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

INCREASE IN BREAKTHROUGH CASES RELATED TO CURRENT COVID-19 SURGE

OLYMPIA –The Washington State Department of Health (DOH) is seeing an increase in the number of “vaccine breakthrough” cases related to the recent increase in overall cases statewide. Even with the increase in breakthrough infections, data continue to show that vaccination is highly protective against hospitalization and death from COVID-19.

Current reporting shows a recent 43% increase in the number of breakthrough cases. The increase in the number of breakthrough cases is related to the increase in the number of total cases statewide. From January 17, 2021 - January 1, 2022, there have been 123,365 vaccine breakthrough cases identified in Washington State. While the majority of individuals with confirmed vaccine breakthrough experienced only mild or no symptoms, at least 3% were hospitalized.

To date, more than 4.8 million people in Washington state are up to date on their vaccines. The breakthrough cases represent a small portion, about 2.5% of the vaccinated population.

Read the press release in English.

UPDATED VACCINE RECOMMENDATIONS

In the last several weeks there have been updates to COVID-19 booster dose eligibility.

As noted in the graphic above, you can now get Pfizer and Moderna mRNA vaccine boosters 5 months after completing the original vaccine series. Children ages 12 and up are now recommended to receive a booster as well.

For more information on primary series and booster vaccines, please visit the FDA website.

HOW WE KEEP VACCINES SAFE

Understanding the Vaccine Adverse Events Reporting System (VAERS)

Millions of people have gotten COVID-19 vaccines under the most intense vaccine safety monitoring in U.S. history. In previous posts, we’ve discussed the safety process that takes a vaccine from trials to emergency use authorization to full FDA approval. But what happens after that? Are experts still monitoring vaccine safety?

VACCINATED OUT OF THE COUNTRY?

Here's what you need to know...

¿DIO POSITIVO EN LA PRUEBA DEL COVID-19?

Qué hacer para cuidarse a sí mismo y a los demás del COVID-19?

Con el fin de las vacaciones de invierno y las variantes del virus propagándose rápidamente, más personas dan positivo con el COVID-19 todos los días. Y a nadie le gusta enfermarse. Afortunadamente, muchas personas, especialmente aquellas que están vacunadas, pueden recuperarse en casa.

Primero que nada: Si tiene síntomas del COVID-19, hágase la prueba lo antes posible. También debe hacerse la prueba si ha estado en contacto cercano con alguien que pueda estar contagiado con el COVID-19. En este caso, hágase la prueba cinco días después de su último contacto con ellos, incluso si no tiene síntomas. Visite nuestra página de localizador de pruebas (solo en inglés) para encontrar centros de prueba cerca de usted, o considere comprar una prueba en el hogar.

¿Su prueba resultó positiva? Quizás se esté preguntando qué hacer. ¿Cómo debe cuidarse mientras está enfermo? ¿Cómo evitar que el virus del COVID-19 se propague a otras personas? Si dio positivo a la prueba del COVID-19, la buena noticia es que hay pasos que puede tomar para ayudar a mantenerse seguros a usted y a los demás.

Leer el artículo en español.

Clinical Updates

MODERNA BOOSTER RECOMMENDED AFTER 5 MONTHS

Washington state has updated Standing Orders for the Moderna COVID-19 vaccine after the CDC announced the Moderna booster doses can be given 5 months after the primary vaccine series. For more information, see the CDC media statement and review the WA DOH Standing Orders.

CDC Media Statement

Washington DOH Standing Orders

VACCINE ORDER APPROVALS PAUSED FOR MLK HOLIDAY

The Washington State Department of Health will be closed on January 17^th in observance of Martin Luther King Day. Therefore, COVID-19 vaccine orders will not be approved on Monday, January 17, 2022. Instead, orders will be approved on Tuesday, January 18, 2022 and regular cadence for approval of orders will resume on Thursday, January 20, 2022.

Please send all questions or concerns to COVID.vaccine@doh.wa.gov.

NEW MONTHLY TEMPERATURE LOG REQUIREMENT COMING SOON!

The COVID-19 Vaccine Program is implementing a monthly temperature log review to ensure the vaccines given in our state are safe and effective. Temperature excursions that occur and are not identified and responded to in a timely manner can affect the potency of the vaccines which can result in patient recalls to re-administer vaccines and lowered vaccine confidence.

• Providers must begin collecting handwritten minimum and maximum temperature data on March 1, 2022.
• For providers with Digital Data Loggers (DDLs) or continuous temperature monitoring devices (TMDs) – a clear summary report may be accepted upon program approval.
• Providers must submit monthly temperature logs for each of their approved storage units beginning on April 1, 2022.
• Additional information and resources are coming through the newsletter and Partner Call. Please reach out to us at COVID.Vaccine@doh.wa.gov if you have questions.

CHECK YOUR PFIZER VACCINE BOXES 

The Center for Disease Control (CDC) confirmed numerous Pfizer vaccine orders were sent out with the incorrect expiration date printed on the box. This error has since been corrected in the ordering system. The correct expiration for Pfizer grey and orange cap vaccine is 9 months from the manufacture date, as seen in the chart below.

As a reminder, providers are able to register for the COVID-19 Vaccine Lot Number and Expiration Date Report, which provides lot numbers and up-to-date expiration dates. This report includes any granted vaccine expiration extensions.

BOOSTER DOSES FOR IMMUNOCOMPROMISED

Vaccination is especially important for those that are immunocompromised.  To ensure they complete their primary series (including additional dose) and booster dose in the most effective timeline, we'd like to share this example and chart.

If an individual aged 12+ received a 3 dose primary series due to being immunocompromised, they should receive a booster dose, or 4^th dose, at least 5 months after their last primary dose.

For example, “Sally” is 45 years old and immunocompromised. She received her first dose of Pfizer vaccine on June 1, 2021 and her second dose on June 23, 2021. Due to her immunocompromising condition, she received a third dose of Pfizer July 23, 2021. This completed her primary series of Pfizer COVID-19 vaccination. She is then eligible for a booster dose (or 4^th dose) on or after December 23, 2021, which was at least 5 months after the last dose of her primary series.

Fore more information on COVID-19 vaccines, including booster doses, please visit the FDA website.

INCLEMENT WEATHER AND RESOURCES FOR HEALTH CARE PROVIDERS

When inclement weather is expected, power outages and vaccine shipping delays are also possible.

Ways to prepare for inclement weather:

• Ensure your vaccine management plan is up to date.
• Ensure vaccines maintain stable temperatures. If you experience a power outage, please refer to the COVID-19 Temperature Excursion Guide.
• If vaccine must be moved due to an emergency, emergency transport does not require prior approval. If vaccines are transported, ensure that a digital data logger is used to record vaccine temperatures while in transit.
• Report all temperature excursions to 360-236-4223 or COVID.vaccine@doh.wa.gov, and call the manufacturers of each vaccine involved in the excursion to verify vaccine viability.

When conducting vaccination clinics prepare for a power outage by bringing paper copies of:

• Temperature logs.
• Hard copy of PrepMod registration.
• Paper to record vaccinations for data entry when system cannot be accessed.
• Vaccine Management Plan to identify if vaccines will need to be transferred to an alternate location if the facility storing the doses does not have power that will return before temperatures go out of range.

Also consider having the following items on hand incase of a power outage onsite at a clinic:

• Spare batteries
• Flashlights

Other Resources:

DOH Storage and Handling Webpage

CDC COVID-19 Vaccine Quick Reference Guide for Healthcare Professionals

HAVING A COMBINED COVID-19 VACCINE AND CHILDHOOD VACCINE EVENT?

The Department of Health is supportive of combined COVID-19 vaccine and childhood vaccine events. As a reminder, health care providers and vaccination sites should:

• Meet the separate requirements of both the Childhood Vaccine Program and the COVID-19 Vaccine Program.
• Email WAChildhoodVaccines@doh.wa.gov for questions on Childhood Vaccine Program forms.
• Return COVID-19 Program forms to COVID.vaccine@doh.wa.gov.
• Email COVID.vaccine@doh.wa.gov with any questions.

Training and Events

COVID-19 VACCINE STORAGE AND HANDLING AND ADMINISTRATION WEBINAR

The Department of Health is hosting a COVID-19 vaccine webinar at 12:00 PM PT on January 27, 2022. The webinar will cover vaccine storage and handling and vaccine administration practices. The training will be lead by the vaccine management team in the Office of Immunization.

Upon completion of this educational activity, participants should be able to:

• Understand storage and transport requirements for each presentation of COVID-19 vaccine.
• Identify best practices for maintaining the cold chain for COVID-19 vaccine.
• Identify resources for COVID-19 vaccine storage and handling, and vaccine administration.

12:00 - 1:00 PM PT
Thursday, January 27, 2022
Register here

HAVE QUESTIONS ABOUT PROVIDER BILLING AND REIMBURSEMENT FOR COVID-19 VACCINES?

We have answers!

On December 7, 2021 the Department of Health hosted a COVID-19 Partner Call and was joined by colleagues from the Health Care Authority and the Office of the Insurance Commission. Discussed was helpful information on provider billing and reimbursement for COVID-19 vaccination.  

The recorded meeting and presentation is available on YouTube in case you were unable to attend.

Additional Resources

FOR THE GENERAL PUBLIC

• COVID-19 Transportation Resource Document This document supports communities and partners with access barriers to vaccines and testing sites. 
• Guidance for Sports and Fitness This new guidance document stands in for the rescinding of the governor's previous Sporting Activities Requirements document. It includes special considerations for different activities across all ages. It also contains optional screening testing and public health mitigation practices.
• Behavioral Health Tips for Getting the COVID-19 Vaccine (PDF) | Spanish (PDF)
• Want to know more about how Washington state allocate doses? Visit our vaccine distribution webpage for the latest information.
• The CDC's After Getting the Vaccine page shares what you can expect after getting vaccinated, including common side effects.

• Find a COVID-19 testing location near you. To make it easier to find a test near you, the Department of Health has created a webpage to help people find COVID-19 testing locations throughout the state.

• The state COVID-19 Assistance Hotline is a general information line related to COVID-19. If you need information or have a general question, call 1-800-525-0127, then press # or text 211-211 for help.

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.
• Updated K-12  2021-2022 Requirements January 7, 2022 updates include updated isolation, quarantine, and testing recommendations to align with CDC changes. Added expanded eligibility for and activities allowed during modified quarantine in the Test to Stay programs.
• Updated K-12 Schools 2021-2022 Supplemental Considerations to Mitigate COVID-19 Transmission. January 7, 2022 updates include clarifications on buses as a structured setting for K-12 close contact exclusion, WAC reporting requirements for school closures, updates to the Test to Stay Program eligibility, and changes to isolation, quarantine and testing to match new CDC guidelines.
• 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.

SIGN UP FOR THE NEWSLETTER

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 January 9, 2022 and was sent out on January 14, 2022.