New Vaccine for Respiratory Syncytial Virus 

On May 3, 2023, the Food and Drug Administration (FDA) approved the first U.S. vaccine against respiratory syncytial virus (RSV). Arexvy (GlaxoSmithKline), is indicated for adults aged 60 years and older to prevent lower respiratory tract disease (LRTD) caused by RSV. The vaccine contains a recombinant subunit prefusion RSV F glycoprotein antigen (RSVPreF3) combined with an adjuvant. The vaccine is anticipated to be available for the 2023–2024 winter season. 

Identifying Internationally Imported Measles Cases 

As international travel returns to pre-pandemic levels, please ensure that all patients exhibiting measles-like symptoms are evaluated. Measles symptoms appear 7 to 14 days after contact with the virus and typically include high fever, cough, runny nose, and watery eyes. Measles rash appears 3 to 5 days after the first symptoms. Please notify your Local Health Department immediately if you identify a suspect measles case to ensure timely testing. Healthcare providers should obtain both a serum sample and a throat swab (or nasopharyngeal swab) from patients suspected to have measles. Measles specimen collection guidance can be found on the Centers for Disease Control and Prevention’s (CDC) Specimen Collection, Storage, and Shipment page. 

COVID-19 Vaccine Recommendations 

Preparing for Reconciliation of Unreported Inventory 

The US Government (USG) is focusing on vaccine accountability activities. The COVID-19 Provider Agreement contained provisions requiring organizations to report the COVID-19 vaccines that were unused.  

VDH understands that waste reporting may be redundant as providers may be reporting their unused vaccine to systems such as Vaccine Finder and/or VIIS. However, to meet the USG accountability requirements, providers must also report COVID-19 doses that were not administered to VDH via a REDCap survey located on its COVID-19 website.  VDH will use the REDCap reports to upload the waste records to CDC’s official Vaccine Tracking System (VTrckS). These VTrckS data are used for the USG’s accountability metrics and will be used to identify jurisdictions with vaccine accountability gaps. The REDCap waste survey is located on the VDH Vaccine Website for Healthcare Professionals  (Look for the button DOSES AT- RISK OF EXPIRING/WASTE REPORTING. It is the first button under the Resources section). 

The survey is designed to report by NDC, as required by VTrckS. If you have a backlog, you may report legacy data under each NDC using a single date. In other words, you do not have to report it by NDC for each day since the pandemic began. 

Ancillary Supply Kits 

As a reminder, you can opt-out of ancillary supply kits for COVID-19 vaccines for adults. You can also opt-out of ancillary supply kits for COVID-19 vaccines for children that do not require diluent; however, you cannot opt-out of kits for vaccines for children that do require diluent. As a reminder, ancillary kits are not distributed with orders of Pfizer 12+ single-dose vials. If you find you need more COVID-19 supplies, please reach out to VaxMax_Help@vdh.virginia.gov. 

Johnson & Johnson/Janssen COVID-19 Expiry Dates 

As of May 6, 2023, all remaining distributed J&J/Janssen COVID-19 vaccines have expired. Please remove and dispose of all expired J&J vaccines according to state and local regulations and record the wasted doses in VaxMax. 

How to Return Ecoflex Coolers 

Please DO NOT call McKesson or UPS to schedule a pickup. The box can be given to any UPS driver or if you prefer, you can drop if off at a UPS drop box or facility. The boxes will be sent back to Cold Chain Technologies, where they will be inspected, cleaned, and refurbished for re-use. A prepaid UPS return label will be included on the inner flap of each EcoFlex cooler shipped.  

New! COVID-19 Therapeutics Product Expiration Dates 

Free COVID-19 Tests for Free Clinics and FQHCs 

The VDH COVID-19 Testing Team provides free at-home/OTC and point of care COVID-19 tests directly to free clinics and federally qualified health centers (FQHCs). Please contact testinginfo@vdh.virginia.gov if your facility is interested in requesting test kits. Please note that this is a separate and different program from the free COVID-19 test kit distribution through HHS/ASPR.  

Mpox Resurgence Reported in Chicago 

In a May 5 press release, Howard Brown Health, an agency that serves the Chicago LGBTQ+ community, reported that it had confirmed 7 cases of mpox since April 17. Some of the people recently diagnosed with mpox were fully vaccinated against the virus. In the 3 months leading up to these cases, the Chicago Department of Health had only reported one case of mpox.  

To prevent further spread of mpox, VDH and CDC encourage people who plan to travel and attend festivals and Pride events this summer to get fully vaccinated for mpox ahead of time. Please share information about the mpox vaccine, including the CDC mpox vaccine locator and information on how to prepare to have a healthy summer.  

Immunize.org Updates the Standing Orders Template for Administering Pneumococcal Vaccines (PCV15, PCV20, and PPSV23) to Adults 

Many healthcare facilities simplify vaccination through the use of standing orders. Immunize.org has made important updates to its Standing Orders for Administering Pneumococcal Vaccines (PCV15, PCV20, and PPSV23) to Adults. This is based upon updated guidance published in CDC’s 2023 Recommended Immunization Schedule for Adults. This includes the option to administer PCV20 to adults aged 65 or older who completed vaccination with PCV13 and PPSV23 at least 5 years earlier. 

The PneumoRecs VaxAdvisor mobile app helps vaccination providers quickly and easily determine which pneumococcal vaccines a patient needs and when. The app incorporates recommendations for all ages so internists, family physicians, pediatricians, and pharmacists alike will find the tool beneficial. If you do not have a device that supports the app, you can access a web version when connected to the internet through a mobile device or computer. 

Medicaid Unwinding: Return to Normal Enrollment 

Starting in March 2023, Virginia began reviewing Medicaid members’ health coverage to make sure they still qualify. For more information on Medicaid unwinding and how providers can help patients during this process, visit the Cover Virginia Webpage. 

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The VDH Healthcare-Associated Infections and Antimicrobial Resistance (HAI/AR) Program publishes the HAI & AR Navigator (previously known as the HAI High Sign) newsletter bimonthly. Newsletter content is written for personnel who work with HAIs, AR, and infection prevention and control (IPC). We encourage infection preventionists, healthcare workers, and public health staff to subscribe to the HAI & AR Navigator and access archived newsletters on the VDH HAI webpage.