VFC

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.

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.

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.

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.

Ensure Patients Are Up to Date With Polio Vaccination

Ensure Patients Are Up to Date With Polio Vaccination

Vaccine-derived poliovirus has been detected in environmental samples and infected one unvaccinated person in New York this year. In some Philadelphia neighborhoods, polio vaccination rates among children remain low.

Prevent community transmission by ensuring patients are up-to-date with polio vaccines in their upcoming well or sick visit.

According to the American Academy of Pediatrics, delaying immunizations at sick visits can lower immunization rates. Use every opportunity to vaccinate!

What is polio?

A potentially disabling and life-threatening disease caused by poliovirus.
Usually spread through the fecal-oral route, and sometimes through the oral-oral route.
Most people infected with polio have no apparent symptoms. Some experience mild symptoms (e.g. sore throat, fever, nausea).
1% of polio cases result in paralysis. Paralytic polio can result in death, especially among people diagnosed as adults.
Up to 40% of children diagnosed with polio experience new symptoms in adulthood (post-polio syndrome).

Who should get vaccinated?

Pediatric

All unvaccinated children should receive the polio vaccine (IPV).
CDC recommends 3 doses of IPV for primary series and 1 booster dose for children at the following ages:
- Dose 1: 2 months old
- Dose 2: 4 months old
- Dose 3: 6 through 18 months old
- Booster: 4 through 6 years old
Unvaccinated or partially vaccinated children should receive IPV vaccination as soon as possible in accordance with the recommended catch-up schedule.

Adult

Unvaccinated or partially vaccinated adults who are at increased risk of infection (e.g. international travelers) should receive their completed series of IPV in the following intervals:
- Dose 1: at any time
- Dose 2: 1-2 months after Dose 1
- Dose 3: 6-12 months after Dose 2

Get Patients On Schedule with MMR & Other Pediatric Vaccines

PDPH strongly encourages providers to ensure children are up to date with their MMR as well as other pediatric vaccines. This is especially urgent given the recent outbreak of measles in Columbus, Ohio. The outbreaks in Columbus have infected over 40 unvaccinated children, from <1 year old to 15 years of age, with cases on the rise. Nearly half of these children have been hospitalized.

Children should be vaccinated against measles at 12-15 months of age, with a booster dose at 4 years of age. Adults surrounding infants who are not yet eligible to be vaccinated are encouraged to make sure their vaccination records are up to date.

View the pediatric vaccination schedule.

Use Every Opportunity to Vaccinate

Review immunization records and recall patients who are not up to date. Use the PhilaVax Recall Report Guide to create a report of patients who are due for vaccine.

Vaccine should be administered to children with mild illnesses such as:

Otitis media
Diarrhea
Upper respiratory tract infections

Vaccine Shipment Delays During the Holiday Season

Submit orders by Wednesday, December 7.

During the holiday season – from mid-December to early January – the distribution center that ships vaccine provided through the Vaccines for Children (VFC) and Vaccines for Adults At Risk (VFAAR) programs will have reduced shipping capacity. Orders submitted during this time will take longer than usual to ship.To make sure that you have the vaccines you need during this time, submit orders by 3:00 PM on Wednesday, December 7. These will be processed and shipped out as usual. Be sure to check the status of your order within 2 business days of submitting.Continue to check for tracking information daily as FedEx and UPS shipping delays continue. Use this job aid to assist you with reviewing this information.Orders submitted after Wednesday, December 7 may not be delivered until the week of January 2, at the earliest. The distribution center will return to normal operations on January 2.For assistance with completing your reconciliation or submitting your order, email our team at DPHProviderhelp@phila.gov.

Storage & Handling Checkup: Temperature Monitoring

Vaccines are temperature sensitive and must be stored in specific temperature ranges to preserve their viability. Vaccines that are exposed to out of range temperatures can lose potency, and people vaccinated with these vaccines will not get the protection they need.

To ensure that every dose of vaccine that is administered at your site is viable, it is critical to monitor unit temperatures in two ways:

Digital Data Logger (DDL) – records temperatures, 24 hours a day, 7 days a week.
- Why? This provides documentation that every dose in your unit has been stored at the right temperature from the time you received it until it is administered to a patient.
Paper Temperature Logs – records twice daily temperature checks.
- Why? This provides a chance to visually check the unit and ensure that the temperatures have not been out out range.

Check Up: Review, Evaluate, and Update!

Make sure that your clinic is recording, reporting and documenting your temperate data the right way.

1. Download and submit your DDL data and send it to our team every 28 days, when ordering vaccine or experiencing a temperature excursion.

2. Fill out the paper temperature log twice each clinic day. When filling out the paper log, always use the DDL as your reference.

Make sure you have the most up-to-date logs:Fridge Temperature Log (Fahrenheit)Freezer Temperature Log (Fahrenheit)Fridge Temperature Log (Celsius)Freezer Temperature Log (Celsius)3. Keep your paper and DDL (electronic) temperature logs on file for 3 years for VFC and VFAAR providers and for 7 years for COVID providers. Our team will review your paper temperature logs during the next site visit to your clinic.

All of our Storage and Handling resources can be accessed here.

Have questions? Reach out to our team at TempCheck@phila.gov for assistance.

Temperature Reporting for Online Vaccine Ordering

Temperature Reporting for Online Vaccine Ordering

Temperature logs must be submitted on the same day as any order placed for federal vaccine (VFC, VFAAR, flu, COVID-19, or monkeypox)!

Temperature logs are to be uploaded in PhilaVax and emailed to tempcheck@phila.gov. The logs must show that the unit is within the appropriate temperature ranges and that there have been no alarms. This reporting guide can assist you in submitting your DDL temperature files.

For more information on ordering and how to upload your temperature log, please attend the next online ordering training on November 10, 2022 from 10:00AM – 11:00AM EST. Click the link below to register for the training.

Register: Online Ordering Training

If your site uses a privately purchased DDL or cannot upload in PhilaVax, please contact tempcheck@phila.gov.

Thank you for keeping Philadelphia safe and healthy!

VFC and VFAAR Shipping Delays

Our vaccine distribution center is currently working through an unanticipated backlog of flu and non-flu VFC and VFAAR orders.To ensure that your site has the vaccines you need during this time, please plan to order additional vaccine before you run out and order an additional 1 -2 weeks of vaccine in your next order, if you have space in your storage units.Continue to order flu vaccine as needed.Order additional non-flu vaccine every 25 days (from last approved order) or when you are down to a 2- 3 week supply of any given vaccine. If it has been less than 25 days since your last order, complete your reconciliation and then email our team at DPHProviderHelp@phila.gov to open your order. Use the ordering formula cheat sheet to calculate how much vaccine to order.