Barcodes on Vaccine Information Statements

A: The purpose of the barcode on the bottom of the VIS is to provide an opportunity to electronically capture the VIS document type (e.g. influenza, MMR) and the edition date of the VIS, as required by the National Childhood Vaccine Injury Act (NCVIA). Providers will have the option to scan the VIS barcode instead of manually recording this information. Use of the barcode will not be required.

A: Scanning the VIS barcode may reduce the time needed to record the VIS information and, more importantly, also reduce the chance of errors in transcribing this information. Additionally, in the future electronic medical records (EMR) vendors may support reading the VIS barcode into the EMR system and validate it against the vaccine selected for, or administered to the patient.

A: The VIS barcode contains the VIS vaccine type (e.g. influenza, measles/mumps/rubella) and the VIS edition date.

A: You can continue to record the VIS document type and edition date manually, as you do now. Once you obtain a two-dimensional (2D) barcode scanner and your computer system is able to accept the data from the VIS barcode, you will be able to scan the 2D barcode to enter the name and edition date into the system.

A: There is no relationship between the VIS barcode and 2D barcodes on vaccine vials and syringes. Both barcodes are Data Matrix barcodes, but they contain different information. Vaccine 2D barcodes contain a global trade item number (GTIN) to identify the product (and also manufacturer), and the vaccine's expiration date and lot number.

A: There are two primary types of barcodes, linear and 2D. Linear and 2D barcodes serve the same purpose, however 2D barcodes can store more information in less area.

A: No. Scanning the VIS barcode will typically only benefit immunizers who use some form of an electronic record-keeping system.

A: If the barcode information does not populate the electronic medical record (EMR), enter the date the VIS was presented, the vaccine type, and the VIS edition date manually (without the scanner). Ensure that your barcode scanner supports reading GS1 2D DataMatrix barcodes, and that your scanner is configured to work with your EMR correctly. If you believe the error is with your barcode scanner, contact the scanner manufacturer or retailer. If you believe the error is with your EMR software, contact your technical support representative.

A: No, using a photocopy of a VIS should not be an issue. However, we recommend you have one master copy, and make copies only from that master. When you copy from a copy, you increase the chance that the barcode will become too blurry for a scanner to read.

A: No, using colored paper should not be an issue. Barcode scanners have the most difficulty reading barcodes on darker papers, such as dark greens and blues. If you have trouble scanning a VIS barcode on a dark paper, try using a lighter color.

A: No, using laminated copies should not be an issue. Barcode scanners can capture the barcode on VISs that are laminated or stored in plastic sleeves.

A: No. Because the information is the same on the English and non-English versions of the VIS, the 2D barcodes will also be the same, representing the same document type and edition date. Law requires that the VIS with the current publication date be given to the patient/parent/guardian; and that the date of that VIS be recorded in the medical record. Translations for some the VIS documents are available on the Immunization Action Coalition (IAC) web-site. “Unfortunately, IAC is not always able to obtain translations as updates are issued.”  In those situations, the current English language edition of the VIS should be given, and can be supplemented any way the provider chooses, including using an older translation of the VIS. For HL7 messaging the current English language VIS date should be captured and included in the message. There is no requirement to record any information about the supplements used. The barcodes on the English language VIS and the corresponding translated VIS documents (with same publication date) are identical. 

A: No, scanning the VIS barcode instead of manually recording the information is optional.

A: Some costs will be incurred to adopt this technology. For example, 2D barcode scanners typically start around $300.00. Your EMR will likely require an adjustment to process the VIS barcode information.

A: No.

A: Some mobile device cameras are capable of scanning a GS1 2D DataMatrix barcode. Your mobile device must have an application to read the barcode and to process the information embedded in the VIS 2D barcode. Unless the application has been designed to process 2D VIS barcode data, the resulting scan will be presented as a data string as defined in the VIS Lookup Table, VIS Fully-encoded text string.

A: If your application has the ability to scan a GS1 2D DataMatrix barcode and it is still not able to scan the VIS 2D barcode, try a different scanning application to see if it corrects the problem.

A: No. Your software system should be able to translate those numbers into the VIS document type and edition date. If you do not see a text description of the VIS document type, contact your software vendor.

A: It depends. Some barcode scanners support reading 2D barcodes as well as linear barcodes. Others, usually older models, can only read linear barcodes. In the future if you wish to read the 2D barcode, you may need to purchase a new barcode scanner. See What is the relationship between the VIS barcode and 2D barcodes on vaccine vials and syringes? for more information.

A: Typically for accounting purposes, 2D barcode scanners are expected to work for five years.

A: Your electronic medical record vendor may need to add fields to the EMR to contain the VIS document type and edition date. In addition, they will need to access a "lookup table" provided by CDC, to translate the numerical data stored in the barcode and determine the VIS document type.

A: A barcode scanner capable of reading a GS1 2D DataMatrix barcode. Most 2D barcode scanners read multiple types of 2D barcodes. Make certain the reader you select can read GS1 2D DataMatrix type 2D barcodes. GS1 2D DataMatrix barcodes are the standard 2D barcode data carrier applied on VIS statements and vaccine products. The CDC does not endorse a particular scanner manufacturer or model. The American Academy of Pediatrics has a guide on choosing a barcode scanner. See the section Choosing a Barcode Scanner in the Clinician Guidance document on the AAP website.

A: You can use the same scanner. However, it will not populate your EMR or IIS until they are programmed to accept the data. See What will my electronic medical record (EMR) vendor need to do so I can scan the barcode information into my system?

A: Just like the other VISs, the Multiple Vaccine VIS will have its own barcode containing the VIS document type and edition date. Scan the Multiple Vaccine VIS separately for each vaccine for which it was used.

NOTE: For the purpose of HL7 messaging, the Multiple Vaccine VIS cannot be recorded by recording vaccine type.  See, Should this information be included in the Hl7 messages or report to the IIS?

A: There are two fields contained in the 2D barcode on the VIS. The first field is a code that identifies the VIS document type (MMR, seasonal influenza, anthrax, etc.). The second field is the edition date of the VIS.

The data structure for the code is a GS1 Global Document Type Identifier (GDTI). The GDTI Application Identifier is "253" and consists of 13 digits followed by an 8 digit serial component (which includes the publication date). There is a "lookup table," which lists the VIS document type, its associated code, and related information. The data structure for the 8 digit serial component consists of the digits "11" followed by the edition date in the YYMMDD format. We expect that EMR vendors can translate the GDTI to the VIS document type and edition date to an easily understood date format.

A: Immunizers will need the barcode data (i.e. GDTI with the VIS edition date) translated into unambiguous text description so that when displayed, the clinician can read which document was recorded.

A: Presently, providers are not required to record VIS information electronically, nor are there plans to require them to do so.

A: There is no expectation that the addition of a barcode to the VIS will change reporting requirements to awardee IISs. However, the Meaningful Use conformance criteria include the transmission of VIS related information and the HL7 implementation guide requires that information about the VIS be included in HL7 messages for each vaccine that is recorded as administered. See Should this information be included in the HL7 messages or reported to the IIS?

A: The CDC has no plans to subsidize or otherwise provide incentives to EMR developers for incorporating the new VIS data coding.

A: The Meaningful Use conformance criteria include the transmission of VIS related information and the HL7 implementation guide requires that information about the VIS be included in HL7 messages for each vaccine that is recorded as administered (as opposed to historical). The HL7 implementation guide has instructions for transmitting the VIS information in the 2D barcode and includes the LOINC concepts for "Date Vaccine Information Statement Presented" and "Document type". The "Document type" contains a code for both the type of VIS and the corresponding publication date.

Conversely, if a provider opts to not scan the VIS barcode the information can be collected and transmitted in an HL7 messaging using the following LOINC concepts: "Date Vaccine Information Statement Presented", "Vaccine type", and "Date Vaccine Information Statement Published". Detailed message specifications are included in the HL7 implementation guide.

NOTE: The multiple vaccine VIS can only be reported in an HL7 message using the 2D barcode method.

A: Yes. Please see the GS1 website for more information regarding the Data Matrix barcode and the data elements for GDTI. A short summary [1 page] can also be found on the GS1 website. See What new data does our application need to accommodate?

A: No. The CDC does not require new reporting from the VIS barcodes which contain information on the VIS document type and edition date. The reporting process by awardees and immunizers should remain the same.

A: The VIS barcoded information does not contain any data that is not currently on the VIS, and there is no requirement that immunizers supply VIS data to the awardees. However, the Meaningful Use conformance criteria include the transmission of VIS related information and the HL7 implementation guide requires that information about the VIS be included in HL7 messages for each vaccine that is recorded as administered. The HL7 implementation guide contains information about transmitting VIS data. See Should this information be included in the HL7 messages or reported to the IIS?

A: Those costs vary by awardee, depending on the systems already in place. If the awardee does not require the transmission of VIS data items, then there are no additional costs. However, if the awardee chooses to collect this information, then the costs will vary, depending on the systems already in place, the software used, and the extent of software modification required.

A: No. There is not a requirement to scan the VIS information. Providers may continue entering this information manually as they do now.

A: It depends. The IIS will need to ability to accept the fully-encoded bar code string and record the document type, the version date and presentation date. Systems may need to be updated to do this.