Vaccine Blurbs Issue #233: Flu and RSV and COVID-19 - Oh My!

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Washington State Department of Health | September 11, 2024


DOH Respiratory Season Vaccine Recommendations Webinar

The Washington State Department of Health is hosting a 2024-2025 Respiratory Virus Season: Vaccine Recommendations, Ordering and Distribution webinar at 12PM Tuesday, September 17.

Presenters will discuss influenza, COVID-19, and RSV epidemiology, vaccine recommendations, and vaccine ordering and distribution. Health care providers, health professionals, and anyone else interested in learning more about this topic are welcome to attend.

Register here

Learning Objectives:

  • Discuss influenza, COVID-19, and RSV epidemiology, clinical overview, and vaccine recommendations.
  • Describe influenza, COVID-19, nirsevimab, and RSV vaccine ordering and distribution.
  • Identify available clinical resources.

Continuing Education & Other Webinar Details

Continuing education will be available for nurses, medical assistants, pharmacists and pharmacy techs. Please register individually if you would like to get CE credit.

The Department of Health will record the webinar for those who are unable to attend.

Find more details on our webinar web page. For other immunization training opportunities, bookmark our immunization training page.


Respiratory Vaccine Ordering Open

Flu and COVID-19 vaccine and RSV products for the 2024-2025 season are available to order.  It can take up to two weeks from the approval date to receive your shipment. Please remember to plan mass vaccination clinics later in September and early October when more flu vaccine is available.

Things to Remember:

  • Childhood vaccine orders for respiratory products will be processed weekly initially and more frequently once we receive additional allocation.
    • Monday - RSV product orders processed
    • Tuesday - COVID-19 vaccine orders processed
    • Thursday - Flu vaccine orders processed
  • All respiratory products can be ordered at any time - you do not need to wait for your assigned ordering window to place an order for these products
  • Place smaller orders more frequently, rather than large orders 
  • Orders may be reduced to meet allocation and product availability - the goal is to ensure all providers receive some product 
  • Providers are required to carry and offer all ACIP recommended vaccines for the population they serve. 
    • We expect all providers to have flu and COVID-19 vaccine available. (DOH-authorized specialty providers may not be required to carry flu and COVID vaccines) 
    • If small infants are served, nirsevimab is expected to be available. 

Error with Minimum Order Quantity for COVID-19 Vaccine

Pfizer’s COVID vaccine for 6 months to 4 years population was entered into the WAIIS incorrectly.

The minimum order quantity was initially set at 10 doses due to it being listed as a 10-pack. However, the 10-pack is of a 3 dose multi dose vial (MDV). Therefore, the minimum order quantity should have been set at 30. Orders placed before 1:00 pm on Tuesday September 10th, will be altered or denied for this vaccine if orders aren’t in 30 dose increments.

Orders for this vaccine can be placed in 30 dose increments if your order was altered or denied.

We are sorry for the inconvenience this may cause.


2023-2024 COVID-19 Vaccines No Longer Authorized

The 2023-2024 COVID-19 vaccines are no longer authorized and should NOT be administered even if they are not expired.

Administration of any 2023-2024 doses on or after August 23 after FDA authorization and approval of the 2024-2025 vaccines is considered a vaccine administration error.

Some of the questions we received from you include:

  • Do we need to contact patients who received a dose on/after August 23rd about revaccination?
  • What is the timing interval for administering the new formula to affected patients once we receive it?

We are actively communicating with the CDC on potential next steps to address these questions and will follow up when confirming guidance is received. For now, here are important steps all providers should take as we navigate the transition to the new formula.

To minimize risk of vaccine administration error, providers should:

  • Remove all 2023-2024 COVID-19 vaccines from storage units immediately, even if they are not expired.
  • Once all inventory is fully accounted for, delete 2023-2024 COVID-19 vaccine listings from the available vaccine inventory in your Immunization Information System (IIS), as applicable.
  • Return all unused 2023-2024 COVID-19 vaccines to CDC's centralized distributor using the normal process for returning spoiled/expired vaccines.
    • Providers must use the category "Spoiled" and the reason "Expired BUD" to reconcile and submit the return of these vaccines in the IIS. Please do not use the "Recall" category.

A Vaccine Adverse Event Reporting System (VAERS) report is required for COVID-19 vaccines under Emergency Use Authorization (EUA). VAERS reporting is strongly encouraged for licensed COVID-19 vaccines.

For licensed COVID-19 vaccines (Moderna and Pfizer-BioNTech in people ages 12 years and older), healthcare providers are strongly encouraged to report the following to VAERS:

  • Any adverse event that occurs after the administration of a vaccine licensed in the United States, whether or not it is clear that a vaccine caused the adverse event. 
  • Vaccine administration errors, whether or not associated with an adverse event.

For COVID-19 vaccines given under EUA, vaccination providers are required to report the following to VAERS:

  • Vaccine administration errors, whether or not associated with an adverse event.
  • Serious adverse events regardless of causality. Serious adverse events per the FDA are defined as:
    • Death.
    • A life-threatening adverse event.
    • Inpatient hospitalization or prolongation of existing hospitalization.
    • A persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions.
    • A congenital anomaly/birth defect.
    • An important medical even that based on appropriate medical judgement may jeopardize the individual and may require medical or surgical intervention to prevent one of the outcomes listed above.
  • Cases of Multisystem Inflammatory Syndrome (MIS) in children and adults.
  • Cases of myocarditis.
  • Cases of pericarditis.
  • Cases of COVID-19 that result in hospitalization or death.

Reporting is also encouraged for any other clinically significant adverse event, even if it is uncertain whether the vaccine caused the event. Information on how to submit a report to VAERS is available at https://vaers.hhs.gov or by calling 1-900-822-7967. Please refer to additional details in the CDC's Clinical Guidance for COVID-19 Vaccination web page.


Flu Vaccine Toolkit for Providers

Providers are welcome to use the communication materials linked below to promote the flu vaccine. These materials explain the importance of getting vaccinated, who is most at risk, and how to find a vaccine. Check back for updated materials throughout the season! 

Flu Free Washington Partner Toolkit

CDC Flu Resource Center - Digital Media Toolkit


Vaccinations for School-Age Children Webinar

Join CDC, Department of Education, National Association of School Nurses, and Alliance for a Healthier Generation on September 25th from 3:00-4:30pm ET for a webinar titled "Vaccinations for School-Age Children: Opportunities for Health Promotion, Collaboration, and Family Engagement!"

This webinar will provider school and healthcare attendees with training on the latest Advisory Committee on Immunization Practices (ACIP) vaccination recommendations for K-12 students and evidence-based strategies and promising practices for strengthening childhood vaccination coverage. 

Register here to receive the calendar invite for this webinar. The training will also be recorded and available on CDC TRAIN for one year. Continuing education credits (CNE, CEU, CPH, CHES) for this activity are pending. 

Clinical Corner

RSV Vaccine and Nirsevimab Recommendations

Adults 60 years and older

  • CDC recommends an RSV vaccine for everyone ages 75 and older and adults 60-74 years old at increased risk of severe RSV.
  • Adults 60-74 who are at increased risk include those with chronic heart or lung disease, certain other chronic medical conditions, and those who are residents of nursing homes or other long-term care facilities.
  • If an adult already received an RSV vaccine, they do not need to get another one at this time.
  • The best time to get vaccinated is in late summer and early fall — just before RSV starts to spread in the community.

Vaccination for pregnant people

  • 1 dose of Abrysvo during weeks 32 through 36 of pregnancy, administered September through January. Additional doses are not recommended at this time if the pregnant person already received a dose.
  • Use the Abrysvo vaccine locator to find pharmacies offering this vaccine.

Immunization for infants and young children

  • 1 dose of nirsevimab is recommended for infants younger than 8 months of age who were born shortly before or are entering their first RSV season (October through March for most of the continental US) IF the mother did not receive RSV vaccine during pregnancy, the mother’s RSV vaccination status is unknown, or the infant was born within 14 days of maternal RSV vaccination.

 

Resources


Updated Bexsero Schedule

FDA approved a new dosing schedule for Bexsero, a MenB vaccine, that matches the schedule for Trumenba. A 6-month interval is required between the 2-dose schedule. If a second dose is given earlier than 6 months after the first dose, a third dose should be administered at least 4 months after the second dose. Immunocompromised people and those at high risk of MenB disease should receive 3 doses at 0, 1–2, and 6-months. If the second dose of a 3-dose schedule is delayed and administered 6 months or longer after the first dose, the third dose is not needed.

Bexsero’s original 2-dose schedule, with a 1-month interval between the doses, is no longer licensed. ACIP (Advisory Committee on Immunization Practices) is expected to review the new schedule at its October 2024 meeting. Questions about patients who previously received 2 doses (1-month interval) of Bexsero may be discussed. Until then, healthcare providers should refer to the updated Bexsero package insert for the currently approved schedule. Immunize​.org is updating MenB resources to reflect the new schedule.


Recording Available for COVID-19 Updates Webinar

The Washington Department of Health (DOH) hosted a webinar on Thursday, August 29, 2024. Department of Health staff discussed current COVID-19 vaccine recommendations, vaccine ordering, and storage and handling guidelines. Continuing education is available for nurses and medical assistants.


Novavax Has Been Authorized for Use

Last week, the FDA authorized the use of the Novavax COVID-19 vaccine 2024-2025 formulation for those people 12 years old and up. The Novavax COVID-19 vaccine is made from a protein-based formulation containing a single antigen corresponding to the Omicron variant JN.1 strain of SARS-CoV-2. This vaccine continues to be used under the terms of EUA, therefore recipients should receive a copy of the EUA Fact Sheet for Recipients and Caregivers. You can find more information on this topic at the following links:

EUA Fact Sheet for Healthcare Providers Administering Vaccine 

 FDA authorized use of the 2024–25 formulation of the protein-based Novavax COVID-19 vaccine

Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC


CDC publishes MMWR report for COVID-19 Vaccine Recommendations

CDC released a report in the MMWR this week regarding the 2024-2025 COVID-19 vaccination recommendations. This document summarizes the recommendations for everyone 6 month and up to be up-to-date with 2024-2025 COVID-19 vaccine. It highlights the safety and effectiveness of the vaccine as well as discussed economic impacts of vaccinations based on demographics, etc. Finally, the article provides a review of the recommendations published in the Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC. You can find the full article here.


For questions about the immunization schedule, the Immunization Information System forecast, or any other immunization clinical questions, please send an email to ImmuneNurses@doh.wa.gov. Check out the Immunization Training web page for more resources and training opportunities.


Helpful Hints

Remember to include your facility's PIN on all communications. Including your PIN in the subject line of all emails ensures your message makes it to the correct person and can be quickly addressed!