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COVID-19 Update for Virginia<\/strong><\/p>\n October 28, 2021<\/p>\n Dear Colleague:<\/p>\n Thank you for your continued partnership in responding to the COVID-19 pandemic. \u00a0Please visit the Virginia Department of Health (VDH) website<\/a> for current clinical and public health guidance, epidemiologic data, and other information.\u00a0 Updates on the following topics are included in this correspondence:<\/p>\n CDC Expands Eligibility for COVID-19 Booster Doses for Certain Recipients of Moderna and Johnson & Johnson COVID-19 Vaccines and Allows for Heterologous Booster Doses <\/strong><\/p>\n On October 21, the Centers for Disease Control and Prevention\u2019s (CDC) Director Dr. Rochelle Walensky endorsed the recommendations of the Advisory Committee on Immunization Practices (ACIP) to expand eligibility for COVID-19 booster shots.\u00a0 Booster doses are now available to certain recipients of the Moderna and Johnson & Johnson (J&J)\/Janssen primary series, and heterologous (or \u201cmix and match\u201d) booster doses are allowed.\u00a0 Booster doses of Pfizer vaccine were already authorized for certain recipients of the Pfizer primary series.\u00a0 On October 20, the U.S. Food and Drug Administration (FDA) amended emergency use authorizations<\/a> (EUAs) for Pfizer, Moderna, and J&J vaccines.\u00a0 Updated FDA fact sheets for healthcare providers (Pfizer<\/a>, Moderna<\/a>, J&J<\/a>) and recipients and caregivers (Pfizer<\/a>, Moderna<\/a>, J&J<\/a>) are also available.<\/p>\n A booster shot of COVID-19 vaccine is recommended at least six months<\/strong> after the completion of an mRNA vaccine primary series (Moderna or Pfizer) for certain populations. These people should<\/strong> receive a booster:<\/p>\n In addition, these people may<\/strong> also benefit from a booster based on their individual benefits and risks:<\/p>\n Moderna sent a letter to vaccine providers<\/a> to alert them of prescribing information for booster doses.\u00a0 Importantly, the booster dose of Moderna COVID-19 vaccine is 50 micrograms (\u00b5g) in 0.25 mL, which is half the dose of the primary series vaccine<\/strong>.\u00a0 Although the dose sizes for the booster and primary series are different, the product used for both purposes is the same.\u00a0 The dose for the Pfizer booster is the same as the primary series vaccine (0.3 mL).<\/p>\n Additionally, all individuals aged \u2265 18 years who received a J&J primary series should <\/strong>receive a single COVID-19 vaccine booster dose at least two months<\/strong> after the J&J primary dose.\u00a0 The dose and the product for the J&J booster is the same as the initial dose (0.5 mL).<\/p>\n CDC recommendations now allow for heterologous (or \u201cmix and match\u201d) booster doses<\/a>.\u00a0 Individuals who are eligible to receive a COVID-19 booster dose may choose which vaccine product they would like to receive as a booster and discuss which product is most appropriate for them with their healthcare provider.\u00a0 If a heterologous booster dose is administered, the interval between the primary series and the booster dose should be based on the vaccine that was used in the primary series.\u00a0 The booster dose size and volume are the same regardless of whether the patient is receiving a homologous (same as primary series) or heterologous (different from primary series) booster.<\/p>\n An individual risk benefit assessment can be used to help determine which booster dose is most appropriate for a particular patient, including the risks of the different available vaccines.\u00a0 The potential risks of an mRNA booster dose include the rare risk of myocarditis or pericarditis.\u00a0 The risk of these conditions is highest among males aged \u2264 30 years based on data from mRNA primary vaccine series.\u00a0 Additionally, the potential risk of the J&J vaccine include the rare conditions of Guillain-Barr\u00e9 Syndrome (GBS) and thrombosis with thrombocytopenia (TTS).\u00a0 Based on data after receipt of the J&J primary dose, the risk of GBS is highest among males aged 50 to 64 years, and the risk of TTS is highest among females aged 18 to 49 years.\u00a0 Vaccine providers should ensure women aged 18 to 49 years are aware of the increased risk for TTS and of the availability of mRNA vaccines.\u00a0 Individuals who had TTS following their initial J&J vaccine should not receive a J&J booster dose.\u00a0 More guidance is available in CDC\u2019s Interim Clinical Considerations for Use of COVID-19 Vaccines<\/a>.<\/p>\n Moderately and severely immunocompromised people who are aged \u2265 18 years and received a two-dose mRNA vaccine and an additional primary mRNA dose may<\/strong> receive a COVID-19 booster dose (i.e., Pfizer, Moderna, or J&J) at least six months after their additional primary dose.\u00a0 Immunocompromised individuals who are aged \u2265 18 years and received the J&J vaccine at least two months ago should <\/strong>receive a booster dose of COVID-19 vaccine.\u00a0 If these individuals receive a Moderna booster dose, they should receive the 50 \u00b5g in 0.25 mL booster dose (half dose).<\/p>\n As a reminder, COVID-19 booster doses may be given at the same time, or anytime before or after other vaccines, including the flu shot<\/strong>.\u00a0 This is especially important now that we are in the flu season.\u00a0 Help keep your patients from falling behind on their recommended vaccines by coadministering them with COVID-19 booster doses or primary series.\u00a0 People seeking a booster dose should be permitted to self-attest to their eligibility.<\/p>\n If your patients are uncertain of which vaccines they received in the past, they can look up their COVID-19 vaccination record at www.vaccinate.virginia.gov<\/a>.\u00a0 If they have difficulty looking up their record, they can contact 877-VAX-IN-VA (877-823-4628).\u00a0 Please also encourage your patients to enroll in CDC\u2019s v-safe after vaccination health checker<\/a>\u2120 and complete health check-ins after COVID-19 vaccination.\u00a0 V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after COVID-19 vaccination.<\/p>\n Update on Pfizer COVID-19 Vaccines for Children Aged 5 to 11 Years <\/strong><\/p>\n On October 26, FDA\u2019s Vaccines and Related Biological Products Advisory Committee recommended the extension of Pfizer\u2019s COVID-19 vaccine EUA for children aged 5 to 11 years.\u00a0 There are still multiple steps that must occur at the federal level before providers can begin administering vaccines to this population.\u00a0 Next, the FDA must decide whether to formally amend the EUA.\u00a0 If amended, CDC\u2019s ACIP will meet and vote on recommendations for Pfizer vaccine for 5 to 11 year olds, and finally the CDC Director will determine official CDC recommendations.<\/p>\n There are some important differences between Pfizer\u2019s vaccine for children aged 5 to 11 years and the vaccine for people aged 12 years and older.\u00a0 The dose size for Pfizer vaccine for 5 to 11 year olds is 10 micrograms (mcg) \/ 0.2 mL, which is a third of the dose size for Pfizer recipients aged 12 years or older<\/strong>.\u00a0 Although the active ingredients in the Pfizer COVID-19 vaccine for 5 to 11 year olds are the same as those in the vaccine authorized for people aged 12 years and older, the product configurations and vials are different.\u00a0 Vaccine providers will be required to use the Pfizer product for 5 to 11 year olds if vaccination is authorized and recommended for this age group.<\/p>\n If FDA amends the Pfizer EUA, available supplies of the vaccine for 5 to 11 year olds will be prepositioned with vaccine providers; however, providers are not able to begin administering these vaccines until the CDC Director provides official recommendations.\u00a0 Initial supplies may be very limited.\u00a0 VDH expects that over the next few months all children in Virginia will have access to the vaccine, but there may not be enough for everyone to get them in the first few weeks.<\/p>\n VDH Webinar on Understanding COVID-19 Vaccine: What the Evidence Tells Us<\/strong><\/p>\n VDH will host a Webinar on Understanding COVID-19 Vaccine: What the Evidence Tells Us<\/a> on November 3 from 6:00 pm to 7:00 pm.\u00a0 This is a free event that has been approved for Continuing Medical Education (CME) credit \/ Continuing Education (CE) credit for physicians, nurses, and pharmacists.\u00a0 This webinar is open to all healthcare professionals and all healthcare staff.\u00a0 Information to access the webinar and descriptions of the panelists are available here<\/a>.\u00a0 Please share this with members of your professional organizations.<\/p>\n VDH Statement on the Use of Ivermectin for the Prevention or Treatment of COVID-19 <\/strong><\/p>\n VDH strongly discourages the ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19 outside of a clinical trial.\u00a0 Ivermectin is approved by FDA for human use to treat infections caused by internal and external parasites.\u00a0 It is not approved to prevent or treat COVID-19, or any other viral infection.\u00a0 Ivermectin is also available to treat certain veterinary conditions; medications formulated or intended for use in animals should not be used by humans.<\/p>\n In addition, we urge physicians, other prescribers, and pharmacists\u2014trusted healthcare professionals in their communities\u2014to warn patients against the use of ivermectin outside of FDA-approved indications and guidance, whether intended for use in humans or animals, as well as purchasing ivermectin from online stores.\u00a0 Veterinary forms of this medication are highly concentrated for large animals and pose a significant toxicity risk for humans.\u00a0 Use of ivermectin for the prevention and treatment of COVID-19 has been demonstrated to be harmful to patients.<\/p>\n Thank you again for your continued partnership as we respond to the COVID-19 pandemic.<\/p>\n Sincerely,<\/p>\n M. Norman Oliver, M.D., M.A. <\/p>\n","protected":false},"excerpt":{"rendered":" COVID-19 Update for Virginia October 28, 2021 Dear Colleague: Thank you for your continued partnership in responding to the COVID-19 pandemic. \u00a0Please visit the Virginia Department of Health (VDH) website for current clinical and public health guidance, epidemiologic data, and other information.\u00a0 Updates on the following topics are included in this correspondence: CDC Expands Eligibility […]<\/p>\n","protected":false},"author":283,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-975","page","type-page","status-publish","hentry"],"yoast_head":"\n\n
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\nState Health Commissioner<\/p>\n