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Minnesota Department of Health
April 22, 2021
Good afternoon,
Here are the COVID-19 vaccine provider updates for 4/17-4/22.
We recognize that everyone is feeling some degree of burnout, stress, and overall emotional toll from not only living in the COVID-19 pandemic for over a year, but also responding to the pandemic in our jobs in one way or another. Additionally, many of us are experiencing grief, trauma, anger, and a multitude of other reactions due to the activities happening in the communities we live or work in.
All of these things can affect work productivity and performance, and that is completely normal. Burnout in the workplace can look like loss of drive, exhaustion, cynicism, catastrophic thinking, conflicted relationships, lack of caring, and decline in performance. Everyone has a different coping strategy for burnout. At the core, it is important to try and get enough sleep, eat enough food each day, drink a lot of water, practice good personal hygiene, and move your body each day. Managing news and social media exposure can also help.
Some reading material includes Issue 12 of the Assistance Secretary on Preparedness and Response’s (ASPR) Exchange, COVID-19 and Healthcare Professional Stress and Resilience (PDF) (find self-care and stress management resources on page 2) and ASPR: Total Force Fitness through HOPE: Applying Warrior Principles to Healthcare (PDF).
The work you are doing as COVID-19 vaccine providers is crucially important during this point in the pandemic, of which we are sure you are acutely aware. We appreciate the work you are doing, and we see how stressful and difficult it can be every day. There is a light at the end of this tunnel that we are in, and we thank you for being great partners in the effort to vaccinate as many Minnesotans as we can.
There are many reasons why someone might be hesitant to get vaccinated. The COVID-19 vaccines are new vaccines, so it is normal for people to have questions. Give the patient time to ask questions and share their concerns. Have resources available to share with them.
You can find resources from MDH in the COVID-19 Vaccine Communication Toolkit to share with patients. The COVID-19 Vaccine Basics (PDF) and Getting Vaccinated For COVID-19 (PDF) pieces supplement the required emergency use authorization fact sheet. These fact sheets are in plain language and translated into 12 languages. See detailed information addressing common questions and concerns at About COVID-19 Vaccine.
New resource! We have new material, What You Should Know About COVID-19 Vaccines (PDF), that debunks a lot of common myths around COVID-19 vaccines. Translations are coming – please share widely!
There have been concerns that access to COVID-19 vaccination may be limited for immigrants because of requests for documentation before receiving the vaccine. Another concern is people being sent bills for COVID-19 vaccine fees. As a reminder, no one should have to provide an ID, prove citizenship status, or have insurance in order to get a COVID-19 vaccine. This information is stated on the MDH website at About COVID-19 Vaccine: Getting Vaccinated. MDH will report providers to Health and Human Services if we receive a credible complaint about their practices.
The Health Resources and Service Administration (HRSA) developed factsheets for patients and providers:
Patient fact sheet
Provider fact sheet
Find more information at HHS: COVID-19 Care for Uninsured Individuals.
As with licensed vaccines, vaccines under an emergency use authorization have the same requirements to report to the Vaccine Adverse Event Report System (VAERS) any situations, including serious adverse events, that occurred after vaccination. This is regardless of determination of cause. Reportable events include the following: vaccine administration errors (even if they did not involve an adverse effect), death, a life-threatening event, an event requiring hospitalization or prolonged hospitalization, prolonged impact on a person’s ability to perform daily activities, a congenital anomaly/birth defect, a significant medical event, Multisystem Inflammatory Syndrome, and cases of COVID-19 that result in hospitalization or death.
Learn more about VAERS at CDC: 10 Things Healthcare Providers Need to Know about the Vaccine Adverse Event Reporting System (VAERS) (PDF). To submit an event, go to VAERS: Report an Adverse Event. There is a checklist on this page to help gather information needed when submitting a report, VAERS 2.0_Checklist (PDF).
With more COVID-19 vaccine becoming available, please be sure to follow best practices found in the Interim COVID-19 Vaccine Provider Guide (PDF) to avoid administration errors (pages 10-12).
Common administration errors/deviations include:
- Vaccinating a person outside the recommended age range (e.g., Moderna or Janssen given to a 16- or 17-year-old).
- Using the wrong route (e.g., administering COVID-19 vaccine subcutaneously).
- Injecting vaccine into the wrong location (e.g., for deltoid injection – too high or too low).
- Administering an incorrect vaccine dose.
- For mRNA vaccines, giving the second dose too early (e.g., before the four-day grace period).
- For Pfizer vaccine, administering only the diluent.
If a vaccine administration/deviation occurs, follow CDC recommendations and complete a VAERS report.
Find more information in the CDC COVID-19 Vaccine Administration Errors and Deviations PDF at the top of the CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines webpage.
Watch this video from the California Vaccines for Children program on the correct way to give an intramuscular injection: YouTube: Intramuscular Injections for Adults.
There are many reasons why vaccine is administered in clinical settings, whether located on-site or at an off-site location (e.g., mass vaccination site). People should receive vaccine in a clinical setting where there is equipment and personnel present to respond to an adverse event (e.g., anaphylaxis). It is also important that appropriate storage and handling procedures are followed to ensure viability of the vaccine. COVID-19 vaccines should not be taken home to administer to family or friends. People who are homebound may receive vaccine from a clinical staff person, according to their agency’s protocol.
Urgent consults
Health care providers can contact the CDC Emergency Operations Center at 770-488-7100 if they need an urgent COVID-19 vaccine safety consultation. In case of a health emergency, providers should call 911.
Complex health situations following COVID-19 vaccination
For complex vaccine safety questions, health care providers or health departments in the United States can request a consultation from CDC Clinical Immunization Safety Assessment (CISA) Project COVIDvax clinicians. For non-urgent concerns, providers may Contact CDC-INFO.
Minor updates to the Reporting Nonviable COVID-19 Vaccine to MIIC (PDF) user guide and COVID-19 Nonviable Vaccine Form (PDF) can be found at COVID-19 Vaccine Providers. We removed language regarding timelines for vaccine wastage and refer to the provider guide for disposal information.
The new Minnesota Immunization Information Connection (MIIC) spreadsheet for entering data into MIIC is available in MIIC. Please remember these best practices when using the spreadsheet:
- Always download and use the spreadsheet template. Please do not edit or change any of the columns or headers, as this may cause MIIC to reject the spreadsheet! Please always use the CSV format.Find user guidance at Submitting and Exchanging Data with MIIC, under “general immunization spreadsheet.”
- Do not use parentheses for phone number area codes. Format is 999-999-9999 or 9999999999.
- MIIC requires codes for race and ethnicity data. Please do notspell out the name from the description code or use the HL7 code. Please find codes at this link Submitting and Exchanging Data with MIIC, under “MIIC codes for data submission and exchange.”
- If race is unknown or the client prefers not to say, use code U or leave it blank.
- MIIC currently accepts only one race code. For clients who identify with multiple races or a race without a specific code, use code O.
- If you enter a CPT code, it must also have a corresponding vaccination date.
Please enter all historical doses into MIIC. This helps us understand vaccination rates across Minnesota. Historical doses are immunizations your organization is reporting to MIIC on behalf of a different organization that administered it. This can include doses administered by other providers in Minnesota, providers in other states (e.g., Arizona or Florida for snowbirds), or other countries. Please enter the data into your organization’s EHR, through the spreadsheet, or directly through user interface. A new user guidance is available at Capturing Immunizations Not Currently in MIIC (PDF).
The Advisory Committee on Immunization Practices (ACIP) is meeting Friday, April 23 to discuss the pause on Johnson & Johnson COVID-19 vaccine.
Since the pause with Janssen (Johnson & Johnson) vaccine, there have been a few questions about its expiration dates. The earliest expiration date for this vaccine is May 25, 2021. Continue to store the vaccine in the refrigerator at the recommended temperature of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit), document storage unit temperatures, and monitor expiration dates.
To check the vaccine’s expiration date you can do one of the following:
Find the updated guide at COVID-19 Vaccine Providers.
Minor updates to the sections “MDH-specific guidance on COVID-19 vaccine recommendations” (p. 9) and “Report vaccine adverse events and administration errors” (p. 18).
As vaccine supply increases, you can expect to receive your Moderna COVID-19 vaccine shipments within two business days of receiving your vaccine order confirmation email from MIIC (health.mdhvaccine@state.mn.us). Please note, this is a slight shift from the previous timeline of 24 hours and may result in Moderna vaccine orders arriving a day later than previously expected. MDH staff are doing everything within their control to get vaccine orders out for delivery as soon as possible to Minnesota providers.
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