Enjoy Tuesday’s NCMS Morning Rounds.

April 27, 2021

Join the Crucial COVID-19 Vaccine Effort

In order to vaccinate as many people as possible with the COVID-19 vaccine, the state now is prioritizing primary care offices as key vaccine access points. Harvard researchers estimate 17 million unvaccinated Americans will visit their primary care physician or PA in the next month, providing a great opportunity for vaccination.

“Our top priority is to make vaccines easily accessible to North Carolinians in settings they trust, so that as many people as possible are vaccinated as quickly as possible,” the NC Department of Health and Human Services (NCDHHS) said in an email sent to primary care practices last week. “Providers are encouraged to accommodate walk-in appointments and to offer vaccines as part of regular patient visits to provide the greatest flexibility and access to people wanting the vaccine. In these circumstances, getting vaccine to people who want the vaccine should be prioritized over ensuring that every dose is used in an open vial.”

To facilitate getting COVID-19 vaccine to primary care practices, the state has developed a step-by-step ‘roadmap’ to enroll in the NC Vaccine Management System (CVMS) and to request vaccine once enrolled and activated. Access that roadmap here.

Anyone age 16 and up is now eligible to receive the vaccine. Pfizer is the only vaccine currently authorized for those under age 18, but the state anticipates the Pfizer COVID-19 vaccine may be authorized for adolescents 12 and up in the next couple of weeks. Pediatric and family medicine practices please take note – if and when the Pfizer vaccine is approved for the younger age group, the state will look to you to help vaccinate 12- to 15-year-olds.

The process to become enrolled and activated to provide the vaccine in your practice can take up to two weeks. Once your practice is enrolled, you will be able to request vaccine doses for the coming week. The state is encouraging primary care practices to get started now to help in the effort to get North Carolina’s population fully vaccinated. If you need help or have questions, please reach out to your Immunization Branch Regional Nurse Consultant with the contact information listed in this map. You may also call the COVID-19 Vaccine Provider Help Center at (877) 873-6247 and select option 1 for COVID-19 questions (Monday – Friday 7 a.m. to 7 p.m. and Saturday – Sunday 10 a.m. to 6 p.m.).

Once enrolled, a new allocation process for vaccine also has been implemented in which you may request the number of first doses of vaccine for the coming week with the opportunity each week to request more doses. The previous 7-day requirement to use up all the first doses no longer exists. You may request doses on an as-needed basis, but to be considered for additional doses you should have administered at least half of your allocated vaccine. Detailed steps are outlined in the roadmap here.

NC Medicaid Payments Deadline Changes

As previously reported in this newsletter, the Advanced Medical Home (AMH) Glidepath Payment program became effective April 1. This program offers time-limited payments to practices that have attested to contacting and testing criteria as an AMH Tier 3 provider as part of the transition to NC Medicaid Managed Care. The attestation deadline for June payments has changed. To be eligible for June payments, attestation MUST be completed by May 14 at 5 p.m.

Additionally, the NC Department of Health and Human Services (NCDHHS) has developed a reconsideration process for providers who either disagree with the outcome of the validation determination for the March payment or who missed the initial attestation deadline due to COVID-19 pandemic and public health emergency related circumstances.
For more information, please see the Advanced Medical Home Tier 3 Glidepath Attestation Payment Updates Medicaid bulletin article.

CDC, FDA Lift Pause on J&J COVID-19 Vaccinations

Late last Friday, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) lifted the 10-day pause on the Johnson & Johnson (J&J) COVID-19 vaccine after the review by the CDC’s Advisory Committee on Immunization Practices. The expert panel, in a 10-4 decision, voted to recommend vaccinations resume but with a warning label on the vaccine about the risks.

The pause in J&J vaccinations came after six cases of a rare and severe type of blood clot were reported among the 6.8 million doses of the shot administered. As of last week, a total of 15 cases of thrombosis have been reported through the Vaccine Adverse Event Reporting System. All of the cases occurred in women between ages 18 and 59, with symptom onset six to 15 days after vaccination.

During the pause, medical and scientific teams at the FDA and CDC examined available data to assess the risk of thrombosis involving the cerebral venous sinuses, or CVST (large blood vessels in the brain), and other sites in the body (including but not limited to the large blood vessels of the abdomen and the veins of the legs) along with thrombocytopenia, or low blood platelet counts. The available data suggest the chance of this occurring is very low, but the FDA and CDC will remain vigilant in continuing to investigate this risk, according to the agencies. They determined that the vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older.

Health care providers administering the vaccine and vaccine recipients or caregivers should review the Janssen COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) and Fact Sheet for Recipients and Caregivers, which have been revised to include information about the risk of this syndrome, which has occurred in a very small number of people who have received the J&J COVID-19 Vaccine.

In the News

Electric Scooter Company Spin To Offer Free Rides To Charlotte Health-Care Workers, Charlotte Business Journal, 4-21-21

Learning Opportunity

Stories of resilience told by people whose lives have been impacted by the overdose crisis.
Centering lived experience is core to the work we do across the state to respond to the overdose crisis. To create a space for storytelling and sharing lived experience, the Duke Opioid Collaboratory, NC DHHS’ Injury and Violence Prevention Branch, and The Monti, will host a virtual event (using Zoom) that builds community through storytelling.

Learn more and register for this free event here.

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