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This weekly newsletter provides summarized content on COVID-19 vaccine related topics. This broad level of information is tailored towards health care professionals, partners, and the general public.

WASHINGTON COVID-19 VACCINATION STATUS: ALL AGES 5 AND UP

• General Updates
• Clinical Updates
• Training and Events
• Additional Resources

General Updates

PFIZER, MODERNA COVID-19 VACCINES NOW RECOMMENDED OVER J&J VACCINE

The Washington State Department of Health (DOH) is recommending people 18 and older choose to receive an mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) instead of the single-shot Johnson & Johnson (J&J) vaccine. This update follows guidance and recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) and the Western States Scientific Safety Review Workgroup. Individuals who wish to receive the J&J vaccine are encouraged to reach out to their health care provider to discuss their options as J&J will still be available across the state.

The preferential recommendation follows new data presented to the ACIP about thrombosis and thrombocytopenia syndrome, or TTS. TTS is a rare but serious condition involving blood clots and a low blood platelet count seen in some people who received the J&J vaccine. However, the risk is rare. Nationwide, 54 cases of TTS, including nine confirmed deaths, have been reported, which is a fraction of a percent of the 14 million doses of J&J given overall. While TTS has been seen in both men and women, the most at-risk group is women 30 through 49. People who received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.

Of the more than 11.4 million doses of COVID-19 vaccine given out across Washington, about 436,000 doses have been the J&J vaccine, which equals about 4%. According to data reported to the Vaccine Adverse Event Reporting System (VAERS) through Nov. 30, there have been six possible cases of TTS following J&J vaccinations in Washington, including one death.

“With this recommendation, COVID-19 vaccines based on mRNA are preferred over J&J vaccine, but J&J continues to be an option for those who aren’t able to receive mRNA vaccine,” said Dr. Tao Sheng Kwan-Gett, Chief Science Officer.

Read the full news release when it becomes available at our DOH newsroom page.

IT IS THE NEWSLETTER'S ONE YEAR ANNIVERSARY

The COVID-19 Vaccine Partner Newsletter first launched on December 11, 2020 to an audience of 24,000 people. We launched with the news that high risk workers in healthcare settings were able to get COVID-19 vaccination.

Since then, the newsletter has grown to over 45,000 people in the state of Washington. Our subscribers are mostly healthcare providers and health professionals, although we have a fair share of the public subscribed as well!

In one year, the newsletter has:

• Sent out 1,991,825 individual emails
• Provided 3,051 links to COVID-19 related content
• Generated 185,680 unique link clicks to COVID-19 related content

We hope that you continue to find the newsletter useful for as long as the pandemic continues. Thank you for your hard work and commitment to the people of Washington state.

Department of Health

DOH COMMEMORATES ONE YEAR OF COVID-19 VACCINES IN WASHINGTON

EL DOH CONMEMORA UN AÑO DESDE QUE COMENZÓ CON LA CAMPAÑA DE VACUNACIÓN CONTRA LA COVID-19 EN WASHINGTON

One year ago today, the first COVID-19 vaccine shipment arrived in Washington. Since then, more than 11.3 million doses of vaccine have been administered across the state and more than 5.4 million Washingtonians have received at least one dose. These remarkable milestones could not have been achieved without the hard work and dedication of health care workers, public health providers, first responders, community members, and countless others who have protected our communities by giving out life-saving vaccines.

This fall, vaccine eligibility expanded to include children as young as 5. In less than six weeks, more than 158,000 children ages 5 through 11 received their first dose.

Booster doses are now recommended for everyone 16 and older six months after completing an mRNA vaccine series (Pfizer-BioNTech or Moderna) or two months after receiving the single shot Johnson & Johnson COVID-19 vaccine. Although most people across the state are vaccinated, more than 1.7 million eligible Washingtonians have not started their vaccination series, which puts them at higher risk of getting seriously sick, hospitalized, or dying from COVID-19.

Read the full news release here.

Hoy se cumple un año desde que llegó el primer suministro de vacunas contra la COVID-19 a Washington. Desde ese momento, se han administrado más de 11.3 millones de dosis de la vacuna (solo en inglés) en todo el estado y más de 5.4 millones de habitantes de Washington han recibido, al menos, una dosis. Este acontecimiento extraordinario no habría sido posible sin el arduo trabajo y la dedicación de los trabajadores de la salud, los proveedores de salud pública, el personal de emergencia, los miembros de la comunidad y un sinfín de otras personas que han protegido a nuestras comunidades gracias a que han administrado estas vacunas que salvan vidas.

El pasado otoño, los niños de 5 años en adelante fueron los siguientes en la lista de elegibilidad para recibir la vacuna. En menos de seis semanas, más de 158,000 niños de entre 5 y 11 años recibieron la primera dosis.

La recomendación del momento es colocar dosis de refuerzo a todas las personas mayores de 16 años seis meses después de haber completado el esquema de alguna de las vacunas de ARNm (Pfizer-BioNTech o Moderna) o dos meses después de haber recibido la dosis única de la vacuna contra la COVID-19 de Johnson & Johnson. A pesar de que la mayoría de los habitantes de Washington ya se han vacunado, más de 1.7 millones de residentes de este estado no han comenzado con sus esquemas de vacunación, lo que significa que tienen un mayor riesgo de contraer la forma grave de la enfermedad, ser hospitalizados o morir a causa de la COVID-19.

Leer el artículo en español.

NEW COVID-19 SAFETY GUIDANCE RELEASED AFTER MULTI-COUNTY OUTBREAK LINKED TO HIGH SCHOOL WRESTLING TOURNAMENTS

The Washington State Department of Health (DOH), is updating the health and safety requirements for high contact indoor sports in the wake of a multi-school, multi-county outbreak. The outbreaks are linked to a series of wrestling tournaments held in early December and are linked to an estimated 200 COVID-19 cases. Genomic sequencing recently confirmed at least three cases are omicron.

DOH takes these outbreaks very seriously and is changing the existing guidance by adding the following health and safety measures for all indoor, high-contact sports and activities (basketball, wrestling, water polo, and competitive cheer), effective immediately:

• Required testing of all athletes, coaches, trainers, and support personnel, regardless of vaccination status.
• Increased testing frequency to three times per week. Among those screening tests, at least one must occur no sooner than the day before the competition; ideally, and whenever possible, the day of the event.

In addition, DOH wants to remind people of existing requirements for all K-12 sporting events that help keep athletes, staff, and families safer when attending these events:

• All indoor event spectators must wear masks and should distance from other families or households to the degree possible.
• Mask wearing is required among all athletes, coaches, trainers, and support personnel in indoor public spaces except when actively competing.
• Referees must wear masks except when actively officiated and running.

DOH also recognizes some of the affected local health, education, or athletic leaders are choosing to postpone or cancel sporting events or pause sporting activities in order to stop further spread of the disease. There may be differences in how these activities are handled, so we would encourage people to be patient with any potential process or scheduling changes at the local level.

Read the full news release here.

COVID-19 OUTBREAKS TRACED TO HIGH SCHOOL WRESTLING TOURNAMENTS

EL RASTREO DE BROTES DE COVID-19 LLEVA A TORNEOS DE LUCHA EN ESCUELAS SECUNDARIAS

The Washington State Department of Health (DOH), in collaboration with several local public health jurisdictions, is investigating multiple outbreaks of COVID-19 among vaccinated and unvaccinated individuals, connected to high school wrestling tournaments. The number of cases linked to the events is estimated to be between 80 and 90, but as this investigation is ongoing, the total may change. As of 11 a.m. Dec. 15, DOH has confirmed three cases connected to the outbreaks are the omicron variant.

The impacted wrestling tournaments all happened on Dec. 4, 2021 and include:

• John Birbeck Invitational in Lacey, WA
• Ed Arima Duals in Sumner, WA
• Lady Jags Kickoff Tournament in Puyallup, WA
• Yelm Girls Varsity in Yelm, WA

Counties that had high school(s) in attendance include Clark, Cowlitz, Grays Harbor, King, Kitsap, Lewis, Mason, Skagit, Snohomish, Pierce, Thurston, Whatcom, and Yakima. A high school in Oregon also sent participants.

Over the coming days, local health jurisdictions will likely send out notifications to the impacted schools with further guidance for next steps. DOH recommends that anyone who attended these events as a participant, coach, official, support staff, or spectator should monitor for symptoms and get tested for COVID-19. Further, anyone with symptoms or who tests positive should stay home from work, school, childcare or social activities.

Read the full news release here.

El Departamento de Salud del Estado de Washington (DOH, por su sigla en inglés), en colaboración con varias jurisdicciones locales de salud pública, está investigando diversos brotes de COVID-19 entre personas vacunadas y no vacunadas relacionados con torneos de lucha en escuelas secundarias. Se estima que la cantidad de casos vinculados con los eventos es de 80 a 90, pero como se trata de una investigación en curso, el total podría variar.

Todos los torneos de lucha afectados tuvieron lugar el 4 de diciembre de 2021 e incluyeron los siguientes:

• John Birbeck Invitational en Lacey, WA
• Ed Arima Duals en Sumner, WA
• Lady Jags Kickoff Tournament en Puyallup, WA
• Yelm Girls Varsity en Yelm, WA

Entre los condados que cuentan con escuelas secundarias asistentes se encuentran Clark, Cowlitz, Grays Harbor, King, Kitsap, Lewis, Mason, Skagit, Snohomish, Pierce, Thurston, Whatcom y Yakima. Una escuela secundaria de Oregón también envió participantes.

En los próximos días, es probable que las jurisdicciones locales de salud envíen avisos a las escuelas afectadas con mayor asesoramiento para los próximos pasos. href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVIDexposed.pdf">El DOH recomienda que todos los que hayan asistido a estos eventos (solo en inglés) en calidad de participantes, entrenadores, funcionarios, personal de apoyo o espectadores controlen la aparición de síntomas y se hagan una prueba de COVID-19. Además, las personas que tengan síntomas o un resultado positivo deberían quedarse en casa y no asistir al trabajo, la escuela ni a actividades sociales o de cuidado infantil (solo en inglés).

Leer el artículo en español.

NOW AVAILABLE: VAERS OVERVIEW VIDEO TO ADDRESS MISINFORMATION

The Washington State Department of Health has produced a new educational video to assist efforts to address one of the most common topics of misinformation being shared about COVID-19 vaccines: VAERS (the Vaccine Adverse Events Reporting System).

VAERS reports can be difficult to understand and often have been misinterpreted. Other times, VAERS is credited as the source of disinformation spread by people who oppose vaccines. The COVID-19 pandemic has elevated concerns of VAERS being misused by groups and individuals who have shared fearful, inaccurate and harmful messages against vaccination.

This 4-minute educational VAERS overview video is available in English and Spanish, and was designed to:

• Address misinformation and disinformation on social media
• Serves as both an educational post and a response to comments about safety
• Encourage proper use of the federal adverse event reporting system
• Embed the video on your webpages where VAERS or safety systems are mentioned. For example, see the VAERS video embedded on DOH’s vaccine safety page here.
• Promote trusted sources of information related to vaccines
• Links to both federal and state websites

Please use and promote this video in your organization and communities, and help distribute to others and ask them to do the same. If you have any questions or need sample social media posts in English or Spanish to go along with these videos, please contact DOH’s Office of Immunization at oicp@doh.wa.gov.

NEW VISUAL AID: COVID-19 SYMPTOM DECISION TREE

The Department of Health has recently created a Symptom Decision Tree for Non-Health Care Settings and the Public. This guide was created to address situations where someone has COVID-19 symptoms or is a close contact to a COVID-19 case.

The visual infographic is a great reference for the general public, but should not be used for school and healthcare settings.

Read the full infographic here.

Clinical Updates

STANDING ORDERS FOR PFIZER COVID-19 VACCINE UPDATED

The Department of Health recently updated the Pfizer-BioNTech COVID-19 Vaccine Statewide Standing Orders for Administering Vaccine. Persons ages 16 and 17 years of age may receive a booster dose based on their individual benefits and risks.

You can read the PDF here.

UPDATED JANSSEN COVID-19 VACCINE EUA

The Food and Drug Administration recently updated the Emergency Use Authorization (EUA) fact sheet for the Johnson & Johnson Janssen COVID-19 vaccine.

FDA recommendations:

• Do not get the Janssen COVID-19 vaccine if you had a blood clot along with a low level of platelets following the Janssen COVID-19 vaccine or following AstraZeneca's COVID-19 vaccine.

Janssen COVID-19 vaccine risks:

• Blood clots with low levels of platelets following Janssen COVID-19 vaccine have been reported. These reports are in both males and females across a wide range of individuals 18 and older. Reporting has been highest in females ages 30 to 49 years, making about 1 case for every 100,000 vaccine doses administered. One out of every seven cases has been fatal.

You can view the revised FDA fact sheet here.

COVID-19 VACCINE AND MONOCLONAL ANTIBODY PRODUCTS: CHANGES FOR MA PLAN CLAIMS STARTING JANUARY 1, 2022

If you vaccinate or administer monoclonal antibody treatment to patients enrolled in Medicare Advantage (MA) plans on or after January 1, 2022, submit claims to the MA Plan. Original Medicare won’t pay these claims.

More Information:

• Medicare Billing for COVID-19 Vaccine Shot Administration webpage
• Monoclonal Antibody COVID-19 Infusion webpage

COVID-19 VACCINE ORDERING REMINDERS

Ensure you have COVID vaccine and do not miss vaccination opportunities as we enter inclement weather season and the holiday delivery schedule.

Vaccine deliveries will not occur:

• December 23rd through December 27th
• December 30th through January 3rd

Please plan accordingly during this time when vaccine will not be delivered. 

Orders placed December 20th through December 22nd are likely to be delivered December 28th or December 29th, if your facility receives deliveries on Tuesdays and Wednesdays.

Holiday hours or closing for the holidays limiting delivery availability (December 20th through December 29th)? Do not place an order for COVID-19 Vaccine until after Wednesday, December 29th and keep in mind that deliveries will not be made until after January 3rd. Delivery of vaccine to a facility that is not open is likely to result in vaccine being wasted, as the vaccine might not be returned to the warehouse in a timely manner.

During the holiday shipping schedule (December 20th-January 3rd) we highly encourage providers to review the Vaccine Advertisement Page in the Washington Immunization Information System (WAIIS) to fulfill vaccine requests during the holiday season. This will assist in the spend down of the Pfizer 1170 12+ (purple cap) and make room for the Pfizer Tris-sucrose 12+ (gray cap).

As of Thursday, December 23rd, the Center for Disease Control (CDC) will be transitioning from Pfizer 1170 12+ (purple cap) to Pfizer Tris-sucrose 12+ (gray cap). Please spend down all doses of 1170 12+ (purple cap) prior to ordering Pfizer Tris-sucrose 12+ (gray cap) to avoid potential confusion when administering vaccine. Here is a link to the U.S. Food and Drug administration fact sheet for Pfizer-BioNTech (gray cap) for 12 years of age and older.

Training and Events

UPDATED GUIDANCE FOR CLINICIANS ON COVID-19 VACCINES

The next Clinician Outreach and Communication Activity (COCA) Call will present the latest evidence on thrombosis with thrombocytopenia syndrome (TTS) after administration of the Johnson & Johnson/Janssen COVID-19 vaccine. Presenters will discuss TTS and updated vaccine recommendations.

If you are unable to attend the live COCA Call, the recording will be available for viewing on the COCA Call webpage a few hours after the live event ends.

The slide set will be available on the day of the call on the COCA Call webpage under Call Materials.

Continuing Education will not be offered for this COCA Call.

11:00 AM - 12:00 PM PT (2-3 PM ET)
Friday, December 17, 2021
Join the Zoom webinar here
View the COCA webpage

WEBINAR RECORDING- HELPING PROVIDERS HAVE CONVERSATIONS AROUND COVID-19

The Dept of Health hosted a webinar on December 13, 2021 with Gretchen LaSalle M.D., Family Physician and Associate Professor for WSU and Anisa Ibrahim M.D., UW Clinic Associate Professor of Pediatrics and Medical Director at Harborview Pediatrics Clinic.

The Helping Providers Have Conversations with Families around COVID-19 Vaccination Webinar covered:

1. The effects of COVID illness and the COVID pandemic on children
2. Effective approaches to the COVID vaccine discussion with families
3. How the vaccine conversation may differ when working with patients from various racial/ethnic groups
4. Responses to common misconceptions and parental concerns about the COVID vaccine for kids

A recording is now available for viewing. Continuing education credit is available for nurses, medical assistants, and pharmacists/pharmacy techs for watching the recording.

Additional Resources

FOR SCHOOLS AND CHILD CARES

• COVID-19 Vaccines: Pediatric Vaccine Toolkit for Schools (PowerPoint) - This toolkit provides a variety of resources for schools, including parent handouts, backpack stuffers, and sample communication.
• Symptom Decision Tree and Contact Tracing Checklist for K-12 Schools Updates include reference to updated quarantine recommendation, addition of contact tracing priority settings.
• Contact Tracing Guide and FAQ for K-12 Schools Updates include updated quarantine recommendation, reference on contact tracing priority settings.
• K-12  2021-2022 Requirements Updates include more details on contact tracing, requirements for quarantine and testing of close contacts, and requirements for performing arts performances and other school activities.
• K-12 Schools 2021-2022 Supplemental Considerations to Mitigate COVID-19 Transmission. Updates include classroom and school closure criteria, contact tracing in high priority settings, timelines for close contact testing, and technical clarifications on antigen testing for Test to Stay programs and performing arts/sporting activities screening testing.
• Secretary of Health’s Mask Order FAQ, to align with a technical update to the secretary’s order related to athletes and coaches at large outdoor gatherings.

School and child care guidance can be found on the Department of Health web page here.

FOR LONG TERM CARE FACILITIES

• LTCF Testing Guidance includes more information on testing beyond routine testing. testing topics for identified COVID-19 cases, and CLIA waivers and reporting results.
• Transfer guidance includes additional information for transfers, including guidance on fully vaccinated residents.
• LTCF Cohorting guidance/isolation/quarantine guidance created for LTCF cohorting and I&Q with up-to-date recommendations.
• What to do if you identify a COVID-19 case in your Long-term Care Facility (wa.gov) – This is new guidance for the long-term care setting that provides a suggested framework for responding to COVID-19 in a long-term care facility.
• L&I and DOH Respirator and PPE for In-Home Care Agencies: Employer responsibilities for respiratory protection program and provision of personal protective equipment (PPE) (wa.gov) – Updates to quarantine for fully-vaccinated exposed residents.
• L&I and DOH Respirator and PPE Guidance for Long-Term Care: Employer responsibilities for respiratory protection program and provision of personal protective equipment (PPE) (wa.gov) – – Updates to quarantine for fully-vaccinated exposed residents.
• LTCF Visitor Announcement Sign – Removed information about the Governor’s proclamation and visitation rules for unvaccinated residents.
• Visitor Log – Updates to quarantine for fully-vaccinated exposed residents.
• LTCF Outdoor Visits – – Updates to quarantine for fully-vaccinated exposed residents.
• What to Do If You Identify a COVID-19 Case in Your Hospital – New guidance for the hospital setting that provides a suggested framework for responding to COVID-19 in a hospital facility.
• LTCF risk assessment community visit – Updates to quarantine for fully-vaccinated exposed residents.
• Interim Guidance for SARS-CoV-2 Source Control in Health Care Settings – Updates to quarantine for fully-vaccinated exposed residents.

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If you aren't already signed up for the COVID-19 Vaccine Partner Newsletter, please visit the Department of Health's email subscribers page here. Once you enter your email, on the next page expand the Immunization topic, select the COVID-19 Vaccine Partner Newsletter, and hit submit.

This newsletter summarizes content from the week of December 12, 2021 and was sent out on December 17, 2021.