Weekly Vaccine Digest 7/28

County of Los Angeles, California sent this bulletin at 07/28/2023 02:45 PM PDT

Weekly Vaccine Digest 7/28

Los Angeles County Department of Public Health

Dear Colleagues and Partners,  

Below are the LACDPH weekly vaccine administration and order updates, upcoming webinars, and newsworthy events. Attached to this email you will find a pdf version of this digest and the links shared during today’s CDPH Office Hours. To view the CDPH recording and slides please visit eziz.org/covid/education.

If you received this email and would like to be added to our listserv, please contact our COVID-19 Provider Vaccine Call Center at covidvaccinereq@ph.lacounty.gov

Table of Contents

·        Page 1: Welcome, Order and Administration Reminders

·        Page 2: Clinical Update, Back to School Immunizations

·        Page 2-3: Fall 2023 COVID-19 Vaccine Transition Timeline

·        Page 3-4: Preparing for Fall COVID-19 Vaccination Efforts

·        Page 4: Older Adult RSV Recommendations

·        Page 4-5: FDA Approval for Nirsevimab

·        Page 5: Ancillary Kits, LACDPH & CDPH Provider Office Hours Link

·        Page 6-7: National Immunization Awareness Month - August

Order and Administration Reminders

  • REMINDER: Please place all orders in myCAvax by the Monday 7/31/23 5pm deadline.
    • IMPORTANT: The last standard ordering review, approval, and order transmission cycle for current COVID-19 vaccine is approaching on Monday July 31, 2023 at 5:00 pm. Providers should order a 2-month supply to last until the new formulation is available this fall.
      • Small orders will continue to be processed by LHDs and the TPR for providers needing additional doses, until the new COVID-19 vaccine is authorized by FDA.
    • Commercialization Resources can be found below:
      • Commercialization at a glance provider transition guide can be found here.
      • EZIZ Commercialization FAQs can be found here.
      • HHS guide on commercialization can be found here.
  • REMINDER: COVID-19 Provider Resources can be found here.
  • REMINDER: Provider Operations Manual can be found here.
  • REMINDER: Please report all COVID-19 doses administered within 24 hours to your medical record system and to CAIR as soon as practicable and no later than 72 hours.
  • NOTE: CDPH is sending out a survey to VFC providers on their brand preference of COVID vaccines for the Fall.
  • NOTE: CA COVID-19 Public Call Center operating hours as of 7/22/23 Mon-Fri 8am-8pm, no longer operating on weekends and holidays.
  • REMINDER: Record Vaccine Waste in myCAvax. Job aid can be found here.

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CLINICAL UPDATE

  • Continue to recommend bivalent mRNA COVID-19 vaccines
    • Bivalent mRNA COVID-19 vaccines protect against severe COVID-19 from currently circulating XBB lineage variants.
    • People who receive a bivalent mRNA vaccine now will most likely be eligible for the Fall 2023 composition (with appropriate interval between doses).
  • No changes to FDA or CDC guidance have been made at this time
    • Expect Fall CDC ACIP meeting for clinical guidance recommendations
  • Recommendation for the 2023-2024 Formula of COVID-19 vaccines in the U.S. can be found here.

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Back to School Immunizations

Please implement strategies at this time of year to ensure that no student misses any school due to immunizations:

  • Use the immunization registry and your electronic health record (EHR) to identify children who missed well child visits and/or recommended vaccinations.
  • Reach out to schedule in-person appointments using a Robocall Script, letter, or text.
  • Plan back-to-school immunization catch-up clinics at convenient times for working parents, including weekends and evenings.
  • Administer needed vaccines at ALL visits, not just well-child checks.
  • Designate a certain number of “immunization-only” appointments each day leading up to school entry.
  • Use effective communication techniques. Talk openly with parents about vaccine safety and concerns. Educational materials should supplement, not replace, conversations. Personal accounts are persuasive and memorable; share the reasons why you support vaccines!

School Immunization Resources for Providers and Families

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Fall 2023 COVID-19 Vaccine Transition Timeline

Week of July 31, 2023

·         CDC will set vaccine thresholds to -0- in anticipation of decreased vaccine demand.

·         Providers to order a 2-month vaccine supply.

·         Last standard and routine vaccine order review & processing cycle.

August 3-Early September

·         There will opportunities to submit additional Small Orders (fulfilled locally/TPR) if needed. Process, including frequency of order submission, is yet to be determined).

·         Ancillary supplies for these small vaccine orders will continue to be provided.

TBD (expected early to mid-September)

·         FDA decisions and amendments to Emergency Use Authorizations (EUAs) / Biologics License Applications (BLAs).

·         Concurrently, USG discontinues distribution of current COVID-19 vaccine composition.

·         Advisory Committee on Immunization Practices (ACIP) discussion on COVID-19 epidemiology and vaccine effectiveness and CDC recommendation.

TBD (ACIP Recommendation + 2 weeks)

·         Fall vaccine availability for administration begins across all age groups with traditional pathways for procurement, distribution, and payment.

 

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Preparing for Fall COVID-19 Vaccination Efforts

  • Vaccine manufacturers are updating and producing vaccine supply based on FDA’s vaccine strain selection
  • Anticipated timeline for vaccine approval and availability is early to mid-September 2023
  • Planning for initial COVID-19 monovalent vaccine supplies to support fall vaccination demand is as important as making sure you are ready and stocked with influenza vaccine this fall!
  • Consider patient population served, including age, insurance coverage, and planned fall vaccination campaigns

Commercial Purchase Information- Moderna

  • Customers can order through their distributors or directly with Moderna
    • Moderna has signed with the major group purchasing organizations (GPOs) and with all major distributers, such as McKesson, Cardinal, AmeriSource/Bergen, etc.
    • Customers may order directly with Moderna at www.modernadirect.com.
    • The Moderna Care Team may be reached at: 1-866-MODERNA / 1-866-663-3762
  • Pre-booking is not necessary but helps with the management of demand and production on the manufacturer side. On the provider side, it may prioritize shipping, and access to limited supply of packaging not available on the CDC Contract (pre-filled syringes).

Commercial Purchase Information- Pfizer

  • Providers may work with their wholesalers prior to and post launch of approved products
  • May order directly with Pfizer for minimum quantity after commercial availability
  • Customers may order directly at https://primecontracts.pfizer.com/
  • The Pfizer customer service team may be reached at 1-800-666-7248.
  • Product will ship direct from Pfizer at ultra-low temperature (ULT). Upon receipt, may storage at ULT or at 2-8 °C (shelf life of the product anticipated to be 10 weeks when stored at 2-8 °C).

Commercial Purchase Information- Novavax

  • Currently working on a Commercialization Information packet for providers.
  • Novavax will work with 3 major distributors for providers to order as needed.
  • Larger volume orders have option to go through Cardinal Health (contracted pricing)
  • Product purchasing information may be directed to Novavax CA Regional Business Director Nidal Naser at nnaser@novavax.com

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Older Adult RSV Vaccine Recommendations

  • Full recommendations published in Morbidity and Mortality Weekly Report (MMWR) on 7/20/23.
  • For the 2023–24 season, clinicians should offer RSV vaccination to adults aged ≥60 years using shared clinical decision-making as early as vaccine supply becomes available and should continue to offer vaccination to eligible adults who remain unvaccinated.
  • Coadministration of RSV vaccines with other adult vaccines during the same visit is acceptable.
  • Recommendation for RSV vaccines for older adults based on efficacy in preventing symptomatic RSV-associated lower respiratory tract infections. Trials were not powered to demonstrate efficacy against hospitalization and death.
  • For RSV vaccination, the decision to vaccinate a patient should be based on a discussion between the health care provider and the patient, which might be guided by the patient’s risk for disease and their characteristics, values, and preferences; the provider’s clinical discretion; and the characteristics of the vaccine.
  • As part of this discussion, providers and patients should consider the patient’s risk for severe RSV-associated disease.
    • Persons with chronic medical conditions
    • Those who are frail or who are of advanced age
    • Residents of nursing homes and long-term care facilities
  • Registration link for the HPV Vaccination Webinar Tuesday, August 8, 2023 can be found here.

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FDA Approval for Nirsevimab in Infants & Toddlers

  • FDA approval on July 17th, 2023, for Beyfortus (Nirsevimab) – single IM injection for the prevention of:
    • RSV lower respiratory tract infection (LRTI) in neonates/infants in 1st RSV season
    • RSV LRTI in children up to 24 months who remain vulnerable going into their 2nd RSV season
  • Safety & efficacy supported by 3 clinical trials
    • 2 trials were randomized, double-blind, placebo-controlled, multicenter clinical trials
  • Possible side effects: rash, injection site reaction
  • FDA Approval announcement from July 17, 2023, can be found here.
  • UPCOMING: CDC Advisory Committee on Immunization Practices (ACIP) Topic: Respiratory Syncytial Virus Vaccines - Maternal/Pediatric, Nirsevimab & VFC Vote
    • Date & Time: August 3rd, 2023, 8 AM
    • Meeting Materials can be found here
    • Draft Agenda can be found here

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Ancillary Kits

  • Are expired surgical masks okay to use?
    • If your clinic's policies allow you to, and you see no deterioration of the masks, then yes.
    • Note: Expiration for these items mostly has to do with the deterioration of the straps.
    • Expiration date for surgical masks can be found printed on outside of kit or on boxes within.
  • Do NOT use needles/syringes/diluent, etc. if expired!
    • Check the expiration date of individual items
    • Expiration date should be printed on the individual items
  • Questions & Corrections:
    • Will Pfizer provide diluent with its commercial vaccine?
      • The answer is yes!
      • Do not expect other ancillary supplies such as needles and syringes.
    • Moderna 6 mo. to 5 yrs. Shelf-Life Extension. At least two lots of Moderna’s Bivalent vaccine for 6mo to 5 yrs. are under consideration for a shelf-life extension. When approved, the new shelf life will be mid-to late November.
    • Pfizer Shelf-Life extension. The Pfizer bivalent vaccines now have an additional six months of shelf life, 18 to 24 months at ULT.

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LACDPH & CDPH Provider Office Hours Link

LA County Department of Public Health Provider Office Hours Information

  • Every other Wednesday from 9am-10am - Next meeting: 08/02/23
    • NOTE: Effective 2/01/23 the Office Hours will be held on a biweekly basis
  • This meeting has been combined with the Mpox Office Hours call. Part one of the meeting will focus on COVID-19 issues while the second part will address Mpox vaccine issues.
  • MS Teams meeting link below; please create a recurring calendar invite with this link.
  • To request meeting slides, please email covidvaccinereq@ph.lacounty.gov

Microsoft Teams meeting

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 323-776-6996,,350547595#   United States, Los Angeles

Phone Conference ID: 350 547 595#

California Department of Public Health Provider Office Hours Registration Link

  • Every Friday from 9am-10:30am.
  • Complete one-time registration here.
  • Meeting recordings and slides can be found here.

Providers should add staff names to the Provider Listserv to receive weekly emails and updates. To be added, please email blanca.corona@cdph.ca.gov

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National Immunization Awareness Month

National Immunization Awareness Month starts August 1; promote vaccination with CDC resources. August is National Immunization Awareness Month (NIAM). This annual observance highlights the efforts to protect people of all ages against vaccine-preventable diseases through on-time vaccination. This year, NIAM serves as a focal point to get back on track with routine vaccines.

During NIAM, encourage your patients to schedule appointments to ensure they are up to date on annual exams and recommended vaccines. Research shows that healthcare providers remain the most trusted source of vaccine information for parents and patients.

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CDC’s NIAM web page includes two toolkits, one for reaching healthcare professionals and the other for reaching parents and patients. Each includes key messages, sample social media content, and educational resources. CDC encourages its partners to share these messages and resources throughout August using the hashtag #ivax2protect. Related Links:

In additional to these resources, during the month of August, your colleagues at Los Angeles Department of Public Health - Vaccine Preventable Disease Control branch will be sending you weekly communication and outreach reminders for specific population groups.   Please be on the lookout for specific resources and messages for Children/Back to School, Adolescents, Adults (including those who are Pregnant), Seniors, Immunocompromised and those with Chronic Diseases.