COVID-19: Common Questions for Providers

The Louisiana Department of Health is now offering COVID-19 on-site vaccinations for Louisiana businesses and other workforces. These vaccinations are administered by a mobile response team that can be scheduled to meet the needs of employers throughout the state. 

To qualify, an employer must have at least 10 people being vaccinated through this mobile service that meet the current eligility criteria - at least 16 years of age. This includes your employees and your employees' dependents.

COVID-19 vaccines currently being administered are from Pfizer, Moderna, and Johnson & Johnson (J&J). Pfizer and Moderna are two dose vaccines, while J&J is one dose. All three vaccines have been authorized for emergency use by the FDA and are safe and effective to use.

Individuals who receive a Pfizer or Moderna vaccination will schedule their second dose during their first dose vaccination appointment. Second doses will be given at the same location where a person received their first dose. Johnson & Johnson vaccine recipients do not require a second appointment.

There is no cost to the employer or the employee for this service and no insurance is required.

Online Workplace Vaccination Scheduling

Fill out the following online form to set up a COVID-19 vaccination event: Workplace Vaccination Support Request 

Louisiana COVID-19 vaccine providers DO NOT need to update their vaccine inventory in VaccineFinder. Louisiana's immunization information system (IIS) LINKS is integrated with VaccineFinder and will automatically update each COVID-19 vaccine provider's inventory.

While we remain in the pandemic, the federal government has ensured that vaccines are made available to those in need without cost to the individual. Providers that participate in the CDC COVID-19 Vaccination Program contractually agree to administer a COVID-19 vaccine regardless of an individual's ability to pay and regardless of their coverage status.

Providers cannot ask a patient for payment, though they can bill insurance for a vaccine administration fee or the federal government if the person is uninsured. A provider also may not bill for a regular office visit to administer the vaccine. Providers administering the vaccine to people without health insurance or whose insurance does not provide coverage of the vaccine can request reimbursement for the administration of the COVID-19 vaccine through the Provider Relief Fund.

The second dose should be administered as close to the recommended interval as possible. If it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after first dose.

There are currently limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window. This allowance is to accommodate situations when it is not possible to administer the second dose at the recommended interval, not to recommend a new or lengthened follow up interval. The goal should remain to administer second doses at 21 days for Pfizer vaccine and 28 days for Moderna vaccine. However, if second dose is administered beyond these intervals, there is no need to restart the series.

mRNA COVID-19 vaccines are not interchangeable. See added language below to provide suggested strategies to help ensure patients receive second dose with appropriate product and interval between doses include:

• Provide COVID-19 vaccination record cards to vaccine recipients, ask recipients to bring card to their appointment for second dose, and encouraging recipients to make a backup copy (e.g., by taking a picture of card on their phone).
• Encourage vaccine recipients to enroll in VaxText, a free text message to receive COVID-19 vaccination second-dose reminders.
• Record each recipient’s vaccination in LINKS as required by the State of Louisiana.
• Record vaccine administration information in patient’s medical record.
• Make appointment for second dose before vaccine recipient leaves, to increase likelihood patients will return to same vaccination site for the second dose.

Using the above strategies, every effort should be made to determine which vaccine product was received as first dose, in order to ensure completion of the vaccine series with same product.

In exceptional situations in which first-dose vaccine product cannot be determined or is no longer available, any available mRNA COVID-19 vaccine may be administered at a minimal interval of 28 days between doses to complete the mRNA COVID-19 vaccination series.

If two doses of different mRNA COVID-19 vaccine products are administered in these situations (or inadvertently), no additional doses of either product are recommended at this time.

As the vaccination provider, you must communicate to the recipient or their caregiver information consistent with the "Fact Sheet for Recipients and Caregivers" (and provide a copy or direct the individual to the vaccine manufacturer's website to obtain the Fact Sheet) prior to the individual receiving the COVID-19 vaccine. Information to be communicated includes:

• FDA has authorized the emergency use of the COVID-19 vaccine, which is not an FDA-approved vaccine.
• The recipient or their caregiver has the option to accept or refuse the COVID-19 vaccine.
• The significant known and potential risks and benefits are unknown.
• Information about available alternative vaccines and the risks and benefits of those alternatives.

COVID-19 Vaccine Fact Sheet for Recipients and Caregivers:

• Moderna EUA Fact Sheet for Vaccine Recipients
• Pfizer-BioNTech EUA Fact Sheet for Vaccine Recipients
• Johnson & Johnson EUA Fact Sheet for Vaccine Recipients

Providers may also use the CDC Prevaccination Checklist for COVID-19 Vaccines  to screen individuals before administering the vaccine to determine if there is any reason they should not receive the COVID-19 vaccine at the moment.

According to the CDC, people who have been fully vaccinated against coronavirus – right now that means with two doses of either the Pfizer or Moderna vaccine – do not have to quarantine if they are exposed to someone infected with the virus. However, they should still take precautions, such as wearing a mask and practicing social distancing.

For people who live in congregate settings such as nursing homes, the Department of Health still recommends quarantining for anyone who has been exposed.

For centrally distributed vaccines, each kit will contain supplies to match the number of doses you are expected to receive, including:

If a COVID-19 vaccine that requires mixing with diluent is ordered and shipped from CDC’s centralized distributor, a mixing kit that includes the necessary needles, syringes, and alcohol prep pads will also be automatically added to the order. For centrally distributed vaccines, providers will have the option to submit the order in a way that opts out of receiving the administration and mixing kits. 

For vaccines that are shipped directly from the manufacturer, a combined kit will be included. This combined kit will include administration supplies (as noted above), mixing supplies, and vials of diluent to prepare the vaccine for use. Because it contains diluent, providers will not have the option to opt out of requesting this combined ancillary kit. 

Ancillary supply kits will not include sharps containers, gloves, and bandages. Additional personal protective equipment (PPE) may be needed depending on vaccination provider site needs. 

Update: Mega Kit content for Pfizer vaccine (12/15/2020)

After a vaccine is authorized or approved for use, many vaccine safety monitoring systems watch for adverse events (possible side effects). This continued monitoring can pick up on adverse events that may not have been seen in clinical trials. If an unexpected adverse event is seen, experts quickly study it further to assess whether it is a true safety concern. Experts then decide whether changes are needed in U.S. vaccine recommendations. This monitoring is critical to help ensure that the benefits continue to outweigh the risks for people who receive vaccines.

Immediately (24/7) report severe COVID-19 vaccine reactions requiring hospitalization to the Office of Public Health (OPH) at 1-800-256-2748. For more information, view the Health Alert Networks Message 20-52: COVID-19 Vaccination Severe/Allergic Reaction Reporting.

v-safe

v-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from CDC may call to check on you and get more information. V-safe will also remind you to get your second COVID-19 vaccine dose if needed.

v-safe Information Sheet 

v-safe Poster 

More Information on v-safe

Vaccine Adverse Emergency Reporting System (VAERS)

VAERS is a national early warning system to detect possible safety problems in U.S.-licensed vaccines. VAERS is co-managed by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). VAERS accepts and analyzes reports of adverse events (possible side effects) after a person has received a vaccination. Anyone can report an adverse event to VAERS. Healthcare professionals are required to report certain adverse events and vaccine manufacturers are required to report all adverse events that come to their attention.

Report an Adverse Event

More Information on VAERS

If your vaccine is set to expire within 48 hours, follow the following instructions:

1. Identify any eligible persons to offer and administer the vaccine.
2. Contact your facilities' vaccine coordinator to determine if any unopened packages that are set to expire can be used to vaccinate any eligible persons at another location or an off-site clinic within 24 hours.

If your vaccine is set to expire within 6 hours, follow the following instructions:

1. Identify any eligible persons to offer and administer the vaccine.
2. Administer second dose to any eligible person. 
3. Administer vaccine to other persons who wants the vaccine.

If you cannot find anyone to administer the vaccine to or you need additional assistance, contact your regional immunization program supervisor. Regional contacts can be found on lalinks.org.

Here are a few helpful tips to avoid vaccine wastage:

• Monitor the expiration date – Always check your inventory in the morning to confirm your vaccine supply is not expiring soon. Make sure to use vaccines that will expire first to avoid vaccine waste.
• Only take out what you need – Only take out the amount of vaccine you will use to vaccinate. Vaccine that sits at room temperature too long will be unusable and will be considered wasted.
• Follow recommended storage and handling guidelines – Follow the manufacturer’s recommended guidelines on how to properly store and handle the vaccine. The COVID-19 vaccine is a sensitive vaccine and requires different storing recommendations based on vaccine storage units available at each site.
• Monitor vaccine storage unit temperatures – Check the temperature in your vaccine storage unit to ensure the vaccine is being kept at the recommended temperatures. Check and record the temperature daily using a temperature log. If the digital data logger can measure minimum/maximum temperatures (min/max), check and record the min/max temperatures at the start of each workday. Otherwise, check and record the temperatures at the start and end of each workday.
• Vaccine wait list – Have an ongoing vaccine wait list for those who want to be vaccinated. This can be helpful if you end up having extra vaccine doses and need to administer them quickly. This can also estimate how much vaccine you will need as the vaccine becomes more readily available.
• Have a backup power supply – It is always good to have your vaccine supply unit connected to a backup power source, in case there is a power outage.
• Educate all staff handling the vaccine – Make sure each staff member that handles the vaccine knows how to properly store, monitor, and administer the vaccine. Staff that is well-trained in storage and handling principles is critical to ensuring vaccine supply potency and patient safety. 

NOTE: Any persons that received a first dose of the vaccine should receive their second dose of the same vaccine from the same vaccination location. 

No. Simply administer the second dose to complete the series. 

If the second dose is administered beyond the allowable interval, the series does not need to be restarted. Providers should not hold or save doses for patients who have not returned more than 42 days after their first dose. Providers should regularly assess missed second doses and repurpose those doses as first doses for eligible persons to initiate the vaccination series. 

For more information, visit cdc.gov.

No. People should not be scheduled to receive dose 2 earlier than recommended (21 days for Pfizer-BioNTech, 28 days for Moderna). Schedulers should offer second dose appointments beginning on the date of the recommended interval or late. CDC guidance allows for dose 2 to be given up to four days before the recommended interval in order to avoid missed vaccination opportunities when a recipient unexpectedly arrives early and might not return on schedule. The series never needs to be restarted due to a delay in the second dose. 

Currently-authorized SARS-CoV-2 antibody tests are not validated to evaluate specific immunity or protection from SARS-CoV-2 infection. The FDA is reminding the public of the limitations of COVID-19 antibody, or serology, testing and providing additional recommendations about the use of antibody tests in people who received a COVID-19 vaccination. Antibody tests can play an important role in identifying individuals who may have been exposed to the SARS-CoV-2 virus and may have developed an adaptive immune response. However, antibody tests should not be used at this time to determine immunity or protection against COVID-19 at any time, and especially after a person has received a COVID-19 vaccination.

People with prior or current SARS-CoV-2 infection

People should be offered vaccination regardless of their history of symptomatic or asymptomatic SARS-CoV-2 infection; this includes people with prolonged post-COVID-19 symptoms. Data from clinical trials indicate that the currently authorized COVID-19 vaccines can be given safely to people with evidence of a prior SARS-CoV-2 infection. Viral testing to assess for acute SARS-CoV-2 infection or serologic testing to assess for prior infection is not recommended for the purposes of vaccine decision-making.

Vaccination of people with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and they have met the criteria to discontinue isolation. This recommendation applies to people who experience SARS-CoV-2 infection before receiving any vaccine dose and those who experience SARS-CoV-2 infection after the first dose of an mRNA vaccine but before receipt of the second dose.

While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of SARS-CoV-2 reinfection is low in the months after initial infection but may increase with time due to waning immunity.

People who previously received passive antibody therapy

Currently, there are no data on the safety and efficacy of COVID-19 vaccines in people who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. Based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon within the 90 days after initial infection, vaccination should be deferred for at least 90 days. This is a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses. This recommendation applies to people who receive passive antibody therapy before receiving any vaccine dose and to those who receive passive antibody therapy after the first dose of an mRNA vaccine but before the second dose, in which case the second dose should be deferred for at least 90 days following receipt of the antibody therapy. Receipt of passive antibody therapy in the past 90 days is not a contraindication to receipt of COVID-19 vaccine. COVID-19 vaccine doses received within 90 days after receipt of passive antibody therapy do not need to be repeated.

For people receiving antibody therapies not specific to COVID-19 treatment (e.g., intravenous immunoglobulin, RhoGAM), administration of COVID-19 vaccines either simultaneously with or at any interval before or after receipt of an antibody-containing product is unlikely to substantially impair development of a protective antibody response. Thus, there is no recommended minimum interval between antibody therapies not specific to COVID-19 treatment and COVID-19 vaccination.