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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

Get Back on Track with Routine Vaccinations

Get Back on Track with Routine Vaccinations

August is National Immunization Awareness Month (NIAM)! This annual observance highlights the efforts of immunization providers who protect patients of all ages against vaccine-preventable diseases through on-time vaccination.

During NIAM, encourage your patients to schedule appointments to ensure they are up to date on annual exams and recommended vaccines. Research has consistently shown that healthcare professionals are the most trusted source of vaccine information for parents and patients.

With children going back to school and adults going back to the workplace, it is now more important than ever for everyone to get back on track with routine vaccinations.

Use the resources below to help encourage routinely recommended vaccines for a variety of audiences.

General Resources:

COVID-19 Vaccination Specific Resources:

For additional National Immunization Awareness Month resources, and more information about NIAM, please visit the CDC NIAM page.

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

Moderna 10-Dose Vials Discontinued

Moderna 10-Dose Vials Discontinued

COVID-19 Vaccine Providers,

Effective Wednesday, July 28 at 4pm ET you will no longer be able to order vials of Moderna 10-dose. All supplies in the warehouses have been depleted and no additional Moderna 10 vials will be manufactured.

PhilaVax ordering for Moderna 10 will be turned off and only Moderna 14-dose vials will be available moving forward.

Any orders placed and approved this week by Wednesday at 5pm will be for the Moderna 14-dose vials. Orders were converted from the 10-dose packaging to the 14-dose packaging as a result of the discontinuation. Ancillary kits should also reflect the 14-dose vials.

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

J&J/Janssen COVID-19 Vaccine Expiration Extension

J&J/Janssen COVID-19 Vaccine Expiration Extension

Dear COVID-19 Providers,

On July 29th, the Food & Drug Administration authorized an extension of the shelf life for Johnson & Johnson’s Janssen COVID-19 vaccine from 4.5 months to 6 months (an additional 45 days).

Click here to read the extension authorization!

The decision is based on data from ongoing stability assessment studies, which have demonstrated that the vaccine is stable at 6 months when refrigerated at temperatures of 36 – 46 degrees Fahrenheit (2 – 8 degrees Celsius).

Providers should visit https://vaxcheck.jnj/ to confirm the latest expiration dates of vaccine, including those currently available for administration throughout the U.S. This extension applies to refrigerated vials of J&J/Janssen COVID-19 vaccine that have been held in accordance with the manufacturer’s storage conditions.

COVID-19 vaccines that are authorized under an EUA do not have fixed expiration dates, and their expiration dates can be extended as we get more stability data. Always be sure to check the manufacturer’s website to obtain the most up-to-date expiration dates for COVID-19 vaccines you have on hand.

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

Reminder: Check the Expiration Date on Your COVID-19 Vaccine!

Reminder: Check the Expiration Date on Your COVID-19 Vaccine!

COVID-19 Vaccine Providers, please make sure you are checking the expiration dates of your COVID-19 Vaccine and using vials with sooner expiration dates first.

If you are approaching vaccine Beyond Use Dates or Expiration Dates, please try to utilize these doses at your site. You can also reach out to us if you are interested in returning vaccine prior to its expiration. We may be able to arrange pickup depending on the amount and expiration date.

We can work together to ensure that wastage is avoided when possible and that we are efficiently utilizing vaccine supply at provider sites.

Here’s how to find the expiration date of the different COVID-19 Vaccine Brands:

Pfizer: Vials stored in an utlracold storage unit can be used until the last day of the month printed on the tray and each vial.

  • Sites are able to order a partial trays/smaller allocations of Pfizer using this form.
  • Orders are due by Wednesday at 5pm along with a reconciliation and a temperature log.
  • Pfizer deliveries from PDPH will arrive frozen on Tuesday or Wednesday.
    • The frozen vaccine can be placed in a standard freezer for two weeks and will have a two week BUD sticker on it. At the end of two weeks, the vaccines can be moved to the fridge for an additional 31 days. You will need to write a new BUD sticker (with the 31 day BUD) once the vaccine is moved to the fridge.

Moderna: The expiration date for doses stored in the freezer can be acquired on the Moderna website by entering the lot number that is printed on the box:

Janssen: The expiration date can be determined three ways:

  • Scan the QR code on the outer carton
  • Call 1-800-565-4008
  • Visit vaxcheck.jnj

We may also be able to transfer unopened vials of Pfizer and Moderna that have been moved to refrigerated temperatures and are nearing their beyond use date (BUD).

To inquire about transferring expiring doses, please email vaccines@phila.gov with “transfer” in the subject.