Weekly Vaccine Digest 10/27

County of Los Angeles, California sent this bulletin at 10/27/2023 03:21 PM PDT

Weekly Vaccine Digest 10/27

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 the LA DPH and CDPH Office Hours. To view the CDPH recording and slides please visit https://eziz.org/.  We have received additional doses for the Bridge Access Program (BAP). Please submit your vaccine order by Monday at 5:00 pm to receive your vaccine order the following week. Orders submitted after Monday at 5:00 pm may take an additional week to deliver. Please order a 1–2-week supply of COVID-19 vaccine through myCAvax and re-order as necessary as you assess patient demand.

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: Order and Administration Reminders

·        Page 2: CDC BUD and VIS, CDPH IZB Request for Application

·        Page 3-5: Nirsevimab Shortage, RSV Risk Factors, RSV Supply and Ordering, COVID-19 Rapid Antigen Test Kits

·        Page 5-6: Patient Access to Paxlovid, Sunsetting USG Therapeutics Program, Communication Tools: COVID-19 Therapeutics

·        Page 7-8: Upcoming Webinars, myCAvax Release 44

·        Page 9: LACDPH & CDPH Provider Office Hours Link

 

Order and Administration Reminders

  • REMINDER: Please place all State General Flu (SGF) orders in myCAvax by 5pm on Monday, 10/27. See Ordering and Distribution Cadence Calendar for more information. Please note that DPH is also filling SGF orders through local fulfillment.
    • LACDPH has depleted our Fluzone inventory and this product is no longer available
  • Vaccine delivered from the DPH warehouse will be delivered 3-7 business days after the order is place in myCAvax. Please present a photo ID (work badge, school ID, driver’s license, etc.) and sign for the delivery when received.
  • REMINDER: If a Shipment Incident results in a Temperature Excursion, providers should always report the Shipment Incident first. CDPH will determine if the vaccine should be reported as waste and then they will inform the provider
    • VFC providers should report temperature excursions and waste events in myVFCvaccines
    • BAP and SGF providers should report temperature excursions and waste events in myCAvax
    • Outbreak (mpox/Jynneos) providers should NOT report temperature excursions in myCAvax, but all waste events should be recorded in myCAvax in vials NOT doses.
  • REMINDER: Pfizer, Moderna, and Novavax are all available for ordering through myCAvax for Bridge Access Program (BAP) providers and through myVFCvaccines for Vaccines for Children (VFC) providers VFC providers may only report through myVFCvaccines.
    • VFC providers that report in the wrong system (myCAvax) should contact the Provider Call Center at ProviderCallCenter@cdph.ca.gov or call (833) 502-1245 for guidance on removing or updating the incorrect report BAP providers may only report through myCAvax.
    • BAP providers that report in the wrong system (myVFCvaccines) should contact the VFC Call Center at myVFCvaccines@cdph.ca.gov or call (877) 243-8832 for guidance on removing or updating the incorrect report
  • REMINDER: Job aid for Vaccine and Clinic Eligibility by Funding Source can be found here.
  • UPDATED: Bap Eligibility Resource can be found here
  • CA BAP Program Requirements can be found here.
  • Additional BAP Resources can be found here.

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CDC Beyond Use Date and Vaccine Information Statement

CDC Storage and Beyond-Use Date Tracking Labels

Apply storage and beyond-use-date tracking labels to reduce administration errors!

COVID-19 Vaccine Information Statement

Currently, providers are required by law to provide EUA fact sheets to vaccine recipients or their caregivers for all uses of Novavax and when Moderna or Pfizer vaccines are given to children 6 months through 11 years of age.

For recipients who are 12 or older receiving Pfizer or Moderna vaccine, a provider may use the COVID-19 Vaccine Information Statement (VIS).

CDC COVID-19 VIS can be found here.

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CDPH IZB – Request for Applications (RFA)

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Nirsevimab (BeyfortusTM) Shortage

  • Current shortage of new respiratory syncytial virus (RSV) immunization nirsevimab (BeyfortusTM) due to higher than anticipated demand
  • CDC recommends prioritizing available nirsevimab 100mg doses for infants at the highest risk for severe RSV disease
  • Prenatal care providers should encourage pregnant people to receive RSVpreF vaccine (Abrysvo, Pfizer) between 32 0/7 and 36 6/7 weeks of gestation to prevent RSV lower respiratory tract infection in infants
    • Discuss potential nirsevimab supply concerns when counseling pregnant people
    • Encourage pregnant people to receive RSVpreF vaccine (Abrysvo, Pfizer) which is effective and will reduce the number of infants requiring nirsevimab during the RSV season.
    • Either RSVpreF vaccination or nirsevimab immunization for infants is recommended to prevent RSV- associated lower respiratory tract disease in infants, but administration of both products is not needed for most infants.

CDC Health Advisory: Limited Availability of Nirsevimab in the United States—Interim CDC Recommendations to Protect Infants from Respiratory Syncytial Virus (RSV) during the 2023–2024 Respiratory Virus Season

  • For infants weighing <5 kg, ACIP recommendations are unchanged:
    • Infants born before October 2023, administer a 50mg dose of nirsevimab now
    • Infants born during October 2023 and through RSV season, administer a 50mg dose of nirsevimab in the first week of life.
  • For infants weighing ≥5 kg, prioritize using 100mg nirsevimab doses in infants at highest risk of severe RSV disease:
    • Young infants aged <6 months.
    • American Indian and Alaska Native infants aged <8 months.
    • Infants aged 6 to <8 months with conditions that place them at high risk of severe RSV disease*
  • Use of palivizumab (SynagisTM) in Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection
    • Follow AAP recommendations for palivizumab-eligible infants aged <8 months when the appropriate dose of nirsevimab is not available.
    • In palivizumab-eligible children aged 8–19 months, suspend using nirsevimab for the 2023–2024 RSV season. These children should receive palivizumab per AAP recommendations.
  • Continue offering nirsevimab to American Indian and Alaska Native children aged 8–19 months who are not palivizumab-eligible and who live in remote regions, where transporting children with severe RSV for escalation of medical care may be challenging, or in communities with known high rates of severe RSV among older infants and toddlers.
  • Avoid using two 50mg doses for infants weighing ≥5 kilograms (≥11 pounds)
    • 50mg doses should be reserved only for infants weighing <5 kilograms (<11 pounds), for example those born during the season who will be at increased risk for severe RSV illness because of their young age.
    • Providers should be aware that some insurers may not cover the cost of two 50mg doses for an individual infant.

Publications/Official Announcements:

  • Supply issues plague nirsevimab by AAP can be found here.
  • CDC reopens limited nirsevimab ordering through VFC by AAP can be found here.
  • CDC Health Advisory 10.23.23 can be found here.

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RSV Risk Factors

  • Chronologic age is the single most important risk factor for RSV hospitalization
    • More than 58% to 64% of pediatric RSV hospitalizations occur in the first 5 months after birth
    • The majority of RSV hospitalizations occur during the first year of life.
  • Certain subgroups of infants with comorbidities, such as prematurity, CLD, or hemodynamically significant CHD, have increased risks for RSV hospitalization.
  • Hospitalization rates for RSV disease and all causes of bronchiolitis are higher in American Indian and Alaska Native (AI/AN) infants and children than in the general US child population of the same ages.
  • Regardless of the presence or absence of comorbidities, RSV hospitalization rates decline during the second RSV season for most children.

Additional Resources:

  • AAP Respiratory Syncytial Virus page can be found here.
  • The American College of Obstetricians and Gynecologists (ACOG) Maternal Respiratory Syncytial Virus Vaccination Practice Advisory can be found here
  • CDC RSV Immunizations Overview can be found here.
  • CDC RSV Immunizations for Infants and Young Children can be found here.
  • CDC RSV Vaccine for Pregnant People can be found here.

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RSV Supply and Ordering

BeyfortusTM Vaccine Supply & Ordering Update-VFC

  • Ordering for Nirsevimab is currently unavailable in myVFCVaccines. Providers were notified on 10/16/2023 & 10/26/2023
  • Ordering will resume as soon as CDC allows ordering, allocations are in place, and supply can support ordering.
  • Most orders placed from 10/11-10/16 have shipped.
  • Given that VFC vaccine supply will be allocated, doses of Nirsevimab (BeyfortusTM) must be administered to VFC eligible patients only. Borrowing is not allowed.

BeyfortusTM Vaccine Supply Update

State Allocations:

  • CDPH has received a limited number of BeyfortusTM 50mg (0.5ml) dose formulation, expected to support ordering for the next 2-3 weeks.
  • -0- doses for the 100mg (1.0 mL) formulation have been allocated, as supply is not available.
  • CDPH is currently determining the provider types that doses would be made available to, potentially focusing on birthing hospitals, Tribal/Indian Health, and LHDs.

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COVID-19 Rapid Antigen Test Kits

COVID-19 Rapid Antigen Tests Available - Please Order Before Wednesday, November 1st

Department Leadership is encouraging you to request COVID-19 antigen tests ahead of Thanksgiving and the winter holidays.  In order to ensure delivery ahead of Thanksgiving holiday and to allow time for distribution to the community, we recommend you request tests as soon as possible, and no later than Wednesday, November 1st. Please see the FAQ for answers to question and use our online form to request COVID-19 rapid antigen tests: https://www.surveymonkey.com/r/YJTH9S9

As we enter the fall and winter months when activities start moving indoors and there is increased travel and gatherings for the holidays, it is important to address the increased risk of COVID-19 exposure. Surveillance data continues to show that COVID-19 is circulating in Los Angeles County at higher levels than seen during the summer and we expect COVID-19 rates to rise this winter. The Los Angeles County Department of Public Health continues to promote access to testing when someone is exposed, and before and after participating in indoor gatherings to support the health and well-being of residents.

Patient Access to Paxlovid: HHS and Pfizer Agreement

  • Protecting individuals in public programs, particularly Medicare
    • Individuals on Medicare, Medicaid, and those who are uninsured will continue to be able to access Department of Health and Human Services (HHS)-procured Paxlovid for free through the end of 2024 via the Patient Assistance Program (PAP).
    • Starting January 1, 2025: Eligible uninsured and underinsured patients can receive USG procured, NDA-labeled Paxlovid at no cost. Participating PAP dispensing sites will be sent replacement product for any dispensed product within this program.
  • Ensuring no HHS-procured product is lost to expiry
    • Undispensed excess supply with an expiration date of December 2023 or later should be returned by December 31, 2023, for a credit replacement to USG inventory of NDA-labeled treatment course.
  • Creating a stockpile for future emergencies
    • In addition to ensuring that HHS maintains every course of Paxlovid that it has purchased, Pfizer will provide HHS with a stockpile of an additional one million treatment courses to ensure preparedness for future COVID-19 surges.
  • Providing a smooth transition to the commercial market
    • HHS will ensure a smooth and predictable transition to the commercial market over the next few months while prioritizing and reserving our HHS-procured treatment courses for people with Medicare and Medicaid, and for those who are uninsured. During this transition to commercial distribution, Paxlovid will remain available for ordering from HHS through Friday, December 15, 2023.
  • HHS and Pfizer agreement to increase patient access to Paxlovid can be found here.

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Sunsetting the US Government (USG) COVID-19 Therapeutics Distribution Program

  • USG prepares to wind down the current distribution of USG-procured COVID-19 therapeutics and transition of the COVID-19 Oral Antiviral (OAV) treatments (nirmatrelvir packaged with ritonavir Paxlovid, and molnupiravir, Lagevrio) to the commercial market.
    • Commercial ordering will begin Wednesday, November 1, 2023
    • Paxlovid will remain available for ordering from HHS through Friday, December 15, 2023.
    • Lagevrio will remain available for ordering through Friday, November 10, 2023
  • Summary table provides an estimated sequence of events based on OAV manufacturers’ commercialization plan
  • Ordering and Distribution Timelines
  • Guidance on Inventory and Disposal Management
  • Data Reporting Requirements
  • Programs for Uninsured and Underinsured Individuals
  • COVID-19 Therapeutics Commercialization Transition guide can be found here. Please note this guide is for planning purposes only as details may change.

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Communication Tools: COVID-19 Therapeutics

  • CDPH Communication Toolkit Resources Page can be found here.
  • COVID-19 Treatment Communication Toolkit can be found here.
  • COVID-19 Treatment Resources for Healthcare Providers can be found here.
  • Respiratory Viruses Communication Tools can be found here.
  • Toolkit for Care Providers email: COVIDRxProviders@cdph.ca.gov

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Upcoming/Archived Webinars

Save the Date for Upcoming LAC DPH-AAP Pediatric Information Session 

 

You are invited to join our upcoming Vaccine Preventable Disease Control (VPDC) Information Session for Pediatric Providers. Tuesday, November 7th at 12:00 pm. In addition to a situation update on seasonal viruses, special guest presenter Dr. G. Kaliah Salas, PsyD, Mental Health Clinical Program Manager at Los Angeles County Department of Mental Health (LACDMH), will be sharing a free screening tool available to primary care providers and presenting on the referral process for LACDMH. 1.0 CEU credit will be provided.

HRSA COVID-19 Response Office Hours

 

HRSA will be hosting an office hours webinar to cover the transition of COVID-19 therapeutics to the commercial market. Please register here.

 

AB 1797 Requirements: CAIR (California Immunization Registry) Webinar

 

Please join us Wednesday, November 1st, 9-10am for a presentation on the new California law requiring (AB 1797) all healthcare providers to report all administered vaccine doses to the California Immunization Registry (CAIR). This presentation will be held virtually on WebEx (meeting link and call-in information is included below); no pre-registration is required.

Some topics we will review:

  • AB1797
  • How to Enroll
  • Data exchange vs. direct data entry
  • User types/roles
  • Benefits for patients/providers

https://lacountyph.webex.com/lacountyph/j.php?MTID=m5887f419fc93a52f2839950435482425

Meeting number: 2554 906 1469

Password: DupMTkBJ346 (38768525 from video systems)

Join by video system

Dial 25549061469@lacountyph.webex.com

You can also dial 173.243.2.68 and enter your meeting number.

Join by phone

+1-213-306-3065 United States Toll (Los Angeles)

Access code: 255 490 61469

 

ACIP Meeting

  • From Wednesday, October 25th-Thursday, October 26th
  • Topics:
    • With votes:
      • Meningococcal and Mpox vaccines
      • 2024 combined immunization schedules
    • Without votes:
      • RSV, Influenza, Chikungunya, Dengue, COVID-19, Pneumococcal vaccines
  • Webcast link and agenda can be found here.

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 MyTurn Release 44 (Thursday 11.2.2023)

Clinic Managers and Vaccine Administrators will be able to:

  • View the updated COVID-19 timing chart hyperlink within the attestation under the ‘Patient Background’ field while on the Vaccine Administration and IIS flow, and under the ‘Vaccine Brand’ field while single editing an appointment and on the Walk- in flow
  • View the updated 'Uninsured status confirmed?' checkbox attestation under the ‘Health Insurance’ section if they select ‘No’ in response to the question ‘Does the patient have health insurance?’ in the Walk-in flow

Clinic Managers and Vaccine Administrators will no longer be able to:

  • View the 'Vaccine Supply' section while viewing / editing clinic details
  • View the tooltip on the 'End Date' field

New MyTurn users will be able to:

  • Receive an automated confirmation email for their application submission, approval, or rejection with the updated Help Desk email and hours of operation
  • See the revised Help Desk email and hours of operation in an error message while adding a new provider location in the unauthenticated digital enrollment flow

Clinic Managers and myCAvax users will be able to:

  • Search for an existing user on the ‘Provider of Record’ field that will filter for contacts with only CEO / CMO / POR titles
  • Input an existing location and edit missing fields while on the authenticated Digital Enrollment flow
  • View the character limit for input in any ‘Name’ or ‘Email’ fields, matching the myCAvax Digital Enrollment flow
  • View a new field labeled as “Please specify ‘Other’ Provider Type” in Step 2 of the Provider Location Information if ‘Other’ is selected as the provider type option
  • View the updated Help Desk hours and email when entering duplicate IIS numbers on the IIS information page and in both the new provider location and existing provider location flows for locations associated with the My Turn program.

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LACDPH & CDPH Provider Office Hours Link

LA County Department of Public Health Provider Immunization Office Hours Information

  • Every other Wednesday from 9am-10am - Next meeting: 11/08/23
    • NOTE: Effective 2/01/23 the Office Hours will be held on a biweekly basis
  • This has been meeting amended to discuss COVID, Mpox, Flu and RSV vaccines. The meeting link will remain the same.
  • 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