LACDPH Vaccine Preventable Disease Control Program November 2023 Updates

RSV 

Infants who are VFC eligible (Medi-Cal, uninsured or underinsured) should receive nirsevimab from their pediatric provider.  If their pediatric provider does not have doses available, they can be referred to DPH clinics: www.publichealth.lacounty.gov/vaccines or call 1-833-540-0473. 

 

Nirsevimab (Beyfortus™) Ordering 

 

COVID-19  

Moderna COVID-19 Vaccine 6M – 11Y 

The Food and Drug Administration (FDA) is advising healthcare providers who administer the Moderna COVID-19 Vaccine (2023-2024 Formula) to individuals 6 months through 11 years of age to ensure that the correct volume of the vaccine (0.25 mL) is withdrawn from the vial, so that the correct dose is administered to the vaccine recipient.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. Moderna created a one minute step-by-step video guide demonstrating how to accurately draw and administer the pediatric COVID-19 vaccine.

 

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.  

 

CDPH COVID-19 Vaccine Sheets 

CDPH developed COVID-19 vaccine sheets that include billing codes (private and public patients), product information from manufacturers, and more, see below by age category: 

• CDPH Vaccine Fact Sheet: COVID-19 Vaccine Infant/Toddler (6M-4Y), 2023-2024 Formula  
• CDPH Vaccine Fact Sheet: COVID-19 Vaccine Pediatric (5-11Y), 2023-2024 Formula  
• CDPH Vaccine Fact Sheet: COVID-19 Vaccine Adolescent/Adult (12Y+), 2023-2024 Formula  

 

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  
• For general Therapeutics questions, please email: COVIDRxProviders@cdph.ca.gov 

 

Influenza (Flu) 

Patients presenting with respiratory symptoms should be tested for flu to inform treatment options. Treatments for flu are available for children with severe, complicated, or progressive illness. There has been an observed lack of prescriptions for flu antivirals in pediatrics. Recent data from the American Academy of Pediatrics indicates that less than 40% of children who are at high risk for severe influenza get treated with Tamiflu. Note that if a child is high-risk and meets eligibility criteria for flu and COVID-19 treatment, they can be treated with Paxlovid and Tamiflu concurrently.  

For more information on flu antiviral medications for children, visit the CDC’s Children and Flu Antiviral Drugs webpage. 

 

RSV 

PCR and antigen tests are effective in testing for RSV. For infants and young children, the sensitivity of RSV antigen tests can be as high as 90%.  

Infants are at high risk for developing bronchiolitis and severe disease. Pregnant mothers should get vaccinated between 32 and 36 weeks. Infants born to mothers who were not vaccinated should receive the infant RSV antibody vaccine Nirsevimab. While supply of Nirsevimab is limited, the CDC advises that clinicians prioritize doses for infants at highest risk for severe RSV disease.  

 

For more information on RSV in Pediatrics, visit the CDC’s RSV in Infants and Young Children webpage.   

For additional clinical questions related to COVID-19 testing, reporting, vaccines, and more, the DPH COVID-19 Provider Call-Line is available Monday through Friday, from 8:00am-5:00pm, by calling (213) 240-7941. For time-sensitive questions after hours, you can reach the on-call clinician at (213) 974-1234. 

 

LACDPH Symptom Guidance  

The Los Angeles County Department of Public Health is pleased to inform you about a new resource: LA County Symptom Guidance for Schools (available in English and Spanish).  

 

This 2-page PDF provides general recommendations and symptom-based considerations for both parents and school/childcare administrators on when children can safely return to school. It is adapted from CDPH guidance developed in conjunction with Pediatric Infectious Disease specialists.  

We hope this new resource serves as a practical tool for use in your clinical work with patients and their parents. Please feel free to download and distribute the document as needed.  

These recommendations do not replace or revise existing laws or requirements applicable to schools and child-care facilities. Instead, they are aligned with the principle that safe, in-person learning and child-care are fundamental to a child’s wellbeing.   

 

For additional health resources relevant to parents, visit the LA County COVID-19 Education Toolkit.