COVID-19 Vaccine Providers Newsletter 07.14.2021

  • Commissioner's Standing Order: On July 12, 2021, the State Health Commissioner issued a standing order that authorizes registered nurses (RNs) and licensed practical nurses (LPNs), licensed in Virginia, to administer COVID-19 vaccines authorized by the U.S. Food and Drug Administration (FDA) at community clinics.  This standing order intends to support the pool of vaccinators at community vaccination clinics, which are sponsored by hospitals and other providers who have signed Virginia’s approved Centers for Disease Control and Prevention (CDC) provider agreement. Written emergency medical protocols, which include standing orders for dispensing medications (e.g., epinephrine, diphenhydramine), are still required to be in place. For more information, please see the Standing Order. Pharmacists, pharmacy interns and pharmacy technicians can find more information in the Summary of Legal Authorities for Pharmacists to Administer COVID-19 Vaccine.
  • Are you interested in speaking to your patients and the community to encourage vaccination and address vaccine hesitancy? The Virginia Department of Health (VDH) offers providers a FREE Tele-Health platform, presentation templates and hands-on technical support to communicate with patients and communities. Click here to learn more and take full advantage of these resources.
  • On July 12, 2021), the FDA updated the Johnson & Johnson / Janssen (J&J/Janssen)  COVID-19 vaccine emergency use authorization (EUA) fact sheets to include a warning about the possible occurrence of Guillain-Barré syndrome (GBS) following vaccination. View the updated J&J/Janssen EUA Fact Sheet for Providers and the J&J/Janssen EUA Fact Sheet for Caregivers and Recipients. View the FDA statement here.
    • In a statement from CDC, the agency said that GBS cases are rare, with about 100 preliminary reports  detected in the Vaccine Adverse Event Reporting System (VAERS), out of 12.8 million doses of J&J/Janssen vaccine administered. These cases have been reported about two weeks after vaccination, and predominantly in males, many aged 50 and older . Most people fully recover from GBS.
    • CDC will continue to monitor for and evaluate reports of GBS occurring after COVID-19 vaccination and will share more information as it becomes available. This issue will likely be discussed at the next Advisory Committee on Immunization Practices (ACIP) meeting on July 22, 2021.
    • FAQs on GBS from the Public Health Communications Collaborative can be found here.
  • WHO's Science in 5 (5-minute video, 7/1): Delta variant and vaccines. All of the vaccines authorized for emergency use by the World Health Organization (WHO) protect against severe COVID-19, hospitalizations, and deaths caused by the Delta variant. Both doses of vaccine (if applicable) are needed to achieve protection against the Delta variant and other variants.
  • On June 23, 2021, the ACIP concluded that the benefits of COVID-19 vaccination to individuals, and at the population level, clearly outweighed the risks of possible myocarditis after vaccination. Continued use of mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna) in all recommended age groups will help prevent severe illness, hospitalization, and death  from COVID-19. Information regarding the risk for myocarditis with mRNA COVID-19 vaccines should be disseminated to providers to share with vaccine recipients.
  • FDA has revoked the EUA for non-NIOSH-approved respirators (such as N95s). The revocation is effective as of July 6, 2021. This action is in coordination with the CDC's recommendation that providers return to conventional personal protective equipment (PPE) strategies. Additionally, the revocation is consistent with the new OSHA Emergency Temporary Standard (ETS), which requires employers to provide NIOSH-approved respirators to employees who may have exposure to COVID-19. As of July 6,  the EUAs issued for Imported, Non-NIOSH-Approved Disposable Filtering Facepiece Respirators and Non-NIOSH-Approved Disposable Filtering Facepiece Respirators Manufactured in China are no longer in effect.  The full list of NIOSH certified equipment is available here.
  • HHS Joint CDC and FDA Statement on Vaccine Boosters (7/8): The FDA and CDC issued a joint statement saying fully vaccinated Americans do not need a booster dose at this time. The agencies “are engaged in a science-based, rigorous process to consider whether or when a booster might be necessary. The process takes into account data from drug companies, but does not rely solely on those data. Any decision on booster doses would happen only if and when the science demonstrates that they are needed. WHO also expressed that more data are needed before a recommendation for booster doses could be made.
  • As authorization of COVID-19 vaccine products expands to include adolescents and children, it is critical to enroll providers in the COVID-19 Vaccination Program to ensure equitable access to COVID-19 vaccination services. Providers enrolled in the Vaccines for Children (VFC) program are well situated to serve in this capacity because of their direct access to the younger patient population and their familiarity with vaccine administration and federal vaccine programs. Though the VFC and COVID-19 Vaccination programs are both federal government programs, they each have distinct requirements based on the associated funding legislation. For this reason, provider agreements remain separate, and VFC providers must sign and adhere to the CDC COVID-19 Vaccination Program Provider Agreement to receive and administer COVID-19 vaccines. See Vaccines for Children -vs- CDC COVID-19 Vaccination Program differences.
For any questions about VaxMaX and its functionality, please visit the VaxMaX help website as a resource for reference guides and tutorial videos.

Best Practice Spotlight

With temperatures increasing over the summer months, it is important to be aware of and prepare for heat-related issues during vaccination events. Here are some tips to avoid heat-related illness:
  • Drink water. When the temperature rises, it is important to drink plenty of water. Drinks that contain caffeine, large amounts of sugar, or alcohol should be avoided because they can cause you to become dehydrated.
  • Keep cool indoors. On hot days, prevent illness by keeping cool indoors. If your sites are not air-conditioned, try to spend the hottest hours of the day in shaded areas.  Be aware of individuals standing in lines waiting for vaccines, as asphalt temperatures can be 40 to60 degrees hotter than surrounding air temperatures.
  • Dress for the heat. Wear lightweight, light-colored clothing.. It is a good idea to wear hats or use an umbrella and to always apply sunscreen to exposed skin to prevent sunburn
  • Limit physical activity. Avoid excessive physical exertion in hot temperatures, especially in the middle of the day. If you must work outdoors, stay hydrated by drinking 2 to4 glasses of water each hour and take frequent breaks in a cool place. Even a few hours in an air-conditioned environment reduces the danger of heat-related illness.
Signs & Symptoms of Heat-Related Illness: Several heat-related health conditions can cause serious health problems. When temperatures are on the rise, watch for the following symptoms:
  • Dehydration— Dehydration is caused by the excessive loss of water and salt from the body because of illness or prolonged exposure to heat. Severe dehydration can become life-threatening if not treated.
  • Heat Cramps— Heat cramps are painful, involuntary muscle spasms that usually occur during heavy physical activity in hot environments. Muscles most often affected include calves, arms, abdominal wall and back. If you are suffering from heat cramps, rest for several hours and drink clear juice or an electrolyte-containing sports drink.
  • Heat Exhaustion— Heat exhaustion occurs when the body loses too much water and salt from sweating during hot temperatures. The elderly, people who work outside, and people with high blood pressure (particularly if they take certain medications) are at risk of heat exhaustion. Continued exposure may lead to heat stroke, which is life-threatening.
  • Heat Stroke— Heat stroke is caused by prolonged exposure to high temperatures or by doing physical activity in hot weather. Sweating has usually stopped and your body temperature becomes too high.  Body temperatures can reach as high as 106 degrees in 15 minutes. Heat stroke is a life-threatening condition and you should seek immediate medical attention if you or someone you know is suffering from heat stroke.
Check out our complete list of updated COVID-19 Vaccination Clinic Best Practices and our Lightning Learnings: Best Practices for Busy Providers!

Upcoming Events

  • Johns Hopkins Vaccine Equity Webinar. Carrying Equity in COVID-19 Vaccination Forward: Guidance Informed by Communities of Color. July 15, 2021 12:00 PM ET. Join us for a webinar to discuss a forthcoming report from CommuniVax, a coalition to strengthen the community’s involvement in an equitable vaccination rollout.
  • Vaccine Unit Pharmacy Office Hours: Thank you for your partnership and support in administering vaccines to Virginians. As we transition into the next phase of vaccine rollouts and with our regular meetings coming to an end, we have decided to launch regular office hours as an opportunity to provide updates and answer questions that may arise from partners.These sessions will begin on Thursday, 8 July at 4:00 pm, and occur every other week moving forward for the months of July and August. Attendance is open to all partners, and although optional, we encourage you all to attend so we can provide vaccination updates in Virginia, share best practices, and field your questions and concerns. Please forward and extend the invite to your member pharmacies.

Helpful Resources

  • Walgreens Video Series “The Vaccine, In Our Words”

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.

VDH COVID-19 Vaccination Response: Healthcare Professionals Website