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Mpox Vaccine: Holiday Instructions and Reminders

The City of Philadelphia is closed on February 20, 2023, in observance of President’s Day. Be sure to submit your mpox requests by Tuesday, February 21 to account for the holiday. Normal deliveries resume on Wednesday and Thursday of that week (week of February 20th).

As a reminder, be sure to accept all pending transfers in PhilaVax. If this is not completed, it affects the ability of your site to submit a correct, completed, and closed reconciliation and an order for more mpox vaccine.

Reach out to dphproviderhelp@phila.gov for questions about inventory and reconciliations.

VFC and VFAAR Shipping Delays

Our vaccine distribution center is currently working through an unanticipated backlog of VFC and VFAAR orders as a result of the winter storm that impacted both the FedEx and UPS main hubs as well as some of our vaccine distribution centers last week. Due to this please be aware that there are likely to be delays with some vaccine shipments this week. For your February order, add 1 to 2 weeks of additional vaccine, if you have space in your storage units. Please add a note to the comments section of the order indicating this intention.As a reminder, you can order routine vaccines every 25 days (from the last approved order). Use the ordering formula cheat sheet to calculate how much vaccine to order. Continue to order flu vaccine as needed.

We’re here to help! Reach out to us with any questions at DPHProviderHelp@phila.gov.

Current Recommendations for Hepatitis B Vaccination

Notes From the Immunization Program:
Current Recommendations for Hepatitis B Vaccination

The Advisory Committee on Immunization Practices (ACIP) has modified its recommendations for hepatitis B (HBV) vaccination. The ACIP now recommends that all adults aged 19-59 years and adults aged 60 and older with risk factors receive hepatitis B vaccines.

Ensure these groups are up to date on hepatitis B vaccination:

Infants
Children aged <19
Adults aged 19-59
Adults aged 60 and older with risk factors for hepatitis B
Risk factors include sexual exposures, people at risk by percutaneous or mucosal exposure, and others. A complete list can be found here.

Adults aged 60 and older without known risk factors may also be vaccinated.

Why hepatitis B and why now?

In 2019, the United States saw a rise in acute hepatitis B cases. Opioid use, which remains a growing public health concern in Philadelphia, has contributed to this increase in cases nationally.

To counter the rising incidence of acute hepatitis B in the U.S., ACIP expanded its recommendations for hepatitis B vaccination in November 2021.

However, a national survey conducted in February 2022 revealed that 55% of family physicians were unaware of the updated hepatitis B vaccine recommendations, and only 8% had fully implemented the new recommendations.

In Philadelphia, we have seen a small rise in the numbers of adults receiving hepatitis B vaccination following the new recommendations. However, the urge to vaccinate Philadelphians remains high. Pennsylvania has the fourth highest number of newly reported chronic HBV cases in the nation and Philadelphia accounts for most of these cases. Syringe exchange programs help decrease risky injection among drug users in Philadelphia, yet obstacles to safe injection persist.

Healthcare professionals can continue to decrease morbidity by promoting hepatitis B vaccination. A vaccine recommendation from patients’ provider is the strongest predictor of whether patients get vaccinated.

Strategies for increasing hepatitis B vaccination rates:

Do not assume that hepatitis B vaccination has been completed. ACIP guidelines state that only written documentation should be accepted as evidence of previous vaccination.
Use Philadelphia’s immunization information system (IIS) to verify whether patients have received hepatitis B vaccination. Providers can register with PhilaVax IIS by completing this form.
- A PhilaVax login enables providers to use the ‘Patient Search’ module to quickly search for a patient and access prior vaccinations received in the city of Philadelphia or surrounding jurisdictions. PhilaVax also hosts a vaccine recommender tool which highlights patients’ overdue vaccinations.
Use every opportunity to offer hepatitis B vaccine to unvaccinated patients, even sick visits. If you don’t stock hepatitis B vaccine, refer patients to another local hospital, health center, pharmacy, or organization that can vaccinate.
- Patients who are uninsured or underinsured can visit a local Federally Qualified Health Center (FQHC), Vaccines for Children (VFC) provider, or Vaccines for Adults at Risk (VFAAR) provider to receive vaccine at no or low cost.
Document hepatitis B immunizations and maintain updated records.
- Participate in Philadelphia’s immunization information system (IIS) to report immunizations given.

Mpox Vaccine: Ordering & Delivery Pause

Mpox vaccine deliveries will be paused the week of January 16 through the 20. Deliveries will resume on Wednesday, January 25. Any orders placed prior will not be fulfilled until the week of January 23. Remember to submit an order request by Monday, January 23, at 5pm for your order to be approved.

January Provider Training Schedule

PDPH offers monthly virtual trainings for interested vaccine providers. View the schedule and sign up for trainings at the links below.

COVID-19 Clinical Rounds for Providers
Tuesday, January 10, 2023, from 1:00 pm – 2:00 pm
This presentation will be conducted by one of PDPH’s clinicians and will include general COVID updates and the most recent FDA/ACIP recommendations for COVID-19 vaccinations.

Storage & Handling Training
Wednesday, January 11, 2023, from 10:00 am – 11:00 am
This presentation will include the most recent storage and handling updates, as well as a review of best practices.

Online Ordering Training
Thursday, January 12, 2023, from 10:00 am – 11:00 am
This presentation will include the most recent Clinic Tools and Inventory managing updates, as well as a live, step-by-step example.

Vaccine Safety Monitoring Systems Training
Wednesday, January 25, 2023, from 9:00 am – 9:30 am
This training includes an overview of the current monitoring systems in place (VAERS, V-Safe, VSD, CISA), an explanation of how to utilize these resources in your practice, and examples of reportable events.

If you can’t attend these trainings this month, they will recur in February. If you have any questions, don’t hesitate to reach out to dphproviderhelp@phila.gov.

PhilaVax User Account Renewal

Dear PhilaVax Users,

PDPH’s Immunization Program is currently undergoing annual PhilaVax user account renewal.

All users must complete the user agreement for the 2023 calendar year for continued access to PhilaVax.

All agreements must be completed by February 7th, 2023. User accounts without an updated agreement by this date will be unable to log into PhilaVax and will be rendered inactive until the agreement is completed.

Find the form here: PhilaVax User Agreement Form

New Vaccine Products Available Through VFC & VFAAR

View more information about Priorix and Vaxneuvance, now available through VFC and VFAAR, below. There have been a number of updates to the available vaccines for the VFC and VFAAR programs. Lists of vaccines currently available through VFC and VFAAR can be accessed through these links.

Complete the following survey to notify our program of which vaccine your site prefers. We will review each site’s submission and reach out with next steps. We recommend that sites that are part of a system or are affiliated use the same vaccine presentations across sites to ensure continuity of care and help prevent administration errors.

Vaccine Change Request

Priorix and Vaxneuvance

In line with the updated ACIP recommendations:

Priorix (Measles, Mumps and Rubella, MMR) is now available through the Vaccines Children (VFC) and Vaccines for Adults at Risk (VFAAR) programs.

Priorix is a vaccine indicated for active immunization for the prevention of measles, mumps, and rubella in individuals 12 months of age and older.
For all recommendations, MMR II and Priorix can be used interchangeably.
VFC and VFAAR providers must decide whether they will order MMR II or Priorix going forward. To change the product your site orders, complete the Vaccine Change Request form, linked above.
CVX code: 03 CPT code: 90707
For more information on Priorix, review the summary document.

Vaxneuvance (15-valent pneumococcal conjugate vaccine, PCV15) is now available through the VFC program.

Vaxneuvance is a vaccine indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F in individuals 2 months of age and older.
For all recommendations, PCV13 and PCV15 can be used interchangeably.
VFC providers must decide whether they will order Prevnar (PCV13) or Vaxneuvance (PCV15) going forward going forward. To change the product your site orders, complete the Vaccine Change Request form, linked above.
CVX code: 215
CPT code: 90671
For more information on Vaxneuvance, review the summary document.

Thank you for keeping Philadelphia safe and healthy. If you have any questions, please email vaccines@phila.gov.

Multi-Dose Vials of VFC Flu Vaccine Available to Order Again

Multi-dose vials (MDVs) of Fluzone are again available to order for your VFC eligible patients.

Please visit our flu ordering page for more information on the available vaccines.

Order Flu Vaccine Today

Have questions?

Contact Christine Wilson at 215.685.6728 or christine.wilson@phila.gov or Charma Miller at 215.685.6667 or charma.miller@phila.gov for assistance.

Thank you for keeping Philadelphia healthy by fighting flu! For more information about influenza in Philadelphia, visit our flu page.

IMPORTANT: The Immunization Program Website Address (URL) is Changing! Update Your Bookmarks!

On January 17, 2023, the PDPH Immunization Program website URL will be changing from vaccines.phila.gov to vaccines.phila.gov. Your bookmarked pages will need to be updated once the new URL goes live on January 17.

How This Will Impact Providers

There will be an automatic redirect in place, where anyone who goes to vaccines.phila.gov will be automatically sent to vaccines.phila.gov. But if you have certain pages on the website bookmarked, these links will have to be updated in January. If you don’t update those bookmarks after January 17, you will see a 404 error message.

Email vaccines@phila.gov with any questions.

Prepare Your Practice to Fight Flu This Winter

Notes From the Immunization Program:
Prepare Your Practice to Fight Flu This Winter

Less than 30 percent of Philadelphians were vaccinated against flu in 2020. Presently, seasonal flu activity is elevated across the country. Ensure your practice is prepared to fight flu this winter.

Remind patients to get vaccinated. Send email, text, or phone call reminders to patients to get vaccinated against flu this season. CDC developed an appointment reminder email template which you can customize for your practice and patient population.

Make a strong vaccine recommendation. Offer flu vaccine and share specific reasons why the flu vaccine is right for the patient.

Young children: “Young children, even those who are healthy, are at high risk of serious flu-related complications. Flu vaccination can reduce the risk of flu-associated death by 65% (nearly two-thirds) among healthy children.”
Pregnant people: “Pregnant people are at high risk of severe flu illness due to changes in the body caused by pregnancy. Complications of the flu can include preterm delivery, pneumonia, and material and fetal death. The flu vaccine is safe and recommended during pregnancy and can also protect your baby for several months after birth.”
Adults 65 years and older: “People who are 65 years and older are at high risk of serious complications due to flu. Most flu-related hospitalizations and deaths have occurred in people 65 years and older.”

Adults with certain medical conditions: “People with certain chronic conditions, like asthma, diabetes, and heart disease, are at high risk of serious complications from flu. These include inflammation of the heart, brain, or muscle tissue”
Healthy adults: “Most healthy adults don’t die from the flu, but your rate of hospitalization can be cut nearly in half by getting the flu shot.”

Discuss practical matters with patients. There are costs to skipping vaccinations, such as the flu shot:

If patients get the flu, they may miss several days of work which can result in lost wages.
Patients who are hospitalized due to the flu can face expensive medical bills.

When discussing the costs of declining vaccination, remember to acknowledge patient concerns. This is particularly important for marginalized patients who have experienced discrimination in medical settings.

Black, Latinx, and indigenous patients experience higher rates of severe flu than white patients. Taking the time to engage with patients in decision making can improve health outcomes, particularly among vulnerable patients.

Continue the conversation. If patients remain hesitant to receive the flu vaccine after counseling, offer educational materials. CDC has informational handouts which you can use at no cost to your practice.

Additionally, this Flu Toolkit is available for health care providers in Philadelphia. It contains guidance on patient counseling, vaccine ordering updates, and flu vaccine promotional posters (available to order).