Weekly Vaccine Digest 02/09/2024 Los Angeles County Department of Public Health

County of Los Angeles, California sent this bulletin at 02/09/2024 02:26 PM PST

Weekly Vaccine Digest 02/09/2024

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 links from today’s CDPH Office Hours. To view the CDPH recordings, slides and other important information please visit https://eziz.org/.

 

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: LA County First Measles Case (LAHAN)

·      Page 4-5: Order and Administration Reminders, VFC Flu Vaccine Pre-Book NEXT STEPS

·      Page 5-6: Long Term Care Facilities and COVID-19 Pharmacy Update

·      Pages 7-8: VFC UPDATES, VFA Timeline and Upcoming Actions

·      Page 8-9: Minor Consent, Upcoming Webinars

·      Page 10: LACDPH & CDPH Provider Office Hours Link

LAC DPH Health Alert First LA County Measles Case

Key Messages Since January 31st, the Los Angeles County Department of Public Health has been investigating a confirmed measles case in a resident with multiple potential sites of exposure to others. This is the first case in LA County since 2020.

  • LA County healthcare providers should be on alert for additional measles cases.
  • Healthcare providers should 1) assure that their patients are up to date on measles-containing vaccine (MMR or MMRV) or are otherwise immune, 2) immunize all international travelers aged 6 months or older for whom there is no documentation of immunity, and 3) immediately report suspect measles to Public Health.
  • All healthcare personnel should have documentation of immunity to measles.

 

Situation

An under-immunized LA County resident was confirmed to have measles on January 31, 2024. The individual was infected during an international trip and traveled to LA County during their infectious period. This is the first case of measles in LA County since February 2020.

Public Health is currently investigating multiple exposures related to this case. Locations where people may have been exposed include the airplane, the Tom Bradley International Terminal, and a chain restaurant in Northridge. Additional locations where possible exposures may have occurred are being investigated. See press release for more details.

Measles is a highly contagious, vaccine-preventable disease that requires high population immunity (95%) for transmission to be interrupted. Similar to this case, domestic measles cases often originate from unvaccinated or under-vaccinated U.S. residents who travel internationally and then transmit the disease to people who are not immune to measles. One person infected by measles can infect up to 90% of their close contacts who are not immune.

This measles case reflects the real threat of measles importation to LA County due to the ongoing global and domestic outbreaks. The Centers for Disease Control and Prevention (CDC) has reported a recent rise in domestic measles cases. Between December 1, 2023, and January 23, 2024, the CDC was notified of 23 confirmed U.S. cases of measles, including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. See CDC clinician communication Stay Alert for Measles Cases (1-25-24).

All county residents who lack measles immunity are at elevated risk of infection, this includes adults, adolescents, and children. Among all children in LA County who entered kindergarten in the 2022-23 school year, 97% were up to date with measles vaccination. However, there was a significant proportion of schools (16%) reporting kindergarten measles vaccination coverage below 95%, creating pockets of susceptible students where measles transmission can occur. See the School Immunization Dashboard for more information about vaccine uptake in your community.

Actions Requested of Providers

Interrupting measles transmission in LA County requires high community vaccination rates, health care provider vigilance in suspecting and diagnosing measles, and isolating cases from susceptible individuals.

  • Vaccinate: Make sure that all patients and healthcare staff are either up to date with their measles vaccinations or immune to measles. All persons who do not have presumptive evidence of immunity should be vaccinated.
  • All healthcare personnel should have 2 documented doses of MMR or laboratory demonstration of immunity.
  • Prior to any international travel, travelers 6 months of age and older should be protected against measles, regardless of their destination.
  • If you do not offer measles vaccines in your practice:
  • For uninsured patients and patients whose insurance does not cover the full cost of vaccines, please reference the LA County Department of Public Health’s vaccine clinic locations website to identify nearby free and low-cost immunization clinics.
  • For insured patients, please refer the patient to a provider or pharmacy who can provide MMR vaccine as these patients will be ineligible to receive vaccine at the above immunization clinics.
  • Suspect: Consider measles in any patient who presents with a febrile rash and clinically compatible measles symptoms (e.g., cough, coryza, conjunctivitis), especially if they are unvaccinated or under-vaccinated or have any of the following risk factors in the past 4 weeks:
    • Travel, especially international or domestic through an international airport.
    • Contact with someone with a febrile rash illness.
    • Exposure to a known or possible measles case.
    • See the DPH Information for Providers to review symptoms and typical presentations of measles.
    • Isolate: Any patients with a febrile rash illness should be immediately identified and separated from other patients prior to or as soon as possible after entry into the facility.
  • Display posters at facility entrances advising patients with fever, rash, or cough to immediately notify facility staff prior to entering the building.
  • The patient should immediately don a well-fitting medical mask or respirator, be removed from waiting rooms and other common areas, and placed in a private room with a closed door on airborne precautions.
  • Any room used to accommodate a suspect measles case should not be used for at least two hours after the patient has left.
  • Do not send suspect measles cases to the Emergency Department (ED) for measles testing unless they require a higher level of care. If ED referral is necessary, be sure to notify the ED first.
  • Notify: Public Health should be contacted immediately, while the patient with suspect measles is still at the facility. Public Health will guide you through collection of specimens for testing (throat swab and urine samples for PCR and blood sample for serology) and management of the patient under investigation as well as asymptomatic contacts of a suspected or confirmed case. See the LA County specimen collection instructions for more details on quantities, storage, labeling, and shipping.
    • Los Angeles County Department of Public Health
    • Weekdays 8:30 am–5:00 pm: call 213-351-7800.
    • After-hours: call 213-974-1234 and ask for the physician on call.
    • Long Beach Health and Human Services:
    • Weekdays 8:00 am-5:00 pm: call 562-570-4302.
    • After hours: call the duty officer at 562-500-5537.
    • Pasadena Public Health Department:
    • Weekdays 8:00 am-5:00 pm: call 626-744-6089.
    • After hours: call 626-744-6043.

Additional Resources

CDC

CDPH

LAC DPH

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Order and Administration Reminders

  • REMINDER: In observance of Presidents’ Day on Monday, February 19, 2024, CDPH and the Provider Call Center will be closed. In addition, LAC DPH Provider Immunization Call Center will also be closed.
  • NOTE: CDPH COVID-19 Treatments webpage for the public has moved to
  • Please submit your vaccine orders 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.
  • REMINDER: February BAP Holiday Shipping Cadence can be found here.
  • The DPH warehouse delivers vaccine 3-7 business days after the order is placed in myCAvax. Please present a photo ID (work badge, school ID, driver’s license, etc.) and sign for the delivery when received.
  • 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 Registry ID's - Under AB 1797, vaccine providers are required to enter here. immunization information into the California Immunization Registry (CAIR).

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Long Term Care Facilities and COVID-19 Pharmacy Update

LTCFs

Dr. Aragon Letter to Directors and Administrators of Long-Term Care Facilities (LTCFs)

  • Highlights To protect our LTCF community:
    • Offer updated COVID-19 vaccine on site at your facilities
    • Strongly recommend COVID-19, influenza, pneumococcal and RSV vaccines to all residents
    • Encourage staff to stay up to date on vaccines recommended for healthcare personnel
    • Provide access to high filtration face masks to residents and staff
    • Track respiratory virus trends in your community
    • Encourage and support appropriate testing of residents, staff and families
    • Make it easy to get COVID-19 prescription medications and have a plan in place
    • Updated guidance on viral respiratory infections in Skilled Nursing Facilities
    • Information sent out via LTCF Listserv and Policy Alerts Listserv.
      • Long-Term Care Facilities Letter can be found here.
      • CDPH Policy Alerts registration can be found here.

Bridge Access Program (BAP) in Pharmacy

 

Bridge Access Program Pharmacy Enrollment

  • All pharmacies are encouraged to join:
    • Community pharmacies
    • Health systems pharmacies
    • Pharmacies that support clinics
    • Pharmacies that support long term care facilities
    • More information on joining eTrueNorth Bridge Access Program can be found here

 

Resource Guide for Pharmacies to Prevent Delayed COVID-19 Treatment

  • Updates include:
    • the most recent resources available for patients to obtain COVID-19 treatment.
    • the California Business and Professions Code (BPC) 4052.04 which states a pharmacist may furnish COVID-19 oral therapeutics following a positive test for SARS-CoV-2.
    • Resource Guide for Pharmacies to Prevent Delayed COVID-19 Treatment can be found here
    • Administration for Strategic Preparedness & Response (ASPR) Update
  • FDA revised letter of authorization for Paxlovid Emergency Use Authorization:
    • Important revision to the EUA Letter of Authorization stating that EUA-labeled Paxlovid distributed by the U.S. government will remain authorized for use only through March 8, 2024.
  • Return date for EUA-labeled Paxlovid with an expiry of December 2023 or later is now extended to February 29, 2024, to ensure a credit to the USG inventory as NDA-labeled supply.
    • For specific information on Paxlovid returns, including to request pre-paid shipping visit Inmar PaxlovidEUAreturns.com, email PaxlovidEUAreturns@inmar.com, or call 877-740-6148.
  • Expanded COVID-19 Treatments Locator is now live: Treatment Locator (hhs.gov)
    • Combines the Test to Treat locator & therapeutics locator. It also has USG PAP participating sites.
    • Providers must opt into the locator.
    • Opting in is a simple yes/no that product is in stock, and sites don’t need an HPOP account to opt into the locator.
    • Partners with an HPOP account can report yes/no using HPOP, and those without HPOP accounts can do so using the voluntary opt in form.

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VFC UPDATES

Recertification Past Due: Wednesday, January 31, 2024

  • Annual 2024 Recertification is through myVFCvaccines
    • Annual Recertification and Training is a federal requirement to maintain active status in the VFC Program and receive publicly purchased vaccines.
    • VFA Recertification in myCAvax - Tuesday, February 20 2024
    • The link to recertify is still available on providers' myVFCvaccines accounts if they did not have a chance to submit prior to the deadline. Please log-in to your myVFCvaccines account, and the link to Recertify will still display.
    • Eventual account termination from VFC Program on MARCH 1
  • All public and private providers must recertify yearly
    • Recertification maintains the PIN’s active status
  • All VFC providers must enroll in CAIR and provide a CAIR ID to recertify. If you’re not sure if your practice is already participating in an immunization registry, contact the CAIR Help Desk (CAIRHelpdesk@cdph.ca.gov or 800-578-7889). CAIR also has Local CAIR Representatives that can support you with any questions you may have.
  • Vaccine Supply, Recertification and Holiday Operation Hours can be found here.
  • Who, When, Where and What You Need to Do for VFC Recertification can be found here.
  • VFC Recertification FAQs can be found here.
  • VFC is actively reaching out to remaining provider sites to prevent suspension of order privileges

Ordering Requirement for VFC Providers

  • VFC requirement: Provider locations who have not ordered and administered all ACIP recommended vaccines for their patient population in the past 12 months will be terminated from the VFC Program.
  • CDPH is currently reviewing accounts who have not ordered VFC vaccines in the past 12 months
  • Coming soon: Survey to go out assessing providers’ barriers to ordering VFC vaccines
  • Survey results will be reviewed prior to account termination

 

VFC RSV Vaccine Supply Update

  • The following RSV immunizations are no longer available for ordering:
    • RSV vaccine ABRYSVO (NDC: 00069-0344-01)
    • Nirsevimab (Beyfortus ) 100mg
  • Ordering is still open for Nirsevimab (Beyfortus ) 50mg
  • Got unused/unexpired doses of prenatal ABRYSVO and nirsevimab? Save them for Fall 2024!
    • Both have a long shelf life, so label appropriately and keep them safe for the upcoming respiratory virus season.
    • Recently shipped products have expiration dates in 2025
    • Please note: unexpired doses cannot be returned to McKesson!

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 VFA Upcoming Actions for Providers

  • With the VFA program being released in myCAvax on Tuesday, February 20, 2024, all VFA providers must complete the recertification process and be prepared for the following trainings and programmatic milestones.

 

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  • February 22, 2024
  • Registerand attend the VFA 101 Training for Providers at 11:00 AM PT.
  • NOTE: Your identified VFA key practice staff should register for the above training and will receive email in early February regarding training reminders and next steps.  
  • February 29, 2024
  • Registerand attend the VFA 102 Training for Providers at 11:00 AM PT.
  • NOTE: Your identified VFA key practice staff should register for the above training and will receive email in early February regarding training reminders and next steps.
    • VFA Providers will do a 2nd “Recertification” in myCAvax when those programs transition in February 2024.
    • Update Key Practice Staff for the adult programs
    • POR to sign updated 2024 VFA Provider Agreement

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Minor Consent

Generally, a parent or guardian’s consent is required for the provision of healthcare, including vaccinations, to minors in California, except under limited circumstances that include:

  • Minors may consent to all medical care if they are: at least 15 years of age; and living separate and apart from the minor’s parents or legal guardian (regardless of consent of parents/guardian or duration of separate residence); and managing the minor’s own financial affairs regardless of source of income pursuant to California Family Code § 6922.
  • Emancipated minors - may consent directly for immunizations and other care.
  • Minors ages 12-17 years who may have come into contact with an infectious, contagious, or communicable disease that is reportable to the local Health Officer may consent to medical care related to the diagnosis or treatment of that disease pursuant to California Family Code § 6926(a). This also includes the prevention of sexually transmitted diseases.

Minor Consent Reminder

Consent to Immunization

  • There are no Federal or California State requirements for informed consent specifically relating to immunization.
  • Federal law requires that healthcare staff provide a Vaccine information Statement to a patient, parent, or legal representative before each dose of certain vaccines.
  • In California, for those under age 18 needing parental consent:
    • Parents or guardians may provide in-person consent for medical care for their children.
    • Signed written, phone or video consent is also possible.
    • In all instances the parent/guardian must confirm that they have been provided the vaccine information statement. Additional resources

Minor Consent Resources

https://teenhealthlaw.org/wp-content/uploads/2023/12/2023CaMinorConsentConfChartFull.pdf

 

https://www.aclunc.org/our-work/know-your-rights/know-your-rights-student-health-rights

https://www.vaxteen.org/california

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UPCOMING WEBINARS

  • Webinar: Virtual Grand Rounds - California's Mental Health Landscape and Brief Interventions to Empower Front-Line Clinicians
    • When: Tuesday, February 13, 2024 at 12PM – 1PM, PST
    • Register here
  • California Immunization Coalition: Community Health Care Workers 101: Making a Difference
    • When: Tuesday, February 13, 2024 at 12PM – 1PM, PST
    • Register here
  • CDPH Infection Prevention Webinar
    • Webinar registration links for Webex can be found here.
  • Look Ahead: Training Opportunities for VFA Providers

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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: 2/14/2024
    • 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, RSV and Measles 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.
    • NOTE: Friday CDPH Office Hours for February 16,2024 has been canceled. The next CDPH Office Hours will be held Friday, February 23, 2024
  • 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