COVID-19 Update for Virginia

May 20, 2022

Dear Colleague:

Below are a few important updates, on the infant formula shortage, COVID-19, monkeypox, and the expected arrival of Ukrainian refugees.

Infant Formula Shortage Information

To help families find infant formula during the shortage, VDH posted information on its VDH blog and the Virginia WIC website.
Additional resources are available through the S. Department of Health & Human Services and the American Academy of Pediatrics.

CDC Recommends Boosters for Children Aged 5 to 11 Years and Strengthens Recommendation for Second Boosters

On May 19, the Centers for Disease Control and Prevention’s (CDC) Director Dr. Rochelle Walensky endorsed the recommendation s of the Advisory Committee on Immunization Practices (ACIP) for children aged 5 to 11 years to receive a booster dose of Pfizer’s COVID-19 vaccine at least 5 months after the completion of a primary Pfizer COVID-19 vaccine series.
Vaccine providers in Virginia may immediately begin administering a single Pfizer booster dose for children aged 5–11 years based on the updated CDC recommendations.
When updated, providers can reference the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States.
Please continue to encourage parents and guardians to enroll their children in v-safe.
In addition, CDC strengthened its recommendation that those 12 years and older who are immunocompromised and those 50 years and older should receive a second booster dose at least 4 months after their first.

Advisory about Treatment of High-Risk Outpatients with Mild to Moderate COVID-19

On April 25, CDC issued a Health Advisory focusing on treatments for patients with mild to moderate COVID-19 who are at high-risk of severe illness.
Antivirals for the treatment of mild to moderate COVID-19 are widely available and can be accessed with a provider prescription at pharmacies statewide using the HHS COVID-19 Therapeutics Locator
EVUSHELD is authorized for the prevention of COVID-19 infection for immunocompromised individuals. Supply of this medication is bountiful and providers are encouraged to assess patients for eligibility. Providers are encouraged to enroll as COVID-19 therapeutic providers and administer EVUSHELD to eligible patients. Alternative locations where EVUSHELD is administered can be found using the HHS COVID-19 Therapeutics Locator
Systemic corticosteroids are not recommended to treat patients with mild to moderate COVID-19 who do not need supplemental oxygen, and antibacterial therapy is not recommended unless there is a specific indication for it.

FDA Limits Use of Johnson & Johnson (J&J)/Janssen COVID-19 Vaccine

Due to the rare risk of thrombosis with thrombocytopenia syndrome (TTS) associated with the J&J vaccine, on May 5, FDA limited the authorized use of this product to adults (≥ 18 years old) for whom other COVID-19 vaccines are not accessible or clinically appropriate and adults who wish to get the J&J vaccine because they would otherwise not be vaccinated.
FDA determined that the known and potential benefits of the J&J vaccine outweigh the known and potential risks in the two groups noted above and align with existing CDC recommendations for use of this vaccine.

Monkeypox Outbreaks in the United Kingdom and Europe

A case of monkeypox has been confirmed in Massachusetts in an adult male with recent travel to Canada.
Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body.
No monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria.
Since early May 2022, the United Kingdom has identified 9 cases of monkeypox; the first case had recently traveled to Nigeria. None of the other cases have reported recent travel.
Information for clinicians is available on the VDH and CDC websites. If you suspect monkeypox in a patient, please report this to your local health departmen t as soon as possible. Healthcare providers evaluating patients for suspected monkeypox should implement standard, contact, and airborne precautions.

Uniting for Ukraine (U4U) Program and Tuberculosis Screening/Testing

As part of the U4U program, up to 100,000 Ukrainians will be allowed to resettle to the United States for a period of two years, provided they identify a U.S.-based supporter and meet certain eligibility requirements, including receipt of a tuberculosis test within 14 days of arrival to the United States.
VDH encourages Ukrainians who arrive in Virginia to work with their sponsor to contact their local health department to receive TB screening/testing. Because Ukraine has a higher incidence of TB and roughly a quarter of their TB cases are multidrug-resistant (MDR) TB, it is important for public health to work proactively to identify and manage any active or latent TB infections in this population.
If U4U participants present to your practice, please contact your local health department (https://www.vdh.virginia.gov/health-department-locator/) to ensure appropriate referral for TB screening/testing.

Many thanks for your continued partnership.

Colin M. Greene, MD, MPH
State Health Commissioner