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      Vermont Vaccine Program Update

Health Department - Immunization Program                  September 2021

 Booster Doses

Refer to the Pfizer-BioNTech COVID-19 Vaccine Booster Shot CDC website for information on booster doses.

Vermont is following the CDC guidance on eligibility, but specific definitions for eligibility based on occupation or medical condition may go beyond CDC guidance. Please refer to the Getting The COVID-19 Vaccine Webpage regularly for current information. 
Only specific populations initially vaccinated with the Pfizer-BioNTech vaccine can get a booster shot at this time. 
 
Booster shots have not been approved for people who received the Moderna or Janssen (J+J) vaccines.
 
Additional doses may be indicated for those who received Moderna as their primary series and are immunocompromised. 
As of September 25, all CDC COVID-19 Vaccination Program enrolled providers may administer a booster dose of Pfizer-BioNTech COVID-19 vaccine to any individual who has completed their primary series at least six months ago and qualify based on any of the following:
  • 65 years or older
  • 18 years or older and are residents in long term care settings
  • 18 years or older with underlying medical conditions as described in and in accordance with the CDCs recommendation.
  • 18 years or older with increased risk of getting COVID-19 disease due to occupational or institutional exposure, such as essential frontline workers and healthcare workers as described in and in accordance with the CDC’s recommendation.

Resources

Vermont's Response

Because of the expected demand, registration start dates for Health Department clinics were broken up by age groups. Starting on Friday, October 1, all those eligible based on the above will be able to register through the state portal for a Vermont-run clinic in your area. 

You and your eligible patients may also be able to make an appointment through a pharmacy (Costco, CVS, Hannaford, Kinney Drugs, Price Chopper/Market 32, Rite Aid, Shaws, Walgreens, Walmart) or your health care provider. 

Check back on the Getting a COVID-19 Vaccine webpage frequently for updates. 

COVID-19 Vaccine and Providers


Expiration Dates and Reporting


Through a weekly Wednesday reconciliation in VIMS, all providers must account for COVID-19 vaccine doses wasted, expired, administered, and in inventory. Determining when a vaccine or diluent expires or has reached its beyond use date is a critical step in proper storage and handling. Expired vaccines and diluents must be removed immediately from storage units to avoid inadvertently administering them. 

Expiration Date vs. Beyond Use Date/Time

  • Vaccine expiration dates are associated with a specific lot number and might be extended as new data is obtained. When a vaccine's expiration date is extended, this change is reflected in VIMS and communicated by the Immunization Program. Providers should update internal systems as appropriate to ensure accurate reporting.
  • When Pfizer and Moderna vaccines are moved out of permanent storage and into refrigerated temperatures, they have a Beyond Use Date that should be documented clearly. Janssen permanent storage is in the refrigerator, and so Beyond Use Dates do not apply. Tracking and adherence to a Beyond Use Date is the practice's responsibility and will not be reflected in VIMS.
  • All COVID-19 vaccines have Beyond Use Times associated with dilution/vial puncture, after which the vaccine must be disposed of. Document these wasted doses in VIMS as Adjust out -> Waste -> No Eligible Person

Pfizer

The FDA has approved extending the expiration dates of vaccine stored in ultra-cold from six to nine months.  While the expiration dates in VIMS have been updated to reflect this change, the expiration dates on the vials will be incorrect. Refer below to ensure accurate tracking and reporting of all expiration dates.

Janssen (J&J) + Moderna

Both the Janssen and Moderna have lot numbers in circulation that may be expired or expiring soon.  Do not dispose of any COVID-19 vaccine without verifying the expiration dates through the manufacture or CDC websites. Extensions are often issued, and the Immunization Program will communicate all extensions as soon as they are confirmed. 

EUA Fact Sheets


Starting October 15, the Vermont Vaccine Depot will no longer supply EUA Fact sheets as a part of the Ancillary supplies included in vaccine shipments.

The fact sheets are still required before each immunization and can be used in various forms:
  • Digital copy provided at the time of registration
  • Review on a device during the appointment
  • Laminated copies provided with paper available on request
  • Enlarged QR code located on the last page of all Recipient Fact Sheets for scanning by patient cell phone. 
Additional EUA information for each vaccine is provided below:

Pfizer:  EUA Fact Sheet for Vaccine Providers and Recipients. (Revised September 22, 2021). The FDA has issued new consolidated fact sheets that address the Pfizer-BioNTech (Comirnaty) use under licensed and EUA status.

Moderna:  EUA Fact Sheet for Vaccine Providers and Recipients (Revised August 27, 2021)

Janssen (J+J): EUA Fact Sheet for Vaccine Providers and Recipients (Revised August 27, 2021)

Ordering Updates - Janssen (J&J) now available


We are pleased to announce that Janssen (J&J) COVID-19 vaccine is available for ordering.
  • Please reserve J&J vaccine for hard-to-reach populations that may not return for a second dose.
  • For practices with the appropriate population, we encourage orders in multiples of 100 doses of J&J through the Distributor.
  • Orders of fewer than 100 doses will come through the Depot. 
Please follow the below guidelines when placing orders for multiple vaccine types. VIMS will not allow two separate Distributor and Depot orders. Orders may be changed to comply with the below. 
  • Sites should place a Distributor order for Pfizer in multiples of 1170, and/or J&J in multiples of 100. All Moderna orders should come from the Depot until further notice. 
  • Sites should place a Depot order for:
    • All Moderna orders
    • Pfizer orders of fewer than 1170 doses
    • J&J orders of fewer than 100 doses.   

2021 / 2022 Flu Season

Ask the Experts: IAC Answers Questions about Influenza Vaccination for the 2021–22 Season

Immunization Action Coalition (IAC) periodically publishes special editions such as this one, providing new and updated Ask the Experts questions and answers from IAC experts.

Influenza Vaccine Ordering


For complete information on placing your initial flu vaccine order, please refer to the August Vermont Vaccine Program Update – Flu Edition.

Review flu-only reconciliation and flu-only ordering resources on our website for information on placing orders in VIMS. 
 

Managing Multiple Types of Vaccine Orders

Some of you will submit routine vaccines, COVID-only, and flu-only reconciliations regularly. Due to the limitations of the VIMS system, it is essential to consider the timing of these reconciliations. Only one reconciliation can be open within the ordering system at one time, and no other activity is allowed. Plan to leave one full business day between the various reconciliations to avoid frustrations.
 

Types of Vaccines Available

  • There is a limited amount of FluMist available for the 2021/2022 season. 
  • A combination of vials and syringes are available, and you may receive any of the available brands. See the vaccine availability sheet for more information. 
  • Vermont will not supply high-dose or adjuvanted vaccines intended for older adults.  

Offsite Flu Clinics

Offsite flu clinics are encouraged to increase access in your community. Similar to last season, there will be some restrictions around the transport and management of vaccines. See Vaccine Storage and Handling for Offsite Clinics for more information. 

The Immunization Program has qualified vaccine carriers available to assist practices in conducting offsite clinics safely and confidently. See the Vaccine Carrier Borrowing Program Guide for more information. 

It is no longer necessary to notify the Immunization Program of any offsite clinic activity. Although when conducting an offsite clinic, it is the practice’s responsibility to:
  • Plan Ahead
  • Communicate Vaccine Need
  • Ask Questions
  • Report issues 
Contact AHS.VDHImmunizationProgram@vermont.gov with any questions. 
 

Coadministration of COVID-19 and Influenza Vaccines


Webinar September 9, 2021 - 2021-2022 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines

During this recorded COCA Call, presenters provide updates on the ACIP recommendations for the 2021-2022 influenza vaccination season and guidance for coadministration of influenza and COVID-19 vaccines. Refer to the CDC’s Interim Clinical Considerations for more information. 
 

Additional Resources

CDC Summary Documents

COVID-19 Vaccine Quick Reference Guide for Healthcare Professionals | CDC
Summary Document for Interim Clinical Considerations | CDC
COVID-19 Vaccine Administration Errors and Deviations | CDC

Interim Clinical Consideration

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States (CDC) 

Summary of recent changes as of September 27, 2021:
  • New section on Considerations for use of a Pfizer-BioNTech COVID-19 vaccine booster dose after completion of a Pfizer-BioNTech primary vaccine series
  • New section on considerations for use of mRNA COVID-19 vaccines in people with a history of myocarditis or pericarditis added to considerations for vaccination of people with certain underlying medical conditions.
  • New information on the occurrence of myocarditis or pericarditis following vaccination with mRNA COVID-19 vaccines added to patient counseling.
Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination (CDC)

Health Care Professional

Health Department Vaccine Information for Health Care Professionals
  • Available Vaccines 
  • Vaccine Distribution in Vermont
  • Vaccine Safety and Reporting Adverse Reactions
  • Enrolling in the Vaccine Program
  • Storage and Handling
  • Inventory Management

Quick References for Patients and Providers

Vaccine Recipient Education (CDC)

Quick references for COVID-19 vaccinators to give people who want more information. The information on this page will help you share clear and accurate information about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns about what to expect when getting vaccinated. This page includes:
Copyright © 2021 Vermont Department of Health, all rights reserved.
You received this email as a contact of the Vermont Immunization Program.

Vermont Department of Health
Immunization Program
108 Cherry Street, Suite 305
Burlington, VT 05401
1-800-640-4374
AHS.VDHImmunizationProgram@vermont.gov



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