On May 12, 2021, after a systematic review of available data, CDC’s Advisory Committee on Immunization Practices (ACIP) made an interim recommendation for use of the Pfizer-BioNTech COVID-19 vaccine in adolescents aged 12–15 years for the prevention of COVID-19. CDC approved the ACIP's recommendation that the Pfizer-BioNTech COVID-19 vaccine is safe for use in 12- to 15-year-olds. All providers in Virginia can begin administering the Pfizer-BioNTech vaccine in this age group, and several providers and schools have already begun to do so successfully.

• • Visit the “Vaccinating Adolescents” folder in the VDH Micro Courses to find quick tips and training for vaccinating adolescents.
  • If you were unable to attend these webinars, watch the recordings of the May 14 Clinician Outreach and Communication Activity (COCA) call What Clinicians Need to Know About Pfizer-BioNTech COVID-19 Vaccination of Adolescents and the May 18 VDH Pediatric COVID-19 Vaccination Expert Panel in the Provider Education section of our webpage.
  • CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States have been updated to reflect this addition. Other key clinical updates involve the coadministration of COVID-19 vaccine with other vaccines and considerations for people with a history of multisystem inflammatory syndrome in children (MIS-C) or adults (MIS-A).
  • Additional useful resources for providers include the following:
    • The CDC Pediatric Healthcare Professionals COVID-19 Vaccination Toolkit provides materials to help healthcare providers give parents clear and accurate information about COVID-19 vaccines. The toolkit includes answers to common questions, an explanation of how mRNA vaccines work, and printable materials to give to parents.
    • FAQs have been posted on the Pfizer-BioNTech product page for providers with information about consent, pre-screening questions, and other issues related to the vaccination of minors.
    • Healthcare providers can customize and send this sample letter to encourage their patients to get a COVID-19 vaccine. It includes the new recommendation that everyone aged 12 years and older get a COVID-19 vaccine.
    • The Vaccine Recipient Education page has been updated to include resources about COVID-19 vaccination for adolescents.
    • Refer to the helpful resources section at the end of this newsletter for a collection of resources and information tailored to adolescents and their parents.

Make every effort to vaccinate each eligible person.

• It is acceptable to open a multi-use vial without a guarantee of using all doses if it means vaccinating one or more eligible individuals.
• Follow clinical best practices for vaccination as well as best practices when managing inventory to maximize vaccination and minimize dose wastage.
• It is no longer imperative to use every dose the week it is received; rather it is acceptable to have multiple weeks of inventory on hand as long as all manufacturer specifications for storage and handling are followed.
• For those holding open clinics, please be flexible in accommodating second-dose needs. Try to schedule each person’s second-dose appointment when they receive their first dose. If that is not possible, make sure they understand that they can receive their second dose anywhere that offers that vaccine. If they cannot find a second-dose appointment at either vaccinate.virginia.gov or by calling 877-VAX-IN-VA (877-829-4682),they can email 2ndvaxdose@vdh.virginia.gov and VDH will find an appointment for them.

VDH is working on solutions at the state level to provide smaller, more manageable allotments of vaccine.

• The goal is to grant providers access to a constant supply of small-quantity COVID-19 vaccine shipments (minimum 1 vial) by breaking shipments down through a central distribution center and a network of regional hubs to share the doses with individual providers across the State.
• A survey was distributed last week to help with the planning around redistribution.  Of the 254 responses, 226 providers are wanting to participate and about 26% are willing to serve as a regional hub.  VDH will be working closely with those who have expressed interest to finalize this redistribution model with one of the providers who will be hubs.

If you have not already, please complete this 3-minute survey by Wednesday, May 26 to opt in to receive smaller shipments of vaccine.

As a reminder, please enter all order requests into VaxMaX by Mondays at 7pm ET. VaxMaX can also be used for in-depth reporting, redistributions, and wastage capture. To access reporting features, providers should see the ‘Provider Reports’ tab in their VaxMaX account. Reports include some of the following views:

1. Supply and demand over time and by provider site
2. Compliance comparing the calculated inventory (shipments +/- redistributions minus administrations) and VaccineFinder inventory inputs
3. Requests/allocations/orders by provider site
4. Demographics of who providers have vaccinated

For any questions about VaxMaX and its functionality, please visit the VaxMaX help website as a resource for reference guides and tutorial videos.

Now that the COVID-19 vaccine is available to patients aged 12 years and older, it’s incredibly important to properly anticipate and address vasovagal syncope (i.e., fainting) after vaccination.

• VDH receives at least one report per day about fainting after a COVID-19 vaccination.
• Reports from the Vaccine Adverse Event Reporting System (VAERS) show that fainting after vaccinations is common in adolescents. 

All healthcare professionals who administer vaccines should be aware of the potential for post-vaccination syncope and the related risk of injury caused by falls. Appropriate measures should be taken to prevent injuries from fainting, including:

1. Preparing clinic staff:
   • Be aware of symptoms that are associated with fainting (e.g., pallor, sweating, weakness, dizziness, nervousness, vomiting).
   • Consider keeping a few cots on site for those who become pre-syncopal or who have a history of fainting.
2. Before vaccination:
   • Ask patients if they have fainted before while getting a vaccine or giving blood.
   • Give patients a beverage and a snack.
   • Reassure patients about vaccination.
   • Have patients seated or lying down for vaccination.

3.  After vaccination:
   • Ensure patients are sitting or lying down.

4.  If patients exhibit any of the above symptoms after vaccination:
   • Ask them to sit and put their head between their knees.
   • Consider escorting them to a cot to lie down.
   • Instruct them to remain seated or lying down until they feel better, even if it’s longer than their 15-30 minute post-vaccination observation period

5.  If a patient becomes faint after vaccination:
   • Rapidly assist the person to a supine or seated position and help protect them
   • From injury and falls.
   • Medical personnel should observe the patient until they are fully alert so that further treatment needs can be determined.
   • VDH does not recommend using ammonia capsules or smelling salts to revive patients, nor providing them with juice as soon as they wake up as these practices can cause adverse events.

To learn more about addressing post-vaccination syncope and other best practices, check out our complete list of COVID-19 Vaccination Clinic Best Practices here, last updated on May 14!

Upcoming Events

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• Mondays, Wednesdays, and Fridays, 4 - 5 pm: VDH | Office Hours for Providers (including VaXMaX assistance)
• May 19, 2 - 3 pm: New Mexico Immunization Coalition (NMIC), NMDOH and Comagine Health | Coexisting with COVID--Strategies for Catching up on Routine Vaccines
• May 19, 3 pm: J&J | Janssen COVID-19 Vaccine: Information for Healthcare Providers Administering Vaccine
  • Additional sessions with same content:
    • May 20, 7 pm
    • May 21, 3 pm
• May 20, 2 - 4:30 pm: National Adult and Influenza Immunization Summit (NAIIS) | Maintaining Influenza Prevention During the Ongoing COVID-19 Pandemic
• May 24, 3 pm: CDC | Partner Update Call: Pregnant During a Pandemic - What the Data Says About COVID-19 and the Vaccine
• May 25, 2 pm: Diverse Elders Coalition | Getting the Vaccine to the Communities Who Need it Most
• National Academies of Sciences, Engineering, and Medicine | Virtual Public Workshop - Back in School: Addressing the Wellbeing of Students in the Wake of COVID-19
  • May 20, 12 - 2:00 PM: Student and Parent Perspective
  • May 25, 12 - 2:00 PM: School and Educator Perspective
  • May 27, 12 - 2:00 PM: Policy Perspective

 

To receive the latest news about the Virginia Immunization Information System (VIIS) and COVID-19 provider enrollment, access the latest VIIS newsletter here. Share the following information for parents and adolescents with your patients and communities:

1. COVID-19 Vaccines for Children and Teens provides information about the benefits of COVID-19 vaccines for adolescents aged 12 years and older, how to find a vaccine provider for adolescents, and what to expect during and after vaccination.
2. COVID-19 Vaccines for Preteens and Teens is a printable fact sheet for parents that explains the benefits of a COVID-19 vaccine for their children, safety information, and what to expect during and after vaccination.
3. Menstrual cycles cannot be affected by being near someone who received a COVID-19 vaccine. This question and answer explains why.
4. It is safe for people who would like to have a baby one day to get a COVID-19 vaccine. This question and answer explains why. 
5. Two new FAQs have been posted to address questions about the safety and benefits of COVID-19 vaccination for adolescents aged 12 years and older.
6. The web pages Key Things to Know about COVID-19 Vaccines and About COVID-19 Vaccines have been updated to include the recommendation that adolescents aged 12 years and older get vaccinated.
7. The web page COVID-19 Vaccine Information for Specific Groups has been updated to help the public find information about vaccination for adolescents.