COVID-19 Vaccines Available for the ASN Program

Adult Safety Net (ASN) Providers, 

As of September 11, 2023, the FDA no longer authorizes the bivalent COVID-19 vaccine administration. Ordering of the bivalent COVID-19 vaccines have ended.

Bivalent COVID-19 vaccines administered from September 12, 2023, and onward are considered administration errors. If an administration error occurred please follow the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines, for guidance.

Since June, DSHS has been preparing for a new monovalent COVID-19 Vaccine recommended by the FDA. On September 12, 2023, the new COVID-19 monovalent vaccines were approved by the ACIP. These vaccines were available to order in the Vaccine Allocation and Ordering System (VAOS) beginning Tuesday, September 18, 2023.

TVFC program providers are required to offer all ACIP recommended vaccines. The following vaccines have been added to the ASN program formulary:

Manufacturer	NDC	Brand, if available	Description	Age
Moderna	80777-0102-95	Spikevax (COVID-19 Vaccine, mRNA) 2023-2024 Formula 0.5 mL	single-dose vial, 10 pack	19 years and older
Pfizer	00069-2362-10	Comirnaty 30mcg	single-dose vial, 10 pack	19 years and older

ASN Program Policy Overview

Patient Eligibility:

The COVID-19 vaccine will be available to uninsured and underinsured individuals who are 19 years of age and older.

• Uninsured is defined as a person who does not have Medicare, Medicaid, or private insurance.
• Underinsured is defined as a person who has health insurance, but the insurance does not cover vaccine costs (i.e., COVID-19 vaccines); a person whose medical insurance does not provide first-dollar coverage (i.e., copay-free coverage) of the COVID-19 vaccinations.
  • First-dollar coverage is defined as health care services, such as COVID-19 vaccinations, covered pre-deductible and without cost-sharing.

Eligibility screening records must be kept on file with the patient’s record for a minimum of five years after the last date of service to the patient and must be easily retrievable.

Administration Fee:

ASN providers are prohibited from charging an administration fee for the COVID-19 vaccine under the ASN program.

Patient Eligibility Screening:

ASN providers must screen patients during each immunization encounter using the updated ASN Adult Eligibility Screening Form and check that the COVID-19 vaccine is administered only to eligible populations in the ASN program. COVID-19 vaccine eligibility must be recorded separately from ASN vaccine eligibility, and ASN vaccines other than the COVID-19 vaccine must not be administered to underinsured adults. Documentation of eligibility screening must include the following:

• Date of screening
• Patient’s name
• Patient’s date of birth
• Clinic name and
• Eligibility status for each visit

Site visits:

ASN program providers must actively engage in compliance site visits, which may include unannounced visits, and partake in other educational opportunities as recommended by DSHS to meet program requirements.

ImmTrac2 Reporting:

It is imperative that providers report all ASN vaccine administration data to the Texas Immunization Registry, ImmTrac2.

When reporting to ImmTrac2, providers are required to document patient eligibility and report vaccine administration data, as outlined in the provider agreement.

Reporting and Waste of bivalent COVID-19 Vaccine:

As the COVID-19 vaccines previously offered under the COVID-19 Vaccine Program are no longer available for ordering, it is essential for providers to update their self-reported inventory in VAOS to reflect a quantity of zero. Providers who maintain a self-reported inventory of these bivalent COVID-19 vaccines after their authorization has ceased may expect follow-up communication from DSHS to verify that the remaining inventory has been appropriately discarded.

• For instructions on reporting waste, review the COVID-19 Vaccine Waste
• For disposal guidance, review the Vaccine Disposal Guidelines

Additionally, the following reports must be submitted in VAOS by the seventh of each month to be able to order ASN vaccine.

Required:

• Temperature logs
• Doses administered
• Physical inventory

If applicable:

• Vaccine loss
• Receipt of vaccine shipments
• Vaccine transfers

Monthly reporting in VAOS is required even if a provider does not order vaccine during the reporting month. Ordering holds will be automatically lifted in VAOS once the required reports have been submitted.

VAOS will calculate MSLs automatically based on patient population then transitions to usage-based calculations after two months when the providers establish ordering history.

Please refer to the attached supplemental CDC Provider Letter – Discontinuation of CDC COVID-19 Vaccination Program for further information.

For any further questions regarding the COVID-19 vaccines, contact your Responsible Entity (RE) or email asninfo@dshs.texas.gov.

Thank you for your continued participation in the ASN program.