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Author: Aimee Lin

Vaccinate Patients Upon Discharging

Vaccinate Patients Upon Discharging

The Philadelphia Department of Public Health (PDPH) is asking hospitals and urgent care facilities to administer COVID-19 Vaccine to patients upon discharging in emergency departments. Hospitals, ED, and UC facilities in the United States play an influential role in building confidence in and improving COVID-19 vaccine uptake, as healthcare providers are the most trusted source of health information.

Emergency departments serve as the primary, and at times only, health care access point for up to 20% of the US population, and urgent care clinics handle more than 29% of primary care visits in the country. We encourage hospitals to expand COVID-19 vaccination efforts to all hospital departments, including postpartum discharges and patients being discharged to long-term care of rehabilitation facilities. Expanding COVID-19 vaccine availability via these locations also makes vaccine more accessible to patients.

We hope this helps push Philly towards reaching the national goal of 70% vaccination coverage by July 4th.

Click to learn more about CDC guidance regarding Vaccine Eligibility and Best Practices to determine if a patient should receive vaccine upon discharge.

Thank you for keeping Philadelphia safe and healthy from COVID-19. If you have any questions, please email vaccines@phila.gov.

CDC Best Practices for Vaccinating Upon Discharge

CDC Best Practices for Vaccinating Upon Discharge

Please see CDC guidance regarding vaccine Eligibility and Best Practices below, to determine if a patient should receive COVID-19 Vaccine vaccine upon discharge:

Vaccine Eligbility:

• Patients who are not moderately or severely ill and are being discharged from hospital admission, 24-hour observation, or an ED or UC visit may be vaccinated. Patients with current COVID-19 infection should defer vaccination until they have met criteria to discontinue isolation.
• If the patient is a minor, providers are to follow all state laws regarding consent of minors for vaccination

Best Practices for Vaccinating Upon Discharge:

• Assess vaccination status at triage, in the patient’s medical history, and during medication reconciliation by asking patient, checking electronic medical/health records, and linking with the jurisdiction’s immunization information system (IIS)
• Address vaccine hesitancy with all patients and those that accompany them as part of routine practice
• Strongly encourage and offer vaccination to all eligible patients and any friends or family who are accompanying them
• Consider using a pharmacist assigned to the facility to help with medication management to support confirming vaccination status before vaccination
• Utilize personnel not involved in the direct care of the patient, if available, to administer vaccines if the department is very busy and it would help work flow
• Offer vaccination services either at bedside or in special vaccination areas during discharge process
• Encourage patients to enroll in v-safe
• Document receipt and/or refusal in chart and IIS
• Complete and provide a COVID-19 Vaccination Record Card to the patient and print out a list of the vaccination(s) given, particularly for patients being transferred/discharged to rehab, long-term care, or psychiatric facilities
• Arrange for second dose appointment, if applicable
• Place patients in the waiting area for the 15-minute observation period after vaccination is complete to assist in improved flow and reduction of crowding

Thank you for keeping Philadelphia safe and healthy from COVID-19. If you have any questions, please email vaccines@phila.gov.

Memorial Day Holiday Vaccine Ordering

Memorial Day Holiday Vaccine Ordering

Please make note of the following changes in COVID-19 vaccine shipping around the Memorial Day Holiday (5/31):

  • During the week leading up to Memorial Day Weekend (May 24 – 28), all vaccine deliveries will continue as usual.
  • There will be no deliveries for any vaccines on Sunday, May 30th and Monday, May 31st.
  • Pfizer vaccine delivery will resume on Tuesday, June 1.
  • Moderna and Janssen vaccine delivery will resume on Wednesday, June 2.

Thank you for keeping Philadelphia safe and healthy.

If you have any questions, please email vaccines@phila.gov.

 

FDA Pfizer Vaccine Storage Update

FDA Pfizer Vaccine Storage Update

On May 19th, the FDA announced the Pfizer COVID-19 Vaccine can now be stored at normal refrigerator temperatures for up to a month (30 days). This is much longer than was previously allowed under the FDA’s emergency authorization and will make storage and distribution of the vaccine easier.

The FDA is now authorizing undiluted, thawed Pfizer-BionTech COVID-19 vaccine vials to be stored in the refrigerator at 2°C to 8°C (35°F to 46°F) for up to 1 month (30 days). Previously, thawed, undiluted vaccine vials could be stored in the refrigerator for up to 5 days.

The FDA says the change should make the vaccine more widely available by making it easier for doctors’ offices to receive, store and administer the vaccine. “Making COVID-19 vaccines widely available is key to getting people vaccinated and bringing the pandemic to an end,” says Dr. Peter Marks, director of the FDA’s Center for Biologics and Research. PDPH hopes that this change will help providers vaccinate more patients in Philadelphia.

Click here to Download the New Pfizer EUA (5/19/2021)

To review the most recent EUA fact sheets for the Moderna and Janssen COVID-19 Vaccines, please click the links below:

Thank you for keeping Philadelphia safe and healthy.

If you have any vaccine storage and handling questions, please email tempcheck@phila.gov.

If you have any other questions, please email vaccines@phila.gov.

Adolescents 12+ May Consent to Receive Pfizer Vaccine

Adolescents 12+ May Consent to Receive Pfizer Vaccine

On 5/14, the Philadelphia Board of Health updated the Emergency Order Concerning COVID-19 Vaccine Information Statements to allow individuals 11 years of age and older to consent to his or her own immunization with a COVID-19 vaccine under an Emergency Use Authorization (EUA), without the approval or consent of a parent or guardian. In this case, an EUA Fact Sheet for Recipients and Caregivers would substitute for a Vaccine Information Statement.

Currently, the Pfizer COVID-19 vaccine is only authorized for 12 years of age and older. The language 11 years and older in the Philadelphia Board of Health order aligns with the original regulations that give individuals 11 years and older the ability to consent for approved vaccines with a Vaccine Information Statement. However, at this time, you should ONLY vaccinate individuals 12 years of age and older with the Pfizer product.

The unaccompanied minor presenting for vaccination can be vaccinated, subject to a vaccine provider’s determination that the minor is able to, and does provide, informed consent.

Click here to download PDPH’s Emergency Order Concerning COVID-19 Vaccine Information Statements

To view the original regulations, please go to Section 4, part b of the Regulations Governing the Immunization and Treatment of Newborns, Children and Adolescents document found here.

AAP Statement on Adolescent COVID-19 Vaccination and Co-Administration

Following the ACIP meeting on May 12, American Academy of Pediatrics (AAP) released a Policy Statement recommending vaccination for eligible children ages 12 and up with the federally authorized COVID-19 vaccine. The statement supports co-administration of COVID-19 vaccine with routine immunizations in order to catch children up on any missed vaccines caused by the pandemic:

For additional guidance regarding vaccinating adolescents and concurrent administration of other vaccines, please download:

Thank you for keeping Philadelphia safe and healthy.

If you have any questions, please email vaccines@phila.gov.

Properly Discard Expired COVID-19 Vaccine

Properly Discard Expired COVID-19 Vaccine

COVID-19 Vaccine Providers, please make sure you are properly discarding wasted and expired COVID-19 Vaccine as they expire, as you would any other biologic waste. Please do NOT mail them back in their packaging.

For more information about vaccine wastage, please refer to the COVID-19 Vaccine Wastage Guidance advisory we sent out last week, which can also be viewed on our website.

Thank you for keeping Philadelphia safe and healthy.

If you have any questions, please email vaccines@phila.gov.

COVID-19 Vaccine Wastage Guidance

COVID-19 Vaccine Wastage Guidance

PDPH is asking providers to ensure vaccination for all eligible patients, even if it means leaving some doses unused or wasted. Here is some information to help you increase vaccination and manage wastage:

1. Prioritize vaccinating eligible persons. Providers should vaccinate any eligible persons who wish to receive vaccine at their clinic location, even if it means puncturing a multi-dose vial and potentially wasting doses.

2. Do not miss an opportunity to vaccinate. PDPH understands that some, or all remaining doses in the vial, may need to be wasted to vaccinate a person. Not missing an opportunity to vaccinate is the more important goal.

3. Follow best practices while managing vaccine inventory. While we want to continue to follow the best practices of using every dose possible, we do not want it to be at the expense of missing an opportunity to vaccinate every eligible person when they are ready to get vaccinated.

4. No penalties for wasting COVID-19 vaccine. We are expecting an increase in COVID-19 vaccine wastage as vaccination efforts progress and opportunities are not missed.

5. Download and use the CDC COVID-19 Vaccine Expiration Date Tracker. This tool helps your site keep track of vaccine wastage.

6. Download and use the Vaccine Wastage Guide. This tool details the vaccine wastage protocols for the Pfizer, Moderna, and Janssen COVID-19 Vaccines.

7. Use the wastage reporting table. This table (below) provides guidance to determine if a dose should be reported as waste. Wastage does not negatively impact a provider, but is simply a means for accounting for inventory.

8. Implement CDC and Idaho tips for not missing opportunities and reducing wastage. See detailed tips below. We can all learn by sharing best practices.

9. Call PDPH if you need help! PDPH is happy to help manage inventory and discuss strategies to minimize vaccine wastage. Contact vaccines@phila.gov

10. Don’t wait, vaccinate!

Wastage Reporting Table:

Below are CDC recommendations ensuring there are no missed opportunities to vaccinate every eligible person:

  • Consider establishing and promoting standing vaccination days or half-days to increase likelihood of larger numbers of people presenting for vaccination on the same day.
  • Vaccinate family members or friends who accompany patients to medical visits even if they are not established patients at the vaccinating practice
  • Continue outreach to employers or other community partners that have a large membership or network to arrange vaccination events.
  • As contingency plan, vaccine providers should attempt to contact additional persons (i.e., from a waitlist or through personal contacts of persons being vaccinated) to use as many vaccine doses as possible.
  • Once punctured, multidose vials must be used within:
    • 12 hours (Moderna)
    • 6 hours (Pfizer)
    • 2 hours (J&J/Janssen)
  • The more Americans who get vaccinated the fewer COVID-19 cases, hospitalizations, outbreaks, and deaths that will occur.

For additional guidance on how to reduce wastage, please refer to the bullet points below written by the Idaho Immunization Program:

  • If feasible, prepare a Standby List strategy appropriate to your setting and the function of your site. “Standby lists” identify, in advance, people who are wanting to receive vaccine at your site.
  • Review your patient lists for those who may not have been vaccinated, and/or ask those who present for care if they are willing to be on waitlists.
  • If available, utilize your local COVID-19 Vaccine Pre-registration System to locate additional residents in your area who are willing to be on waitlist. These pre-registration systems were established by localities to identify people who wanted to be vaccinated. People would enter their name and contact information to receive a vaccine at a future date.
  • Review daily the clinic/appointment schedule to determine if it matches available vaccine inventory.
  • As a clinic or appointment day progresses, monitor no-shows and extra doses to anticipate potential need/ability to reach additional people.
  • Determine time of day that is appropriate for your site to activate the Standby List strategy.
  • Use the Standby List to call people who may be able to arrive at the administration site before the end of your vaccination clinic.
  • If individuals with future appointments are rescheduled for the end of the day, republish those future appointments as available by the end of the day.
  • For vaccines administered to standby patients, sites should use relevant registration and reporting mechanisms as well as ensure that second dose appointments are scheduled for the appropriate timeframe at the same location

Thank you for keeping Philadelphia safe and healthy from COVID-19.
If you have any questions, please email vaccines@phila.gov.

Pfizer Vaccine for Pediatric Providers

Pfizer Vaccine for Pediatric Providers

UPDATE: Please refer to the PDPH Emergency Order Concerning COVID-19 Vaccine Information Statements 5/14 for guidance.

On May 10, the US Food and Drug Administration (FDA) expanded the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine to adolescents ages 12-15 years. Yesterday, May 12, the CDC Director adopted the CDC’s Advisory Commitee on Immunization Practices’ (ACIP) recommendation that endorsed the safety and effectiveness of Pfizer-BioNTech COVID-19 vaccine in this population. Providers may begin vaccinating 12–15-year-old patients today. This advisory contains important information regarding administering Pfizer COVID-19 Vaccine to adolescents and teenagers.

If your site has not already enrolled as a COVID-19 Vaccine Provider, you can enroll now to make sure your adolescent patients can get vaccinated!

Click here to enroll in our COVID-19 Vaccine Program!

Ordering Partial Trays of Pfizer & Adolescent Vaccination Updates

Please use this guide to order a partial tray of Pfizer.

For the week of 5/10, orders must be received by noon on Friday, 5/14. Going forward, orders must be submitted by 5 pm on Wednesday.

Only use this process to order if you’re been directed to during your COVID vaccine enrollment process.

Offering COVID-19 Vaccine

There is no longer a residency requirement for COVID-19 vaccinations. You are free to vaccinate individuals who live outside of Philadelphia city limits going forward.

PDPH does not require COVID-19 Vaccine providers to offer vaccinations to the greater public unless a site is specifically interested in vaccinating more than their patients.

If your site is interested in offering the vaccine at an off-site location, offering the vaccine to the whole family, or have questions about offering the vaccine in your community, email vaccines@phila.gov so that we can connect you with the right Philadelphia Immunization Program team member.

Co-administration

Per the ACIP meeting on 5/12, COVID-19 vaccines may be administered without regard to timing. This includes simultaneous administration of other vaccines on the same day, as well as co-administration within 14 days. We will forward the MMWR documenting this decision once its is published.

Consent

The patient or their parent and guardian must have had the opportunity to have his/her questions answered satisfactorily before the immunization is given. Written consent for immunization is not required. Implicit consent is acknowledged by the presentation for vaccination of an adolescent with their parent or guardian. There is no Vaccine Information Sheet (VIS) for this vaccine. The FACT SHEET FOR RECIPIENTS AND CAREGIVERS about the Emergency Use Authorization (EUA) Pfizer-BioNTECH COVID-19 Vaccine to Prevent Coronavirus must be shared with the intended vaccine recipient or their parent or guardian prior to immunization.

Currently in Philadelphia, individuals 16 -18 years of age may authorize his or her own immunization with the Pfizer vaccine under the EUA, without the approval or consent of another person. At this time, individuals 12 to 15 years of age must have a parent’s implicit consent for vaccination under an EUA.

Click here to download PDPH’s Emergency Order Concerning COVID-19 Vaccine Information Statements. To view the original regulations, please go to Section 4, part b of the Regulations Governing the Immunization and Treatment of Newborns, Children and Adolescents document found here.

Wastage

As COVID-19 vaccine supply becomes more available and appointments become more sporadic, PDPH is asking providers to ensure vaccination for all eligible patients, even if it means leaving some doses unused or wasted.

Right now, it is critical that providers prioritize vaccinating eligible persons who are willing to be vaccinated over wasting vaccine. Providers should vaccinate any eligible persons who wish to receive vaccine at their clinic location, even if it means puncturing a multi-dose vial and potentially wasting doses. PDPH understands that some, or all remaining doses in the vial may need to be wasted to vaccinate a person.

Please download our Vaccine Wastage Guide here. You can find additional information on vaccine wastage guidance by reading this detailed Vaccine Wastage Advisory.

Pfizer Resources

Thank you for keeping Philadelphia safe and healthy.

If you have any questions, please email vaccines@phila.gov.

Providers Can Now Vaccinate Non-Philadelphia Residents

Providers Can Now Vaccinate Non-Philadelphia Residents

During this phase of the COVID-19 vaccine rollout, vaccine supply has become more available. There is no longer a residency requirement for COVID-19 vaccinations. This will allow providers to vaccinate people who live outside of Philadelphia city limits going forward.

As vaccine appointments have become more sporadic, we hope that this change helps your site vaccinate as many patients as possible, and lessens vaccine wastage.

Thank you for keeping Philadelphia safe and healthy.

If you have any questions, please contact vaccines@phila.gov.

Enroll as a COVID-19 Vaccine Provider!

Enroll as a COVID-19 Vaccine Provider!

Providers that are able to report to the PhilaVax IIS and store COVID-19 vaccines are able to pursue enrollment as a COVID-19 vaccine provider with PDPH.

The Philadelphia Department of Public Health (PDPH) encourages all eligible providers to enroll within the COVID-19 vaccine program and assist in the effort to vaccine Philadelphia against COVID-19.

How Do I Enroll?

PDPH has created a comprehensive 8 page Provider Guide to help aid new and prospective COVID-19 Providers with the provider enrollment process.

Click here to download the Provider Guide!

The Comprehensive Provider Guide to the Enrollment Process covers:

  • Who can be a provider?
  • How do you become a provider?
  • How long does it take to enroll and start vaccinating?
  • Enrollment tips
  • Reporting guidelines
  • Storage and Handling requirements
  • Philavax and Ordering inquiries

There is also a FAQ section at the end which covers questions related to enrollment, reporting, ordering/PhilaVax, and storage and handling. If you have specific questions about a topic, the Provider Guide has specific emails listed for who to contact.

Once you have reviewed the guide, you can start filling out our COVID-19 Vaccine Provider Enrollment Form.

If you have any general questions, please email vaccines@phila.gov.

Thank you for keeping Philadelphia safe and healthy from COVID-19!