Health Advisory: COVID-19 and Childhood Immunization Provider Updates and Reminder to Participate in KPHD COVID Response After Action Survey

| May 13, 2022

Requested Actions

COVID-19 VACCINE

  • Be aware, on May 5, 2022, the Food and Drug Administration (FDA) limited the authorized use of the Johnson & Johnson (Janssen) COVID-19 Vaccine following an analysis of the risk of thrombosis with thrombocytopenia syndrome (TTS) after administration of the Janssen COVID-19 Vaccine to:
    • People age 18 years and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate.
    • People age 18 years and older who choose to receive Janssen COVID-19 Vaccine because they would otherwise not receive a COVID-19 vaccine.
  • Be aware, on May 6, 2022, Washington State Dept. of Heath (DOH) removed their standing order for Janssen COVID-19 Vaccine. Providers may continue to administer Janssen COVID-19 Vaccine to the individuals identified above only under their own standing orders.
    • Counsel recipients of the Janssen COVID-19 Vaccine about the risks of TTS approximately 1-2 weeks after vaccination.
    • Do not administer the Janssen COVID-19 Vaccine to people with a history of TTS following Janssen COVID-19 Vaccine or any other adenovirus-vectored COVID-19 vaccine.
  • Be aware, KPHD will continue to administer Janssen COVID-19 vaccine at our in-office vaccine clinic; we will not offer Janssen COVID-19 vaccine at community pop-up events.
    • Provide your patients seeking Janssen COVID-19 vaccine at our office with signed documentation (a note, prescription, order, or other) indicating that you have discussed the vaccine with them and approve administration.  
  • Report any COVID-19 vaccine reactions to the Vaccine Adverse Events Reporting System to sustain the robustness of our national safety surveillance system.
  • Continue to promote patients get up to date on their COVID-19 vaccination. Research continues to show that vaccination against COVID-19 saves lives.
  • Be aware, the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) is scheduled to meet June 7 to discuss an emergency use authorization for a COVID-19 vaccine manufactured by Novavax, a protein-based vaccine. VRBPAC has additional dates scheduled in June to review Moderna and Pfizer-BioNTech COVID-19 vaccine to include younger populations.
  • Report COVID-19 and other notifiable conditions to Kitsap Public Health 24/7 by calling 360-728-2235 or use the Reportable Disease Fax Form and fax to 360-813-1168 with any corresponding lab results.

Childhood Immunization

  • Be aware, a recent DOH report shows routine childhood immunization rates in Washington State decreased 13% in 2021 compared to pre-pandemic levels. Rates declined the most in children age 19-35 months.
  • Assess vaccination status of your pediatric patients and work with families to get children up to date.

COVID Response After Action Survey

  • Provide your input and feedback on the Kitsap Public Health District COVID-19 response “after-action” review via online survey until May 18th. Access the survey at: https://www.surveymonkey.com/r/Kitsap_County_COVID19_AAR_Survey
  • Forward the survey link to others involved in COVID response efforts in your organization, including healthcare providers, nurses, emergency technicians, faculty, volunteers, or others.

Background

COVID-19 Vaccine Update

FDA limited the authorized use of the Janssen COVID-19 Vaccine to people age 18 years and older who otherwise would not be vaccinated or for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate. This decision came after the FDA analyzed, evaluated, and investigated reported cases of thrombosis with thrombocytopenia syndrome (TTS), a syndrome of rare and potentially life-threatening blood clots in combination with low levels of blood platelets with onset of symptoms approximately 1-2 weeks following administration of the Janssen COVID-19 vaccine.

In December 2021, the Advisory Committee on Immunization Practices made a preferential recommendation for the use of mRNA COVID-19 vaccines over the Janssen COVID-19 Vaccine in all people 18 years and older in the U.S. The Centers for Disease Control (CDC) endorsed that Janssen COVID-19 Vaccine may continue to be offered for people with a contraindication to mRNA COVID-19 vaccines or when a person would otherwise remain unvaccinated.

As of March 18, 2022, FDA and CDC has identified 60 confirmed cases of TTS following Janssen administration, including 9 fatal cases. This is a reporting rate of 3.23 per million doses of vaccine administered and a reporting rate of TTS deaths 0.48 per million doses of vaccine administered.

To make this determination, the FDA considered that reporting rates of TTS and TTS deaths following administration of the Janssen COVID-19 Vaccine are not appreciably lower than previously reported. Furthermore, the factors that put an individual at risk for TTS following administration of Janssen COVID-19 Vaccine remain unknown. The FDA also considered that individuals with TTS may rapidly deteriorate, despite prompt diagnosis and treatment, that TTS can lead to long-term and debilitating health consequences and that TTS has a high death rate. The agency also considered the availability of alternative authorized and approved COVID-19 vaccines which provide protection from COVID-19 and have not been shown to present a risk for TTS.

The FDA has determined that the known and potential benefits of the vaccine for the prevention of COVID-19 outweigh the known and potential risks for those 18 years and older who would otherwise not be vaccinated or for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate.

Additional Information

COVID-19 Situation Update

As of May 7, 2022, Kitsap County has a 7-day case rate per 100,000 is 219.3. This moves Kitsap into the “medium” community level in the CDC Community Levels Data Tracker. For the week ending May 7, 2022, 17 COVID-19 hospitalizations among Kitsap residents had been identified, 18 for the week prior. You can see this data on the KPHD dashboards.

As of May 7, 2022, 78% of Kitsap County residents have initiated their primary vaccine series, 70% are fully vaccinated. You can see this data on our KPHD COVID Vaccine dashboard.

COVID-19 Vaccine Information

COVID-19 Testing Information

COVID-19 Therapy Information

Department of Health and Human Services (HHS) allocates monoclonal antibodies and oral antivirals to each state. DOH distributes doses to enrolled providers. Providers must enroll to order therapies in Healthcare Partner Ordering Portal (HPoP) to manage COVID-19 therapies. Email mcm@doh.wa.gov for support enrolling.

Additional Information

COVID-19 Prevention Information

Share with patients:

COVID-19 Reporting Information

  • Report COVID-19 and other notifiable conditions to Kitsap Public Health 24/7 by calling 360-728-2235 or use the Reportable Disease Fax Form and fax to 360-813-1168 with any corresponding lab results.

Contacting the Health District

  • Call (360) 728-2235 and leave a message. Includes reporting notifiable conditions 24 hours a day, 7 days a week. Leave the patient’s name, date of birth and disease.
  • Fax (360) 813-1168.

Additional Resources