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Author: Viviana Sanchez-Gomez

Increase in Mpox Cases in Philadelphia

Increase in Mpox Cases in Philadelphia

There is an active mpox outbreak in the Philadelphia area. There were 5 confirmed cases between January and October 2023, and Philadelphia began seeing an increase in cases in November 2023. In recent weeks, 0–4 cases per week have been reported, with a total of 17 cases identified. Vaccination continues to be an important preventative measure as recent cases were unvaccinated.

Eligible individuals should receive mpox vaccination with the Jynneos vaccine. Vaccinating high-risk individuals will help prevent further community spread.   

Use the button below to order the Jynneos vaccine.  If you do not carry the Jynneos vaccine, please counsel and refer to either Health Center #1 or available Rite Aid pharmacies. Use the CDC’s mpox vaccine locator to find a Jynneos provider in your area.  


JYNNEOS Commercialization  

Bavarian Nordic (Jynneos manufacturer) intends to move the Jynneos vaccine (mpox) to a commercial market in the spring. In anticipation of this change, providers are encouraged to place vaccine orders to accommodate your patient population. Once the Jynneos vaccine is commercialized, please refer patients to Rite Aid pharmacies and FQHCs.

Clade I Variant

Clade I mpox virus, a highly transmissible variant causing more severe disease, is circulating in the Democratic Republic of Congo (DRC). To date, only Clade II has been detected in the U.S. since 2022. Similar to Clade II, Clade I can also be acquired through sexual contact. Clinicians should inquire about travel to the DRC in all patients with suspected mpox. Testing for suspected Clade I should be coordinated through PDPH. To report cases, please call (215) 685-6748. For immediate reporting and consultation after hours, on weekends, and on holidays, please call (215) 686-4514.

Resources

Protect Children Against Travel-Associated Infections 

Protect Children Against Travel-Associated Infections 

This blog post was written alongside Dr. Mayssa Abuali, who has served the Philadelphia pediatric community for the past 10 years

There are several measles outbreaks internationally and 58 measles cases have been reported across 17 jurisdictions the United States in 2024. 93% of US cases were linked to international travel. Most cases occurred among unvaccinated individuals.  

As the summer season and international travel near, pediatric healthcare providers should ensure children are current on routine immunizations, including MMR and other vaccines that protect against travel-associated infections. 

Prior to international travel, CDC recommends: 

  • Infants 6 months of age or older receive their first MMR vaccine at least two weeks prior to departure. 
  • Children aged 12 months and older should receive their second dose prior to travel, and at least 28 days after the first dose.
  • At this time, the CDC does not recommend early doses of MMR for domestic U.S. travel.

In addition to measles vaccination, providers should also offer:  

  • Early hepatitis A vaccine to infants of 6 months of age or older traveling to endemic areas
  • Early meningitis vaccine to travelers heading to Hajj pilgrimage in Mecca or to the meningitis belt in sub-saharan Africa. The available conjugate ACWY vaccines include:  
    • MenQuadfi is approved for use in individuals 2 years of age and older. 
    • Menveo is approved for use in individuals ages 2 months and older.  
  • Typhoid vaccine if traveling to an endemic area (i.e., Africa, Latin America, Asia). Typhoid vaccines are only available at travel clinics. There are two typhoid vaccines licensed in the U.S.:
    • Vi capsular polysaccharide vaccine (ViCPS) for intramuscular use approved for 2 years and older. 
    • Live attenuated vaccine (Vivotif) for oral use approved for 6 years and older.

Resources  

RSV Season Ends March 31

RSV Season Ends March 31

As the respiratory syncytial virus (RSV) season draws to a close on March 31, we want to remind all healthcare providers of important considerations regarding administering nirsevimab (Beyfortus) and RSV immunization. 

  • End of RSV season: The RSV season officially concludes on March 31. Therefore, it is essential to administer all remaining doses of nirsevimab to eligible children before April 1. 
  • Do not discard unused immunizations: If you possess surplus doses of nirsevimab at the end of this RSV season, do not discard them. The expiration date for Beyfortus has been extended to two years. These doses can be safely stored and utilized when the RSV season resumes on October 1.   

We recognize the challenges encountered during this RSV season and extend our gratitude to all healthcare providers for their patience, flexibility, and perseverance. According to the CDC’s latest data, 43% of newborns received RSV coverage this year despite the limited availability of Beyfortus.

If you have any questions or require further guidance, please contact Victor Obeck, VFC coordinator, at victor.obeck@phila.gov.

PhilaVax Closed to VFC Orders from 3/26 through 4/1

PhilaVax Closed to VFC Orders from 3/26 through 4/1

PhilaVax will be temporarily closed to new VFC orders from 12 p.m. on Tuesday, March 26, until 12 p.m. on Monday, April 1, while the vaccine prices are updated for 2024.

Any orders entered into PhilaVax IIS during this time will be deleted from the system and not processed.

If you need to place an order, submit it before 12 p.m. onTuesday, March 26. 

Normal order processing and shipping will resume at 12 p.m. on Monday, April 1.

Recommend HPV Vaccine at Every Visit! 

Recommend HPV Vaccine at Every Visit! 

The HPV vaccine is approved for ages 9 years through 45 years for all genders. The American Cancer Society and American Academy of Pediatrics (AAP) recommend vaccination at age 9. 

Early vaccination at age 9-10 years has several benefits, including more robust immune response and increased likelihood of completing the series.

March 4 is International HPV Awareness Day!

To help increase HPV vaccination rates back to pre-pandemic levels:

  • Recommend HPV vaccine at every visit for 9-26-year-olds who have not begun or completed their series. Data shows that your recommendation may improve vaccination rates by 5 times. 
  • For adults aged 26 years through 45 years, engage in shared decision making to help determine the benefits of vaccination.  
  • Vaccination recommendations should be made in all healthcare settings, including acute, non-acute, GYN, dental, and pharmacy locations. 

Steps to Recommend HPV Vaccine to Hesitant Parents

Use a Presumptive Announcement Approach

  • Your child is __ years old.
  • Today, they are eligible to receive Tdap, HPV, and MCV vaccine.
  • We will make sure they get all these shots to keep them safe and healthy.

If parent hesitates:

Connect and Counsel:

  • What’s your main concern?
  • Counsel using a research-tested method (ex.”Over 30,000 Americans get cancer from HPV every year. Most could be prevented with the HPV vaccine.”)

If parent declines:

Try Again

  • Almost 70% of parents who initially declined later agree to HPV vaccine or plan to vaccinate soon.

Clinical Guides

Physician assistants & nurse practitioners: Action Guide

Nurses & medical assistants: Action Guide

Print Resources

PDPH postcards and posters promoting pediatric and HPV vaccine.

Online Resources

New research reinforcing starting HPV vaccination at age 9.

If you have any questions, reach out to our team at vaccines@phila.gov.

Protect Your Patients from Flu, COVID-19, and RSV 

Protect Your Patients from Flu, COVID-19, and RSV 

There are currently high rates of respiratory illness nationwide, including flu, COVID-19, and RSV. Continue to recommend immunization to prevent severe illness and hospitalization. Below, review eligibility recommendations from the CDC and stay updated on flu products available to order through the Vaccines for Children (VFC) program.

Recommendations for Flu Immunization and Co-Administration  

CDC recommends: 

  • Everyone aged six months and older should get an annual influenza vaccination. 
  • If needed, influenza and other vaccines (e.g., COVID-19, RSV) may be given at the same visit. 
  • Infants six months and older may receive influenza and COVID-19 vaccines at the same visit when they receive the RSV preventive antibody, nirsevimab.  

Please ensure that children under nine years of age who have received only one dose of influenza vaccine across all previous seasons return for their second dose four weeks later (refer to figure).  

No longer available for ordering:  

  • FluMist (AstraZeneca / 66019-0310-10) 

Available to order for VFC-eligible patients 

  • Fluzone (Sanofi / 49281-0639-15) 
  • Flucelvax (Sequirus / 70461-0323-03) 
  • FluLaval (GSK / 19515-0814-52)  

VFC Products Available for the 2023-2024 Flu Season 

You can order flu vaccine anytime—no need to wait between orders or complete a reconciliation. 

As a reminder, educational and promotional print materials related to flu and COVID-19 immunization are available to order on our website

Additional Resources 

Mpox Vaccine: Presidents’ Day Reminder

Mpox Vaccine: Presidents’ Day Reminder

The City of Philadelphia is closed on Monday, February 19, 2024, in observance of Presidents’ Day. Be sure to submit your Mpox vaccine requests by Tuesday, February 20, at 5 p.m. to account for the holiday. Regular deliveries resume on Wednesday and Thursday of that week (week of February 19). 

Remember to submit your temperatures to tempcheck@phila.gov and complete a reconciliation of the vaccine on hand for your order to be approved.

If you have any questions, contact Marguerite Horton at marguerite.horton@phila.gov.

Click the button below to submit your order for the mpox vaccine.

Beyfortus (Nirsevimab) Supply and Borrowing Update

Beyfortus (Nirsevimab) Supply and Borrowing Update

The supply of nirsevimab allocated to the Vaccines For Children (VFC) program has been depleted. Therefore, no doses are available to order for the remainder of the 2023-2024 respiratory syncytial virus (RSV) season.

As we approach the end of the RSV season on March 31st, we urge all VFC sites to utilize any remaining doses of nirsevimab in stock. For those with nirsevimab doses on hand, we strongly recommend immunizing all eligible infants against RSV. Previous guidance to offer nirsevimab to all infants less than eight months of age and to high-risk infants 8-19 months of age should be followed. It is no longer necessary to prioritize or reserve doses.

To ensure that as many eligible infants as possible are immunized

  • Bidirectional borrowing of Beyfortus is permitted between now and March 31, 2024. 
  • VFC-provided doses can be administered to private and CHIP-insured patients. 
  • Private doses administered to VFC-eligible patients will be replaced. 
  • Doses borrowed during this time will be tracked for replacement in the fall. 
  • To borrow doses, reach out to Victor Obeck at victor.obeck@phila.gov. 
  • This supersedes previous messaging on borrowing.

Thank you for your continued efforts to ensure the timely and effective administration of vaccines. 

For further information or questions, reach out to Victor Obeck at victor.obeck@phila.gov.

Reminder for Bridge Access Providers

Reminder for Bridge Access Providers

Only adults 18 and over who are uninsured or underinsured are eligible to receive a COVID-19 vaccine under the Bridge Access Program (BAP). 

Screening an individual for eligibility before giving a BAP COVID-19 dose is a requirement outlined in the provider agreement.

  • Uninsured: an individual who does not have health insurance.
  • Underinsured: an individual with health insurance, but the insurance does not cover the total cost of a COVID-19 vaccine.
  • Any individual with health insurance that covers the total cost of a COVID-19 vaccine would be ineligible for a BAP dose. Many insurance plans will cover the cost of the COVID-19 vaccine, including Medicaid, Medicare, and some private health insurance plans.  

Notes:

  • Redistribution of the COVID-19 vaccine is not permitted under the BAP. Unauthorized redistribution of Bridge doses may result in a suspension or termination from the program.
  • If your practice has multiple locations, you will not be able to redistribute doses between the locations. 

Every site interested in being enrolled in the BAP must complete enrollment individually. Complete the Bridge Program Interest Form to begin the enrollment process.

Find the form using the button below:  

Join Us for a PCP Measles Update

Join Us for a PCP Measles Update

Join Division of Disease Control (DDC) infectious disease experts Dr. Shara Epstein and Dr. Mayssa Abuali for a virtual measles update for primary care providers (PCPs). In a recent advisory, we encouraged pediatric providers to catch up patients on their MMR vaccination.

This informative session is for PCPs who would like to learn more about recent measles cases from physicians working in outbreak response with the Department of Public Health. 

Meeting details: 

Date: Friday, January 12, 2024

Time: 11 a.m. – 12 p.m.