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Local Health Department Immunization Information
On this page:

  • Immunization Billing Resources
  • Adult Immunization Special Project 2012-13
  • 2013 Public Immunization Provider Conference
  • Oregon  Vaccines for Children (VFC) Program
  • Model Standing Orders
  • MVR Cover Sheet and Instructions
  • PE43 Updated June 2012
  • Public Provider Vaccine Adverse Event Report (VAERS) form
    Send completed report to:
    Oregon Immunization Program
    Oregon Health Authority
    Public Health Division
    PO BOX 14450
    Portland, OR 97293-9929
    Fax: 971-673-0278
    ATTN: Carol Easter
    Do Not E-Mail Report
  • Immunization Rates and Performance Measures
  • 2014 Performance Measures
  • 2010  Immunization Rates and Percent Population Served
  • Vaccine Administration Record - Pediatric and Adult now on one form
    English (pdf)                      Spanish (pdf)
  • Forms Retention Schedule

  • Local Health Department (LHD) Annual Plan

    All Local Health Department immunization programs are required to complete and submit an electronic version of the Immunization Plan Checklist. The next request for this checklist will coincide with the 2014-2015 Annual Plan required for all Local Health Departments.

    Prior immunization triennial plans focused on quality improvement objectives and activities conducted by LHDs, both in-house and in the community. The new format is a checklist intended to simplify annual reporting obligations and allow local programs to do what they do best: provide the community with low and no-cost immunization services. The checklist is designed to document compliance with Program Element 43, which details required Local Health Department (LHD) immunization program services.

    LHD immunization programs must continue to meet immunization performance measures and report on their progress towards:

    • monitoring and providing services to Hepatitis B-exposed infants
    • entering shot records in a timely fashion
    • correctly coding patient eligibility in ALERT IIS
    The new checklist has a section to document your efforts.

    LHDs must submit an electronic version of the new annual plan checklist in December 2013. The specific due date is to be determined, and will coincide with the due date of the LDH 2014-2015 Annual Plan.
    The checklist will be forwarded to your Oregon Immunization Program (OIP) health educator for review and approval.

    If there are questions about the checklist or where to locate the information you will need to complete it, please contact your OIP health educator (971-673-0300 or via e-mail).


    317 policy changes (Oct. 1, 2012)

    Additional Resources