Notices

Mpox Vaccination Update: Intradermal or Subcutaneous Regimen Permitted

The U.S. Department of Health and Human Services (HHS) and the CDC have updated the mpox provider agreement to allow for both an intradermal and subcutaneous route of administration to be used for mpox vaccination. There is reported vaccine hesitancy due to concern over possible hyperpigmentation or scarring following intradermal administration. This change highlights that concerns about intradermal administration should not be a barrier to vaccination.

At the height of the outbreak, the intradermal route was preferred because it increased the number of available vaccine doses, while safely providing a similar immune response against mpox. However, mpox providers now have the flexibility to offer the intradermal or subcutaneous regimen based on optimal vaccine use and acceptance, feasibility of administration, and available vaccine supply. Both subcutaneous and intradermal vaccine regimens provide a safe immune response against mpox.

For more information view the CDC’s interim clinical considerations for JYNNEOS.

Thank you for the work you are doing to promote vaccination against mpox in Philadelphia.

View the Mpox Vaccination Program Provider Agreement.

Moderna Shelf-Life Extensions

FDA has approved a shelf-life extension for the following Moderna monovalent products. Below, find a table with updated expiration dates for the specific lots impacted by the extension.

With the Moderna Vial Expiration Checker, Moderna also allows vaccine providers to look up expiration dates by lot number, which includes the new expiration dates listed above. To find the expiration date, locate the lot number printed on the carton and/or vial and enter it into the lot number search field on the website, then press “submit.”

When checking existing vaccine inventory, be sure to apply these new expiration dates.

For additional information, view the CDC overview of Moderna vaccine.

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

Shelf Life Extensions on Moderna and Pfizer Products

Expiration dates of the following monovalent Moderna 10 products have been extended:

Moderna has verified the new expiration dates above and updated the Moderna Vial Expiration Checker.Additionally, Pfizer will be sending out short dated products and advises to hold on to products expiring soon in anticipation of a shelf life extension. If you have Pfizer vaccine products expiring soon set these aside and label them as “Do Not Use” until further information is received. This extension will be in reference to expiration dates only. BUD labels should still be monitored and disposed of once no longer viable.

Mpox Website

The PDPH Mpox website is here! Visit the page for everything you need to offer Mpox vaccine at your site. The page includes information on:

Enrolling as a provider
Ordering vaccine
Vaccine administration
Reporting wastage

Visit the Mpox Page

Why the name change?

The World Health Organizations (WHO) announced this week that they are phasing out the use of the term “monkeypox.” The change was prompted by observation of racist and stigmatizing language online, in other settings, and in some communities when the outbreak expanded earlier this year.

In line with the WHO recommendation, the Philadelphia Immunization Program and CDC is phasing out use of the term “monkeypox” and will use the new term “mpox” going forward. This change from the WHO will enhance the U.S. response to mpox by using a less stigmatizing term. We appreciate your understanding as our team works to implement this change throughout the related documents, forms and webpages.

Have questions?

Please contact Kenya Mack, our Adult Coordinator, at Kenya.Mack@phila.gov.

Updates to Pfizer Ordering Quantity

The minimum ordering quantity of monovalent and bivalent Pfizer for ages 12 and up has been reduced from 300 doses to 180 doses in PhilaVax. Monday.com ordering quantities have also been updated to reflect this. Orders exceeding 20 vials of these vaccines should be placed through PhilaVax instead of Monday.com.

Additional VFAAR Flu Vaccine Now Available for Ordering

The CDC has allotted additional doses of flu vaccine to the Immunization Program. VFAAR flu is now available for ordering. Due to the limited capacity, orders are limited to 200 doses per site to ensure everyone has access to flu vaccine.These flu vaccines are now available to order for your VFAAR patients:

VFAAR
- Flulaval prefilled syringes
- Flucelvax prefilled syringes

Please visit our flu ordering page for more information on the available vaccines.As a reminder, VFAAR flu vaccine can be administered to all adults regardless of insurance status during the 2022-2023 flu season. This is a special allowance by the CDC during flu season this year. While flu is available for everyone, 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. For more information, visit our website.

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.

MPOX Eligibility: Anyone At Risk Can Be Vaccinated

Monkeypox (mpox) vaccine eligibility has expanded. Anyone who feels they are at risk for acquiring monkeypox is now eligible for vaccination. They do not need to meet any further eligibility criteria. Outreach should continue to those who are most at risk, including gay, bisexual, transgender, other men who have sex with men, or non-binary persons who meet the following criteria:

Have had multiple or anonymous sex partners in the past 14 days.
Have had any newly diagnosed STI in the past 12 months, including gonorrhea, chlamydia, early syphilis, or HIV.
Have recently attended or plan to attend any venue where anonymous sex or sex with multiple partners will occur (e.g. saunas, bathhouse, sex clubs, sex parties).
Have met recent partners or plan to meet new partners through social media platforms (such as Grindr, Tinder or Scruff), or at clubs, raves, sex parties, saunas).

In addition, anyone with known close contact (skin-to-skin) with someone with monkeypox in the past 14 days should be vaccinated immediately.

Remember to give your patients a Monkeypox Vaccine Information Statement (VIS) before vaccinating.

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.