 458, 459 and 464, F.S. may apply for access to
the system.
Individuals applying for access are termed “applicants” and are considered “authorized
responsible individuals” for their organization. Florida SHOTS considers these applicants
and “authorized responsible individuals” owners of the Florida SHOTS organization
account for which they applied and are granted access to the system through. Being the
“owner” of the account, this individual is ultimately responsible for any action taken by
other individuals granted system user access to Florida SHOTS under his/her authority.
Currently, the system includes persons born January 1, 1977 and later who have
presented for services in any the 67 county health departments, persons born on or after
January 1, 2003 that have been automatically loaded to the system via an interface with
the Office of Vital Statistics, and persons entered by other private providers. The
application has many benefits for providers: calculation of immunization status,
recommendation on immunizations, and printing official immunization forms (needed for
enrolling children in school and day care), to name a few. Additionally, using Florida
SHOTS to access and update childhood immunization records will greatly facilitate the
ability to track immunization records statewide as children move to different parts of the
state.
Florida SHOTS serves as a tool to help the state reach and sustain high childhood
immunization levels and keep vaccine-preventable diseases at a minimum. It is
important that you read and follow the instructions contained in this guide and that data is
entered as accurately as possible. Many other providers in the public and private sectors,
as well as yourself, will depend on the accuracy of the data entered into Florida SHOTS.
1.1
Registry Participation—Parents and Children
As provided by s. 381.003, F.S., parents have a right not to have their children’s
immunization record shared in the state immunization registry. If a parent
chooses to opt out, this means that their child’s immunization records will not be
transferred between participating organizations (including CHDs) and will only
be updateable by the last organization which had ownership of the record. The
immunization history entered for children opting out will not be shared with other
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 4
organizations participating in Florida SHOTS, and therefore may not be the most
up-to-date information.
Registry participation notification is required by s. 381.003, F.S. Providers must
notify parents/guardians that their child’s immunization records may be stored in
Florida SHOTS and accessed by participating health care providers. Notification
can be achieved by simply displaying the notification information contained on
the ‘Florida SHOTS Notification and Opt Out Form’ (Form DH 1478) in an easily
viewable location.
If parents choose not to participate, they should be provided a copy of the ‘Opt
Out’ form. A copy of this form can be found in appendix “A”, and also can be
printed from the Florida SHOTS web site within the application. By choosing not
to participate, the child’s immunization records will only be accessible to the last
health care provider to update the child’s record prior to the processing of the optout form. The form must be completed by the parent and mailed to the
Department of Health at the address indicated on the form. Since January 1, 2003,
parents of newborn children have received direct notices of registry participation
via the Department of Health’s Vital Statistics birth notification.
If a parent chooses to change their mind and decides to have their child participate
after opting-out, they need to contact the Department of Health. A client’s opt-out
status can not be changed unless BOI receives a signed letter from the parent or
guardian with the client’s name, DOB and social security number requesting that
the opt-out status be changed. The letter must be faxed to the BOI office (850)
412-5801 and the user must call 877-888-7468 to notify the staff that a
confidential fax is on the way. Once the fax is received the opt-out status will be
changed. An ‘Opt-out Status Change’ form can be located in the user guide under
Appendix A.
1.2
Using This Guide
This guide has been designed as a reference and training manual for both County
Health Department (CHD) and private practice users of all skill levels. Readers
will notice throughout the guide that certain features and system areas are
accessible only by CHD users. These areas are identified by asterisks (*) within
the text of the feature’s description and also by an orange box around the affected
areas of screen captures like this:
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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1.3
Service Site Information
The Florida SHOTS system offers the ability to designate multiple service sites
(clinics) for organizations. During the enrollment process, we will identify if
multiple service sites are needed by consulting with the named administrator and
responsible authorized individual (applicant) and will add them accordingly.
Having multiple service sites will allow users the flexibility of logging in to one
organization and associating patients and the vaccinations they receive to a
specific service site, rather than the organization in general. This is particularly
beneficial with group organizations having multiple clinics. By using service sites
under one organization instead of multiple organizations, monitoring and
maintaining access and running various reports can be done without requiring
access to each organization in Florida SHOTS.
If, after enrollment, additional sites are desired, users designated as Florida
SHOTS local administrators may call the helpdesk to request the new site(s).
Also, if a site is no longer needed, the helpdesk can archive the site so that it is not
available for selection in the system.
As a general note, if your organization has multiple service sites defined in the
system, many system functions will require a selection of which site applies to the
current task or situation. This applies to everything from what site a patient
primarily goes to and which site a vaccination was given at to which site’s address
should be printed on the DH 680 Form or Immunization History Report, among
other places. If your organization has only one site, the service site selection box
will not be present, even if a screen capture in this guide shows one.
2.0 Gaining Access to Florida SHOTS
Once the application for access to Florida SHOTS has been approved, the authorized
responsible individual within the organization will receive the following three pieces of
information for accessing the system:

Organization Login ID (OID): The OID is a unique identifier that will be
assigned to the organization by the Florida Department of Health (DOH).
Permission to log onto the system by other users (employees) is provided by the
designated administrator for the organization. All staff authorized to access
Florida SHOTS by the responsible authorized individual will use the same
organization ID to access the system. Each organization’s responsible authorized
individual is accountable for any and all access to Florida SHOTS using the
organization login ID issued through the individual’s application.
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Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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2.1

User Name: The user name, like the provider organization ID will be a unique
alphanumeric identifier that informs the system of the identity of the user within
the provider organization. The Bureau of Immunization will assign a username
and temporary password to the named contact person who, in turn, will assign
user names and temporary passwords to those individuals within the practice who
are designated to have access to the system by the responsible authorized
individual.

Password: The password will be a unique code that will allow authorized users to
access the system. Like the user name, this identifier must be kept confidential. A
temporary password is given upon account creation to the first user
(administrator) and should also be given by administrators when creating new
users. Each user will be required to change this password for security purposes,
following initial access. Passwords must be at least 7 characters long, are case
sensitive, and should be changed once every 30 days.
Florida SHOTS Main Menu (Logging In)
This application is best viewed using Microsoft Internet Explorer 5.5 or above,
Windows 2000 or better, a screen resolution of at least 800 x 600, and your
browser should have cookies enabled. Having Java enabled is also suggested, but
not required. Once the responsible authorized individual has obtained the
necessary access information as described in Section 2.0, this individual will need
to
point
their
web-browser
to
the
following
URL:
https://www.flshots.com/flshots/signin.csp. It is suggested that users add this URL
to their “Favorites” within Internet Explorer. Once the Florida SHOTS main
menu (Figure 2.1-1) appears enter the access information provided by the BOI.
Note: When entering the access information, passwords must be entered exactly
as they were created. For example, if the password that is established were
MIAPEDS, it would have to be entered in all caps. Only password fields are
case sensitive in the Florida SHOTS system. Any text typed in lowercase letters
in all other fields is automatically converted to uppercase for display and
storage in the database.
If a user enters incorrect login information, an alert box will be displayed and the
user will be required to reenter the login information (Figure 2.1-2). After three
failed attempts, the account will be locked, and an administrator may need to
unlock it. The local administrator will be able to unlock the individual accounts of
staff members they have added to their organization’s account. However, if the
local administrator on the account is locked out, that person will need reset their
password or call the Florida SHOTS helpdesk directly to have their account
unlocked.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 7
Figure 2.1-1, Main Menu
Figure 2.1-2, Invalid Login Alert
For new users, once all of the access information has been entered and the Login
function is utilized, the system will generate a message prompt notifying the user
that the current password must be changed before proceeding (Figure 2.1-3) if this
is the first time the user has logged onto the system.
Figure 2.1-3, Password Change Notification
After clicking the “OK” button located on the message prompt, the system will
display a new window, which asks the user to enter his/her old password along
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 8
with the new password (Figure 2.1-4). Changing and confirming the password
will occur for users accessing the system for the first time, and for those for which
the password has or is about to expire. Once the password has been changed and
confirmed the user will need to click on the “Submit” button located on the screen
for the system to accept the change. A password confirmation screen will appear
once the user name and password have been verified by the system. At this point,
the user is ready to begin using the application.
Note: If the user wishes not to enter a new password when prompted, the
“Cancel” function can be used. However, when the user attempts to access the
system at a later date, he/she will then be required to change the password.
Passwords may also be changed manually at any time by clicking on “Change
Password” located in the “Administration” sub-menu.
Figure 2.1-4, Password Change & Confirmation
Reminder: Current password must be entered exactly as it was created. New password
can be entered in any format (upper/lower/mixed case) but must be entered exactly the
same when logging in.
2.2
Password Expiration and Grace Login
If a user has not changed his/her password before the password expiration date
(default is 30 days from date last changed) their account will be expired; however
one additional login using correct login account information is allowed before the
user is locked out of his or her account. This one additional login after the
account has expired requires a password change and will eliminate a local
administrator’s intervention in setting up a new password and reactivating the
expired account.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 9
When a user’s password remains expired for 60 days or more, their account will
automatically be inactivated. User’s that need to have their access reinstated need
to contact their local administrators (local administrators see section 20.4 for
additional information).
2.3
Forgot your password?
If a user forgets their password, Florida SHOTS will allow resetting the password
by answering user-selected security questions. If a user logs in to the system and
has not selected security questions and provided answers, they will be prompted
to do so (Figure 2.3-1). Questions and answers provided may be changed later by
selecting the “Security Question Edit” link from the Administration menu.
Figure 2.3-1, Security Question Edit
Once questions and answers are on file, if a user forgets their password, they
should click the “Forgot Password?” link on the login screen (Figure 2.3-2). Users
will then be prompted to enter their organization logon id and their username
(Figure 2.3-3) and then answer their security questions. If the questions are
answered correctly, users will be allowed to reset their password. If the questions
are not answered correctly after three attempts, the user’s account will be locked
and a local administrator or the Florida SHOTS helpdesk will need to unlock the
account.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 10
Figure 2.3-2, Forgot your password?
Figure 2.3-3, Forgot your password?
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 11
3.0 Navigation
This section gives a brief overview of the look and feel of the application, while the
remaining sections of the manual describe the many valuable features of the application
in detail. Each feature will be thoroughly discussed throughout the manual. Florida
SHOTS is a web-based application and is separated into 3 distinct sections: 1) The header
information, which contains the patient identifier information, 2) Data Screens (to the
right) and 3) The system menu, from which each data screen and system feature can be
accessed (to the left). The different data screens are where users will perform the major
functions of the application (Figure 3.0-1). Users simply use their mouse to click on any
field and enter the available information.
Figure 3.0-1, Data screens example
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 12
The menu on the left side of the screen allows users to perform various functions
regarding their patients’ records, administration of their account, running reports,
extracts, and reminder recall, getting help with using Florida SHOTS, and providing
feedback. The currently active menu option will be highlighted in yellow. Below is a
brief description of each menu option’s functionality:

Submit – IMPORTANT – This is the most important button to understand as it
results in data being permanently stored on the central
server. This button becomes active (yellow) once
changes are made to a record, and allows users to
save the data at any point during the patient
registration or update process, after all required
information is entered.

User Name – The Person who is logged into Florida
SHOTS will be identified in the upper left-hand
corner right below the submit button. This is useful
for those offices where multiple individuals are
working from the same computer. For security
reasons, leaving Florida SHOTS logged in and
unattended is not advised but if this should happen
and the user listed is not you, it is advised to log out
of the system and log back in using your user account.

Task List – This function is an area used to support
user notification of items needing attention. Only
users who can perform the functions which require
attention will see the Task List. Currently, for CHD
and private users, the Task List mirrors the
functionality of the “To-be Certified 680s” function.
Additional tasks may be defined in future updates. If
any tasks remain in the list when signing out, users
will see a pop-up message warning them that tasks are
still present.

Patients – Users can search, complete, or update
patient information (demographics, immunization,
etc), generate forms, reports, and release the patient
record.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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o Search for Patient – This link allows the user to search the immunization
registry for existing patients and access patient records.
o Redisplay Search Results – This link displays the previous search results.
o Today’s Patient List – This link will display the list of patients you have
accessed today for quick retrieval of records.
o Search for Form 680 – This link allows users to search directly for
existing Form 680’s created by any organization.
o To-be Certified 680s – Visible only to users who can certify 680s. Allows
users to view patients for which Parent Pin numbers have been created but
680 forms have not yet been certified.
o Patient Identification – Provides basic patient information like name,
sex, social security number, date of birth, etc.
o Patient Information – Users can record and update address, county of
residence and other demographic information.
o Parent/Guardian – Information on the patient’s parents or legal guardian
can be recorded on this screen.
o Immunization Status – This screen allows users to view the
immunization status (past due, up to date, complete, etc.) and vaccination
recommendations for a patient.
o Vaccinations – This screen allows users to record, edit, and view
immunizations given to a patient.
o Adverse Events – This screen allows users to specify whether or not a
patient has experienced an adverse event to a vaccination
o Contraindications – This screen allows users to specify whether or not a
patient has experienced a contraindication to a vaccination.
o Contact Attempts – Allows users to view, add, and edit contact attempt
information for each client.
o Exclude From Recall – Gives users the ability to exclude patients from
showing in a reminder recall based on selected vaccine series.
o New Imm Status – Users can see the latest immunization status after
updates to the immunization record have been made.
o HMS Demographics - * CHD users only. This link can be used to import
demographic data from the Health Management System.
o Merge History – Users can review if the current patient record has ever
been merged with other duplicate patient records and can check each
merge event for accuracy.
o Religious Exemption – Takes users to the DH Form 681 screen.
Depending on the rights the user has in Florida SHOTS, the user may
create, view, certify, download, or print the DH Form 681, the Rescission
of the DH Form 681 or the Parent’s proof of the DH Form 681.
o Form 680 – Takes users to the DH Form 680 (Florida Certificate of
Immunization). Users may create, view, certify, download, print, and
attach Parent Pins to 680s here.
o Create Pin – Visible only to users who can certify 680s. Allows users to
create Parent Pin numbers ahead of creating and certifying a 680 form.
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Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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o Form 687/Form 1478 (opt-out) – These links allow users to view or print
the Immunization Clinic Record Card (Form 687) or the Opt-out form
(1478).
o Immunization History (Report) – This link allows users to view and
print a summary of the immunizations received by a patient (this can be
given to parents for their information).
o Patient Demographics (Report) – * CHD users only. This link allows
CHD users to view and print a summary of all demographics fields for a
patient. This report can be used to facilitate patient registration with the
Health Management System.
o Close Patient
 Release Patient Record – Releases the updated patient record
 Discard Updates – This button allows the user to Exit the current
patient without saving any of the information entered.

Reminder Recall – Allows users to run reports and create labels for their patients
who have or will become due for immunizations within specified date ranges.
Currently overdue patients can also be included in those reports and labels.

Vaccine Inventory - * CHD users only at this time. This collection of menu
items allows users to monitor and maintain their vaccine inventory. Functions
include the ability to receive, adjust, transfer, modify expiration dates, view
transaction history, and archive/unarchive.

Assess Imm Levels – Provides users with reports and an extract used to evaluate
immunization coverage levels for their organization.

Reports – Allows users to create, view, print, and download various useful
reports including vaccine utilization, physical inventory, and immunization
statistics.

Administration – Allows users with administrative rights to add users within
your facility, unlock passwords, and manage user accounts.
o Change Password – Users can change
password, and administrators can reset forgotten
passwords.
o Security Question Edit – Users may edit their
security questions and answers.
o Organization Edit – Administrative users can
view and edit information on file for their
organization.
o Personnel List – Administrative users can add
or edit existing users, unlock accounts, reset
forgotten passwords, and terminate user access.
Only administrators will see this option.
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Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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
Customer Support – Provides users with the
following links:
o Announcements – Allows users to see current
list of system announcements. Also seen on
sign-in page (see figure 2.1-1).
o Contacts – This link provides telephone and
email contact information for getting in touch
with the Florida SHOTS team.
o Provide Feedback – This button allows users to complete an online
trouble ticket or suggestion form, where all comments/suggestions are
welcome.
o User Guide – Users may download this user’s guide in Adobe Acrobat
(.pdf) format by clicking on this link.
o Web Based Training – Users may utilize the web-based training course
by clicking on this link. Additional login is not necessary. For questions
regarding the Web Based Training (WBT), please contact the helpdesk.

Sign Out – This button allows the user to save the current patient and exit the
system entirely.
Help Text – Every screen has a help text toggle link. The user can click on it to show or
to hide some helpful information about how to complete that page.
3.1
Today’s Patient List
The “Today’s Patient List” function, accessible from the top of the main system
menu, is a handy tool to allow users to quickly reload patients accessed previously
in the same business day. Clicking on any row in the list will allow users to load
the selected patient. Hovering your mouse pointer on any row will also show the
patient’s address and current immunization provider in a purple pop-up box
(Figure 3.1-1). Users may click the ‘Print’ button to print the list of today’s
patients if needed.
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Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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Note: Selecting the “Today’s Patient List” function will release any record
currently open.
Figure 3.1-1, Today’s Patient List
4.0 Patient Search
Once the system has authenticated the user based on the Organization Login ID, User
Name, and Password entered, the patient search screen will appear (Figure 4.0-1). Users
will perform all patient searches from this screen. A new patient cannot be registered
into Florida SHOTS until a search of the registry has been performed. The purpose of
this functionality is to prevent or minimize duplication of patient records. It is important
to verify the patient search information if no results are returned or if results returned do
not include the requested patient.
Figure 4.0-1, Patient Search Screen
To begin the search, enter the patient’s last name, first name, date of birth, and gender (or
for CHD users, optionally enter only the State ID number) and click the “Search for
Patient” button.
*Note: Only CHD users will have the option to search by State ID number. If data has
been entered by one search method and you wish to switch methods, or search using
different criteria, all fields must be clear of data. Click the ‘Reset Search Fields’ button at
any time to clear all data.
After completing a patient search, one of three things will happen: an exact match based
on the criteria entered, a list of potential matches if an exact match cannot be located, or
no matching records.
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All potential matches will be displayed below the search criteria (Figure 4.0-2). The user
can review the patient information supplied in the search results section (Name, Sex,
DOB and SSN if available) in order to determine if the search results contain the correct
patient. Each patient’s current address and CIP (Current Immunization Provider) on
record will be displayed in a tool-tip box by moving your mouse pointer over each row in
the results list. Users may select any displayed patient’s record by clicking on that
corresponding patient, or the user can click ‘Add New Patient’ to add a new patient if
certain that it has not been found.
If the requested patient is not found, the system will display a message that states “No
Matching Records Found” (Figure 4.0-3). The reason this message is being returned
can be due to the fact that either the patient has not been entered into Florida SHOTS or,
based on the search criteria, the record could not be found. At this point, the user
must verify and/or modify the search criteria and search again if needed, or the user can
add the individual as a new patient.
Users must be certain before a new patient is added to avoid the creation of duplicate
records. The more complete and accurate the information the user provides, the more
likely the patient being searched will be found. It is important that you DO NOT
create or add test data into the production system. For more information on advanced
searching techniques and for assistance in performing a more thorough search using the
“Extend Search” function, please see section 4.1.
Note: The search will be performed regardless of patient gender to produce additional
results. Results with matching gender will be listed first, followed by results with gender
unknown and lastly with results where the gender is opposite of what was selected. This
behavior also applies to the “Search for Form 680” function (section 16.3).
Figure 4.0-2, Patient Search Example
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Figure 4.0-3, No Matching Records found Message
4.1
Extended Search
Florida SHOTS has two different internal searching methods it uses to retrieve
patient records. The first method, which is used when clicking the “Search for
Patient” button on the Patient Search page, finds patient records where the date of
birth matches and the names begin with what was entered in the name fields. This
search method is the quickest, which is why it is the default method of searching.
Even if partial names are used for the search, this method will return all records
matching the DOB and begin with the entered names. As a result, this may return
more results than expected so users are encouraged to always use the patient’s full
and complete name.
The second method of searching uses a robust searching software tool to look for
records that ‘sound like’ the search criteria entered. This will return useful results
if the name is spelled incorrectly, either by the user performing the current search
or the user that originally created the record (e.g. Smith vs. Smyth or Chris vs.
Kris). This search method also will account for cases where the date of birth
entered is similar to, but not exactly the same as, a record already in the system
(e.g. 1/10/08 vs. 10/1/08).
If some results are returned from the initial search (performed when clicking the
“Search for Patient” button) but do not contain the patient you are looking for, in
some cases you may be able to do a more thorough search by clicking the “Extend
Search” button (Figure 4.1-1). If this button is not active, the extended search has
automatically been performed for you. It is very important that partial name
searches not be performed or extended searches will return few, if any, additional
results.
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When additional results are found due to an extended search, these records will
have a purple + next to them in the results list (Figure 4.1-2). When no additional
records are found via the extended search, users will receive a “No Additional
Records Found” message beneath the results list.
In order to prevent test or erroneous data from being added, patient names will be
validated by the system. If an entered name is found to be invalid, users will see
an error message. If the name you are attempting to enter is a real name and you
have confirmed this with the patient/guardian, please contact the Florida SHOTS
helpdesk.
Figure 4.1-1, Extend Search
Figure 4.1-2 Extend Search Results
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4.2
Patient Load Warning Message
When a patient record is selected and opened by clicking on the desired row in the
search results or when loading a patient record from “Today’s Patient List” (see
section 3.1), users will see a warning message pop-up if any of the following
conditions are true:
 Patient is “due now” for at least one vaccination
 Patient is “over due” for at least one vaccination
 Patient meets the criteria for an Immunization Status Note to appear (see
section 6.1).
All series which are “due now” or “over due” and any notes that apply will all be
present together in the same pop-up message (Figure 4.2-1).
Figure 4.2-1, Patient Load Pop-up Warning
Note: Pop-up message will not display when loading a patient who’s record is
marked as “Inactive – Deceased”.
4.3
Invalid Names
In an effort to minimize and eliminate test, erroneous or fictitious patient records
from entering the system, Florida SHOTS maintains a list of invalid names. This
function prohibits the use of invalid names when adding or updating a patient
record. Users are asked to always verify that the name being entered or updated is
the patient’s full and complete name. Names should not be modified in Florida
SHOTS for any reason other than a legitimate name change. If a name being
entered or updated is on the invalid names list, the user will not be allowed to add
the patient or save the change (Figure 4.3-1). This message will display using the
Search for Patient or Search for Form 680 functions. If the name is accurate and
the user receives an error, please contact the Florida SHOTS helpdesk for
assistance.
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Figure 4.3-1 Invalid Name Error (Example)
5.0 Patient Registration
Note: throughout the application asterisks (*) and blue highlighting are used to denote
required fields.
If the patient that is being searched is not found, the system will generate a message that
states “No Matching Records Found”. If the user wishes to add the patient as a new
patient, the user will need to click on the “Add New Patient” button on the search screen.
Users cannot add a patient without first searching the registry. This is to prevent duplicate
records from being created. Within the registration process, there are several key pieces
of information that are required; this section will outline all of necessary information to
register a patient. Within the application, users will notice a navigation menu that leads
to several screens. Users can access the various functions of Florida SHOTS by
navigating the various parts of the menu. Three screens (“Patient Identification”, “Patient
Information”, and the “Parent/Guardian” screens) are used for demographic and patient
registration purposes (Figure 5.0-1). These screens are designed to capture identifying
data about patients, their residence, and their parents or guardian. This information
includes address, phone number, etc.
Figure 5.0-1, Patient Registration Menu Items
The blue area (patient information banner) at the top of the screen (Figure 5.0-2) will
show basic patient identification information as it is entered. This header provides the
following information for each patient: Name, State Immunization ID (unique number
assigned to each patient registered in Florida SHOTS), Sex, DOB, SSN, Status (overall
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immunization status – Overdue, Due Now, Up-To-Date, or Complete), CIP (Current
Immunization Provider – current provider of immunizations) and Site (service
site/facility where the patient receives care). A contraindication or religious exemption
notification will also display in the banner area, when on the patient’s record.
Figure 5.0-2, Patient Information Banner
See Section 6.0 for information on immunization status. The status indicator in the
banner is the patient’s overall status. If any one vaccination series is considered over due,
the patient’s overall status will be “over due”. Then, in descending order of priority, the
overall status will show as “due now”, then “up to date” if any one series is marked as
such. If all required series are considered complete, the overall status will be “complete”.
If the overall status is “Over Due” or “Due Now”, it will be highlighted in red.
5.1
Patient Identification
When accessing either a new patient or an existing patient record, the system will
always first display the Patient Identification screen (Figure 5.1-1). Registering
a patient first involves entering the required detailed demographic information on
the Patient ID screen. The full name, date of birth, sex, and race are required
fields on the Patient ID screen and are marked with an asterisk. Users must
complete the demographic information prior to entering a vaccine history. The
Patient ID screen allows the user to capture the following information:
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First, Middle and Last Names – Users will be required to specify a reason
if changing an existing name.
Aliases
Patient Status* – By default, status is set to “Active”. Other options
include: “Inactive – Deceased”, “Inactive – Documented Move”, and
“Inactive – Unable to locate/No response”. Moved or Gone Elsewhere
(MOGE) date is required for all inactive statuses. Date of Death is also
required for status of Inactive – Deceased.
*Two inactive statuses have been added for CHD users: “Inactive –
“WIC/Private Provider No Recall” and “Inactive – “WIC/Private Provider
Recall”. These statuses can be used for patients being registered at the
CHD who will not be visiting the CHD for immunization services, but
there is a need to capture immunization histories (e.g. WIC patients).
Note, the CHD will become the Current Immunization Provider (CIP) at
registration but selection of either of these two inactive statuses will
exclude these records from assessments and CASA extracts (see section
18).
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If you wish to be able to use the Reminder Recall function (see section 14)
on these patients, choose “Inactive – “WIC/Private Provider – Recall”.
The reminder recall feature allows running reports for active patients,
“WIC/Private Provider – Recall” patients, or both.
The CASA extract function will not include clients having either of these
two new statuses unless they have a WIC ID and the “only patients with
WIC ID” option is chosen.
No inactive status other than “Inactive – Deceased” may be selected if
there is any vaccination on record for the patient that was given within the
last 30 days by the user’s organization.
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Date of Birth – Users will be required to specify a reason if changing an
existing date of birth. On records having a birth certificate number (added
by Vital Statistics) date of birth cannot be changed directly. If the DOB
field is believed to be incorrect, please report this to the FLSHOTS
Helpdesk
Date of Death – Required if status is Inactive – Deceased. If entered and
MOGE date is blank, date of death will be copied to MOGE. If status is
anything other than Inactive – Deceased, status will be changed to
“Inactive – Deceased”.
State of Birth – Similar to date of birth, if the patient’s record contains a
birth certificate number, state of birth may not be changed by users. If the
state of birth field is believed to be incorrect, please report this to the
FLSHOTS Helpdesk.
Date Moved or Gone Elsewhere – Required if status is Inactive. If entered
and date of death is blank, inactive status of “documented move” or
“unable to locate/no response” must be chosen. Patients with a Moved or
Gone Elsewhere (MOGE) date will be included in the CASA file extract.
If the child’s MOGE date occurs before they are two years of age, the
organization performing the CASA evaluation will be responsible for the
child’s immunization status.
Social Security Number (SSN)
WIC ID* – Enables entry of WIC identification number
*CHD users only, otherwise a display field.
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
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Medicaid Number (if known; also include dates of coverage)
o Begin date
o End date
If dates of coverage include today or there is no end date, the VFC
eligibility will automatically be set to “Medicaid”. Medicaid start date
may be listed as occurring before the date of birth so long as it is within
the same month and year the child was born. This field is only accessible
by VFC providers and county health departments.
Sex
Birth Certificate Number – This number will be pre-populated via the
Vital Statistics interface for children born on or after 01/01/03 and cannot
be edited. If this number is present, date of birth and state of birth fields
may not be user-edited.
Death Certificate Number– This number will be pre-populated via the
Vital Statistics interface for all recorded deaths in the state. Date of death
and MOGE date will be automatically filled in and status of “Inactive –
Deceased” will be automatically selected. This number cannot be edited.
Race
Birth Event Outcome – This field will be used in the case of multiple
births (twins, triplets, etc).
Birth Order – The order in which the multiple-birth child was born.
Opt-out Form 1478 – Information (if any) on the last organization to
provide a copy of the form and the date it was provided. If the form was
provided by the Office of Vital Statistics, that date will be shown as well
(VS 1478 Provided). Users from the currently logged in organization can
also select if they provided the form and enter the date.
Comments – Comments may be entered on a patient record to
communicate with others in your organization. Comments entered by one
organization are not viewable to another, and view-only accounts will not
see this option.
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Figure 5.1-1, Patient Identification screen
Any patient whose status is “Inactive” will not show when utilizing the Reminder
Recall function (see section 14.0).
As noted above, if a user attempts to change an existing first or last name or date
of birth, they will be required to select a reason for the change (Figure 5.1-2). This
is to reduce the possibility of unintentional, unnecessary, and invalid changes.
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Figure 5.1-2, Name/DOB Change
Reasons for name change include: ‘Birth name update’, ‘Full name update’,
‘Legal Documentation’, ‘Marriage/Divorce’, and ‘Transposed names’. Reasons
for DOB change include: ‘Incorrect date entered’ and ‘Transposed values’.
FLSHOTS staff has internal reports which are used to monitor changes and any
unusual or inappropriate changes will be reviewed with users being contacted to
make corrections or provide information, when necessary. To avoid issues, please
make sure patient names and dates of birth are accurate to legal records.
Nicknames and other variants should go in the ‘Alias’ fields, below the legal
name.
The Cancel button located at the bottom right of the screen allows users to clear
all data that has been entered on this screen. Once the required data has been
entered, users can click on Next to proceed to the Patient Info screen to continue
registering the new patient. Edits performed will not be saved until the “Submit”
button is clicked. When entering a new patient, users must enter all required
demographics fields on the “Patient Identification” and “Patient Information”
screens before submitting information.
5.2
Patient Information
The Patient Information screen allows the user to enter contact information
(phone, address) for the patient (Figure 5.2-2). The remaining fields on this
screen allow users to capture the following information:
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Physical Address – allows for entry of address, city, state & zip code.
Mailing Address – needs to be used if the mailing address is different
from the physical address.
County of Residence – this field requires the user to enter the county in
which the patient resides.
Phone Number – allows users to enter a 10-digit phone number for the
patient.
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
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Language – allows users to enter the patient’s native language, if other
than English.
Current Imm (Immunization) Provider (CIP) – shows the current
provider of immunizations for this patient. On creation of a new patient,
your organization will be listed as the CIP. When editing an existing
patient from the system that you are not the CIP of, a warning message
will pop up alerting you that your organization is becoming the CIP if the
CIP was “Generic Private Provider” or will ask you if you want your
organization to become the CIP if the CIP was another provider (Figure
5.2-1).
Figure 5.2-1, CIP changing message example
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Imm Service Site – If your organization has more than one service site
(clinic) defined in the system, please select which location this patient is
primarily associated with.
High Risk - * Viewable by CHD users only. For records originating from
Vital Statistics, a patient will be considered high risk if any of the
following is true of the patient’s mother at the time of birth of the patient:
o Married = no
o Education level <= 12th grade
o Number of live births >= 3
o Age at this birth <= 21
o Month prenatal began >= 6 months
Religious Exemption This field is used to indicate when a child has been
issued a Religious Exemption after filing form DH681. If the value of this
field is “Yes” this child is not receiving immunizations due to religious
beliefs and a Florida Certificate of Immunization form (DH680) cannot be
issued for school. Also, if “Yes”, an additional field will be shown
displaying the date the Religious Exemption was issued.
Registry Participation – this field indicates if the patient has opted-out of
participation in the registry (status of “No”). When a patient “Opts-out”,
users are not allowed to view or enter patient information into the system
unless their organization was the last to update the record before the optout notification was processed by the Bureau of Immunization
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Figure 5.2-2, Patient Info Screen
The Cancel button located at the bottom of the screen allows users to clear all data
that has been entered on this screen. Once the required data has been entered,
users can proceed to the Parent/Guardian Information screen to continue
registering or updating the patient record.
5.3
Parent/Guardian Information
The Parent/Guardian screen allows users to collect information regarding the
patient’s mother and father, or legal guardian (Figure 5.3-1). There are no
required fields on this screen; however, it is highly recommended that you collect
this information in order to further verify the child’s identity, to aid in tracking
patients, or to call parents about missing immunizations. The parent or guardian
names listed will be available to select for printing on the DH680 (Certificate of
Immunizations) form for “Parent or Guardian”. Data obtained through the Office
of Vital Statistics will be pre-populated for all new births. The fields on this
screen allow users to capture the following information for the mother, father
and/or legal guardian:
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First, Middle, Last Name – Maiden name will only apply to the mother.
Daytime & Nighttime Phone Number
Date of Birth
Social Security Number (SSN)
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Figure 5.3-1, Parent/Guardian Information
5.4
HMS Demographics
The HMS Demographics function allows users to update patient records in
FLSHOTS with changes made in HMS (assuming the patient exists in both
systems). The function can be accessed by selecting the ‘HMS Demographics’
option from the “Patients” section of the main system menu after finding and
opening a patient record. After a brief moment, while FLSHOTS communicates
to the local HMS system, both records will appear side-by-side (Figure 5.4-1).
Figure 5.4-1, Compare HMS Data
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This page displays all demographic information recorded in both Florida SHOTS
and HMS. To accept all data from HMS click on ‘Select HMS data’ at the bottom
of the page, then click the ‘SUBMIT’ button to save and update the information in
Florida SHOTS. Any difference between the records will be listed in bold and
may have one of the following icons displayed in the “Copy?” column:
Indicates the HMS record will be copied to the immunization record if the
'Select HMS Data' button is clicked.
Indicates that the HMS record fails an immunization edit and cannot be
copied.
Indicates that the HMS record cannot be used because one of the
following is true:
 A birth certificate number is on file for the patient.
 An imprecise date cannot be used if a precise date is on file.
 Data is not recorded in HMS; therefore the immunization record cannot be
updated.
 The HMS information in this field is never used to update the
immunization record.
 A precise date of death cannot be updated if there is a death certificate
number on file.
Note: If updating the FLSHOTS version of the patient record will cause a name or
DOB change, users will be required to specify a reason for the change (Figure
5.4-2). Name and DOB changes shouldn’t occur at the same time but if they do,
users may see an error message and the copy will not be allowed (Figure 5.4-3).
Figure 5.4-2, Name/DOB Change
Figure 5.4-3, Copy prohibited due to name and DOB issues
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6.0 Immunization Status
The immunization status function contains the current state of a child’s immunizations
according to Florida SHOTS data prior to any updates made by the current user. Users
can obtain system recommendations for vaccines that are due by clicking on the
Immunization Status link (for new and existing patients) from the “Patients” menu. The
Florida SHOTS application will return immunization recommendations based on the
patient’s age and shot history, and updates the information on the Immunization Status
screen (vaccines & doses due, etc) according to standards developed by the American
Academy of Pediatrics and the Advisory Committee on Immunization Practices (ACIP).
This immunization status will remain the same until the user performs all necessary edits
to the record and then selects the highlighted yellow submit button to update the
Immunization Status. The user may want to check the Immunization Status screen after
entering and submitting shot information on each patient to determine the new status and
check for updates.
Figure 6.0-1, Immunization Status
When the Submit button is selected after entering updates (i.e. vaccinations) to the
record, a request is sent to the central registry to run a series of algorithms against the
patient shot history. These algorithms return the latest immunization status based on the
information entered by the user. This action will take a few seconds. Changes to the
client’s immunization status will then show on the Immunization Status screen.
The immunization status screen lists the recommended vaccination series and each series’
status (Figure 6.0-1). If a series is not yet completed, the immunization status screen will
display minimum and recommended due dates for when the next dose for each series
should be administered. Additionally, the screen also indicates whether or not the patient
has experienced any contraindications to a series that may preclude further immunization.
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Series will display as due now, overdue, up-to-date, not started or complete based on
patient age and vaccinations received thus far. Series statuses of “Over Due” and “Due
Now” will be highlighted in bold red font.
The display of both minimum and recommended due dates for each series are governed
by minimum and recommended intervals from the last valid dose given. By moving the
mouse pointer over any line for an incomplete series, a purple hover-text box will
display, showing all vaccine types that could be given to satisfy the current dose needed
and the minimum and recommended dates for use of each type (Figure 6.0-2). The list of
types will be sorted with the highest recommended choice first.
This information can also be shown in detail format by clicking the button to “View
Vaccine Recommendations” (Figure 6.0-3). This page will show all possible vaccines
that can be given and when for each series not completed and can also be printed.
Figure 6.0-2, Immunization Status
Figure 6.0-3, Series Vaccine Recommendations
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There may be circumstances when the minimum due date for a given dose may also
become the recommended due date. This can occur if the calculated recommended due
date for the next dose due in a series would fall on a date after the maximum age has been
reached for a particular vaccine. In these instances the Immunization Status screen will
display a footnote indicating the reason for the recommendation (Figure 6.0-4).
Figure 6.0-4, Recommended Date Set As Minimum Date
If there are other vaccines that could be given by using the recommended interval, the
recommended due date will not be shown for vaccines where the calculated
recommended due date would be beyond the maximum age for the vaccine (Figure 6.05).
Figure 6.0-5, No Recommended Date
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6.1
Immunization Status Notes
The Immunization Status page will also display “notes” below the main status
area to alert users of opportunities to vaccinate patients needing certain
recommended vaccinations (Figure 6.1-1).
Figure 6.1-1, Immunization Status Notes
Current notes are as follows:
 TDAP – Reminder to administer TDAP will show for any patient age 10
to 18 years who does not have a valid dose of TDAP recorded (Figure 6.12).
Figure 6.1-2, TDAP Note
 PCV13 – Recommendation to administer a dose of PCV13 will be shown
for all patients age 24 to 59 months who have already completed the
PNEUCON series but a valid dose of PCV13 has not been recorded
(Figure 6.1-3).
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Figure 6.1-3, PCV13 Note
If any contraindication has been recorded for the patient, even if it may not affect
the vaccines recommended by the notes, the notes will have an additional warning
to review the contraindication(s) before administering vaccinations (Figure 6.1-4).
Figure 6.1-4, Contraindication Warning
Note: The rules which cause these notes to appear also control how the TDAP and
PCV13 selections in Reminder Recall work under “Include only specific series or
vaccines” (see Section 13.0). Also, if a patient is subject to one of these notes,
when loading the patient record, users will see a pop-up message which contains
the note and contraindication warning, if applicable (Figure 6.1-5, see Section 4.2
for more on the patient load warning pop-up).
Figure 6.1-5, Patient Load Pop-up Message
6.2
New Immunization Status
After entering in new shot records and submitting the information, the New
Immunization Status link becomes highlighted. If selected, the New
Immunization Status link evaluates the clients’ new shot history, saves the record
and then returns the user to the Immunization Status screen.
7.0 Entering Vaccinations
Once a patient has either been registered as a new patient or for existing patients, adding
vaccinations is accomplished by first clicking on the “Vaccinations” link on the left hand
side menu. Users can add shots by clicking on the “Add a Vaccination Record” or the
“Add Historical Vaccination Records” buttons (Figure 7.0-1). Users will have other
selections for existing patients and they are discussed later in this section.
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Figure 7.0-1, Vaccination List
7.1
Vaccination List Overview
This section describes the layout of the Vaccination List screen. Adding and
working with vaccinations are discussed in the sections that follow. Please refer to
Figure 7.0-1 in the previous section while reviewing this information.
The first item to note at the top of the list area is the “Sort by” option. This control
will determine if the list of vaccinations are sorted alphabetically by series (family
of related vaccines), by vaccine, or chronologically by date administered. The
default sort is by vaccine.
The following is a description of what each column means when reading the
vaccination list.
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Vaccine Series – The name of the series the vaccination belongs to. For
example, DTAP, DT, TD, and TDAP are all considered part of the
“DTAP” series as would any combination vaccine which contains DTAP.
Combination vaccines like Pediarix or MMR, will appear on multiple lines
showing a dose of each series represented by the vaccine.
Vaccine Type – The name of the vaccine administered.
Date Given – Date of administration of the vaccine.
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7.2
Dose/Interval – The dose number calculated by the algorithm for this
vaccination is on top and the number of days since the previous dose is on
bottom. See Section 7.7 for information on invalid doses (those showing a
dose number of 0 with a red asterisk).
Age Yr Mo/in Days – The age of the patient at the time of the shot in
years and months is on top and in days on bottom.
Total Mos/Adv Event? – The age of the patient at the time of the shot in
months is on top and if an adverse event has been recorded for this
vaccination (see Section 8.0), it will be noted below the age in months as
‘Y’, if not, ‘N’ will be shown.
Provider/Person – Name of the organization who claims to have given
the vaccination is on top and if selected by that organization when adding
the vaccination, the Provider Person ID of the person administering the
vaccination will appear on bottom. If this column is blank, the vaccination
was recorded historically and/or the organization adding the vaccination
record chose not to claim they administered it.
Source – Name of the organization who caused the record to be added.
This can be the same as the ‘Provider’ organization but may be different.
Useful in the case of historical records when the provider organization is
not the organization adding the records.
Add Vaccinations
After selecting the “Add a Vaccination Record” button, the system will display
the Add Vaccination Record screen (Figure 7.2-1). The Add Vaccination Record
screen is equipped with pull down selection lists that are kept up-to-date with new
vaccines added at the central registry. (Appendix F lists a description of each
vaccine type.) To display the selections, simply click on the down arrow next to
each box.
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Figure 7.2-1, Add Vaccination Record
The following is an explanation of the data contained within the Shot Entry
Screen:
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Vaccine Type – Enter the type of vaccine the individual received.
Date Given – Enter the date or, if vaccine was given today, enter “T” and
the current date will be automatically supplied.
VIS Date – Enter the date of the Vaccine Information Statement provided
for this vaccination. Some combination vaccines may require multiple VIS
publication dates for each statement needed. If a single VIS statement is
developed where multiple are needed currently, for a limited time users
may see a button labeled “Other VIS Options”, allowing them to use either
the separate statements or the newer combined statement. Required for
VFC organizations (those with a VFC pin number and start date on file),
optional otherwise. This information will be included on the Form DH687,
Clinic Record Card.
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VIS Recipient – Select the person receiving the VIS statements for this
patient. Mother, father, guardian and patient names will be available when
present in the patient record. “Other” may be selected and users may enter
the name of the person receiving the form as well as that person’s
relationship to the patient. If the relationship is mother, father, or guardian
and the name entered is different than what is already on record, the user
will be given the option to replace the current information with the new
information. This information will be included on the Form DH687, Clinic
Record Card along with whether or not this person also gave consent for
treatment.
Consent for treatment given by VIS recipient – When VIS information
is recorded, this field is enabled and required. Leaving the default value at
“Yes” indicates consent for receiving the indicated vaccine was given by
the person receiving the VIS statements. If the person giving consent is
not the same as the person that received the statements, local policy on
documentation of consent for treatment should be used. This information
will be included on the Form DH687, Clinic Record Card along with the
name of the VIS recipient.
Injection Site * – The specific place on the body where an immunization
is administered. A complete list of locations and their associated acronyms
available for selection can be found in Appendix B.
* Note: Required only for CHD users.
Injection Route * – The method used to administer the immunization. A
detailed list of available options can also be found in Appendix B. When a
selection of Intranasal or Oral is selected, an Injection Site is not required
*.Note: Required only for CHD users.
Provider Org. ID – Select your organization name if your organization
gave this vaccination. If this is a historical record received elsewhere,
select “OTHER”.
Provider Person ID – Select the provider person id of the staff
administering the immunization.
o If vaccination date given < 30 days ago (including today) and the
user’s organization is chosen as having administered the
vaccination (Provider Org ID), provider person is required.
o If vaccination date given > 30 days ago and the user’s organization
is selected as the Provider Org ID, provider person is optional.
o Provider person not shown if Provider Org ID is selected as
“OTHER”.
o Provider Person ID list refreshes as to the date entered for the
vaccine given. This means a provider ID that has an end date prior
to the date an immunization is given will not appear in the provider
person drop-down list.
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Imm Service Site – If your organization has more than one service site
(clinic) defined in the system and this vaccination was given by your
organization, select which site/clinic where the vaccination was
administered.
VFC Eligibility – Specify the patient’s eligibility for receiving VFC
vaccine as it applies to this vaccination.
Private Organizations –
o VFC Eligibility field will not be displayed unless a VFC pin
number and start date are recorded for your organization by
Florida SHOTS staff.
o If VFC pin and start date are recorded and vaccination date given >
VFC start date and < VFC end date (if also recorded), VFC
Eligibility field will be enabled, otherwise it will be disabled and
not shown.
o If VFC Eligibility field is enabled and patient <= 18 years old as of
vaccination date given, VFC eligibility is required, otherwise
optional.
o Medicaid is the only choice shown for VFC Eligibility if Medicaid
ID is recorded for the patient and vaccination date given is >
Medicaid start date and < Medicaid end date (if also recorded).
County Health Departments –
o VFC Eligibility is enabled and required if the vaccine chosen is a
VFC vaccine and the program component is 01, regardless of
vaccination date given or age of patient, otherwise VFC Eligibility
is disabled and not shown. Medicaid is the only choice shown if
Medicaid ID is recorded for the patient and vaccination date given
is > Medicaid start date and < Medicaid end date (if also recorded).
o If VFC Eligibility “FQHC Only” is selected, but the service site is
not identified as an “authorized FQHC” the user will see the
following warning (Figure 7.2-2):
Figure 7.2-2, VFC Eligibility FQHC Warning
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Program Component* – For CHD users only. If your CHD is listed as
the Provider Org ID, a program component selection will be required for
patients <= 18 years old as of the date given*. Program component “01”
represents State Supplied Vaccines. The “05” program component
represents those vaccines purchased by the County Health Departments
from outside sources rather than those provided from the State. The “09”
program component represents the Hepatitis vaccines (A, B and A+B) that
are provided either by the Hepatitis Program or STD clinics to patients
considered to be at risk.
* If the patient is <= 18 years old as of the date given and <= 18 years old
as of today’s date, the program component will default to 01 when
accessing the Add Vaccinations Screen. If the patient is > 18 years old as
of today’s date but still <= 18 as of the date given that is entered, program
component 01 will be automatically selected when the date given is
entered.
Manufacturer Code/Lot Number* – The Manufacturer Codes are listed
in a box with a drop down menu. Once a manufacturer is selected, the Lot
Number becomes a required field. The Lot Number is a free-text
alphanumeric field. If the manufacturer of the vaccine has changed
recently, it may be in FLSHOTS as an inactive manufacturer. If the
manufacturer you are looking for is not in the list, check the “Include
Inactive” box to show all known manufacturers.
* When using inventory (currently CHD users only) and vaccine is
available with quantity on hand, a different selection method will appear
(see section 7.3).
After entering the shot information, users may mark the “Add another…”
checkbox to add another shot, or uncheck it and click the “Next” button and the
system will return the user to the “Vaccination List” screen. As immunizations
are added, users will notice the shots entered displayed on the “Vaccination List”
screen (Figure 7.0-1). These shots can be organized by series, type or date
depending on your preference.
Notice that each of the entered shots displays with no dose number when first
added. Before a dose number can be displayed for a shot, that shot must be saved
and evaluated (recomputed) with regard to any other shots on the patient’s record
and the stored vaccination recommendations (algorithms), by clicking on the
“Submit” button or “New Imm Status” link.
Note: The system will warn users when attempting to add a vaccination for which
the patient is currently contraindicated (Figure 7.2-3).
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Figure 7.2-3, Contraindication Warning
7.3
Entering Vaccinations using Inventory
* Currently, this feature is enabled for CHD users only. A later system release
will allow use by all users. For instructions on updating and maintaining
inventory records, see section 19.
When your organization has inventory available for use, the Add Vaccination
screen will display available inventory records to choose from when adding
vaccinations. The vaccination detail fields will be used to filter the inventory
records displayed, beginning with the vaccine type (Figure 7.3-1).
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Figure 7.3-1, Add Vaccination
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Users may continue entering details and the inventory record list will continue to
shorten or disappear if there happens to be no inventory available based on the
selections made. The inventory records list is limited by vaccine type, service site,
program component, inventory location, mfg/lot, and vaccination date given
(there might or might not be inventory available depending on when you indicate
the vaccination was given based on inventory available at the time of the
vaccination).
At some point, a selection from the inventory record list must be made by clicking
the “Select” button next to the record you wish to reduce inventory from as a
result of this vaccination. This selection may be made at any time as long as at
least the vaccine type is selected. Once selected, you may de-select by clicking
the “Deselect” button. This will clear any inventory-related selections from the
detail fields (including default selections not made by the user).
If the inventory record list is too long, you can limit the results returned by filling
in more details as mentioned above, or you can click the “Hide” buttons next to
rows you wish to remove from view. Select “Unhide – x” to unhide records,
where “x” is the number of records you have hidden.
The “Reduce Inventory on-hand count” checkbox controls whether or not
inventory will be reduced as a result of this vaccination. Unchecking this box will
remove the inventory record selection list from the screen and replace the mfg/lot
selection with individual fields for manufacturer and lot number (as in section
7.2).
Note: “Reduce inventory” must be checked if your organization is selected as
the provider of the vaccination, the vaccination date given is within up to 14
days prior to today’s date, and program component 01 or 09 is selected.
Reduce inventory does not have to be checked for vaccinations older than 14 days
or those within 14 days that are from program component 05. Service Site must
be selected whenever “Reduce inventory” is checked.
7.4
Changing / Deleting Vaccinations When Using Inventory
* Currently, this feature is enabled for CHD users only. A later system release
will allow use by all users. For instructions on updating and maintaining
inventory records, see section 19.
It is important to recognize the effect changing or deleting vaccinations has on
inventory. With Florida SHOTS, vaccine inventory will be automatically adjusted
when changes are made to vaccinations that affect the inventory record chosen for
the vaccination.
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
7.5
Changes to vaccinations – If a change to a vaccination alters the inventory
record chosen to reduce inventory for, the system will automatically add
the dose back to the previously chosen inventory record and reduce
inventory on the newly chosen inventory record.
Deleting vaccinations – If a previously recorded vaccination is deleted, the
system will automatically add the dose back to the inventory record that
was originally reduced.
Historical Vaccinations
Users can simultaneously enter several shots via the “Historical Shots” screen
(Figure 7.5-1). Users can select a vaccine type, and then enter all the dates in
which that vaccine type was given. Additionally, a user can select a date and then
all vaccines given on that date (a capital “T” can be used to indicate today’s date).
Note that by clicking on the checkboxes, the user indicates that the shot was
provided by their organization. The user can then click “Next” and is returned to
the Vaccination List screen and will need to click “Submit” or “New Imm Status”
to evaluate and save the vaccinations.
Figure 7.5-1, Historical Shots Screen
Note for VFC clinics: Using the “Historical Shots” page does not offer any
method to record VFC eligibility as it pertains to each vaccine given. Eligibility
should always be recorded for current vaccinations given so the historical entry
method should not be used for current vaccinations.
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Note for CHD users: Due to additional details required of CHD users for
accurate documentation, vaccinations administered within the last 30 days by
your organization may not be entered via the “Historical Shots” page.
7.6
Additional functions
Users will notice that the Vaccinations List screen contains additional
functionality pertaining to each vaccination. To utilize the functions, first select a
vaccination by clicking on a row in the list and then click on the appropriate
button (Figure 7.6-1).
To highlight a vaccination,
click anywhere on a row.
The information for that
vaccination will be
underlined. Next, click the
“View”, “Change”, or
“Contact Info” button.
Figure 7.6-1 – Additional Functions
The following is a description of each of the buttons:

View – By clicking on this button, the system will display the Shot Entry
screen which contains the shot details in read only format. Users will not
be able to change any of the data while utilizing the View Shot Details
Button.
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
Change – By clicking on this button, the system will display the Shot
Entry screen and allow the user to change the date and other information
contained in the screen, except for the vaccine type. If the type is
incorrect, the user must delete that shot. Once changes are made, this
screen displays tracking information showing the original record and
modifications (Figure 7.6-2).
Figure 7.6-2, Changing Vaccinations

Provider Contact Info – Clicking this button will display the contact
information for the provider that gave the highlighted vaccination. This is
useful in cases where another organization is listed as the provider of a
vaccination and a correction or deletion needs to be made.
Users may only change or delete vaccinations where the provider is listed as their
organization or where no provider is specified (shows as blank in vaccination
list). If a user attempts to change or delete a vaccination from an unspecified
provider, they will receive a warning message and must click ‘OK’ to continue
with the change or delete operation (Figure 7.6-3).
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Figure 7.6-3, Warning Messages
To delete a vaccination record, the user must first check the delete box next to the
vaccination, then click the ‘Next’ button, and then click ‘Submit’ (Figure 7.6-4).
Figure 7.6-4, Shot Deletion
Older vaccination records recorded using mfg codes which do not match current
values will appear in a view-only box labeled “Historical Mfg/Lot” when
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selecting to view or change the vaccination (Figure 7.6-5). This will disappear if
new mfg/lot information is provided or may be left as-is.
Figure 7.6-5, Historical Mfg/Lot
7.7
Invalid doses and alternate schedules
After submitting new vaccinations or changes to existing vaccinations, the system
will compare the patient’s vaccination record to stored vaccination schedules
(algorithms) to check each vaccination’s validity. The system algorithms are
interpreted directly from CDC/ACIP vaccination recommendations, which are
regularly monitored for potential updates or changes. If a recorded vaccination is
found to be invalid in the evaluation process, it will be flagged as dose “0*” for
that series (zero with a red asterisk). If the user were to hover around the dose
number with their mouse pointer, a two-tone purple hover text box will pop up
with the type of error and specific details on why the dose was invalid (Figure
7.7-1). If assistance is needed in understanding the message or why the
vaccination was invalid, please inform the helpdesk and they will provide
assistance in researching the problem.
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Figure 7.7-1 – Invalid Dose Message Example
The system will also inform users of what schedule the system is considering for
each vaccination series by hovering over the series name. The basic schedule for
each series is called “ACIP”; alternate schedule names vary. There are alternate
schedules for each series that are designed to appropriately evaluate clients that
receive certain immunizations outside of the recommended schedule or with
different vaccines. The hover text will also inform users as to how many doses are
required to complete that series based on the schedule the patient is being
evaluated by (Figure 7.7-2).
For example (Figure 7.7-2), if a patient begins to receive a series of HIB
PRPOMP or COMVAX, which contains HIB PRPOMP, or the patient is greater
than 12 months old and has only received 2 doses of another HIB vaccine, the
pop-up will show that the patient is on the “ACIP HIB PRPOMP or 12M
W/2DOSE” alternate schedule and only 3 doses are required (usually at 2, 4, and
12 months of age).
Figure 7.7-2 – Schedule name/doses required example
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Note: If the validity of a dose is in question, please inform the Florida
SHOTS Helpdesk. In certain cases, the validity may be overridden.
8.0 Adverse Events
Florida SHOTS users can record and/or view adverse events associated with a
vaccination by selecting the Adverse Events menu item. The user will need to highlight
the Vaccine Date to access all vaccines given on that particular date (Figure 8.0-1).
Figure 8.0-1, Adverse Event Screen
Adverse events are usually reported by a parent or guardian, and are recorded by a
provider. To add or change an existing adverse event, users will need to highlight and
click on the corresponding vaccination date for which the adverse event applies. The
system will then display the Adverse Event Record screen (Figure 8.0-2), and all
vaccinations given on the specified date. The user selects the specific vaccine
corresponding to the reported adverse events, and records the information.
Figure 8.0-2, Adverse Event Entry Screen
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To begin recording the adverse event, highlight the vaccine type shown inside the
“Vaccine Type” box located on the right hand side of the screen. Next, enter the
associated adverse event information by selecting as many valid symptoms as appropriate
from the “Symptoms” box; to select multiple symptoms, hold down the Ctrl key and
click on the symptom. Enter the date the symptoms began and who reported the event.
Click on the “Next” button to record this event into the patient’s record. The adverse
event should now be displayed for the previously selected date and will be indicated with
a “Y” next to the vaccination date. Adverse events that have been recorded should
display for the appropriate vaccine on the Adverse Events screen. Changes to a record
may be made, and additional adverse events may be entered using this screen as well.
Additionally, adverse events are also indicated on the patient’s shot record (in the
Vaccinations screen) with the age of the patient in months and the designation of “Y” in
the “Total Mos/Adv. Event” column. While an adverse reaction to a vaccine is an
important event to be aware of, it does not necessarily preclude continued vaccination.
A link to the Vaccine Adverse Event Reporting System (VAERS) is located on the
Adverse Event Record screen to allow users to easily navigate to the online VAERS
system to officially document adverse events with the Centers for Disease Control and
Prevention (CDC).
9.0 Contraindications
The Contraindications menu allows users to identify a contraindication to a vaccine for
the patient (Figure 9.0-1). Contraindications may be permanent or temporary and should
be denoted as such. A contraindication is a medical condition that prohibits providing
one or more immunizations to a patient because of a likely harmful reaction. If a
contraindication has not been entered for the patient, the screen will be blank and users
will only have the option to add a contraindication at this point.
Figure 9.0-1, Contraindication List Screen
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To enter a contraindication, users will need to click the “Add” button located on the
Contraindications screen. Once the Add button is utilized, the Add Contraindication
screen will appear (Figure 9.0-2). The Add Contraindication screen has various pulldown menus that aid the user in selecting the Vaccine Series, Vaccine Type, and
Contraindication Type. Contraindication information should be entered under the
direction of medical personnel and only valid contraindications should be used.
Note: that the Expiration Date is only a required field if the contraindication is
designated as temporary.
Occasionally, patients will have a valid reason, medical or otherwise, which prevents
them from receiving one or more vaccines. The contraindication screen provides a place
to enter this information, and to track temporary medical exemptions for those patients.
Users can select the contraindication menu from anywhere in the application.
Figure 9.0-2, Contraindications Entry
For a temporary contraindication, the Expiration Date impacts the date printed for
‘Temporary Medical Exemptions’ found on the Florida Certificate of Immunizations (DH
Form 680). Permanent contraindications, which prohibit providing a given vaccine type,
impact the patient’s immunization status, and printing the permanent medical exemption
on the DH Form 680. The following is a description of the required and optional fields
within the contraindications entry screen:
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
Series – This drop down menu allows users to select the series that is associated
with the vaccine.
Vaccine Type – This drop down menu allows users to select the vaccine type to
associate with the contraindication. Once the correct series is chosen, the vaccine
type drop down menu will only populate with vaccines associated with the series.
If attempting to contraindicate against an entire series which has multiple vaccine
types, the choice of “All Vaccines” should be used.
Permanent or Temporary Contra-Type – Users can select whether or not the
contraindication is Permanent or Temporary. If Temporary is selected, users will
be required to enter an expiration date.
Expiration Date – This field allows users to enter an expiration date for the
contraindication only if the contraindication is labeled as temporary.
Contraindication Type – This drop down menu allows users to select a valid
contraindication for the vaccination.
Disease Verification – Only applicable when using the “VZV1” permanent
contraindication. Select whether disease notification was provided by parent or by
physician.
Disease Year – Only applicable when using the “VZV1” permanent
contraindication. Enter the year in which the patient was diagnosed with Varicella
(Chickenpox) disease.
Other Description – This field allows users to enter a description for the
contraindication if the “Other” type is utilized.
Comment – This field allows users to enter any comments deemed necessary to
provide additional information.
Date Identified – This field allows users to enter the date the contraindication
was identified (default is today’s date). The date cannot be greater than “today’s”
date.
Special Note: For a permanent Varicella (Chickenpox) contraindication, indicate
whether the disease has been verified by the parent or a physician. Then enter the year the
disease occurred. This is so the correct year will print out on the DH680 form.
Once the contraindication information has been entered users have the option of utilizing
the “Next” button which will save the contraindication and return the user to the
Contraindication List screen (Figure 9.0-1) or the user may utilize the “Cancel” button
which will delete all of the information entered and return the user to the
Contraindication List screen without saving the information. Note that the Submit
button is yellow indicating that the user can save the data at any time. Once the
contraindication is entered and saved, the contraindications screen will now show the
information entered (Figure 9.0-3). Users will notice once a contraindication is entered,
and the ability to View, Change, or Delete will be available.
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Figure 9.0-3, Updated Contraindications Screen
Contraindications will not show on the Vaccinations screen, but are reflected under the
“Immunization Status” page, and on the header of every patient with a contraindication
(Figure 9.0-4). When changes are made to a patient’s record and their status is
recomputed by clicking on Immunization Status, the resulting forecast for the patient’s
future shot schedule is automatically adjusted to take any contraindications into account.
When a patient is unable to complete a vaccine series due to contraindications, their
Immunization Status will show as being complete because of a contraindication.
Figure 9.0-4, Immunization Status, Contraindications
10.0 Contact Attempts
The Contact Attempts page can be accessed by selecting “Contact Attempts” from the
“Patients” menu (Figure 10.0-1). This page allows the user to maintain all contact
attempts recorded for a patient by adding, editing, and deleting contact attempt records.
Attempts may be logged automatically by utilizing the Reminder Recall function (see
section 12.0) or manually by clicking the “Add” button.
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Once the “Add” button is clicked, a new attempt will be added to the list and will already
contain today’s date as the date entered, which can be edited, the source will be listed as
manual, and the user’s name will be recorded as the user entering the contact attempt. All
that remains is for the user to select what method was used to contact the patient, and
then click “Next”, followed by “Submit”. At this time, the choices are “Letter”,
“Telephone”, or “Home Visit” and only one of each type may be entered per patient, per
day. This rule also applies to automatically entered contact attempts (through Reminder
Recall).
Figure 10.0-1, Contact Attempts
11.0 Exclude From Recall
The “Exclude From Recall” function can be accessed from the “Patients” menu by
selecting “Exclude From Recall” (Figure 11.0-1). This page will allow users to exclude
certain vaccination series from causing a patient to appear in a Reminder Recall list.
To use, simply check the box next to which vaccine series should not cause a patient to
be recalled and supply a reason, then click “Next”, followed by “Submit”. Date entered
and user will automatically be recorded.
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Figure 11.0-1, Exclude From Recall
12.0 Merge History
The “Merge History” function can be accessed from the “Patients” menu by selecting
“Merge History”, located in the “Patient Data” section (Figure 12.0-1). The Merge
History function allows users to review a side by side comparison of the information
contained on duplicate records and the results when the records have been consolidated
into a single record. This function shows users the information contained in each former
record as well as the information that was kept on the current record. This allows users to
verify that the resultant record contains the correct information.
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Figure 12.0-1, Merge History
The side by side comparison screen will show the State Immunization Id of each record
and the date and time of the merge at the top of the page. The information from each
record is listed in vertical columns. When information from the duplicate records is
different, the horizontal row containing data will be highlighted in green.
The following fields will display on the Merge History Side By Side Comparison screen:
 State IMM Client ID – A unique identifier generated by Florida SHOTS when a
new patient is added to the system.
 Name
 Date of Birth
 Sex – Patient gender
 Race
 SSN – Social Security Number
 Street Address
 City
 State
 Zip Code
 Phone Number
 Mother’s Name
 Mother’s Date of Birth
 Mother’s SSN
 Father’s Name
 Father’s Date of Birth
 Father’s SSN
 Universal Birth Cert # – A unique identifier issued by the office of Vital Statistics
for new births.
 Birth Order – Displays as a single birth or lists the order in which the patient was
born in instances of multiple births.
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Birth Plurality – Indicates a single or multiple birth
Medicaid # – A unique identifier issued by the Medicaid Program
WIC ID – A unique identifier issued by the WIC (Women Infants & Children)
Program.
Org/ Chart # – Displays the organization name and chart number used when
vaccination records are added from organizations that upload data to Florida
SHOTS (can be multiple org/chart entries). Chart numbers are generated by the
system an uploading organization uses to track patients and is used by Florida
SHOTS to aid in matching when new uploaded records are received.
CIP/Site – Current Immunization Provider of the patient and assigned clinic
location (for organizations having multiple sites).
IMM Record Status – Displays the last status of the patient record indicated by
the CIP (active, inactive, etc.).
Date of Death
Date of Last Update Overall – Indicates the date the record was last modified.
Any Adverse Events (Y/N) – Shows a ‘Y’ for yes or an ‘N’ for no to indicate if
there are any Adverse Events entered for the patient’s immunization record.
Any Contraindications (Y/N) – Shows a ‘Y’ for yes or an ‘N’ for no to indicate if
there are any Contraindications entered on the patient record.
Following the contraindications line on the side-by-side, the vaccination history for the
patient will be shown in date order. Each entry will show the date, vaccine type, and the
name of the provider that either “entered” the vaccination in the system (but didn’t
necessarily administer it) or actually “provided” the vaccination. If “Record A” and
“Record B” were given a similar, but different vaccination on the same day, the
vaccinations will be seen on separate lines. Only vaccines between the two records that
match would appear on the same line.
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Figure 12.0-2, Merge History
Florida SHOTS patient records are entered from a variety of sources and received by
multiple methods. The information that displays on the side by side comparison screen
will vary depending on where the data originated. Records input by the office of Vital
Statistics or electronically uploaded from a MCO (Managed Care Organization) will
display with a CIP of ‘Generic Private Provider’. Records submitted via a Generic Private
Provider will have no contact information.
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Records that are manually entered or sent electronically from medical providers will
display the organization name, telephone number and contact name in the CIP row. For
organizations with more than one location, the site phone number where the patient is
currently being treated will also display. On individual vaccine records, the contact name
and number will show.
When there is no merge history for a particular patient you will receive a message
indicating that there is no available merge information (Figure 12.0-3).
Figure 12.0-3, No Merge Information
When a patient has had more than one duplicate record merged, users will see a screen
showing the data of each merge with the most recent on top. (Figure 12.0-4) Clicking on
the record will open the side by side comparison screen for that merge event. Once users
have finished reviewing the information they can click on the ‘Return to Merge History’
button located at the bottom of the page.
.
Figure 12.0-4, Multiple Merges
Sometimes patient historical merge data happened so far in the past that users will receive
a message which displays “Data not available”. (Figure 12.0-5) This information has
been archived.
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Figure 12.0-5 Alert Message
13.0 Religious Exemption
The Religious Exemption function helps users to keep up with those patients whose
parents/guardians have chosen not to immunize for a particular series of shots or possibly
all of the school age required shots based on their religious beliefs. As of Release 10.3.1,
CHD users have the ability to create an electronic record, in Florida SHOTS, of those
patients who have a religious exemption form (DH 681) on file. Users also have an
electronic record of those parents/guardians that have chosen to remove or rescind the
DH 681 as some parents/guardians chose to do.
Note: Only CHDs can create or rescind the DH 681: Religious Exemption. If you are a
Private Provider with a patient that wants a DH 681 created or rescinded, please send
them to their local county health office.
13.1 Viewing the DH 681: Religious Exemption Form
To access the Religious Exemption function, click on “Religious Exemption”
from the “Patients” section of the main system menu. You must be in a patient
record to access it. If a form has never been created for a patient, the Form 681
(Religious Exemption) screen displays with no signed form on file (Figure 13.11).
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Figure 13.1-1 Form DH 681 (Religious Exemption) no signed form on file
If a DH 681 is on file, the screen displays with the following information for each
DH 681 which has been created for the patient: electronic signature of the CHD
administrator or designee who signed it, the date it was authorized, and the CHD
who authorized the form (Figure 13.1-2). Note: only CHD users may rescind an
active DH681 (see section 13.4).
Figure 13.1-2 Form DH 681 (Religious Exemption) signed form on file
Clicking on the ‘View’ button will display a PDF of the DH 681, to allow
viewing, printing, or saving (Figure 13. 1-3).
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Figure 13.1-3 PDF version of the Form DH 681 (Religious Exemption)
If a patient has a DH 681 on file prior to Release 10.3.1, users will see it in the
list, showing that the exemption has been converted (Figure 13.1-4). Note: only
CHD users may rescind an active DH681 (see section 13.4).
Figure 13.1-4 Form DH 681 (Religious Exemption) no signed form on file
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The PDF will provide the parent/guardian with the following information:
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Child’s Name
Child’s DOB
SS# if provided
Name of Parent/Guardian requesting the form
Electronic Signature of the Parent or Guardian requesting the form
Date the form was authorized.
Electronic Signature of the Administrator or designee signing the form
Date the Administrator or designee authorized the form.
County Health Department and Address where the DH 681 was
authorized.
13.2 Creating a DH 681: Religious Exemption
*This information is specific to CHDs. Private practice users are not allowed to
create or sign a DH 681. Individuals must go to a County Health department if
they want a religious exemption for their child.
Users with the system rights to create the DH 681 should access a patient record
and click on ‘Religious Exemption’ under the “Patients” area of the menu. It will
bring up the “Form 681 (Religious Exemption)” screen showing any prior
DH681s and will also provide the ‘Create Current Form 681’ button. Click the
button to reach the Form 681 where you will create the electronic record (Figure
13.2 – 1)
Figure 13.2-1 Form 681 screen with Create button
When a user actually creates the Form 681, the screen will provide the name,
DOB and SS# (if provided) of the patient record you have accessed. (Figure 13.2
-2) It will require the user to provide the additional information:
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Relationship of the individual requesting the form.
Last Name and First Name of the individual requesting the form.
Florida SHOTS will pre-populate the Request Date with the date the form
is being created.
CHD Administrator or designee who is electronically signing the form.
Florida SHOTS will pre-populate the Authorization Date to the date the
form is being created.
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There is the additional option to update the patient record with the
Parent/Guardian information. Many records do not have this information
included and clicking this box enables Florida SHOTS to have the most
accurate data possible about its patients.
Figure 13.2-2 Creating the Form 681
Once all of the fields are complete, click the ‘Create Electronic Religious
Exemption Record’ button to create and save the electronic DH681 (Figure 13.23).
Figure 13.2-3 Successfully Created Form 681
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13.3 Rescinding the DH 681 Form: Religious Exemption
If a user with the appropriate rights needs to rescind the DH 681 at the
parent/guardian request, they should access the Form DH 681 screen from the
“Patients” section of the main system menu, showing the DH 681 on file. To
rescind the active DH681, click the “Rescind’ button (Figure. 13. 3-1) which
would then display the “Rescind Form 681” page. (Figure 13.3-2)
Figure 13.3-1 Rescinding the Form 681
Figure 13.3-2 Rescinding the Form 681
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Florida SHOTS displays the information for the top half of the form. This
information is:
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Patient Name
Patient DOB
Patient SS# (if provided)
Relationship of parent or guardian that requested the DH 681
Last Name of the parent or guardian that requested the DH 681
First Name of the parent or guardian that requested the DH 681
Date the DH 681 was requested
CHD that Authorized the DH 681
Name of the CHD Administrator or designee who authorized the DH 681
Date the DH 681 was authorized.
The user must then complete the following fields:
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Relationship of parent or guardian that is requesting the rescission of the
DH 681
Last Name of the parent or guardian that is requesting the DH 681
First Name of the parent or guardian that requested the DH 681
Date the DH 681 rescission was requested
Reason for the rescission
o Parent asks for removal
o Form was created in error
Name of the CHD Administrator or designee who is approving the
rescission of the DH 681
Date the DH 681 rescission was approved.
The CHD that is rescinding the DH 681 is provided by Florida SHOTS.
Clicking the Rescind the Electronic Religious Exemption Record button
will bring up a successfully rescinded box (Figure 13.3-3).
Figure 13.3-3 Successfully Rescinded Form 681
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When the user clicks ’OK’, it brings them to the Form 681 screen where they can
view the rescinded 681, view the proof of rescission or create a new Form 681
(Figure 13.3-4).
Figure 13.3-4 View Rescinded Form 681 or Create New Form 681
13.4 Viewing a Rescinded DH 681 and a Parent’s Proof of Rescission
At times, parents or guardians do choose to rescind the DH 681 and vaccinate
their child. When this occurs, users will be able to view and/or print the rescinded
copy of the DH 681 and the parent’s proof of rescission.
Users reach the rescinded DH 681 just as they do a current 681. The screen
provides the same information as it does a current form with this additional
functionality and data available: date the form was rescinded and the ability to
review the “Parent’s Proof of Rescission” by clicking the appropriate button
(Figure 13.4 -1).
Figure 13.4-1 View Rescinded 681 and Parent’s Proof of Rescission
If users click the ‘View’ button for a rescinded 681, they will see a PDF that looks
exactly like the valid exemption, except for that the word “Rescinded” is printed
in bold letters across the bottom and the rescinded 681 has the electronic signature
of the parent/guardian who requested the rescission and the CHD Administrator
or designee who authorized rescission of the form (Figure 13.4-2). The electronic
signature of the parent/guardian and CHD Administrator or designee could be
different individuals than those on the authorized DH 681 because the individuals
who authorized the creation of the form and those that authorized its recession
may be different.
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Figure 13.4-2 Rescinded 681
The Proof of Rescission provides a combination of the information from the DH
681 and the Rescinded DH 681 (Figure 13.4-3). It tells the user both the
parent/guardian that requested the DH 681 originally and the parent/guardian that
rescinded the form. It tells both the CHD Administrator or designee who
authorized the DH 681 and the CHD Administrator or designee who rescinded it.
In addition, it provides the reason the parent/guardian requested the rescission.
This screen also allows the user to go back to the Form 681 screen or to print the
Proof of the Rescission if needed.
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Figure 13.4-3 Proof of Rescission
14.0 Reminder Recall
The Reminder Recall function helps users to keep their patients’ immunizations up to
date by creating reports that show patients who are, have been, or will become due for
various vaccinations. Users can refine what patients they’re looking for by specifying
certain date ranges, vaccine series, and dose numbers in the search criteria. Users can also
download the reports in Excel format for offline use.
To access the Reminder Recall function, click on “Reminder Recall” from the main
menu. This can be done with or without an active patient record in use. After opening the
Reminder Recall menu, click “Recall Patients” and if a Reminder Recall has never been
run, the Reminder Recall Patient Search screen will be displayed to allow users to create
a new Reminder Recall list (Figure 14.0-1). If a Reminder Recall has been run before, the
Reminder Recall Log will be displayed instead showing previously created lists (Figure
14.0-2).
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Figure 14.0-1, Reminder Recall Patient Search
Figure 14.0-2, Reminder Recall Log
To create a new Reminder Recall list from the log screen, select “Create New List” to
display the Reminder Recall Patient Search Screen. To open one of the previously created
lists for reprinting or further work, click on the row of the list you wish to work with. To
delete a previously created Reminder Recall list, click on the “Delete” button next to the
list you wish to delete. Reminder Recall lists will automatically remove themselves from
the log after 14 days.
When creating a new Reminder Recall list from the Reminder Recall Patient Search
screen, you will first select what time span to check for patients that are or will be due for
shots. You may select from four options: any immunization due within the last 30 days,
the next 30 days, the next 60 days, or within a particular date range. By checking the box
labeled “Include all overdue patients”, any patients that have an overall immunization
status of “Overdue” (overdue for at least one required vaccination) will also be included
in the report.
If your organization has more than one service site (clinic) defined in the system, select
which clinic(s) this Reminder Recall is being run for by clicking one or more individual
sites or selecting “All”.
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After the due date range is specified (and sites, if applicable), you will select which
series/vaccines to include in the report and what intervals to use to determine overdue
status. You may select to include all series and vaccines or you may individually specify
which series or vaccines to include. If “Include all series and vaccines” is selected, you
may choose to have the report based on the recommended CDC schedule or by the
minimum intervals between vaccine doses. If “Include only specific series or vaccines” is
selected, individual selections are made for which series/vaccine, which interval, and
which dose to include (Figure 14.0-3).
Note: TDAP and PCV13 selections added to recall specifically for patients ageappropriate for and needing these vaccines. Interval and dose number selection is not
provided.
Figure 14.0-3, Reminder Recall Specific Series or Vaccine Types & Dose Numbers
To create a report with specific series or vaccines, select “Include only specific series/
vaccines”. Next, check the appropriate “Include?” box to activate that series or vaccine
type. Once checked, users can select the Interval Type (minimum or recommended) and
dose number for each included series/vaccine. Note: selections made under the “Include
only specific series or vaccines” section will limit the ability to refine results once the
report has been generated.
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Once your selections are made, click the button labeled “Start Search” to begin scanning
the system for your patients that are due for any vaccine during the date range selected
and for your overdue patients (if requested). Once the search is completed, the Reminder
Recall Patient List screen will be shown (Figure 14.0-4).
Figure 14.0-4, Reminder Recall Patient List
From the Reminder Recall Patient List screen, users can further narrow their results by
utilizing the “Refine Patient List Options” and then clicking on the button “Refine Patient
List”. Users may show only patients of a certain age (default is 0 to 227 months of age),
those due for any series or one or more specific vaccine series or dose, those with
complete address information, and whether or not to include *“WIC/Private Provider”
inactive patients (CHD only). Users may sort the report by patient name, date of birth,
first series due date, and zip code.
Users may print the report as it is displayed, create labels from the report, and download
the report to an Excel file at any time by clicking the appropriate button to the right of the
screen. Above these buttons, users have the option of specifying what method of contact
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will be used to contact the patients in the created list. Selecting a method will update the
contact attempts stored on each patient’s record (See section 10.0).
To print the report as it is displayed, click on the “Print Report” button.
Labels can be prepared by clicking on “Create Labels”. The Reminder Recall Label
Format Screen will then be displayed to select options (Figure 14.0-5). From here, users
can select the first line of the label, the layout of labels to be printed, and the sort to be
performed. To print the labels, users should load the correct Avery standard label sheet(s)
in their printer and click on “Create Labels”. An Adobe PDF file will be generated
containing the labels (Figure 14.0-6).
Note: When ‘guardian or parent’s name’ is selected for the first line, the order of
preference for the name used will be guardian, mother, then father. If this option is
chosen, the first name found will be used and if no names are found, ‘TO THE
PARENTS AT’ will be used.
Figure 14.0-5, Reminder Recall Label Format
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Figure 14.0-6, Reminder Recall Print Labels
Depending on the number of pages to create, the label generation process may take some
time. Pay close attention to your browser’s activity animations and/or progress bar as
progress will not be shown on the label setup page. Note: a system limit is in place which
will prohibit users from creating a pdf which contains more than 800 pages of labels (at
30 labels per page). If an attempt is made, users will see an error message and will need
to change criteria, like age range, in order to try again and produce fewer labels.
From the Reminder Recall Patient List screen, users can also download the report in
Excel format for offline storage and formatting by clicking the button “Download to
Excel”. After clicking the button, the Excel file will be displayed (usually in a new
browser window) and can be saved by clicking “File” from the menu bar and then “Save
As”.
15.0 Immunization History Report
Users have the ability to view or print a patient’s Immunization History Report, as well as
the Florida Certificate of Immunization (Form 680). The Immunization History Report is
a listing of all immunizations received by the patient, where they were administered and
by whom, the corresponding dates in which the vaccination was received, and
recommended next due dates for each series. The official 680 Form is used to show
proof of obtaining the immunization requirements for schools and child care centers.
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The Immunization History Report can be obtained by clicking on “Immunization
History” under the report menu located on the left-hand side of the screen. Once this
button is utilized, the Immunization History Report will appear (Figure 15.0-1). If your
organization has more than one service site (clinic) defined in the system, select which
site the report is being printed from to continue. This will determine which clinic address
will print on the form. To print the report, users should click the “Print” button, located at
the bottom of the screen.
Figure 15.0-1, Immunization History Report
The report shows vaccines received which belong to a named vaccination series first,
sorted by date given. Following that are vaccinations received which do not belong to a
named vaccination series (e.g. Cholera, Yellow Fever, etc.). The series name for these
will appear as “OTHER” and the vaccinations will also be sorted by date given. The last
rows in the report are for required vaccinations for which the series has not started. This
is to alert the reader as to the recommended date for the first dose of the series.
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16.0 Form 680 – Certificate of Immunizations
The Florida Certification of Immunization (Form 680) can be viewed and printed by
utilizing the “Form 680” link located on the left-hand side of the screen. Once this link is
clicked, the Florida Certification of Immunization selection criteria screen will appear
(Figure 16.0-1). Users have the option of printing the form in several different formats,
according to the intended use of the form and status of the patient.
Figure 16.0-1, Create Form 680
To begin creating the form, first the form type must be selected and users may choose
from either Part A for patients that are up-to-date for their age and meet the ageappropriate school requirements for grades K-12, Part A for only the 7th Grade
requirements, Part B for temporary medical exemptions, and Part C for permanent
medical exemptions. If a Part B is chosen, an expiration date is required (generally 15
days after the next scheduled appointment). If a Part B is chosen and the patient has
received all the vaccinations they can for now (they are currently up to date), the system
will pre-populate a suggested expiration date equal to 15 days after the earliest next
recommended due date amongst all series that are not complete.
If a patient is complete on all series except DtaP, only the final dose remains to be
administered, and the next recommended due date + 15 days (what would otherwise be
the default, as noted above) is more than one year in the future (typical when the next
dose is the booster), the user will not be allowed to create the DH 680, Part B. The Form
680 page will have the Part-B selection disabled and a red warning message explaining
why the function is not being allowed (Figure 16.0-2). These patients should receive a
DH 680 Part A.
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Note: In cases where a default date is supplied by the system, if that date would otherwise
be more than 1 year in the future, the date field would instead be left blank for user entry.
Users may still edit any date which may be populated in that field.
Figure 16.0-2, Form 680 Temporary Medical Exemption Disabled
If your organization has more than one service site (clinic) defined in the system, you will
be required to select which site applies to this form before creating it so the proper
address and site name will appear. Site selection will not be shown if your organization is
a single clinic.
Next, a parent or guardian name must be selected. If the name to be used is already on the
patient record it will be pre-populated when mother, father, or guardian is selected from
the selection list. The name may be edited if needed and any changes will be saved with
the record. If the desired name is not on the patient’s record, it may be entered and will
also be saved when the 680 form is created.
Finally, the user will need to click on the “Create Current Form 680” button located on
the bottom of the screen. If either or both “Part A” selections are made and the patient is
presently overdue for any vaccination series which appear on the Form 680, a warning
box will appear (Figure 16.0-3).
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Figure 16.0-3, Overdue Warning
If one or more vaccination series which appears on the 680 has a permanent
contraindication, users must confirm if they attempt to create a non-part C 680 and viceversa (Figure 16.0-4). The special “VZV1 contraindication used for setting the Varicella
disease year will NOT generate warnings.
Figure 16.0-4, Part C warnings
Once the “Create Current Form 680” button is utilized, the Florida Certification of
Immunization (Figure 16.0-5) will appear, and the user may then print the form at that
time by clicking the “Print” button at the top-right of the screen. The form may be printed
on standard printer paper since the state seal and other identifying marks are part of the
printed image. The previously used special DOH blank blue printer paper is no longer
needed.
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Figure 16.0-5, Florida Certification of Immunization
16.1 Electronically Certifying a Form 680
Certain users may also be able to create an electronically certified Form 680 if
authorized by their local Florida SHOTS administrator (see section 21.4). If
authorized, after clicking the “Form 680” link in the main menu, users will see the
Form 680 generation page as before but with a new section used to select which
provider’s signature is to appear on the electronically certified form (Figure 16.11).
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Figure 16.1-1, Certified Form 680 Setup
Begin by creating the 680 as normal by selecting the form type, indicating which
service site the form is being given at (if applicable), and selecting the parent or
guardian receiving the form. Select the provider’s name from the ‘Physician or
Authorized Signature” drop-down box. The names that appear in this list are those
who the local Florida SHOTS administrator has given the permission to certify a
Form 680.
If providers are setup in your organization’s personnel list with ‘work location’
defined, they will not appear in the selection list unless their work location
matches the selected service site. If their name should still be selected, check the
box labeled ‘Show all certifiers’ and then open the list again to find the provider’s
name.
Once a provider name is selected, the option to create a ‘parent access pin’ will be
shown and selected by default (see Appendix E for more details) and the ‘Create
Current Form 680’ button will change to be ‘Create Certified (e-signed) Form
680’ (Figure 16.1-2).
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Figure 16.1-2, Certified Form 680 Setup
Note: The following instructions are for certifying a form only (‘Create a
parent access PIN’ option unchecked).
Clicking the ‘create’ button will generate the form and present the user with two
options to certify it: ‘Certify (e-sign) & Print’ and ‘Certify (e-sign) Only’ (Figure
16.1-3).
Figure 16.1-3, Completing Certified Form 680
Once the desired certify option is selected, the form will be certified and if not
already printed, may be printed by selecting the ’Print’ option from the top-right
of the displayed form. The certified form will show the embedded authorized
signature as well as a unique electronic certification number and the Florida
SHOTS logo. A certified 680 form is not valid without this special number and
logo (Figure 16.1-4). The user that created the certified Form 680 will also be
displayed on the form on the “Issued By” line even if it is the same as the
authorized signature. In addition, users will have the option to download the form
in Adobe PDF format for archival purposes by clicking the ‘Download to Pdf
File’ button.
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Figure 16.1-4, Completed Certified Form 680
Note: If a user has the ability to certify (given to them by their Florida SHOTS
administrator), but chooses not to (doesn’t select a provider from the list), a
second browser window will display which explains the benefits of using certified
Form 680s. If the user does not have the ability to certify, the page will also list
instructions on how to set preferences to produce certified 680s (Figure 16.1-5).
Figure 16.1-5, Benefits and Setting Preferences
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16.2 Working with previously certified Form 680s
Certified Form 680s will be permanently maintained with each patient record and
may be viewed at any time by any organization. Organizations that created the
certified Form 680s may also decertify the forms if needed (certified a Form 680
on the wrong patient, incorrect patient information or vaccinations, etc.). The last
Form 680 that was certified for the patient will always be displayed on the From
680 creation page (Figure 16.2-1).
Figure 16.2-1, Certified Form 680 History
Additional previously certified Form 680s may also be present on a patient’s
record and may be listed by clicking the “Show historical Certified 680s” button.
To view a form, click “View”. If your organization was the one that certified the
form you may also decertify it by clicking “Decertify”. Users will be given a
warning when attempting to decertify a form as it is an irrevocable action.
When viewing a previously certified Form 680, if any patient information present
on the form has changed since the form you are viewing was certified, you will be
presented with a warning at the top of the form (Figure 16.2-3).
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Figure 16.2-3, Changes Made Since Certification
To show what has changed since the form was certified; click the “Show
Changes” button (Figure 16.2-4).
Figure 16.2-4, Changes Made Since Certification
Users may print the previously certified form by clicking the “Print” button. Just
as when the form was originally certified, users may again choose to download
the form in Adobe PDF format by clicking the ‘Download to Pdf File’ button at
the bottom of the screen.
16.3 Search for Certified Form 680
Users may directly search for certified Form 680s without first searching for a
patient. To do so, click the “Search for Form 680” link from the main menu
(Figure 16.3-1).
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Figure 16.3-1, Search for Form 680
This page is divided into two sections: “Patient 680 Search Criteria” and “My
Organization 680 Search Criteria”. If the user’s organization does not have any
users capable of creating certified Form 680s, they will not see the “My
Organization 680 Search Criteria” section.
To search for Form 680s certified for a patient by any organization (including
your own), change the search option to “By Patient (certified by any
organization)”. Enter the required search criteria (last name, first name, date of
birth, and sex) and click the “Retrieve Certified Form 680s meeting the above
criteria”. A list of matching certified form 680s will appear below the button
(Figure 16.3-2).
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Figure 16.3-2, Search for Form 680 Results
Users may view the Form 680 by clicking “View”, decertify it by clicking
“Decertify” (if your organization was the one that previously certified it), and
may also load a patient’s record in the background by clicking anywhere else on a
row containing the patient. This will make it easy for you to quickly view or work
on the patient’s record if needed or to verify that you are looking at the correct
patient’s Form 680s. Users will get the option to continue or cancel loading the
patient record after clicking on a row. Hovering over a row will show the patient’s
address and current immunization provider (as well as who issued the certification
and who the certifier was if searching by patient) in a purple pop-up box.
To search for Form 680s certified by only your organization, select “By my
organization only” as the search option (this is the default). By default, only the
certification date range will be populated and it will contain a range going back 30
days from today’s date. This date range is the only required information when
searching by Form 680s certified by your organization. Users may optionally add
patient name information to limit the results and may even enter the certification
identifier number that was created when the Form 680 was certified.
Click the “Retrieve Certified Form 680s meeting the above criteria” button to
retrieve matching Form 680s (Figure 16.3-3). By using the “By my organization
only” search, you may also print the results list as a report and/or download the
results list to an Excel file by clicking either the “Print Report” or “Download to
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Excel” buttons, respectively. This is an effective way of monitoring and
reviewing Form 680s certified by your organization on a regular interval.
Figure 16.3-3, Search for Form 680 Results
If some results are returned from the initial search (performed when clicking the
“Retrieve Certified From 680’s meeting the above criteria” button) but do not
contain the patient you are looking for, in some cases you may be able to do a
more thorough search by clicking the “Extend Search” button. If this button is not
active, the extended search has automatically been performed for you. It is very
important that partial name searches not be performed or extended searches will
return few, if any, additional results. When additional results are found due to an
extended search, these records will have a purple + next to them in the results list.
When no additional records are found via the extended search, users will receive a
“No Additional Records Found” message beneath the results list. This
functionality is similar to that found when using the “Search for Patient” function
(see section 4.1).
Note: The search will be performed regardless of patient gender to produce
additional results. Results with matching gender will be listed first, followed by
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results with gender unknown and lastly with results where the gender is opposite
of what was selected. This behavior also applies to the “Search for Patient”
function (section 4.0).
16.4 Form 680 Rules for View Only Users
Florida SHOTS users who are assigned to a view only organization or users in a
full access organization with a view only role will only be allowed access to
previously certified Form 680s. View only users are prohibited from creating,
certifying, or decertifying Form 680s.
When a Certified Form 680 is on file, view only users will be able to view and
print any currently certified Form 680 (Figure 16.4-1).
Figure 16.4-1, Certified Form 680
When no Certified Forms have been created for a patient, view only users will
receive a “No Certified Form 680s are on file for the patient” message when
selecting the Form 680 link in the menu (Figure 16.4-2).
Figure 16.4-2, Certified Form 680
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16.5 DH 680 Variations
There are times when the DH680 will vary from the normal and show something
different than the date vaccine given on the provided space for a vaccine series.
Examples of those variations are provided below:
 If a patient completes a vaccine series in fewer doses than the standard
schedule then the word "COMPLETE" will appear in the first available
slot of the applicable row. (Figure 16.5-0).
. Figure 16.5-0, Series shown as “COMPLETE” on DH 680
 If a patient is over 7 but has not completed their DTAP series, "MAX
AGE" will display in the first empty slot of the DTAP row (Figure 16.51).
. Figure 16.5-1, Series shown as “MAX AGE” on DH 680
 Non-TDAP vaccinations will display on the TDAP line if they are to be
treated as the booster. The display will show the vaccination date and
vaccine name in parenthesis (Figure 16.5-2).
. Figure 16.5-2, Display of non-Tdap on Tdap Line on DH 680
17.0 Form 687 – Immunization Clinic Record Card
The Immunization Clinic Record/Signature Card (DH Form 687) (Figure 17.0-1) is the
permanent medical record for a client’s immunizations and users have the ability to print
an electronic version of the form. The electronic Form 687 allows users to retrieve hard
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copies of client’s records from another site or CHD, eliminate the tedious process of hand
writing a new clinic record card each time a client presents at a new site or CHD for
services and to document client services quickly and easily.
Figure 17.0-1, Immunization Clinic Record/Signature Card
Users may select to sort vaccinations by date administered or by series name and may
also elect not to show the patient’s SSN on the 687 form by unchecking the “Print SSN”
box. If your organization has more than one service site (clinic) defined in the system,
select the appropriate site to indicate the clinic location shown on the form. Print options
include the ability to print a blank form with no shot data or the entire shot history. If the
blank option is chosen, a blank version of the 687 will print, allowing manual entry. Click
on Get Patient Form to retrieve the electronic Form 687.
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Figure 17.0-2 Immunization Clinic Record/Signature Card
The Form 687 – Immunization Clinic Record/Signature Card provides a wealth of
information regarding the client (Figure 17.0-2). Demographic information, Medicaid#,
State Immunization ID, Clinic Location, WIC ID#, Religious Exemption Issued date
(when recorded), Contraindications, Adverse Reactions, Client’s Current Age, and
whether or not the DH 1478 Opt Out Form was provided. Parent/Guardian signature is
not required.
The body of the document displays designated vaccination information including: Series,
Dose, Date Given, Mfg/Lot#, Vaccine Type, VFC, Route/Site of vaccination, the Service
Provider, whether the shot was given In-House, the Vaccine Information Statement (VIS)
publication date(s), the VIS recipient and whether or not the VIS recipient was the person
giving consent for each immunization. When a patient has had Varicella Disease the
information will display at the bottom of the form. Users can either “Print” the Form 687
or return “Back” to the criteria page.
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18.0 Assess Immunization Levels
The Florida SHOTS Assess Immunization Levels functions are located under the system
menu option “Assess Imm Levels” and include the following:
 Create Assessment File – The starting point for all assessment activities. An
assessment file must be created prior to using any of the other functions.
 Survey Report – Creates a coverage assessment report similar to that of the
National Immunization Survey showing coverage levels for compliance with
recommended age-appropriate vaccinations.
 Summary Report – Creates a coverage assessment report identifying coverage
levels for compliance with each of the recommended age-appropriate vaccination
series and several combinations (ex. 4-3-1-3-3-1 for compliance at 2 years old).
This report is similar to the summary report generated using CoCASA.
 Late Up-To-Date Report – Creates a report listing patients who were not complete
for age-appropriate vaccinations at the selected compliance age, but were
complete by the reported assessment date. Series that were completed late are
shown.
 Not Complete Report – Creates a report listing patients not complete for
recommended age-appropriate vaccinations and which vaccinations they are
missing.
 No Imms Report – Creates a report listing patients who have no record of
receiving required vaccinations
 Patient List Report – Creates a list of all patients who are included in an
Assessment File.
 Create CASA Extract File – Allows users to create and download a data file
containing the immunization history of selected patients for importing into the
CDC’s CoCASA software.
Note: Several of the Assessment Level Reports can be created based on ageappropriate vaccination series and combinations. Most of the reports have defaults
set for the following doses to have been administered by the chosen compliance
age:
12 months: 3:2:2 = 3 Dtap, 2 Polio, 2 HEP B
24 months: 4:3:1:3:3:1 = 4 Dtap, 3 Polio, 1 MMR, 3 HIB, 3 Hep B, 1 VZV
(Varicella).
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18.1 Create Assessment File
Users may access the “Create Assessment File” function from the Assess Imm
Levels sub-menu. If some assessments have already been created, users will see
the Create Assessment File List and may elect to create a new assessment file by
clicking the “Create New File” button (Figure 18.1-1), taking the user to the
Create Assessment File Criteria page (Figure 18.1-2). When accessing for the first
time, users will automatically be taken to the Create Assessment File Criteria
page.
Figure 18.1-1, Assessment File List
Figure 18.1-2, Create Assessment File
On the criteria page, enter the age range you wish to use to assess your coverage
levels. The maximum range allowed is 0 to 47 months of age. The default is 24 to
35 months. Click “Create Assessment File” to begin the data collection process
and display the status page (Figure 18.1-3).
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Figure 18.1-3, Assessment File Status – Running
This process can take some time to complete depending on the number of patients
the system will have to check. Users may navigate away from this page and do
other work and may also log off of Florida SHOTS if desired. The data collection
process will continue and the status of the file will be listed as “Running” on the
assessment file list. The status page may be displayed again by clicking on the
assessment in the list. Users may cancel the process by clicking the “Cancel”
button. Cancelled assessments will display as “Cancelled” in the assessment list
and completed assessments will display as “Complete”.
Clicking on a completed assessment will also bring up the status page allowing
you to see the details of the assessment as well as if any user has downloaded an
extract file from it (Figure 18.1-4).
Figure 18.1-4, Assessment File Status – Complete
18.2 Assessment Reports and Extract Overview
All the assessment reports and the CASA extract file are accessible from the
Assess Imm Levels sub-menu. These functions have some common features
which are explained in this section.
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When you select the report or extract from the menu, the first page you will see is
the list of assessments that have been created, similar to the “Create Assessment
File” screen (Figure 18.2-1). Before creating a report or extract, a completed
assessment file must be chosen to base the report or extract on.
Figure 18.2-1, Example of Assessment File List
Once the desired assessment is chosen, the selected report or extract’s criteria
screen will display. The first entry fields on each function’s criteria page will be
the age range. This is the age range of patients in the assessment file that you wish
to run the report or extract for. By default, the age range will be automatically set
to that of the chosen assessment file. This range may be reduced but may not be
larger. The “as of” date from the selected assessment file will also be displayed.
If your organization has multiple service sites (clinics) defined in the system, each
report and the extract may also be run for all, one, or multiple choices.
Each report and the extract may also be run based on service site selection (if
applicable) for either all patients for which your organization is the current
immunization provider, or only patients that have a WIC ID (regardless of
inactive/active status).
18.3 Immunization Survey Report
The Immunization Survey Report can be accessed from the Assess Imm Levels
sub-menu by selecting the “Survey Report” option. After selecting an assessment
from the assessment list, users will be taken to the “Survey Report Criteria” page
to setup and generate the report (Figure 18.3-1).
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Figure 18.3-1, Survey Report Criteria
The compliance age selected will determine which age-appropriate vaccinations
and combinations will be checked for coverage levels.
To create the report, select the desired report format and click “Generate Report”.
Selecting “Survey Report” will allow you to display and print the report, while
selecting “Excel file – download” will display a dialog box allowing you to save
the report in Excel format for later offline use.
Figure 18.3-2 shows an example of the report with the compliance age selected as
24 months.
Figure 18.3-2, Immunization Survey Report
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18.4 Immunization Summary Report
The Immunization Summary Report can be accessed from the Assess Imm Levels
sub-menu by selecting the “Summary Report” option. After selecting an
assessment from the assessment list, users will be taken to the “Summary Report
Criteria” page to setup and generate the report (Figure 18.4-1).
Figure 18.4-1, Summary Report Criteria
The compliance age selected will determine which age-appropriate vaccinations
and combinations will be checked for coverage levels and controls which are
available for selection in the “Base Complete on” selection box.
The “Base Complete on” selection will control which vaccine series or
combination to check for patients that are not complete and report on how many
could be complete with one additional visit along with how many vaccinations
they would need at that visit.
To create the report, select “Generate Report”. Figure 18.4-2 shows an example of
the report with the compliance age selected as 24 months and “Base Complete
on” set at 4:3:1:3:3:1.
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Figure 18.4-2, Immunization Summary Report
18.5 Late Up-To-Date Report
The Late Up-To-Date Report can be accessed from the Assess Imm Levels submenu by selecting the “Late Up-To-Date Report” option. After selecting an
assessment from the assessment list, users will be taken to the “Late Up-To-Date
Report Criteria” page to setup and generate the report (Figure 18.5-1).
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Figure 18.5-1, Late Up-To-Date Report Criteria
The compliance age selected will determine which age-appropriate vaccinations
and combinations will be available for selection in the “Base Complete on”
selection box.
The “Base Complete on” selection will control which vaccine series or
combination to check for patients that were late in receiving the required doses.
To create the report, select the desired report format and click “Generate Report”.
Selecting “Late Up-To-Date Report” will allow you to display and print the
report, while selecting “Excel file – downloaded” will display a dialog box
allowing you to save the report in Excel format for later offline use.
Figure 18.5-2 shows an example of the report with the compliance age selected as
24 months and “Base Complete on” set at 4:3:1:3:3:1.
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Figure 18.5-2, Late Up-To-Date Report
18.6 Not Complete Report
The Immunization Not Complete Report can be accessed from the Assess Imm
Levels sub-menu by selecting the “Not Complete Report” option. After selecting
an assessment from the assessment list, users will be taken to the “Not Complete
Report Criteria” page to setup and generate the report (Figure 18.6-1).
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Figure 18.6-1, Not Complete Report Criteria
The compliance age selected will determine which age-appropriate vaccinations
and combinations will be available for selection in the “Base Complete on”
selection box.
The “Base Complete on” selection will control which vaccine series or
combination to check for patients that are not complete.
To create the report, select the desired report format and click “Generate Report”.
Selecting “Not Complete Report” will allow you to display and print the report,
while selecting “Excel file – downloaded” will display a dialog box allowing you
to save the report in Excel format for later offline use.
Figure 18.6-2 shows an example of the report with the compliance age selected as
24 months and “Base Complete on” set at 4:3:1:3:3:1.
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Figure 18.6-2, Immunization Not Complete Report
18.7 No Immunizations Report
The No Immunizations Report can be accessed from the Assess Imm Levels submenu by selecting the “No Imms Report” option. After selecting an assessment
from the assessment list, users will be taken to the “No Immunizations Report
Criteria” page to setup and generate the report (Figure 18.7-1).
Figure 18.7-1, No Immunizations Report Criteria
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To create the report, select the desired report format and click “Generate Report”.
Selecting “No Immunizations Report” will allow you to display and print the
report, while selecting “Excel file – downloaded” will display a dialog box
allowing you to save the report in Excel format for later offline use.
Figure 18.7-2 shows an example of the report with an inactive patient and a
patient with a religious exemption.
Figure 18.7-2, No Immunizations Report
18.8 Patient List Report
The Patient List Report can be accessed from the Assess Imm Levels sub-menu
by selecting the “Patient List Report” option. After selecting an assessment from
the assessment list, users will be taken to the “Patient List Report Criteria” page
to setup and generate the report (Figure 18.8-1).
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Figure 18.8-1, Patient List Report Criteria
To create the report, select the desired report format and click “Generate Report”.
Selecting “No Immunizations Report” will allow you to display and print the
report, while selecting “Excel file – downloaded” will display a dialog box
allowing you to save the report in Excel format for later offline use.
Figure 18.8-2 shows an example of the report with a list of all the patients
included in an assessment file, whose data displays on the various assessment
reports.
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Figure 18.8-2, Patient List Report
18.9 Create CASA Extract File
To create a CASA extract for importing into CoCASA, users must select “Create
CASA Extract File” from the Assess Imm Levels sub-menu. After selecting an
assessment from the assessment list, you will be taken to the “CASA Extract File
Criteria” page (Figure 18.9-1).
Figure 18.9-1, CASA Extract File Criteria
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To generate the extract from the assessment file, click “Start Download” and a
dialog box will display to allow you to save the file. After saving, the file can be
imported into CoCASA.
19.0 Reports
This section will go over the use of the various reports that are available to all users.
Note: The “Physical Inventory Report”, “Vaccine Return Form”, “Vaccine
Accountability”, and “Vacc Demand Forecast” features are only available for CHD users.
Private provider users will see “Physical Inventory Worksheet” instead of “Physical
Inventory Report”.
19.1 Vaccine Utilization Report
Users have the ability to create the Vaccine Utilization Report, a statistical report
which will provide vaccine usage information for a specified time period. The
user initiates the Vaccine Utilization report by specifying the selection criteria,
and the reporting format. Based on the entered selection criteria the system will
extract the vaccine utilization data and a report is generated in the designated
format.
The Vaccine Utilization Report Criteria Entry page can be accessed by clicking
on “Vaccine Utilization” under the Reports menu (Figure 19.1-1).
Figure 19.1-1, Vaccine Utilization Report Criteria
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To retrieve the report information, first enter the date range desired to search for
utilization information. The selection criteria for client detail report contents are:
one or more specified Vaccine Types or “ALL”, one or more VFC Eligibility
types or “ALL” (only for VFC organizations), * and one or more Program
Components or “ALL” (only for CHDs). The report can either be viewed on
screen and printed or downloaded into an Excel file by making a selection under
“Report Format”. The report can be sorted by vaccine type, then date given, by
date given, then vaccine type, by patient name, then vaccine type, or by program
component, then vaccine type (for CHDs). Click “Generate Vaccine Usage
Report” to display or download the report (Figure 19.1-2).
The Vaccine Utilization Report heading format consists of specific field results
derived from the initial report criteria input: Organization, Date Given, Vaccine
Types, VFC Eligibility, Report Format and Sort on.
The data output columns include: Vaccine Type, Date Given, VFC Eligibility,
Mfg/Lot#, Service Provider, CPT, Program Component, Patient Name, Date of
Birth, SSN and Sex. Totals are compiled for Patient Name and Vaccine Type.
Figure 19.1-2 Vaccine Utilization Report (Client Detail Page)
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19.2 Physical Inventory Reports
Two Physical Inventory reports are available. The version users will have access
to will depend on if their organization is using inventory or not.
*Inventory related features are currently accessible by CHD users only. A later
system release will allow use by all users.
Physical Inventory Worksheet – For organizations not using inventory –
The physical inventory worksheet is a computer-assisted worksheet for
calculating and tracking your vaccine inventory. To access the report, select
“Physical Inv Worksheet” under the Reports menu (Figure 19.2-1).
Figure 19.2-1, Physical Inventory Worksheet Criteria
From here, users must supply a vaccination date given range and select the
vaccine type(s) to appear on the report. The report may be viewed and printed by
selecting “Detail Report” as the report format (Figure 19.2-2) or the report may be
downloaded as an Excel file by selecting “Excel File – downloaded”.
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Figure 19.2-2, Physical Inventory Worksheet
The report will show the number of doses administered for each vaccine type used
during the time frame indicated in the report criteria (column G). The following
columns will need to be filled in by hand after printing:




D – Beginning Inventory – Inventory count for each vaccine type at
beginning of time period.
E – Doses Received In – Count of doses received for each vaccine type
during the time period.
F – Doses Sent Out – Count of doses transferred out of your clinic of this
vaccine type during the time period.
I – Physical Inventory – Current actual count of quantity on hand of each
vaccine type.
After filling in the appropriate fields and performing a basic calculation, you can
find the variance (Column J), which will indicate if you are over or short
compared to the calculated doses on hand (Column H) based on doses
administered. Once completed, this report can assist in inventory tracking and will
show if there are any issues concerning doses administered and vaccine supply
that need to be addressed.
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Physical Inventory Report – For organizations using inventory –
*Currently available to CHD users only.
The Physical Inventory Report is an enhanced version of the Physical Inventory
Worksheet designed to further assist users with inventory reconciliation (Figure
19.2-3).
Figure 19.2-3, Physical Inventory Report
In addition to the standard selection criteria available from the “Worksheet”
version, users may also chose one, multiple, or all available inventory locations to
run the report on. Indicate the date range to report on and make any other
selections that are desired and click “Generate Physical Inventory Report” to view
and print the report (Figure 19.2-4).
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Figure 19.2-4, Physical Inventory Report
The Physical Inventory Report will gather information from inventory transaction
history (see section 20.7) for the date range entered and based on any additional
selection criteria provided. The report is grouped first by inventory locations, then
by Program Component, then by Vaccine Type. Below is a description of the
lettered columns.





D – Begin Inventory – Quantity on hand for each vaccine at beginning of
the reported date range
E – Doses Received In – Amount of doses received into inventory during
the reported date range
F – Doses Transferred In – Amount of doses added to each vaccine’s
quantity on hand during the reported date range as a result of an inventory
transfer (within your organization)
G – Doses Sent Out – Amount of doses removed from each vaccine’s
quantity on hand during the reported date range as a result of an inventory
transfer (within your organization)
H – Doses Adjusted – Net result of inventory adjustments made to each
vaccine during the reported date range
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



I – Doses Administered – Net result of doses administered during the
reported date range (includes any deletions)
J – Calculated Doses On Hand – Sum of D+E+F-G+H-I
K – Physical Inventory – Space for writing hand count of each vaccine
L – Variance – Space for hand calculation of J-K
19.3 Doses Administered Report
The Doses Administered Report can be accessed by clicking on “Doses
Administered” under the Reports menu (Figure 19.3-1). This report will show a
count of how many vaccinations were administered by series dose number
(including invalid doses) and patient age group. This report can be useful in
determining which patients are receiving the most of which doses.
Figure 19.3-1, Doses Administered Report Criteria
To begin, enter the vaccination date given range and select the vaccine type(s)
desired to appear on the report. The report may be viewed and printed by
selecting “Detail Report” as the report format (Figure 19.3-2) or the report may be
downloaded as an Excel file by selecting “Excel File – downloaded”. To run the
report, click “Generate Doses Administered Report”.
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Figure 19.3-2, Doses Administered Report
19.4
Vaccine Return Form
*Currently available to CHD users only
The Vaccine Return Form can be accessed by clicking on “Vaccine Return Form”
under the Reports menu (Figure 19.4-1). This form will show a count of how
many doses of vaccine were adjusted in inventory using a reason of wasted,
spoiled, unusable, or expired. The form pre-populates with the users name, phone
number, and default dates. Only adjustment reasons whose effective date is on or
between the From/Thru dates will appear on the form.
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Figure 19.4-1, Vaccine Return /Waste Form
The form requires users to enter a detailed explanation of why the vaccine became
unusable and to describe precautions taken to prevent its reoccurrence (Figure
19.4-1). Once the explanation is provided, the form may be generated by clicking
the ‘Generate Vaccine Return and Waste Form’ button. Users can also elect to
print out a blank form to complete by hand by clicking the ‘Show Blank Form’
button.
Once the generate or show option is chosen, the appropriate form is displayed
(Figure 19.4-2).
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Figure 19.4-2, Vaccine Return and Waste Form
Instruction for returning the vaccine to the distributor and the form to the VFC
program office are included on the bottom of the page.
19.5 Vaccine Accountability Report
*Currently available to CHD users only
The Vaccine Accountability Report can be accessed by clicking on “Vaccine
Accountability” under the Reports menu (Figure 19.5-1). This report will show a
detailed statistical breakdown of vaccine inventory usage and adjustments for
limited vaccines tracked by the Vaccines for Children program (program
component 01). The report was created to allow CHDs and the state office to have
access to the same data for accountability tracking. This report is useful in
determining areas where improvements may be needed.
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Figure 19.5-1, Vaccine Accountability Criteria
To begin, enter the ‘From and Thru’ dates. The vaccine types available include
Program Component 01 vaccines only. The report may be viewed and printed by
selecting “Detail Report” as the report format or the report may be downloaded as
an Excel file by selecting “Excel File – downloaded”. If “Display Location
Details” is selected, the report will be grouped first by location, and then by
vaccine type. If not selected, the report is grouped by vaccine type only. Users
may opt to show the associated manufacturer and lot numbers of the transferred or
adjusted vaccine. “Display Transfer Details” lists the name of the specific site or
provider where vaccine was sent and changes into and out of Program Component
01. If not selected, the report hides specific details about transfer. To run the
report, click “Generate Vaccine Accountability Report”.
Figure 19.5-2, Vaccine Accountability Report
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The Vaccine Accountability Report has two distinct sections; the top of the report
(Figure 19.5-2) displays a summary of accountability data. This section includes
totals for individual sites as well as a Grand Total for the organization.
Accountability details are as follows:
-
-
-
-
-
-
-
Begin Inv – Displays data based on the end of the day balance from the
day before the “From Date” entered and includes inventory transactions
through the time of the reports creation.
Rcvd – Displays amount of vaccine received during selected date range.
Doses Admin – Displays number of doses administered.
Net Intra Xfer – Displays amount of vaccine transferred internally from
site to site within an organization, from one location to another, and
transfers in or out of Program Component 01.
Imprcs Msure & Auto Inc – displays any adjustments recorded as an
increase with the reason of ‘imprecise measurement of extraction’. Auto
increment is a system generated adjustment that occurs only when more
than one user reduces inventory at the exact same time and the inventory
record has a balance of zero. This function rarely occurs and is only used
to bring a negative inventory balance back to zero.
Waste – Displays the amount of vaccine inventory that was adjusted
under the reason ‘Wasted’ for broken vials or that was drawn up, but not
administered.
Spoil – Displays adjustments entered for reasons related to storage and
temperature control.
Expire – Displays inventory amount that expired before being
administered.
Allowed Adjs – Combined adjustments considered acceptable by the
Vaccines for Children program office including vaccine that is recalled
and lost or damaged due to natural disaster or while being transported.
Also shows external transfers to other counties or private providers.
Total Unacct’d For Vaccine – displays total inventory adjustments where
the reason ‘unaccounted for’ was selected. Based on the net total number
of doses, a percentage and dollar amount will be generated of unaccounted
for wasted vaccine. Also, an absolute value count of total doses (showing
the total number of doses adjusted in any direction) will be displayed
along with a corresponding percentage and dollar amount.
Calc On Hand – Total of actual vaccine inventory available.
Total Wasted, Spoiled and Expired Vaccine – Displays total inventory
adjustments where the reason ‘Wasted’, ‘Spoiled,’ or ‘Expired’ was
selected. Based on the total number of doses, a percentage and dollar
amount will be generated of wasted vaccine.
The lower section of the report displays specific details based first on each
location when selected and then by vaccine type (Figure 19.5-3). Only this section
of the report displays criteria details when selected.
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Figure 19.5-3, Vaccine Accountability Report
The Vaccine Accountability Report will also show details of select similar
vaccines that have been grouped together. Vaccine groups include “HEP B” (HEP
B2 DOSE and HEP B), “HIB” (HIB PRP-T and HIB PRPOMP), “ROTAVIRUS
(ROTATEQ and ROTARIX), and “TD” (TD and TD DECAVAC). These vaccine
groups will be shown in addition to each vaccine separately, and will appear at the
end of each report section, depending on options selected (Figure 19.5-4).
Figure 19.5-4, Vaccine Accountability Report Groups
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19.6 Vaccine Demand Forecast Report
*Currently available to CHD users only
The Vaccine Demand Forecast Report can be accessed by selecting “Vacc
Demand Forecast” from the Reports menu (Figure 19.6-1).
Figure 19.6-1, Vaccine Demand Forecast
This report is designed to provide organizations with the ability to forecast
demand for vaccine based on prior trends and usage in order to facilitate the
vaccine ordering process. A similar version of this report allows Bureau of
Immunization staff the same ability on a state-wide basis. The selection criteria
available are defined as follows:
-
Forecast Starting Month – The first month for which you want the
system to project vaccine demand.
Ending Month – The last month for which you want the system to project
vaccine demand.
# of months usage to estimate – This number refers to how many months
worth of vaccine you would like to have on hand for each month in the
forecast period. The default value is 1, meaning the system will assume
you want to maintain a 1-month supply during each of the forecast
months. This number can be changed to a number within the range of 112. It is recommended that CHDs keep a two month supply on hand.
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-
-
-
-
# of trend months – This number refers to how many months prior to the
current month should the system look to determine what the average
monthly usage is for a given vaccine. The system will also look at the
same timeframe last year and compare the two trends to determine the %
change.
Vaccine Types – Users may select one, multiple, or all vaccines to
forecast demand.
Report Format – Users may elect to view and/or print the report or
download a copy in Excel format.
Imm Service Sites – For organizations having multiple service sites
(clinics) defined in the system, this selection box controls which inventory
locations are available for selection in the box below. Users may select
one, all, or multiple sites.
Locations – Based on the selection(s) made in the “Imm Service Sites”
box, this box will show what inventory locations are available to be
included in the report. Users may select one, all, or multiple locations.
Sort by
 If “Location” is selected, the report will generate one detail section
for each inventory location the user has selected to be included in
the report for each month in the forecast period. Each detail section
will show the demand forecast results on rows for each vaccine
type selected for the report. If your organization has 3 inventory
locations and 6 vaccines have been selected for a forecast period
that is 2 months long, the report will contain 6 detail sections, each
having 6 rows.
 If “Vaccine” is selected and the “Summary Only” checkbox is not
checked, the report will generate one detail section for each
vaccine type the user has selected to be included in the report for
each month in the forecast period. Each detail section will show
the demand forecast results on rows for each inventory location
selected for the report. If your organization has 3 inventory
locations and 6 vaccines have been selected for a forecast period
that is 2 months long, the report will contain 12 detail sections,
each having 3 rows.
 If “Vaccine” is selected and the “Summary Only” checkbox is
checked, the report will generate one detail section for all vaccine
types the user has selected to be included in the report for each
month in the forecast period. Each detail section will show the
demand forecast results on rows for each vaccine type selected for
the report. If your organization has 3 inventory locations and 6
vaccines have been selected for a forecast period that is 2 months
long, the report will contain 2 detail sections, each having 6 rows.
This is the most compact version of the report.
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Summary Only – Available only if “Sort by” is set to “Vaccine”.
Reduces the length of the report by grouping all data from the location(s)
selected together. See the above “Sort by” description for more details.
Figure 19.6-2 is an example of the Vaccine Demand Forecast Report. The forecast
period was 10/2008 to 11/2008 (2 months). All vaccines and locations for the
organization were included. “Sort by” was set to “Vaccine” and “Summary Only”
was checked. The “# of months usage to estimate” and “# of trend months” were
of 2 and 6, respectively. The second (of two) detail section was omitted for
clarity.
Figure 19.6-2, Vaccine Demand Forecast Report
The following is information on each column in a detail section of the report.
-
Vaccine – Name of each vaccine selected to be in the report
Administered Apr 07 to Sep 07 – Doses administered during the period
established to find the usage trend from the previous year.
Administered Apr 08 to Sep 08 – Doses administered during the period
established to find the usage trend from the current year.
Difference – The difference in both number and percent of the two doses
administered columns.
Administered Oct 07 to Nov 07 – Doses administered during the time
period one year prior to the month for which this detail section is
projecting usage.
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-
-
-
Projection Based On – If the % difference in trend periods is between 1
and 50 or is negative, the projection will be based on last year’s doses
administered for the current forecast month (previous column) plus the %
difference noted in the trends. If the % difference is greater than 50, the
projection will be based on the current trend average + 25%. If the %
difference is 0, the projection will be based on the current trend average
(average per month usage during the current year’s trend period).
2 Mo Proj Usage –The value in this column is how much usage the
system projects you will have times the “# of months usage to estimate”
value entered when creating the report. The number in the column title
will change depending on the “# of months usage to estimate”.
Inv on Hand 10/01/08 – The amount of actual inventory on hand at the
beginning of the forecast period.
Amount Needed – This value is how much vaccine is projected as needed
to satisfy the projected usage and is calculated by subtracting the current
inventory on hand by the value from the projected usage column.
Amount to Ship – This column is repeated values from the previous
column and is only relevant to Bureau of Immunization staff in the Excel
format version of the report for tracking purposes.
19.7 Religious Exemptions
The Religious Exemptions Report can be accessed by clicking on “Relig
Exemptions” under the Reports menu (Figure 19.7-1).
Figure 19.7-1, Religious Exemptions Report
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This function is designed to allow organizations to generate a report showing the
count and percentage of patients the organization is the CIP (Current
Immunization Provider) for who have a religious exemption on their record*.
Users can limit results by including only patients in a specific age range by
completing the “Current Patient Age (in yrs) From:” and “Thru:” fields. The
report may be viewed and printed by selecting “Detail Report” as the report
format or the report may be downloaded as an Excel file by selecting “Excel File
– downloaded”. The Religious Exemptions Report will display statistical data
only. To include a list of the specific patient names included in the report, check
mark the “Show Patient Detail” box (Figure 19.7-2). Then click the “Generate
Religious Exemptions Report” button to create the report.
*CHD users can also choose to include specific religiously exempt patients in
three different ways via the “County Determination by” option:



When "County Determination by CIP" option is selected, exempt patients
will be included when their CIP is your CHD, regardless of issuing CHD
or county of residence.
When "County Determination by County of Residence" is selected,
exempt patients will be included when the patient's county of residence is
your county, regardless of issuing CHD or CIP.
When "County Determination by Issuer" option is selected, exempt
patients will be included when the CHD issuing the exemption was your
CHD, regardless of CIP or county of residence.
Figure 19.7-2 Religious Exemptions Report
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20.0 Working with Inventory
*Currently, this feature is enabled for CHD users only. A later system release will allow
access for all users.
With system Release 9.2.5, Florida SHOTS allows users with appropriate permissions the
ability to maintain their vaccine inventory. The inventory features can be accessed from
the main menu, listed under “Vaccine Inventory”. This sub-menu will not be available
until activated by Florida SHOTS staff. The sections that follow describe the functions
available. Please see section 7.0 for details on how to associate vaccinations given with
available inventory.
20.1 Maintain Locations
With Release 10.3.1 as Florida SHOTS changes to support vaccine ordering,
users will not be allowed to create new inventory locations nor will they be
allowed to modify existing locations.
To view current locations, select “Maintain Locations” from the inventory menu
(Figure 20.1-1). To view an existing location, select it by clicking on its row in
the list, which will take you to the Change Inventory Location screen (Figure
20.1-2).
Figure 20.1-1, Location List
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Figure 20.1-2, Change Inventory Location
If any information is incorrect or if an inventory location is improperly connected
to a particular service site, please contact the Florida SHOTS Enrollment Desk at
(877) 888-7468.
Note: A service site (clinic) may have more than one inventory location, but a
single inventory location should not be shared by more than one service site in the
system.
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20.2 Receive Inventory
In order to receive inventory, you must have at least one inventory location
defined (see section 20.1 above). To begin, select “Receive Inventory” from the
Inventory menu (Figure 20.2-1). The top half of the screen represents the receipt
and is where line items will appear when added. Line items are added by using the
line item detail fields on the bottom half of the screen.
Receipt summary
Line item details
Figure 20.2-1, Receive Inventory
Receiving inventory traditionally occurs upon receiving a shipment of vaccine.
Therefore, each inventory receipt will list the contents of a shipment and, upon
completion, add the new vaccine to the indicated inventory locations
(incrementing the doses available for any existing vaccine of the same type,
manufacturer, lot #, and expiration date).
First, complete the fields identifying this receipt:
- Document Number – Used to identify the shipment. It can be an invoice
number or some other unique identifier to describe the shipment.
- Received Date – Date vaccine shipment was received.
- Shipment Source – Identifies where vaccine was received from
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Line items identify details about each type of vaccine received in a shipment and
are used to update or create the actual inventory records in the system. To add a
line item to the receipt, enter the details in the line item section and click “Add
Line-Item” (Figure 20.2-2). Service site is optional as it is only used to limit the
choices available for selecting an inventory location.
Note: With Release 10.3, NDC is a required field for Program 01 (VFC vaccine)
and Program 09 (Hepatitis program) and must be selected from a drop-down list
instead of entered by hand. VFC and Bureau of Immunization staff now maintain
the data in FLSHOTS representing all available NDC codes and the purchasing
contracts they fall under as these change year to year. Linkages are also
maintained such that the system knows what vaccine types, program components,
and manufacturers apply to each NDC and what NDCs are allowed to be received
into inventory.
As a result of the NDC data now being accurate and maintained in FLSHOTS, the
first selection of Program Component will filter the list of vaccine types to only
those matching the selected program. Likewise, the vaccine type field will filter
the list of NDCs which apply to that vaccine and the NDC selected will filter the
manufacturer list to only that which produced the selected NDC. For this reason,
data entry should proceed in order from the top down. In some cases, selections
may be made for you if only one selection is available.
Note: If recording receipt of vaccine where the original manufacturer is not longer
active, check the “Include inactive” box to show all valid manufacturers including
inactive ones. This condition should only apply to program component 05 (NonVFC vaccine).
Figure 20.2-2, Receive Inventory
You may edit details of an existing line item by selecting the line item you wish to
edit, making the needed changes, and clicking “Change line-item”. Click “Cancel
line-item” while editing to reset the line item details to their state before any
changes were made. Click “Clear line-item” to clear the line item area to allow for
creating a new line item or to select another line item to edit (Figure 20.2-3).
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Figure 20.2-3, Receive Inventory
You may save your work on the receipt at any time by clicking Submit.
Inventory records representing vaccine listed in the receipt will not be
created, updated, or be available for use until the receipt is completed. To
complete a receipt, check the “Complete” checkbox, located next to the Submit
button, and then click Submit. Receipts saved but not completed can be returned
to later to complete, change, or delete by visiting the “List Receipts” screen (see
section 19.3).
When entering or editing a line item, you are not allowed to use the same
manufacturer and lot number for a different vaccine or with a different expiration
date than one already in the receipt. You are also not allowed to submit the receipt
if one of the listed manufacture/lot number combinations exist in your receipt
with a different vaccine type or expiration date than one that has already been
received into inventory previously. The system will flag the line item in error by
highlighting the incorrect field in red (Figure 20.2-4).
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Figure 20.2-4, Receive Inventory
Note: These conditions are not allowed to occur when receiving new inventory
but they are allowed (by acknowledging a warning) when utilizing the “Chg
Inventory Record” function (see section 20.10). This is a protective measure to
avoid accidental mistakes.
20.3 List Receipts
All receipts entered, both complete and incomplete, will be listed on the “List
Receipts” screen. The List Receipts screen is accessed from the Inventory menu
and will first display only the selection criteria used to filter the list of receipts
(Figure 20.3-1).
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Figure 20.3-1, List Receipts
The values in each selection box are representative of all inventory received up to
that time. As more receipts are recorded, more values will be selectable. To return
a list of receipts, make any filtering selections desired (optional) and click
“Retrieve matching Receipt Records” (Figure 20.3-2). The Receipt Date range is
defaulted to show the last month’s (30 days) worth of receipts. You may select no
criteria for a list of all receipts made during the Receipt Date range.
Figure 20.3-2, List Receipts
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You may select any receipt in the results list to view or complete (if marked
incomplete) by clicking on the appropriate row in the list. Receipts not yet
completed may also be deleted by checking the delete box at the end of the
appropriate row and clicking Submit. Any receipt viewed will have a “Return to
List Receipts” button next to the Shipment Source field that will return the user to
the List Receipts screen.
A new receipt may be entered through this screen by clicking “Enter a new
Receipt”.
20.4 Adjust Inventory
The Adjust Inventory function is used to make corrections to the quantity
associated to various inventory records. This can be used because of expired
vaccine being discarded, physical inventory count differing from system quantity,
etc. Select “Adjust Inventory” from the Inventory menu to begin (Figure 20.4-1).
Figure 20.4-1, Adjust Inventory
The values in each selection box are representative of all inventory received up to
that time excluding archived inventory (see section 20.6). As more receipts are
recorded, more values will be selectable. Make any filtering selections desired
(optional) and then click “Retrieve Inventory records meeting the above criteria”
to return a list of inventory to adjust (Figure 20.4-2).
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Figure 20.4-2, Adjust Inventory
Select an inventory record to adjust by clicking on its row. This will take you to
the Adjust Inventory screen for the selected inventory record (Figure 20.4-3).
Figure 20.4-3, Adjust Inventory
Complete the adjustment details and click Submit to save and make the
adjustment effective. Adjustment details are as follows:
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-
-
Effective Date – Default is today’s date. This represents the date the
adjustment should be considered effective. For most adjustments this
would be today’s date. Effective date cannot be more than 45 days in the
past.
Effective Quantity – Not editable. This number is the amount of doses on
hand for this vaccine as of the effective date (not necessarily today).
Adjust Direction – Select whether to adjust down or up.
Adjust Qty – Amount to adjust
Adjustment Reason – Reason for adjustment. The options for adjustment
reasons will vary according to if inventory is being increased or decreased.
The reason “Expired” will only be an option for a selected vaccine that has
reached its expiration date. The reason “Other” is only available for an
adjustment to vaccines from program component 05 or 09. When
“OTHER” is the reason, comments are required. See list of available
reasons below.
Comment – Available only when “OTHER” is selected. List any
additional comments you may have about the adjustment.
Once an adjustment reason is selected, a description of the reason will display in
the center of the screen. Several adjustment reasons will require an additional
explanation to be selected (Figure 20.4-4). Certain adjustment reasons will also
display a “Returned?” box. Check this box to indicate if vaccines for the adjusted
inventory record were returned to their shipping source.
Figure 20.4-4, Adjust Inventory
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Adjustment Reasons:
Decrease Direction –









Expired – Vaccine has reached its expiration date (available for
expired vaccine only)
Recalled – Doses recalled by vaccine manufacturer
Spoiled – Doses that have spoiled/gone bad due to exposure to
improper temperature, contamination, etc.
o Temperature not maintained
o Not refrigerated or stored properly
o Refrigerator or other mechanical failure
Transferred To Another County – Doses that have been transferred
to another County Health Department or other organization. If not
transferred to another organization, users may select “Private
Provider” and then enter in the provider’s name in the text box that
appears to the right.
Unaccounted For – Unable to account for missing or excess doses.
Unusable – Natural or other disaster or lost in transit
o Natural disaster/power outage
o Lost or damaged in transit
Wasted – Doses that have been wasted due to being drawn and not
administered, dropped, etc.
o Broken vial
o Drawn but not administered
Other – Applicable only to program component 05 or 09 vaccine.
Used in cases where no other option applies, such as data entry
error.
BOI Manual Adjustment – If program component 01 vaccine
needs adjusting for a reason other than what is available, such as a
data entry error, users should contact FLSHOTS staff (DL IMM
SUPPORT TEAM for CHD users) to request a BOI Manual
Adjustment.
Increase Direction


Imprecise Measure of Extraction – More doses were extracted
from a vial than indicated when received (increase only, max of 2
doses).
Unaccounted For – Unable to account for missing or excess doses.
Note: Inventory adjustments can also be reversed. See section 20.9 for more
information.
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20.5 Transfer Inventory
The Transfer Inventory function is used to move quantities of vaccine from one
inventory record to another. Usually, this is done to move vaccine to another
inventory location within your organization, but can also be done to change a
vaccine’s program component. To access this function, select “Transfer
Inventory” from the Inventory menu (Figure 20.5-1).
Note: An inventory record is defined as a unique combination of Inventory
Location, Program Component, Vaccine Type, Manufacturer, Lot #, and
expiration date.
Figure 20.5-1, Transfer Inventory
The values in each selection box are representative of all inventory received up to
that time excluding archived inventory (see section 20.6). As more receipts are
recorded, more values will be selectable. Make any filtering selections desired
(optional) and then click “Retrieve Inventory records meeting the above criteria”
to return a list of inventory records to transfer out of (Figure 20.5-2).
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Figure 20.5-2, Transfer Inventory
Select an inventory record to transfer out of by clicking on its row. This will take
you to the Transfer Inventory screen for the selected inventory record where you
will indicate which inventory record will receive the transfer (Figure 20.5-3).
Figure 20.5-3, Transfer Inventory
The top half of the screen will show the details of the inventory record you chose
to be reduced. The bottom half holds selection criteria to filter the list of possible
inventory records to receive the transfer. The selection criteria will only show
values for inventory records that match the record you selected on manufacturer,
lot number, and NDC (expiration dates will also match due to Receive Inventory
rules).
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Make any filtering selections desired (optional), and click “Retrieve Inventory
records meeting the above criteria” to allow you to choose the inventory record to
receive the transfer (Figure 20.5-4).
Figure 20.5-4, Transfer Inventory
If the selected inventory has existed under another location or program
component with the same vaccine type, manufacturer, lot, and NDC but not where
you wish to transfer it, you can create a new inventory record by clicking “-orCreate a new Inventory record to receive the transfer” (Figure 20.5-6). You
MUST attempt to retrieve potential records to receive the transfer before this
button is available.
Selecting a record to receive the transfer will take you to the last step and allow
you to complete the transfer process (Figure 20.5-7). If you elected to create a
new record to receive the transfer, one more step is necessary (Figure 20.5-6).
If the inventory you wish to transfer has never existed under any other inventory
location or program component with the same values, you will not have a
selection to make and will only have the option to create a new inventory record
to receive the transfer (Figure 20.5-5).
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Figure 20.5-5, No records exist to receive transfer
Next, click the “Create a new Inventory record…” button and on the following
page, select the inventory location and program component which will receive the
transfer and click the ‘Submit’ button to proceed (Figure 20.5-6). Note that after
clicking ‘Submit’, an inventory record has already been created at the new
location with a quantity on hand of zero.
Figure 20.5-6, Create new record to receive transfer
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Figure 20.5-7, Transfer Inventory
To complete the transfer, select the effective date of the transfer, the amount to be
transferred, and the reason for the transfer. Effective date cannot be earlier than
one day before today’s date. Pay special attention to the before and after
quantities of the supplying and receiving inventory records to verify the transfer is
setup correctly. A reason of “OTHER” requires comments, otherwise comments
are optional. Click Submit to complete the transfer.
Note: If transferring vaccine which does not have an NDC (anything received into
program 05 or most older records prior to Release 10.3) into program component
01 or 09 and you need to create a new record to receive the transfer, NDC will be
required to complete (Figure 20.5-8).
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Figure 20.5-8, NDC required on new records for PC01 and PC09
If the NDC of the record receiving the transfer is not linked to the manufacturer
listed for the record the transfer is coming from, you will see a warning message
and must choose to override or cancel. This can occur when creating new records
to receive transfers or when transferring doses from older records created prior to
Release 10.3 which happen to have NDC codes (Figure 20.5-9).
Figure 20.5-9, NDC not provided warning
20.6 Archive Inventory
The archive inventory function allows users to prevent unused inventory records
from displaying in the Adjust Inventory, Transfer Inventory, and Transaction
History areas. To be eligible for archiving, an inventory record must have had
zero doses available for 45 days. To see inventory eligible for archiving, select
“Archive Inventory” from the Inventory menu (Figure 20.6-1).
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Figure 20.6-1, Archive Inventory
From the list of eligible records, select the record(s) you wish to archive by
checking the box at the end of each row. You can check all boxes at the same time
by clicking “Mark all records”. Click Submit to archive the selected record(s). See
section 20.9 if you wish to unarchive previously archived records.
20.7 Transaction History
The Transaction History log will show all activity concerning each inventory
record you have used. This includes adjustments, transfers, administration of
vaccinations, and receiving. To access the Transaction History function, select
“Transaction History” from the inventory menu (Figure 20.7-1).
Figure 20.7-1, Transaction History
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The values in each selection box are representative of all inventory received up to
that time. As more receipts are recorded, more values will be selectable. Make
any filtering selections desired (optional) and then click “Retrieve Inventory
records meeting the above criteria” to return a list of inventory records to view
transaction history for (Figure 20.7-2).
Figure 20.7-2, Transaction History
Select the inventory record you wish to view transactions for by clicking on its
row in the list (Figure 20.7-3).
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Figure 20.7-3, Transaction History
You may sort the results list by either of the blue highlighted columns by clicking
on the heading. The directional arrow will indicate the direction of the sort. All
vaccine administrations are grouped by day so multiple doses given on one day
will appear as one transaction. Except for vaccinations administered, the name of
the user who caused the transaction to occur as well as details for the transaction
will display on the Transaction History for each inventory record. When a
vaccination record is modified which affects inventory, a “Note” will be
generated describing the specific change. This allows users to follow changes to
inventory records more closely and be able to track changes back to the patient
records that caused them. A “Note” appears in the transaction history log of an
inventory record when changes are made to the ‘Date Given’, ‘VFC Eligibility’,
or ‘Reduce inventory on-hand count’ check box on a vaccination or when the
originally selected inventory record for the vaccination is de-selected and changed
to another source for the vaccine.
20.8 Unarchive Inventory
To unarchive previously archived inventory, select “Unarchive Inventory” from
the Inventory menu (Figure 20.8-1). You may filter potential results by entering
any of the available selection criteria (optional). Click “Retrieve matching
archived Inventory records” to display the list of archived inventory records
matching your criteria.
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Figure 20.8-1, Unarchive Inventory
You may sort the results list by either of the blue highlighted columns by clicking
on the heading. The directional arrow will indicate the direction of the sort.
Select which record(s) you wish to unarchive by checking the box(es) at the end
of each row. Click Submit to unarchive the selected records. Unarchived records
will still have a quantity on hand of zero so adjustments or transfers may be
needed.
20.9 Correcting Inventory
Mistakes happen and Florida SHOTS is here to help. The Florida SHOTS
inventory functions have been configured to allow correcting of common
mistakes users may make. The following information details the various areas
where corrections can be made based on the fields where problems may occur.
Inventory Receipt Errors –

Correction needed to “Document Number”, “Received Date”, “Shipment
Source”, or “Other Vendor Name”
Mistakes made to these fields can be corrected by retrieving the receipt from the
‘List Receipts’ page, located in the ‘Vaccine Inventory’ section of the main menu.
Users need only to search for and retrieve the receipt containing the fields that
need correcting, make the desired corrections, and re-submit the data (Figure
20.9-1). It is advised to exercise caution when changing the “Received Date” field
as doing so changes the date when the inventory that is part of this receipt is
available for use in the system.
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Users will receive a warning when attempting to update any field and must
acknowledge it to continue (Figure 20.9-2).
Figure 20.9-1, Change Inventory Receipt
Figure 20.9-2, Change Warning
If the change made was to the receipt date, for tracking purposes, a new
transaction is added to the transaction history for the affected inventory record
(Figure 20.9-3).
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Figure 20.9-3, Transaction History
Inventory Record Errors –

Change needed to MFG, Lot #, Expiration Date, or NDC code
Changes needed to these fields on an existing inventory record can be
accomplished by using the ‘Chg Inventory Record’ feature, located in the
‘Vaccine Inventory’ section of the main menu (Figure 20.9-4).
Figure 20.9-4, Chg Inventory Record
Once the “MFG/LOT LIST” page opens, use the selection criteria boxes to make
selections for the inventory you are looking to update and click the “Retrieve
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MFG/Lot records meeting the above criteria” button to retrieve a list of records to
choose from. This list is of all unique combinations of vaccine type, MFG, Lot #,
and expiration date in your inventory. In other words, if you have the same
vaccine in more than one location, it will only appear once in this list. This way, if
you make a change, it will be copied to the other inventory records that matched
your selection.
Make your selection by clicking on a record. Doing so will bring up the “Change
Inventory Record” page (Figure 20.9-5).
Figure 20.9-5, Change Inventory Record
Make any needed changes and click “Submit” to save.
Note: If you are making a change such that the combination of MFG and Lot # for
this vaccine type is the same as that of another inventory record with a different
vaccine type or if the expiration date on this inventory record is changed such that
there are existing inventory records having the same vaccine type, MFG, and Lot
# but a different expiration date, you will be presented with a warning message
(Figure 20.9-6).
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Figure 20.9-6, Warning Messages
After acknowledging the warning, the “Change Inventory Record” page will have
a checkbox added called “Mfg/Lot Override”. By checking this box and clicking
“Submit”, the user is acknowledging to the system that this operation should be
allowed.
Also, if changing the manufacturer or NDC would make the resulting
combination invalid according to FLSHOTS, you will also see a warning which
may be overridden by clicking ‘OK’ (Figure 20.9-7).
Figure 20.9-7, MFG/NDC mismatch warning
If changing the NDC code to another NDC which was at one point valid but is not
currently allowed to be ordered, users will see a warning which also may be
overridden by clicking ‘OK’ (Figure 20.9-8).
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Figure 20.9-8, NDC change warning
If changing the NDC code to another NDC which is not valid for the vaccine type
of the record being changed, users will see an error message and cannot complete
the change (Figure 20.9-9). Please check to make sure you are updating the
correct inventory record and that the NDC you are changing to is appropriate for
the selected vaccine type.
Figure 20.9-9, NDC change error
If making a change to a record causes it to be the same as an existing record, they
will not combine and will appear separately if you revisit the “MFG/Lot List”
page (Figure 20.9-4) or the “Transaction History” page.
Users should be extremely careful when utilizing this feature. If not sure, please
contact the Florida SHOTS helpdesk.

Change needed to Program Component or Inventory Location
These changes can be handled by utilizing the “Transfer Inventory” function. See
section 20.5 for more information.

Change needed to Vaccine Type or # of doses
These changes can by handled by utilizing the “Adjust Inventory” function. See
section 20.4 for more information.
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If the vaccine type recorded on an inventory record is incorrect, that inventory
must be adjusted down to zero doses and received again as a new record. For this
scenario and if the number of doses is off due to data entry error, if the vaccine
was from program component 01 (VFC vaccine), users should contact the
Vaccine Accountability representative at the Bureau of Immunization and/or the
DL IMM SUPPORT TEAM for a “BOI Manual Adjustment”.

Change needed to previously recorded inventory adjustment
If, after completing an inventory adjustment, a user finds that all or part of it was
done incorrectly (too much, too little adjusted, wrong record adjusted, etc.), the
entire adjustment can be reversed.
To do this, the inventory record which was adjusted needs to be found by using
the ‘Transaction History’ function (see section 20.7). After selecting the record
from the list on the “Inventory Transaction Criteria” page, the “Inventory
Transactions” page will be displayed. Any adjustment which has not already been
reversed will have a checkbox to the right of its row in the “Reverse?” column
(Figure 20.9-10).
Figure 20.9-10, Inventory Transactions
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To reverse the transaction, check the box and click “Submit”. The transaction
history will update showing both the original “Adjustment” and the “Reverse
Adjustment”, both having the same affective date and opposite quantities, the net
result being an adjustment of zero doses on that day for that inventory record
(Figure 20.9-11).
Figure 20.9-11, Inventory Transactions

Multiple Doses Given on the same date for Program Component 05 & 09
Occasionally a patient will receive more than one dose of a vaccine on the same
date. If multiple doses are given on the same date using Program Component 05
or 09, the inventory must reflect the correct doses. Florida SHOTS does not allow
entry of two doses of the same vaccine type to be entered for the same date. To
document the second dose, go to the Patient Identification screen. In the
comments box, make a note that two doses of vaccine were given on the same
date (Figure 20.9-12).
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Figure 20.9-12, Two Doses Given On the Same Date
To reconcile the inventory, go to Adjust Inventory and decrease the dosage by one
for the mfg/lot # provided to the patient. Choose the adjustment reason of “Other”
and write an explanation in the Comment box. Make sure to include the patient’s
State IMM ID number for reference (Figure 20.9-13).
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Figure 20.9-13, Adjusting two doses given on the same date
To verify the updated inventory, go to the Transaction History page and confirm
the validity of the transaction. The extra dose will need to be written on the DH
687 Form since Florida SHOTS does not have the capability to display multiple
doses on the form.
21.0 System Administration
Once the administrative user has accessed the application by entering the proper security
information, the patient search screen is the first to appear (Figure 21.0-1). To begin
utilizing administrative functions, click on the Administration link on the left menu.
After clicking on the Administration link, the “Administrative Menu” opens up. The
administrative functions allow administrators to update their organization information
through the “Organization Edit” screen and add, modify, or end user access, unlock
accounts, and renew or reset user passwords (on the Personnel List screen).
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Figure 21.0-1 Patient Search Screen
21.1 Organization Edit Information
Administrative users can edit the contact information and password expiration
timeframe (maximum default is 30 days) in the Organization Edit screen from
the sidebar menu (Figure 21.1-1). If any information is incorrect, please send an
email to Florida SHOTS staff ([email protected]).
Figure 21.1-1, Organization Edit
Once the “Organization Edit” link has been utilized, the Enrolled Organization
Maintenance screen will appear (Figure 21.1-2). This screen allows users to
review the information that was provided to Florida SHOTS regarding their
organization during the application process. It is beneficial to verify that the
information is correct, especially the organization’s physical address (and those of
service sites), as they will display on the 680 forms printed by your organization.
Local Organization Administrators may only edit or update the contact
information and password expiration timeframe. If needed, users may also utilize
the “Print DH1479” button to print out the user agreement form with all pertinent
information pre-populated.
Note: if any information is incorrect, please contact the registry staff at 1-877-888-SHOT.
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Figure 21.1-2, Enrolled Organization Maintenance Screen
21.2 Viewing Site Information
By clicking the ‘View Service Sites’ button, located on the “Enrolled
Organization Maintenance” page (Figure 21.1-2), users will be able to see the Site
List of all of the sites that have been created for them (Figure 21.2-1). New sites
can be requested from the Florida SHOTS helpdesk and sites no longer needed
may be archived by the helpdesk as well. By changing the ‘Show sites:’ selection,
users can view only the “Active” sites, only the “Archived” sites, or “All”. If
your organization has several sites the Site List can be sorted by the field column
headers. Click on any column to sort by that field: Site Name, Default, In Use,
Address, VFC PIN or VFC Status.
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Figure 21.2-1, Site List
Click on any row to view details for each site (see section 21.3). Note: all
organizations will automatically start with one site by default, named the same as
their organization. This site’s address will default to the physical address given
for the organization. Please verify all sites for accuracy and if any changes are
needed or if any sites need to be added or archived (clinic closed for example),
please inform the FLSHOTS Helpdesk
21.3 Site Maintenance
To view details regarding a particular service site, select a site by clicking on its
row in the Site List (see section 21.2).
The “Site Maintenance” page and the information displayed there will look
different depending on whether or not the site is enrolled in the Vaccines For
Children program (VFC) and has a VFC Pin number and enrollment data on file..
Site Maintenance (non VFC) –
A Site Maintenance screen without a VFC pin attached (Figure 21.3 -1) will
provide the FLSHOTS Service Site Address and Contact Information. Local
Organization Administrators can do several things at this screen:
 Update the FLSHOTS Service Site Contact Information
 Click the change button beside the FLSHOTS Contact Name for the Site
to reach the Personnel List and select someone else as the Florida Shots
Site Contact.
 Click the contact name, which is a link, to reach that individual’s
Personnel Maintenance page. From here they can update this individual’s
personnel record if it is needed.
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
This page also has the added feature, in the upper left-hand corner, of a
link called ‘View Org Info’ which allows the Local Organization
Administrator to view the information displayed on their Enrolled
Organization Maintenance screen.
Figure 21.3-1, Site Maintenance
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Site Maintenance (VFC) –
The Site Maintenance screen for a site enrolled in VFC provides you the same
information you would see on a site not enrolled with VFC but with added detail
sections showing all data collected by the VFC program regarding enrollment and
participation in VFC (Figure 21.3-2):
Figure 21.3-2, VFC Site Maintenance




VFC PIN Number and VFC EID (unique enrollment identification number
used internally by VFC staff)
VFC Shipping Address - Defaults to “Same as Service Site Address”
VFC Mailing Address - Defaults to “Same as VFC Shipping Address”
VFC Shipping Contact Info - The phone, fax, and email portion defaults to
“Same as Service Site Contact Info” and is a single set of values
associated with the pin. The VFC program requires two contact persons;
where as, the Florida SHOTS account only requires one contact.
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
VFC Maintenance – Milestones the site completed to receive their PIN.

Ordering Profile – Communicates the types of VFC vaccine the site can
order, the frequency with which the vaccine can be ordered, the site start
date for ordering vaccine, if the site has an end date, and the fact that the
site can place orders.
o This Site Can Place Orders checkbox will be used by the VFC
Office to address temporary situations where they may revoke a
site’s ability to order vaccine.

Delivery Time – Daily times the site will receive VFC vaccine from the
shipping organization, along with an additional shipping note from the
VFC office if so noted and a Fully Formulated Shipping Note compiled
from the daily times and the additional note that will appear on all orders
for the delivery organizations.
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
Enrollment Data – Provided by the site to the VFC office during
enrollment and re-certification. This includes patient counts by age group
to show patients which are and are not eligible to receive VFC vaccine.

The Physician List – This area of the Site Maintenace screen for a site
with a PIN attached to it communicates the following information about
each provider attached to the site:
o Name,
o Medical License number if provider has one (medical assistants
can be immunization providers, but will not have license
information),
o Current VFC Physician status for the VFC EID
o Roles the individual has with the Florida SHOTS org and VFC
Site.
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
System Data – This area of the Site Maintenance screen for a site with a
PIN attached to it communicates the latest information regarding the VFC
program as it relates to the site: for example, when the last order was
submitted, when it was approved, etc.
21.4 Adding Personnel
New personnel are added to the system by the Local Organization Administrator
(LOA) under the Organization Login ID assigned to the organization. The
Local Organization Administrator is the individual(s) designated by the applicant
within the enrollment application as a participant in Florida SHOTS with the
authority to manage system access for other users within the organization. The
administrator(s) displayed in the system may or may not be the same as the
applicant. This person will be able to grant access to others within the facility as
approved by the applicant.
By clicking on the Personnel List link located in the ‘Administration’ section of
the main menu, the system will display the Personnel List at which the Local
Organization Administrator can view a full Personnel List or click to add a new
person to the Florida SHOTS system (Figure 21.4-1). The administrator can sort
the Personnel List so that it displays Personnel by the following:



Active, Locked & Expired
Inactive
Only VFC – Used to filter one or both of the other two options to show
only those personnel having a relationship to the state VFC program.
In addition, the administrator can also sort the Personnel List by the individual
column headers to make it easier to search for: an individual, if the administrator
is trying to unlock an account, for example; or group, if the administrator is
searching for VFC or status, for example. The available column sorts are:





System User ID
Name
Title
Auth Level – Authorization level
Applicant – Owner of the Florida SHOTS account
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








Contact – Person is a known organization or site contact for Florida
SHOTS
IMM Provider
VFC – Person is a VFC enrollee, contact person, or known immunization
provider for a given PIN number.
Start Date
End Date
Password Exp.
Locked
Role
Status
If administrators click on an individual user’s name from the “Personnel List”
page, they can reach that individual’s “Personnel Maintenance” page to modify
their access information as needed.
Figure 21.4-1, Personnel List
The Florida SHOTS Local Org Administrator will need to manage access to the
Florida SHOTS system by each individual user as employment begins, is
terminated, or if access rights change for whatever reason.Remember that all
users are required to maintain patient confidentiality and the responsible
authorized individual is accountable for any and all access to Florida SHOTS,
described in forms (DH 1479 or DH 2115).
The “Add New Person” button within the Personnel List screen takes
administrators to the Personnel Maintenance page for creating a new personnel
record. There, administrators must enter several key pieces of information
regarding the new person to be added (Figure 21.4-2). Use of Florida SHOTS is
managed through the assignment of Start and End Dates, authorization levels, and
roles. The system administrator must have the user’s start date (if known) prior to
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entry into the system. End dates are not required but should be added when a
person leaves the organization or no longer requires access as a system user.
Figure 21.4-2, Add New User
For each new person to be added, the administrator must enter the following
information:









First Name and Last Name
Prefix (if desired)
Title (if applicable)
Email Address – Optional for all users but future enhancements may
utilize this information.
National Provider ID (if known)
Specialty - (if applicable)
Medicaid Number - (if applicable)
Medical License Prefix - (if known)
Medical License Number - (if known)
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

Start Date This start date is the date the person began their association
with the organization (hire date) and controls when a person’s Provider
Person ID (if the person is an immunization provider) will appear in the
provider drop-down lists on the different pages that this list appears. This
start date can be the same as the “System User” start date for convenience,
but any vaccinations this person may have given before this date will not
be able to be recorded as administered by them.
End Date –This end date is the date the person’s association with the
organization ended or when they no longer administer vaccinations. This
controls when an individual’s Provider Person ID will be removed from
the provider drop-down list.
Note that by using the capital “T” on any date field, today’s date is
automatically entered





Immunization Provider – The administrator must designate whether or
not the user being entered is an “Immunization Provider”. A “provider”
is an individual that administers vaccinations. Some providers may not use
the system, so the “system user” checkbox may remain unchecked and the
lower half of the screen can be ignored. The drop-down dialog box
contains a “Yes” and “No” to choose from. All “providers” can be chosen
as having administered a vaccination, regardless of if they are a system
user.
Provider Person Id – Required if “Immunization Provider” is “Yes”.
This will uniquely identify each “provider” in the system with a short
name or abbreviation. A list of these IDs will show on the “Add a
vaccination” and “Adverse events” screens when indicating that your
organization gave a vaccination. A suggested Provider Person ID will be
displayed in this field when the “Immunization Provider” selection is
changed to “Yes”. Administrators may accept this Provider Person ID or
type in a different one, if needed.
Certify Form 680 – Set to “Yes” if this person’s name may be used as an
authorized signature for certifying Form 680s. Users may be able to both
have their name used as an authorized signature and create a certified
Form 680 (See “Create Certified Form 680” option below).
Sign Form 681 – Set to “Yes” this user will appear in a drop-down list as
an e-signer for the DH 681: Religious Exemption Form. This permission
should only be set for the CHD Administrator or the Administrator
“designee”. Users may be able to both have their name used as an
authorized signature and create a certified Form 681 (See “Create Form
681” option below).
Work Location – Select from a list of your organization’s service sites (if
your organization has more than one) which service site this person
normally works at. This selection will be used as the default when creating
a Form 680.
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







System User ID – This identifier will be unique to each user that has
access to the system, and is used to log into the application. A suggested
user ID will be displayed in this filed upon checking the “System User”
checkbox. Administrators may accept this user ID or type in a different
one, if needed. User IDs must be at least 7 characters long and may only
contain letters or numbers.
Expiration Date – Date password is scheduled to expire for this user. The
date is calculated based on the date the password was last changed plus the
number of days listed in the “Default Password Expire Days” field in the
“Account Information” section of the Organization Maintenance screen
(accessible from the Administration menu, default is 30 days). This value
can be changed; provided the date entered is not before the start date and
not more than 30 days from today (T + 30 can be used as a shortcut for
this).
System User Start Date – Date the user has access to login to Florida
SHOTS. The system will populate this field when the Local Org
Administrator checks the System User field.
System User End Date – Entering a date in this field eliminates the user’s
ability to login to Florida SHOTS. It does NOT impact Provider Person
IDs for those individuals who give shots in your organization, but are no
longer using the system day-to-day. Administrators have the ability to
terminate, limit, or extend a staff member’s access by changing the
System User End Date. The system will only accept a system user end
date that is equal to or greater than the password expiration date.
System Password – The password established by the system
administrator must be shared with the user prior to attempting to access
the system for the first time. The user must later change this password if
“User must change password at next logon” is checked. System passwords
must be at least 7 characters long, may only contain letters or numbers,
may not equal the word “password” or the user’s user ID, and may not
repeat any of the previous three passwords or any that have been used in
the past 30 days. Passwords are case-sensitive.
Confirm Password– This box requires the user to re-enter the same
password that was entered in the system password dialog box. This is to
protect against errors in entering the passwords.
Account Locked – This box will be checked if a user account is locked.
Administrators just need to uncheck it to reinstate access. Resetting the
password after unlocking a user is also recommended.
Authorization – The ‘Authorization’ pull-down menu allows the
administrator to grant a basic access level for a user. There are two basic
levels of access in Florida SHOTS: Full Access and No Access. Full
Access should always be used unless it is necessary to terminate a user’s
access.
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



Role – The ‘Role’ pull-down menu is used to select what specific type of
access each user will have. There are at most, three options to choose
from as listed below. The choice of Local Org Administrator is only
viewable on users designated as administrators by Florida SHOTS staff. If
other administrators are necessary, or there is a need to change
administrators, please notify Florida SHOTS staff.
o Local Org Administrator – The highest level within the
application, with full read/write privileges to the database. These
individuals are responsible for granting user access, set up, and
management of user names and passwords. Local administrators
may not assign this role to any other users. If other administrative
users are needed, please contact the Florida SHOTS helpdesk.
o Local Org Staff – Allows access to view and modify patient
records and print reports but does not allow access to
administrative functions.
o Org View Only – Allows users to view and print patient records
and reports but does not allow editing of any information or access
to administrative functions.
o Local Org Staff Inventory - * Applies to CHD users only at this
time. Same permissions as Local Org Staff but with access to
inventory maintenance functions.
o Local Org Inventory Only - * Applies to CHD users only at this
time. Allows user only to be able to access inventory maintenance
functions.
Create Certified Form 680 – Set to “Yes” this person is authorized to
create a certified Form 680. Users may be able to both create a certified
Form 680 and have their name used as an authorized signature (See
“Certify Form 680” option above). Users with a view only role are
prohibited from creating or certifying Form 680s.
Create Form 681 – Set to “Yes” this person is authorized to create a
Form 681. These are CHD users who create the form for the CHD
Administrators or their “designee” who e-sign the forms. Users with a
view only role are prohibited from creating or e-signing Form 681s.
User Must Change Password at next logon – This box is checked to
require the user to change their password after the next login (used for
initial setup or when resetting passwords).
Prior to granting access for new Florida SHOTS personnel to use the system,
Administrators should place a check mark in the box located at the bottom of the
screen which states: “User must change password at next logon”. By checking
this box, the user that was entered will be required to enter and confirm a new
password when they first attempt to log into the system.
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As with the Service Site page, the Personnel Maintenance page also has the added
feature, in the upper left-hand corner, of the ‘View Org Info’ link giving the Local
Organization Administrator a view of their Enrolled Organization Maintenance
information.
To save the new personnel record, click the “Submit” button at the bottom-left of
the screen. If the administrator needs to totally clear the entry and start over, the
“Cancel” button can be used to clear the entire page prior to clicking on “Submit”.
Once the information has been entered and saved, the new user will now be
displayed on the Personnel List page (Figure 21.4-1).
As new personnel are added, the list will continue grow. The list displays user
privileges in the “Authorization Level” and “Role” columns, whether or not the
user is an “IMM Provider”, and the “Start and End Dates” of their privileges.
Each system user should have a unique and personal user name and password.
User names and passwords should be different for all staff members and must be
maintained routinely by the system administrator.
Only use valid, legal names when creating personnel records. DO NOT create a
personnel record such as, “Nurses Station” and allow an entire group of
individuals to use it at a site. Remember, these “User Names”, are tied to patient
shot records and tell the patient, the doctor’s office, and the state who provided
that individual their shot.
The “authorized responsible individual” (applicant), who signed the application
on file with the DOH, is ultimately responsible for actions taken within Florida
SHOTS when that personnel is using a Provider Person Id and/or System User
Name which falls under that applicant’s Organization Login ID. Due to the
size of some organizations, Local Organization Administrators or another
applicant “designee” may take oversight of Florida SHOTS information at
the “site” or local level.
After clicking the “Submit” button, Administrators can perform other functions,
or sign out and leave the application.
21.5 Managing Site Responsibilities
If an organization has multiple sites, the administrator must determine whether or
not that person has any site responsibilities for the organization and assign them on
the “Site Responsibilities” page once an individual’s personnel record is created
(Figure 21.5 -1). It is from this page that administrators can assign an individual as
a Florida SHOTS site contact or assign them as VFC site contact if their
organization participates with that program. This page also allows them to see if
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that individual has responsibility for their organization’s VFC program as the VFC
enrollee.
To assign these responsibilities, the administrator will click on ‘Service Site
Responsibilities’ at the bottom of the Personnel Maintenance page, see (Figure
21.4-2). This will bring them to the “Service Site Responsibilities” page see
(Figure 21.5-1), which gives the person’s name with the following options:




selecting this individual as the FL Shots Service Site Contact
selecting this individual as the VFC Primary Contact (if applicable)
selecting this individual as the VFC Secondary Contact (if applicable)
selecting this individual as a VFC Immunization Provider (if applicable)
Some individuals do work at multiple sites within their organizations so
administrators can choose to select one individual as contacts for multiple sites. It
is the exception, but this situation does occur. Florida SHOTS applicants may also
be listed as a contact for one or more sites and likewise, VFC enrollees may also
appear as VFC contacts.
In addition to selecting personnel as site contacts, the “Service Site
Responsibilities” page also provides the administrator with the following
information about each site:



VFC EID
VFC PIN
VFC Status
Once the administrator assigns an individual as a contact, they will see this
individual as the contact when they view that site’s “Site Maintenance” page
(Figure 21.3-2). It will not be noted on an individual Personnel Maintenance page
that they are a Florida SHOTS or VFC site contact. This is only noted on the
“Service Site Responsibilities” page and the “Site Maintenance” page.
As with the Service Site and Personnel Maintenance pages, the Service Site
Responsibilities page also has the added feature, in the upper left-hand corner, of
the ‘View Org Info’ link giving the Local Organization Administrator a view of
their Enrolled Organization Maintenance information.
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Figure 21.5-1, Service Site Responsibilities
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21.6 User Account Maintenance
Occasionally, users may become locked out or their account may become expired.
Accounts can become locked after invalid login information is entered 3 times
and an account can expire if the user hasn’t changed their password in over 30
days from the last time it was set or changed. Administrators may unlock these
accounts through the personnel maintenance screen of the affected user(s).
To get to a particular user’s maintenance screen (the same seen when adding new
users) (Figure 21.4-2), simply click on the row with the user’s name in the
Personnel List page (Figure 21.4-1). This is accessed by clicking on “Personnel
List” in the Administration submenu. If a user is locked out, the “Account
Locked” checkbox will be checked and must be unchecked prior to any further
maintenance. A user’s password can be reset at any time by entering a new
password and confirming the password. Changing a password will automatically
renew a user’s expiration date. If only the expiration date needs to be changed,
that can be done by itself at any time by entering “T+30” for a new expiration
date, 30 days from today. After any of these changes are made, the administrator
must click the “Submit” button to save the changes. The administrator can then
verify that the changes have been made by checking the personnel list.
User accounts will automatically become inactive if a user fails to update their
password if left expired for 60 days or more. Users may do this themselves by
utilizing the grace login feature or a local administrator may assist them (see
section 2.2 and above). Inactive user names will not be available for selection to
certify a Form 680 or as an Immunization Provider on the “Add a Vaccination”
screen. This does not apply to personnel accounts that are not marked as “System
Users”. Inactive accounts can be reactivated by a local administrator by removing
the “End Date” on the account and updating the password expiration date. Users
that become inactive will only display on the “Inactive” or “All” view of the
Personnel List. Administrators are encouraged to keep up with their personnel
records and to check the “Inactive” section of your personnel list frequently.
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APPENDIX A
Bureau of Immunization
Florida SHOTS Notification and Opt Out Form
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FLORIDA SHOTS/IMMUNIZATION REGISTRY
REQUEST TO CHANGE OPT-OUT STATUS
I am the parent or legal guardian of the child(ren) indicated below. I request an Opt-Out status
change for the child(ren) listed below to allow immunization records in Florida SHOTS to be
shared with health care providers who are authorized system users.
Parent’s Name (Print):
Last Name
First Name
Signature of Parent:
Date:__________________ Phone: (
)
Please Print (Fill out information for each child)
Child’s Name:
Last Name
First Name
Middle Initial
Child’s Date of Birth: __________________________
Month/Day/Year
Child’s SSN:__________________
Child’s Name:
Last Name
First Name
Middle Initial
Child’s Date of Birth: __________________________
Month/Day/Year
Child’s SSN:__________________
Child’s Name:
Last Name
First Name
Middle Initial
Child’s Date of Birth: __________________________
Month/Day/Year
Child’s SSN:__________________
Fill out the form above and fax to the Bureau of Immunizations at (850) 922-4195, with attention
to Florida SHOTS. Cover page should include the name of the person sending the fax with a call
back number, level of urgency, and confidential fax designation. Call the Florida SHOTS tollfree number to apprise staff of the fax arrival. The phone number is 1-877-888-SHOT (7468).
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APPENDIX B
Florida SHOTS Glossary
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ACIP – Advisory Committee on Immunization Practices; A national group charged with
developing standards for childhood immunizations.
Address – The number, street name, and other information that describes where a building is or
where somebody lives. A person may reside at one location (physical address), but receive mail
at another (P.O. Box – mailing address).
Adverse Event – Documented antagonistic or harmful reaction to a vaccine (i.e. fever). Within
PPS, the series of screens allows a user to indicate that a client has experienced an adverse event
to a vaccination and to list the symptoms that accompanied the adverse event.
Alias – An assumed name or a nickname.
Birth Certificate # – An official personal identifier defined by the Office of Vital Statistics and
given to each child born in the state of Florida.
BOI – Bureau of Immunization
CDC – Centers for Disease Control and Prevention
CIP – Current Immunization Provider
Confidentiality – The treatment of information that an individual has disclosed in a relationship
of trust with the expectation that it will not be divulged to others in ways that are inconsistent
with the understanding of the original disclosure.
Contraindication – A predefined medical condition of the client or a member of the client’s
household that prohibits providing one, several, or, in rare cases, all immunizations, because of a
likely adverse reaction.
County of Residence – County where patient lives (not necessarily the county where they
receive services).
Date Given – The date a vaccine was administered.
Dose – Number of immunizations in a series.
Florida SHOTS – Florida State On-Line Tracking System – The official name for the Statewide
immunization registry.
HIPAA – Health Insurance Portability and Accountability Act. A public law enacted in 1996,
which requires the promulgation of regulations to ensure the confidentiality of certain health care
information.
Immunization – The process of inducing or providing immunity by administering an immunobiologic (antigenic) substance.
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Immunization History Report – Displays list of valid vaccinations received and the next
recommended due date for each. “Complete” will be displayed when a series has been
completed.
Immunization Status – Provides information on how the active patient is doing in each of the
required and recommended immunization series. Next dose number, recommended and
minimum due dates with suggested vaccine types, and complete reason (when applicable) are
shown along with whether or not the series is excluded from Reminder Recall for this patient.
Injection Route – the injection route in which the vaccination was administered. Such as:
Abbreviation
Long Name
IM
Intramuscularly
IN
Intranasal
OTH
Other
PO
Oral
SC
Subcutaneous
Injection Site – The injection site in which the vaccination was administered. The following is a
complete listing of injection sites within Florida SHOTS.
Abbreviation
LDT
RDT
LTR
RTR
LAT
RAT
LLT
RLT
LG
RG
Long Name
Left Deltoid LA – Left Arm
Right Deltoid RA – Right Arm
Left Triceps LA – Left Arm
Right Triceps RA – Right Arm
Left Anterior Thigh LT – Left Thigh
Right Anterior Thigh RT – Right Thigh
Left Lateral Thigh LT – Left Thigh
Right Lateral Thigh RT – Right Thigh
Left Gluteus LG – Left Gluteus
Right Gluteus RG – Right Gluteus
Manufacturer Code – This field requires the selection of the manufacturer of the vaccine.
Medicaid # – Medicaid is a program funded by the U.S. and state governments that pays the
medical expenses of people who are unable to pay some or all of their own expenses. These
individuals are assigned a number for claims.
Multiple Birth – If a twin, triplet, etc., provide birth order (1st, 2nd, 3rd born, etc).
Private Provider Org. ID – The private provider ID is an identifier that allows the system to
determine the provider of a vaccination.
Provider: An organization or individual who provides immunization and other services.
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Vaccine Series: The series is the “family” of vaccines. For example, the DTAP series has
several different vaccine types that may be used to complete the series. Examples include
DTAP, DT, TD, or TDAP. Combination vaccines like Pediarix will count for doses in multiple
series (DTAP, HEP B, and POLIO, in the case of Pediarix).
Vaccine Type – The vaccine type is the actual vaccine that was administered for a given series.
For instance, the HIB series has many different vaccine types that can be administered to meet
requirements for the vaccine series.
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APPENDIX C
Florida SHOTS
Valid Contraindications
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Florida SHOTS – Valid Contraindications
The table below is the complete list of all contraindications available for selection within Florida
SHOTS, both temporary and permanent. On the DH680, codes are used to note which
contraindications are present on the patient’s record at that time. Codes are used to protect
patient confidentiality so as not to reveal potentially sensitive information.
These codes are shown here in parenthesis after each contraindication. Note: Some
contraindications are only relevant to particular vaccines or series so all contras shown may not
be visible at the same time.
General for all Vaccines
Permanent Contraindications
1. Anaphylactic reaction to a vaccine - (ALL1)
2. Anaphylactic reaction to a vaccine constituent - (ALL2)
Temporary Contraindications
1. Moderate or severe illnesses with or without a fever - (ALL3)
2. Other – (ALL4)
DTP/DtaP (ALL, DTP, DT, DTAP, DTP-Acthib, DTP-HIB, TD (Adult))
Permanent Contraindications
1. Encephalopathy within 7 days of administration of previous dose of DTP (DTP1)
2. Fever of >= 40.5 degrees C (105 degrees F) within 48 hours after vaccination
with a prior dose of DTP - (DTP2)
3. Collapse or shock like state (hypotonic-hyporesponsive episode) within 48 hours
of receiving a prior dose of DTP - (DTP3)
4. Seizures within 3 days of receiving a prior dose of DTP - (DTP4)
5. Persistent, inconsolable crying lasting >= three hours within 48 of receiving a
prior dose of DTP - (DTP5)
6. Anaphylactic reaction to a vaccine - (DTP6)
Temporary Contraindications
1. Other - (DTP8)
Polio (OPV/IPV)
Permanent Contraindications
1. Infection with HIV or a household contact with HIV - (OPV1, POL1)
2. Known altered immunodeficiency (hematologic and solid tumors; congenital
immunodeficiency; and long-term immunosuppressive therapy) – (OPV2,
POL2)
3. Immuno-deficient household contact – (OPV3, POL3)
4. Anaphylactic reaction to neomycin or streptomycin – (IPV1, POL4)
Temporary Contraindications
1. Pregnancy – (OPV4, IPV2, POL7)
2. Other – (OPV8, IPV8, POL8)
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MMR
Permanent Contraindications
1. Anaphylactic reaction to egg ingestion and to neomycin - (MEA1, MUM1,
RUB1)
2. Known altered immunodeficiency (hematologic and solid tumors; congenital
immunodeficiency; and long-term immunosuppressive therapy) – (MEA2,
MUM2, RUB2)
3. Active Tuberculosis – (MEA5, MUM5, RUB5)
4. Lab confirmed immunity – (MEA6, MUM6, RUB6)
Temporary Contraindications
1. Pregnancy (MEA3, MUM3, RUB3)
2. Recent immune globulin administration (MEA4, MUM4, RUB4)
3. Other (MEA8, MUM8, RUB8)
HIB
Permanent Contraindications
1. Anaphylactic reaction to a vaccine – (HIB1)
Temporary Contraindications
1. Other – (HIB8)
Hepatitis A
Permanent Contraindications
1. Anaphylactic reaction to a vaccine - (HEPA1)
2. Lab confirmed immunity – (HEPA6)
Temporary Contraindications
1. Moderate or severe illnesses with or without a fever – (HEPA2)
2. Other – (HEPA3)
Hepatitis B
Permanent Contraindications
1. Anaphylactic reaction to common baker’s yeast – (HEP1)
2. Lab confirmed immunity - (HEP6)
Temporary Contraindications
1. Other – (HEP8)
HPV
Permanent Contraindications
1. Anaphylactic reaction to a vaccine – (HPV1)
Temporary Contraindications
1. Other – (HPV2)
VZV
Permanent Contraindications
1. Not susceptible/Had disease – (VZV1)
2. Anaphylactic reaction to vaccine – (VZV2)
3. Immunodeficiency – (VZV3)
4. Active Tuberculosis – (VZV4)
Temporary Contraindications
1. Other – (VZV5)
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2. Pregnancy – (VZV8)
Rotavirus
Permanent Contraindications
1. Anaphylactic reaction to a vaccine – (ROT2)
Temporary Contraindications
1. Moderate or severe acute illnesses with or without a fever – (ROT1)
Pneunmococcal
Permanent Contraindications
1. Anaphylactic reaction to a vaccine – (PNC1)
Temporary Contraindications
1. Other – (PNC8)
H1N1
Permanent Contraindications
1. Anaphylactic reaction to egg ingestion and to neomycin – (H1N11)
2. Anaphylactic reaction to a vaccine – (H1N12)
3. Concomitant pediatric and adolescent aspirin therapy and Reye’s Syndrome –
(H1N13)
Temporary Contraindications
1. Other – (H1N14)
Meningococcal
Permanent Contraindications
1. Anaphylactic reaction to vaccine or vaccine components – (MEN1)
2. Known history of Guillain-Barre syndrome – (MEN2)
3. Known hypersensitivity to dry natural rubber latex – (MEN3)
Temporary Contraindications
1. Other – (MEN4)
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APPENDIX D
Example Florida Certificate of Immunization
(Form 680)
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APPENDIX E
Allowing Parents Access to Download
Certified Form 680s
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1. Overview
Florida SHOTS is now offering parents a way to get and print their children’s
Certificates of Immunization (DH Form 680s) from their home computers.
Healthcare providers can now create a PIN that will be attached to a Certified (esigned) Form 680 and will allow parents to access the Certified 680 from their
home computers. The form is legal and valid in the state of Florida for
admittance to schools and daycare facilities and may be printed on standard
white paper.
Parents accessing the Certified Form 680 from home will be required to enter the
Certification PIN and State IMM Id found on the information sheet their
healthcare provider will give them. A PDF version of the form allows it to be
printed or saved.
2. Creating A PIN Only
Healthcare providers will have the options to: create a PIN before creating a
Certified (e-signed) Form 680, create both the PIN and the Certified 680 at the
same time, or not create a PIN at all for a Certified 680.
A provider may choose to create the PIN while the parent is in the office so the
instruction sheet may be handed to them, but may not have time to update and
create the Form 680 at the time of the visit. If a PIN is needed follow the steps
listed below to create a PIN:


Open the patient’s record in Florida SHOTS.
On the menu bar select “Create Pin” located under the Form 680 header.
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
The CREATE FORM 680 CERTIFICATION PIN page will open. The
following information is found on this page:
 Patient Name – the patient name will automatically appear.
 Parent/Guardian Name – The parent or guardian on record will
appear. If no parent/guardian name exists in the child’s record the
following notice will appear and prompt a parent or guardian name
to be added:


Certification Pin – This will not appear until you have created the
PIN.
Created – This date will be the day the PIN is created.
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


Will be deleted on – When creating a PIN before you have created
a Certified Form 680, you will have 10 days to create the form. If
you do not create a Certified 680 the PIN will be deleted on the
date shown here.
 Site – If your organization has more than one service site, you must
select the patient’s primary service location from the drop box.
To create the PIN, click the Create Certification Pin button.
The top half of the page will now be completely filled in. The provider will
have the following three options:
 Change site – this button will only be active if you choose a
different site from the drop box. Once you have selected the site
you wish to replace the previously recorded site with, click on the
this button to save the new site.
 Delete Certification Pin – this button will delete the PIN that has
been created.
 Print Parent Get DH 680 Instructions – this button will print the
bottom half of the screen which is an information sheet for the
parents/guardians. The instructions include the two pieces of
information a parent will need to have (“State IMM Id” and
“Certification PIN”) in order to retrieve and print (or save) their
child’s Form 680 from home. Providers should print this page and
hand it to the parent.
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

Once the Parent Get DH 680 Instruction sheet has been printed and given
to the parent the provider is done creating the PIN. The information sheet
may be printed again from the ‘Create Pin’ page until it has been attached
to a certified 680 (see note below).
The provider must login to Florida SHOTS and create a Certified (esigned) Form 680 within 10 days of creating the PIN to keep the PIN from
being deleted.
When a provider opens a patient’s record within the 10 day grace period and
clicks on “Form 680” to create the Certified Form 680, the message below will
appear on the Form 680 page, letting the provider know the PIN created earlier
will be attached to the 680.
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Note: The option to show and print the associated parent information sheet will
be found again at the bottom of the Form 680 when it has been certified as well
as the option to download the certified Form 680 in pdf format. The PIN
information sheet and download option can be seen at any time afterwards by revisiting the patient’s 680 page and viewing a stored certified 680 (see next
section).
3. Creating a Certified (e-signed) Form 680 and PIN
Creating a certified 680 and a PIN at the same time is quick and easy. To
accomplish this create a certified Form 680 as normal (see Section 15.1) except
leave the ‘Create a parent access PIN’ checkbox checked when clicking the
‘Create’ button.
NOTE: If a healthcare provider wishes to create a Certified Form 680, but does
not want to issue a PIN to the parent/guardian, uncheck the box. The parent will
not be able to get the Form 680 from home and the healthcare provider will have
to print it in the office.
Once the provider has selected to either certify or certify and print, two new
options will appear at the bottom of the screen:
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 194

Show Parent Get DH 680 Instructions – this button will open the parent
information sheet which should be printed and handed to the
parent/guardian. To print, scroll to the bottom of the screen and click the
Print Parent Get DH 680 Instructions button.

Download to Pdf File – this button will create a PDF version of the
Certified Form 680 which can be printed directly onto white paper, as the
Department of Health watermark is visible on the PDF document, making
it a legal and valid form.
After providing the parent/guardian with the Information Sheet, the provider is
done. If the parent should lose the Information Sheet, the provider may print out
another copy by opening the patient’s record in Florida SHOTS, navigating to the
Form 680 page, and clicking ‘View’ on any previously Certified 680 where a
Parent PIN was attached. At the bottom of the 680 the options to show (and then
print) the parent information sheet and download the 680 in pdf format will be
displayed as they were when the 680 was initially certified.
4. To - Be Certified List
When a user who has the ability to create certified Form 680s logs into Florida
SHOTS they will be directed to the TO – BE CERTIFIED LIST page if there are
any patients who have PINs assigned, but have not yet had a Certified 680
created. The user may choose to delete the PIN by clicking on the Delete button
or they may open the patient record by clicking on the patient’s name and then
proceed to create a certified Form 680.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 195
Once the user has navigated away from this screen they can return at any time
to view their list of patients in need of a Certified 680 by clicking on the “To-be
Certified 680s” tab located under the Patients header on the menu bar.
5. How Parents/Guardians Will Get the Certified Form 680
Parents or guardians may get and print the Certified Form 680s by visiting the
Florida SHOTS’ website at www.flshots.com. On the website homepage the
parent will click on the Get DH 680 button and be redirected to the “Get Your
Child’s Florida Certification of Immunization (DH Form 680)” page. The parent
will need to follow the instructions below to get their child’s Certified 680.



Enter the State IMM Id exactly as it is printed on the Get DH 680 Form
Information sheet.
Enter the Certification PIN exactly as it is printed on the Get DH 680 Form
Information sheet.
Click on the Retrieve Form button.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 196
Parents will need Adobe’s Reader installed on their computer to be able to open
the PDF version of the Certified 680. If the parent does not have Adobe Reader
installed they may follow the instructions on the page and use the provided link
before trying to get the form.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 197
If parents encounter any errors, the error message(s) will be displayed between
the Certification PIN field and the retrieve button.
For a detailed explanation of any error encountered, parents may click the “More
Optional Instructions” link to display a page explaining all error messages.
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 198
APPENDIX F
Florida SHOTS
Vaccine Type Information
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
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Vaccine Information Table
FLSHOTS Name
CHOLERA
DT
DTAP
DTAP-HIB
DTAP-IPV
DTP
DTP-ACTHIB
DTP-HBOC
FLU3Y+ P
Vaccine
Cholera
Diphtheria, Tetanus
Diphtheria, Tetanus, acellular
Pertussis
DtaP+ActHIB
DtaP + IPV
Diphtheria, Tetanus, Pertussis
DTP+ ActHIB
DTP+ HibTITER
Influenza vaccine, 3Y +
FLU3Y+ PF
Influenza vaccine, 3Y +,
preservative free
FLU6-35 P
FLU6-35 PF
Influenza vaccine, 6-35mo
Influenza vaccine, 6-35mo,
preservative free
Influenza vaccine, high-dose,
seasonal
Influenza, seasonal, intradermal,
preservative free
Influenza vaccine live, intranasal
Influenza virus vaccine, NOS
Hep A Immune Globulin
Novel Influenza-H1N1-09, nasal
Novel Influenza-H1N1-09,
preservative-free
FLU HIDOSE
FLU-ID
FLU-MIST
FLU UNK
GAMMA
H1N109 MST
H1N109 PF
Brand Name
*
DT
Tripedia,Daptacel
Infanrix
TriHIBit
Kinrix
*
*
Tetramune
Fluarix
Fluvirin
Fluzone
FluLaval
Afluria
Fluarix
Fluvirin
Fluzone
FluLaval
Afluria
Fluzone
Fluzone
Manufacturer (Code)
*
Sanofi Pasteur (PMC)
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
*
Sanofi Pasteur (PMC)
Wyeth (WAL)
GlaxoSmithKline (SKB)
Novartis (NOV),
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
CSL Biotherapies (CSL)
GlaxoSmithKline (SKB)
Novartis (NOV),
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
CSL Biotherapies (CSL)
Sanofi Pasteur (PMC)
Sanofi Pasteur (PMC)
Fluzone
Sanofi Pasteur (PMC)
Fluzone Intradermal
Sanofi Pasteur (PMC)
Flumist
*
GamaSTAN
*
*
MedImmune (MED)
*
Talecris (TAL)
MedImmune (MED)
CSL Biotherapies (CSL)
Novartis (NOV)
Sanofi Pasteur (PMC)
CSL Biotherapies (CSL)
Novartis (NOV)
Sanofi Pasteur (PMC)
CSL Biotherapies (CSL)
Novartis (NOV)
Sanofi Pasteur (PMC)
Talecris (TAL)
Nabi (NAB)
Merck (MSD)
GlaxoSmithKline (SKB)
Merck (MSD)
GlaxoSmithKline (SKB)
Merck (MSD)
GlaxoSmithKline (SKB)
Wyeth (WAL)
*
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
H1N109 P
Novel Influenza-H1N1-09
*
H1N109 UNK
Novel Influenza-H1N1-09, all
formulations
*
HBIG
Hep B Immune Globulin
HEP A
Hepatitis A
HEP B
Hepatitis B
HEP B 2-DOSE
HEP A-HEP B
HIB (HBOC)
HIB (UNK)
HIB PRP-T
2 Dose Hepatitis B
Hepatitis A+B
Haemophilus influenzae type b
Unknown Hib
Hib (PRP-T)
HyperHEP B
Nabi-HB
VAQTA
Havrix
Energix-B
Recombivax HB
Recombivax HB
Twinrix
HibTITER
*
ActHIB
Hiberix
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 200
HIB PRPOMP
HIB-HEP
HPV4
HPV2
IPV
JENCEPH
Hib (PRP-OMP)
Hib + Hep B
Human Papillomavirus –
quadrivalent
Human Papillomavirus – bivalent
Polio
Japanese Encephalitis
LYME
MEASLES
MCV4
Lyme
Measles
Meningococcal Conjugate
MPSV4
MMR
MMRV
MR
MUMPS
MUMPS-RUB
OPV
PEDIARIX
PENTACEL
PPSV23
PCV7
PCV13
RABIES IM
Meningococcal Polysaccharide
Mumps,Measles,Rubella
Mumps,Measles,Rubella,Varicella
Measles, Rubella
Mumps
Mumps, Rubella
Oral Polio
DtaP, Hep B, IPV
DtaP,Hib, IPV
23-valent Pneumococcal
polysaccharide
7-valent Pneumococcal conjugate
13-valent Pneumococcol conjugate
Rabies, intramuscular
RIG
RIG-HT
ROTARIX
ROTATEQ
RUBELLA
TD
Rabies Immune Globulin
Rabies Immune Globulin
Rotavirus
Rotavirus
Rubella
Tetanus,Diphtheria
Prevnar
Prevnar
Imovax
RabAvert
HyperRAB
Imogam Rabies-HT
Rotarix
ROTATEQ
Meruvax II
Td
TD DECAVAC
TD TENIVAC
TDAP
TD, preservative free
TD, preservative free
Tetanus, Diptheria,
acellular Pertussis
Typhoid, intramuscular
Typhoid, oral
Varicella
Yellow fever
Varicella Zoster Vaccine
Decavac
Tenivac
Boostrix,
Adacel
Typhim Vi
Vivotif
Varivax
YF-Vax
Zostavax
TYPHOID IM
TYPHOID PO
VZV
YELLOW FEVER
ZOSTER VZV
PedvaxHIB
Comvax
Gardasil
Merck (MSD)
Merck (MSD)
Merck (MSD)
Cervarix
IPOL
JE-VAX
Ixiaro
*
Attenuvax
Menactra
Menveo
Menomune
M-M-R II
ProQuad
*
Mumpsvax
*
*
Pediarix
Pentacel
Pneumovax
GlaxoSmithKline (SKB)
Sanofi Pasteur (PMC)
Sanofi Pasteur (PMC)
Novartis (NOV)
*
Merck (MSD)
Sanofi Pasteur (PMC)
Novartis (NOV)
Sanofi Pasteur (PMC)
Merck (MSD)
Merck (MSD)
*
Merck (MSD)
*
*
GlaxoSmithKline (SKB)
Sanofi Pasteur (PMC)
Merck (MSD)
Wyeth (WAL)
Wyeth (WAL)
Sanofi Pasteur (PMC)
Novartis (NOV)
Talecris (TAL)
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
Merck (MSD)
Merck (MSD)
Massachusetts Biologic
Labs (MBL)
Sanofi Pasteur (PMC)
Sanofi Pasteur (PMC)
GlaxoSmithKline (SKB)
Sanofi Pasteur (PMC)
Sanofi Pasteur (PMC)
Berna (BPC)
Merck (MSD)
Sanofi Pasteur (PMC)
Merck (MSD)
* Product information not available
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 201
APPENDIX G
Selected Resources
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 202
Selected Resources:

CDC Vaccines and Immunizations – http://www.cdc.gov/vaccines/
o Childhood, Adolescent, and Adult Immunization Schedule –
http://www.cdc.gov/vaccines/recs/schedules/default.htm
o Epidemiology and Prevention of Vaccine Preventable Diseases (Pink
Book) –
http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm
o Recommended minimum ages and intervals (Pink Book, Appendix A) –
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/A/age
-interval-table.pdf

Centers for Disease Control and Prevention – http://www.cdc.gov

Advisory Committee on Immunization Practices –
http://www.cdc.gov/vaccines/recs/ACIP/default.htm

American Academy of Pediatrics – http://www.aap.org
Florida Department of Health
Bureau of Immunization – 5/25/2012
User’s Guide to Florida SHOTS – Version 10.3.8
Page 203
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