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Bivalent Pfizer and Moderna Booster Vaccines Now Available for Ordering

Providers can now sign into Philavax to place your orders. Orders are due by Wednesday at 5pm.Please note: bivalent vaccine orders will ship sometime after Labor Day. No vaccines will be delivered on Labor Day. Monday.com ordering, partial orders, will not be available until the week after Labor Day. Please do not place Monday.com orders for bivalent vaccines at this time.

Monkeypox Inventory Update and Ordering Cadence

To facilitate the transition to intradermal (ID) administration of the Jynneos Monkeypox (MPX) vaccine, please:

Accept all Monkeypox inventory into your inventory location. Use this guide.
Complete an inventory reconciliation titled “SubQ to ID Transition,” so that we have an accurate count of the number of vials you have on hand. Use this guide.
Email vaccines@phila.gov when the reconciliation is complete so PDPH staff can update your inventory to reflect the number of ID doses you have on hand.

Beginning Monday 08/22, we are moving to a weekly ordering cadence for the MPX vaccine.Providers will need to enter orders by 5 pm on Mondays. If your request is approved, you can expect to receive MPX doses Wednesday or Thursday following your request date.Please remember for your request to be approved you must:

Upload your temperature logs to PhilaVax or email them to tempcheck@phila.gov.
Report wasted doses in PhilaVax. Because Jynneos is licensed for one dose per vial, wastage will be considered as any wastage of a full vial of vaccine for any reason. See wastage reporting instructions here and additional wastage guidance here.
Submit your reconciliation in PhilaVax. A reconciliation guide can be found here.
Find the order form here.

Additional Resources

Need a refresher on the Inventory Module in PhilaVax? Find a video guide here.
Use this dose tracker to track JYNNEOS administration at your practice.

If you have questions about accessing MPX vaccine, email vaccines@phila.gov.

Bivalent Pfizer and Moderna Boosters Are Coming

On June 30, 2022, the U.S. Food and Drug Administration (FDA) advised manufacturers seeking to update their COVID-19 vaccines to add an Omicron BA.4/5 spike protein component to the current vaccine composition to create a bivalent booster vaccine. Pending potential FDA Emergency Use Authorizations (EUAs) for new bivalent COVID-19 boosters developed by Pfizer-BioNTech and Moderna in or around September 2022, CDC’s Advisory Committee on Immunization Practices (ACIP) will convene to discuss potential recommendations. Administration of any new bivalent COVID-19 boosters can begin only after CDC’s official recommendations.What We Know So Far:

Pre-ordering for both Pfizer and Moderna bivalent boosters will begin on Monday, August 22, 2022, and close Wednesday, August 24, 2022, at 5pm.
- Sites should plan to manage necessary freezer/refrigerator space as well as inventory/ordering to avoid waste when developing their overall fall vaccine plans.
These bivalent formulas can only be used for boosters for individuals who have completed their primary series.
Bivalent boosters will include a BA.4/5 valence specifically.
The original Pfizer and Moderna vaccine formulas should only be used for primary series vaccinations once the bivalent products arrive.
- As the cap colors/borders will be the same for bivalent boosters and the original formulas, sites will need to be mindful of packaging/labeling to differentiate the two products.
Delivery will begin after Labor Day – date TBD.
ACIP will meet to make official recommendations about vaccine intervals and dosing schedules.
EUAs for these two bivalent products are not yet available.
It is expected that at least one bivalent vaccine for children ages 11 years and younger may be authorized within a short time following the authorization(s) of bivalent vaccines for people ages 12 years and older.

Pfizer Bivalent Booster

Age: 12+ – pendingShips: Ultra-cold on dry iceStorage: Ultra-cold – until manufacture expiration date Fridge – 10 weeksDoses per vial: 6Cap color: GreyMinimum Order Quantity: 300 doses (5 boxes)Moderna Bivalent BoosterAge: 18+ – pendingShips: FrozenStorage: Frozen – until manufacture expiration date Fridge – 30 daysDoses per vial: 5Cap color: BlueMinimum Order Quantity: 100 doses (2 boxes)

VFAAR Flu Vaccine Available for All Adults for the 2022-2023 Season

VFAAR Flu Vaccine Available for All Adults for the 2022-2023 Season

On October 15, 2021, the Centers for Disease Control and Prevention (CDC) issued a special allowance for Vaccines for Adults at Risk (VFAAR) flu administration. VFAAR flu vaccine can be administered to all adults regardless of insurance status during the 2022-2023 flu season.Contrary to our default policy of allowing only the truly uninsured to receive VFAAR flu doses, the CDC is making an exception to the screening requirement for flu only.

Why is VFAAR flu vaccine available to everyone?

The intent of removing the eligibility requirements for these federally funded doses is to ensure that everyone has access to flu vaccine. However, as providers, we ask you to follow the ordering algorithm below to ensure that throughout the flu season, you continue to have doses on hand for all your patients – especially the uninsured:

Use your existing privately purchased vaccine to vaccinate insured individuals.
Order a supply of VFAAR vaccines to vaccinate uninsured patients.
Do not miss opportunities. Vaccinate your patients with the most appropriate supply you have in stock.

Which supply of vaccine should I use?

Continue to vaccinate uninsured adults with flu from your VFAAR vaccine supply. As reminder, you cannot withhold a dose of VFAAR flu vaccine because a patient is unable to pay the administration fee.
Continue to vaccinate insured adults with flu from your privately purchased flu supply. However, if private doses are not available (because you’re waiting for your shipment or your supply is depleted), do not miss an opportunity; remember everyone is eligible to receive a dose from the VFAAR supply. And the VFAAR vaccines you use on private patients do not have to be replaced.
- Do not charge anyone’s insurance for the cost of the VFAAR flu doses. This is considered fraud and could affect your ability to receive VFAAR doses going forward. You can charge patients’ insurance an administration fee for doses of VFAAR flu that are administered to insured patients.
Use the flowchart below to assist you with identifying the correct supply:

Order Soon!

Remember to order VFAAR flu vaccine as needed throughout the 2022-2023 flu season. If you have any questions about your VFAAR supply contact Kenya Mack at kenya.mack@phila.gov for assistance.Visit our Flu Page on our website for more information on what vaccines are available and to gain access to flu resources and free print materials.Thank for your helping to keep Philadelphia safe from the flu!

VFC & VFAAR Flu Ordering Will Open 8/29/22

VFC & VFAAR providers can order flu for the 2022-23 season starting Monday, 8/29/22.

Make sure your site is ready!

Account for any unused 2021-22 VFC/VFAAR flu vaccine still at your site using PhilaVax:
- Process a return for the unopened vials online in the Vaccines Returns module. A job aid with step by step instructions can be found here.
- Complete an adjustment for any open MDVs in the Inventory Module. A job aid with step by step instructions can be found here.
- Complete these steps today to avoid delays in processing your site’s 2022-23 flu season orders. If you have questions, contact DPHProviderHelp@phila.gov.
Order flu materials for your office. Get the conversation started about the importance of flu vaccination with these free posters.
Make sure that your EHR/EMR is set-up to report this year’s flu products. These are the vaccine available this year.

Visit our Flu Page on our website for more information on what vaccines are available and to gain access to flu resources and free print materials.

Monkeypox Update: Switch to JYNNEOS Intradermal Strategy

Due to a shortage of doses, the PDPH recommends that providers switch to intradermal vaccination as soon as possible.

Intradermal administration involves injecting the vaccine superficially between the epidermis and the hypodermis layers of the skin, typically of the inner side of the forearm.

Intradermal JYNNEOS administration can be considered for most adults ages 18 years and older. Exceptions include people with a history of developing keloid scars. It is also recommended that clinicians observe patients after vaccination to monitor for the occurrence of immediate adverse reactions; 15 minutes is suggested for most patients, 30 minutes for persons with a history of anaphylaxis to gentamicin, ciprofloxacin, chicken, or egg protein.

Vaccine Schedule and Dosing Regimens

While JYNNEOS dose availability is currently limited, the recommendation is for providers to begin with a single shot. When there is enough vaccine to administer two shots (a complete dose), the recommended dosing interval between the first and second dose of JYNNEOS vaccine for both the standard (subcutaneous administration) and the alternative (intradermal administration) dosing regimens is 28 days for both.

For further questions, email vaccines@phila.gov.

Full CDC Vaccination Record Cards

Vaccination record cards for many recipients of COVID-19 vaccines are now full, especially for those who are over 50 and/or immunocompromised. If a vaccination card is full, the CDC recommends that a second card be completed, and the two cards stapled together. Encourage the patient to photograph both cards in case the two become separated, if possible. Both cards should be presented when vaccination history is required for travel, employment, or any other purpose requiring official, universally recognized documentation. Patients should bring both cards to future vaccination appointments for verification of vaccination history.

When a Vaccination Record Card is Full:

Complete a new card for the patient
Staple both cards together
Encourage the patient to photograph both cards in case they become separated
Bring both cards to future vaccination appointments

Providers are supplied with CDC vaccination cards as part of the ancillary kits in a 1:1 dose/card ratio. Many providers are reporting an abundant supply of CDC vaccination cards. Please utilize your current supply of vaccination cards to support distribution of a second card to those that need them. If your site has any concerns about your vaccination card supply, please reach out to PDPH.

Invitation to Discuss Monkeypox Testing, Treatment, and Vaccine

FQHC Partners,

On Wednesday, August 17, PDPH is inviting you to participate in a discussion about monkeypox testing, treatment, and vaccine. Please mark your calendars, and join using the meeting information below!

PDPH is inviting you to a scheduled Zoom meeting.
Topic: FQHC Discussion on monkeypox testing, treatment, and vaccine
Time: Aug 17, 2022 12:00 PM Eastern Time (US and Canada)

Join Zoom Meeting
https://us06web.zoom.us/j/81516780822

Meeting ID: 815 1678 0822

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Meeting ID: 815 1678 0822

Find your local number: https://us06web.zoom.us/u/kcXvdHapmW

Thank you for your dedication to keeping Philadelphians safe and healthy.

Updated Eligibility Criteria for Monkeypox Vaccine

There has been a recent update in eligibility criteria for monkeypox vaccination, including sex workers of any sex or gender, as well as anyone who has had recent close contact with someone infected with monkeypox.Eligible individuals include:

Gay, bisexual, transgender, non-binary, and other men who have sex with men, transgender, or non-binary persons, who are 18 years of age or older.
- And have had multiple or anonymous sex partners in the last 14 days, and/or believe they have been exposed to an STI within the last 14 days.
- Or have had any newly diagnosed STI in the past 6 months*, including gonorrhea, chlamydia, early syphilis, or HIV.
Sex workers of any sex or gender.
Anyone with known close, skin-to-skin contact within the last 14 days with someone infected with monkeypox.

*Eligibility criteria has been modified from a newly diagnosed STI in the past 3 months to the past 6 months.

Thank you for your dedication to curbing the spread of monkeypox. If you have any questions about these criteria, please reach out to vaccines@phila.gov.

Menactra No Longer Available Through VFC or VFAAR

Menactra can no longer be ordered through VFC or VFAAR. The inventory of Menactra at the CDC depots has been depleted.

Sites that were using Menactra, need to transition to one of the other MCV4 products available, Menveo from GSK or MenQuadfi from Sanofi, if they have not already.

If your site ordered Menactra, and you have not already, please take a few minutes to complete this survey to let us know which MCV4 vaccine you plan to order going forward.

Complete the Survey