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Vermont Vaccine Program Updates
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Nirsevimab Administration
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Nirsevimab can be administered to infants starting October 1st. The Immunization Program is receiving an allocation of nirsevimab every two weeks. We will ask for you to order smaller amounts more frequently while we build our supply. The allocations we are expected to receive are more than double what we got last season. Between Abrysvo, the vaccine available to pregnant individuals, and Nirsevimab we will have enough supply to ensure every infant who is eligible will have access to an RSV prevention product.
We have worked on pre-placing 50mg doses at birthing facilities and have asked all enrolled birthing facilities to have a month’s supply available for October. There are three birthing hospitals who are not yet enrolled, and we would like Primary care offices in those areas to stock 50mg and 100mg nirsevimab. The three birthing hospitals are: North Country Hospital, Copley Hospital and Northeastern VT Regional Hospital.
Primary Care Providers can begin ordering 50mg doses in VIMS on Monday 9/30/2024 for young infants under 11 lbs. who were born before October 1. Please order thoughtfully as additional doses will become available every two weeks.
Here’s a quick reminder of who can receive it:
- Infants under 8 months (if their birth parent didn’t get the RSV vaccine):
- A weight-appropriate dose should be given within one week of birth, between October and March, ideally at a birthing facility to prevent missed opportunities.
- Healthy infants born in February or March 2024 who were administered a dose of nirsevimab as young infants are not eligible for a second dose of nirsevimab.
- For infants born outside of the seasonal administration window (April through September), the optimal timing for nirsevimab administration is shortly before the RSV season begins (e.g., October or November). The dosage administered will depend on the infant’s weight at time of administration.
- Children 8 to 19 months:
- A dose should be given before their second RSV season for those at severe risk, including:
- Premature babies with chronic lung disease
- Children with weakened immune systems
- Children with severe cystic fibrosis
- American Indian and Alaska Native children
Dosage:
- 50 mg for infants under 11 lbs. (5 kg)
- 100 mg for infants 11 lbs. or more (5 kg)
- High-risk young children receive 200 mgs, given as two separate 100 mg doses.
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The following are an excerpt of slides from the COVID-19, FLU, RSV: Be Ready for Respiratory Virus Season call on September 30th which answer some frequently asked questions about nirsevimab.
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Provider Update Call Recap
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Thank you to all who joined us on this call. If you couldn't make it or would like to review the materials, you can find the slides and recording on our website.
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Immunization Team Quarterly Provider Update Call
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Please join the Immunization Team for our quarterly Provider Update call. Among other topics we'll review ACIP's October meeting notes, discuss IMR updates, and answer your questions.
This call will be recorded and available on our website, along with the slides, shortly after the conclusion of the meeting. It will also be linked in the subsequent Provider Update.
If you didn't receive an invite via email, you can join the meeting here. We look forward to seeing you at noon on Wednesday, November 6!
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Flu & COVID-19 Vaccine Coding
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Here are updated CPT and CVX codes for 2024-2025 Flu & COVID-19 vaccines. Please make sure yor EHR has been updated accordingly.
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JYNNEOS to Become Available in VIMS
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JYNNEOS is approved by the U.S. Food and Drug Administration (FDA) for prevention of smallpox and mpox disease in adults 18 years and older at high risk for infection, and it is currently on the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) routine immunization schedule for certain individuals at risk for mpox.
All JYNNEOS that has been distributed by the Depot will expire on October 31st, 2024. We will open ordering for JYNNEOS in VIMS on Monday, October 23rd, and welcome practices to order in time to replace their current supply before expiration. As with most vaccine orders, we expect 4-7 business days between the date of order, and the delivery of the vaccines.
We have a small number of sites that have been regularly ordering JYNNEOS vaccine. If your practices sees eligible patients who are interested in being protected against MPOX please consider stocking the vaccine. If you don't have a freezer and only a small need, reach out to the local district office for assistance.
Storage and handling guidelines:
Store in the freezer until the expiration date. Once the item is transferred to the refrigerator, the BUD of 8 weeks begins.
Resources:
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Vaccination Rates of Vermont Adults with Disabilities
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Some individuals with a disability are more likely to get sick and have worse symptoms from diseases that could be prevented by vaccines. Medical conditions and social factors, like not having enough support, can make it harder for them to stay healthy, access care and get vaccines.
The Behavioral Risk Factor Surveillance System (BRFSS) Survey asks Vermonters questions about their health habits, including vaccination status. The survey also asks about disabilities. Survey data from 2020, 2021 and 2022 were used to see how many Vermont adults with a disability got vaccines for influenza, pneumococcal, tetanus, COVID-19 and shingles.
For many vaccines, people with and without disabilities have similar rates of vaccination. However, some groups did have significantly lower vaccination rates.
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Tips from the Ordering Team
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Diluent Notes:
For shipments containing diluent, ensure that you count the number of diluent doses as soon as the order is unboxed. Any missing diluent must be reported to the Program the day the shipment is received.
- Merck Frozen Vaccine Shipments – Diluent is in the lid compartment of the shipping box.
- Please note that diluent and vaccine may not have the same expiration dates.
- Diluent that has been disposed of in error cannot be replaced by the program and would have to be purchased by your office.
Vaccine Ordering Intent & Funding:
For our funding and supply management purposes, please ensure that you order vaccines specifically for the age group you plan to administer to.
Pediatric (PED) intent is for ages Birth through 18 years.
Adult (ADU) intent is for ages 19 through 64.
Please note that there may be instances where it is necessary to order the same product for both pediatric and adult administration. If you have any questions or need further clarification, feel free to reach out.
Miscellaneous Ordering:
Due to limited allocations, we kindly ask that practices order only the amount of COVID-19 and flu vaccine they plan to use within a 4-week period. We discourage stockpiling vaccines, as any temperature excursions or power outages could result in unnecessary wastage.
If you have any special clinics or additional appointments scheduled, please notify us in the Practice Comments section of your order. This will help us streamline our processes and avoid the need to reach out for confirmation.
Thank you for your understanding and cooperation!
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This section serves to highlight a specific CDC requirement of all VFC and/or VFA vaccine providers. If you have any questions about how to best comply with CDC requirements, reach out to your Regional Specialist or our main email inbox.
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Vaccine Storage and Handling for Offsite Clinics
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Here is some timely storage and handling guidance. You can find the entire document, including a checklist for before, during and after the clinic on our website.
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The following ACIP updates to recommendations this month are listed below:
There will be an ACIP meeting held on October 23-24. A draft agenda has been posted. We will featue voting results and updated recommendations at our Quarterly Provider Update Call on November 6 and in next month's edition of this newsletter.
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Important Correction of Drug Information: Fluzone
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Sanofi has sent an email to practices who are carrying Fluzone that has a label formatting error. Please note that there are no vaccine quality or patient safety or effectiveness concerns associated with the syringe labels. You can read more from Sanofi.
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Enhance Vaccination Experiences and Reduce Injection Anxiety
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In Clinical Resources: Improving the Vaccination Experience, Immunize.org provides print and video tools to create a positive vaccination experience and ease injection anxiety in children and adults. Links to additional resources from trusted partner organizations are also provided.
The web page links to all our printable clinical resources on addressing vaccination anxiety, two in-depth webinars, and six brief videos that run 4 minutes or less. The short videos are ideal to share with patient families on your website or social media. As with all Immunize.org resources, these are free to download, link, copy, and share.
The video topics include:
Related Link
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Join NDSU CIRE for a monthly webinar series to improve your vaccine knowledge and confidence in recommending immunizations. Webinars will be held over the noon hour multiple times each month. Content experts will address a new topic each month, such as vaccine safety, new recommendations, and communicating about vaccines.
Free continuing education credits will be available. Webinars will be recorded and available on CIRE’s YouTube page for credit until June 2025.
Everyone is welcome! Education is intended for healthcare providers, clinic staff, and local public health unit staff.
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Back to School Means Updating Childhood Vaccines
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In the August 23 issue of Clinical Advisor, there’s an article by Mary Beth Koslap-Petraco from Immunize.org called "Back to School Means Updating Childhood Vaccines." Here’s the first paragraph:
"As summer winds down, it’s time to get back into the school groove and make sure kids are set for a healthy year. One key thing to check is their vaccination status. Since the COVID-19 pandemic, fewer kids are getting their required vaccines, and the drop is even more noticeable among those eligible for the Vaccines for Children (VFC) program. This program offers free vaccines to uninsured kids or those on Medicaid, and in some places, it even covers kids whose insurance doesn’t. Now’s a good time to review what vaccines are needed to keep students healthy and prevent infections"
Want to read the rest of the article?
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Who Needs to Get Immunized? Your Clinic Staff!
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As you prepare to vaccinate patients for the 2024 - 2025 respiratory disease season, ensure your team is also protected against flu, COVID-19 and RSV (for those who are eligible).
As you gear up to vaccinate patients for the 2024-2025 respiratory season, make sure your team is also covered against the flu, COVID-19, and RSV (if they’re eligible).
Getting vaccinated is not just about your own protection; it’s also a way to show your patients that you believe in and value immunizations. After getting your shots, you can confidently say:
“I got vaccinated against the flu and COVID-19 to protect myself from serious complications like pneumonia and hospitalization. I also want you to stay safe, so let’s make sure you get your vaccines before you leave today.”
Encourage Your Staff to Get Vaccinated Many practices either require or offer flu shots for their staff. If that’s not an option at your place, here are some ideas to support their vaccination:
- Build Confidence: Share reliable information and let staff ask questions. Provide stickers like “I got my flu shot” and “I got my COVID vaccine” to boost morale.
- Find a Flu Shot: Share the flu vaccine finder link so staff can locate nearby vaccination sites: vaccinefinder.org
- Offer Vouchers: Provide vouchers for free or low-cost vaccines at local pharmacies.
- Give Time Off: Allow staff some time off to get vaccinated.
- Create Incentives: Set up fun prizes, like a pizza party, for the team that gets fully vaccinated first.
Recommended Resources
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Ask the Experts: Immunize.org Answers Questions about Vaccination against Respiratory Viruses for Fall and Winter 2024
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Here are 13 Q&As based on the fall 2024 updates to CDC clinical guidance and ACIP recommendations for vaccination against influenza, COVID-19, and RSV.
You can find all of these questions and answers, plus more than 1,300 others about vaccines and vaccine administration, on our "Ask the Experts" main page at www.immunize.org/ask-experts.
Immunize.org's team of experts includes Kelly L. Moore, MD, MPH (team lead); Carolyn B. Bridges, MD, FACP; Iyabode Beysolow, MD, MPH; and Jane R. Zucker, MD, MPH.
Influenza
COVID-19
RSV
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