LACDPH Vaccine Preventable Disease Control Program January 2024 Updates
County of Los Angeles, California sent this bulletin at 01/24/2024 09:23 AM PST
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Vaccines for Children (VFC) Program's Annual Recertification due end of January 2024 The Vaccines for Children (VFC) Program's Annual Recertification is here! Recertification is a federal requirement that must be completed annually by enrolled providers to continue receiving publicly funded vaccines. VFC providers are required to order all ACIP-recommended vaccines including COVID-19 vaccines to meet the needs of their patient population. New providers that enrolled prior December 2023 will also be expected to complete 2024 VFC Recertification. Providers will have until January 31, 2024, to complete the process. Resources:
RSV Immunization for Infants: Nirsevimab Ordering Manufactures confirmed that 230,000 additional doses of Nirsevimab will become available this month, January 2024. If your practice sees young or vulnerable infants and has not yet ordered Nirsevimab (BeyfortusTM), order now to protect as many patients as possible with available VFC supplies, following CDC's Updated Guidance for Healthcare Providers on Increased Supply of Nirsevimab to Protect Young Children for Severe RSV during the 2023-2024 Respiratory Virus Season. CDC advises healthcare providers to return to ACIP recommendations on use of Nirsevimab in young children.
Ordering Tips:
Once immunizations are received, please make sure doses administered are reported to CAIR, following the appropriate VFC Eligibility. VFC doses must only be administered to VFC-eligible patients. Borrowing is not allowed. The following resources can help your practice ensure prioritization of high-risk populations considering limited Nirsevimab supply: IMM-1496 Optimizing RSV Protection for Infants with Limited Supply of Nirsevimab (BeyfortusTM)- Update January 2024. RSV Vaccine Administration Errors in Young Children and Pregnant People (CDC COCA) On January 22, 2024, CDC released a Clinician Outreach and Community Activity (COCA) to highlight reports in administration errors. Since the approval of RSV vaccines and the monoclonal antibody Nirsevimab, the CDC and Food and Drug Administration (FDA) has received reports of Pfizer (Abrysvo) or GSK (Arexvy) RSV vaccines being administered in error to young children. CDC and FDA have also received reports of the GSK RSV vaccine (Arexvy) being adminsitered in error to pregnant people. As of January 2024, the number of reports received by VAERS suggested that these types of errors are uncommon in young children less than 2 years of age (25 reports) and pregnant people (128 reports) relative to an estimated 1 million infants protected from RSV either through infant receipt of Nirsevimab or through vaccination of pregnant people. New Refrigerated Pfizer 12yrs+ COVID-19 Vaccine Available CDC has replaced the current Pfizer COVID-19 vaccines for persons 12+ (NDC 00069-2362-10) on CDC's pediatric and adult contracts with this new presentation:
The new Pfizer product is now available to order in myCAvax. Despite the transition to the refrigerated Comirnaty, providers who have the original Pfizer 12+ vaccine on hand can and should continue to use this product until it is consumed, expired, or has been stored at 2°C-8°C for longer than the allowable 10 weeks. For more information and resources please refer to this CDPH communication, and to the updated COVID-19 Vaccine Adolescent/Adult (12Y+) fact sheet. |
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The Centers for Disease Control and Prevention (CDC), issued a health advisory to alert healthcare providers to low vaccination rates against influenza, COVID-19, and RSV (respiratory syncytial virus). Currently, there is still high levels of respiratory virus activity in Los Angeles County with RSV, SARS-CoV2 and influenza circulating. Because of this, it is still critical for healthcare providers to recommend and administer COVID-19, Flu, and RSV vaccines to prevent severe illness and hospitalization for the remainder of the respiratory virus season. Healthcare providers should also counsel patients about testing and other preventative measures, including covering coughs/sneezes, staying at home when sick, washing hands, and wearing a mask in public spaces. Pediatricians are trusted sources for patients and their families for accurate vaccine education. As of January 2024, only 11% of Los Angeles County residents have received an updated 2023-2024 COVID-19 vaccine. COVID-19 vaccination rates for children and adolescents remain low, with 5% among adolescents 12-17 years old, 4% among children 5-11 years old, and 3% among children 6mos-4 years old receiving an updated dose. Stay up-to-date on respiratory disease in LA County with the new RespWatch report- a summary of COVID-19, influenza, RSV, and other respiratory disease surveillance. Sign up to receive the full report by emailing "Subscribe" to Influenza@ph.lacounty.gov or by visiting the RespWatch webpage. |
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The 2023-2024 respiratory virus season poses a triple threat due to COVID-19, RSV, and flu. Here are some testing and treatment considerations when providing care to patients with respiratory symptoms. Consider testing for COVID-19, Flu, and RSV COVID-19 PCR testing is preferred. Antigen tests may be more convenient but are also more likely to produce false negative results. The FDA recommends a retest 48 hours after initial test to confirm. It is recommended that every U.S. household have a supply of antigen tests at home to test as needed. Every home in the U.S. is eligible to receive 4 COVID-19 test kits. Starting 11/20/23, 4 additional test kits can be obtained by visiting https://www.covid.gov/tests.
Treatment for healthy infants and young children remains supportive. However, for high-risk children over 12 years old and weighing at least 88 pounds, Paxlovid can be beneficial. Treatment should be started within 5 days of symptom onset. For more health information on COVID-19 in Pediatrics, visit the CDC's COVID-19 Information for Pediatric Healthcare Providers webpage. 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 (AAP) indicates that less than 40% of children who are 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. |
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We are currently seeing Measles cases in the United States with two active and unrelated measles outbreaks among unvaccinated people: Philadelphia and New Jersey. According to the Centers for Disease and Control (CDC), from January 1 to December 31, 2023, a total of 56 measles cases were reported by 20 jurisdictions. Below are tools and resources to review: Measles Diagnosis and Testing LACDPH Measles Toolkit
CDC Measles Toolkit
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January is Cervical Cancer Awareness Month, an opportunity to support those affected by cervical cancer and spread awareness about preventing human papillomavirus (HPV)- related cancers by increasing HPV vaccine uptake. While HPV vaccine has been available since 2006, many are still not aware that HPV infection is common and can lead to many cancers prevented by the HPV vaccine, including cervical, vaginal, and vulvar cancers in females, penile cancer in males, and oral and anal cancers in all. HPV vaccination series may start at age 9 and should be completed before age 13. Resources for Providers:
Resources for Patients:
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Refer to the Conversation Guide for Healthcare Providers (CDC) for more information about talking with patients about how to protect against fall and winter respiratory viruses.
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Resources for Patients and their Families
If you are not administering COVID-19 vaccine or need to refer out, below are tools to assist patients in location where to get vaccinated:
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Immunization Recommendations During Pregnancy hosted by CDPH and the California Primary Care Association (CPCA) When: Thursday, January 25, 2024, from 12-1pm (PST). Pre-registration is required. Meeting Link: Click here to register. Strategies for Improving HPC Vaccination Rates hosted by the National Foundation for Infectious Diseases (NFID) When: Thursday, January 29, 2024, from 10-11 am/1-2pm ET. Pre-registration is required. Meeting Link: Click here to register. Provider Vaccine Office Hours hosted by Los Angeles County Department of Public Health When: Wednesday, January 31, 2024, from 9-10 am. This webinar will include information regarding respiratory virus season in Los Angeles County. Pre-registration is not required. The meetings are scheduled for every other week. Meeting Link: Click here to join. Immunization Skills Institute hosted by Los Angeles County Department of Public Health The Immunization Skills Institute (ISI) is an immunization training tailored for medical assistants (MA), pharmacists, licensed vocational nurses (LVN), or anyone who provides immunizations. This three-hour training combines lecture and mentored practice sessions, to increase competency in safe, effective, and caring immunization techniques. Space is limited and classes fill quickly, so, register today! For more information and registration click here. Upcoming dates:
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