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PhilaVax Closed to Orders from 3/29 through 4/4

PhilaVax will be temporarily closed to new VFC/VFAAR orders from 12PM on Wednesday, March 29, until 9AM on Tuesday, April 4, while the vaccine prices are updated for 2023.During this time, any orders entered into PhilaVax IIS will be deleted from the system and not processed.If you need to a place an order, submit it before 12 PM on Wednesday, March 29. Normal order processing and shipping will resume at 9 AM on Tuesday, April 4.

Ukrainian Refugee Engagement Survey

The PDPH Immunization Program is interested in engaging further with providers who see patients that identify as Ukrainian refugees. Please provide answers to the below questions to the best of your ability, as it applies to your practice.

If you have any questions or need further assistance, contact aleah.mckenzie@phila.gov, veronica.alvarez@phila.gov, or thang.song@phila.gov.

Ukrainian Refugee Engagement Survey

Minimum Ordering Quantity Reduction

The minimum order quantity for bivalent Moderna 6mo – 5yr old (NDC 80777-0283-99) vaccine is being reduced to 20 doses per order. As a reminder, one carton of this vaccine contains 20 doses in 10 two-dose vials.Because ancillary supplies are packed well in advance of demand, they will continue to be shipped in minimum quantities to support 100 administrations per kit with this product. If you have sufficient supplies to support administration of the doses you order, we recommend opting out of receiving ancillary kits when placing orders for Moderna bivalent pediatric vaccines.

Moderna Monovalent Products Set to Expire

PDPH has some important updates to share regarding Moderna COVID-19 vaccines. Moderna-10 and Moderna-5 monovalent products for individuals aged 6 and older are set to expire in early April. There will not be any additional shelf-life extensions for these products.

The Moderna 6-11 and 12+ monovalent products ordered in the next few weeks will be short-dated, with expirations in early April.

Providers will need to order monovalent vaccines produced by Pfizer (ages 6 and older) and Novavax (ages 12 and older) to begin and complete primary series for their patient populations.

PDPH will accept orders for Moderna monovalent vaccines through March 8 to support primary series vaccinations. After March 8, providers will need to order alternative vaccines from Pfizer (ages 6 and older) and Novavax (aged 12 and older) for individuals seeking monovalent, primary series vaccines.

In anticipation of the upcoming expiration of Moderna’s monovalent vaccines for people ages 6 and older, providers should be aware that depending on the date of the first Moderna dose, the same product may not be available to complete the primary series. In this case, a different COVID-19 vaccine may be administered to complete the primary series at a minimum interval of 28 days from the last COVID-19 vaccine dose.

Please read CDC guidance on interchanging COVID-19 vaccines here.

The U.S. government has an ample supply of monovalent vaccines produced by Pfizer (ages 6 and older) and Novavax (ages 12 and older) to begin and complete their primary series.

In summary:

All Moderna adult (12+) and pediatric (6-11) monovalent COVID-19 vaccines will reach their expiry in early April.
Moderna is not seeking a shelf-life extension for these vaccines.
Ordering for Moderna adult (12+) and pediatric (6-11) monovalent COVID-19 vaccines will end on March 8.
Ordering for Moderna bivalent vaccines for all age groups will remain available.
Pfizer (12+ and 5-11) and Novavax (12+) monovalent vaccines remain available for ordering for primary series vaccination. There is ample supply of both products, and providers can order additional supply.

COVID Updates: Enrollment & VaccineFinder Inventory

Enrollment

Starting March 1, 2023, the COVID program will no longer be enrolling any new providers as we near the end of the public health emergency on May 11, 2023. We apologize for any inconvenience and will reach out again if there are any changes.

VaccineFinder: Report Expired and Depleted Inventory

Reporting your vaccine stock in VaccineFinder is critical to the management of your inventory. This informs the public that you have vaccine available and assures them that the information they see in VaccineFinder represents your available vaccine selections. Help prevent vaccine inventory misinformation in your community by reporting inventory on hand. Zero out inventory in VaccineFinder when you no longer offer it at your site.

Providers who are enrolled in the COVID-19 Vaccination Program are required to report to VaccineFinder on a weekly basis. Please ensure that your inventory is being updated weekly even if no vaccine was administered during that timeframe. Lack of adherence to this requirement can result in your site’s next vaccine order being rejected. If your staff does not have access to the VaccineFinder system or has further questions, please reach out to covidproviders@phila.gov for further assistance.

New Vaccine Products Available Through VFC

On November 4, 2022, FDA licensed a new formulation of Rotavirus Vaccine, Live, Oral (Rotarix, GSK). The new formulation comes as a liquid that does not require mixing or dilution. The new formulation (1.5mL x 10 applicators) will be available for VFC providers to order March 1, 2023. The original formulation (1mL x 10 vials and applicators) will be available until the supply is depleted or expires.To change the formulation that your site orders, complete the Vaccine Change Request Form. Our team will review your request and reply 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.

RotarixRotarix, oral (1.5 mL x 10 applicators) will be available March 1, 2023, through the Vaccines Children (VFC) program.

UPDATE: The ACIP routine recommendation for Rotarix is a two dose series, given at 2 and 4 months of age. For catch up vaccination: Do not start the series on or after 15 weeks, 0 days. The maximum age for the final dose is 8 months, 0 days. View the 2023 ACIP pediatric/adolescent schedule.
CVX code: 119
CPT code: 90681
NDC number: 58160-0740-21

For more information on the new formulation of Rotarix, review the package insert.Additional resources:

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

What’s New With Pediatric Vaccines?

What’s New With Pediatric Vaccines?

This month, the Advisory Committee on Immunization Practices published updated immunization schedules for 2023. COVID-19 vaccine has been added to the routine pediatric immunization schedule for ages 6 months and up, among other important additions. There have been several recent changes to vaccine products for pediatric patients as well.

ACIP Immunization Schedule Changes

The changes in the Advisory Committee on Immunization Practices’ pediatric immunizations schedule from 2022 to 2023 are:

COVID-19 row: COVID-19 vaccination now recommended from age 6 months–18 years.
Pneumococcal conjugate row: PCV15 has been added. It is interchangeable with PCV13.
IPV row: A “See Notes” section has been added to the column for people aged 17–18 years.

The changes in the catch-up immunization schedule for 2023 are:

Pneumococcal conjugate row: Language has been revised. The text now reads “This dose is only necessary for children aged 12–59 months regardless of risk, or aged 60–71 months with any risk, who received 3 doses before age 12 months.”

The changes in the immunization by medical indication schedule for 2023 are:

COVID-19 row: A new row was added to summarize COVID-19 vaccination recommendations by medical conditions or other indications.

View the full MMWR here.

Product Changes

The changes in routine pediatric vaccine products from 2020-2021 to 2022-2023 are:

MMR: Priorix added.
Meningococcal conjugate (MCV4): Menactra discontinued, and MenQuadfi added.
Pneumococcal conjugate (PCV15): Vaxneuvance added.
Flu (IIV4):
- Flucelvax (multi-dose vial): now available at 6 mo+ instead of 2 yrs+.
- Flucelvax (single dose syringe): now available at 6 mo+ instead of 2 yrs+.
- Fluzone (multi-dose vial): now available at 6 mo+ instead of 3 yrs+.
- Afluria (pre-filled syringe): 0.25 mL pre-filled syringe for 6 – 36 months no longer available. 0.5 mL pre-filled syringe available at 3 yrs+.
- Afluria (multi-dose vial): available at 6 months – 3 yrs for 0.25 mL dose and at 3 yrs+ for 0.5mL dose.

The American Academy of Pediatrics offers customizable reminder and recall resources for your practice to help ensure children are caught up on routine vaccinations.

If you are not already a Vaccines for Children (VFC) provider, enroll your practice in the VFC program using this guide.

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.