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Run: VFC Vaccine Inventory and Borrowing Log

Track VFC vaccine inventory, dose use, waste, and any public/private stock borrowing in one audit-ready log. Use it to reconcile counts, document PII disclos...

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Log Entry Details

Entry Date (required)

Date this log entry is completed.

Clinic / Site Location (required)

Location where the inventory event occurred.

Completed By (required)

Name or role of the staff member completing the log entry.

Entry Type (required)

Choose the primary reason for this entry.

Vaccine Product and Inventory

Vaccine Name (required)

Product name or abbreviation used by your program.

Stock Type (required)

Indicate whether the inventory is public VFC stock or private stock.

Lot Number (required)

Lot number for the vaccine product.

Expiration Date (required)

Expiration date for the lot.

Manufacturer

Manufacturer name, if needed for reconciliation.

Inventory Movement and Dose Counts

Starting Quantity On Hand

Count at the beginning of the reporting period or before the event.

Doses Administered

Number of doses given from this stock or lot.

Doses Wasted / Spoiled

Number of doses discarded due to waste, spoilage, or breakage.

Quantity Adjustment

Positive or negative adjustment to reconcile inventory counts.

Ending Quantity On Hand

Count remaining after administration, waste, and adjustments.

Borrowing Between Public and Private Stock

Did borrowing occur? (required)

Select yes if doses were temporarily moved between public and private stock.

Borrowing Direction

Choose the direction of the borrowing event.

Borrowed Quantity

Number of doses borrowed.

Reason for Borrowing

Brief explanation of why borrowing was needed.

Replacement Due Date

Date by which borrowed doses should be replaced, if applicable.

Reconciliation, Consent, and Audit Trail

Reconciliation Notes

Explain discrepancies, corrections, or follow-up actions needed.

Were any patient identifiers collected in this entry? (required)

Use only if your workflow requires linking doses to specific patients.

PII Disclosure Acknowledged

Confirm that only minimum necessary PII is collected and used for the stated purpose.

Yes No N/A

Audit Trail Reference

Optional internal reference number, batch ID, or reconciliation ticket.

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