Immunization resources for community vaccine providers

• All vaccine ordering (including COVID-19)
  Use this form to order all vaccines from Public Health.
  
  • Primary care providers and COVID-19 vaccine
    • The Province requires COVID-19 vaccine to be documented in the provincial immunization registry
    • If you have completed the onboarding process:
      • When you order COVID-19 vaccine, click the above link “All vaccine ordering” choose “SPRI” for the first drop down (Vaccine request type)
    • If you have NOT completed the onboarding process and want to provide COVID-19 vaccines:
      • Email immunizationlogistics@fraserhealth.ca
  • Fax orders are no longer accepted
    • Vaccine ordering is done via the online vaccine order form and is automatically submitted directly to your local public health unit
  • Ensure you submit the number of doses needed
  • The amount of doses requested is not guaranteed. Public Health will try to accommodate as much as possible, however there are times when the available stock may be limited
  • If Public Health is not able to fill your order by the date you have requested for pick up, they will call your office to notify and arrange an alternate pick up date
• Frequency of ordering
  • Your local public health unit will fill orders for a duration of up to four weeks
  • Please ensure you provide a minimum of two business days when ordering vaccine, as it may take some time for the local public health unit to procure and prepare your vaccine
• Urgent orders
  • Place your order via the online vaccine order form and follow up with a call to the local public health unit
  • The team will do their best to accommodate any last minute requests if we have available resources and supply
• Picking up and transporting vaccine
  To ensure vaccine stability is maintained, the appropriate equipment is necessary when transporting vaccine. Ensure you arrive with the appropriate cooler and materials for vaccine pick up as public health is unable to provide these to our immunizing partners.
  • Insulated containers:
    • Large enough to store vaccines, ice/gel packs, and insulating materials during transport
    • External surface material is strong and durable
    • Lid is tight fitting
  • Insulating materials:
    • Used as a barrier to prevent direct contact between vaccines and frozen ice packs
    • Flexible insulating blankets and gel packs at refrigerator temperature (+2°C to +8°C)
    • Bubble wrap
    • Crumpled packing paper
      • Note: A layer of paper towel is not sufficient as a barrier to protect vaccines from contact with frozen material.

  

Vaccines may be inactivated by exposure to excess light, heat or freezing, depending on the nature of the product, the temperature reached and the duration of exposure. Any loss of vaccine potency is permanent and irreversible which would result in lower level of protection against disease. By maintaining optimal temperatures while transporting, storing and handling vaccines you:

• Ensure the best quality vaccine for your clients
• Assist in preventing vaccine wastage

What you can do to decrease vaccine wastage?

• Encourage all staff to:
  • Read BCCDC's handle vaccines with care
  • Review and save BCCDC's vaccine management website
• Designate one staff member (and a back-up) to be responsible for vaccine management
• Monitor vaccine refrigerators with maximum-minimum thermometers
  • See BCCDC's Immunization Manual – Appendix E for details
• Check and record refrigerator temperatures (current, minimum, and maximum temperatures) twice daily. Refer to BCCDC's Refrigerator temperature form for instructions
• Store vaccines with the shortest expiry date at the front of the fridge so they are used first (first to expire, first out)
• Never store vaccine on fridge door shelves due to temperature fluctuations
• If the vaccine is involved in a cold chain incident/break (e.g. power failure) quarantine the vaccine in the refrigerator, complete the BCCDC Cold Chain Incident Form, and send the form to your local health unit.
  • If you have questions about how to report a cold chain incident you can call your local health unit for advice

BCCDC Resources

• BCCDC Immunization Manual - Appendix E
• Vaccine Storage and Handling – Quick reference guide for those that handle vaccines
• Checklist for safeguarding the storage and handling of your vaccine supply
• Equipment malfunction or power failure
• Handle Vaccines with Care
• Temperature Monitoring form
  • Temperature Monitoring Form Instructions

Refrigerators (section 3.1)

• Do's and don'ts
  • Refrigerators should be vaccine only: No food or beverages allowed
  • “First to expire, first out.” Rotate vaccine stock so that the vaccine expiring is always at the front
  • Clearly label biological products that have had a cold chain incident, but are subsequently deemed to be usable. Use these vaccines as soon as possible
  • Refrigerator should be in a well-ventilated area - away from walls or other structures
  • Ensure area around the refrigerator is clean and free of dust
  • Keep refrigerator out of direct sunlight
  • Connect the refrigerator to a dedicated electrical circuit
  • DO NOT store vaccine on the door shelves

Please review National Vaccine storage and handling guidelines to ensure your facilities refrigerator meets necessary criteria.

Fraser Health maintains an up to date immunization registry for all immunizations provided to children <18 years of age as well as adults. This immunization information is then updated in the provincial immunization registry.

1. All other vaccines ordered from Fraser Health (except COVID-19 and Influenza)

Complete the Immunization report form on all clients immunized

• Please ensure all fields are completed
• Fax the Report of Immunization to your local Public Health Unit on a weekly basis

2. COVID-19 vaccine ordered from Fraser Health

The province requires that all COVID-19 vaccine is documented in the provincial immunization registry.

Primary care providers

• Follow the documentation guidelines and standards provided to you by the province.
• If you have not yet registered to provide and document COVID-19 vaccine and would like more information please email immunizationlogistics@fraserhealth.ca.

Pharmacists

• Continue to follow your reporting guidelines as per the BC Pharmacy association.

Fraser Health facilities (such as acute care or Urgent and Primary Care Centres/UPCCs)

• Follow your Fraser Health internal guidance documents regarding reporting requirements.
• COVID-19 and influenza reporting record.

3. Influenza vaccine ordered from Fraser Health

Community vaccine providers (physician offices, nurse practitioners, etc.)

• We strongly encourage CVPs to report all client’s seasonal influenza records
• To have this recorded in the provincial immunization registry:
  
  • Fill out the influenza immunization entry form
  • Fax to Fraser Health at 604-528-5459

Pharmacists

• Continue to follow your reporting guidelines as per the BC Pharmacy association.

Fraser Health facilities (such as acute care sites or UPCCs)

• Follow your Fraser Health internal guidance documents regarding reporting requirements.

Vaccine return form

To assist in managing the vaccine supply more efficiently and to monitor vaccine wastage, Public Health is requesting vaccine that was ordered through Public Health and can not be used for any reason, be returned to the health unit. The reasons may include:

• Surplus / over-ordered
• Cold chain incident. Before returning any vaccine in the event of a cold chain incident, call your local health unit to assess if the vaccine can or cannot be used. In some circumstances vaccine may still be used
• Recall
• Expired product
  • Remove vaccine from the fridge immediately to avoid accidental use

In the event that you need to return publicly funded vaccine, please complete the Vaccine Return Form and return it to the health unit with the vaccine. Do not discard unused or expired vaccine.

• If you ordered vaccine from BCCDC, follow your usual return process directly with BCCDC

• Have a non-urgent question about immunization products you are providing? Vaccine providers can now request a consultation with our public health nurses using our online consultation request portal.
• Learn how to use and access the portal: Quick reference guide and FAQ.
• For urgent questions, call your local public health unit.

• BCCDC vaccine management
  These resources will help you control the temperature of your vaccines during storage and distribution.
  
• Quick reference guide – BCCDC vaccine storage and handling
• Refrigerator temperature form | Instructions
• Cold chain incident form (PDF; Excel) | Instructions
• Equipment malfunction or power failure (emergency plan checklist)
• Storage and handling vaccine supply (checklist)

Find health unit locations and contact information.

Public Health immunization logistics team contact information

• The newly formed Public Health Regional Immunization Logistics team is available to support our Community Vaccine Provider partners with any questions or clarification required. Please feel free to reach out at any time
• General Email inbox: Immunizationlogistics@fraserhealth.ca
• If you have any questions regarding your vaccine order contact your local Public Health Unit directly

• Immunizer education videos – BCCDC Immunization clinical resources page
• A better immunization experience
• Adverse events following immunization
• Rotavirus parental survey presentation
• Talking about vaccines
• BCCDC Immunization Course homepage
• Full Immunization competency course – For those providing vaccines other than just COVID-19 and/or influenza
• COVID-19 Immunization competency course – for those who will be providing COVID-19 vaccines only
• Influenza Immunization competency course – for new immunizers who will be providing influenza vaccines only
• Pearls for Immunization Practice
• Online self learning course provides practical immunization information to assist immunizers in the practice setting as well as highlights important immunization resources
• Immunization Communication Course
• Highlights the importance of effective immunization communication and helps immunizers skillfully address different client types and complex immunization questions
• Vaccine Storage and Handling Course
• Provides information regarding how to appropriately handle and store vaccines based on the provincial guidelines
• Foundations of Influenza Disease and Vaccines
• Provides information regarding influenza disease, influenza vaccines and practice considerations
• Seasonal Influenza Update
• Reviews the previous influenza season and provides the latest updates on influenza disease, vaccine product and practice considerations

• Your local public health unit will fill orders for a duration of up to four weeks for routine requests as outlined in the “Criteria for Pharmacist Access to Publicly Funded Vaccines” document on the Vaccine resources for pharmacists - Province of British Columbia (gov.bc.ca) website
• Orders for vaccines under the “case-by-case requests” section of the “Criteria for Pharmacist Access to Publicly Funded Vaccines” document will be provide as outlined in this criteria

Visit BCCDCs immunization clinical resources page

• Routine schedule infographic for infants and children, school age children and adults 18+ who were not immunized in childhood
• MSP billing codes and record card and many more resources

BCCDC immunization manual provides best practice guidelines for immunization services and publicly funded eligibility guidelines.

• COVID-19
  • General eligibility page
  • BCCDC specific product pages
    
  • BCCDC schedule infographic
• Part one - Immunization schedules includes:
• Schedule A: Basic immunization for children starting series at two months of age
• Schedule B: Children one to six years of age (inclusive) when starting or resuming immunization
• Schedule C: Children and adolescents seven to 17 years of age (inclusive) when starting or resuming immunization
• Schedule D: Adults age 18 and older when starting or resuming immunization
• Schedule E: Routine immunizations for adults who have completed a primary series of childhood vaccines
• Minimum intervals between vaccine doses
• Part two - Special populations includes:
  • Immunization of individuals at high risk, immunocompromised individuals, chronic medical conditions, occupation, lifestyle and other high-risk conditions
• Part four - Biological products includes:
  • Product-specific information on vaccines and immune globulins including eligibility, dosing and scheduling

You have an important role in monitoring vaccine safety in B.C. In fact, the Public Health Act requires a health care professional who is aware of an adverse event following immunization (AEFI) to report the event to the medical health officer.

Criteria for reporting and managing adverse events are found in the B.C. Communicable Disease Control (BCCDC) Manual, Chapter two: Immunization, Part 5 - Adverse events following immunization.

To report an AEFI follow these steps:

1. Download the Report of adverse event following immunization case report form
2. Refer to the AEFI user guide and the video how to complete the two page AEFI form - YouTube for instructions on how to complete the form
3. Fax the completed form to 604-528-5469, ATTN: AEFI Admin

For additional information and resources, please go to the Adverse events following immunization (AEFI) section on the BCCDC website.

Medical health officer (MHO) updates

• MHO updates
• Subscribe to MHO updates

Fraser Health resources

• Vaccination Status Reporting Regulation
• How clients can request their immunization records
• How to book an immunization appointment
• Immunization coverage

BCCDC Immunization clinical resources

• Schedules
• Records
• MSP billing codes
• Injection sites/routs
• Reducing immunization pain
• Forms and letters
• Education videos

Additional vaccines that are not publicly funded

• Additional vaccines that are not included in the BC routine immunization schedules
  • Extra Protection: Childhood vaccines available for purchase
  • Extra Protection: Information for health care providers
  • Vaccines Recommended for Adults in B.C. – Online Quick Reference Guide for Health Care Providers

BCCDC Immunization updates

• BCCDC Immunization updates main website
• BCCDC offers a free subscription service to receive automatic notification by email whenever the immunization and communicable disease control manuals are updated.
  • To subscribe to the service, go to the BCCDC’s website and enter your email address in the section that states “Get email updates.” The next time the page is updated, you will receive an email alerting you to the latest update