Combating the Novel Coronavirus (COVID-19): Week of Oct. 11

MHA Covid-19 update

MHA Covid-19 updateAs federal regulatory agencies evaluate COVID-19 vaccine and treatment possibilities, more than 5.5 million Michigan residents ages 16 and older have received at least one dose of a vaccine to protect them against the deadly disease, equating to 68.2% of that population as of Oct. 15. Meanwhile, despite the rate of new cases decreasing in many of the states that had been experiencing a surge in hospitalizations and deaths, cases in Michigan have been increasing. Nearly 8,300 new cases were reported for Oct. 14 and 15, with 2,010 adults and 29 children hospitalized in the state Oct. 15. Total deaths in Michigan attributed to confirmed cases of COVID-19 reached 21,563 Oct. 15.

The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Moderna Expiration Date Extended for Frozen Vaccines

The Michigan Department of Health & Human Services (MDHHS) announced Oct. 13 that Moderna received approval for a two-month extension of FROZEN Moderna COVID-19 vaccine. Some lots with an initial expiration of September or October will be extended if stored in frozen stateSeventy-eight lots are impacted by this extension.

The MDHHS does not have a list of these lot numbers, but Moderna is working diligently to get the extended lots updated in their tools and databases, with a priority on older lots first. To look up Moderna expiration, scan the QR code located on the carton or use the company’s expiration date lookup feature on its website. Healthcare providers are encouraged to continue checking these resources to determine whether they have lots that are impacted by this extension. Moderna vaccine should not be disposed of until an accurate expiration date is assessed.

Providers who have vaccines that are unexpired under the extension should update their outbreak inventory in the Michigan Care Improvement Registry (MCIR) with a new expiration date, following the instructions on the tip sheet How to Correct a COVID-19 Vaccine Expiration Date in the MCIR. Questions about the extension or the MCIR process can be directed to the MDHHS Division of Immunization team. Members with other vaccine-related questions may contact Ruthanne Sudderth at the MHA.

Merck Requests FDA Approval for COVID-19 Treatment Pill

Merck formally requested approval from the U.S. Food and Drug Administration (FDA) Oct. 13 for a groundbreaking antiviral medication that effectively treats COVID-19. Trials demonstrate the treatment regimen, which comes in pill form that patients can take themselves at home, reduced risk of hospitalization and severe illness by at least 50%.

Approval would add a new effective treatment to providers’ toolboxes in keeping patients with COVID-19 out of the hospital. Unlike currently available antibody treatments that require providers to set up and staff infusion clinics, the pill could help provide relief to providers struggling with staffing and other treatment resources. If approved, the MHA will advocate that all payers, both public and private, cover the drug for all covered lives.

The MHA will keep members apprised of developments on this issue.

CDC Releases Planning Information for Vaccinating 5- to 11-year-olds

The Centers for Disease Control and Prevention (CDC) recently issued an initial planning document for jurisdictions to prepare for the distribution of vaccines for children ages 5 to 11. The document provides initial information pertaining to pediatric COVID-19 vaccines, as well as several assumptions that can be made about the pediatric COVID-19 vaccination program. Specifically, the document highlights the packaging changes and storage requirements for the Pfizer pediatric COVID-19 vaccine for kids ages 5 to 11. The Pfizer vaccine for this age group is currently under review at the FDA, and a decision on whether an emergency use authorization (EUA) for the product will be granted is expected in the coming weeks.

Ordering of the Pfizer vaccine and any subsequent pediatric COVID-19 vaccines will begin when the FDA issues an EUA. Vaccine administration will begin once the CDC director makes a determination after reviewing recommendations from the Advisory Committee on Immunization Practices. The MHA will keep members apprised of developments on the vaccine for younger children. Members with questions may contact Ruthanne Sudderth at the MHA.

U.S. Homeland Security & Governmental Affairs Committee Requests Provider Input

Sen. Gary Peters (D-MI), chairman of the Committee on Homeland Security & Governmental Affairs, and the committee’s ranking member Sen. Rob Portman (R-OH) are seeking firsthand accounts from individuals and organizations (healthcare providers, state and local governments, first responders, etc.) who experienced challenges securing personal protective equipment and other medical products during the early months of the COVID-19 pandemic. Currently, the committee request is open-ended.

This is part of the committee’s ongoing oversight of federal pandemic preparedness and the COVID-19 response. The committee will examine reports of fraud, exploitation, and faulty equipment and medical supplies. To this end, providers can report issues about vendors, counterfeit medical products, price-gouging or other challenges obtaining supplies during the response. The information received will help inform the senators’ bipartisan oversight and efforts to strengthen U.S. medical supply chains, improve emergency preparedness, highlight new and successful supply chain methods, and prevent bad actors from taking advantage of future national crises. Members interested in submitting their experiences can do so online.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpageQuestions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of Sept. 13

MHA Covid-19 update

MHA COVID-19 UpdateCOVID-19 cases and related hospitalizations have continued to climb in Michigan, with 1,356 adults and 17 children hospitalized Sept. 17 with confirmed cases. The total number of confirmed cases in the state since the pandemic began is nearing 1 million, reaching 988,725 cases that had caused 20,665 deaths as of Sept. 17. Meanwhile, by Sept. 16, just 66.7% of Michigan residents ages 16 and over had received at least one dose of a vaccine to combat the illness.

The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Hospitals May Verify Employee Vaccination Status Through MCIR

The MHA has been working with the Michigan Department of Health & Human Services (MDHHS) Division of Immunizations on changes that will allow hospitals to use the Michigan Care Improvement Registry (MCIR) to verify the COVID-19 vaccination status of employees to comply with state and federal data reporting rules. Hospitals may now use MCIR for this purpose; however, they must submit an additional form. The original MCIR provider agreement was meant for the establishment of a MCIR site for provider/patient relationships and does not cover providers as employers.

Hospitals and health systems that would like to use their existing MCIR site to do employee status checks need to complete the new MCIR Agreement “Provider as Employer” Addendum and send it to the Division of Immunizations Lansing Office as instructed on the Addendum. Before accessing MCIR to verify employee vaccination status, the employer must obtain written employee consent and retain it indefinitely to make available to the MDHHS upon request.

Organizations may also consider setting up a new MCIR site to effectively separate patient vaccination status checks from those for employees. To do so, they will need to complete a new MCIR Provider Agreement to establish the site and obtain a MCIR ID, and then complete the Addendum.

Additional functions for the MCIR system are being explored, and hospitals and health systems will receive additional information when they are in production. Members with questions may contact Ruthanne Sudderth at the MHA.

No Expansion of Expiration Date for Johnson & Johnson Vaccine

The Centers for Disease Control and Prevention has confirmed that expiration dates of the Johnson & Johnson COVID-19 vaccine have not been given an additional extension. Many unused doses will expire soon, and providers are urged to check their inventory to ensure no expired doses are administered. Expiration dates can be found by scanning the QR code located on the outer carton, checking the Janssen Expiration Lookup website or calling (800) 565-4008. Providers should use this vaccine only until the expiration date and then follow requirements for disposal and report wastage into MCIR.

Questions regarding vaccines may be directed to Ruthanne Sudderth at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of Aug. 16

MHA Covid-19 update

MHA COVID-19 UpdateThe delta variant of COVID-19 has created crises in many parts of the nation and caused Michigan’s case numbers to climb, with nearly 930,000 confirmed cases that have led to over 20,000 deaths as of Aug. 20. Hospitalizations due to confirmed cases of COVID-19 in the state Aug. 20 totaled 912 adults and eight children. Meanwhile, the Centers for Disease Control and Prevention’s data tracker indicated 65% of Michigan residents ages 16 and above had received at least one dose of vaccine as of Aug. 18.

The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Federal Agencies Announce Plans for Third and Booster Shots

The Centers for Disease Control and Prevention (CDC) recently announced it recommends a third dose of mRNA vaccines (Pfizer and Moderna) for individuals with moderately to severely compromised immune systems. At this time, a second dose of the Johnson & Johnson vaccine has not been recommended. The CDC advises that people talk to their healthcare provider about their medical condition and whether getting an additional dose is appropriate for them.

In addition, the Biden administration plans to offer COVID-19 booster shots starting Sept. 20 to all Americans ages 18 and older who received Pfizer or Moderna vaccines. This is due to growing evidence that a third dose of the vaccine will be needed to maintain strong immunity, which experts have long expected would be necessary. The recommendation will include waiting until eight months after becoming fully vaccinated to receive a booster, meaning healthcare workers and nursing home residents would likely be first in line.

The administration shared that this booster dose policy depends on authorization from the U.S. Food and Drug Administration and a review by the CDC’s vaccine advisory committee. Administration officials said they anticipate also offering booster shots to people who received the one-shot Johnson & Johnson vaccine but are waiting for further data before officially making that recommendation. The recommendations are based on several studies showing effectiveness of the mRNA vaccines may decline by as much as 30% around the eight-month mark.

There is an important nuance in the language used to describe these additional doses: the “third dose” is used to describe the dose given to immunocompromised individuals, while a “booster” is used to describe the additional dose given to all other recipients.

Vaccines administered by Michigan providers have increased recently to an average of 39,000 first doses per week, rising from averages in the 20,000s in June and early July. Members with questions may contact Ruthanne Sudderth at the MHA.

MDHHS Launches Vaccination Record Website for Public

The Michigan Department of Health and Human Services (MDHHS) has launched the Michigan Immunization Portal, a website that allows any individual 18 or older who has been immunized in the state of Michigan to check and obtain a copy of their vaccination record online. Once an individual provides the necessary information, their immunization record will be pulled from the Michigan Care Improvement Registry and provided to them. This function may be especially useful for providers who are contacted by individuals who have misplaced their COVID-19 vaccination cards. Members may promote this tool to their patients and the public as appropriate. Questions may be directed to Ruthanne Sudderth at the MHA.

Changes Coming to Payer Policies for COVID-19 Coverage

Health insurers in Michigan have begun announcing that, in the coming months, they will no longer cover the full cost of COVID-19 treatments. Beneficiaries of Blue Cross Blue Shield of Michigan, for example, will resume taking responsibility for their cost sharing for any necessary COVID-19 care after Sept. 30, 2021. It should be noted that COVID-19 vaccines will remain available at no cost to patients in the U.S. The MHA will continue to urge the public to take advantage of free and low-cost preventive measures like masks and vaccines to avoid the risk of hospitalization, death and preventable healthcare costs. Members with questions may contact Ruthanne Sudderth at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of June 7

MHA Covid-19 update

MHA COVID-19 UpdateThe Michigan First-Dose Tracker indicates that, as of June 10, 60% of Michiganders ages 16 and over had received a COVID-19 vaccine. By June 12, more than 892,000 cases of COVID-19 had been confirmed in the state since the pandemic began; but more than 852,000 of those Michiganders had recovered from the disease as of June 11.

The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

FDA Extends Shelf Life of Johnson & Johnson (J&J) Vaccine

The U.S. Food and Drug Administration (FDA) announced it is increasing the shelf life of J&J/Janssen’s COVID-19 vaccine by 1.5 months. This extension comes at a time when hundreds of thousands of doses of the vaccine had been set to expire at the end of June.

The announcement extends the vaccine’s shelf life from three months to 4.5 months and was based on data from ongoing studies, which demonstrated that the vaccine is stable at 4.5 months when refrigerated at temperatures of 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius). J&J said vaccine providers should visit its website to check expiration dates of vaccines currently available.

To check the expiration date for a current supply of the vaccine, enter the lot number from the carton or vial at the company’s Expiry Checker webpage or call its automated response system at (800) 565-4008. The J&J COVID-19 vaccine may be administered until 11:59 p.m. ET on the expiry date.

Members are encouraged to use their J&J supply for vaccination at discharge from inpatient or emergency/urgent care settings. If additional doses of this vaccine are needed, providers should use the normal weekly ordering process through the Michigan Care Improvement Registry.

Members with vaccine questions may contact Ruthanne Sudderth at the MHA.

Visitor Screening Requirements Remain in Place

Although there have been many changes to public health orders recently, members are reminded that the requirement that all visitors coming into health facilities be screened for COVID-19 remains in place. This requirement is part of the emergency public health order issued in June 2020, which remains in effect until rescinded. Members with questions may contact Adam Carlson at the MHA.

MDHHS Seeks Healthcare Provider Input on Expanded Vaccine Data Tool

MI Lighthouse is a tool focused on providing granular, community-level vaccine coverage data to local public health departments, built by the University of Michigan and the MDHHS. The current version has been helpful for local public health departments but contains identifiable information. The MDHHS is now looking to expand access to information by building a version of this tool with unidentifiable data for vaccine providers, municipalities and other partners to inform more focused vaccine clinic planning and outreach.

The MDHHS would like to meet with organizations that have a need for statistics on vaccination coverage to inform the planning for building the next version of the MI Lighthouse tool. Organizations that volunteer would be asked to participate in user research interviews and to potentially be the initial testers for the tool. Interested hospitals/health systems should email Kirtana Choragudi at the University of Michigan, with a copy to Sarah Lyon-Callo at the MDHHS.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Weeks of May 24 and 31

MHA Covid-19 update

MHA COVID-19 UpdateWith approximately 8.4 million doses of COVID-19 vaccine administered in the state, more than 59% of Michiganders ages 16 and over have received at least one dose. Since the beginning of the pandemic, nearly 890,000 cases of the disease had been confirmed as of June 3. The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

MIOSHA Releases New Emergency Rules for Employers, MDHHS Updates Masking Order

Gov. Gretchen Whitmer May 24 announced updates to the COVID-19 emergency rules from the Michigan Occupational Safety and Health Administration (MIOSHA) to guide employers as they allow employees to return to in-person work. She also announced an updated Michigan Department of Health and Human Services (MDHHS) COVID-19 Gatherings and Face Masks epidemic order, effective June 1.

The updated MIOSHA COVID-19 emergency rules took effect May 24 and are set to expire Oct. 14, in accordance with the MI Vacc to Normal plan and recent health guidelines and orders. Because Michigan has vaccinated more than 55% of adults, the MIOSHA removed the requirement that employers must create a “policy prohibiting in-person work for employees to the extent that their work activities can feasibly be completed remotely.” The agency has also rescinded the draft permanent COVID-19 rules and canceled the public hearing that was scheduled for May 26.

The MIOSHA has updated other aspects of the emergency rules to reflect the recent order from the MDHHS and guidance from the Centers for Disease Control and Prevention (CDC). The rules include:

  • Excessive requirements for personal protective equipment use in the healthcare setting have been removed, along with all industry-specific references.
  • Employers may allow fully vaccinated employees to not wear face coverings and social distance provided they have a policy deemed effective to ensure unvaccinated individuals continue to follow these requirements.
  • Employers should continue to have and implement a written COVID-19 preparedness and response plan in accordance with the updated rules.
  • Of note for hospitals, the emergency rules state that “fully vaccinated persons must continue to wear face coverings when in the healthcare setting where patients may be present and when using airplane or public transportation if required by the latest CDC guidance.”
  • Employers must still screen all employees and contractors daily. However, the rules state that a record of health screenings must only be maintained for unvaccinated employees.
  • Employees must maintain six feet of separation only if unvaccinated.

The MHA has identified several areas of confusion with the new rule set and is seeking a frequently asked questions document from the MIOSHA for clarification. For example, although the rules require screening all employees regardless of vaccination status, they only require record-keeping for unvaccinated employees and contractors. The MHA will apprise members of any clarifications from the administration. Members with questions on the new rules may contact Adam Carlson at the MHA.

The updated MDHHS COVID-19 Gatherings and Face Masks epidemic order eliminates outdoor capacity limits entirely and increases capacity for indoor social gatherings to 50%. Under the new order, which will be in effect from June 1 through July 1, masks will continue to be required indoors for individuals who are not yet vaccinated. MHA members are reminded that the MDHHS order regarding hospital visitation policies remains in effect. That order requires health screenings for visitors entering healthcare facilities, among other things.

MDHHS Cautions Providers Regarding False COVID-19 Vaccine Cards

The MDHHS distributed an alert May 27 urging healthcare providers to watch for false vaccine cards/records. The department has received reports of individuals selling false COVID-19 vaccination record cards that may be presented at provider offices, local health departments and other vaccination locations. It has also received reports of blank copies of the CDC COVID-19 Immunization Record cards in circulation, which provides opportunities for entering false information.

These activities make it even more important that providers verify an individual’s immunization status in the Michigan Care Improvement Registry (MCIR) prior to vaccine administration. Accessing the MCIR record ensures the correct immunization status is available and allows providers to verify whether the person has received a dose of COVID-19 vaccine. Out-of-state COVID-19 vaccination record cards should be reviewed for completeness and to ensure that the doses are accurate before entering the information into the MCIR.

Some important points to keep in mind while reviewing the COVID-19 vaccination record card include:

  • Review the record in the MCIR to compare immunization data.
  • Look for completeness of COVID-19 vaccine information.
  • Review vaccinator information.
  • Look for any abnormalities such as alterations to the text or documentation on the card.
  • If the vaccination location is listed on the vaccine record card, verify with the facility that the vaccine was administered there. The facility may wish to follow up with its legal counsel if it is determined to be a false record.
  • If given the opportunity, attempt to learn where the person obtained the card. Any false information found should be reported to local law enforcement.
  • If given the opportunity, make a copy of the card. When the COVID-19 vaccination record is handed to a COVID-19 vaccine provider, it becomes part of the medical appointment and, thus, part of the appointment documentation, including the potential falsification of immunization documentation.

All COVID-19 vaccine providers and medical professionals must report any false medical information as soon as possible. An FBI Public Service Announcement was issued in March alerting the public that selling false COVID-19 vaccination record cards is illegal.

The MDHHS also has related resources available in the MCIR:

Pfizer Vaccine Now Available in 450-Dose Minimum Orders

The Pfizer COVID-19 vaccine is now available in shipments of 450 doses, while the 1,170-dose shipment will continue to be available. Both options were expected to be available for Michigan COVID-19 vaccine providers to order through the MCIR by May 28.

Healthcare providers are encouraged to review the following information regarding the new 450-dose shipment quantities:

  • The new 450-dose packs include three trays of 25 vials each (75 vials total).
  • Vials will be shipped in the same thermal shipping container as the 1,170-dose orders and will include the same Controlant temperature monitor.
  • There will be no dry ice replenishment (shipped 24 hours after receipt) for the 450-dose pack.
  • The newly extended refrigerator storage temperatures should decrease the need for dry ice. Therefore, Pfizer asks that the thermal shipping containers and Controlant monitors be returned within 10 days. For storage and handling guidance, including the updated refrigerator storage timeframe, see the CDC’s Pfizer-BioNTech Storage & Handling Summary.
  • The Product Information Guide has been updated with this configuration, National Drug Code information, dimensions and more.

New ancillary kits have been created to support the 450-dose minimum order size. A complete list of the items in the kits is available on page 12 of the Product Information Guide.

Questions about these ordering guidelines and ancillary kits should be directed to the MDHHS immunizations team. Members with other vaccine questions may contact Ruthanne Sudderth at the MHA.

June 14 COVID-19 Summit to Review Mi-COVID19 Data Registry Findings

In continued partnership with the Michigan Hospital Medicine Safety Consortium, the MHA and the Michigan Chapter of the Society for Critical Care Medicine will host a virtual COVID-19 Summit following up on the Mi-COVID19 webinar series. The COVID-19 Summit will be held virtually from 9 to 11 a.m. June 14.

This summit will share key findings and crucial lessons learned from the Mi-COVID19 data registry and review the current state of COVID-19 in Michigan. The MHA will lead a session dedicated to public policy in pandemics. More information is available in the event’s agenda.

Anyone involved with caring for patients with COVID-19 is welcome to attend. Registration for the COVID-19 Summit is available at no cost to MHA members. Questions about the event should be directed to Josh Suire at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of May 17

MHA Covid-19 update

MHA COVID-19 UpdateAs of May 20, the Michigan Vacc to Normal Tracker indicated more than 57% of Michiganders ages 16 and over had been given at least one dose of a COVID-19 vaccine. The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

MHA Board of Trustees Holds Special Meeting on COVID-19

At a special meeting on COVID-19 issues held May 18, the MHA Board of Trustees received updates on and discussed COVID-19 case data and trends, vaccine progress, return-to-work policies, state budget matters and health equity commitments. Board members confirmed the need for the MHA to continue advocating for clear and consistent public health rules related to mask wearing and vaccine status, especially for healthcare facilities, and remain heavily engaged in the promotion of COVID-19 vaccines.

On the issue of return to work, the MHA is in communication with both the Michigan Department of Health and Human Services (MDHHS) and the Michigan Occupational Safety and Health Administration (MIOSHA) about the need for prompt guidance that considers health facilities as it relates to gathering sizes, mask wearing and more. The MIOSHA has stated it is working on updated emergency rules to reflect new federal mask-wearing guidance, but said until then, “MIOSHA will consider compliance with the MDHHS order as good faith to comply when responding to employee complaints or conducting investigations related to COVID-19.” The MHA will keep members informed of progress on the return-to-work rules.

The next MHA Board of Trustees meeting will occur June 23, the day prior to the 2021 MHA Annual Membership Meeting. Members with questions about the Annual Meeting may contact Erin Steward at the MHA.

State to Reopen Faster than Original “Vacc to Normal” Plan

Gov. Gretchen Whitmer May 20 announced modifications to the recently implemented Vacc to Normal campaign that ties reopening measures to the state’s vaccination rate, providing specific dates for increasing capacity limits. Starting June 1, capacity limits will be lifted completely for outdoor gatherings and indoor capacity limits will be increased to 50%. As of July 1, the state’s broad indoor masking requirement will expire. The announcements did not specifically address healthcare; the MHA continues to advocate strongly for healthcare settings involved in patient care to be given special consideration in the crafting of the MIOSHA rules. MDHHS Director Elizabeth Hertel is expected to sign the order May 24.

The MHA will notify members know as soon as the MIOSHA issues new guidance. Members with questions may contact Adam Carlson at the MHA.

Vaccine Orders Must Comply with Shipping Timelines; No Memorial Day Shipments

The MDHHS immunizations team recently reminded healthcare providers to observe the Centers for Disease Control and Prevention’s stated shipping hours when ordering first and second doses of COVID-19 vaccine through the Michigan Care Improvement Registry (MCIR). Beginning May 24, the MDHHS will reject any orders with noncompliant shipping hours. Questions on this requirement may be addressed to the immunizations team.

The MDHHS announced there will be no vaccines shipped May 31 due to the Memorial Day holiday. Healthcare providers should take the following schedule into consideration for their vaccination planning efforts.

  • Pfizer Vaccine: No vaccine deliveries will occur Monday, May 31.
  • Moderna Vaccine: No vaccine deliveries will occur Monday, May 31, or Tuesday, June 1. (Ancillary kits may arrive June 1 for vaccine orders arriving Wednesday, June 2.)
  • Johnson & Johnson (J&J) Vaccine: No vaccine deliveries will occur Monday, May 31, or Tuesday, June 1. (Ancillary kits may arrive Tuesday, June 1, for vaccine orders arriving Wednesday, June 2.)

Providers needing to place vaccine orders for clinics scheduled during the holiday weekend must ensure the orders are entered into the MCIR, approved by the local health department and approved/processed by the MDHHS by Tuesday, May 25, for the Pfizer vaccine and by Wednesday, May 26, for the Moderna or J&J vaccines. Questions about these ordering requirements should be directed to the MDHHS immunizations team.

Members with additional vaccine questions may contact Ruthanne Sudderth at the MHA.

FDA Updates Certain COVID-19 Monoclonal Antibody Authorizations

The Food and Drug Administration (FDA) recently updated its emergency use authorizations for two intravenous infusion therapies for outpatients at risk for progressing to severe COVID-19 disease. Included were updates on the patient selection criteria and safety summary for the monoclonal antibodies bamlanivimab and etesevimab administered together and the patient selection criteria for the monoclonal antibodies casirivimab with imdevimab (REGEN-CON) administered together.

For details on the changes, see the FDA fact sheets for bamlanivimab and etesevimab and REGEN-COV.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of May 10

MHA Covid-19 update

MHA COVID-19 UpdateAs the spring surge of COVID-19 cases continues to recede in Michigan, the state has surpassed the 55% mark in adults ages 16 and older receiving at least one dose of the vaccine to prevent the disease. In addition, the Michigan Department of Health and Human Services (MDHHS) has launched its “Vacc to Normal” tracker that reports both state and federal data on vaccination rates, providing markers for reopening the state’s economy.

The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Press Conference Urges Youth Vaccinations

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) voted late May 12 to recommend use of the Pfizer COVID-19 vaccine in children ages 12 to 15. The MDHHS and the Protect Michigan Commission, with assistance from the MHA, held a press conference May 13 promoting this expansion of eligibility and urging parents to get their kids vaccinated as quickly as possible.

Because research has shown that children are more likely to get vaccinated if their parents are vaccinated, the MHA encourages members to begin their outreach on the vaccine eligibility of this age group with adults already vaccinated by their hospitals/health systems.

Pfizer’s studies have proved its vaccine is safe and effective for 12- to 15-year-olds, for whom it is 100% effective in preventing COVID-19. In addition, the CDC announced that COVID-19 vaccines may now be given in conjunction with other vaccines. It was previously recommended that two weeks pass between getting a COVID-19 vaccine and any other inoculation. With this change, providers are encouraged to offer other recommended immunizations when administering COVID-19 vaccine to young teens to help offset the decreased rate of childhood vaccinations during the pandemic.

The MDHHS is also urging all primary care physicians (PCPs), especially pediatricians, to enroll as COVID-19 vaccine program participants to ensure all families with a PCP can access the vaccine. Hospitals that wish to transfer vaccine to any primary care office settings must verify the office setting is enrolled and has a redistribution agreement in place to ensure the vaccine supply is tracked appropriately.

The state’s Vacc to Normal economic reopening plan will not include the numbers of vaccinated 12- to 15-year-olds toward easing public health measures and gathering capacity limits, as the plan ties vaccination rates of adults 16 and older to those events. The newly eligible age group, which comprises approximately 498,000 kids in Michigan, will be included in the regular data tracking on the state’s vaccine dashboard. On May 10, Michigan reached the milestone of 55% of adults having at least initiated vaccination, which will allow office workers to return to their places of employment May 24.

Vaccine Now to Be Ordered via Michigan Care Improvement Registry

The MDHHS has announced a change in the way COVID-19 vaccines are allocated. Providers must now electronically request their desired doses through the Michigan Care Improvement Registry (MCIR), including both first and second doses. Orders will not be automatically approved; local health departments (LHDs) will review requests and approve allocations accordingly. Providers should ensure they are following LHD guidance prior to placing an order in MCIR.

Providers should plan operationally to order second doses within the MDHHS MCIR order timing recommendations to ensure they arrive before patients’ second dose appointments. The MDHHS has provided a tip sheet on how to place orders; a recording and slides from a May 11 webinar detailing the process; and additional ordering information and resources on its website. It will add other materials as they are created throughout the transition.

The state has also received an allocation of the Moderna vaccine in the new 14-dose (maximum 15-dose) vials. Both the 10- and 14-dose vials may be ordered via MCIR.

Comprehensive resources for COVID-19 vaccination efforts are available on the MDHHS COVID-19 Vaccine Provider Guidance webpage. Members with vaccine questions may contact Ruthanne Sudderth at the MHA.

CDC Updates Guidance, Michigan Lifts Mask Requirement for Fully Vaccinated Individuals

CDC Director Rochelle Walensky, MD, announced May 13 revised guidance allowing fully vaccinated individuals to participate in any indoor or outdoor activity without masks. Walensky cited several factors that influenced the decision, including published literature on the safety of the COVID-19 vaccine and its effectiveness on the original virus and its variants circulating in the United States; the low risk of transmission from vaccinated individuals; and universal access to vaccines. The recommendations specifically apply to individuals in nonhealthcare settings. The CDC stated that healthcare settings can continue infectious disease practices that require masks within their facilities.

The following day, Gov. Gretchen Whitmer announced the MDHHS would update its Gathering and Mask Order to align with the updated CDC guidance, effective May 15. Under the updated order, Michiganders who are outdoors will no longer need to wear a mask regardless of vaccination status. Residents who have not completed their vaccinations must continue to wear a mask or face covering indoors to protect themselves and others. After July 1, the broad indoor mask mandate will expire.

While the MDHHS order has been updated, the Michigan Occupational Safety and Health Administration (MIOSHA) emergency rules for workplace safety remain in effect. Among other things, the rules stipulate screening and tracking of visitors and employees, mask wearing and other social distancing measures. The MHA has been in contact with the MIOSHA and expects the emergency rules to be significantly revised in the coming days (see below).

Process to Approve MIOSHA Permanent COVID-19 Workplace Rules Continues

The MIOSHA continues to pursue permanent workplace COVID-19 rules, even though Michigan is making progress vaccinating eligible residents. Because the state recently reached the 55% vaccination benchmark in the governor’s MI Vacc to Normal plan, in-person work will no longer be prohibited where it is feasible for the employee to work remotely, beginning May 24. All other workplace regulations that govern the use of personal protective equipment, physical distancing, contact tracing and other pandemic-related modifications would be required under the rules.

The MHA submitted comments to the MIOSHA expressing disagreement with the proposed permanent COVID-19 rules as written, because they fail to address concerns on cementing rules into the administrative code that do not reflect the rapidly changing environment related to the pandemic. The MHA recommended the rules be updated to address, at a minimum, two main concerns:

  1. Any new standard should be promulgated in a manner that would allow future updates, based on current CDC guidance, to be made automatically.
  2. A sunset clause for the rules to expire after the MDHHS declaration of emergency has ended.

The MIOSHA will host a public hearing at 9 a.m. May 26.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of April 26

MHA Covid-19 update

Gov. Gretchen Whitmer announced during an April 29 news conference that future epidemic order actions will be based on four vaccination-based milestones that will enable the state of Michigan to return to normalcy. Dubbed the “MI Vacc to Normal” challenge, the program’s goal is to reach a point where 70% of adults in the state are vaccinated and broad mitigation measures are lifted unless unanticipated circumstances arise. Meanwhile, Michigan’s hospitalization rates, testing positivity rates and other important measures are improving, although relatively high levels of acuity and pediatric admissions continue to cause high levels of stress on hospital staff and resources.

The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Administration of Johnson & Johnson Vaccine Resumes

The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (CDC ACIP) voted April 23 to recommend that providers resume vaccinations using the Johnson & Johnson (J&J) single-dose COVID-19 vaccine for anyone 18 and older. The CDC issued an updated Morbidity and Mortality Weekly Report April 27 providing the most recent recommendations for use of the J&J vaccine. The Michigan Department of Health and Human Services (MDHHS) also issued an alert advising providers to resume use of the vaccine.

The J&J vaccine was placed on a pause April 13 while experts conducted a thorough safety review after reports of a rare blood clotting syndrome in some people. The CDC and the Food and Drug Administration (FDA) confirmed that 15 cases of the blood clots have been reported to the Vaccine Adverse Reporting System, including the six cases originally reported, and that all occurred in women between the ages of 18 and 59. Due to the unique treatment required for these adverse events, the agencies also ensured providers and clinicians were made aware of their potential and could properly recognize and manage them. Shipments of the J&J vaccine are scheduled to resume during the week of May 3.

Both the Janssen COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine and the Fact Sheet for Recipients and Caregivers have been revised to include information about the risk of the blood clotting syndrome and should be reviewed prior to administration of the J&J vaccine.

CDC and MDHHS Provide Updated Vaccine Information

The CDC has issued updated interim clinical considerations for COVID-19 vaccines authorized for use in the United States. Providers are encouraged to review these considerations, as they cover such topics as interchangeability of vaccines, people vaccinated outside the U.S., antiviral therapy and vaccination, vaccination of pregnant or lactating individuals, and much more.

In addition, the MDHHS issued an alert on several updates to Moderna vaccines, including vaccine vial fill volume, updated labeling, and storage and handling modifications.

A recent emergency use authorization (EUA) revision indicates the Moderna vaccine will be available in two different vials by early May. Shipments of the new vials could occur as early as May 3, including the current maximum 11-dose vial and a new maximum 15-dose vial. Details about these new vials and packaging are available in the updated Moderna EUA fact sheet for providers.

Updated guidance for storage and handling of the Moderna COVID-19 vaccine have also been issued that include changes to time frames. The MDHHS clarified vaccine temperatures and storage time frames with the manufacturer, and an updated storage and handling summary and preparation/administration Moderna documents are available online.

Share Children’s Hospital Clinical Collaborative Open Letter on MIS-C

Leaders from a group of children’s hospitals and hospitals with extensive pediatric care programs together penned an open letter to clinicians and families across Michigan to raise awareness of multisystem inflammatory syndrome in children (MIS-C) as the spring surge continues to recede. These clinicians warn that Michigan could see children across the state experiencing MIS-C symptoms two to five weeks following the surge’s peak as children are exposed to the virus.

The letter offers details of the symptoms to be aware of, when to seek medical care, and links to appropriate treatment guidelines for clinicians. The MHA is distributing this letter on behalf of this group of pediatric clinical leaders from across the state and thanks them for their leadership around this critical issue.

Member hospitals and health systems are encouraged to distribute this letter to their physicians and ambulatory or primary care practices. The association will also share it on its social media channels to promote greater awareness among Michigan residents, especially families with children.

Members with questions may contact Laura Appel at the MHA.

Recording Vaccines on Michigan Care Improvement Registry is Important Step

Because increasing numbers of patients are seeking second doses at providers other than the one that provided their first dose, members are encouraged to review the proper procedures for looking up and recording vaccinations in the Michigan Care Improvement Registry (MCIR). The MDHHS has shared that it is receiving growing numbers of incorrect or duplicate vaccination records and wants to ensure an accurate reporting of the populations that have been vaccinated. Several detailed training guides are available online that vaccination teams can review at their convenience.

When patients present without their COVID-19 vaccine card, vaccination providers are urged to check MCIR to confirm the date and brand of their first dose to avoid medication errors that impact the effectiveness of the vaccine and other issues. Patients should also be encouraged to keep their vaccine card in a safe place and take a photo of it in the event it is misplaced.

Vaccinating Those Who Have Recovered from COVID-19

Although previous guidance recommended waiting 90 days before administering a vaccine to someone who recently had COVID-19, providers are now advised to vaccinate patients as soon as their symptoms have subsided and they are well enough to receive a shot. The change is due to the vaccine no longer being in limited supply.

However, patients who received monoclonal antibody (mAb) treatments for COVID-19 should not be vaccinated until 90 days after treatment, per CDC and MDHHS recommendations. It is not yet known how effective vaccines are in those who have previously received an antibody treatment for a COVID-19 infection or whether the antibody treatment could interfere with the body’s immune response to a vaccine.

The MHA recently cohosted a webinar with the MDHHS on mAb therapies and how to execute a successful mAb therapeutics clinic. A recording of the webinar is available online for those who were unable to participate.

Vaccination Rates Declining

As of May 1, more than 6.9 million doses of COVID-19 vaccine had been administered in Michigan, resulting in more than 4 million Michiganders having received at least one dose and more than 3 million getting all recommended doses of vaccine. Nearly 50% of adult residents have received at least one dose. However, the number of vaccinations administered in Michigan in the last week has dropped significantly, and supply has outpaced demand for the vaccines.

Because Black and Hispanic residents are being vaccinated at a slower pace than white Michiganders, the Protect Michigan Commission continues to make vaccine equity a high priority and has engaged partners to assist with doing door-to-door sign-ups, education and more. MHA members that are working with community partners are encouraged to ensure some of those partners are focused on reaching people of different races, ethnicities and cultures where they are in their communities.

Members with questions regarding vaccines should contact Ruthanne Sudderth at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Week of Feb 8

MHA Covid-19 update

MHA COVID-19 UpdateAs of Feb. 10, the state’s COVID-19 Vaccine Dashboard indicated nearly 1.5 million doses of vaccine have been administered in Michigan to protect residents from the disease. While the virus continues its assault across the globe, the MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Governor’s Proposed Budget Protects Hospital Priorities, Funds COVID-19 Needs

The Executive Budget Recommendation presented to the Michigan Legislature Feb. 11 fully protects hospital and healthcare priorities and includes new funding for pandemic-related needs including testing, vaccine operations and more (see related article).

Vaccination Supply Shortages Discussed

The MHA continues to host monthly calls with the Michigan Department of Health and Human Services (MDHHS) and supply chain leaders at member hospitals. During the Feb. 8 call, the groups discussed a shortage of some types of vaccination supplies and efforts at the state level to address them. The MDHHS reminded hospital leaders that it has a limited supply of syringes available to assist with administering the sixth dose of the Pfizer vaccine that is sometimes available in a vial. A shortage of sharps containers is expected to continue for a few months. Hospitals that need additional vaccination supplies are encouraged to contact their local healthcare coalitions.

The group also discussed an alert from 3M about counterfeit N95 masks that have been found in several states. Members are encouraged to check their inventory and contact 3M at (800) 426-8688 if they have the counterfeit masks. Facilities that face a significant N95 shortage due to this fraud should contact their healthcare coalition to help fill emergency supply gaps. Members with questions may contact Adam Carlson at the MHA.

Federal Pharmacy Vaccine Program Adds Doses to State Supply

Through a federal program announced Feb. 2, COVID-19 vaccine is being sent directly to Meijer and other pharmacies to administer doses to priority populations. The doses being sent to these pharmacies are in addition to states’ existing allocation sent to hospitals and health departments. The additional doses are being sent to community pharmacies as an additional access point and are separate from the pharmacy program responsible for vaccinating long-term care facility residents/staff. The federal government has also announced it will begin sending some doses directly to federally qualified health centers.

The MHA has communicated with the state about the need to ensure any pharmacy receiving vaccine directly from the federal government is following state prioritization guidelines. State officials will work with their federal partners to communicate these priority group requirements to any pharmacy receiving vaccine directly from the federal government.

All vaccine providers in Michigan are expected to follow current priority groups for vaccinations. The vaccines should currently be administered to the following population groups:

  • Phase 1A (healthcare workers and long-term care residents).
  • Phase 1B groups A and B (first responders, pre-K through grade 12 educators, childcare workers, corrections workers and workers in other congregate care settings).
  • Phase 1C group A (residents age 65 years and older).

The state is also working to vaccinate veterans. Providers should not yet begin to vaccinate those under 65 with underlying conditions (phase 1C group B). The state’s vaccine prioritization document provides complete details about these categories. The priority groups follow federal guidance closely and are unlikely to be changed.

Vaccination Data Required

It continues to be important for providers to enter and update data on employee and patient COVID-19 vaccinations in the state EMResource portal each Wednesday. In addition, members should report race and ethnicity data on those receiving vaccinations in the Michigan Care Improvement Registry, as a primary goal for the state is to ensure there is no disparity in vaccination rates across races and ethnicities. Members facing challenges in collecting this data or with other data-related questions should contact Jim Lee at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).