Common COVID-19 Vaccine Questions for Providers
With more than 1,700 Louisiana providers enrolled to administer vaccines, and with minimum amounts of vaccine being allocated to Louisiana by the federal government, only a small percentage of providers have received doses to date. In fact, last week, we were only able to send vaccines to 298 locations.
We have selected pharmacies based on the following criteria:
- Geographic location – We are attempting to have it least one vaccine provider in every parish.
- Population served – We are intentional about including pharmacies and clinics in underserved and high volume areas.
- Input from local public health leaders – Our regional directors review the proposed locations and provide feedback.
- State leadership – Final decision made by LDH leadership and Administration -
With more than 1,700 vaccine providers enrolled, Louisiana has developed a robust network of vaccine providers who are ready when more vaccine arrives. We are confident that we will continue to make vaccine available at more locations each week.
At this time, there is not a process in place for a facilities or sites like these to have a vaccine provider come on-site and conduct mass vaccinations.
We hope, at some point in the future when we have a strong and steady supply of the vaccine, to put such a program in place. Until then, we can offer several suggestions:
- Just as everyone else, contact local pharmacies (see covidvaccine.la.gov) and try and schedule individual appointments for your staff and customers.
- Work with a local pharmacy to see if it might be an option for them to establish an on-site program for you.
Of course, the limiting factor for all of these approaches is the continued lack of vaccine, both at the State, local and individual provider level.
Louisiana COVID-19 vaccine providers DO NOT need to update thier 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. Inforamtion 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:
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.
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 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.
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.