Weekly Vaccine Digest 12/20

County of Los Angeles, California sent this bulletin at 12/20/2023 04:16 PM PST

Weekly Vaccine Digest 12/20/23

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 you will find a pdf version of this document and the LAHAN. 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 1-3: Holiday Shipping Cadence, Order and Administration Reminders

·Page 3-5: LAHAN

·Page 5-6: COVID-19 Storage and Handling, VFC/VFA Recertification

·Page 6: Vaccine for Children (VFC)

·Page 7-8: RSV, California Immunization Registry (CAIR)

·Page 8: My Turn Release 46

·Page 9: LACDPH & CDPH Provider Office Hours Link

Holiday Shipping Cadence

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Order and Administration Reminders

  • Holiday Note: The CDPH Immunization Updates for LHDs and Providers are cancelled on the following dates:
    • Friday, December 22, 2023
    • Tuesday, December 26, 2023
    • Friday, December 29, 2023
    • Tuesday, January 2, 2024
  • REMINDER: There will be NO BAP or VFC deliveries from December 20th through December 29th.
  • REMINDER: The CDPH Provider Call Center will be closed on Monday, December 25, 2023, and Monday, January 1, 2024
  • 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.
      • Note: Expired or spoiled Jynneos vaccine does NOT need to be returned to LAC DPH or the manufacturer. Ignore the “Return Shipping Method” section when reporting a waste event and leave it as the default. That section is only for providers in counties besides LA County.
  • 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
    • V-safe is also available for 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
  • Covid-19 Vaccine Fact Sheets can be found here.
  • Novavax COVID-19 Vaccine Resources:
  • CDPH Office of Communications Job Aid: Pregnancy and Immunizations. English and

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LAHAN: CDC Health Advisory: Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and RSV Immunizations and Use of Authorized/Approved Therapeutics in the Setting of Increased Respiratory Disease Activity During the 2023 – 2024 Winter Season.

The CDC issued a health advisory on 12/14/23 alerting healthcare providers to increasing influenza, SARS-CoV-2, and RSV activity and low vaccination rates against these pathogens. CDC urges providers to recommend and offer immunizations and to offer antiviral medication to eligible patients. The CDC has created communication tools including a Conversation Guide for Healthcare Providers and Healthcare Provider Toolkit to support providers’ efforts to protect their patients this respiratory virus season.

 

Below, we provide additional information on influenza, COVID-19, and RSV activity and immunizations in Los Angeles County.

 

Percent of Respiratory Specimens Testing Positive by Viral Etiology Los Angeles County Sentinel Surveillance Laboratories 2023-2024 Influenza Season

 

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Source: LACDPH Resp Watch

 

Influenza:

  • In Los Angeles County, the percentage of specimens testing positive for influenza at sentinel surveillance sites continues to increase and is currently at 14.2% In addition, there continues to be an increase in influenza hospitalizations. Influenza-like illness accounts for a significant proportion of emergency department visits in Los Angeles County, particularly among children 0-17 years of age. 
  • As of 11/30/2023 we estimate that this season's flu vaccine coverage in Los Angeles County was 22% in all persons ages 6 months and older and 51% in persons ages 65 years and older.

COVID-19:

  • As of 12/15/23 in Los Angeles County, the percentage of specimens testing positive for COVID-19 at sentinel surveillance sites remains high and is currently at 10.3%. COVID-positive hospitalizations have been increasing. For the week ending 12/9/23, there was an average of 524 hospitalizations a day.
  • As of 12/10/23 we estimate that coverage with the updated 2023-2024 COVID-19 vaccine in Los Angeles County is 9% in all persons ages 6 months and older and 23% in persons ages 65 years and older.

RSV:

  • In the week ending 12/9/23, 12.5% of all specimens tested at sentinel surveillance laboratories in Los Angeles County were positive for RSV.
  • As of 12/12/23 we estimate that that in Los Angeles County RSV vaccine coverage is 6.5% for persons ages 60 years and older, and 8% for females ages 15-45 years who were presumed to be pregnant. We estimate that only 6.7% of eligible infants have received nirsevimab.
  • Immunizations are now available to prevent RSV in infants (either through maternal vaccination and directly to infants) and adults over 60 years. RSV vaccines (Abyrsvo and Arexvy) are available at pharmacies and providers offices and are covered by Medi-Cal, MediCare Part D, and most private insurance companies. Infants who are uninsured or on Medi-Cal can receive nirsevimab at our Los Angeles County Department of Public Health clinics for free.

For more information regarding respiratory virus activity in Los Angeles County, please refer to LACDPH Resp Watch.

We encourage all providers to continue to contact their patients to recommend and offer these immunizations.

 

Medications:

All providers should offer therapeutics to eligible patients. Both influenza and COVID-19 antiviral medications are underused but can assist in decreasing hospitalizations if used promptly in high-risk individuals. Since Paxlovid and Lagevrio have transitioned to the commercial market, patient assistance programs are now in place to assist with access to these products. Information about these programs can be accessed at paxlovid.com/paxcess and merckhelps.com/.  Please see the 12/18/23 CDPH Health Advisory for additional guidance regarding COVID-19 Therapeutics and services. Patients can still access COVID-19 therapeutics and telehealth services for free through the Los Angeles County Department of Public Health at 1-833-540-0473. Providers inquiring about access to any remaining US Government supplies can reach out to DPH-Therapeutics@ph.lacounty.gov.

 

Please refer to the CDC communication for additional information regarding immunizations, antiviral medications, reporting of MIS-C, and resources for preparing your patients for the fall and winter virus season.

 

CDC Health Advisory can be found here.

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COVID-19 Vaccine Storage & Handling

  • COVID-19 Vaccine Presentation Change
    • New Refrigerated Pfizer 12y+ COVID-19 Vaccine!
    • For orders placed on December 11th or earlier, this new product will NOT be used to fulfill those orders.
    • This new presentation comes as single-dose pre-filled syringe and MUST BE STORED BETWEEN 2°C - 8°C (36°F and 46°F).
    • The expiration date is printed on the carton or syringe labels.
    • Pfizer-BioNTech COVID-19 vaccines for children aged 6m-4y and 5-11y, that ship to providers in CDC’s programs directly from Pfizer on dry ice and can be stored at either at ultracold temperatures until expiry or up to 10 weeks at 2°C - 8°C.
    • Pfizer will continue to allow providers to privately order the original pre- filled syringes (PFS) for age 12+ so, providers may have BOTH presentations – PFS with a 10-week beyond-use-date (BUD) and PFS that can be used through the expiration date.

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VFC & VFA RECERTIFICATION

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Vaccine for Children (VFC)

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  • BeyfortusTM VFC Ordering
    • Additional doses of nirsevimab (BeyfortusTM) have been received from CDC this week.
    • Ordering is available to all providers for both BeyfortusTM formulations, 50mg and 100mg.
    • Multiple general reminders are being shared with VFC providers urging them to place orders, given increase in RSV activity, and the holiday shipping blackout.
    • Specific outreach has been done with providers that have not ordered any doses yet, including birthing hospitals, and pediatric practices that have history of pneumococcal conjugate vaccine ordering.
  • BeyfortusTM Vaccine Supply
    • Sanofi has announced the release of an additional 230,000 doses of nirsevimab (BeyfortusTM), made up of 50mg and 100mg doses, in January 2024.
    • It is estimated that ~58% of these doses will support Vaccines for Children Program across the U.S
  • Sanofi Beyfortus (nirsevimab-alip) Injection Update
  • COVID-19 Vaccine Ordering
    • We are actively tracking VFC vaccine ordering for Pediatric COVID-19 vaccines among participating providers.
    • Of the 3,312 active VFC providers, 1,926 (58%) have ordered a total of 179,470 COVID doses. This is 124 more providers who have ordered since last report on 11/27/2023.
    • 38% of providers eligible to order COVID-19 vaccines that have NOT ordered doses will be outreached by VFC Program Representatives
  • COVID-19 Vaccines Update
    • New Refrigerated Pfizer 12y+ COVID-19 Vaccine Coming next week!
    • CDC will be replacing the current Pfizer COVID- 19 vaccine for persons 12y+ (NDC 00069-2362- 10) on CDC’s pediatric and adult contracts with this new presentation:
      • NDC00069-2377-10Refrigeratedformulation (product has never been frozen)
      • The carton will contain 10 prefilled syringes
      • Must be stored refrigerated at 2-8C
      • Shelf life aligns with the expiration date printed on the carton and syringe labels (6 months from production to expiry)
  • Comirnaty Single-Dose Glass Prefilled Syringes 2023-2024

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RSV

  • CDPH Respiratory Virus Dashboard is now Live
    • Interactive display allows the viewer to track influenza and COVID-19 side by side
    • Scroll down for more detailed views
    • ICU bed availability is also tracked
    • All views statewide for now
  • Young Children and Older Adults at Increased Risk for Severe Viral Respiratory Illness
    • In the last 4 weeks, hospitalization rates have increased by:
    • 200% for influenza
    • 51% COVID-19
    • 60%for RSV
  • Urgent Need: Increase Respiratory Virus Immunization Coverage
    • Vaccine coverage is low for all recommended respiratory vaccines
    • Recommend and administer immunizations to prevent severe illness.
    • Everyone 6 months and older to stay up to date on COVID-19 vaccinesand get a seasonal flu vaccine. 
    • RSV immunizations are now available for infants and young children, pregnant people and adults 60 years and older. 
  • Fall and Winter 2023-2024 Immunizations guide can be found here.
  • RSV Summary
    • Influenza, COVID-19, and RSV hospitalizations are increasing
    • Infants and older adults are at high risk of severe disease from respiratory viruses
    • Urgent need to continue immunization efforts to prevent severe illness this season. Your strong recommendation is critical!
    • Remember to treat COVID-19 and influenza, especially for high-risk individuals
    • Recent data supports effectiveness of immunizations to prevent severe illness

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California Immunization Registry (CAIR)

  • CAIR Updates
    • Sunday, December 3, 2023, release included:
      • Addition of new vaccines:
        • Penbraya and Cyfendus
          • Penbraya will appear under MenACWy and MenB on the patient's record
      • Ability to add both doses of Beyfortus administered on the same day
        • Updated logic to disclose patients when accessing records for better user experience.
          • Clicking this button will automatically change the disclosure status from "No" to "Yes"
          • The same applies to accessing records whose share status is "No"
    • Thursday, December 14, 2023, release:
      • x release to address technical performance
      • Includes the adult RSV schedule
    • Beginning Wednesday, December 20, 2023, CAIR Quick Entry will allow users to submit, view and edit vaccine administration data for most vaccines to Immunization Information Systems (IIS).
    • CAIR Hub was down part of Monday, December 18, 2023; issue resolved
    • Reports must be submitted or edited by December 22, 2023
    • Only Admin users will be able to submit reports after Friday, December 22, 2023.

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My Turn Release 46 (Wednesday 12/20/2023)

Clinic Managers and Vaccine Administrators will be able to view:

  • The new ‘CAIR Quick Entry’ tab with the ‘Upload Records’ and the ‘View / Edit Records’ dropdown options
  • The ‘Inline Submission’ page with multiple entry fields and the ‘CSV Submission’ page with the downloadable CSV template and instructions
  • The ‘CAIR Quick Entry Record Details’ page by selecting the ‘View / Edit Records’ dropdown option from the ‘CAIR Quick Entry' tab and choosing a specific record
  • The ‘Step 2 - Patient Information’ section and enter the Patient details by choosing the ‘Inline Submission’ tab from the ‘CAIR Quick Entry Upload Records’ page
  • The updated age groups on the age filter to effectively sort appointments based on age
  • The new ‘Inline Submission’ tab and ‘CSV Submission’ tab on the ‘Upload Records’ page
  • An option to create a new appointment using the ‘Add New Appointment’ functionality when they select either ‘Asian’ or ‘Native Hawaiian or Pacific Islander’ while creating a COVID-19, Flu, or mpox appointment on the ‘Patient Background’ section in the VA flow
  • An error message if they select ‘Prefer not to say’ along with another option for the ‘Please select your race or nationality’ question in the Walk-In, IIS, Bulk Upload, and VA flows for Covid, Flu, or mpox appointments
  • New buttons to edit / delete records on the ‘View / Edit record’ page
  • Two new subfields on choosing ‘Asian’ or ‘Native Hawaiian and Other Pacific Islander’ options for the ‘Please select your race or nationality’ question in the Walk-In, IIS, and VA flows

Clinic Managers will be able to view:

  • New tiles and a list of recent records with errors / warnings on selecting the ‘CAIR Quick Entry’ dropdown option from the filter on the My Turn Dashboard

New My Turn Users will be able to view: 

  • The new ‘After enrolling in My Turn you will have access to:’ section with CAIR Quick Entry related information added to the ‘Step 1 - Create an account’ page on the unauthenticated flow

 

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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: 1/03/2024
    • 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