COVID-19 Vaccine Providers Newsletter 04.15.2021

We are closely monitoring the actions by the federal government to pause all Johnson & Johnson vaccinations while it investigates an extremely rare possible side effect. In their April 14 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended that the pause of all Janssen/Johnson & Johnson vaccinations be continued until more information can be gathered. The committee will meet again in 7-10 days.

• In Virginia, we issued this statement that recommends ceasing all Janssen/Johnson & Johnson vaccines until this investigation is complete. You should have also received a message from Dr. Avula on April 13.
• If you have the ability to administer the Pfizer-BioNTech or Moderna COVID-19 vaccine, this is the preferred alternative.  Otherwise, individuals will need to be contacted to reschedule any upcoming appointments for the Janssen/Johnson & Johnson vaccine.
• This pause is reassuring in that it demonstrates that the systems that are in place to monitor vaccine safety are working. We look forward to a thorough review by federal health officials. In the meantime, we will continue Virginia’s vaccine rollout with the other two authorized vaccines developed by Pfizer and Moderna.
• If you are a COVID-19 Vaccination Provider with Janssen/Johnson & Johnson vaccine, please immediately implement the following CDC operational guidance until further notice:
  1. Mark any Janssen/Johnson & Johnson vaccine in your inventory “Do not use. Awaiting guidance.”
  2. Continue to store the vaccine in the refrigerator between 2°C and 8°C (36°F and 46°F).
  3. Follow vaccine storage practices and continue to monitor and document storage unit temperatures.

• The CDC Health Alert Network (HAN) issued a health alert on April 13, 2021, entitled “Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia after Receipt of the Johnson & Johnson COVID-19 Vaccine.” It summarizes known information about a rare type of blood clot in individuals after receiving the Johnson & Johnson COVID-19 vaccine and includes recommendations for clinicians, public health, and the public. You can sign up to receive the latest news from CDC’s HAN here.

Vaccination providers are required to enroll with the CDC and adhere to strict requirements for vaccine handling, storage, administration, and other requirements. If providers do not adhere to these requirements, it will impact their ability to receive future COVID-19 vaccine shipments.

• Providers are permitted to bill patient insurance for vaccine administration when it is available, and the federal government provides a fixed reimbursement fee for vaccinating uninsured patients. If your insurance claims are being rejected, please contact the insurance providers directly for more information.
• Providers are not permitted to charge patients directly for any amount, and VDH has repeatedly reminded the public that they will never be asked for money in connection with their vaccination. On its webpage regarding provider requirements, the CDC reminds providers that the “COVID-19 Vaccine is Provided at 100% No Cost to Recipients,” providers “must administer COVID-19 Vaccine at no out-of-pocket cost to the recipient,” and providers “may not charge an office visit or other fee if COVID-19 vaccination is the sole medical service provided.”
• Additional guidance from VDH can be found here, located on our COVID-19 website for Health Professionals.

Providers are responsible for properly maintaining COVID-19 vaccination medical records.

• Within 24 hours of administering a dose of COVID-19 vaccine, record the required information in the vaccine recipient’s record and report required information to VIIS (consider using an EMR that automatically sends this information to VIIS, like PrepMod).

As a reminder, Virginia will move to Phase 2 on Sunday, April 18. This means everyone aged 16 years and older who lives or works in Virginia will become eligible to get the COVID-19 vaccine. As a provider, you may direct individuals to vaccinate.virginia.gov where they can schedule a vaccine appointment. Individuals may also call 1-877-VAX-IN-VA (877-829-4682) to schedule an appointment.

The new Pfizer shippers are in circulation this week! These are AeroSafe soft boxes with a more colorful exterior and an aluminum frame inside. Both types of shippers will be used as we move ahead.

We have passed 100 days since the first orders of vaccine were shipped. This is a good time to check the dates on vials that may be reaching expiration. Determining when a vaccine or diluent expires is an essential step in the vaccination process. The expiration date should be checked before preparing and administering the vaccine.

1. Pfizer expiration dates are written on the vial
2. Moderna expiration dates can be checked by scanning a QR code on the vial  (open the camera app on your smartphone and direct it at the QR code)
3. Janssen/Johnson & Johnson expiration dates can be checked by scanning the QR code on the outer carton, calling 1-800-565-4008, or going to www.vaxcheck.jnj

Regularly checking dates on stored vials will help reduce waste. Follow a “first-in/first-out” practice for vaccine administration and store your vaccine inventory to ensure the older vials are used first.

• When the expiration date has only a month and year, the product may be used up to and including the last day of that month unless the vaccine was contaminated or compromised in some way.
• If a day is included with the month and year, the product may only be used through the end of that day unless the vaccine was contaminated or compromised in some way. 

Check out our complete list of COVID-19 Vaccination Clinic Best Practices here.

• April 15, 2 - 3 pm: CDC COCA Call | Johnson & Johnson/Janssen COVID-19 Vaccine and Cerebral Venous Sinus Thrombosis with Thrombocytopenia - Update for Clinicians on Early Detection and Treatment
• April 16, 10-11:30 am: University of Minnesota School of Public Health | Health Disparities Roundtable: Disparities in COVID-19 — Social Justice, Policy, and Ethical Considerations in Vaccinating the U.S. Population
• April 16, 12 pm: AMCHP | Earning Trust, Building Vaccine Confidence: Learning from Global and Local Initiatives
• April 16, 1:15 - 2:45 pm: APHA | Addressing COVID Vaccination Rates in Underserved Communities Data, Tools, and Supporting Information
• April 19, 3 pm: CDC | COVID-19 Partner Update: When to Clean, When to Disinfect, and What Science Says about SARS-CoV-2 on Surfaces
• April 20, 12 pm: PHCC | Case Study: Successful COVID-19 Messaging in Rural Communities
• April 28, 12 - 1 pm: VDH | Unsure about Getting a COVID-19 Vaccine? A Candid Conversation with an Expert
• Mondays, Wednesdays, and Fridays, 4 - 5 pm: VDH | Office Hours for Providers
• Tuesdays, Thursdays, 4 - 5 pm: VDH | Office Hours for Providers: VaxMaX Assistance

• Visit this CDC website for updates and resources regarding the recommendation to pause the Janssen/Johnson & Johnson vaccine, including guidance for those who have already received this vaccine.
• The Product Information Guide for COVID-19 Vaccines and Associated Products has been updated and can be found here on the VDH website. This guide has undergone a redesign but still retains the same information as the previous version. Minor additions include:
  1. Pfizer storage information—freezer storage option (page 8)
  2. Supplemental needle and syringe flyers and instructions (pages 24-29)
  3. View this 3-minute video demonstrating how VanishPoint retractable needle syringes work.

• For resources on COVID-19 vaccine training for healthcare professionals, visit CDC's Webpage for Training and Education for COVID-19 Vaccination and the training plan, skills checklists, best practices micro-courses, and more on the VDH website for Healthcare Professionals.
• Health Equity in Action - Provides COVID-19 health equity projects, data, and additional resources.
• View VDH’s micro-courses on handling vaccine safely for quick videos (less than 5 minutes each) and resources including handling dry ice, monitoring vaccine temperature, avoiding needlestick injury, and inventory and expiration dates.