
Requested actions
- Be aware, Washington State Department of Health (DOH) issued an alert of high rates of unaddressed behavioral health concerns among healthcare and public health workers.
- Engage in a PsySTART-Responder assessment, an evidence-based method to gain awareness of one’s own psychological risk and develop individualized coping plans. To create a PsySTART account, email DOH-BHadmin@doh.wa.gov with subject line “PsyStart”.
- Practice resilience to reduce compassion fatigue, burnout, emotional exhaustion, depersonalization and stress.
- Promote COVID-19 vaccine and vaccinate everyone 12 years or older against COVID-19.
- Make COVID-19 vaccination a new vital sign. Review all patients’ vaccination records and help them get up to date with all vaccines. You can administer COVID-19 vaccine simultaneous with, or within any number of days of, other vaccines.
- 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 any additional doses of Moderna or Pfizer vaccine after getting Johnson & Johnson/Janssen (J&J) vaccine.
- 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.
- Sign up for DOH’s Power of Providers initiative, committing to ask patients’ vaccination status, offer vaccine education, give vaccine or a referral, and empower patients to share their vaccination status. Sign up to join the campaign.
- Be aware the U.S. Food and Drug Administration (FDA) and Centers for Disease Control (CDC) are investigating possible risk of Guillain-Barré Syndrome (GBS) following J&J vaccination.
- Continue to report myocarditis or pericarditis in people who got COVID-19 mRNA vaccine within the last 2 weeks. Report in Vaccine Adverse Events Reporting System (VAERS) and to the Health Department’s reporting line. Include vaccine manufacturer, vaccine lot number, vaccination date, dose number, patient gender, age and history of prior SARS-CoV-2 infection.
- Be aware the FDA extended the shelf life of J&J COVID-19 vaccine from 3 months to 4½ months. Visit Janssen’s lot expiry checker to determine the updated expiration of your vaccine.
- Store J&J vaccine expiring July 24 or July 28 separate from all other vaccine, if you have capacity. The FDA may extend their expiration another 45 days. Do not use or dispose of expired vaccine until further guidance.
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 vaccine locator, DOH.
- COVID-19 vaccine for providers
- COVID-19 vaccine provider toolkit and resources, DOH.
- COVID-19 vaccination for providers, CDC.
- Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis, CDC.
- COVID-19 vaccine quick reference guide for healthcare professionals, CDC.
- COVID-19 vaccine training module on best practices for providers, CDC.
- Janssen (Johnson & Johnson) health alert, CDC.
- Vaccine-induced immune thrombotic thrombocytopenia frequently asked questions, American Society of Hematology (ASH).
- Diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia webinar, ASH and CDC.
- April 15, 2021 Clinician Outreach and Communication Activity (COCA) call: Janssen (Johnson & Johnson) COVID-19 vaccine and cerebral venous sinus thrombosis with thrombocytopenia update for clinicians on early detection and treatment, CDC.
- Association of mRNA vaccines with myocarditis and pericarditis after vaccination:
- Follow-up of patients with myocarditis, consult recommendations, American Heart Association and the American College of Cardiology.
- Clinical considerations: Myocarditis and pericarditis after receipt of mRNA COVID-19 vaccines among adolescents and young adults, CDC.
- COVID-19 subcommittee of the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines, WHO news release, May 26, 2021.
- Myocarditis and pericarditis following mRNA COVID-19 vaccination, CDC.
- Selected adverse events reported after COVID-19 vaccination, CDC.
- Myocarditis and pericarditis resources for the public, CDC.
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.
- What to do if you have COVID-19.
- What to do if you may have been exposed to COVID-19.
- What to do if you have COVID-19 symptoms and have not been tested or exposed.