White House

• 6/21/2022:  Remarks by President Biden on COVID-⁠19 Vaccines for Children Under Five - The United States is now the first country in the world to offer safe and effective COVID-19 vaccines for children as young as six months old. In the first time in our fight against this pandemic, nearly every American can now have access to lifesaving vaccines. And we’re ready. Parents will soon be able to start scheduling an appointment and addressing vaccines at pediatricians’ offices,[and] children’s hospitals. And starting today, you can go to Vaccines.gov and find information and appointments near you. More and more locations will be ramping up, and more vaccines are delivered to providers in your areas every day.

VDH

• Revised Standing order authorizing dispensing and administering of the covid-19 vaccine under Virginia Code 54.1-3408(P) 
  • Legal summary of legal authorities for Pharmacists to administer COVID Vaccines
• CDC Guidance or Materials
  • New - 6/24/2022:   Moderna COVID-19 vaccine recommended for children and adolescents  [Media Statement]. CDC endorsed the Advisory Committee on Immunization Practices’ (ACIP) recommendation that children aged 6 through 17 years of age can receive the Moderna COVID-19 vaccine for a primary series. Children and adolescents who receive the Moderna COVID-19 vaccine will need two doses separated by at least 28 days for their primary series. There are separate Moderna products for children 6 through 11 years of age and adolescents 12 through 17 years of age.  CDC will provide additional guidance in its Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States.
• New - 6/18/2022: CDC Recommends COVID-19 Vaccines for Young Children [Media Statement]. CDC endorsed the Advisory Committee on Immunization Practices’ (ACIP) recommendation that all children 6 months through 5 years of age should receive a COVID-19 vaccine. This expands eligibility for vaccination to nearly 20 million additional children and means that all Americans ages 6 months and older are now eligible for vaccination. More information can be found in CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States.
• Updated - 6/21/2022: Pfizer-BioNTech COVID-19 Vaccine (also known as COMIRNATY): Overview and Safety. CDC recommends Pfizer COVID-19 vaccines for children ages 6 months through 4 years. The primary series consists of 3 doses. For immunocompetent children, the first and second doses are separated by three to eight weeks and the second and third doses are separated by at least eight weeks. For people who are moderately or severely immunocompromised (have a weakened immune system), the first and second doses are separated by three weeks, and the second and third doses are separated by at least eight weeks. Boosters are currently not authorized for children in this age group.
• Updated - 6/19/2022: Moderna COVID-19 Vaccine (also known as Spikevax): Overview and Safety. CDC recommends Moderna COVID-19 vaccine for children aged 6 months through 5 years. For children with a normal immune system, the primary series is 2 doses, with the second dose given 4-8 weeks after the first dose.  For children who are moderately or severely immunocompromised (have a weakened immune system), the primary series consists of three doses. An interval of 4 weeks is recommended between the first and second doses, and the second and third doses should be separated by at least 4 weeks.
• Updated - 6/19/2022: Myocarditis and Pericarditis After mRNA COVID-19 Vaccination. CDC continues to recommend that everyone ages 6 months and older get vaccinated for COVID-19. The known risks of COVID-19 illness and its related, possibly severe complications, such as long-term health problems, hospitalization, and even death, far outweigh the potential risks of having a rare adverse reaction to vaccination, including the possible risk of myocarditis or pericarditis.
• Updated - 6/19/2022: COVID-19 Vaccines for People who are Moderately or Severely Immunocompromised. Children aged 6 months through 11 years who are moderately or severely immunocompromised should receive primary series doses – and boosters, if eligible – as shown on the linked page.
• Updated - 6/19/2022: COVID-19 Vaccine Side Effects in Children and Teens. Common COVID-19 vaccine side effects that children aged 4 and older may experience after their second dose include: Pain, swelling, and redness at the injection site, , fever (usually low grade), tiredness, headache, chills, muscle or joint pain, and swollen lymph nodes. For children aged 3 years and younger, common side effects can include: Mild pain and redness at the injection site,  swollen lymph nodes, irritability or crying, sleepiness, and loss of appetite.

 

FDA

• New: FDA Authorizes Moderna and Pfizer-BioNTech COVID-19 Vaccines for Children Down to 6 Months of Age - On June 17, the U.S. Food and Drug Administration (FDA)authorized emergency use of the Moderna and Pfizer-BioNTech (Pfizer) COVID-19 Vaccines  for the prevention of COVID-19.  For the Moderna COVID-19 Vaccine, the FDA amended the emergency use authorization (EUA) to include use of the product in individuals 6 months through 17 years of age.  For the Pfizer COVID-19 Vaccine, the FDA amended the EUA to include use of the vaccine in individuals 6 months through 4 years of age. The FDA’s evaluation and analysis of the safety, effectiveness and manufacturing data of these vaccines was rigorous and comprehensive, supporting the EUAs.The agency determined that the known and potential benefits of the Moderna and Pfizer COVID-19 vaccines outweigh the known and potential risks in the pediatric populations for whom these vaccines are now authorized for use. Prior to making the decision to authorize these vaccines for the respective pediatric populations, the FDA’s independent Vaccines and Related Biological Products Advisory Committee was consulted and voted in support of the authorizations.
• Updated - 6/21/2022: Pulse Oximeter Accuracy and Limitations: FDA Safety Communication. With the advent of the Covid-19 pandemic, pulse oximetry has been used more to measure blood oxygen levels in patients. Per the NIH Clinical Spectrum of SARS-CoV-2 Infection, a pulse ox value can help determine if someone has ‘moderate’ or ‘severe’ Covid-19 illness. This has implications in determining whether a patient with Covid-19 can be treated as an outpatient or needs hospitalization. At least one study (from Sjoding and others) suggests that pulse oximetry may lack accuracy in black patients. In its update, FDA notes it will convene a meeting of the Medical Devices Advisory Committee later in 2022 to examine this in more detail.

• On Thursday, June 23, 2022, Pfizer Pediatric Vaccine (under 5 years of age), Moderna Pediatric Vaccine (under 6 years of age), and Comirnaty will be available to order in VaxMaX.

 

• Doses requested June 23rd through June 27th will be delivered Friday - July 1st, Tuesday - July 5th, or Wednesday - July 6th.

 

• The VDH Vaccine Unit Allocation Team is working to make Moderna (blue cap/purple label) available for ordering. Additional information regarding the process for initial orders will be provided by EOD 6/27/2022.

 

Independence Day 2022 Holiday Ordering and Shipping Schedule

• NO ORDERS WILL BE DELIVERED MONDAY, July 4, 2022 – INDEPENDENCE DAY

 

• McKesson Specialty (Moderna and Janssen) will not deliver vaccine orders on July 5, 2022.

 

• Pfizer-BioNTech Vaccines
  • No vaccine deliveries will occur on Saturday, July 2 through Monday, July 4, 2022.
  • Pfizer will be closed for the holiday weekend, and no orders will be processed July 4-5, 2022.
  • Orders placed on Friday, July 1 will be delivered on Tuesday, July 5, 2022.
  • If you would like to hold delivery for Friday, July 1, contact Pfizer by Tuesday, June 28, 9:00 p.m. EST via email at cvgovernment@pfizer.com.
  • If you would like to hold delivery for Tuesday, July 5, contact Pfizer by Wednesday, June 29, 9:00 p.m. EST via email at cvgovernment@pfizer.com.

• Moderna and J&J/Janssen Vaccines
  • No vaccine deliveries will occur Saturday July 2 through Tuesday, July 5, 2022.
  • McKesson will be closed for the holiday weekend. No orders will be processed July 4 or 5, 2022.
  • Orders placed by 12:00 p.m. EST on Friday, July 1 will be delivered on Wednesday, July 6, 2022.
  • McKesson Specialty customer service is reaching out to awardee and partner ordering points of contact to determine if order holds are requested. If you have not already spoken with McKesson Specialty customer service and want to request a hold for your orders for Friday, July 1, please call 1-833-343-2703 or email COVIDVaccineSupport@McKesson.com by 12:00 p.m. EST on Wednesday June 29, 2022.

• For questions about VaxMaX and its functionality, please visit the VaxMaX Help website, which includes reference guides and tutorial videos.

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

Pfizer Webinars for Healthcare Providers

• Pfizer has expanded its training sessions to address questions about currently recommended COVID-19 vaccine products as well as vaccines for children that are anticipated to be approved through an EUA.
• The COVID-19 vaccine medical updates and site training webinars aim to educate providers and immunization staff on the proper use of the Pfizer-BioNTech COVID-19 vaccines.
• For details, see dates and links for upcoming training sessions.
  • The trainings will include presentations on COVID-19 vaccines with a MAROON cap for individuals 6 months through 4 years of age.
  • Daily trainings (Monday through Friday) will continue through July 8, 2022 (with no training on July 4th).
  • While current trainings follow a Tuesday, Wednesday, Thursday schedule, future trainings will be offered 5 days per week as the pediatric vaccines roll out

VDH External Web Updates 

• If You are Sick page - Updated to reflect current VDH isolation and quarantine guidance. Moved the "Steps to take if you are sick" section to the top of the page and moved the "Get Tested for COVID-19" section below.
• VDH When to End Isolation or Quarantine:
  • On page two, the time frame for when quarantine and testing are not required if you have recently had COVID-19 was extended from 90 days to 6 months.
  • The recommendation for masking and testing for close contacts who are not required to quarantine was removed.
  • Previously, children aged 12-17 years who had not yet received a booster dose (and were therefore not considered “up to date” on COVID-19 vaccinations) were granted an exception and not required to quarantine after an exposure. This grace period has ended, and children aged 12-17 years who are not up to date on vaccinations must follow quarantine guidance. Currently, children aged 5-11 years who have not received a booster may still be considered “up to date” on COVID-19 vaccinations until the start of the 2022-2023 school year.
  • On page three, updated wording for up-to-date close contacts from “should get tested at least 5 days after” to “can consider getting tested”.
  • Updated the link to CDC Quarantine Guidance to VDH Quarantine Guidance.

• Interim Guidance for Child Care Facility Collaboration with the Local Health Department -
  • Updated VDH guidance that those who have recovered from confirmed COVID-19 within the past six months (changed from CDC recommendation of 90 days) do not need to quarantine or wear a mask after a close contact.
  • Added CDC updates regarding prevention strategies that should be considered at different COVID-19 Community Levels.
  • Updated facility reporting requirement to: "may voluntarily report suspected outbreaks of COVID-19 using the online reporting portal."

• VDH Flowchart for K-12 and Child Care Parents: If my Child is Ill or Exposed to COVID-19 -
  • Removed recommendation that even if quarantine is not required, testing is recommended on Day 5, and that masks should be worn around others for a full 10 days.
  • Added links to CDC Guidance for definition of “up to date” with COVID-19 vaccinations, updated footnote to reflect this.
  • Removed guidance that students ages 12-17 years who completed their COVID-19 primary vaccine series but have not yet received a booster can forgo quarantine.
  • Included guidance that students ages 5-11 who have received the primary series but not a booster dose may forgo quarantine at this time, until the start of the 2022-2023 academic school year.
  • Updated time frame of recovery from COVID-19 infection from 90 days to 6 months; those who have recovered from COVID-19 in the last 6 months are not required to quarantine after a close contact exposure to an individual with COVID-19.
  • Updated “COVID-19 Symptoms” to link to CDC’s guidance on symptoms of COVID-19.
  • Added guidance that children <2 years of age and those who cannot mask should quarantine or isolate at home for the full 10 day period.

Resources for vaccinating young children (6 months through 6 years of age)

Less than 11 months of age: anterolateral thigh:  https://www.cdc.gov/vaccines/hcp/admin/downloads/IM-Injection-Infants-508.pdf

1-2 years of age: anterolateral thigh: https://www.cdc.gov/vaccines/hcp/admin/downloads/IM-Injection-1-2-Years-508.pdf

3-6 years of age: deltoid muscle: https://www.cdc.gov/vaccines/hcp/admin/downloads/IM-Injection-3-6-Years.pdf

Needle gauge guide: https://www.cdc.gov/vaccines/hcp/admin/downloads/vaccine-administration-needle-length.pdf

CDC IM injection video: deltoid and anterolateral thigh: https://youtu.be/PqSuCPnPeYE