How the program works
online by providing key contact information and attesting to the role and
responsibilities for participating in the program. When the prescriber registers
on-line a response is immediately sent regarding program acceptance or denial.
If accepted, the prescriber is provided a registration number to use when
enrolling patients or completing a
Dose Authorization Request Form.
To enroll patients, the registered prescriber helps the patient complete the
and then faxes the form, with proof of income, to the GSK Vaccines Access Program
at 1-877-VAC-1555. A reply of acceptance or denial will be faxed back to the
prescriber, at the number provided on the application, within 10 minutes.
If the patient is accepted into the program, the prescriber can administer the vaccine.
Once accepted into the program, the patient is eligible to receive those GSK vaccines
that are offered as part of the program for up to 12 months.
Prior to administering subsequent doses to an enrolled patient, the prescriber must
complete and fax a Dose Authorization Request Form. Once the prescriber has received
approval, the dose can be administered.
Vaccine usage is automatically tracked by the program and replenished on a monthly basis.
The first shipment is sent 30 days after the initial dose is used to the address provided
on the application.
The GSK Vaccines Access Program does not pay for administrative fees or other office visit fees.