7/26/21 Health Advisory: COVID-19 Updates for Providers

| July 26, 2021
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Requested actions

Background

Behavioral health concerns among healthcare and public health workers

Recent surveys found high rates of depression, anxiety, acute traumatic stress, alcohol misuse and post-traumatic stress disorder and suicidal ideation among healthcare and public health workers who have worked during the COVID-19 pandemic. In response, DOH released an alert to warn of the increased risk and share an evidence-based tool to help develop individualized coping skills. The alert also provides recommendations and resources on building resilience, mental and emotional wellbeing, and self-care. Learn more about the behavioral health effects to Washingtonians during the COVID-19 pandemic.

COVID-19 vaccine

Power of Providers campaign

Gov. Inslee and DOH launched the Power of Providers (POP) initiative asking providers to make the Power of Providers community vaccination commitment and take 4 simple steps with every patient to promote COVID-19 vaccine:

  • Seek. Proactively reach out to patients to learn if they got COVID-19 vaccine and if not, invite them to do so.
  • Ask/Educate. Ask patients at every visit if they are vaccinated and check their immunization record. If the patient is not vaccinated, provide information, recommend and offer the vaccine.
  • Vaccinate. If the patient is interested, provide vaccine right then or give them a referral using vaccinelocator.doh.wa.gov or by calling 833-VAX-HELP.
  • Empower. Empower vaccinated patients to share their vaccination status with friends, family and others. Empower staff to talk with patients and people in their own lives about their vaccination status and the importance of vaccines.

Support vaccine equity

Providers should continue to support equitable access to vaccine. DOH created multiple community-specific resources for outreach and engagement. Additional ways to achieve equitable access are:

  • Reach out to eligible patients, especially those from communities highly impacted by COVID-19.
  • Meet people where they are with the goal of “vaccines going to people, not people going to vaccines.”
  • Partner with local, trusted community organizations and groups and the Health Department to coordinate vaccination events. Use DOH’s Equitable Vaccine Site Placement Planning Tool.
  • Do not turn people away at the end of the day to avoid opening a new vial to save just a few doses. For tips to minimize vaccine waste, see DOH’s general vaccine wastage guidance.

Booster doses

Do not administer any doses of vaccine beyond the doses recommended by the Advisory Committee on Immunization Practices (ACIP), even if your patient requests it. ACIP does not recommend booster doses, meaning more than 2 doses of Moderna or Pfizer vaccines, or more than 1 dose of J&J vaccine. ACIP does not recommend any additional doses of Moderna or Pfizer vaccine after getting J&J vaccine. ACIP is exploring whether to promote an additional dose of COVID-19 vaccine among immunocompromised people.

Promote full vaccination

A growing number of people are not getting the second dose necessary to complete their series. Getting the second dose of COVID-19 vaccine ensures the highest level of protection against the virus and its variants. Schedule appointments or direct people to a vaccine location where they can get the appropriate second dose of COVID-19 vaccine, matching the same brand as their first dose.

Risk of Guillain-Barre Syndrome after Johnson & Johnson vaccination

On July 8, the FDA updated its J&J EUA fact sheet to reflect an increased risk of GBS, a rare neurological complication, during the 42 days following J&J vaccination. GBS is a neurological disorder in which the body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis. VAERS received 100 suspected cases of GBS among J&J vaccine recipients. Most cases were reported 2 weeks after vaccination among mostly men over 50. To date, 12.8 million doses of J&J vaccine have been administered in the U.S., suggesting a rate of 1 case per 128,000 people. So far, most cases reported have recovered.

ACIP met July 22 to review the situation. CDC and the Western States Scientific Safety Review Workgroup continue to recommend all 3 COVID-19 vaccines equally. Given increasing COVID-19 variant infections and higher risk for virus spread, continued vaccination is critical to prevent increased disease.

Clinical guidance

  • If a patient refuses J&J COVID-19 vaccine, offer Moderna or Pfizer. It is important to continue protecting people against COVID-19.
  • People who previously had GBS may receive any of the COVID-19 vaccines.
  • Distribute the most up to date EUA fact sheet for patients, which includes a description of what symptoms they should watch for.
  • If patients call you with any of the following symptoms within 42 days of receiving J&J vaccine, advise them to seek medical attention right away:
    • Weakness or tingling, especially in the legs or arms that worsens and spreads to other parts of the body.
    • Difficulty walking.
    • Difficulty with facial movements, including speaking, chewing or swallowing.
    • Double vision or inability to move eyes.
    • Difficulty with bladder control or bowel function.

Vaccine resources

COVID-19 testing

We have test kits for you. Abbott Laboratories extended all BinaxNOW tests’ shelf life to 12 months. See Abbott’s BinaxNOW COVID-19 Ag Card Product Expiry Update for new expiration dates by lot number.

COVID-19 test processing

Labs report varying amounts of time to process COVID-19 tests. To support faster turnaround, we encourage providers to use in-state labs. The table below shows COVID-19 test processing times for in-state private labs.

LAB TIME TO PROCESS TEST TESTS PROCESSED DAILY
FidaLab 24-48 hours 500
Kaiser 24 hours 600-700
LabCorp 24-48 hours Unknown
Northwest Pathology 24-48 hours 20,000
Quest 24-48 hours 700
UW Virology 24-48 hours 6,000-8,000
Atlas Genomic 16 hours 10,000

Patient education

Share the following materials with patients.

Additional resources