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The following is an example of the Immunization Administration Report.

 

Immunization Administration Report

 

 

The report displays the following information on each entry:

 

Row One

 

•Patient Name: Displays the patient name.

 

•Visit Number: Displays the patient visit number.

 

•Profile Number: Displays the patient profile number.

 

•DOB: Displays the patient's date of birth.

 

 

Row Two

 

•Immunization: Displays the immunization description.

 

•Admin Date/Time: Displays the immunization administration date and time.

 

 

Row Three

 

•NDC: Displays the immunization NDC number.

 

•Lot Number: Displays the immunization lot number.

 

•Expiration Date: Displays the immunization expiration date.

 

 

Row Four

 

•Manufacturer: Displays the manufacturer of the immunization.

 

•Publicly Supplied: Displays an N if the immunization was not publicly supplied and a Y if the immunization was publicly supplied.

 

•VFC Status: Displays the vaccine for children eligibility status.

 

 

Row Five

 

•Dose Number: Displays the immunization dose information.

 

•Vaccine Series Complete: Displays Yes, No, or UNK if it unknown.