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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.

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.

Return All Unopened Seasonal 2020/21 VFC/VFAAR Influenza Vaccine

Return All Unopened Seasonal 2020/21 VFC/VFAAR Influenza Vaccine

All VFC/VFAAR influenza vaccine supplied by the Philadelphia Immunization Program during this past flu season has expired. Please account for unused VFC/VFAAR flu vaccine at your site using PhilaVax:

  • Process a return for the unopened vials online in the Vaccines Returns module. A job aid with step by step instructions can be found here.
  • Email DPHProviderHelp@phila.gov to account for open vials of flu vaccine.

Return your vaccine before August 15th

Please complete these steps by August 15, 2021 to avoid delays in processing your site’s 2021-22 flu season orders. If you have questions, contact DPHProviderHelp@phila.gov.

Vaccine available for the 2021-22 flu season:

Don’t delay, return your expired vaccine now!

It is difficult to anticipate exactly when flu vaccine will be available. However, the health department is committed to getting flu vaccine to our providers as soon as it arrives. To prevent delays, please complete your flu return today.

All communication about the availability of flu vaccine will be made via email and posted on our website. Keep an eye out for upcoming messages! If you need to add more people to our mailing list, please contact us at vaccines@phila.gov.

Thank you for helping to protect Philadelphians this past year! We look forward to working together to keep people safe from the flu next season.

MenQuadfi (MenACYW-TT), a New Meningococcal Vaccine, is Now Available for VFC

MenQuadfi (MenACYW-TT), a New Meningococcal Vaccine, is Now Available for VFC

To download a PDF version of this PDF, click here!

In 2020, the Food and Drug Administration licensed an additional meningococcal serogroups A, C, W, and Y (MenACWY) – MenQuadfi
(MenACYW-TT), from Sanofi Pasteur Inc.

MenQuadfi is now available for providers enrolled in the Vaccines for Children (VFC) program. This advisory includes an overview
of important information about MenQuadfi.

MenQuadfi is licensed for use in individuals 2 years and older in the United States.

Recommendations For Use

Eligible Groups for Receipt of VFC Supplies of MenQuadfi

VFC supplies of MenQuadfi may be given to VFC-eligible children aged 2 years through 18 years.

Licensed Dosing Schedule

MenQuadfi is for intramuscular use only.

MenQuadfi is approved for routine vaccination of children and teens, age 11 through 18 years: a single dose at age 11 or 12 years with a booster dose at age 16 years.

MenQuadfi may also be used for children at increased risk who are age 2 years and older (the primary dosing schedule and booster dose interval varies by age and indication):

  • People with functional or anatomic asplenia
  • People who have persistent complement component deficiency (an immune system disorder) or who take a complement inhibitor (eculizumab [Soliris] or ravulizumab [Ultomiris])
  • People who have HIV infection
  • People who are at risk during an outbreak caused by a vaccine serogroup
  • People age 2 months and older who reside in or travel to certain countries in sub-Saharan Africa as well as to other countries for which meningococcal vaccine is recommended (e.g., travel to Mecca, Saudi Arabia, for the annual Hajj)
  • Microbiologists who work with meningococcus bacterial isolates in a laboratory
  • First-year college students living in residence halls who are unvaccinated or undervaccinated; these students should receive a dose if they have not had a dose since turning 16 or if it has been more than 5 years since their previous dose

These recommendations are summarized in Table 3 of the recommendations published by ACIP in MMWR in 2020: www.cdc.gov/mmwr/volumes/69/rr/pdfs/rr6909a1-H.pdf.

The Advisory Committee on Immunization Practices (ACIP) recommends that whenever feasible, the same manufacturer’s brand should be used to complete the series. However, if the previous brand is unavailable or unknown, any brand may be used to complete the series. Do not defer immunization solely to wait for a specific meningococcal vaccine brand to be available. From age 2 years and up the MenACWY vaccines are interchangeable.

Storage

  • MenQuadfi should be stored at 2º to 8ºC (36º to 46ºF). Do not freeze. Product which has been exposed to freezing should not be used. Do not use after the expiration date shown on the label.

How MenQuadfi is supplied

  • MenQuadfi is supplied in a single-dose vial in packages of 5 vials (NDC No. 49281-0590-05). The dosage for MenQuadfi is 0.5 mL. MenQuadfi does not contain a preservative. The vial stopper for this product is not made with natural latex rubber.

Ordering and Billing

MenQuadfi is available for ordering through the PhilaVax IIS as of today, June 8, 2021. Please contact Christine Wilson (Christine.Wilson@phila.gov) or Charma Miller (Charma.Miller@phila.gov) to add MenQuadfi to your next order. Please note, your practice must choose a single product to order for each antigen. We recommend that sites that are part of a system, or are affiliated, use the same vaccine presentations across sites to ensure continuity of care and help prevent administration errors.

  • CVX code: 203
  • CPT code: 90619

Resources

Vaxelis (DTaP-IPV-Hib-HepB), a Hexavalent Vaccine, is Now Available for VFC

Vaxelis (DTaP-IPV-Hib-HepB), a Hexavalent Vaccine, is Now Available for VFC

To download a PDF version of this notice, click here!

Vaxelis is now available for providers enrolled in the Vaccines for Children (VFC) program. This advisory includes an overview of important information about Vaxelis.

Vaxelis is a hexavalent combined diphtheria and tetanus toxoids and acellular pertussis (DTaP) adsorbed, inactivated poliovirus (IPV), Haemophilus influenzae type b (Hib, PRP-OMP), and hepatitis B (HepB) (recombinant) vaccine. In 2018, FDA licensed Vaxelis for use in children age 6 weeks through 4 years: it is indicated as a 3-dose series for infants at ages 2, 4, and 6 months. ACIP voted to add Vaxelis to the Vaccines for Children (VFC) Program in 2019. Vaxelis became commercially available in the United States in 2021.

Recommendations For Use

Eligible Groups for Receipt of VFC Supplies of Vaxelis

VFC supplies of Vaxelis may be given to VFC-eligible children from 6 weeks through 4 years of age (prior to the 5th birthday).

Licensed Dosing Schedule

Vaxelis is indicated for active immunization to prevent diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and invasive disease due to Haemophilus influenzae type b. Vaxelis is approved for use as a 3-dose series in children from 6 weeks through 4 years of age (prior to the 5th birthday). Vaxelis is indicated for use in infants at ages 2, 4, and 6 months.

Recommended minimum ages for administration of Vaxelis (DTaP-IPV-Hib-HepB) vaccine and intervals between doses — United States, 2020*

Age/Interval
Minimum age for any dose 6 weeks
Minimum interval between doses 1 and 2 4 weeks
Minimum age for dose 2 10 weeks
Minimum interval between doses 2 and 3 4 weeks
Minimum age for dose 3 24 weeks†
Maximum age for any dose 4 years, 364 days (do not administer on or after the fifth birthday)

† If the third dose of DTaP-IPV-Hib-HepB is given before age 24 weeks, an additional dose of hepatitis B vaccine should be given at
age ≥24 weeks to complete the hepatitis B series.

*DTaP-IPV-Hib-HepB can be used for children aged <5 years requiring a catch-up schedule. However, vaccine doses should not be
administered at intervals less than the minimum intervals indicated in this table.

For guidance on transitioning to Vaxelis and how it fits into the immunization schedule, visit: https://www.vaxelistransition.com.

The Advisory Committee on Immunization Practices (ACIP) recommends that whenever feasible, the same manufacturer’s brand should be used to complete the series. However, if the previous brand is unavailable or unknown, any brand may be used to complete the series. Do not defer immunization solely to wait for a specific brand to be available.

Storage

Vaxelis should be stored at 2º to 8ºC (36º to 46ºF). Do not freeze. Product which has been exposed to freezing should not be used. Do not use after the expiration date shown on the label.

How Vaxelis is supplied

Vaxelis is supplied in a single-dose vial in packages of 10 vials (NDC no. 49281-0590-05). The dosage for Vaxelis is 0.5 mL. Vaxelis does not contain a preservative. The vial stopper, syringe plunger stopper, and syringe tip cap are not made with natural rubber latex.

Administration

Just before use, shake the vial or syringe until a uniform, white, cloudy suspension results.

Inspect the vial or syringe for particulate matter and discoloration prior to administration. If either of these conditions exist, the product should not be administered.

Administer a single 0.5 mL dose of Vaxelis intramuscularly. In infants younger than 1 year, the anterolateral aspect of the thigh is the preferred site of injection. The vaccine should not be injected into the gluteal area.

Vaxelis should not be combined through reconstitution or mixed with any other vaccine. Discard unused portion. Vaxelis is for intramuscular use only.

Precautions and Contraindications

Do not administer Vaxelis to anyone with a history of severe allergic reaction to a previous dose of Vaxelis, any ingredient of Vaxelis, or any other diphtheria toxoid, tetanus toxoid, pertussis containing vaccine, inactivated poliovirus vaccine, hepatitis B vaccine, or Hib vaccine.

Do not administer Vaxelis to anyone with a history of encephalopathy within 7 days of a pertussis containing vaccine with no other identifiable cause.

Do not administer Vaxelis to anyone with a history of progressive neurologic disorder until a treatment regimen has been established and the condition has stabilized.

Ordering and Billing

Vaxelis is available for ordering through the PhilaVax IIS as of today, June 8, 2021. Please contact Jillian Brown (Jillian.Brown@phila.gov) to begin the process of transitioning to Vaxelis at your site. Please note, your practice must choose a single type of combination vaccine to use as part of the primary series. We recommend that sites that are part of a system or are affiliated use the same vaccine presentations across sites to ensure continuity of care and help prevent administration errors.

  • CVX code: 146
  • CPT code: 90697

Resources

Vaccine Information Statements (VIS):

CDC Morbidity and Mortality Weekly Report (MMWR): https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6905a5-H.pdf.

For guidance on transitioning to Vaxelis and how it fits into the immunization schedule, visit: https://www.vaxelistransition.com.

Product insert for Vaxelis includes additional vaccine information, found at: https://www.merck.com/product/usa/pi_circulars/v/vaxelis/vaxelis_pi.pdf.

Additional information on vaccines and vaccine preventable diseases can be found at: http://www.cdc.gov/vaccines/

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.