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Health Professionals

The Virginia Department of Health’s up-to-date resources relevant for health professionals and their response to COVID-19 in Virginia. This page includes clinician’s letters, information on infection prevention, testing, and other COVID-19 topics.

Thank you for your continued work to protect the health and well-being of all Virginians.

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FDA places new limits on use of the Johnson & Johnson (Janssen) COVID-19 vaccine

May 5, 2022 - After considering additional information on adverse effects of the Johnson & Johnson (Janssen) COVID-19 vaccine, particularly thrombosis with thrombocytopenia syndrome (TTS), the U.S. Food and Drug Administration (FDA) has placed new limits on its use. The vaccine is now authorized for use only in adults aged 18 years and older “for whom other authorized or approved are not accessible or clinically appropriate” or “who elect to receive that vaccine because they would otherwise not receive [any] COVID-19 vaccine.”  Examples of such individuals include people who had an anaphylactic reaction after having had an mRNA COVID-19 vaccine; people with personal concerns about receiving an mRNA vaccine who would otherwise not get a COVID-19 vaccination; and people who would otherwise remain unvaccinated because of limited access to mRNA COVID-19 vaccines. An updated FDA fact sheet provides details of the new limitations.  

Updated guidance on eligibility and timing for second COVID-19 vaccine booster doses

April 25, 2022 - CDC has issued a set of Clinical Considerations to help clinicians discuss with patients their eligibility for and timing of their second booster doses of COVID-19 vaccines. Within the group of people now considered eligible for second booster doses, these guidelines discuss considerations for who might consider getting a second booster dose now and who might consider waiting to get their second booster dose. A one page fact sheet also outlines the guidelines for second booster doses.

Availability and use of outpatient treatments of mild to moderate COVID-19 in high risk patients

April 25, 2022 - The CDC Health Alert Network recently issued an advisory on both recommended and potentially harmful treatments for initially mild to moderate COVID-19 in outpatients who are considered to be at high risk for severe outcomes. Recommendations to clinicians, health departments and the public include (with links): (1) prescribing updated therapeutics when indicated based on NIH’s COVID-19 Treatment Guidelines; (2) staying updated on points of access to specific antiviral and other treatments through local pharmacies and other “test-to-treat locations; (3) avoiding use of dexamethasone and antibacterial treatments without specific indications; (4) also preventing severe outcomes by encouraging patients to remain up to date with COVID-19 vaccination.

Differentiating symptoms of COVID-19 from seasonal allergies

April 18, 2022 – With the start of seasonal allergy season and with COVID-19 continuing to spread, there is value in considering the clinical similarities and differences between the symptoms seen with these two conditions. A table summarizing their similarities and differences highlights the overlap of many of these symptoms but indicates that some symptoms can be used to help differentiate the two. For example, fever, chills, shortness of breath, or muscle aches are more likely to occur with COVID-19 than with most seasonal allergies. Conversely, sneezing and itchy and watery eyes are more likely to be seen among patients with seasonal allergies. Nevertheless, anyone whose symptoms might indicate COVID-19 should be given a SARS-CoV-2 viral test.

Sotrovimab should no longer be used to treat COVID-19 in Virginia due to increasing proportions of cases caused by the Omicron BA.2 sub-variant

April 5, 2022 – Use of the monoclonal antibody sotrovimab to treat COVID-19 patients in Virginia has been restricted by the U.S. Food and Drug Administration (FDA) due to a rapidly rising proportion of new COVID-19 cases in HHS Region III (that includes Virginia) being caused by the Omicron BA.2 sub-variant. As of the week ending on April 2, 2022, 67.7% of COVID-19 cases in HHS Region III were caused by the BA.2 variant, against which sotrovimab is far less likely to be effective. Sotrovimab is not authorized in any U.S. state or territory at this time.

Sotrovimab use had previously been authorized by FDA for the treatment of mild-to-moderate test-positive COVID-19 in adults and pediatric patients aged 12 years or older weighing at least 40 kg who were at high risk of developing severe COVID-19. Paxlovid, molnupiravir, remdesivir, and bebtelovimab remain as possible treatment options for such patients.

Selected recent COVID-19-related articles from CDC’s Morbidity and Mortality Weekly Report (MMWR)

The MMWR articles summarized and linked in this section are those that most directly address the needs of Virginia’s healthcare providers.

Effectiveness of additional or booster doses of COVID-19 vaccine in preventing COVID-19 in nursing home residents

May 6, 2022 - In February and March 2022, when Omicron variants accounted for >99% of isolates, data from >15,000 U.S. nursing homes indicated that, compared to a standard primary COVID-19 vaccine series, additional doses (for immunocompromised people) or booster doses of COVID-19 vaccine had a vaccine effectiveness of 46.9% in preventing SARS-CoV-2 infection. Along with other COVID-19 prevention strategies (e.g., COVID-19 testing and vaccination of staff members and visitors), nursing home residents should be kept up to date with COVID-19 vaccination.

Seroprevalence of Infection-Induced SARS-CoV-2 Antibodies

April 26, 2022 (Early Release)-. During December 2021-February 2022, seroprevalence (proportion of the population with SARS-CoV-2 antibodies) increased from one in three to three in five - almost 60% of the U.S. population. These findings show a high infection rate for the Omicron variant, especially among children and adolescents with approximately 75% serologic evidence of previous infection with SARS-CoV-2. People aged 65 years and older had the lowest seroprevalence. Staying up to date with vaccination is still recommended for all eligible people, including those with previous SARS-CoV-2 infection.

Hospitalizations of Children Aged 5–11 Years with Laboratory-Confirmed COVID-19

April 22, 2022- During the period of Omicron predominance, COVID-19–associated hospitalization rates in children aged 5–11 years were twice as high for unvaccinated compared to vaccinated children. The largest group of unvaccinated were among Non-Hispanic Black children, while children with diabetes and obesity were more likely to experience severe COVID-19. Of hospitalized children, 30% had no underlying medical condition and 19% were admitted to an intensive care unit.

Effectiveness of COVID-19 vaccination in preventing COVID-19-related hospitalizations among people with prior SARS-CoV-2 infections

April 12, 2022  - Among persons who previously had COVID-19, mRNA vaccination protected against subsequent COVID-19-related hospitalizations with the Omicron variant. Vaccine Effectiveness was 35% after two doses and 68% after a single booster dose. All eligible people, including those with prior SARS-CoV-2 infection, should stay up to date with COVID-19 vaccination.

Cardiac complications after COVID-19 and after mRNA COVID-19 vaccination

April 8, 2022 - Using data from a 40 healthcare system surveillance network providing care for more than15 million patients aged 5 years or older, the relative risks (RR) for myocarditis, pericarditis or other significant cardiac outcome “was significantly higher after SARS-CoV-2 infection than after mRNA COVID-19 vaccination for both males and females in all age groups.” Even among 12–-17 year old males, the group in which vaccine-related myocarditis is most common after the first, second or unspecified vaccine dose, the RR ranged from 1.8 - 5.5. These findings support continued mRNA COVID-19 vaccine use.

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Page Last Updated: May 9, 2022

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