Vaccine Blurbs Issue #234: Vaccine Shipping Delays

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Washington State Department of Health |September 25, 2024


Vaccine Shipping Delays

Our vaccine distributor, McKesson, is currently facing shipping delays for vaccine orders due to an unusually high volume of orders in September. CDC is monitoring the situation and working with McKesson to resolve this issue as quickly as possible. 

Current status: 

  • Flu Orders: Backlog - estimated return to current September 30th
  • Routine Orders: Backlog - estimated return to current October 2nd 
  • Frozen COVID Orders - Current 

Thank you for your understanding and patience as we work with McKesson to resolve this issue. 


Vaccine Shipping Reminders

Remember that even though you may place orders for refrigerated and frozen vaccines at the same time, they are shipped separately because refrigerated vaccines are shipped by McKesson and frozen vaccines (Varicella, MMRV & some COVID vaccines) are shipped directly from the manufacturer. The manufacturers have 2 weeks (14 days) from the order approval date to ship the vaccines. 

Please plan accordingly and ensure that you are keeping a 30 day safety stock at all times. You can use the Recommended Order Quantity (ROQ) to calculate how much vaccine to order but remember to factor in seasonality and other reasons for increased need. 


RSV Ordering Update

We saw a large quantity ordered at the start of September when ordering opened and did not have enough product available to meet demand. While we estimate there will be sufficient product for the season, it is under allocation by CDC and we have a limited quantity available to fill orders each week. 

We will receive allocations from CDC on the following dates throughout October and will process nirsevimab orders each Monday as we have allocation available: 

  • September 30
  • October 7
  • October 14
  • October 28

Providers should place orders based on what can be administered over a 2 week period and place more frequent orders. Orders do not have to submitted during your assigned ordering schedule. 


Novavax COVID-19 Vaccine Coming Soon

Updated Novavax COVID-19 vaccine for the 2024-2025 season has been authorized and will available for order in the IIS on October 1, 2024. 

The expiration date on the current supply is 10/31/2024. Novavax is pursuing a shelf-life extension for this and future lots and anticipates receiving monthly shelf life updates throughout the COVID vaccination season. 

Shelf-life extensions will be communicated by Novavax. An Expiration Look-Up Tool is available for providers to check the most up-to-date information about product expiry before vaccine is administered. The Look-Up Tool is also available via OR code located on the outer vaccine carton. 

Given the current shelf life, CDC will continue to ship Novavax vaccine up until 18 days before expiry. To minimize wastage, please place smaller, more frequent orders. 


Pfizer Pack List Update

There are three different pack list options for the 2024-2025 season. Providers should be familiar with all options. 

pack slip options
shipping label example

Comirnaty (never frozen) 12y+ vaccine shipments are shipped refrigerated using a qualified pack out. It will not include a temperature monitor device. All pack lists for this product include information to help determine viability. The pack list shows the date and time by which the product must be received. If received after the stated date and time, Pfizer will need to be contacted to determine product viability. 


VaxCards: Immunization Quick Reference Cards

VaxCards by SRHD

Check out this new resource from the Spokane Regional Health District! VaxCards are a downloadable/printable quick reference tool for providers that include information on storage and handling, administration, and recommendations specific to each CVP vaccine product. You can find this and many more helpful resources on the CVP Storage & Handling webpage


RSV Immunization Recommendations

Since we are underway for the respiratory season, we wanted to continue to provide RSV immunization recommendations.

Nirsevimab recommendations for children

  • Nirsevimab is recommended for infants younger than 8 months of age between October through March in their first RSV season 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. Please do NOT use Abrysvo, Arexvy, or mRESVIA for children.
  • The child‘s age on the day nirsevimab is given should be used to determine if the child is eligible for immunization. Nirsevimab is not needed for most infants who are born 14 or more days after their mother received RSV vaccine except in rare situations.
  • Healthcare providers may use clinical judgement in determining when to give nirsevimab outside of October through March. Special circumstances may also need to be considered, such as travel to areas with increased RSV activity or concerns that the child may not return when nirsevimab should be given.
  • Nirsevimab is recommended for children ages 8 through 19 months at increased risk for severe RSV disease and entering their second RSV season. These children include American Indian or Alaska Native children, those with chronic lung disease of prematurity who required medical support, children with severe immunocompromise, and children with cystic fibrosis.
  • Children ages 8 through 19 months not at increased risk of severe RSV disease should NOT receive nirsevimab. CDC does not currently recommend nirsevimab for anyone aged 20 months or older.
  • Dosage for age less than 8 months: 50 mg for infants weighing <5 kg [<11 lb] or 100 mg for infants weighing ≥5 kg [≥11 lb]
  • Dosage for age 8 through 19 months: 200 mg, administered as two 100 mg injections
  • Nirsevimab and routine childhood vaccines can be administered during the same visit. No interval between nirsevimab and live vaccines (MMR, varicella, FluMist) is needed.

Abrysvo vaccine recommendations for pregnant people

  • CDC recommends one dose of Pfizer’s Abrysvo for people who are 32 through 36 weeks gestation. Abrysvo is currently the only RSV vaccine licensed for pregnant people. GSK's Arexvy and Moderna's mResvia are NOT approved for use during pregnancy.
  • Pregnant people who are more than 36 weeks 6 days should not be vaccinated, since it’s unlikely there will be enough time to protect the infant. Instead, their infant should receive nirsevimab.
  • In most of the continental United States, pregnant people should receive RSV vaccine from September through January so that their babies are protected against severe RSV disease at birth.
  • If a pregnant person already received Abrysvo during any previous pregnancy, CDC does not recommend another dose of RSV vaccine during subsequent pregnancies. If the mother was not vaccinated during the current pregnancy, the infant should receive nirsevimab during October–March.
  • Maternal RSV vaccine can be administered during the same visit that a patient receives a Tdap, COVID-19, and/or influenza vaccine.
  • Please document Abrysvo administration in the EHR, WAIIS, and prenatal records that are sent to the hospital prior to delivery.
  • Find Pfizer's RSV Vaccine at a Location Near You (abrysvo.com)

RSV vaccine recommendations for adults

  • CDC recommends a single dose of any FDA-licensed RSV vaccine for all adults ages 75 and older and adults ages 60–74 at increased risk of severe RSV.
  • Adults at highest risk for severe RSV disease include those with chronic heart or lung disease, weak immune systems, certain underlying medical conditions such as diabetes or obesity, or adults living in nursing homes. Adults in other long-term care facilities are not included in the list of those at highest risk. For the complete list of risk factors for severe RSV disease, see RSV Clinical Overview.
  • Eligible adults may receive any RSV vaccine: Arexvy, mResvia, or Abrysvo. RSV vaccine can be given at any time, but the best time to vaccinate patients is in late summer and early fall before RSV usually starts to spread in the community.
Clinical Corner

ACIP PCV21 Recommendations Published in MMWR

CDC published Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024. Below is a brief summary:

  • PCV21 (Capvaxive, Merck) is an option for adults aged ≥19 years who are currently recommended to receive PCV15 or PCV20. PCV21 contains eight serotypes not included in other licensed vaccines.
  • Unlike PCV15 (Vaxneuvance, Merck) and PCV20 (Prevnar 20, Pfizer), which are routinely recommended for children, PCV21 does not provide protection against certain serotypes responsible for a significant burden of disease in children. For this reason, PCV21 is not licensed or recommended for use in children.

Additional resources:


University of Washington offers free online lecture series on viral hepatitis; CME credit available

University of Washington launched a free Hepatitis B Online curriculum to help healthcare providers learn how to diagnose, treat, and prevent hepatitis B virus infection, while earning CME or CNE credits.


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

It's officially fall and a great time to review your facility's emergency plans!  Please take a minute to review your facility's Vaccine Management Plan and ensure you are prepared for a power outage or storage unit failure.

Remember, a transfer request does not need to completed or require pre-approval for emergency transport.