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CDC Clinician Outreach and Communication Activity (COCA) Call on 9/9/2021

CDC Clinician Outreach and Communication Activity (COCA) Call on 9/9/2021

The Centers for Disease Control and Prevention (CDC) has announced a Clinician Outreach and Communication Activity (COCA) Call.

When: September 9th at 2pm EDT.

Topic: 2021-2022 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines

Meeting link: https://www.zoomgov.com/j/1610456908?pwd=cFI3YzIvMWZzOFE4bmEwakswaUZsdz09#success

Webinar ID: 161 045 6908

Passcode: 220280

Click here to join the CDC Coca Call!

During this COCA Call, presenters will provide updates on the Advisory Committee on Immunization Practices (ACIP) recommendations for the 2021-2022 influenza vaccination season and guidance for coadministration of influenza and COVID-19 vaccines.

There will be a web on-demand version of the call available after the live event.

Please click here to access additional COCA calls and other training from CDC, the World Health Organization, and other training providers.

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

Additional VFC Flu Vaccine Presentations Available to Order

Additional VFC Flu Vaccine Presentations Available to Order

FluMist intranasal sprayers and Fluzone multidose vials are now available to order for your VFC patients.

Please refer to the flu ordering guide for the full product information for these vaccines.

As a reminder, all flu vaccine from the 2020-2021 season must be accounted for before you can order flu for the 2021-2022 season. Guidance on accounting for remaining doses can be found here.

Order Flu Vaccine Today!

Have questions?

Contact Christine Wilson at 215.685.6728 or christine.wilson@phila.gov, or Charma Miller at 215.685.6667 or charma.miller@phila.gov for assistance.

Thank you for keeping Philadelphia healthy by fighting flu! For more information about influenza in Philadelphia, visit our flu page.

VFAAR Flu Vaccine Available to Order

VFAAR Flu Vaccine Available to Order

A supply of FluLaval pre-filled syringes for your VFAAR patients is now available to order.

Please note, all flu vaccine from the 2020-2021 season must be accounted for before you can order flu for the 2021-2022 season. Guidance on accounting for remaining doses can be found here.

We will send out additional emails and update the flu page as more presentations of flu become available.

Order Flu Vaccine Today!

Have questions?

Contact Christine Wilson at 215.685.6728 or christine.wilson@phila.gov, or Charma Miller at 215.685.6667 or charma.miller@phila.gov for assistance.

Thank you for keeping Philadelphia healthy by fighting flu! For more information about influenza in Philadelphia, visit our flu page.

Pfizer-BioNTech Vaccine Gets Approval & Expiration Extension

Pfizer-BioNTech Vaccine Gets Approval & Expiration Extension

The Pfizer-BioNTech vaccine has been granted official Food and Drug Administration (FDA) approval! The vaccine will now be marketed as Comirnaty (koe-mir’-na-tee), for the prevention of COVID-19 disease in individuals 16 years of age and older. Although the full approval is only for individuals 16 years of age and older, Comirnaty can still be given to individuals 12 through 15 under the existing EUA. The Comirnaty vaccine is still contracted under the federal government and will not be distributed commercially at this time. Providers are expected to continue following the CDC Provider Agreement terms set forth at the time of enrollment with PDPH.

In addition to the FDA’s full approval, an amendment to the EUA for the Comirnaty vaccine has been made to extend the expiration dates from 6 to 9 months.

Cartons and vials of Pfizer-BioNTech’s Comirnaty vaccine may remain in use for 3 months beyond the printed date as long as authorized storage conditions (-90°C to -60°C or -130°F to -76°F) have been maintained. Frozen vials stored at -25°C to -15°C and refrigerated vials stored at 2°C to 8°C are NOT eligible for extension.

See the below chart for guidance:

Printed Expiry Date Updated Expiry Date
August 2021 November 2021
September 2021 December 2021
October 2021 January 2022
November 2021 February 2022
December 2021 March 2022
January 2022 April 2022
February 2022 May 2022

The extended expiration date is effective immediately for all currently available batches that have not yet expired. Please note: Expiration dates extension does NOT apply to vials dated July 2021 and earlier

Currently available vaccine will not have an updated NCD. Please refer to the
current EUA Fact Sheet for information by clicking the button below. And additional information on Comirnaty’s storage and handling may be found at: Administration Overview for Pfizer-BioNTech COVID-19 Vaccine.

If you have questions about the extended expiration or the storage requirements of Comirnaty vaccine, please contact us at vaccines@phila.gov.

Thank you working to keep Philadelphia safe and healthy. Together we can stop COVID-19!

Vaccine Formulary Updates and Ordering Directions

Vaccine Formulary Updates and Ordering Directions

COVID-19 vaccine ordering will remain dynamic over the next few weeks as new configurations (anticipated in late October) become available, phase out, and product lines are reintroduced. We continue to have a healthy supply of all vaccine and we hope to keep you as informed as possible regarding the shifts in vaccine configurations.

Although vaccinations have been expanded for immunocompromised individuals, we want to encourage all sites to use what you have on hand to meet these needs given the large volumes of inventory in the field. We want you to use vaccine to the best of your ability. We continue to be cautiously optimistic that the Pfizer vaccine, currently held at ultra-low temp conditions, will receive an extension. You should consider these possible extensions prior to placing orders for additional Pfizer vaccine.

Please review the following upcoming changes below.

COVID-19 Vaccine Ordering Tips!

  • Use the COVID-19 vaccine you have in your inventory before ordering more.
  • Only order vaccine that you can reasonably administer.
  • Administer, report, and assess your vaccine needs.
  • Order again – as needed!

Vaccine Configurations to be Phased Out this Week!

Pfizer 450 for ages 12+

  • 450-pack Pfizer configuration comes to an end this week.
  • Any site ordering more than one 450-pack this week should order an 1170 pack instead.
  • We anticipate new smaller package configurations will be available in October. Stay tuned for more details!

Returning and Ongoing Vaccine Configurations

Pfizer 1170 returning August 18th

  • Pfizer 1170-pack will be re-introduced on Aug 18th.
  • Ancillary kits:
    • Ancillary kits for this packaging are configured with 80% 1” needles that may be used for pediatric patients.
    • Some of the needles in the adult kit are 1.5” long and should not be used to vaccinate pediatric patients (see Vaccine Administration: Needle Gauge and Length (cdc.gov)).
    • Providers may need to acquire additional 1” needles to supplement the adult ancillary kit if needed.
  • Orders submitted with a pediatric order intention will error out.

Moderna 100 – Temporary Only returning for a limited time only on August 19th at 12pm Eastern

  • Limited supply of 4.5 million doses
  • Moderna 100-pack will be re-introduced on Aug 19th.
  • All due to expire in Nov/Dec 2021

Moderna 140

  • Ages 18+ (awaiting EUA expansion for adolescents to activate PED ancillary)

J&J/Janssen 100 estimated return in September

  • Maximum orders of 100 doses
  • 6-month shelf life

Dry Ice Will Not be Provided for Pfizer Vaccine

Given the updated storage capability for Pfizer vaccine (2-8C for 30d) and based on the availability of dry ice locally for sites that need it, dry ice recharges will not be provided to support the 450 or 1170 packs:

  • If you intend to use the Pfizer thermal shipping container for temporary ULT storage, you must have a plan in place for replenishing the dry ice every five days.
  • Locations utilizing the shipping container for storage must activate the data monitoring system (via email from Controlant)

If you have any questions about ordering please contact us at vaccines@phila.gov. Thank you for helping keep Philadelphia safe and healthy!

Formulary Updates

Vaccine Formulary Updates and Ordering Directions

COVID-19 vaccine ordering will remain dynamic over the next few weeks as new configurations (anticipated in late October) become available, phase out, and product lines are reintroduced. We continue to have a healthy supply of all vaccine and we hope to keep you as informed as possible regarding the shifts in vaccine configurations.  
 
Although vaccinations have been expanded for immunocompromised individuals, we want to encourage all sites to use what you have on hand to meet these needs given the large volumes of inventory in the field. We want you to use vaccine to the best of your ability. We continue to be cautiously optimistic that the Pfizer vaccine, currently held at ultra-low temp conditions, will receive an extension. You should consider these possible extensions prior to placing orders for additional Pfizer vaccine.
 

COVID-19 Vaccine Ordering Tips! 

· Use the COVID-19 vaccine you have in your inventory before ordering more.
· Only order vaccine that you can reasonably administer.
· Administer, report, and assess your vaccine needs .
· Order again, as needed! 

Vaccine Configurations to be Phased Out this Week!

Pfizer 450 for ages 12+

  • 450-pack Pfizer configuration comes to an end this week.
  • Any site ordering more than one 450-pack this week should order an 1170 pack instead.
  • We anticipate new smaller package configurations will be available in October. Stay tuned for more details!

Returning and Ongoing Vaccine Configurations 

Pfizer 1170 returning August 18th

  • Pfizer 1170-pack will be re-introduced on Aug 18th.
  • Ancillary kits: 
  • Ancillary kits for this packaging are configured with 80% 1” needles that may be used for pediatric patients.
  • Some of the needles in the adult kit are 1.5” long and should not be used to vaccinate pediatric patients (see Vaccine Administration: Needle Gauge and Length (cdc.gov)). 
  • Providers may need to acquire additional 1” needles to supplement the adult ancillary kit if needed.
  • Orders submitted with a pediatric order intention will error out.
 

Moderna 100 – Temporary Only returning for a limited time only August 19th at 12pm Eastern

  • Limited supply of 4.5 million doses
  • Moderna 100-pack will be re-introduced on Aug 19th.
  • All due to expire in Nov/Dec 2021

Moderna 140 

  • Ages 18+ (awaiting EUA expansion for adolescents to activate PED ancillary)

J&J/Janssen 100 estimated return September

  • Maximum orders of 100 doses
  • 6-month shelf life

Note: Dry Ice Will Not be Provided for Pfizer Vaccine

Given the updated storage capability for Pfizer vaccine (2-8C for 30d) and based on the availability of dry ice locally for sites that need it, dry ice recharges will not be provided to support the 450 or 1170 packs:

  • If you intend to use the Pfizer thermal shipping container for temporary ULT storage, you must have a plan in place for replenishing the dry ice every five days.
  • Locations utilizing the shipping container for storage must activate the data monitoring system (via email from Controlant)

If you have any questions about ordering please contact us at vaccines@phila.gov. Thank you for helping keep Philadelphia safe and healthy!

Pediatric Flu Vaccine is Available to Order!

Pediatric Flu Vaccine is Available to Order!

A supply of FluLaval pre-filled syringes for your VFC patients is now available for ordering!

Please note, all flu vaccine from the 2020-2021 season must be accounted for before you can order flu for the 2021-2022 season. Guidance on accounting for remaining doses can be found at this notice here. And more information on how to Order VFC/VFAAR flu vaccine can be found at this notice here.

We will send out additional emails and update the flu page as more presentations of flu become available.

Have questions?
Contact Christine Wilson at 215.685.6728 or christine.wilson@phila.gov, or Charma Miller at 215.685.6667 or charma.miller@phila.gov for assistance.

Vaccine Information Statements and Code Updates

Vaccine Information Statements and Code Updates

VFC and VFAAR Providers,

Updated editions of some of the Vaccine Information Statements (VISs) have been posted on the CDC’s VIS website. The Philadelphia Department of Public Health (PDPH) encourages providers to begin using the updated VISs immediately, but previous editions may be used until they run out.

The table below lists the fourteen VIS documents that have been updated on the CDC website as of 8/6/2021.

For more information, please visit the CDC’s VIS website.

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

How to Order VFC/VFAAR Flu Vaccine 2021-22

How to Order VFC/VFAAR Flu Vaccine 2021-22

Please note, all flu vaccine from the 2020-2021 season must be accounted for before you can order flu for the 2021-2022 season. Guidance on accounting for remaining doses can be found here.

To place your first flu order…

1.  Complete a reconciliation. (If it’s been less than 2 weeks since your last reconciliation, email Christine and Charma to skip this step)

2. Submit your temperature data since your last order.

3. On the Vaccine Order page check the “Will this be an influenza order?” box.

4. Order what your site needs for a 4 to 6-week period. Be sure that you have room in your fridge to store all the flu and other vaccine you order.

5. Check the status of your order 2 business days later in the PhilaVax IIS:

    • APPROVED: Your flu vaccine is on its way.
    • REJECTED: Click on view next to your order to review the notes from the VFC staff. Once all issues have been resolved, resubmit your order.

For additional flu orders, start with step 2.  Additional flu orders do not require a completed reconciliation if a reconciliation has been completed in the last 60 days. Flu vaccine can be ordered as often as needed. There is no minimum time between orders.

The Immunization Program will make every effort to fulfill your flu vaccine request. If flu product is available in limited quantity, your order may be reduced. If your order is reduced, a note will be added to the PhilaVax IIS comment box on the order page.

Flu vaccine may arrive separately from other vaccines even when ordered at the same time. The day you receive your flu order, log into PhilaVax IIS and electronically add the doses to your inventory. Contact us immediately if the temperature monitor indicates an out-of-range temperature when vaccines are delivered:

Updates

Check our Flu updates section, for updates throughout the flu season.

9/2/21– FluMist intranasal sprayers and Fluzone multidose vials are now available to order for your VFC patients.

9/2/21– A supply of FluLaval pre-filled syringes for your VFAAR patients is now available to order.

8/23/2021 – Pediatric Flu Vaccine is Available to Order! A supply of FluLaval pre-filled syringes is now available to order for your VFC patients. To allow as many sites as possible to access flu vaccine at this time, initial orders may be reduced.

7/26/2021 – These are the vaccines that will be available for the 2021-2022 flu season.

Have Questions?

Contact Christine Wilson at 215.685.6728 or christine.wilson@phila.gov, or  Charma Miller at 215.685.6667 or charma.miller@phila.gov  for assistance.

Thank you for keeping Philadelphia healthy by fighting flu! For more information about influenza in Philadelphia, visit our flu page.

Avoiding Administration Errors: Scheduling Errors

Avoiding Administration Errors: Scheduling Errors

Dear Immunization Provider,

The Immunization Program thanks you for your critical role of ensuring children in Philadelphia receive up-to-date immunizations prior to the school year!

To help you in your immunization efforts we have assembled some tips for avoiding one of the most common vaccine administration errors: scheduling errors!

What are Administration Errors?

Administration errors due to scheduling occur when vaccines are given too early – either before the appropriate minimum age or before the recommended interval for a particular vaccine.

Unfortunately, early doses are not valid. Minimum ages and dosing intervals have been studied for efficacy and safety. Administering vaccines out of this range may not generate an adequate immune response, leading to vulnerability to disease, side effects, or harm to the provider’s relationship with the patient/parent. It is in everyone’s best interest to avoid administration errors!

Exception: There is a 4-day grace period before the minimum interval or age, although this should not be used when scheduling visits. This does not apply to the 28-day interval between two live injectable vaccines (e.g. MMR, Varicella) or Flumist if not administered simultaneously, or intervals between the rabies vaccine.

Common Scheduling Errors

Here are some of the most common scheduling errors found when reviewing immunization histories and scheduling immunization appointments:

  • Administering the 1st dose of MMR, varicella, or hepatitis A vaccine before 12 months of age
  • Giving the 4th dose of DTap before age 12 months (or less than 6 months after the 3rd dose)
  • Not administering a dose of IPV after 4 years of age (at least 6 months after previous dose)
  • Finishing the hepatitis B series before 24 weeks of age
  • Administering any vaccine (except hepatitis B) before age 6 weeks
  • Giving the 2nd dose of MenACWY vaccine before age 16 years for a healthy adolescent
  • Inadequate spacing for the hepatitis A, hepatitis B, IPV and HPV series
  • Using the incorrect needle size
  • Injecting vaccine at the incorrect injection site
  • Confusing Tdap (Tetanus, Diphtheria, Pertussis) and DTap (Diphtheria, Tetanus, Pertussis) vaccines

Tips from the Immunization Program

Here is a list of tips to find past administration errors and avoid them going forward:

  • Keep an immunization schedule handy for clinical and office staff!
  • When scheduling well-child visits, ensure a child will have reached the appropriate age (e.g., will be at least 12 months on the date of their 1-year well-child visit).
  • Review the patient’s immunization record, by searching the PhilaVax IIS or by obtaining the patient’s vaccination records by contacting their previous healthcare provider.
  • Use the tools in PhilaVax to understand what is indicated for the patient.
    • A red exclamation mark means that a dose is not valid.
    • Click “Recommend” below a patient’s record to see when vaccines are recommended.

Did you know? You can update your PhilaVax settings so recommended vaccines display at the top of your screen when reviewing patient records. Follow the steps below and reference the screenshots to do it yourself!

  1. Click your username in the upper right-hand corner (see screenshot 1)
  2. Under “User Defaults,” click “Display Today’s Recommendations” (see screenshot 2)
  3. Click “Update” to save the change (see screenshot 2)
screenshot 1
screenshot 1
screenshot 2
screenshot 2

 

What do I do if an Administration Error Happens?

  • Check for guidance from the Advisory Committee for Immunization Practices (ACIP) and Centers for Disease Control and Prevention (CDC)
  • Make a report to the Vaccine Adverse Events Reporting System (VAERS)
    • Recommended if a dose administration error occurs (required for a COVID-19 vaccine under Emergency Use Authorization)
    • Required if an adverse event occurs

Have questions about vaccine scheduling or the PhilaVax software? The Philadelphia Immunization Program is here to help! You can email us at vaccines@phila.gov for assistance.

Resources & References