Reflection
Last week the CDC recommended the Pfizer vaccine for use in everyone aged 12 years and older. Wisconsin is pleased to welcome this age group to COVID-19 vaccination. Due to the hard work of vaccinators, as of Wednesday, 28,910 (9.8%) of Wisconsin adolescents have already gotten their first dose!
Please remember that only Pfizer COVID-19 vaccine is authorized for anyone 12 years and older. Moderna and Johnson & Johnson (Janssen) are only authorized for those 18 years and older.
Parental Consent for Vaccination of Individuals Under the Age of 18
According to the Centers for Disease Control and Prevention, state laws establish vaccination requirements for school-aged children. In Wisconsin, the age of majority is 18 years of age, unless emancipated. Therefore, all unemancipated individuals under 18 years of age require parent or guardian consent to receive the COVID-19 vaccine.
In Wisconsin, vaccinators are able to accept written or verbal (i.e., via telephone) consent to administer the COVID-19 vaccine from the minor’s legal parent or guardian who cannot be present at the time of vaccination. Vaccinators are not required to accept written or verbal consent but are permitted to accept these forms of consent should they choose to do so. WI DHS does not have a sample written consent form for vaccinators to use. Vaccinators are encouraged to work with their own legal counsel regarding methods of consent for vaccinating minors in their clinic.
New and Updated COVID-19 Vaccine Clinician Resources
The following materials have been updated to reflect the latest ACIP recommendation to include adolescents aged 12 to 15 years as eligible for Pfizer-BioNTech COVID-19 vaccine.
A new safety webinar has been added to the COVID-19 Vaccine Webinar Series. The “Ensuring Vaccine Safety in the United States: A Primer for Healthcare Workers” module reviews many aspects of vaccine safety so that health care professionals can educate their patients and answer any questions they might have. Each webinar in the series is approximately 15 minutes and offers CE.
General information about COVID-19 vaccine products for clinicians and health care professionals can be found on the COVID-19 Vaccination webpage.
Clinical information including FAQs, contraindications and precautions and administrative resources can be found for each vaccine on their own product webpage. Scrolling to the bottom of each vaccine specific webpage will bring you to a list of storage and handling resources.
Pfizer Expands Storage at Refrigerator Temperatures
On May 19th, the FDA authorized an amendment to the Pfizer-BioNTech COVID-19 vaccine EUA. The amendment allows for undiluted vials of Pfizer-BioNTech vaccine to be stored in the refrigerator (2°C to 8°C) for up to 1 month. This is a change from the previous 120 hours of allowable storage time at 2°C to 8°C. This applies to vaccine currently in-hand as well.
The amended EUA Factsheet can be found here: https://www.fda.gov/media/144413/download.
Important: Report All Adverse Events to VAERS
It is a requirement of the EUA that vaccine providers report adverse events to VAERS, including myocarditis and pericarditis. Without this reporting, DHS, CDC, and FDA cannot know the scope of a potential issue, investigate it, and provide you with accurate information to inform communications. Health care providers should consider myocarditis in an evaluation of chest pain after vaccination and report all cases to VAERS.
In recent weeks, there have been reports of myocarditis occurring after COVID-19 vaccination, including in Europe, where the EMA recently requested data from Pfizer and Moderna on reports of myocarditis and pericarditis after vaccination. CDC is aware of these reports, which are rare given the number of vaccine doses administered, and continues to monitor available data.
Myocarditis is the inflammation of the heart muscle and pericarditis is the inflammation of the lining outside the heart. In both cases, the body's immune system is causing inflammation in response to an infection or some other trigger. While myocarditis can be serious, it is frequently mild and self-limited. Symptoms can include abnormal heart rhythms, shortness of breath, or chest pain.
As part of COVID-19 vaccine safety efforts, CDC has been closely monitoring myocarditis/pericarditis in multiple safety systems, including the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safety Datalink (VSD).
To date, there has not been a safety signal identified in either VAERS or VSD. CDC will continue to evaluate reports of myocarditis/pericarditis occurring after COVID-19 vaccination and will share more information as it becomes available.
CDC continues to recommend COVID-19 vaccination for people 12 years and older.
COVID-19 Vaccine Program Webinar Schedule
We will host our last clinical webinar on Tuesday, May 25 at 9:00 a.m.
There will not be webinars on the following dates:
Starting on June 8 at 11:00 a.m., we will hold a combined stakeholder and vaccinator weekly webinar series on Tuesdays. You will need to register for the webinar below. All of our webinars are recorded and will be posted to the DHS COVID-19 Vaccinator webpage.
Register in advance for this webinar:
https://dhswi.zoom.us/webinar/register/WN_0FqZyszZSS-PkgE-T8xYzA
Providers to Now Manage Public Information on Vaccines.gov (VaccineFinder)
This week, the Wisconsin Department of Health Services (DHS) is transferring the responsibility of updating vaccinator public profile information on Vaccines.gov (previously VaccineFinder) to vaccinators themselves.
Currently, DHS manages the inventory and public profile information on Vaccines.gov on behalf of vaccinators. Going forward, DHS will continue to manage and report inventory data on behalf of vaccinators, but vaccinators themselves will manage the public-facing information (whether site is displayed or not, website, phone number, hours, additional details, etc.). CDC and DHS recommend that all providers offering walk-in hours make sure to indicate this in the appropriate field in your profile.
You will be onboarded to VaccineFinder (COVID Locating Health provider portal). You should have received an email from vaccinefinder@auth.castlighthealth.com on Monday, May 17, to begin the registration process.
For more details on the process, refer to the previous communication sent Wednesday, May 19.
Distribution Updates and Information
Administration of Pfizer COVID-19 vaccine to adolescents and changes to vaccine uptake may create redistribution issues within Wisconsin as we continue to carry out vaccination efforts. CDC has provided information and developed new tools to assist with issues.
Pfizer 1170 – Adolescent Supplies
Currently, the only option available from Pfizer for orders of COVID-19 Vaccine is the 1170 dose minimum order. These kits contain approximately 82% 1” needles, which are the recommended needle size for vaccination of most adolescents. CDC asserts the combinations of 1” and 1.5” needles in the Pfizer 1170 ancillary kit are sufficient to meet the current needs of adolescent vaccination programs, but an additional pediatric kit has been planned.
Pfizer 450 – Coming Soon
A smaller Pfizer 450 dose pack will be released after Memorial Day, and this kit will have options for ordering pediatric or adult ancillary kits. Orders for the 450 dose pack will be placed with intent. Vaccine orders will require jurisdictions to select either an adult or pediatric ancillary kit. The pediatric kit contains 100% 1” needles. Shipping of these smaller orders and ancillary kits will begin the week of June 1. Additional information to come.
Pfizer Inventory and Adolescents
Inventory tracking information currently indicates approximately 35 million doses of Pfizer COVID-19 exists in over 20,000 locations nationwide. This supply is sufficient to vaccinate the estimated 17 million adolescents between 12 and 15 years of age. CDC and DHS encourages vaccinators to follow appropriate redistribution guidelines and utilize existing inventory as much as possible to begin vaccination of adolescents. The PfizerCOVID-19 vaccine supply chain is expected continue to allocate vaccine to sufficiently support all vaccination programs in Wisconsin.
Ancillary Kit Redistribution Tool – Ancillary Redistribution Gadget for Healthcare Workers (ARGH)
Providers that are redistributing COVID-19 vaccine must also send corresponding ancillary kit supplies. To better assist providers with the breakdown and redistribution of ancillary kits, the CDC has created an ancillary kit configuration tool. The tool, which is an excel document, calculates the quantity of each kit item that must be repackaged to support administration of the number of doses being redistributed. The tool supports Pfizer, Moderna, and Janssen ancillary kits.
Memorial Holiday Ordering
Pfizer Deliveries from a Hub (quantities less than 1170 doses)
- No vaccine deliveries will occur on Friday, May 28, or Monday, May 31
- If you need vaccine for clinics scheduled on the holiday weekend, submit your orders prior to Tuesday, May 25 at 12 p.m. for Thursday delivery
- Orders submitted between Tuesday, May 25 at 12 p.m. and Thursday, May 27 at 12 p.m. will delivered on Tuesday, June 1
- Orders submitted after Thursday, May 27 at 12 p.m. may not be processed until Tuesday, June 1 for delivery on Wednesday
Pfizer Direct Shipments (quantities of 1170 doses or more)
- No vaccine deliveries will occur on Monday, May 31
- If you need vaccine for clinics scheduled on the holiday weekend, submit your orders prior to Tuesday, May 25 at 12 p.m.
- Orders submitted between Tuesday, May 25 at 12 p.m. and Thursday, May 27 at 12 p.m. will deliver on Tuesday, June 1
Moderna and Johnson & Johnson Direct Shipments
- No vaccine deliveries will occur on Monday, May 31, or Tuesday, June 1. You may receive ancillary kits on Tuesday, June 1 for vaccine orders arriving Wednesday, June 2.
- If you need vaccine for clinics scheduled on the holiday weekend, submit your orders prior to Wednesday, May 26 at 12 p.m.
- Orders submitted between Wednesday, May 26 at 12 p.m. and Thursday, May 27 at 12 p.m. will deliver on Wednesday, June 2
No orders will be processed between Friday, May 28, and Monday, May 31. Orders submitted after Thursday, May 27 will be processed on Tuesday, June 1 at 12 p.m. for Thursday/Friday delivery that week.
Individuals Vaccinated Outside of the United States
The CDC Interim Clinical Considerations for Use of COVID-19 Vaccines page has been updated to address how to handle individuals vaccinated outside of the US. This link will take you directly to the relevant section on the main Clinical Considerations page:
https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#not-authorized-vaccines
For LTHDs Only-COVID-19 Vaccine Section Updates
The Johnson & Johnson (Janssen), Moderna, and Pfizer COVID-19 sections of the Immunization Program Policy and Procedure Manual have each been updated to include information on co-administration of COVID-19 vaccine with other recommended vaccines and guidance on administering COVID-19 vaccine among persons diagnosed with multisystem inflammatory syndrome in children (MIS-C) or adults (MIS-A). Updated sections have been posted to SharePoint (PCA Portal).
Advancing Health Equity through COVID-19 Vaccination
DHS, in collaboration with other public health and health care partners, has been hosting a series of shared learning forums each Thursday in May for the statewide network of vaccinators working to distribute the vaccine safely, efficiently, and equitably across Wisconsin. The final session will be on Thursday, May 27 from 12:00 – 1:00 PM and the topic will be “Partnering with trusted messengers to increase vaccine confidence.” You can register and view the past forums here.
COVID-19 Vaccination Community Features
One way CDC is contributing to vaccination efforts is by promoting the work happening in communities across the country through COVID-19 Vaccine Community Features. Each week CDC will feature stories that celebrate the people behind the vaccination program and give other communities ideas to improve their programs. Send stories you would like us to feature to ISDcomm@cdc.gov. Include “CVCF Submission” in the subject, a summary of your story, and contact information. We will review the suggestion and send follow up instructions.
Reminder: Lyft and Uber Offering Free Rides to COVID-19 Vaccination Appointments
Through July 4, Lyft and Uber will offer free rides to COVID-19 vaccination appointments to people who do not have access to transportation. The feature will launch in their apps and should be rolled out within the next week.
Updated Clinical Guidance from CDC
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MMWR Early Release: The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine in Adolescents Aged 12-15 Years — United States, May 2021
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MMWR Early Release: Interim Estimates of Vaccine Effectiveness of Pfizer-BioNTech and Moderna COVID-19 Vaccines Among Health Care Personnel — 33 U.S. Sites, January-March 2021
Updated Communication and Education Resources
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