• UPDATED: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States - New section on Considerations for use of a Pfizer-BioNTech COVID-19 vaccine booster dose after completion of a Pfizer-BioNTech primary vaccine series.

• CDC recommends that the following groups should receive a booster dose of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after completing their Pfizer-BioNTech primary vaccine series:
  • People aged 65 years and older
  • Residents aged 18 years and older in long-term care settings
  • People aged 50–64 years with underlying medical conditions
• CDC recommends that a booster dose of Pfizer-BioNTech’s COVID-19 vaccine should be made available so that the following groups may receive a booster dose of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after completing their Pfizer-BioNTech primary vaccine series, based on their individual benefits and risks:
  • People aged 18–49 years with underlying medical conditions
  • People aged 18–64 years at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting https://www.cdc.gov/vaccines/covid-19/categories-essential-workers.html
• During its discussions, ACIP highlighted the following:
  • COVID-19 vaccine recommendations may be updated, as needed, to reflect changes in U.S. COVID-19 disease trends, new information on COVID-19 vaccine effectiveness and safety, and updated benefit-risk analyses.
  • There is an urgency to provide guidance on the use of a booster dose for people who received a primary vaccine series with Moderna and Janssen COVID-19 vaccines.
  • COVID-19 vaccines currently approved or authorized in the United States remain effective against severe disease, hospitalization, and death. Fully vaccinated persons of all ages are much less likely than unvaccinated persons to become infected with COVID-19 and to require hospitalization.
  • High and equitable COVID-19 vaccination coverage with a COVID-19 primary vaccine series remains the highest priority and is fundamental to reducing COVID-related morbidity and mortality.
• Revised Order Authorizing Dispensing and Administering of the Covid-19 Vaccine Under Virginia Code 54.1-3408(p)
  • This updated order references and authorizes:
    • Pharmacists actively licensed in Virginia who are in good standing to practice in Virginia per the Virginia Board of Pharmacy to dispense and administer FDA-authorized COVID-19 vaccines;
    • Pharmacy technicians and pharmacy interns who have satisfied the requirements of the PREP Act acting under the supervision of a pharmacist, as defined above, who have enrolled in the CDC COVID-19 vaccination program to administer FDA-authorized COVID-19 vaccines; and
    • Registered nurses (RNs) and licensed practical nurses (LPNs) actively licensed in Virginia who are in good standing to practice in Virginia per the Virginia Board of Nursing to administer FDA authorized COVID-19 vaccines at community vaccination events.
• FAQs About Medical Consent & Pfizer-BioNTech Booster Doses for Long-term Care Residents - In response to inquiries about medical consent surrounding the administration of a booster shot of Pfizer-BioNTech COVID-19 vaccine to residents in long-term care settings at least six months after their Pfizer-BioNTech primary series, the CDC has developed responses to frequently asked questions
• VDH will be opening Community Vaccination Clinics (CVC) to administer first, second and booster doses.  The first CVC will open in Fairfax October 5, followed by Prince William October 7 and in Norfolk October 9th.
• NEW: CDC is partnering with schools and districts in states across the U.S. this fall to evaluate mask adherence in K-12 schools. CDC will train school-identified observers to collect data on mask adherence across participating schools. Observers may include high school students who are interested in science or public health, and the project offers a great opportunity for real-world public health experience. Schools can also use staff or volunteers to conduct observations. Results from this investigation will be used to inform decision-making around masking in K-12 school settings, report findings to evaluate messaging and education around wearing masks, and to identify locations on school campuses where mask use can be improved. If you are interested in participating or would like to learn more, please see the attached flyer or email eocevent335@cdc.gov.
• Updated: SARS-CoV-2 Variant Classifications and Definitions - The U.S. Government SARS-CoV-2 Interagency Group (SIG) added a new variant classification designated Variants Being Monitored (VBM). VBM now includes variants for which there are data indicating a potential or clear impact on approved or authorized medical countermeasures, or that have been associated with more severe disease or increased transmission but are no longer detected or are circulating at very low levels in the United States, and, as such, do not pose a significant and imminent risk to public health in the United States.  The following variants are classified as VBM: Alpha (B.1.1.7, Q.1-Q.8); Beta (B.1.351, B.1.351.2, B.1.351.3); Gamma (P.1, P.1.1, P.1.2); Epsilon (B.1.427, B.1.429); Eta (B.1.525); Iota (B.1.526); Kappa (B.1.617.1); B.1.617.3; Mu (B.1.621, B.1.621.1); Zeta (P.2).

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

• At present, booster doses are only recommended for those with first and second doses of the Pfizer-BioNTech vaccine who have a qualifying condition, occupation, or institutional setting. Individuals who received a primary series with Moderna or Johnson & Johnson (Janssen) vaccines are not approved for boosters. Information on boosters for these vaccines is expected in the future.

• Check out our complete list of COVID-19 Vaccination Clinic Best Practices and our Lightning Learnings: Best Practices for Busy Providers!

Upcoming Events

• NEW from the American Academy of Pediatrics (AAP): Outpatient COVID-19 Treatment Strategies, Caring for Patients During Surge, Providing Acute Care in Ambulatory Setting 
  • To help pediatricians manage COVID-19 surges while also meeting the needs of non-COVID-19 patients, the AAP has released interim guidance on monoclonal antibody treatment/post-exposure prophylaxis, managing care of patients in inpatient/outpatient settings during episodes of surge, and providing acute care in ambulatory settings.
  • Interim Guidance: Outpatient COVID-19 Management Strategies in Children and Adolescents
  • Interim Guidance: Caring for Patients in Inpatient and Outpatient Settings During Episodes of Surge
  • Interim Guidance: Caring for Children with Acute Illness in the Ambulatory Care Setting During the Public Health Emergency
  • AAP News: What to know about monoclonal antibody therapies, surge episodes, providing acute care
  • HealthyChildren.org: COVID-19 page
• Updated: Appendices
  • Updated the close contact exception in K-12 settings: In the K–12 indoor classroom setting or a structured outdoor setting where mask use can be observed (i.e., holding class outdoors with educator supervision), the close contact definition excludes students who were between 3 to 6 feet of an infected student (laboratory-confirmed or a clinical diagnosis) if both the infected student and the exposed student(s) correctly and consistently wore well-fitting masks the entire time.
    • Of note, VDH's exception to the close contact definition for K-12 students applies in indoor and outdoor K-12 settings. The exception also applies on school buses when certain prevention measures are in place. More details are available here.
    • The “Public Health Recommendations” section was updated to summarize recommendations for close contacts based on vaccination status or history of prior infection, and to include new guidance for people with prior infection in the past 90 days.
• Updated: VDH COVID-19 General FAQs -  NEW: 9th amendment of Prep Act; close contact in K-12 settings; schools- question of vaccine requirements; school requirements for protecting staff; guidance for athletes and spectators of school sports UPDATES: school close contact definition exception on school buses; link to FAQs on public transportation order; testing for fully vaccinated individuals after an exposure; links to Coronavirus Self-Checker; risk of reinfection; shorter quarantine duration options in schools; links to Clarification of VDH K-12 Close Contact Definitions and Quarantine Periods; workplace and business mask guidance; The Virginia Standard; Infection control guidance - Long-Term Care Facilities; routine testing - LTCF staff; Long-COVID as a disability; links to Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2
• Updated: VDH Variants web page - Included a new variant category (variants being monitored) and current classification of variants.
• Updated: VDH If you are sick web page - Updates include new information about why monoclonal antibodies are not a substitute for vaccination and information about ivermectin. Added a link to the American Academy of Physical Medicine and Rehabilitation long COVID dashboard.
• Updated: VDH Health Professionals page - Updated new rotating "Hot Topic" section with information on CDC MIS-C materials and recent CDC HAN alert.  Also added archive for previous Hot Topic items.
• Counterfeit or fake vaccination cards should be reported to the HHS Office of the Inspector at 1-800-HHS-TIPS or www.oig.hhs.gov and the FBI at tips.fbi.gov.