Since April 2021, cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination (Pfizer-BioNTech and Moderna).
- CDC is actively monitoring these reports, which are rare given the number of vaccine doses administered, and is investigating if there is a connection with mRNA vaccination.
- CDC published Clinical Considerations for myocarditis and pericarditis following COVID-19 vaccination.
- Additionally, resources for the public have been added to CDC’s website that can be a resource for your patients.
With temperatures rising during the summer, it is critical to make sure you are following all guidance for maintaining COVID-19 vaccines at the proper temperatures at all times (this includes storage, transport, and pre-drawn syringes or bottles prior to vaccine administration). If you are hosting a mobile, pop-up, or outdoor vaccine clinic, plan accordingly so vaccines never reach a temperature over 77 degrees Fahrenheit. VDH encourages drawing up vaccine doses as needed versus pre-drawing multiple doses. Visit the following resources for additional guidance:
- CDC’s Quick Reference Guide Vaccine to Storage and Handling of COVID-19 Vaccine
- VDH’s COVID-19 Vaccine Storage and Handling One-Pager
Currently, it is not possible for states or providers to transfer or donate vaccines across international borders because that doesn’t comply with the Public Readiness and Emergency Preparedness (PREP) Act.
In Virginia, Executive Order 79 took effect on May 28. Capacity limits, distancing, and other business requirements are fully lifted with this order, but VDH continues to encourage businesses and other establishments to follow VDH/CDC recommendations and best practices. New guidance is available in VDH General Recommendations for Businesses. Visit the VDH mask page for complete information on when masks are required or recommended.
- CDC’s Interim Public Health Recommendations for Fully Vaccinated People do not apply to healthcare settings. This means that staff, patients, residents and visitors should continue to wear masks as recommended in all healthcare facilities.
- Healthcare facilities should continue to refer to the Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for recommendations regarding source control and physical distancing in healthcare settings.
VDH has launched the Small Shipment Redistribution Program (SSRP) - a voluntary network of geographically dispersed providers who coordinate with a central distribution center (hub) to order smaller quantities of the vaccine than is available through direct federal shipments.
- To participate in the program, please place order requests by 7pm ET on Mondays using the RedCap Survey link here.
- Note: This is not meant to replace the normal ordering procedures; if a provider is able to handle standard shipping quantities, providers should do so.
As a reminder, VaxMaX should be used for all other provider vaccine requests, redistributions, and inventory tracking and reporting.
Virginia COVID-19 Vaccination Updates
VaccineFinder now redirects to a new website, vaccines.gov, which is available in English and Spanish, and has high accessibility standards.
- The website provides information about nearby locations offering vaccines.
- In addition to the website, people in the U.S. are also now able to utilize a text messaging service, available in both English and Spanish where they text their ZIP code to 438829 (GETVAX) or 822862 (VACUNA) to find three locations nearby that have vaccines available.
- Please share this resource with your patients and community.
VDH has launched a Vaccinate with Confidence webpage for providers with resources for inspiring vaccine confidence and webinar recordings focused on the topic. Please visit the site and share with your networks and colleagues.
- According to the manufacturer, clinical trial data showed that its vaccine was at least as effective in adolescents aged 12 to 15 years as it was in adults.
- FDA is reviewing these data and could add an amendment covering that age group to the vaccine’s existing emergency use authorization (EUA) by next week.
- If you anticipate providing COVID-19 vaccines to children under 16 years of age, VDH encourages you to attend our May 18 expert panel focused on pediatric COVID-19 vaccination.
As a reminder, the following updates were made to the Moderna COVID-19 vaccine EUA on April 1 regarding its storage and handling.
- Frozen Vaccine: Moderna vials can now be stored frozen between -50o to -15oC (-58o to 5oF). This is an increased range from the original temperatures. This new, wider temperature range is consistent with temperature requirements for other recommended vaccines stored in the freezer.
- Refrigerated Vaccine/Unpunctured Vials: Vials may be stored between 8° to 25°C (46° to 77°F) for a total of 24 hours. This is an increase from 12 hours.
- Punctured Vials: After the first dose has been withdrawn, the vial should be held between 2° to 25°C (36° to 77°F) for up to 12 hours. Vials should be discarded 12 hours after the first puncture. This is an increase from 6 hours.
Best Practice Spotlight
To minimize the number of unused expired doses and manage expired doses correctly, follow these best practices:
Minimizing number of unused expired doses:
- Monitor expiration dates weekly, rotate stock as needed, and follow a “first in, first out” strategy to manage inventory.
- If nearing expiration, check posted manufacturer information, use the CDC’s Vaccine Lot Number and Expiration Date webpage, or request access to a new COVID-19 Vaccine Lot Number report via CDC’s Vaccine Code Set Management Service (VCSMS). This report is updated daily and includes COVID-19 vaccine lot numbers and expiration dates provided to CDC by the vaccine manufacturers.
- Based on the latest expiration information, remove expired vaccine from the storage unit immediately. Do not administer expired vaccine.
- If expired vaccine is inadvertently administered, it is considered a vaccine administration error and requires remediation, including submitting a VAERS report, contacting the recipient to inform them of the error, and it may or may not require revaccination based on the manufacturers’ guidance. Guidance on vaccine administration errors can be found in Appendix A of CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States.
- Dispose of expired vaccine vials (with any remaining vaccine) and packaging as medical waste according to your local and state regulations. Do not return vaccine in the thermal shipping container.
- Promptly report any expired vaccine using the COVID-19 Wastage Report Form. There are no negative consequences for reporting waste, and it will not negatively impact future allocations.
- VDH | Commonwealth of Virginia COVID-19 Accountability Transport, Redistribution, Transfer & Waste
- VDH | Guidance on Additional, Extra, Expiring COVID-19 Vaccine for Providers Participating in the Commonwealth of Virginia COVID-19 Vaccination Program
- CDC | Vaccine Storage and Handling Toolkit including COVID-19 vaccine addendum
- CDC | Identification, Disposal, and Reporting of COVID-19 Vaccine Wastage
- CDC | COVID-19 vaccine product web pages and storage and handling summaries
Check out our complete list of updated COVID-19 Vaccination Clinic Best Practices and our Lightning Learnings: Best Practices for Busy Providers!
- Mondays, Wednesdays, and Fridays, 4 - 5 pm: VDH Office Hours for Providers (including VaxMaX assistance)
- June 2, 7 pm: “Making it Plain Town Hall: Barbershop and Salon Talk”
- June 3, 4 pm: “Juntos Sí Podemos Webinar Series for Promotores/Community Health Workers: CBOs outreaching to Mexican Immigrant Communities”
- June 9, 3 - 4 pm: COVID-19 Vaccine Update – Pregnant Women, Children & Variants
- Visit VDH’s Lightning Learning: Best Practices for Busy Providers for quick bites of learning on COVID-19 vaccination topics, including post-vaccination observation, avoiding needlesticks, handling vaccine safely, vasovagal syncope, administration of intramuscular vaccines, vaccinating adolescents, proper use of PPE, and more.
- CDC Training for Healthcare Professionals - Added new trainings, including What Clinicians Need to Know About Pfizer-BioNTech COVID-19 Vaccination of Adolescents, Janssen COVID-19 Vaccine and Thrombosis with Thrombocytopenia Syndrome, and Underlying Medical Conditions and Severe COVID-19: Evidence-based Information for Healthcare Providers.
Information about the COVID-19 vaccination program is changing frequently. This newsletter will offer regular updates to providers who have submitted an intent to vaccinate or signed the CDC provider agreement within Virginia.