Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers

June 4, 2021

From:
Dr. Piotr Oglaza
Medical Officer of Health
Hastings Prince Edward Public Health

In this Issue:

1. Local COVID-19 Vaccine Coverage Update
2. In-Home COVID-19 Vaccinations Referrals now Being Accepted Through Primary Care Providers
3. COVID-19 Vaccination of Special Populations - Updated Recommendations
4. Accelerated Second COVID-19 Vaccine Dose Interval
5. Second Dose Guidance for AstraZeneca/COVISHIELD Vaccine
6. NACI’s COVID-19 Vaccine Interchangeability Statement
7.    Extended AstraZeneca COVID-19 Vaccine Expiry Date
8. Patient COVID-19 Vaccination Status - Communication Strategy for Health Care Providers
9. Updated COVID-19 Resources & Guidance Documents

COVID-19 Vaccine News & Updates

Local COVID-19 Vaccine Coverage Update

As of June 1, 2021, 53% of Hastings Prince Edward (HPE) residents over the age of 12 (or 89,180 individuals) have received their first dose of COVID-19 vaccine. Currently, 5% of area residents (7,924 individuals) have received their second dose.

In-Home COVID-19 Vaccinations Referrals now Being Accepted Through Primary Care Providers

HPEPH, in partnership with Hastings-Quinte Paramedic Services, is beginning to offer COVID-19 vaccines in personal residences for those who are not able to attend a mass immunization clinic or pharmacy. If your patient has significant mobility limitations that require a vaccine in their personal residence, please refer them to us through this referral form. Once the referral is received, the patient will be contacted by HPEPH with an appointment date for the vaccine. Specific times for appointments are not available due to the travel times between homes for the paramedics. Space for in-home vaccine appointments are VERY limited so please limit referrals to patients that truly would have no way to get to a mass immunization clinic or pharmacy.

Please be assured that HPEPH adheres to strict privacy and security of information policies and procedures and is accountable to the legislated privacy acts (PHIPA and MFIPPA). All information collected will be stored securely with administrative, technical and physical safeguards according to HPEPH privacy and record retention policies.

COVID-19 Vaccination of Special Populations - Updated Recommendations

In an updated statement on May 28, 2021, the National Advisory Committee on Immunization (NACI) updated their recommendations for COVID-19 vaccinations of special populations stating:

“International real-world data showed that COVID-19 vaccines are safe in these populations. As such, NACI recommendations for those who are immunosuppressed, have an autoimmune condition, are pregnant or are breastfeeding are now the same as the recommendations for the general adult population.

Updated recommendation: NACI preferentially recommends that a complete two-dose vaccine series with an mRNA COVID-19 vaccine (Pfizer-BioNTech, Moderna) should be offered to individuals in the authorized age group, including those who are immunosuppressed, have an autoimmune condition, are pregnant or are breastfeeding. If they are not able to receive an mRNA vaccine, for example because of an allergy, another authorized COVID-19 vaccine should be offered.”

In response to this updated statement, the Ministry of Health has released an updated version of the COVID-19 Vaccination Recommendations for Special Populations guidance document.

Accelerated Second COVID-19 Vaccine Dose Interval

Due to a stable supply of COVID-19 vaccine, Ontario has updated the eligibility for accelerated second dose appointments starting with individuals aged 80 and over, beginning on May 31, 2021. The Ministry of Health updated the following document to align with the updated approach: Vaccine Clinical Advisory Group (VCAG) Recommendations on Exceptions to Extended Dose Intervals for COVID-19 vaccines

Local residents are asked to remain patient as vaccine supply remains limited in our region, and many individuals are still waiting for their first dose. HPEPH can only offer appointments for the number of vaccines that are provided to our region. Beginning Monday May 31, HPEPH began work to offer earlier second doses to those who are eligible, while continuing to offer first dose appointments. For more information, review our recent media release or the provincial announcement.

Second Dose Guidance for AstraZeneca/COVISHIELD Vaccine

The Ministry of Health has updated the Administration of AstraZeneca COVID-19 Vaccine/COVISHIELD Vaccine guidance document to reflect the updated NACI statement and refer individuals to the COVID-19 Vaccine Information for Individuals that received a first dose of the AstraZeneca COVID-19 vaccine/ COVISHIELD vaccine document. Individuals who received the first dose of the AstraZeneca/COVISHIELD COVID-19 vaccine who wish to receive a second dose of a COVID-19 vaccine, should receive the second dose 12 weeks following their first dose for optimal protection. Individuals who received their first dose of the AstraZeneca vaccine from March 21 onwards will be eligible to receive a second dose of the AstraZeneca vaccine from May 31 onwards at a 12-week interval, with appointment dates based on the timing of their first dose

NACI’s COVID-19 Vaccine Interchangeability Statement

On June 1, 2021, NACI released their recommendations for COVID-19 vaccine interchangeability, or “mixed vaccine schedules” in their NACI Rapid Response: Interchangeability of COVID-19 Vaccinations statement. The statement advises that:

• Persons who received a first dose of the AstraZeneca/COVISHIELD vaccine may receive either AstraZeneca/COVISHIELD vaccine or an mRNA vaccine (Pfizer-BioNTech or Moderna) for their second dose, unless contraindicated.
• Persons who received a first dose of an mRNA vaccine (Pfizer-BioNTech or Moderna) should be offered the same mRNA vaccine for their second dose. If the same mRNA vaccine is not readily available or unknown, another mRNA vaccine can be considered interchangeable and should be offered to complete the vaccine series”
• To book or accelerate their second dose appointment, individuals should follow guidance provided at covid-19.ontario.ca/book-vaccine.

The Public Health Agency of Canada (PHAC) has created a brief summary of the NACI recommendations.

Extended AstraZeneca COVID-19 Vaccine Expiry Date

“Health Canada has issued an authorization to extend the expiry date of specific lots of the AstraZeneca COVID-19 vaccine from 6 months to 7 months, following the review of submitted stability data. Vaccine doses with an original expiry date of May 31, 2021 [Lots MT0055 and MT0056] can now be used until July 1, 2021. The product labelling in Canada, including the product monograph, remains unchanged. Health Canada’s regulatory information can be found at: covid-vaccine.canada.ca/” (Ministry of Health, 2021)

Patient COVID-19 Vaccination Status - Communication Strategy for Health Care Providers

The Ministry of Health and OntarioMD are collaborating to provide patient COVID-19 vaccination information to physicians and other healthcare providers via four possible methods:

1. COVID vaccination data is available through the provincial clinical viewers, Connecting Ontario and Clinical Connect. Access to the viewers can be requested via Ontario Health’s Digital Health Service’s website. This data is available effective immediately.
2. The Health Report Manager (HRM), which pushes data prospectively to physicians the physician namehas been collected through COVaxON at point of vaccination, will start to push the complete history of COVID vaccination events to physicians based on patient rostering (Implementation date is TBD as this is contingent on patients reporting up to date physician information).
3. There are also plans to provide curated lists of patients that have been vaccinated and make them available to their listed physician through the eReport tool which is available to any patient enrollment model (PEM) physicians in Ontario. This list will be provided monthly, and the Ministry is targeting early June for the first monthly report to be shared with physicians in patient enrolment models. Any PEM physician with an Ontario Health ONE ID account will have access to their reports. Physicians without a One ID account can get one through the CPSO website or by making a request at Ontario Health’s Digital Health Service’s website. Implementation date is TBD.
4. Pilots are currently underway with a few EMR vendors to receive COVaxON data into their EMRs via the Digital Health Drug Repository. Although this solution provides information directly into the physician's EMR, it requires a long-term implementation approach as it EMR vendors must include the development, test and deployment of this feature into their product roadmap. Implementation date is TBD.

COVID-19 Resource & Guidance Document Updates

Updated COVID-19 Resources & Guidance Documents

The following documents have been updated and are available on the Ministry of Health website:

• COVID-19 Guidance: School Case, Contact, and Outbreak Management
• COVID-19 Safety Guidelines for: Day Camps

Back to Summary

Contact Information: 

To give us your comments: hart.sara@hpeph.ca

To report communicable diseases:613-966-5500 x349

To report AEFI or DOPHS: Online / Fax: 613-966-1813 or CDCFAX1@hpeph.ca

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