Weekly Vaccine Digest 11/03

County of Los Angeles, California sent this bulletin at 11/03/2023 02:30 PM PDT

Weekly Vaccine Digest 11/03

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 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 1-2: Order and Administration Reminders

·Page 2-5: Ensuring Correct Dosing of Moderna, CDPH IZB Request for Application, ACIP Clinical Updates

·Page 5-7: Nirsevimab Supply and Order Update VFC, COVID-19 At-home Tests, Pharmacy Long Term Care Facilities

·Page 8: Communication Tools: COVID-19 Therapeutics, Upcoming Webinars

·Page 9-10: MyTurn Release 44, 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, 11/06. 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.
  • NOTE: CAIR/RIDE Registry ID's - Under AB 1797, vaccine providers are required to enter immunization information into the California Immunization Registry (CAIR) OR Healthy Futures/RIDE.
  • NOTE: V-safe for RSV Vaccines in Older Adults Now Available
    • V-safe now available for adults 60 years and older who received RSV vaccine
      • Will be available soon to pregnant people who received RSV vaccine
    • V-safe is a safety monitoring system that lets you share with CDC how you, or your dependent, feel after getting an RSV vaccine.
    • Using V-safe after RSV vaccination requires a new registration.
    • Please encourage your patients to participate.
    • CDC V-safe
    • V-safe print materials

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Ensuring Correct Dosing of Moderna COVID-19 Vaccine (2023-2024 Formula) to Individuals 6 months through 11 years (0.25mL) 

Please be aware that FDA released important information to ensure correct administration of the Moderna COVID-19 Vaccine (2023-2024 Formula) for individuals 6 months through 11 years.  

The announcement advises that providers who administer the Moderna COVID-19 Vaccine (2023-2024 Formula) to individuals ages 6 months through 11 years should ensure that the correct volume of the vaccine (0.25 mL) is withdrawn from the vial and administered to the recipient. Providers should discard the vial and excess volume after extracting a single 0.25mL dose. Excess volume should not be used to administer an additional dose. Additionally, never combine partial doses from multiple vials to make one dose for a patient. 

FDA shared this information after learning some healthcare providers may not recognize that the single dose vial of Moderna COVID-19 Vaccine (2023-2024 Formula) contains more than 0.25 ml of the vaccine and may be withdrawing the entire contents of the vial to administer to an individual. FDA has not identified any safety risks associated with administration of the higher dose in individuals 6 months through 11 years of age, and no serious adverse events related to this issue have been identified.  

For additional information, see the FDA announcement, updated Moderna fact sheet, and the vaccine administration resources listed at the end of this message.

Resources for Moderna Vaccination Administration:

General Resources for Vaccination Administration:

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CDPH IZB – Request for Applications (RFA)

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Advisory Committee on Immunization Practices (ACIP) COVID-19 Vaccine Updates

COVID-19 vaccine implementation review

  • Commercialization and Bridge Access Program (BAP)
  • COVID-19 vaccine coverage data and survey results

COVID-19 vaccine policy

  • Review of current vaccine guidance – Use of COVID-19 Vaccines
  • Future considerations include:
    • Additional vaccine doses for older adults
    • Future vaccine formula updates
    • As needed recommendation update based on ongoing surveillance of VE, safety, and epidemiology

Increased Flexibility for Interchangeability of COVID-19 Vaccines

Updated language - In the following circumstances, an age-appropriate COVID-19 vaccine from a different manufacturer may be administered:

  • Same vaccine not available at the vaccination site at the time of the clinic visit
  • Previous dose unknown
  • Person would otherwise not receive a recommended vaccine dose
  • Person starts but unable to complete a vaccination series with the same vaccine due to a contraindication

COVID-19 Vaccine Age Transition Guidance Update

  • CDC recommends that people receive the age-appropriate vaccine product and dosage based on their age on the day of vaccination (Table 1 and Table 2).
  • If a person moves to an older age group between vaccine doses, they should receive the vaccine product and dosage for the older age group for all subsequent doses.
  • However, for children who transition from age 4 years to age 5 years and children who are moderately or severely immunocompromised and transition from age 11 years to age 12 years, FDA authorization allows for an alternative dosage (see Table 1 and Table 2).

Vaccine Safety – COVID-19 and Flu Vaccines

  • Summary and interpretation of analyses of ischemic stroke and bivalent mRNA COVID-19 and influenza vaccination
    • Inconsistent results, most studies found no association
    • The benefits of vaccination still far outweigh the risks, especially in older adults
    • COVID-19 and influenza disease are associated with an increased risk of stroke
  • Next steps
    • CDC will conduct additional analyses and continue safety monitoring
    • No changes to CDC guidance on coadministration of COVID-19 and influenza vaccines.
    • Get vaccinated to protect against the clear risks from COVID-19 and influenza this winter.

Other ACIP Topics

  • Influenza vaccine
    • Safety with co-administration with mRNA COVID-19 vaccines and Zoster vaccine
    • Safety of vaccination in pregnant person, effectiveness against flu-associated hospitalizations and ED visits in infants
  • Pentavalent Meningococcal vaccine now recommended; formal guidance and updated materials are coming soon.
  • Pfizer's pentavalent MenABCWY vaccine (PenbrayaTM) now licensed and recommended as an option when both MenACWY and MenB vaccines are indicated at the same visit.
  • Product included in the Vaccines For Children Program.
  • New adult pneumococcal vaccines under late stage of development
  • Chikungunya vaccine under consideration by FDA, not yet licensed
  • RSV Vaccines for Older Adults
    • Review of epidemiology of RSV in adults
    • GSK safety and immunogenicity in persons 50-59 years of age
    • Future work group discussion: RSV vaccine is not currently approved for ages 50-59 years. If approved, future discussion about guidance anticipated.
  • 2024 Combined Immunization Schedules Approved
    • Updates to tables and notes that includes addition of new vaccines (e.g. mpox and RSV vaccines).
    • Addition of an “Addendum” page to allow for timely posting of new recommendations that occur during the year.

Additional Resources:

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Nirsevimab (BeyfortusTM) Supply and Ordering Update VFC

  • Due to supply limitations nationwide, nirsevimab (BeyfortusTM) was temporarily paused
  • from VFC ordering on October 16.
  • With the arrival of a very limited number of doses at CDC’s VFC distributor, CDC has implemented allocations to states. Allocations from CDC is expected to be replenished every 2 to 3 weeks, and as product is made available by the manufacturer.
  • CDPH has received a limited number of BeyfortusTM doses expected to support ordering for the next 2-3 weeks:
    • 50mg (0.5 mL) dose formulation: 6,430 doses
    • 100mg (1 mL) dose formulation: 6,060 doses
  • The VFC Program has now opened ordering for nirsevimab (BeyfortusTM) in MyVFCvaccines but only for a limited number of VFC Providers, including hospitals, Tribal Health Clinics, select Federally Qualified Health Centers (FQHCs)/Rural Health Centers (RHCs) and Public Health Department Clinics.
  • Additional doses will be made available to additional VFC Providers as more doses are received.
  • Ordering limits are based on monthly order averages of hepatitis B doses for hospitals, and PCV for outpatient providers. Maximum amounts providers may request will be indicated as part of the ordering process and the limits may be changed depending on supply.

CA VFC Program’s No Borrowing Policy

  • The California Vaccines for Children (VFC) Program has a no borrowing policy.
  • Although earlier this fall CDC allowed states to determine the feasibility of implementing borrowing, CDC now acknowledges that borrowing and replacing doses is not feasible during the shortage.
  • Given that VFC supply is allocated, doses of nirsevimab (BeyfortusTM) ordered through the VFC Program must be administered to VFC eligible patients only. Borrowing is not allowed.

VFC Pediatric RSV Inventory Requirement

  • According to VFC Program Participation requirements, VFC providers are required to maintain an inventory of both VFC and privately purchased immunizations based on the populations served and as reflected in the Provider’s VFC Population Profile.
  • Given the current supply limitations which continue to evolve, CDC recognizes that some VFC providers may be challenged to maintain private stock of nirsevimab (BeyfortusTM) during the 2023-2024 respiratory virus season.
  • As a result, the VFC Program is temporarily suspending the requirement to stock private supply of nirsevimab (BeyfortusTM) for providers that serve privately insured patients. This requirement will go back into effect August 1, 2024.

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California Healthcare Centers, Clinics and Pharmacies Request COVID-19 At-home Tests!

  • One-time distribution in preparation for the respiratory viral season
  • Tests are for uninsured, underinsured, Medicare recipients, or at high risk of severe disease.
  • COVID-19 tests must be provided for free.
  • Your organization CANNOT bill patients’ insurance for the tests.
  • At-home tests are self-tests; they must be distributed to the individual and performed by the individual (or their parent/guardian).

At-home Test Ordering Information

  • Tests expire December 2023 (extended expiration)
  • Use this link to place an order for up to a 2-month supply of tests before November 30, 2023: https://labsupport.powerappsportals.us/ordercovidotc/ *
  • Tests must be stored INDOORS, in a temperature-controlled space [less than 86 degrees] as soon as they are delivered.
  • A case of 180 tests is 12” L x 13” W x 11” H.
  • A pallet of 15,120 tests is 4 ft x 4 ft x 6 ft.

NOTE: Tests are to be ordered directly by the health care center, clinic, or pharmacy. Order form should NOT be shared with the public.

 

Free COVID-19 At-home Tests: Please Share

  • All insured people can request 8 free (or reimbursed) tests each month from pharmacies or retail stores through Saturday, November 11, 2023.
  • Learn more at How to Get Testing CA All
  • S. households can order 4 more free COVID-19 rapid tests: https://www.covid.gov/tests
  • Home Test to Treat is a federal program that offers free tests and free treatment (if eligible) for COVID-19 at home 24/7. No insurance or appointments needed!
  • For more information on the changes to COVID-19 Medical Coverage COVID-19 Medical Coverage Changes

Extended Expiration Dates on At-home Tests

  • Most printed expiration dates are not correct and have been extended.
  • Check to see the correct expiration date on the FDA website.
  • Replace tests that are older than the extended expiration dates.
  • If newer tests are not easily available, you may use an expired test as long as the internal control line remains valid.

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Pharmacy Long-term Care Facilities (LTCF)

  • Find Bridge Access Program Pharmacies here.
  • Actively working with federal partners on LTC facility needs for staff members.
  • Identified all pharmacies that either have their primary or secondary focus on LTCFs
  • Some of the pharmacies on the list are Retail and LTC pharmacies
  • Some are considered ‘closed door’ and only support facilities without offering any retail operations.

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 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.

 

Vaccines for Adults (VFA) Webinar

  • When: Wednesday November 15, 2023
  • Time 12PM-1PM
  • Registration link can be found here.

 

COVID-19 Crucial Conversations Webinar:  Talking to patients about staying safe from respiratory viruses during the holidays

  • When: Wednesday November 15, 2023
  • Time: 12PM-1PM
  • Registration link 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.

NOTE: My Turn Public users may experience a temporary degradation of service due to security maintenance on Tuesday, November 7, 2023, from 4:00 PM – 5:00 PM PT.

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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