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Minnesota Department of Health
May 27, 2021
Good afternoon,
Here are the COVID-19 vaccine provider updates for May 21 to May 27, 2021.
Due to the federal holiday, there will be no COVID-19 vaccine deliveries on Monday, May 31. Pfizer vaccine orders will be out for delivery Tuesday, June 2. Moderna and Johnson & Johnson vaccine orders will be delivered on Wednesday, June 3.
In recent weeks, there have been increased reports to the Vaccine Adverse Event Reporting System (VAERS) of cases of myocarditis and pericarditis happening after mRNA COVID-19 vaccination, particularly in adolescents and young adults. These reports are rare given the number of vaccine doses administered.
Most patients who received care responded well to treatment and rest and quickly felt better. Cases reported to VAERS have occurred:
- Mostly in male adolescents and young adults age 16 years or older.
- More often after getting the second dose.
- Typically within several days after COVID-19 vaccination.
Symptoms can include abnormal heart rhythms, shortness of breath, or chest pain.
CDC continues to recommend COVID-19 vaccination for everyone 12 years of age and older, given the greater risk of COVID-19 illness and related, possibly severe complications. CDC is actively monitoring these reports, by reviewing data and medical records, to learn more about what happened and to see if there is any relationship to COVID-19 vaccination. Find more information at CDC Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination.
Health care providers should consider myocarditis in an evaluation of chest pain after vaccination and report all cases to VAERS: Report an Adverse Event.
Together, we have achieved incredible success in vaccinating over 60% of Minnesotans Minnesotans age 16 and older with at least one dose of vaccine. As we are in this next phase of having ample vaccine supply and decreasing demand, we are asking vaccinators to become increasingly creative in finding opportunities to offer vaccine to people in places they trust, such as during primary care visits. We understand that given the complexities of vaccine inventory management, ensuring there is vaccine available to anyone who wants it at various times may make it harder to use every single dose in a vial.
Vaccinators across the state have been good stewards of this vital public resource. As much as possible, we strongly encourage you to use creative strategies, some of which are listed below, to ensure all doses get used. However, when the choice is between getting someone vaccinated or preserving additional doses, the answer is clear: prioritize getting another Minnesotan vaccinated.
We are “investing” in getting as many Minnesotans vaccinated as possible by vaccinating everyone who is willing to receive vaccine, even if that means not every dose in a vial can be used.
Minimizing wastage
Below are several ways we expect vaccinators will implement to minimize wasted doses:
- Store your vaccine at the temperature with the longest expiration time possible until you need it. Know the exact storage and handling requirements, including thawing and refrigerator times, for each of the vaccines you are working with by printing and referring to the EUA Fact Sheets for Healthcare Providers. Find them at FDA: COVID-19 Vaccines.
- In a clinic setting, look ahead at your schedule and the patients’ records and/or MIIC to assess the need for COVID-19 vaccine. This will help anticipate how much vaccine will need to be used on a daily or weekly basis.
- Label vials as they are opened with the date, time, and expiration time. Draw up only the dose being administered to a specific patient.
- Minimize open vials. Do not open another vial until you have used all the doses in the current vial. Do not “pool” vaccine or combine residual vaccine from multiple vials to obtain a dose.
- Keep multi-dose, labeled vials in a central location, so multiple vaccinators have access to the same vial to increase the likelihood of all doses being used.
Tracking wastage
Accurately tracking wastage will continue to be a priority. Registered COVID-19 providers must report vaccine wastage in the Minnesota Immunization Information Connection (MIIC). Due to the shift in strategy from not wasting doses of vaccine to not missing an opportunity to vaccinate, we are expecting more wastage and are allowing providers to report wastage on a weekly basis. Providers with more than one location may report wastage at all locations under one hub. Providers reporting under one hub should choose the site that directly receives the most shipments of COVID-19 vaccine for the organization. Providers must report wastage by manufacturer but may combine reporting under one lot number of the same manufacturer. Please refer to the updated guidance at Reporting Nonviable COVID-19 Vaccine to MIIC (PDF).
If you are a provider with multiple locations and need to add staff to have access to the hub location in MIIC to report wastage, please reach out to us at health.mdhvaccine@state.mn.us and we’ll make sure the right staff have access to the proper locations.
When reporting in MIIC, please disregard any automatic email responses you may get about shipping labels or expired or spoiled COVID-19 vials. COVID-19 vaccine cannot be returned to the manufacturer or McKesson. Dispose of vials per recommendations found in MDH’s Interim COVID-19 Vaccine Provider Guide at COVID-19 Vaccine Providers.
- Registered COVID-19 providers are now able to directly request COVID-19 vaccines in the Minnesota Immunization Information Connection (MIIC). A user guide on how to request special event vaccine in MIIC is available at MIIC User Guidance and Training Resources under "Vaccine Ordering and Management."
- You must have a user role with ordering privileges in order to request doses. Please contact mdhvaccine@state.mn.us for assistance.
- Order what your site will need for the week ahead. Include the total number of doses needed (first and second doses). MDH will no longer automatically ship second doses to sites.
- Sites will not get a confirmation email after they submit their requests. Instead, they will get an email Thursday or Friday after MDH processes their order. Providers can refer to the user guide for more information on how to check the status of their requests in MIIC.
- COVID-19 vaccine requests need to be made in specific multiples of shipment packaging sizes:
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Janssen/Johnson & Johnson COVID-19 multi-dose vials of 5 doses: requests must be made in 100 dose increments. We cannot ship less than 100 doses.
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Moderna COVID-19 multi-dose vials of 10 doses: requests must be made in 100 dose increments. We cannot ship less than 100 doses.
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Moderna COVID-19 multi-dose vials of 14 doses: requests must be made in 140 dose increments. We cannot ship less than 140 doses.
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Pfizer COVID-19 195 multi-dose vials of 6 doses: requests must be made in 1,170 dose increments. We cannot ship less than 1,170 doses.
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Pfizer COVID-19 75 multi-dose vials of 6 doses: requests must be made in 450 dose increment. We cannot ship less than 450 doses. (There will be a limited supply of these orders.)
Today, Governor Tim Walz announced a vaccine incentive program called “Your Shot for Summer.”
The first 100,000 Minnesotans who get their first shot between May 27 and June 30 will be able to choose an incentive of their preference. Information on the program, including verification of the first dose and reward options, can be found at: State of Minnesota: Summer Vaccine Rewards. Minnesotans can also register through the MDH COVID-19 Public Hotline by calling 1-833-431-2053.
Vaccine providers will not have to do anything. The person who is vaccinated would be responsible for applying for an incentive. As expected by CDC, continue providing every patient with a fully filled out vaccination card—this will also help patients when they apply for their incentive.
It is important that patients have full documentation that they received both doses of vaccine for a two-dose series on one record card. If the person does not have their original card, please give them a new card, and fill out the first dose for them as well. We encourage you to do this when you verify their first dose in MIIC or in your electronic medical record rather than send them to the MIIC record request line to gather the information on their first dose.
COVID-19 provider guide, appendices, and modules have been updated at COVID-19 Vaccine Providers.
- Main guide: Updated vaccine ordering and distribution for how to request doses (page 5). Additional information and example provided in Expiration dates and beyond-use dates section (page 8).
- Appendix A: Changed vaccine ordering section to Vaccine dose packs which includes information on the 450 and 1,170-dose packs (page 3).
- All appendices: Updated vaccine recommendations to refer to CDC’s interim clinical considerations for information on coadministration of COVID-19 vaccine and other vaccines.
- Module 3/Pfizer-BioNTech and Module 5/Janssen training modules have been updated.
FDA has amended the Pfizer-BioNTech EUA to allow undiluted, thawed Pfizer-BioNTech COVID-19 vaccine vials to be stored in the refrigerator at 2 to 8 degrees Celsius for up to one month.
- Pfizer vaccine vials must remain undiluted to remain at 2 to 8 degrees Celsius for one month.
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Vaccine must still be used within its expiration date. Expiration dates do not change with the extended duration of refrigerator storage. If the vaccine has expired it must be discarded, even if it has only been in the fridge for a few days.
Some of the Janssen (Johnson & Johnson) vaccine and other vaccines are expiring soon!
- Make sure you are checking expiration dates before administering vaccine. For a full list of lot numbers, go to CDC Home Page Vaccine Lot Number and Expiration Date.
- If you have vaccine that you do not think you will be able to use before it expires, especially the Janssen vaccine, contact mdhvaccine@state.mn.us for help in identifying partners who may be able to use doses.
- First in, first out: Use the oldest vaccine first when managing your inventory.
- Take any expired vaccine out of the unit and dispose of it properly; it cannot be returned and leaving it in the refrigerator risks someone giving an expired dose. Make you sure report expired doses to MIIC as wastage, see instructions at Reporting Nonviable COVID-19 Vaccine to MIIC (PDF).
Parents and guardians can now enroll adolescents (ages 12 and older) in the CDC V-safe After Vaccination Health Checker and complete health check-ins on their behalf after COVID-19 vaccination.
All adolescents in the family who are eligible to be vaccinated can be enrolled. Parents and guardians should use their smartphone to complete a separate v-safe registration for each adolescent. All v-safe communications will be sent to the parent or guardian’s smartphone.
CDC encourages parents and guardians to take advantage of the waiting period immediately after vaccination to enroll adolescents. Enrolling in v-safe is fast and easy to do. Parents will just need their smartphone and the vaccination record card their adolescent received during COVID-19 vaccination.
Encourage your patients to enroll in v-safe! Share information in your vaccination clinic with V-safe Print Resources.
Vaccination data for the 12-15-year-old age group is now included on the Vaccine Data dashboard. There is new 12+ category for the county-level data, along with the 16+, 65+, and total population tabs. The 16+ age group is the default group when you first visit the dashboard, and you can toggle to the other population options.
The following documents have recently been updated by CDC:
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