Programs

The Adult Safety Net program (ASN) helps to vaccinate the adult population to prevent infection with potentially devastating diseases.

Our program was created by the Texas Department of State Health Services (DSHS) Immunization Unit to increase access to vaccination services in Texas for uninsured adults, thereby raising the immunization coverage levels and improving the health of Texans.

Like infants and children, adults are also at risk for contracting vaccine-preventable diseases. In addition to becoming severely ill, infected adults risk spreading these diseases to infants who are too young to be vaccinated. The solution is to vaccinate our adult population to prevent infection with potentially devastating diseases.

Our Requirements

The Adult Safety Net program helps to vaccinate our adult population to prevent infection with one of these potentially devastating diseases. The following are key requirements to be a part of our program:

• Anyone 19 years of age or older and does not have health insurance is eligible to receive low-cost vaccines under the Adult Safety Net program.
• You may be charged an administration fee of up to $25 per vaccine(except for the COVID-19 vaccine). If you cannot pay the fee, notify the provider, and you will not be denied vaccination.
• Individuals are not eligible to receive ASN vaccines if enrolled in Medicare or Medicaid, have other health insurance, or if their existing healthcare insurance does not cover vaccinations.

Finding a Provider Near You

To locate an Adult Safety Net provider, please contact DSHS Immunizations Section at 800-252-9152 and refer to the spreadsheet of Adult Safety Net providers below. Enrolled providers may be subject to change.

Texas Vaccines for Children

Making it easier for children 0-18 years old to get vaccinated is what we’re all about. That’s why we offer low-cost vaccines to children who are uninsured, underinsured, covered by CHIP, Native American or Native Alaskan heritage, as well as those on Medicaid.

The Texas Vaccines for Children (TVFC) program provides low-cost vaccines to eligible children from birth through 18 years of age who meet one or more of the following criteria:

• Eligible for participation in the Medicaid program
• Enrolled in the Children's Health Insurance Program (CHIP) 1
• American Indian or Alaska Native (As defined by 25 U.S.C. 1603)
• Uninsured Children: Children who do not have health insurance
• Underinsured: Children who have commercial (private) health insurance, but
  • Coverage does not include vaccines; or
  • Covers only selected vaccines (TVFC-eligible for non-covered vaccines only); or
  • Health insurance covers all vaccines, but the plan has a fixed dollar limit or cap on the amount that it will cover for vaccines (TVFC-eligible once fixed dollar amount or cap is reached).

  1. Though children whose insurance pays for vaccines do not qualify for TVFC vaccine, CHIP children do qualify by special arrangement.

  2. Underinsured children must be seen by a Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), or deputized clinic.

  Find a Provider

  For additional information, please contact your local health department, Health Department Region or the TVFC program at 888-777-5320 or vacCallCenter@dshs.texas.gov

  Recommended vaccines birth to 15 months

  These recommendations must be read with the notes that follow. For those who fall behind or start late, provide catch-up vaccination at the earliest opportunity as indicated by the green bars. To determine minimum intervals between doses, see the catch-up schedule on CDC.

  Legend
  🟨 Range of recommended ages for all children	🟩 Range of recommended ages for catch-up vaccination	🟪 Range of recommended ages for certain high-risk groups	🟧 Recommended vaccination can begin in this age group	🟦 Recommended vaccination based on shared clinical decision-making	🔲 No recommendation/ not applicable

  Vaccine and other immunizing agents	Birth	1 mo	2 mos	4 mos	6 mos	9 mos	12 mos	15 mos
  Respiratory syncytial virus (RSV-mAb [Nirsevimab])	One dose depending on maternal RSV vaccination status - See notes 🟨					One dose (8 through 19 months) - See notes 🟪
  Hepatitis B (HepB)	First dose 🟨	←Second dose→ 🟨		🟩	←Third dose→ 🟨
  Rotavirus (RV) RV1 (two-dose series); RV5 (three-dose series)	🔲		First dose 🟨	Second dose 🟨	See notes 🟨	🔲
  Diphtheria, tetanus and acellular pertussis (DTaP:	🔲		First dose 🟨	Second dose 🟨	Third dose 🟨	🟩		←Fourth dose→ 🟨
  Haemophilus influenzae type b (Hib)	🔲		First dose 🟨	Second dose 🟨	See notes 🟨	🟩	←Third or Fourth dose - See notes→ 🟨
  Pneumococcal conjugate (PCV15, PCV20)	🔲		First dose 🟨	Second dose 🟨	Third dose 🟨	🟩	←Fourth dose→ 🟨
  Inactivated poliovirus (IPV:	🔲		First dose 🟨	Second dose 🟨	←Third dose→ 🟨
  COVID-19 (1vCOV-mRNA, 1vCOV-aPS)	🔲				One or more doses of updated (2023–2024 Formula) vaccine (See notes) 🟨
  Influenza (IIV4) OR Influenza (LAIV4)	🔲				IIV4 or LAIV4 Annual vaccination one or two doses 🟨
  Measles, mumps, rubella (MMR)	🔲				See notes 🟪		←First dose→ 🟨
  Varicella (VAR)	🔲						←First dose→ 🟨
  Hepatitis A (HepA)	🔲				See notes 🟪		←Two-dose series - See notes→ 🟨
  Tetanus, diphtheria and acellular pertussis (Tdap: ≥7 yrs)	🔲
  Human papillomavirus (HPV)	🔲
  Meningococcal (MenACWY-CRM ≥2 mos, MenACWY-TT ≥2years)	🔲		See notes 🟪
  Meningococcal B (MenB-4C, MenB-FHbp)	🔲
  Respiratory syncytial virus vaccine (RSV [Abrysvo])	🔲
  Dengue (DEN4CYD: 9-16 yrs)	🔲
  Mpox	🔲

  Additional information can be found on CDC: Birth to 15 Months.

  Updated: December 20, 2023

  Recommended vaccines 18 months to 18 years

  These recommendations must be read with the notes that follow. For those who fall behind or start late, provide catch-up vaccination at the earliest opportunity as indicated by the green bars. To determine minimum intervals between doses, see the catch-up schedule on CDC.

  Legend
  🟨 Range of recommended ages for all children	🟩 Range of recommended ages for catch-up vaccination	🟪 Range of recommended ages for certain high-risk groups	🟧 Recommended vaccination can begin in this age group	🟦 Recommended vaccination based on shared clinical decision-making	🔲 No recommendation/ not applicable

  Vaccine and other immunizing agents	18 mos	19-23 mos	2-3 yrs	4-6 yrs		7-10 yrs		11-12 yrs	13-15 yrs	16 yrs	17-18 yrs
  Respiratory syncytial virus (RSV-mAb [Nirsevimab])	One dose (8 through 19 months), See notes 🟪		🔲
  Hepatitis B (HepB)	←Third dose→ 🟨	🟩
  Rotavirus (RV) RV1 (two-dose series); RV5 (3-dose series)	🔲
  Diphtheria, tetanus and acellular pertussis (DTaP:	←Fourth dose→ 🟨	🟩		Fifth dose 🟨		🔲
  Haemophilus influenzae type b (Hib)	🟩			🟩	🟪	🟪
  Pneumococcal conjugate (PCV15, PCV20)	🟩			🟩	🟪	🟪
  Inactivated poliovirus (IPV:	←Third dose→ 🟨	🟩		Fourth dose 🟨		🟩					See notes 🔲
  COVID-19 (1vCOV-mRNA, 1vCOV-aPS)	One or more doses of updated (2023–2024 Formula) vaccine (See notes) 🟨
  Influenza (IIV4) OR Influenza (LAIV4)
  Influenza (IIV4)	Annual vaccination one or two doses 🟨							Annual vaccination one dose only 🟨
  Influenza (LAIV4)	🔲		Annual vaccination one or two doses 🟨					Annual vaccination one dose only 🟨
  Measles, mumps rubella (MMR)	🟩			Second dose 🟨		🟩
  Varicella (VAR)	🟩			Second dose 🟨		🟩
  Hepatitis A (HepA)	← Two-dose series, See notes→ 🟨		🟩
  Tetanus, diphtheria and acellular pertussis (Tdap: ≥7 yrs)	🔲					🟩		One dose 🟨	🟪 🟩
  Human papillomavirus (HPV)	🔲					🔲	🟪 🟧	See notes 🟨	🟩
  Meningococcal (MenACWY-CRM ≥2 mos, MenACWY-TT ≥2years)	See notes 🟪							First dose 🟨	🟩	Second dose 🟨	🟩
  Meningococcal B (MenB-4C, MenB-FHbp)	🔲							(10 through 18 years) See notes 🟪		🟪 🟦
  Respiratory syncytial virus vaccine (RSV [Abrysvo])	🔲							Seasonal administration during pregnancy, See notes 🟪
  Dengue (DEN4CYD: 9-16 yrs)	🔲							10 through 16 years - Seropositive in endemic dengue areas (See notes) 🟨			🔲
  Mpox	🔲										🟪

  Additional information can be found on CDC: 18 Months to 18 Years.

  Updated: December 20, 2023

  IIS (ImmTrac2)

  Keeping up with vaccine records is now easier than ever, thanks to ImmTrac2, the Texas Immunization Registry.

  Texas Department of State Health Services (DSHS) offers the Texas Immunization Registry at no cost to all Texans. The registry is secure and confidential and safely consolidates and stores immunization records from multiple sources in one centralized system.

  2003–2005

  The 78th Legislature in 2003, passed House Bill 1921. The bill strived to clarify immunization registry components to:

  • Reduce confusion about parental consent.
  • Increase provider and client participation.
  • Protect the privacy and confidentiality of registry data.
  • Increase the utility of the registry and registry data.
  • Transition from requiring a written signature on the provider registration and renewal form to allowing the use of an online form.

  DSHS implemented House Bill 1921 in 2005. The bill’s key requirements:

  • All healthcare providers and payors must report to ImmTrac all vaccines given to children under 18 years old.
  • While registering for a birth certificate, parents can grant consent to participate in the registry or can request exclusion from the registry.
  • A parent may submit a child's immunization history to ImmTrac for inclusion in the registry.

  2007

  The 80th Legislature passed Senate Bill 11 in 2007, changed the process for receiving parental consent, and added first responders and adverse vaccine reactions.

  • Authorized ImmTracusers were now able to affirm to DSHS that they received written parental consent without actually submitting the paper form.
  • ImmTraccould include immunization information on first responders (peace officers, fire protection personnel, emergency medical services personnel) and their immediate family members 18 years of age and older. The registry now captured information about people who get an immunization, antiviral, or other medication given in preparation for a potential declared disaster, public health emergency, or in response to such an event.
  • ImmTrac began tracking adverse reactions to an immunization, antiviral, or other medication given in preparation for a potential declared disaster, public health emergency, or in response to such an event.

  2009–2011

  During the 81st Legislature, Senate Bill 346 passed and changed the registry from a children's-only registry to a lifetime registry (enrollment from birth to death), allowing Texans aged 18 years or older to store their immunization records in the registry. In 2011, ImmTrac implemented the new legislation and began promoting the registry and adult consent requirements. Adults may grant consent at any time to participate in ImmTrac, and consent is valid for a lifetime.

  2015–2017

  During the 84th Legislature, in 2015, House Bill 2171 passed. It extended the time for maintaining information in the immunization registry after an individual becomes an adult, from 18 to 26 years of age.

  On April 3, 2017, DSHS Immunization Unit replaced ImmTrac with the Texas Immunization Registry, the enhanced ImmTrac2. The new system includes upgrades for immunization users, including enhanced immunization history and forecasting capabilities, client and immunization de-duplication, and report-generating capabilities.

  Currently, the registry is one of three programs at the DSHS participating in the stages of Meaningful Use (MU) as defined by the Centers for Medicare and Medicaid Services Electronic Health Record (EHR) Incentive Programs. Meaningful Use is in its second of three stages.