CDC | NCIRD Technical Implementation Guide: Vaccine Administration 1

TECHNICAL IMPLEMENTATION GUIDE: 

VACCINE ADMINISTRATION

Vaccine 2D Barcode Scanning 

Implementation Toolkit 

National Center for Immunization and Respiratory Diseases (NCIRD)

Centers for Disease Control and Prevention (CDC)
Con

Table of 

tents

1 Introduction 

Plan and Prepare

3 Overview of Technology Components

4 Scanning Devices: Procurement

5 Scanning Devices: Configuration

6 Scanning Devices: Installation

7 EMR: Functionality for Vaccine Administration

8 Training

Go-Live and Maintain

10 Technology Checklist for Go-Live

11 Maintenance

12 Troubleshooting Tips

13 FAQs

Appendix

15 Acronyms

16 Sample Process Flow for Vaccine Administration

17 Questions for Project Lead

18 EMR Capability Guide

19 UoU Barcode Specifications

20 VIS Barcode Specifications 

21 Mapping Table for Vaccine Administration 

22 Immunization Information Systems

23 Resources

Indicates that the page includes a checklist or activity.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 1

Introduction

The Technical Implementation Guide: Vaccine Administration is intended for information 

technology (IT) personnel and/or electronic medical record (EMR) personnel who are 

assisting with the implementation of vaccine two-dimensional (2D) barcode scanning for 

vaccine administration in ambulatory clinics, health care facilities, and health systems. 

This Guide provides recommendations on technology needs and training drawn from pilot 

projects performed by CDC from 2011 to 2017 and additional information from the field.

It is important to note that a 2D barcode must be present on the vaccine’s 

primary packaging (e.g., the unit of use (UoU), vial, or syringe) to scan for vaccine 

administration. While 2D barcodes are mandatory on the vaccine secondary 

packaging, or unit of sale (UoS), the secondary packaging barcode is not needed while 

scanning for administration. Manufacturers are not required to add UoU barcodes to 

products, but an increasing number have added barcodes to the UoU packaging for 

the purpose of scanning upon administration.

Using This Guide

This Guide is divided into the following chronological phases. The first two and the last two phases 

have been paired in this document because the tasks in the pairings are closely related. 

1

Plan & Prepare

2 3

Go-Live & Maintain

4

For more information on...

Implementing vaccine 2D barcode scanning for inventory, refer to Technical 

Implementation Guide: Vaccine Inventory. 

Implementing vaccine 2D barcode scanning for data entry to the 

Immunization Information System (IIS), jump to page 22.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 2

Plan and Prepare 

Overview of Technology Components | 3

Scanning Devices: Procurement | 4

Scanning Devices: Configuration| 5

Scanning Devices: Installation| 6

EMR: Functionality for Vaccine Administration | 7

Training | 8
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 3

EMR System

The EMR, or an 

approved third-party 

medical record 

application, must 

have the capability 

to capture and parse 

alldata available in 

the scanned barcode 

(National Drug Code 

(NDC), lot number, 

expiration date).

3

Plan and Prepare

Overview of Technology Components 

Scanners cannot work independently—they must communicate with computing devices to transmit 

data to an EMR when a 2D barcode is scanned on the UoU packaging. The scanners, computers, 

and EMRs must be properly configured for smooth implementation and seamless integration of 2D 

barcode scanning into the vaccine administration workflow. 

Technology Considerations for Workflow Decisions 

The Project Lead, IT personnel, and/or EMR personnel should discuss the feasibility of scanner 

installation in the desired location(s) identified by the health care providers and determine if 

additional equipment is needed to integrate 2D barcode scanning into the workflow. Hardware 

purchasing and installation decisions directly affect workflow, so it is important that all personnel 

collaborate during this stage.

Computing 

Devices

Computers, tablets, 

and/or mobile 

workstations that 

can access and edit 

the EMR must be 

prepared to receive 

information from 

the scanners, either 

through a wired or 

wireless scanner.

2 2D Barcode 

Scanning Devices

Scanners or mobile 

applications with 2D 

barcode scanning 

capabilities must 

be available at the 

appropriate locations 

and should be 

configured to scan the 

appropriate barcode. 

1

Suitable Scanner 

Locations 

(e.g., central prep 

station, patient rooms, 

mobile stations)

Number of 

Scanners

(e.g., number of 

primary and backup 

scanners)

Types of 

Scanners

(e.g., wired, 

wireless)

Additional 

Equipment

(e.g., mobile workstations, 

computers, stands, 

mobile devices)

A sample process flow and suggested questions for the Project Lead can 

be found in the appendix.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 4

Scanning Devices: Procurement

The revised vaccine administration workflow should determine the number and type of scanners 

needed in the clinic. There are several scanners in the market that are suitable for use in a clinic 

setting. Below are some considerations to review before purchasing scanners. If implementing in a 

health system, procurement decisions may be made centrally.

Plan and Prepare

Ensure that the chosen scanner is compatible with both your hardware 

(e.g., computers, workstations) and software (e.g., EMR, IIS).

• Reminder: 2D barcodes require imager barcode scanners and cannot

be read by 1D laser scanners.

Determine the number of wired or wireless scanners needed. 

• Wired scanners cost ~$135 to $300 each, with wireless options from

~$260 to $800 (as of May 2020).

• Wired scanners can be moved from one computer to another if

needed. Wireless scanners may rely on Bluetooth connections, which

can make switching computers time-consuming and cumbersome.

• If installing a Bluetooth scanner, confirm that computers have

Bluetooth capability and consider any additional security

requirements.

• Confirm that the wire length of wired scanners supports the

previously selected scanner location(s).

Account for stands or wall mounts, if needed. Note that the preferences of 

the health care providers should be considered while determining location 

and set up of stands and wall mounts.

If your clinic already uses a scanner or mobile device for another purpose 

and wishes to use this device for vaccine 2D barcode scanning, confirm that 

the device: 

• Has 2D barcode scanning capabilities.

• Is placed in the proper location or can be relocated to the proper location.

• Can be configured to the EMR/IIS using the configuration barcode.

The American Academy of Pediatrics (AAP) outlines other considerations

for choosing a scanner.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 5

Plan and Prepare

Scanning Devices: Configuration

Configuration barcodes provide instructions to 

the scanner for how to parse the data contained 

in the 2D barcode. The scanner will follow those 

instructions until configured otherwise. For 

example, if the UoU configuration barcode is 

scanned, that scanner will be prepared to receive 

and parse UoU barcodes into the appropriate fields 

of the patient record in the EMR until a different configuration barcode is scanned. Configuration 

barcodes may also be rescanned to “reset” the scanner if any issues arise with configuration to the 

EMR. Note that configuration barcodes will be different from the setup barcodes provided by the 

scanner manufacturer, which may also need to be rescanned if a reset is needed.

Tip from the field:

If your EMR does not provide configuration barcodes or 

TA for configuring your scanner, consider reaching out to 

other health care systems that use your EMR to discuss their 

existing configuration barcodes, which may be able to be 

modified to fit your needs. 

Configuration barcodes will be unique for the type of barcode and for your EMR. For example, a 

Vaccine Information Statement (VIS) barcode contains different data than the UoU barcode and 

will therefore need to populate different fields in the EMR (see VIS Barcode Specifications in the 

appendix for more information). However, once created, the same UoU and VIS configuration 

barcodes may be able to accommodate all scanners within the health facility or across health system 

locations (if applicable) using the same EMR. 

If your EMR does not provide configuration technical assistance (TA), you may 

need to create a configuration barcode. To create a configuration barcode, the 

characters in the barcode’s data string will need to be mapped to the 

corresponding data fields in the EMR.

Refer to pages 19 and 20 for the data strings of the UoU and VIS barcodes 

(respectively) and a representation of the EMR fields that should receive 

the scanned and imported barcode data.

Some EMRs may provide configuration 

assistance and some scanner 

manufacturers may provide 

information on configuration. Reach 

out directly to confirm available 

services and information.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 6

Plan and Prepare

Scanning Devices: Installation 

After procurement, scanners must be connected to the computing device, configured to the EMR, 

and tested. To configure the scanner to the EMR, a configuration barcode should be obtained or 

created for each type of barcode (UoU for administration, and possibly VIS for VIS documentation) 

that will be scanned. Installation, configuration, and testing instructions are listed below. Note that 

the order of these steps may vary at your organization or some steps may be bypassed depending 

on configuration services provided by your EMR.

INSTALL scanner

1. Use a USB cable to connect wired scanners to a computing device. Wireless scanners 

(or mobile devices) can be connected to a computing device through Bluetooth or other 

protocol in the scanner manufacturer’s user manual. 

2. Connect the power adaptor to a power source, if needed. 

3. Power on the scanner and confirm that the scanner is functional.

SCAN configuration barcode 

4. Log in to the EMR and navigate to the relevant page and field. 

5. Follow the steps in the scanning manual (provided by your scanner manufacturer)

to properly set up your scanner and to ensure connectivity.

6. Scan configuration barcode to instruct the scanner how to parse the data into the 

EMR fields.

TEST scanner on sample

7. Scan a sample UoU found on a vaccine product or VIS barcode found on a VIS. You may wish 

to use a nonproduction environment in the EMR while scanning a sample barcode.

8. Confirm that the system properly reads the data elements in the 2D barcode on the 

UoU or VIS. 

9. Confirm that the system accesses the appropriate mapping tables in the back end by 

confirming the accuracy of the data in the populated fields.

10. Repeat steps 4 through 9 for each type of barcode (UoU and VIS). Remember that when a 

configuration barcode is scanned, the EMR will follow that configuration until it is 

given alternate instructions through a different configuration barcode. 

Key for success: Consider storing copies of all configuration barcodes by each 

scanning station. The barcodes are helpful to have available if there are issues with 

configuration and the scanner needs to be “reset.”

For scanner troubleshooting tips, see page 12.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 7

Plan and Prepare

EMR: Functionality for Vaccine Administration 

Implementation of 2D barcode scanning for vaccine administration requires an EMR capable of 

capturing and processing the barcode data. Listed below are required and recommended EMR 

functionalities for successful 2D barcode scanning during vaccine administration. Items are listed 

chronologically within each grouping. 

Monitor and establish connection with the barcode scanner. 

Receive and process incoming 2D barcode data from the UoU.

Validate that the barcode is applicable to the EMR module.

Read the data elements present in the 2D barcode string.

Display the scanned data elements and other key data in the respective fields.

Allow users to verify scanned data and manually enter additional data that cannot be 

automatically imported.

Allow users to manually edit fields after data has been imported.

Provide separate set of VIS fields to capture information for each VIS given (if applicable).

Notify users when a barcode is not identifiable.

Minimum Required Functionalities

Use the scanned data to look up other key data about the vaccine or VIS (e.g., manufacturer and 

other product information) in the mapping table. 

If applicable, validate barcode data against the product identifier, expiration date, and lot number 

stored in the inventory for the same vaccine.

Warn users in the event of missing data or discrepancy.

Use all three data elements to access stored inventory data for additional data such as 

manufacturer and other product information.

Save original scanned values (if providing an option to modify them).

Alert users if the barcode indicates that the vaccine is expired.

Validate the scanned vaccine against the patient medical record for accuracy.

If administration module is connected to inventory, alert users if vaccine is not present in 

inventory or is recalled.

Additional Recommended Functionalities

Third-Party Apps

If your EMR does not have 

2D barcode scanning capability, 

reach out to your vendor 

to discuss compatible third-party 

applications with 

scanning functionality. 

For more information on...

Required and recommended EMR functionalities, refer to the EMR/IIS 2D Barcode 

Functional Capabilities Guide.

Questions to ask your EMR vendor when determining compatibility and capabilities, refer to 

the EMR capability guide in the appendix.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 8

Plan and Prepare

Training 

Train IT and EMR Personnel

All IT and EMR personnel should be properly trained to use 2D barcode scanners and equipped to 

support the staff that will be scanning 2D barcodes on vaccines. A “train-the-trainers” training may be 

helpful for health systems implementing scanning across facilities to ensure that IT and EMR personnel 

are prepared to support the health care providers and other personnel who may use the 2D barcode 

scanners. 

Train Health Care Providers

Additionally, IT and EMR personnel may be able to support the overarching training conducted for 

staff prior to implementation or go-live. The IT and EMR personnel should coordinate with the Project 

Lead to confirm the training plan and their role in delivering the technology-related aspect of training.

At a minimum, it is recommended that the training for scanner use covers the follow technologyrelated topics:

Barcode data and the fields that are expected to populate upon scanning.

Instructions for scanner use.

Explanation of setup barcodes provided by the scanner manufacturer and 

how to use them.

Explanation of configuration barcodes and how to use them.

Scanner maintenance.

Basic troubleshooting tips: 

• Confirm that scanner is plugged in to the appropriate outlets if needed.

• Clean lens of scanner.

• Rescan configuration barcode.

• Restart scanning screen in software to restart scanning process.

Procedures for escalating issues (help desk contact information, ticket 

creation, etc.).

Instructions for scanning to IIS, if applicable.

Key for success: Hands-on experience of scanning in a training or 

nonproduction environment in the EMR can enhance training for health care 

providers and other staff who may use the 2D scanners and may reduce the 

number of challenges and questions that arise after go-live. 

For more guidance on training staff, refer to the training materials.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 9

Go-Live and Maintain

Technology Checklist for Go-Live | 10

Maintenance | 11

Troubleshooting Tips | 12

FAQs | 13
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 10

Go-Live and Maintain

Technology Checklist for Go-Live

Complete the following checklist for go-live to ensure that everything is functioning properly and 

ready for use. You may wish to add additional items to this checklist as you prepare. 

Have all scanners and other hardware been installed, properly set up, and 

tested for functionality?

Have all scanners been plugged in and set up in desired locations?

Have all scanners been configured using the appropriate (manufacturer, UoU, 

VIS, and/or IIS) configuration barcode?

Has a sample UoU or VIS barcode been scanned by each scanner to confirm 

proper configuration with the EMR?

Have the appropriate configuration barcodes been stationed by each scanner 

or workstation for troubleshooting?

If applicable, is a configuration barcode available for IIS configuration? 

Have scanning instructions and/or troubleshooting tips been made available 

by each scanning station?

Has the mapping table been updated and confirmed to be accurate? 

Have monitoring and evaluation methods been put in place (if applicable)? 

Key for success: Confirm system administrators and EMR contacts are aware 

of implementation plans and the go-live date, and confirm that the necessary 

personnel are available for immediate questions and technical assistance. 
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 11

Go-Live and Maintain

Maintenance 

Maintaining functional technology is critical for implementation of 2D barcode scanning and 

sustaining high scanning rates. While the bulk of the work is done in the Plan and Prepare phase, 

maintenance and ongoing tasks will be required after 2D barcode scanning is implemented to 

continue supporting the practice.

Mapping Table| The mapping table will only be useful if the data is accurate. It will need to be 

regularly validated and maintained.

Technology | If any of the technology components—the scanning device, computing device, or 

EMR—changes or malfunctions, the scanning process will break down.

Confirm scanners are functional. They may need to be reprogrammed or replaced after 

significant use.

Monitor EMR updates. Review the release notes for updates that might impact scanning. 

For example, an EMR update may require a new configuration barcode.

Be prepared to adjust technology and hardware according to changes in workflow. 

Identifying the best workflow can be an iterative process, so anticipate changes as 2D barcode 

scanning is implemented. 

Training | Continuous and ad hoc training on technology and workflow expectations can improve 

staff performance. Below are a few instances where continued or ad hoc training may be required:

The scanning workflow is revised.

A new employee is onboarded.

There is a reduction in scanning adoption and practices.

When a vaccine is restocked: If a new vaccine is ordered:

Confirm that the UoU data elements in 

the mapping table are entered.

Validate mapping table data to confirm 

that no changes have been made (e.g., 

quantity, dose, route of administration) 

since the last shipment.

Add data to the mapping table for the 

new vaccine. Some known information 

may be entered prior to receipt of the 

shipment (i.e., vaccine name).

Scan the UoU barcodes and validate 

the data in the mapping table.

Confirm that all parties are aware of their responsibilities, including 

the cadence for monitoring and maintenance.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 12

Troubleshooting Tips

ISSUE RESOLUTION

The scanner is not 

working at all.

• Verify that the scanner is properly connected to the computing device. 

 Confirm wired scanners are firmly plugged into the computer.

 Confirm that the wireless scanner’s Bluetooth is not disconnected from 

the computing device. If the scanner has a battery, confirm that the 

battery is sufficiently charged. 

The scanner 

does not scan 

consistently.

• Verify that a red beam of light is visible when a vial is placed underneath the lens 

(in mounted mode). If a red beam is not visible, verify that the scanner is securely 

attached to the computer.

• Confirm that the scanner lens is clean. If you are not sure, clean the scanner lens 

with an alcohol prep pad or a moist clean cloth and then dry with a clean cloth. 

Water droplets severely degrade scanning efficiency.

• Check the scanner lens to see if it is scratched. If so, it will need to be serviced/

replaced. Please call or email the scanner manufacturer or call the number on the 

base of your scanner.

• Try to scan the barcode with another scanner. If successful, then the problem is 

with the first scanner and it should be serviced. Try resetting the scanner to factory 

settings, scanning the setup barcodes from the manufacturer, and rescanning the 

configuration barcode. 

Sometimes, the 

scanner has 

trouble reading 

barcodes.

• Vaccine manufacturers have tried to address readability of vaccine barcodes in 

terms of barcode label quality. However, if you still have trouble reading certain 

barcodes please report to CDC at iissb2dbarcode@cdc.gov, after escalating 

appropriately within your organization. CDC reguarly works with vaccine 

manufacturers to ensure all packaging meets regulatory requirements and 

usability standards.

• If you need to reconfigure your scanner to a different system (EMR, inventory 

management system, and/or IIS) and have trouble reading the scanner 

configuration barcodes provided to you, repeated copying might have 

degraded the barcode quality. Try printing a fresh copy from the electronic 

copy to reinstate optimal quality of the barcodes.

The wrong 

fields are being 

populated with 

the barcode data.

• Confirm the scanner is properly configured by rescanning the scanner 

manufacturer’s standard setup barcode and your organization’s configuration 

barcode. 

• Confirm the configuration barcode is correct (e.g., confirm the UoU configuration 

barcode is scanned prior to scanning the UoU barcode on the vaccine). 

• Encourage quality assurance checks and allow for manual entry to adjust 

if data parsing is problematic, due to situations such as the lot number 

beginning with the same number as the GS1 application identifier.

The mapping 

table is not 

populating the 

expected fields.

• Confirm that the data in the mapping table are up to date. CDC’s NDC Crosswalk 

tables may be useful resources when updating mapping tables, though they are 

not comprehensive and additional data sources may be needed. 

Go-Live and Maintain
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 13

FAQs

QUESTION ANSWER

Will the scanner be 

damaged if it gets 

wet?

The sealed casing of your scanner protects it from minimal amounts of 

moisture. However, it should not be sprayed or immersed in liquid.

What are the software 

requirements and 

how does the system 

actually work?

No additional software is required, nor is there a “system” that is being 

added to yours. The scanner works in place of a keyboard. The user 

needs only to put the cursor on the field before scanning. The scanner 

is configured to read the 2D barcode from the vial or packaging and 

populate the lot number and expiration date fields into an EMR or IIS 

system.

Will the scanner be 

configured for both 

my IIS and EMR?

Yes, as long as the EMR and IIS have the data fields to capture lot 

number and expiration date, the scanner should work with both 

systems. In some EMR and IIS systems, the lot number field is a 

dropdown menu and the lot number is appended by other fields. For 

example, a lot number, such as 12345Y, may display with other fields: 

12345Y|MCK|12302022. In such cases, scanning the 2D barcodes will 

not populate the right data fields and cannot be used.

Will the scanner be 

damaged if dropped 

on the floor?

The scanners are expected to survive a free fall of six feet onto a hard 

concrete floor. However, we encourage you to position it away from 

workplace settings that could damage its internal parts.

Can I detach the 

scanner any time or do 

I need to do something 

special first, such as a 

safe stop?

While it is advisable to “safe eject” attached devices, the scanners 

have not been shown to be adversely impacted if unplugged without 

doing so. However, please close out the EMR/IIS software menu if 

it is actively accessing the scanner to prevent potential data loss or 

interruption of workflow.

Go-Live and Maintain
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 14

Appendix

Acronyms | 15

Sample Process Flow for Vaccine Administration | 16

Questions for Project Lead | 17

EMR Capability Guide | 18

UoU Barcode Specifications | 19

VIS Barcode Specifications | 20

Mapping Tables for Vaccine Administration | 21

Immunization Information System | 22

Resources | 23
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 15

Acronyms

Acronym Description

2D Two-dimensional 

AAP American Academy of Pediatrics

EMR Electronic medical record

GDTI Global Document Type Identifier

GTIN Global Trade Identification Number

IIS Immunization Information System

IT Information technology 

NDC National Drug Code

TA Technical assistance 

UoS Unit of sale

UoU Unit of use

VIS Vaccine Information Statement 

Appendix
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 16

Sample Process Flow for Vaccine Administration

Outlined below is the sample process for 2D barcode scanning in a facility that has implemented 

scanning for administration.

The sample process flow assumes that the EMR has a mapping table that can populate EMR fields, the 

EMR pushes data to the IIS, and the VIS is scanned. This process flow is a sample and may be adapted 

Appendix

to fit your organization’s needs if helpful for implementation.

For more details on workflow, refer to the 

Workflow Determination Tool.

Physician orders vaccine

Health care personnel collects 

ordered vaccine 

VIS scanned

Vaccine administration record saved

Data submitted directly to IIS

Health care personnel prepares vaccine

This is an optional 

step depending on 

requirements of your EMR. 

See page 20 for details. 

If your IIS does not accept 

data directly from your 

EMR, see page 22. 

EMR record populated with 

UoU information 

Additional fields may be 

populated by doctor’s 

order or from mapping 

table when UoU is scanned.

Vaccine UoU barcode

scanned for administration

UoU data can also be 

manually entered if 

needed (e.g., product not 

2D barcoded).
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 17

After discussing with the Project Lead, refer to page 4 for considerations to keep in mind while 

purchasing scanners and other equipment.

Appendix

Where will scanners need to be installed? 

How many scanners are needed at each location?

Are computers already set up near the desired scanner locations?

Can any computers be relocated? 

How many additional computers may be needed?

Are mobile workstations or devices an option?

Are wired or wireless scanners preferred in each location? 

If a wire is needed, how long should the wire be?

If wireless, do any security issues need to be addressed? 

Is there enough space to install the scanner, or is rearranging needed?

Is a wall mount or stand needed?

Will any scanners be used with mobile stations?

Will the scanners be used with one or more processes (e.g., administration, 

inventory, IIS, VIS)? 
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 18

Appendix

EMR Capability Guide

2D barcode scanning can play a role in recording vaccine administration and Vaccine Information 

Statements (VIS). Both use cases requires unique functionalities from your EMR. Below are some sample 

questions you can ask your EMR vendor to help determine your 2D barcode scanning capability.

Task Questions for EMR Vendor

Vaccine 

administration

• Does the EMR have 2D vaccine barcode scanning capability in its 

current use? 

 If not, is scanning capability available in a different or 

upgraded package?

 If not, is there a third-party application that could be used 

for this purpose? 

• Does the EMR recommend certain 2D barcode scanners or 

require certain scanner specifications? 

• If inventory is managed through the EMR and linked to the 

vaccine administration module, is it set up so that it will create an 

alert if the vaccine is any of the following:

 Expired.

 From the wrong funding source.

 Not one which has been ordered. 

 Active in the office’s inventory.

 The one with the shortest expiration date.

VIS recording • Is the EMR capable of recording VIS prior to administering a vaccine?

• Can the EMR use scanned data elements (i.e., VIS document code 

and edition date) to look up additional information about the VIS?

For additional list of questions, please visit the AAP website.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 19

Appendix

UoU Barcode Specifications 

The data string pictured below is sample data for a UoU barcode. This diagram should be 

referenced when creating a configuration barcode. The NDC, expiration date, and lot number 

should be parsed to populate the respective fields in the EMR after proper scanner configuration.

The sample vaccine administration record below includes several fields commonly displayed in EMRs 

during vaccine administration. Based on your EMR’s data fields, the lot number, NDC, and expiration 

date fields may be populated when the UoU 2D barcode is scanned. However, EMRs vary across 

health systems so the displayed fields will be dependent on your EMR. For example, an EMR might 

not have the NDC displayed on the record, but it will capture and process it in the back end. 

A mapping table or database with stored vaccine data may enable the 

remaining fields to be populated when a 2D barcode is scanned. See 

Mapping Table for Vaccine Administration for more information.

Vaccine Administration Record

Lot Number Date

Manufacturer Time

NDC Dose

Product Site

Exp. Date Route

01003492815890581713102810U4275AA

00349281589058

GS1 

Application 

Identifier

GS1 

Application 

Identifier

GS1 

Application 

Identifier

Expiration Lot Number

Date

GTIN

National Drug Code Check 

Digit

GS1 

Indicator 

Digit

GS1 US 

Placeholder
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 20

Appendix

VIS Barcode Specifications 

2D barcodes are also included on Vaccine Information Statements (VIS), which are informational 

documents shared with the patient at the time of vaccine administration. The purpose of this 

barcode is to provide the option of electronically capturing the name and the edition date of the 

VIS, as required by the National Childhood Vaccine Injury Act (NCVIA).

Requirements and protocols for VIS 

documentation may vary among EMRs and 

clinic policies. There are several approved 

methods for sharing the VIS with the 

patient. Some clinics may provide electronic 

VIS documents to patients and require only 

a checkbox in the EMR to confirm that the 

VIS was given to the patient. Other clinics 

may provide hard copies and require data 

entry in the EMR. 

Work with the Project Lead to confirm 

the VIS protocols at your clinic or health 

system and what information needs to be 

entered in the EMR at the time of vaccine 

administration. If documentation of the 

Global Document Type Identifier (GDTI) and 

edition date is required in the EMR, the use 

of 2D scanning may be a useful method for 

entering this information. The data string 

pictured below indicates the components of 

a VIS barcode and can be referenced when 

creating a configuration barcode. 

Office use only

4 Risks of a vaccine reaction

 Soreness, redness, or rash where the shot is given 

and rash all over the body can happen after MMR 

vaccine.

 Fever or swelling of the glands in the cheeks or 

neck sometimes occur after MMR vaccine.

 More serious reactions happen rarely. These can 

include seizures (often associated with fever), 

temporary pain and stiffness in the joints (mostly 

in teenage or adult women), pneumonia, swelling 

of the brain and/or spinal cord covering, or 

temporary low platelet count which can cause 

unusual bleeding or bruising.

 In people with serious immune system problems, 

this vaccine may cause an infection which may 

be life-threatening. People with serious immune 

system problems should not get MMR vaccine.

People sometimes faint after medical procedures, 

including vaccination. Tell your provider if you feel 

dizzy or have vision changes or ringing in the ears.

As with any medicine, there is a very remote chance 

of a vaccine causing a severe allergic reaction, other 

serious injury, or death.

 5 What if there is a serious 

problem?

An allergic reaction could occur after the vaccinated 

person leaves the clinic. If you see signs of a 

severe allergic reaction (hives, swelling of the face 

and throat, difficulty breathing, a fast heartbeat, 

dizziness, or weakness), call 9-1-1 and get the person 

to the nearest hospital.

For other signs that concern you, call your health 

care provider.

Adverse reactions should be reported to the Vaccine 

Adverse Event Reporting System (VAERS). Your 

health care provider will usually file this report, or 

you can do it yourself. Visit the VAERS website at 

www.vaers.hhs.gov or call 1-800-822-7967. VAERS 

is only for reporting reactions, and VAERS staff do not 

give medical advice.

 6 The National Vaccine Injury 

Compensation Program

The National Vaccine Injury Compensation 

Program (VICP) is a federal program that was 

created to compensate people who may have been 

injured by certain vaccines. Visit the VICP website 

at www.hrsa.gov/vaccinecompensation or call 

1-800-338-2382 to learn about the program and 

about filing a claim. There is a time limit to file a 

claim for compensation.

7 How can I learn more?

 Ask your healthcare provider.

 Call your local or state health department.

 Contact the Centers for Disease Control and 

Prevention (CDC):

 -Call 1-800-232-4636 (1-800-CDC-INFO) or

 - Visit CDC’s www.cdc.gov/vaccines

8/15/2019 | 42 U.S.C. § 300aa-26

Vaccine Information Statement (Interim)

MMR Vaccine 

VACCINE INFORMATION STATEMENT

Many Vaccine Information Statements are 

available in Spanish and other languages. 

See www.immunize.org/vis

Hojas de información sobre vacunas están 

disponibles en español y en muchos otros 

idiomas. Visite www.immunize.org/vis

U.S. Department of 

Health and Human Services 

Centers for Disease 

Control and Prevention 

MMR Vaccine (Measles, Mumps, and 

Rubella): What You Need to Know

1 Why get vaccinated?

MMR vaccine can prevent measles, mumps, and 

rubella.

 MEASLES (M) can cause fever, cough, runny nose, 

and red, watery eyes, commonly followed by a rash 

that covers the whole body. It can lead to seizures 

(often associated with fever), ear infections, 

diarrhea, and pneumonia. Rarely, measles can 

cause brain damage or death.

 MUMPS (M) can cause fever, headache, muscle 

aches, tiredness, loss of appetite, and swollen and 

tender salivary glands under the ears. It can lead to 

deafness, swelling of the brain and/or spinal cord 

covering, painful swelling of the testicles or ovaries, 

and, very rarely, death.

 RUBELLA (R) can cause fever, sore throat, rash, 

headache, and eye irritation. It can cause arthritis 

in up to half of teenage and adult women. If a 

woman gets rubella while she is pregnant, she 

could have a miscarriage or her baby could be born 

with serious birth defects.

Most people who are vaccinated with MMR will 

be protected for life. Vaccines and high rates of 

vaccination have made these diseases much less 

common in the United States.

2 MMR vaccine

Children need 2 doses of MMR vaccine, usually:

 First dose at 12 through 15 months of age

 Second dose at 4 through 6 years of age

Infants who will be traveling outside the United 

States when they are between 6 and 11 months 

of age should get a dose of MMR vaccine before 

travel. The child should still get 2 doses at the 

recommended ages for long-lasting protection.

Older children, adolescents, and adults also need 

1 or 2 doses of MMR vaccine if they are not already 

immune to measles, mumps, and rubella. Your 

health care provider can help you determine how 

many doses you need.

A third dose of MMR might be recommended in 

certain mumps outbreak situations.

MMR vaccine may be given at the same time as 

other vaccines. Children 12 months through 12 

years of age might receive MMR vaccine together 

with varicella vaccine in a single shot, known as 

MMRV. Your health care provider can give you more 

information.

 3 Talk with your health care 

provider

Tell your vaccine provider if the person getting the 

vaccine:

 Has had an allergic reaction after a previous dose 

of MMR or MMRV vaccine, or has any severe, 

life-threatening allergies.

 Is pregnant, or thinks she might be pregnant.

 Has a weakened immune system, or has a parent, 

brother, or sister with a history of hereditary or 

congenital immune system problems.

 Has ever had a condition that makes him or her 

bruise or bleed easily.

 Has recently had a blood transfusion or received 

other blood products.

 Has tuberculosis.

 Has gotten any other vaccines in the past 4 weeks.

In some cases, your health care provider may decide 

to postpone MMR vaccination to a future visit.

People with minor illnesses, such as a cold, may be 

vaccinated. People who are moderately or severely ill 

should usually wait until they recover before getting 

MMR vaccine.

Your health care provider can give you more 

information.

Sample VIS with barcode shown next to

 the magnifying glass icon. 

For more information on VIS, visit https://www.cdc.gov/vaccines/hcp/vis/. 

253 088698300011 11121206

GS1 Application

Identifier for 

GDTI

GDTI 

(Global Document 

Type Identifier)

Serial Component 

Edition Date 

11 + YYMMDD
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 21

Appendix

Mapping Table for Vaccine Administration

A mapping table or database with stored vaccine data enables additional fields to be populated 

when a 2D barcode is scanned. Even though the UoU barcode contains only three data fields, 

additional fields in the vaccine administration record, such as the product name, manufacturer, 

dose, and route, may be populated upon scanning. The sample vaccine administration record below 

portrays sample data fields that may be able to be populated by the mapping table. 

Depending on the facility’s workflow, a doctor’s vaccine 

order may populate some of the fields of the record from 

the mapping table prior to scanning for administration. In 

this case, the EMR can validate that the scanned vaccine 

matches the ordered vaccine or can alert the vaccine 

administrator if the incorrect vaccine was scanned. 

If a similar mapping table is not already in use in your 

EMR, a one-time setup may be needed. Once the mapping 

table is set up, it is important that the data are accurate 

and up to date. The information should be validated upon 

the receipt of a vaccine shipment, or any other time that 

the data may have updates. If available, follow your EMR’s 

recommendations for populating and validating the data.

Basic recommended data elements are listed to the right, 

but additional data elements may be helpful and applicable 

to your clinic’s needs. CDC’s NDC Crosswalk Tables may be 

a useful source for populating the table, though it is not 

comprehensive and additional data sources may be needed. 

Recommended Data 

Elements for Mapping Table

UoU NDC*

UoU GTIN* 

UoU Lot Number*

Expiration Date* 

Product Name

Manufacturer 

Dose

Route of Administration

Vaccine Administration Record

Lot Number Date

Manufacturer Time

NDC Dose

Product Site

Exp. Date Route

*Indicates which elements are found in UoU 

barcodes. If the scanned data elements 

match the data found in the mapping table, 

the corresponding data elements may 

populate the EMR record fields.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 22

Appendix

Immunization Information System

In addition to scanning for vaccine administration and vaccine inventory, a third use case for 

scanning is for data entry to the Immunization Information System (IIS). Many EMRs push data to the 

IIS so that dual entry of vaccine data to the IIS is not necessary. However, the IIS may accept scanned 

data if the EMR does not push data to the IIS.

Because vaccine administration records are frequently transmitted from the EMR directly to the IIS, 

IIS data can benefit from the increased data accuracy of 2D barcode scanning. If the EMR transmits 

vaccine administration data directly to the IIS, no further action is needed.

However, if the IIS does NOT automatically accept data from the EMR and manual/dual entry is 

required, vaccine administration data entry may be performed with 2D barcode scanning. 

If the IIS platform already accommodates 2D barcode scanning, reference the 

configuration instructions to create a unique configuration barcode. Though the 

same information will be imported, the IIS is a different interface than the EMR and 

will likely require a unique configuration barcode.

If the IIS platform does not accommodate 2D barcode scanning, it may be helpful to 

discuss system capabilities with your IIS vendor, as the requirements for integrating 

2D barcode scanning into the EMR are the same for the IIS. 

Note: Integration with the IIS may be managed from the health system 

level. If the clinic is part of a health system, confirm how IIS is managed 

prior to following the steps listed above.
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 23

Appendix

Resources

Immunization Information Technology: A Guide for Pediatricians on Immunization Information 

Systems and Two-Dimensional Barcoding, AAP 

Functional Capabilities Report, CDC

NDC Lookup Crosswalk, CDC

Below are other resources available in the Implementation Toolkit listed roughly in the order that 

they may be referenced during implementation. 

Resource Description Intended User

One-pager: Vaccine 2D 

Barcode Scanning

Informational one-pager 

with overview of vaccine 2D 

barcode scanning and benefits 

to implementation

Health care leadership, sitelevel administrator, personnel 

unfamiliar with or new to 2D 

scanning

Guide for Project Lead Guide for all aspects of planning 

the implementation of vaccine 

2D barcode scanning

Health care leadership, sitelevel administrator

Technical 

Implementation Guide: 

Vaccine Inventory

Guide for technology 

and hardware needs for 

implementing 2D barcode 

scanning for vaccine inventory

IT personnel, inventory 

management system personnel

Workflow 

Determination Tool

Workflow process maps for 

identifying where and how to 

add 2D barcode scanning into 

the vaccine administration 

workflow 

One-pager: Vaccine 

2D Barcoding for Mass 

Vaccinations

Informational one-pager on 

the benefits of 2D barcode 

scanning in a mass vaccination 

scenario

Health care leadership, sitelevel administrator, inventory 

manager
CDC | NCIRD Technical Implementation Guide: Vaccine Administration 24

For more information, contact CDC

1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348 | www.cdc.gov

The findings and conclusions in this report are those of the 

authors and do not necessarily represent the official position of the 

Centers for Disease Control and Prevention.