VAQTA

Indicated For

Hepatitis A prevention

About This Medication

# Merck Vaccine Patient Assistance Program Patient Guide: How to Get VAQTA (Hepatitis A Vaccine, Inactivated) at Low or No Cost The **Merck Vaccine Patient Assistance Program** provides **VAQTA**, the inactivated Hepatitis A vaccine, free of charge to eligible uninsured U.S. residents aged 19 and older facing financial hardship. This guide explains eligibility, the application process, and next steps in simple terms to help you access this important vaccine. ## About VAQTA and Why It Matters **VAQTA** is a vaccine that protects against Hepatitis A, a serious liver infection spread through contaminated food, water, or close contact with infected people. It contains inactivated (killed) virus particles to stimulate your immune system without causing illness. VAQTA is typically given in a two-dose series, six to 18 months apart for adults, or as a single dose for children aged 12 months to 18 years. It's recommended by the CDC for travelers to high-risk areas, people with chronic liver disease, men who have sex with men, and others at increased risk. Without vaccination, Hepatitis A can cause fever, fatigue, jaundice, and in rare cases, liver failure. This program ensures cost isn't a barrier for those who qualify[1][5]. ## Who Qualifies for the Program? To qualify, you must meet these key criteria: - Be a **U.S. resident** aged **19 or older** (no U.S. citizenship required). - Have **no health insurance or vaccine coverage** (including private insurance, HMO, Medicaid, Medicare, etc.). - Demonstrate **financial or medical hardship** through income verification. - Have a licensed healthcare provider (doctor, nurse practitioner, etc.) who determines VAQTA is medically appropriate. The program prioritizes uninsured patients unable to afford the vaccine otherwise. A healthcare professional must prescribe it and co-sign the application[1][2][3]. ## Income Eligibility Breakdown Specific federal poverty level (FPL) thresholds aren't published; eligibility is based on **gross annual household income** (before taxes, including Social Security, pensions, etc.) relative to household size and overall hardship. You report your income and household members on the form. Merck verifies via credit check (no impact on your score) or proof documents. Lower incomes improve chances, but no strict cutoff is listed—focus is on uninsured status and need. Here's a general guide based on program emphasis on hardship: | Household Size | Estimated Income Consideration | Notes | |---------------|-------------------------------|-------| | 1 (Individual) | Must show hardship; provide proof | Primary for uninsured | | 2 (Couple) | Scaled to household; verify total | Include all dependents | | 3 | As above | Social Security/pensions count | | 4+ | Per person; no fixed FPL % | Employer letters, tax forms accepted | Submit proof like recent 1040 tax form, pay stubs, benefit statements (SSI, VA, unemployment, pension), or employer letter. Call **(800) 293-3881** for personalized guidance[1][3][5]. ## Insurance Requirements You **must have no insurance or other coverage** for vaccines. This includes: - Private health insurance or HMO. - Medicaid, Medicare (including Part D for Medicare beneficiaries). - Any prescription drug coverage. Disclose all on the form. Medicare patients are ineligible. If you gain coverage later, reapply may be needed[1][2][3]. ## Step-by-Step Application Process 1. **Talk to your doctor**: Discuss Hepatitis A risk and if VAQTA is right. They confirm need and will co-complete the form. 2. **Download the form**: Get the English or Spanish enrollment form from merckhelps.com/VPAP[1][6]. 3. **Fill Section 1 (Patient)**: Enter name, address, phone, DOB, gender, US resident status (yes/no), insurance details (must be none), **gross annual household income**, household size, income verification choice (Option 1: credit check; Option 2: attach proof doc), and sign twice (declarations and authorization)[3][7]. 4. **Provider completes Sections**: Insurance confirmation, consent, vaccine details (VAQTA name/NDC, dose #), practice info, signature/date[3][7]. 5. **Review together**: Ensure all fields complete, legible (black/blue pen), no stamps. 6. **Fax immediately**: Provider faxes **all pages** to **(800) 528-2551**. Do **NOT** administer vaccine first[1][5][7]. 7. **Wait for approval**: Processed in <10 minutes; provider gets phone confirmation number[1][3]. **Tip**: Use the checklist PDF for accuracy[3]. ## Timeline and Delivery - **Processing**: Goal of **less than 10 minutes** after complete fax receipt[1][3][4]. - **Confirmation**: Provider called with number—administer vaccine only then. - **Replacement**: Merck ships **quarterly** to provider's office (not direct to you). Use within **30 days** of approval or reapply. Provider reports admin date/lot# for replacement[2]. - **Multi-dose**: New form/approval per dose[1][5]. ## Reauthorization and Refills **Reauthorization required** for each dose. Submit new form before next vaccination. No automatic refills—provider requests replacement quarterly[1][2]. ## Alternatives if Denied or Ineligible - **State/local programs**: Check Vaccines for Adults (VFA) via CDC or health department for free/low-cost vaccines. - **Federally Qualified Health Centers (FQCs)**: Sliding-scale clinics often provide vaccines. - **Patient Access Network (PAN) Foundation** or similar for vaccines. - **Retail pharmacy discounts**: GoodRx for VAQTA (cash price ~$70/dose, but program is free if eligible). - **Contact Merck**: Call (800) 293-3881 to appeal or clarify denial (e.g., incomplete form). - **Other Merck PAPs**: For non-vaccines, but VAQTA-specific here. If insured, explore coverage or manufacturer copay cards. ## Important Disclaimer This guide is for informational purposes based on Merck's Merck Vaccine Patient Assistance Program details as of latest available info. Eligibility, processes, and availability can change—**always verify with Merck at (800) 293-3881 or merckhelps.com**. Not medical advice; consult your provider. Program doesn't guarantee approval. Administering vaccine pre-approval disqualifies replacement. Income verification may access credit data (no score impact). Merck may update forms/NDC—use current ones[1][2][3][5]. **Word count: 1028**

Program information last verified: March 30, 2026