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Minnesota Department of Health
July 29, 2021
Good afternoon,
Here are the COVID-19 vaccine provider updates for July 23 to July 29, 2021.
The U.S. Food & Drug Administration (FDA) has authorized an extension of the shelf life for the Janssen (Johnson & Johnson) single-shot COVID-19 vaccine from 4.5 months to 6 months.
Vaccine providers should visit Expiry Checker: Janssen COVID-19 Vaccine Under Emergency Use Authorization to confirm the latest expiration dates of vaccine. If the lot number you enter displays the original expiration date, you will want to keep checking as information is still in the process of updating.
Many of our adolescents are behind in their routine recommended vaccinations due to the pandemic. With the start of school and flu season fast approaching, now is a good time to start preparing for co-administering all recommended adolescent vaccines. CDC recommends administering COVID-19, influenza, and other vaccines on the same day for kids 12 and older.
Don’t miss an opportunity to vaccinate! Look up the patient’s record in Minnesota Immunization Information Connection (MIIC) to determine if they are due for flu, Tdap, meningococcal, and HPV. If your clinic provides these routine vaccinations, administer all doses that are due or overdue. If your site only administers COVID-19 and/or flu, let parents know their adolescent is due for other vaccinations and the importance of getting vaccinated. Connect them with a community health center if they do not have a primary care provider. For a list of community health centers in Minnesota, visit Health Centers. Or refer them to the Minnesota Vaccines for Children program. Learn more at Free or Low-Cost Shots for Children.
Planning for the upcoming flu season is starting! CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines supports administering COVID-19 vaccine with other vaccines, including flu. Don’t miss opportunities to vaccinate for COVID-19 and/or flu.
We advise providers to let people know of the potential for increased reactogenicity when receiving adjuvanted or high-dose flu products with COVID-19 vaccines. It is unknown whether the reactogenicity of COVID-19 vaccine is increased with co-administration. There may be significant pain/redness/swelling at the injection site and other systemic reactions. When administering vaccines that may be more likely to cause a local reaction, administer them in different limbs when possible.
The Advisory Committee on Immunization Practices (ACIP) met on July 22, 2021, to discuss the data and clinical considerations for additional COVID-19 vaccine doses specifically in people who are immunocompromised. ACIP members did not vote, and no recommendations were made. The safety, efficacy, and benefit of additional doses of COVID-19 vaccine in immunocompromised people continues to be evaluated.
There is no authorization to administer additional vaccine to any person who is fully vaccinated. This will not happen until the FDA provides regulatory allowance by either an amendment to the current emergency use authorization (EUA) or full licensure to a vaccine product, and ACIP provides the accompanying clinical guidance. All providers enrolled to be COVID-19 vaccinators must follow the ACIP recommendations as outlined in the COVID-19 Vaccine Provider Agreement.
On July 22, 2021, the Advisory Committee on Immunization Practices (ACIP) met to review reported cases of Guillain-Barré syndrome (GBS) in recipients of the Janssen (Johnson & Johnson) COVID-19 vaccine. These reports are rare, but likely indicate a small possible risk following receipt of this vaccine.
Recent data show thousands of hospitalizations are estimated to be prevented as a result of Janssen COVID-19 vaccination.
The balance of benefits and risks varies by age and sex, but ACIP reviewed the benefits and risks of Janssen vaccine in the United States and determined that the benefits of using Janssen COVID-19 vaccines under the Food and Drug Administration’s (FDA) Emergency Use Authorization (EUA) clearly outweigh the risks of GBS.
CDC will be updating the interim clinical considerations stating that people with a prior history of GBS can receive any of the authorized COVID-19 vaccines. Given the possible association between Janssen vaccine and GBS, patients with a history of GBS and their clinical team should discuss the availability of mRNA vaccines to offer protection against COVID-19. It is important for patients and providers to be aware of both the benefits and risks of COVID-19 vaccination when choosing a vaccine product.
FDA will be updating the EUA fact sheets for health care providers and recipients.
On July 21, 2021, The American Hospital Association (AHA) released a policy statement on mandatory COVID-19 vaccination of health care personnel:
“The evidence is clear: COVID-19 vaccines are safe and effective in reducing both the risk of becoming infected and spreading the virus to others,” said Rick Pollack, AHA’s president and CEO. “The AHA supports hospitals and health systems that choose, based on local factors, to mandate COVID-19 vaccines for their workforce. Doing so will help protect the health and well-being of health care personnel and the patients and communities they proudly serve.”
The full policy statement from the AHA on the vaccination of health care workers can be found at American Hospital Association Policy Statement on Mandatory COVID-19 Vaccination of Health Care Personnel (PDF).
With the spread of the highly transmittable Delta (B.1.617.2) variant in the United States, CDC released a MMWR: Guidance for Implementing COVID-19 Prevention Strategies in the Context of Varying Community Transmission Levels and Vaccination Coverage on July 27. It asks local decision-makers to assess five critical factors to determine the need for layered prevention strategies across a range of settings: level of COVID-19 community transmission, health system capacity, vaccination coverage, capacity for early detection of increases in COVID-19 cases, and populations at risk for severe outcomes from COVID-19.
To increase vaccine coverage, consider implementing or continuing these strategies as discussed in the MMWR:
- Primary vaccination efforts should be accelerated in counties with low vaccination coverage.
- Public health practitioners should work with clinicians and community partners to build confidence in the vaccine and ensure equitable access.
- Organizations should establish supportive policies. Examples include allowing employees to receive vaccines during work hours, taking paid leave to get vaccinated at a community site, and/or offering flexible, nonpunitive sick leave options for employees.
COVID-19 vaccines authorized in the United States are effective against severe illness and death.
Organizations that are interested in becoming a COVID-19 vaccine provider in Minnesota will need to complete the MDH COVID-19 Vaccination Pre-Registration Survey. We use the survey to invite providers to register officially as a COVID-19 vaccine provider.
More information can be found at COVID-19 Vaccine Provider Registration.
Before you place an order for COVID-19 vaccine in MIIC, review our online tool Smartsheet: COVID-19 Vaccine Available for Redistribution Page. Sites can submit requests for redistributed vaccine in the SmartSheet dashboard. This is an opportunity for sites to receive vaccines that are currently unavailable for direct ordering, like Janssen vaccine and Moderna 10-dose vials. This is also an opportunity for sites to receive vaccine in quantities less than the minimum shipment size. Please continue to submit your requests for redistributed COVID-19 vaccines using this dashboard.
MDH has a contracted courier that can aid in the redistribution of COVID-19 vaccine as needed. Providers with excess inventory of COVID-19 vaccine doses that would better serve the community if they were redistributed to other sites should fill out the Vaccine Available Form located on the same webpage.
If you have questions regarding this tool, please email health.mdhvaccine@state.mn.us.
Moderna 10-dose vials are no longer available for direct ordering in MIIC. They are still available via redistribution, so please review our SmartSheet tool (see article above) if your site is interested in 10-dose vials. Moderna 14-dose vials will continue to be available for direct ordering in MIIC.
The MIIC data quality team would like to remind organizations that if they are entering historical COVID-19 vaccine information, they are required to enter exact administration dates. Shots with estimated dates of administration should not be entered into MIIC. We recommend checking MIIC to see if the shot is already in the client’s record with an exact date. If the vaccine is not yet in MIIC, reference the client’s CDC vaccination card to confirm administration dates. If you need help accessing MIIC, please contact the MIIC Help Desk at health.miichelp@state.mn.us.
If you are a COVID-19 vaccine provider and interested in receiving extra support for following up with clients who are overdue for their second dose, MIIC can work with you to send your patients who are overdue for a second dose a text message reminder and information on how to schedule a second dose.
If you are interested in participating or would like more information about this service, please contact Sang Phung at sang.phung@state.mn.us.
Vaccines should be delivered directly to the facility where they will be used, when possible. However, if you need to transport vaccine, such as for a back-to-school clinic, follow these best practices to ensure you are delivering viable vaccine.
- All COVID-19 vaccine must be transported at refrigerated temperature, 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit). If vaccine is frozen before transporting, it should still be packed in a cooler at refrigerated temperatures. Time in transit counts as thawing time.
- Vaccine must be transported in a stable storage unit and monitored with a digital data logger (DDL). For details on acceptable vaccine transport equipment, see Section 6 in the CDC Vaccine Storage and Handling Toolkit (PDF).
- Record temperature and time during transit using the COVID-19 Vaccine Temperature Monitoring and Documentation Form (PDF).
- Transport vaccine in unpunctured vials whenever possible.
- Partially used vials may be transported, however, only for limited circumstances such as vaccinating homebound people or small group homes.
- There may be limited instances when the only option is to transport vaccine in a pre-drawn syringe. U.S. Pharmacopeia includes guidance for transporting pre-drawn vaccine in syringes in the USP COVID-19 Vaccine Toolkit.
- Remember to include the time spent in transport in the beyond-use date for the vaccine products. For more information on beyond-use dates, refer to the Interim COVID-19 Vaccine Provider Guide (PDF) in the storage and handling section on page 8.
Additional guidance for transporting COVID-19 vaccines can be found in MDH’s Transporting COVID-19 Vaccines (PDF) or CDC’s COVID-19 Vaccine Storage and Handling Addendum in the CDC: Vaccine Storage and Handling Toolkit.
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