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at merck we believe no one should go without the adult vaccines they need adult vaccines distributed through the merck vaccine patient assistance program are free of charge to all eligible patients this short video will explain how to complete the application for the merck vaccine patient assistance program to get this application click on the merck vaccine patient assistance program tab in the frequently asked questions section of merckhelps.com click on your vaccines name from the products listed on merckhelps.com or call 800 293 please complete and have your health care provider fax this application to the program first for the program to determine your eligibility your healthcare provider must do this before administering the vaccine you may qualify for the merck vaccine patient assistance program if you reside in the united states or a u.s territory you do not need to be a u.s citizen you have a prescription for a merck adult vaccine from a health care provider licensed in the u