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Minnesota Department of Health
March 18, 2020
Good afternoon,
Here are the COVID-19 vaccine provider updates for 3/12-3/18.
The provider guide and appendices have had a refresh at COVID-19 Vaccine Providers.
Key updates to the main guide:
- Condensed “Clinical considerations for authorized COVID-19 vaccines” section with link to CDC webpage (p. 8).
- Added information about the Minnesota Vaccines for Children Program and COVID-19 vaccine providers not needing to be enrolled to vaccinate 16- to 18-years-olds (p. 5).
- Updated ancillary supply kit section on who to contact with questions or issues (p. 5).
- Added recommendation not to store vaccine in the freezer sections of a combination household storage unit (p. 7).
- Updated observation period following vaccination language (p. 3).
Appendix A/Pfizer BioNTech updates: Updated vaccine storage options section (p. 6).
Appendix B/Moderna updates: Added information regarding report of some vials tinted slightly green (p. 6).
The following on-demand trainings for registered COVID-19 vaccine providers on the COVID-19 Vaccine Trainings for Health Professionals site have been updated:
- Module 1: Vaccine planning, vaccine supplies, and storage and handling.
- Module 2: Vaccine administration and inventory reporting.
Below each training in the transcript and resources pertaining to each module. Watch for future updates to Module 3/Pfizer BioNTech and Module 4/Moderna.
A reminder that vaccinators, especially volunteer vaccinators, need just-in-time training for the COVID-19 vaccine. The ancillary kits may contain supplies that they are not familiar with. Experienced vaccinators should review specifics about the vaccine they are using, IM injections in the deltoid muscle, and patient education. Staff should also know who to ask about questions or problems such as needle sticks.
Needle sticks
With the volume of vaccinations being administered, needle sticks may be on the rise. All vaccination sites should have policies and procedures in place should an employee or volunteer experience a needle stick injury. Include this information in your training. When a needle stick occurs (or other exposure to blood or body fluid), the person should immediately follow these steps:
- Wash puncture site with soap and water for 15 minutes.
- Flush splashes to the nose, mouth, or skin with water.
- Irrigate eyes with water, saline, or sterile irrigants.
- Report the incident to a supervisor.
- Immediately seek medical treatment.
Resources for post-exposures:
Resources on needle stick prevention:
Vaccine providers are encouraged to report any issues with equipment in the ancillary kits.
- Contact McKesson directly who responds to problems and identifying trends for kits (e.g., missing supplies, etc.) at SNSSupport@McKesson.com. This is a change in process from contacting MDH first with issues with the kits. Going forward, MDH will get involved at the request of McKesson as needed.
- If an error or injury occurs during vaccine administration, enter the information at VAERS: Report an Adverse Event to VAERS.
- For defective or faulty medical equipment (e.g., syringes, needles), complete FDA form 3500 at FDA: MedWatch Online Voluntary Reporting Form.
Be prepared to provide photos, lot number, order number, date ordered, and dates received when filing a report for a deficient ancillary kit.
We need your help to ensure that Minnesotans are getting vaccinated without barriers. Please read the following reminders and ensure everyone in your organization who is vaccinating is following this guidance.
- COVID-19 vaccine is free. There must not be any out-of-pocket cost to the recipient, regardless of their immigration status.
- There should not be a perceived requirement for insurance. You cannot deny anyone vaccination based on the vaccine recipient’s coverage status or network status.
- You can seek appropriate reimbursement from a program or plan that covers COVID-19 vaccine administration fees for the vaccine recipient, such as:
Any potential violations of these requirements will be reported to the Office of the Inspector General, U.S. Department of Health and Human Services, by calling 1-800-HHS-TIPS or at tips.hhs.gov.
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Legal IDs or proof of citizenship are NOT required. Providers should ask for a full name, date of birth, address, phone number, and gender so that the dose can be reported to the Minnesota Immunization Information Connection (MIIC) appropriately. Providers should never ask about immigration status when administering the COVID-19 vaccine.
If you are collecting information at the time a person makes an appointment online, please make it clear that they can get vaccinated without insurance or an ID. Give clear instructions on how to make an appointment without these items.
The Minnesota Department of Health has heard of several instances where rumors of clinics vaccinating anyone 18 and older have started circulating on social media or by word of mouth. These rumors can cause people to show up at vaccination clinics who are not eligible and who do not have appointments. We wanted to share some reminders to providers:
- Make sure you are only promoting clinics for people who are currently eligible for vaccination.
- Ask for documentation of eligibility when appropriate (such as a work ID, pay stub, prescription, etc.), but do not let lack of documentation be a barrier to vaccination.
- We know documentation for underlying medical conditions and other eligibility criteria can be difficult to verify. Do your best to make communications to patients clear about who is eligible to make appointments to help make sure people who are not eligible are not scheduling appointments.
- Consider having a waitlist ready for filling last-minute appointments due to cancellations or no-shows. Fill this waitlist with eligible people as much as possible before expanding to other high-risk non-eligible people.
- Instruct patients not to share appointment links with family and friends who are not eligible, especially if the clinic is by invitation only.
We are pleased so many Minnesotans are eager to get vaccinated. As supply grows in the coming weeks, we look forward to expanding eligibility to more Minnesotans as soon as we are able to do so. Thank you for helping to make sure current priority groups are being vaccinated to help protect our most at risk and vulnerable residents.
Resources:
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Vaccine product
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Doses/vial
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Volume
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Ancillary content
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Pfizer
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6
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0.3 mL
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6 doses/vial
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Moderna
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10
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0.5 mL
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10 doses/vial
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Janssen
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5
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0.5 mL
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5 doses/vial
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- Only administer full doses.
- Never try to pool vials to make a full dose.
- Do not refreeze any COVID-19 vaccines.
The CDC Vaccine Storage and Handling Toolkit was updated March 4, 2021, with a COVID-19 vaccine addendum with storage and handling best practices for COVID-19 vaccines. It clarifies vaccination provider requirements, language related to FDA authorization of COVID-19 products, and storage and handling information for Pfizer-BioNTech, Moderna, and Janssen (Johnson & Johnson) COVID-19 vaccines.
For COVID-19 vaccines that need two doses, it is important for people to receive both doses, and that both doses are the same vaccine product. Providers need to make every effort to keep the second doses within the recommended interval.
- We expect providers to schedule second doses for patients receiving the first dose.
- Whenever possible, providers should accommodate giving a patient their second dose of vaccine, even if they did not receive their first dose from you.
Learn more at COVID-19 Vaccine Second Dose Guidance.
Communicating the importance of being completely vaccinated
There are several reasons someone might not be getting their second dose of COVID-19 vaccine. They may be hesitant about getting another shot, concerned of side effects, thinking they don’t need two doses, or they might forget.
We have information on why the second dose is important at About COVID-19 Vaccine in the “Getting Vaccinated” section. Share this information with people who are hesitant or want more information on second doses:
- It is very important that someone gets both vaccine doses, the same product for each dose, and that the doses are given at the correct interval.
- The vaccine works best after two doses.
- If someone only gets one dose, they may not be as well protected against COVID-19.
- The second dose boosts your immunity to COVID-19 and will help even if it is a longer time between shots.
- It is best if you can get your second dose within six weeks from your first dose, but even if it is longer than that, you do not need to start over.
Thank you for your help in spreading our messages!
Encourage people to set up their appointment for the second dose before they leave. Have a system to track people who are ready for second doses who have not returned; continue to reach out to them! If someone declines the second dose, you may document that in your medical record, but continue to encourage them to complete the series.
Client follow-up efforts
MDH is working with providers on plans for following up with clients who are overdue for a second dose of COVID-19 vaccine. It is important for providers to maintain lists of clients who have not received a second dose and conduct outreach to those clients. Please contact the MIIC help desk with any questions about this work or if you would like to request a list of clients who missed a second dose.
Providers enrolled in the COVID-19 vaccine program do not need to be enrolled in the Minnesota Vaccines for Children (MnVFC) program to administer COVID-19 vaccine to 16- and 17-year-olds. You can be reimbursed by medical assistance (MA) for the administration fee for COVID-19 vaccines given to this age group, even if you are not enrolled in MnVFC. Remember that Pfizer is the only COVID-19 vaccine product that is currently authorized for this age group.
The Janssen vaccine is shipped at refrigerator temperatures in the packaging McKesson uses for our routine vaccines. These containers do not need to be returned. Continue to return the frozen vaccine containers that the Moderna vaccine comes in, and the ultra-cold shippers the Pfizer vaccine comes in. Return shipping labels are included in the packaging.
Janssen and Moderna vaccine shipments often go out for next-day delivery once the order is placed in MIIC. If you receive an order confirmation email on a weekday morning, it is likely that you will receive your vaccine the next day. Please keep these details in mind when planning for appointments.
The Minnesota Immunization Information Connection (MIIC) conducted a four-part webinar series. Recordings for all the webinars are posted at MIIC User Guidance and Training Resources.
We are hosting office hours for health care providers. The office hours happen weekly on Tuesdays at 12:30 p.m. for 30 minutes.
This is time for you to come and ask questions of the vaccine clinical experts at MDH. Feel free to drop in at any point during the half hour time slot.
Tuesdays at 12:30 p.m.: Click here to join the Teams meeting. Join on your computer or mobile app.
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