Vaccine Information for Health Care Professionals

Vaccine Information for Health Care Professionals

The Health Department is working closely with the Centers for Disease Control and Prevention (CDC) and other partners to distribute vaccines as they become available. You can find the most current information and guidance on these pages.

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Updates

covid-19 vaccine Program Update

Vaccines available

Three COVID-19 vaccines are authorized for use by the U.S. Food and Drug Administration (FDA).

Vaccine EUAs, linked below, are updated frequently and represent the most accurate information for administration, storage, handling, and other considerations. The EUA supersedes packing inserts, CDC resources, and any previous health department communications.

See the vaccine comparison chart with key details for each vaccine from the Asociation of State and Territorial Health Officials (ASTHO)

About the Pfizer-BioNTech vaccine

Doses to be fully vaccinated
Both the adult and pediatric formulations of the Pfizer-BioNTech vaccine require 2 doses about 21 days apart. It takes 14 days after your second dose to be protected from COVID-19.
 
Additional (3rd) dose
People who are moderate to severely immunocompromised, are 12 years and older, and received a Pfizer-BioNTech primary series should receive an additional primary dose of Pfizer BioNTech at least 28 days after their second dose. Learn more about additional doses.
 
People 16 years and older and 6 months past their second or additional dose of Pfizer should get a booster dose. Any of the three COVID-19 vaccines can be used for the booster dose.

Additional and booster doses are not approved for children 5 to 11 years old.

Resources

About the Moderna Vaccine

Doses to be fully vaccinated
The Moderna vaccine requires two doses about 28 days apart. It takes 14 days after your second dose to be protected from COVID-19.

Additional (3rd) dose
People who are moderately to severely immunocompromised, are 18 years and older, and received a Moderna primary series should receive an additional primary dose of Moderna at least 28 days after their second dose.
 
Booster dose
People 18 years and older and 6 months past their second or additional dose of Moderna get a booster dose. Any of the three COVID-19 vaccines can be used for the booster dose.

Resources

About the Janssen (Johnson & Johnson) Vaccine

Doses to be fully vaccinated
The Janssen vaccine requires one dose. It takes about 14 days after you get your vaccine to be protected.
 
Additional Dose
The Janssen (Johnson & Johnson) vaccine is not approved for additional doses. 
 
Booster dose
People 18 years and older and at least 2 months after the first dose should get a booster dose. Any of the three COVID-19 vaccines can be used for the booster dose.

Resources

ADDITIONAL AND BOOSTER DOSE RESOURCES

As new COVID-19 vaccines are approved, the CDC compiles resources on the U.S. COVID-19 Vaccine Product Information page. 

    Enrolling in the COVID-19 Vaccine Program

    To manage and administer vaccines through your office, you must enroll in the Vermont COVID-19 Vaccine Program, a separate process from how you may already be receiving other state-supplied vaccines.

    The Immunization Program has engaged with Independent, Hospital associated, and Federally Qualified Health Care (FQHC) provider offices. Most primary care offices are currently offering COVID-19 vaccine, or are in the process of doing so. We don't know when the COVID-19 vaccine will be provided through the Vermont Vaccine Program like other state-supplied vaccines, so enrollment is highly encouraged. Contact the Immunization Program at AHS.VDHImmunizationProgram@vermont.gov for more information.

    Non-primary care providers may also enroll to offer COVID-19 vaccines. This includes but is not limited to emergency medical services, home health care providers, pharmacies, urgent care facilities, specialty practices (ex: ob/gyn, pediatrics), substance use treatment and recovery centers, and college health centers. If your facility is interested in offering the COVID-19 vaccine, contact the Immunization Program at AHS.VDHImmunizationProgram@vermont.gov.

    Enrollment Resources

    Ordering and tracking vaccine inventory

    Once enrolled, you will receive information primarily by email. It will be sent from AHS.VDHImmunizationProgram@vermont.gov, or AHS.VDHCovidVaxDistribution@vermont.gov to the vaccine coordinator and back-up, as listed on your COVID-19 Enrollment form.

    If you are an enrolled facility and need access to order or manage COVID-19 inventory, sign up for the Vaccine Inventory Management System (VIMS).

    VIMS COVID-19 Vaccine Ordering Process

    New COVID-19 Expiration Date and Beyond Use Date (BUD) Guidance

    The below steps must be done in order.

    1. Adjust in/out
    Inventory adjustments for wastage, expiration, or transfer should happen the day they occur. Complete any needed adjustments before reconciling. Do not adjust the vaccine into your VIMS inventory. The vaccine will populate into your inventory when transferred or delivered from the Distributor, Depot, umbrella organization, or another practice. If you are concerned that it is not appearing, contact AHS.VDHImmunizationProgram@vermont.gov before making any changes.
    2. Reconcile
    A reconciliation of COVID-19 inventory is required in VIMS every Wednesday. Refer to the guides and tutorials.
    3. Order
    If you need any additional COVID-19 vaccine, place an order on Wednesday by 3 pm, after reconciliation. Refer to the reference materials.
    4. Confirmation
    A confirmation email will come from AHS.VDHCovidVaxDistribution@vermont.gov to the vaccine coordinator and back-up the Thursday following your vaccine order. This email will include the delivery method (Depot or Direct ship), quantity and type of vaccine, and delivery day (Depot only). Don't assume order quantity until receipt of this e-mail. 

    Ancillary Supplies

    COVID-19 vaccine comes with additional supplies to assist locations in administration. These supplies include needles, syringes, alcohol pads, vaccination cards, needle info cards, and PPE (e.g., face shields and surgical masks) for vaccinators. Ancillary supplies do not include sharps containers, gloves, or bandages.

    Direct shipping or Depot Delivery

    Place a Depot request for all COVID-19 vaccines if any part of your order is below the minimum quantities. The Immunization Program will adjust your order to direct ship certain vaccines where appropriate.

    Direct Ship

    The Health Department prefers to use direct distributor deliveries. With direct ship the COVID-19 vaccine ships directly to you, just like routine vaccines. However, there are minimum order limitations.
    Ancillary supplies arrive in separate packaging within a day or two of the vaccine delivery.

    Depot Delivery

    The Depot delivers vaccine and ancillary supplies to sites that need less than the minimum order quantities. Deliveries are batched geographically, and the date is confirmed by email. When the vaccine supply is not limited, a three-week order is preferred to reduce the number of deliveries.  All vaccines coming from the Depot should be placed in refrigerated temperatures unless otherwise stated. 

    Get ordering information for other vaccines

    Vaccine storage and handling

    Part of ensuring a safe and effective vaccine is administered to patients is providing proper storage and handling. The Health Department offers training guides, tools, and resources to help.

    Receipt and Management of COVID-19 Vaccine: You may receive the COVID-19 vaccine through your umbrella organization, transferred from the Depot, or directly from the distributor. Each method varies in storage requirements, inventory management, and communication structure, outlined in this guidance document. 

    Temperature Monitoring

    Temperature Excursions Protocol: Enrolled facilities must follow these steps whenever a vaccine has a period of being out of the appropriate temperature range. Never assume vaccine viability. Always contact the Immunization Program before taking any steps to change the vaccine temperature.

    The Health Department provides enrolled locations with a temperature monitoring device compliant with CDC requirements. SensoScientific devices are cloud-based, and LogTag devices require a software download. Third-Party temperature monitoring is permitted only if it complies with the CDC requirements.

    If you have any questions about temperature monitoring or vaccine storage and handling, please reach out to the Immunization Program at AHS.VDHImmunizationProgram@vermont.gov, 1-800-640-4374.

    Expiration Date vs. Beyond Use Date

    Expiration Date​​

    • Is associated with a specific lot number and might be extended as new data is obtained.​​
    • Dates presented on the manufacture box/vial may not be accurate. Any change to the expiration date is reflected in VIMS.​​
    • The date on the pediatric Pfizer vial (orange label), and the adult Pfizer vial (gray label - not yet available) is the Manufacture's date NOT the expiration. Add 9 months to the labeled date for all documentation

    Beyond Use Date​​ (BUD)

    • Once a BUD passes, the vaccine is no longer viable. It must be removed from storage, documented in VIMS as waste, and disposed of.
    • Each vaccine has unique storage parameters. Check vaccine EUA before storing COVID-19 vaccine at your practice. 
    • When Pfizer vaccine is moved out of ultracold freezer storage and into refrigerated temperatures, it has a BUD that should be documented clearly.​​ This is not its expiration date. 
    • BUD Tracking and adherence to a Beyond Use Date is the practice's responsibility and will not be reflected in VIMS.​​

    Offsite Vaccine Clinics

    COVID-19 Vaccine Storage and Handling for Off-site Clinics: The vaccine is at greater risk of temperature fluctuations when administered away from a monitored storage unit. Anyone participating in or planning an offsite COVID-19 clinic should review this guide well before the clinic date to ensure all preparations are made.

    Vaccine Carrier Borrowing Program Guide: The Immunization Program has qualified vaccine carriers available to assist practices in conducting offsite clinics safely and confidently. You may request a vaccine carrier from the Immunization Program for temporary use and return it when no longer needed. The Vaccine Depot will deliver your vaccine carrier with a manufacturer user guide and a digital data logger.  

    Packing Vaccine for Transport during Emergencies (CDC): This guidance is only appropriate for the short transfer of vaccine between monitored units. The Immunization Program expects practices to take advantage of the Vaccine Carrier program and plan accordingly.

    Offsite Hourly Vaccine Temperature Log: Use this document to track the time the vaccine leaves and returns to monitored storage and the hourly temperatures throughout the clinic as read on the provided LogTag device.

    Minimizing Waste Policy: This Department of Health policy will help sites reduce waste while ensuring no missed opportunities to vaccinate.

    School Nurse Role During School-Located Vaccine Clinic: Information on what a school nurse can and can not assist with during an SLVC. 

    VAMS Quick Guides: If your clinic is using VAMS (Vaccine Administration Management System) please direct questions to ahs.vdhophpvams@vermont.gov, 1-802-863-7428 (8:00-4:30 M-F). 

    Resources

    COVID-19 Vaccine: Quick Reference Guide for Healthcare Professionals (CDC): A printable table that provides basic information on the proper storage, preparation, and administration of the currently authorized COVID-19 vaccine products in the United States. 

    Storage and Handling Summary: The below CDC documents include vaccine storage and handling details in a concise, printable sheet.

    Get storage and handling information for other vaccines

    Administering the vaccine

    Anyone administering the COVID-19 vaccine at your office should be familiar with the nuances of each vaccine. Consider taking the CDC’s General Best Practice Guidelines for Immunization course for general information on vaccine administration.

    Interim Clinical Considerations for Use of COVID-19 Vaccines (CDC): Most COVID-19 administration questions can be answered through this frequently updated resource. 

    AUTHORIZED AGE GROUPS AND TIMING

    Under the EUAs, the following age groups are authorized to receive a primary COVID-19 vaccination series:

    • Pfizer-BioNTech – adult formulation (purple or gray cap): ages ≥12 years
    • Pfizer-BioNTeach – pediatric formulation (orange cap): ages 5 through 11 years
    • Moderna: ages ≥18 years
    • Janssen (Johnson & Johnson): ages ≥18 years

    Children and adolescents outside of these authorized age groups should not receive COVID-19 vaccination at this time.

    See the additional primary dose and booster dose sections of the CDC’s Interim Clinical Considerations and Vaccines Available above for guidance on administration beyond the primary series. 

    Timing

    • Pfizer-BioNTech – adult formulation, purple cap (Dilute, 30 µg, 0.3 ml each): three weeks (21 days) apart
    • Pfizer-BioNTech – adult formulation, gray cap (Do Not Dilute, 30 µg, 0.3 ml each): three weeks (21 days) apart
    • Pfizer-BioNTech – pediatric formulation, orange cap (Dilute, 10 µg, 0.2 ml each): three weeks (21 days) apart
    • Moderna (100 µg, 0.5 ml): one month (28 days) apart
    • Janssen (Johnson & Johnson):  (500 µg, 0.5 ml): single dose

    For mRNA vaccines (Pfizer-BioNTech and Moderna):

    • Second doses administered within a grace period of ≤4 days from the recommended date for the second dose are considered valid.
    • Any dose administered earlier than the 4 day grace period (17 days for Pfizer-BioNTech, 24 days for Moderna) should be repeated. The repeat dose should be spaced after the improperly spaced dose by the minimum interval
    • The second dose should be administered as close to the recommended interval as possible. However, there is no maximum interval between the first and second dose for either vaccine.

    For guidance on any administration errors, see Appendix A: Vaccine administration errors and deviations from the Interim Clinical Considerations. 

    Resources

    Assessing patient need

    As your patients continue to get vaccinated at community clinics, utilize the IMR reporting tools to help inform outreach and vaccine needs at your practice. 

    Pfizer-BioNTech (purple cap) - 12 years of age and older

    Pfizer-BioNTech (gray cap) - 12 years of age and older

    Pfizer-BioNTech (orange cap) - 5 through 11 years of age

    Moderna 

    Janssen (Johnson & Johnson) 

    Side effects, adverse reactions, and reporting

    Side Effects

    ANAPHYLAXIS

    Anaphylaxis, an acute and potentially life-threatening allergic reaction, has been reported following COVID-19 vaccination. Those administering COVID-19 vaccines should review the CDC’s Interim Considerations: Preparing for the Potential Management of Anaphylaxis After COVID-19 Vaccination.

    V-safe

    V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after a patient receives a COVID-19 vaccination. Enrolling to receive electronic health check-ins is a manual process where a patient registers online through a website or QR code. More information on V-safe can be found on www.cdc.gov/vsafe. 

    Information sheets and posters are available in English, Vietnamese, Spanish, Simplified Chinese and Korean from the CDC. The information sheets are also translated into the following languages:
    Arabic | Burmese | French | Kirundi | Nepali | Somali | Spanish | Swahili | Vietnamese

    VAERS

    Health care providers are required by Vermont law to report any adverse events that happen after vaccination to VAERS. To report an adverse event, go to https://vaers.hhs.gov/ and fill out the VAERS online form or downloadable PDF.

    Anyone can make a VAERS report, including a patient or a guardian. All adverse events should be reported as soon as possible and duplicate reporting is allowed. Please submit to VAERS even if you are unsure if a report should be filed.

    Talking with patients about the vaccine

     

    Patient resources
    COVID-19 Vaccine Communication Card: a tool to make sure patients who are deaf and hard of hearing or need to communicate visually can easily understand and be understood by vaccine clinic staff. See Tips for Using Visual Communication Cards with people who are English language learners, Deaf, hard-of-hearing or Deaf-blind.

    Vermont Department of Health Resources

    About Taking Prevention Steps After Vaccination
    Patients receiving the COVID-19 vaccine series should be advised to continue taking all prevention steps.

    Webinars & Resources

    COVID-19 Immunization Program Office Hours

    Vermont Vaccine Program Updates

    Additional Training

    CDC Webinars

    Contact Us

    Call 802-863-7240