Highlights from CDC Webinar for Providers on Pfizer Vaccine

LeadingAge NY knows that members are eager to get information regarding the vaccine. There is a lot of information coming out, and it is rapidly evolving. Last week, we shared this article with members regarding a webinar conducted by New York State Department of Health (DOH) officials regarding the effort to begin vaccinations in nursing homes in New York. All members are encouraged to review the article, as it has useful information regarding the Pfizer vaccine. Additionally, while nursing home residents and staff are a top priority population, we anticipate learning more about vaccination efforts for other members soon, the timing of which will depend in large part on the supply of vaccine. The initial vaccinations conducted will use the Pfizer vaccine; however, the Moderna vaccine is about 10 days behind Pfizer in the authorization process. Presuming that process continues without delay, New York is anticipating supplies of the Moderna vaccine quickly after approval.

Below are some useful resources to help educate and prepare for vaccination:

CDC Clinical Partner Call Summary

LeadingAge NY and LeadingAge National staff participated in the CDC Clinical Partner Call: Pfizer-BioNTech COVID-19 Vaccine webinar on Sun., Dec. 13^th; below are some key highlights based on our collective notes.

The Pfizer COVID-19 vaccine received an EUA on Dec. 13^th for use with those age 16 and older. The Pfizer vaccine is an mRNA vaccine, which takes advantage of the process that cells use to make proteins in order to trigger an immune response. It is the first vaccine to use this technology, but this technology has been studied for more than a decade. The vaccine does not contain a live virus, making it safer to produce and administer. The vaccine has been rigorously tested, phases 1, 2, and 3.

Administration of Vaccine

The Pfizer vaccine requires two doses that should be administered 21 days apart; however, there is a four-day grace period for the second dose. Administration of the second dose between 17 and 21 days is considered valid. If the second dose is not given within the 21 days, it should be administered as soon as possible thereafter. Efficacy of a single dose has not been evaluated.

The vaccine should be administered alone with a minimum interval of 14 days before or after the administration of other vaccines.

People are urged to get both doses of the vaccine, regardless of side effects, which may include nausea, fatigue, fever, and/or chills. The side effects are more likely to occur after the second dose of the vaccine and are likely to resolve within one to two days.

It takes one to two weeks after the second dose to be fully vaccinated. It should be noted that while the vaccine is highly effective, some people may still get COVID-19, and at this time we are unsure of ability to transmit the virus after vaccination. Thus, ongoing precautions should be continued after the vaccine, such as social distancing, mask wearing, and hand hygiene.

It is important that people know which vaccine they receive so that they can receive the proper vaccine in the second dose. The Pfizer vaccine is not interchangeable with the other vaccines that may become available. If two doses of different vaccine are administered inadvertently, no additional doses of either product are recommended at this time.

It was strongly recommended that everyone document receipt of vaccine in their patient records. There will be materials in the long term care facility toolkit that we anticipate shortly that providers can use and adapt, and to document that residents do consent to the vaccine.

It was indicated that receipt of vaccine will not affect results of PCR or point-of-care (POC) tests. Antibody tests could be affected; a positive test could indicate either vaccination or prior infection.

Vaccination of Special Populations

People who have recovered from COVID-19, whether symptomatic or asymptomatic, can get the vaccine; however, if they are currently infected, they should await recovery from their acute illness. There is no minimum interval after recovery, but the person should at least be beyond isolation period and beyond acute illness. The evidence so far is that reinfection is uncommon within the first 90 days, so you could delay vaccination until closer to the end of the 90-day period.

The vaccine may be administered to those with underlying medical conditions who have no contraindications to vaccination, including those with increased risk of COVID-19.

Persons with HIV infection or taking immunosuppression medications might be at increased risk for COVID-19. They may still receive the COVID-19 vaccine but should be counseled about the unknown risk profile of the vaccine.

Pregnant women who are part of a targeted group to receive the vaccine should be given the option to be vaccinated. There is no data on the safety, but studies are underway. Pregnant women and providers should consider the level of community transmission, the risks to her and potential risks to the fetus, the efficacy of the vaccine, the known side effects of the vaccine, and the lack of data about the vaccine during pregnancy. She should discuss this decision with her health care provider.

Breastfeeding women in a group recommended to be vaccinated should be given the option to be vaccinated. There is no data on the safety of COVID-19 vaccines in lactating women or the effects on the breastfed infant. She should discuss this decision with her health care provider.

People in the general community who have a known COVID-19 exposure should not seek the vaccine until quarantine has ended to protect health care personnel. For long term care and other health care personnel and residents of long term care with a known COVID-19 exposure, the vaccine may be given before the quarantine period is up, while using appropriate safety protocols. In other congregate settings, such as correctional or homeless shelters, the vaccine can be administered to those who have been exposed.

Precautions

Severe allergic reaction to any component of the vaccine is a contraindication to the vaccine. Appropriate medical treatment used to manage allergic reactions must be immediately available in the event.

Patient Vaccine Counseling

Before vaccination, providers should counsel on local and systemic post-vaccination symptoms.
Unless a person develops a contraindication, they should be encouraged to complete the vaccine series.
Antipyretic or analgesic medications may be taken for treatment of post-vaccine symptoms.
Given the currently limited data, vaccinated persons should continue to follow all COVID-19 guidance.

Follow-Up After Administering Vaccine

All patients receive the patient Frequently Asked Questions (FAQ) sheet that Pfizer has available online.
All patients are provided a vaccine shot card.
All vaccinations given are reported to the vaccine registry. Knowing which product someone received is critical so it can be certain they get the same product in their second dose.
If a patient has an adverse event, it is required to be reported to the Vaccine Adverse Events Reporting System (VAERS). Additionally, there will be a smartphone safety monitoring system called V-SAFE, which is not a requirement, but recommended.

Vaccine Safety Webinar

There was an additional webinar held on Dec. 14^th for clinicians on vaccine safety; however, LeadingAge NY staff and many members were unable to access due to volume of participants. The slides can be accessed here, where we anticipate a recording of the webinar being posted as well.

Click here for more information about additional CDC webinars being offered.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828