This email is being sent to local health officers, tribal health directors, COVID-19 vaccinators, COVID-19 vaccine stakeholders, HERC coordinators, and key DHS staff.
Thanksgiving Holiday Vaccine Ordering and Delivery Cadence
No COVID-19 vaccine will be delivered from November 24 to 28. Deliveries will resume on Monday, November 29. Please plan to order early prior to the holiday week.
Pfizer
- Vaccine will not be delivered Wednesday, November 24, through Sunday, November 28.
- If you need vaccine for clinics scheduled during the holiday weekend:
- Submit your orders early, during the week of November 18
- Orders placed between 8:00 a.m. on Friday, November 19, and 8:00 a.m. on Wednesday, November 24, will be delivered the week of November 29.
Moderna
- Vaccine will not be delivered Wednesday, November 24, through Sunday, November 28.
- If you need vaccine for clinics scheduled on the holiday weekend:
- Submit your orders early, during the week of November 18
- Orders placed between 8:00 a.m. on Friday, November 19, and 8:00 a.m. on Wednesday, November 24 will be delivered the week of November 29.
Pfizer Pediatric COVID-19 Vaccine: Clinical Materials for Children Ages 5-11 Years
The U.S. Food and Drug Administration (FDA) has authorized a COVID-19 vaccine for children ages 5-11 years of age, and the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) has new recommendations on vaccinating this population. Below is a list of new clinical materials related to these recommendations:
For more clinical information and materials, visit https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/index.html. Additional information for vaccinators is now available on the DHS Guidance for Vaccinating Children Ages 5-11 webpage.
Pfizer Pediatric Expiration and Manufacturing Dates
Pfizer pediatric COVID-19 vaccine for children ages 5-11 years (orange cap) does not have an expiration printed on the vial. Instead, each vial has the lot number and date of manufacture printed on the label. The date on the label is not the expiration date.
The shipper box should be unpacked immediately upon receipt, as indicated on the carton. The contents must be placed in an ultra-cold freezer -90⁰C to -60⁰C or a refrigerator at 2°C to 8°C. Do not place the product in a regular freezer. Note: an orange sticker has been added to the shipper boxes to reinforce this message.
The QR code provided on the Pfizer pediatric vaccine carton provides a link to the EUA but does not provide information on expiration dates.
CDC will have clinical materials to assist with tracking expiration and beyond-use dates posted soon.
Pfizer Pediatric Ancillary Kits
ACIP recommends a 22–25 gauge 1-inch needle when administering a vaccine by intramuscular injection to children one year of age and older. Vaccine administration guidelines are outlined in the ACIP Vaccine Administration Guidelines for Immunization webpage and a chart summarizing needle length recommendations can be found in the Vaccine Administration: Needle Gauge and Length page. A copy of this chart is also included in each ancillary supply kit.
It is critical for all intramuscular (IM) injections that the needle be long enough to reach the muscle mass and prevent vaccine from seeping into subcutaneous tissue. The most common technique when administering an IM injection is grabbing the muscle and bunching subcutaneous and muscle tissue to minimize the chance of striking bone, requiring a 1-inch needle or larger to ensure IM administration. Studies have shown that use of longer needles is associated with less redness or swelling than occurs with shorter needles because of injection into deeper muscle mass, preventing irritation of the subcutaneous tissue.
Pfizer Pediatric Diluent Extraction
The FDA EUA requires the addition of 1.3mL diluent to every vial of Pfizer pediatric COVID-19 vaccine for children ages 5-11 years. Pfizer recommends the use of a syringe with appropriate graduations to dilute with the directed 1.3 mL of saline. The impact to the final dose with a 1.2 or 1.4 mL dilution volume would be within 4% of the target dose. Using a syringe with 0.2 mL graduations and estimating the 1.3 mL volume will not significantly impact the intended dose.
Alternately, vaccinators may use syringes in their inventory they are more comfortable using to dilute the vaccine and replace syringes from their private supply with those from the ancillary supplies kit.
Moderna-10
Moderna-14 has been replaced by Moderna-10. Therefore, providers will no longer be able to order Moderna in quantities of 140 doses. Orders include two ancillary kits to support administration of booster doses. Going forward, orders of Moderna-10 placed in the Wisconsin Immunization Registry (WIR) need to be a minimum of 100 doses and in quantities of 100 doses.
Moderna Syringe and Extraction Guidance
ACIP and CDC do not yet have any official guidance regarding use of syringes with 0.2 mL intervals to draw up doses of Moderna booster vaccine formulation, which is authorized for administration in a 0.25 mL dose. When using syringes that have tick marks at 0.2 mL intervals, vaccinators should use their best judgment to draw up half-way between 0.24 and 0.26. Alternately, vaccinators may use syringes in their inventory they are more comfortable using to administer the vaccine and replace syringes from their private supply with those from the ancillary supplies kit.
Increased Incidence of Multi-System Inflammatory Syndrome in Children
DHS has issued DPH Numbered Memo BCD 2021-09 on the increased incidence of Multi-System Inflammatory Syndrome in Children. This memo includes information for Wisconsin clinicians, hospitals, clinics, and local and tribal health departments. Please distribute this memo widely.
All of our memos can be found on the DPH Communicable Diseases Memos webpage.
Children and COVID-19: Strategies and Partnerships for Vaccination
With the recent FDA authorization and the ACIP recommendation that children ages 5-11 years be vaccinated against COVID-19, states are rapidly preparing for the rollout of the vaccine for younger children. The National Academy for State Health Policy (NASHP) recently published a blog highlighting strategies states can use to support this vaccine rollout. Please access the blog at the following link: COVID-19 Vaccines and Children: State Strategies to Increase Access and Uptake through Pediatric Providers.
Additionally, NASHP and the Duke-Margolis Center for Health Policy are hosting a webinar, Children and COVID-19: Strategies and Partnerships for Vaccination, on Wednesday, November 17, from 3:30-4:30 p.m. CST. Please join for a discussion on how state officials, pediatric providers, schools, community clinics, and other partners are working together to build vaccine confidence, engage parents and communities, and ensure that vaccines are available to children ages 5-11 years in places that are safe, convenient, and trusted.
This webinar will feature a discussion with White House officials, as well as a panel of state leaders, pediatric providers, school officials, and leaders from community health centers to discuss how they have approached planning and partnerships, and how they are addressing logistical challenges to vaccinating children.
Speakers and panelists include:
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Cameron Webb, MD, JD, Senior Policy Advisor for COVID-19 Equity, White House COVID-19 Response Team
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Brandy Emily, DNP, RN, Health Equity Branch Chief, Colorado Department of Public Health and Environment
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Deborah Greenhouse, MD, FAAP, Pediatrician, Columbia, South Carolina
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Alycia Meriweather, Deputy Superintendent, Detroit Public Schools Community District
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Christian Ramers, MD, MPH, Assistant Medical Director for Research & Special Populations, Family Health Centers of San Diego
For an agenda and registration, please click here.
New and Updated Resources
Updated Clinical Guidance from CDC
Updated Communication and Education Resources from DHS
In Case You Missed It
Wisconsin COVID-19 Vaccination Program Webinar Schedule
Weekly COVID-19 Vaccination Program Webinar is held on Tuesdays from 11 a.m.-12 p.m.
Register for the meeting series here. Watch recordings of past webinars here.
Please note:
- As of November, there is a new meeting series link and you will need to re-register.
- Thanksgiving week, November 23, DHS will not be holding a COVID-19 Vaccination Program Webinar. The weekly webinar will return as usual on Tuesday, November 30.
Pfizer for Children Ages 5-11 Years Now Available on Vaccines.gov
Vaccines.gov now includes a public search field for the Pfizer-BioNTech vaccine for children ages 5-11 years old. Please review your public display information in the portal, including drop-in availability and notes, to ensure that it aligns with your pediatric vaccination plans.
Updating Vaccines.gov Public Profile
Newly registered vaccinators will receive an email from VaccineFinder@auth.castlighthealth.com inviting them to create a COVID Locating Health Account automatically.
Existing vaccinators that never set up an account, or are unable to access their account, can request a registration email by contacting CDC directly at 833-748-1979 or emailing at cars_helpdesk@cdc.gov.
DHS encourages all vaccinators to consider the following when updating their public profile information on Vaccines.gov:
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If you are offering walk-in hours, make sure you indicate that in the appropriate field in your profile. This is a field offered by Vaccines.gov.
- In the “Notes” section:
- Include information about what accommodations are available for individuals with disabilities and how they can contact your organization in advance.
- Include information about parking, entrances, and other access details.
- Include information in Spanish and/or other languages spoken by individuals in your community when possible.
Support:
The CDC and VaccineFinder offer a number of resources for providers. Starting with VaccineFinder Checklist for Providers found on the COVID-19 Vaccine Provider Information webpage is recommended.
DHS will also continue to provide Vaccines.gov support to vaccinators.
For support with inventory or address issues, please email dhscovidvaccinator@wi.gov with the subject VACCINES.GOV, and a DHS representative will respond within 1-3 business days.
For all other support, please use the Contact Us link on Vaccines.gov.
Pfizer COVID-19 Vaccine Medical Updates and Immunization Site Training Sessions
Pfizer Vaccines US Medical Affairs, with its partner BioNTech, continues to host daily Medical Updates and Immunization Site Training Sessions for all providers on the storage, handling, and administration for currently available vaccine presentations of its COVID-19 vaccine. The current focus is on the emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine for children ages 5-11 years. These sessions will be updated to reflect new information and changes as they evolve. Such updates will be identified at the start of each session and further explained during each presentation.
Please click on the links below to join the sessions at the designated times.
Date & Time Password
Moderna Booster EUA Discussion
Join Moderna and Dr. Jerome Adams, Dr. Lauren B Angelo, and Dr. Jaime E. Fergie for a roundtable to discuss the EUA for the Moderna COVID-19 Vaccine Booster Dose, the data that informed this authorization and recommendation, and the impact on clinical practice. Please register at the link below to attend.
November 18, at 2:00 p.m. CST – Register here
COVID-19 Vaccine Webinar for Rural Communities
The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) is hosting a COVID-19 Vaccine Webinar for Rural Communities on Monday, November 15, 2021, from 12:00-1:30 p.m. CST. The webinar, designed for community partners and vaccinators in rural areas, offers attendees the opportunity to learn more about federal COVID-19 vaccine resources, health care workforce mandates, health care coverage related to the COVID-19 vaccine, and more. Register today.
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