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      COVID-19 Vaccine Program Update

Health Department - Immunization Program                  April 09, 2021

Vermont Vaccination Data

The Vermont Forward Plan ties reopening to specific vaccine milestones in the state.
As of April 8, over a 43% of Vermonters have received at least one dose of COVID-19 vaccine.  This includes approximately 90% of those 70 years old and older.
Vermont is currently #1 nationally in vaccinating those 65+, #4 in total doses administered, and #8 in percent of population fully vaccinated. For more information please refer to the COVID-19 Vaccine Dashboard.

Current State of COVID-19 Vaccine in Vermont

COVID-19 Vaccine Currently Allocated to:

  • Community Clinics 
    • Hospitals, Health Department PODS, the National Guard 
  • Homebound Populations
    • Home Health and Hospice, EMS
  • Federally Qualified Health Centers (federal allocation and/or and state enrolled)
    • NOTCH
    • Little Rivers Health Care
    • Northern Counties
    • CHCB– Champlain Islands 
    • Rockingham Family Health – Springfield 
    • The Health Center – Plainfield 
    • Mountain Health Center
  • Pharmacies (federal and state enrolled)
  • Serving Licensed Long-Term Care
    • Health Direct, Genoa
Additional community partners throughout the state are receiving COVID-19 vaccine for targeted clinics aimed at reaching populations at higher risk. 

COVID-19 Vaccines Available

All three COVID-19 vaccines are available across Vermont.

Advising Patients on How to Get Vaccinated

Vermont has a plan to make COVID-19 vaccine appointments available to everyone 16 years and older by April 19, 2021. Patients should be encouraged to get the vaccine when they are eligible

For up to date information on priority populations and eligibility, see About COVID-19 Vaccines in Vermont or sign up for the Weekly COVID-19 Update

If a patient is eligible based on age

  • Those living in Vermont that are age eligible can register for vaccine appointments through the Health Department website: 
  • Answers to the most common registration questions are in the Registration and Appointments FAQ.
  • A patient may come to their primary care provider about questions in the CDC’s Pre-vaccination Checklist for COVID-19 Vaccines.
  • New clinics are being added regularly, and there are enough reservations for everyone eligible. Second dose scheduling will occur at the first dose appointment.

If a patient identifies or lives with someone who identifies as Black, Indigenous, or Person of Color (BIPOC)

All Vermonters age 16 years and older who identify as Black, Indigenous and person of color, including anyone with Abenaki or other First Nations heritage – as well as their household members - can make an appointment for vaccination through the state system, pharmacy, or a BIPOC-focused community clinic. 

Registering on the state system:
  • Patients can use the same online registration system or phone number (855-722-7878) and state they identify as BIPOC or live with someone who identifies as BIPOC. 
  • Note: If newly eligible to get a vaccine for a reason other than your age, patients may need to answer a few new eligibility questions before making an appointment.
    • Log in to your account and click on the "Dependent/Spouse" tab.
    • Click on "UPDATE DETAILS" for the person who needs an appointment, check the consent box and update your information.
More information is available through the Health Department website on the BIPOC Household Focused Clinics and How Vermont is Working Towards Equity.

If a health care worker (HCW)

Those who are 1A eligible can make appointments at most Vermont pharmacies currently administering COVID-19 vaccine. To register for a community clinic call the Health Department's Vaccine Call Center 855-722-7878 to be screened for eligibility and make an appointment. 

Learn more by reviewing the Policy for COVID-19 Vaccination Eligibility for Phase 1A

If a specific vaccine is indicated

The state appointment system now shows which vaccine is available at an appointment. The vaccine brand name is next to the Event location.

Most pharmacy registration systems indicate which brand they will provide at the time of registration. 

When Janssen is Medically Indicated
It is medically indicated to receive the Janssen (J&J) vaccine when an individual has had a significant reaction to a first dose of mRNA vaccine or they have an allergic history that would indicate significant reaction to an mRNA vaccine.

A person who is unable to complete their Pfizer or Moderna COVID-19 vaccine series due to a contraindication may receive Janssen (J&J) as their second dose. If J&J is scheduled as a second dose it needs to be at least 28 days from their first COVID-19 vaccine. 

See the section labeled “interchangeability of COVID-19 vaccine products” in Interim Clinical Considerations for Use of COVID-19 Vaccines

If a patient is pregnant, trying to get pregnant, or nursing

Efficacy
American Journal of Obstetrics & Gynecology (AJOG): COVID-19 vaccine response in pregnant and lactating women: a cohort study

"This study provides the first data from a large cohort on maternal antibody generation in response to COVID-19 vaccination, compares vaccine-generated immunity to that from natural infection in pregnancy, and suggests vaccination of pregnant and lactating women can confer robust maternal and neonatal immunity."

Safety
Studies on vaccine safety are on-going. Current data does not show any increased risk and experts believe COVID-19 vaccines are unlikely to pose a specific risk to those who are pregnant, lactating, or trying to become pregnant. Please encourage pregnant patients who receive the COVID-19 vaccine from participating in the CDC's V-safe program.  This program gathers as much data as possible to help others make informed decisions. 
  • Pregnant people are at increased risk for severe illness from COVID-19, including illness that results in ICU admission, mechanical ventilation, and death compared with non-pregnant people of reproductive age. 
  • It is recommended that certain groups (e.g., health care personnel) be vaccinated, but getting vaccinated is a personal choice for people who are pregnant.  Those 16+ who are pregnant are currently eligible to receive vaccines at any Vermont clinic or pharmacy.
  • Routine testing for pregnancy before COVID-19 vaccination is not recommended. 
  • For more information on the considerations pregnant patients may discuss with their healthcare provider, please visit the CDC’s Vaccination Considerations for People who are Pregnant or Breastfeeding
The Heath Department has created a video resource to share with patients called “Sara Asks” that is available in many languages.

If a vaccinated patient lost the federally issued card proving vaccination

If a patient asks you for a record of their COVID-19 vaccination, you may access this information on the Vermont Immunization Registry (IMR) through the Vaccine Administration Record Report for COVID-19 Vaccine report. 

A patient may also request this information from the IMR by contacting them directly at vaxrecordrequest@vermont.gov or call 888-688-4667, option 3.

They can get a copy of your record as an encrypted email or through the mail. On weekdays, they may expect an email within an hour or two. Mail will take about one week. 

A patient may also request this information from the IMR by contacting them directly at IMR@vermont.gov or 888-688-4667. Instructions are available for individuals Requesting Vaccination Records from the IMR.

Please do not advise the patient to return to where they received their immunizations.

If your patient is a resident of another state

Out-of-state residents may be vaccinated:
  • They are a patient-facing health care worker in Vermont.
  • They work directly with students or staff in a school building or licensed child care center in Vermont.
  • They are employees of state, local, and county emergency response organizations (fire, emergency medical service, police) or work in a facility that houses inmates operated by the Department of Corrections.
  • Anyone who has moved to Vermont within the last six months, with the intention of becoming a resident and who is in an age group, occupation or another group that is currently eligible. This includes college students who intend to stay in Vermont this summer. 

Out-of-state residents who may NOT be vaccinated:

  • College students who are residents of another state, and who do not intend to stay in Vermont for the summer.
  • Residents of other states with primary care providers in Vermont. Primary care providers do not currently have vaccine. These out-of-state residents should be vaccinated in their home states.

The State expects to expand registration for COVID-19 vaccines to any college students who do not meet the residency definition above, as well as second homeowners returning to Vermont for the summer months, on April 30.

Supplying COVID-19 Vaccine to Primary Care Providers

Prioritization of Mass Vaccination Events

Prioritizing mass vaccination events has been crucial to ensuring Vermonters are immunized as quickly as possible.  A centralized registration system exists, allowing Vermonters to sign up for vaccinations across the state.  All those administering COVID-19 vaccines in Vermont, except a few retail pharmacy chains, use the centralized registration system. In the first week of April, an average of over 7,000 vaccines were administered daily in Vermont. This includes first and second doses.

Allocation Uncertainty

The CDC provides Vermont with a varying weekly allocation, and the goal is to use the total allocation each week.  Every week, vaccine distribution is re-evaluated and used to inform the state registration system's available clinic schedule.  Sometimes we get more than we are expecting, but other times we may get less.  The current system is flexible enough to allow for these changes and works towards never letting the vaccine sit idle. 

Storage and Shipment Limitations

Pfizer-BioNTech – 1170 doses/shipment, 6 doses/vial
Moderna – 100 doses/shipment, 10 doses/vial
Janssen (J&J) – 100 doses/shipment, 5 doses/vial

The Pfizer, Moderna, and Janssen vaccines have sensitive temperature requirements, and all vaccines must be used within 6 hours of puncture/dilution. Smaller volumes are occasionally transferred from a centralized location, but this process is labor-intensive and minimized where possible. 

What Offices Can Expect

While exciting data (Pfizer, Moderna, Janssen) is coming out on the safety and efficacy of COVID-19 vaccines on pediatric aged patients, we do not have a timeframe for when vaccination will be permitted for any ages under 16 years old. Currently, Pfizer is the only vaccine authorized for use in those 16 and 17 years old.
 
We anticipate that Primary Care Offices can expect to see the option to carry COVID-19 vaccine for use in their patient population by the end of Summer, 2021. By this time, there will be less focus on mass vaccination events, centralized registration, and the goal of using every dose every week. We anticipate that Pfizer shipment sizes will be reduced, and updated manufacture data or new vaccine presentations may increase the vaccine shelf life and make management less challenging. 

The Immunization Program will work with your Primary Care Offices through this process and support you in managing this new vaccine. In the coming weeks, the Immunization Program will schedule an "All Provider Call." to be held by the end of May. During this session, our program will present information on providing COVID-19 vaccine to all enrolled PCP offices who want it and be available to answer questions. 

 

We thank you for all you have done to support Vermonters in this effort. 

Impact of COVID-19 on Childhood Immunization Rates in Vermont

The COVID-19 pandemic has hampered global efforts to protect children against vaccine preventable diseases like measles, pertussis, and hepatitis, and the impact can also be seen in Vermont. Review the recent Data Brief: COVID-19 Impact: Fewer Doses of Routine Childhood Vaccines for a look at the change in immunizations reported among young Vermonters birth - 17 years old from 2019 to 2020, the time-period most likely impacted by COVID-19. 

Infants and Toddlers (0-36 months)

Key immunizations in this age group: Diphtheria, Tetanus, and Pertussis (DTaP), Polio (IPV), Hepatitis B (HepB), Haemophilus Influenza Type B (Hib), Measles, Mumps, and Rubella (MMR), Varicella, Pneumococcal conjugate, Hepatitis A (HepA), Rotavirus, and Influenza.
In 2019, Vermont providers reported 116,184 immunizations to children ages 3 and under. In 2020, providers reported 109,630 immunizations in this age group, a decrease of 5.6%.
Data Source: Vermont immunization Registry.  Data are as of February 10, 2021.

Training Opportunities

Clinical Outreach and Communication Activity (COCA) Webinars

Janssen – Manufacturer Webinar Series

Manufacturer Educational Webinar Series: https://www.janssencovid19vaccine.com/hcp/webinars.html

Janssen will offer a regular educational webinar. There will be one session a day for 8 weeks, starting on March 8: The webinar is approximately 30 minutes in length.

CDC – COVID-19 Vaccine Training Modules

Additional Resources


Vermont Department Of Health


Health Care Professionals

Health Department Vaccine Information for Health Care Professionals
Find more resources about:
  • Available Vaccines 
  • Vaccine Distribution in Vermont
  • Vaccine Safety and Reporting Adverse Reactions
  • Enrolling in the Vaccine Program
  • Storage and Handling
  • Inventory Management
  • FAQ (updated 3/11)

Vermont Immunization Registry

The Vermont Immunization Registry (IMR) has developed many tools to assist practices. For more information, access, and additional tools, visit the IMR website

Centers for Disease Control (CDC)


Talk with Your Patients About the COVID-19 Vaccine

Interim Clinical Considerations

COVID-19 Vaccine Product Information

Find a suite of information and materials needed for each specific COVID-19 vaccine covering administration, storage and handling, safety, and reporting.

Other Resources


Report Adverse Events in VAERS

Your patients may come to you to report a vaccine reaction after receiving the COVID-19 vaccine elsewhere. Safety is the first priority when it comes to vaccines. Please report all vaccine adverse reactions to the Vaccine Adverse Event Reporting System (VAERS) in the timeliest fashion possible. Anyone can submit a report to VAERS, including patients or guardians. All VAERS reports can be submitted by visiting https://vaers.hhs.gov/.

Reach out to the Immunization Program at AHS.VDHImmunizationProgram@vermont.gov with any questions.

ASTHO Vaccine Comparison

Association of State and Territorial Health Officials (ASTHO) has developed a consolidation of the current COVID-19 vaccines and compared their:
  • Target population
  • Efficacy
  • Administration
  • Side effects
  • Pregnant/lactating individuals
  • Storage requirements
 COVID-19 Vaccine Comparison: Issue Brief (March)

AIM COVID-19 Vaccine Candidates (03/17/2021)

Association of Immunization Managers (AIM) COVID-19 Vaccine Candidate Information
  • Vaccine Technology Type
  • Storage Requirements
  • Doses
  • Handling and Administration
  • Efficacy
  • Timeline of Development
  • Government Contract
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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