Introduction and contact information
Dear Colleagues,
The Los Angeles County Department of Public Health (LAC DPH) can assist your practice to enroll in the State’s COVID-19 vaccine program. We can provide support to ensure you are prepared to receive, store, administer, and report the administration of COVID-19 vaccines. We can also provide ongoing support as your practice begins its COVID-19 vaccination program.
Once enrolled LAC DPH will support you to ensure you're ready to administer vaccine.
Please contact: COVAXonboard@ph.lacounty.gov for more information or join one of the Office Hours sponsored by LAC DPH or the California Department of Public Health (CDPH).
It is now easier to enroll and provide COVID-19 vaccinations – view the Become a Vaccine Provider flyers to learn more:
- Adult and Prenatal Providers
- Pediatric Providers
- LAC DPH Office Hours for COVID-19 and Mpox vaccines. Every other Wednesday (effective 2/1/23) 9am-10am. The first portion of the meeting is on COVID-19 issues, the second portion is on Mpox vaccine issues. Join via Microsoft Teams or call +1 323-776-6996, 350 547 595#, phone conference ID: 350 547 595#. To request meeting slides, please email covidvaccinereq@ph.lacounty.gov
- CDPH COVID-19 Vaccination Program Consolidated webinar (COVID-19 vaccine, COVID-19 therapeutics, Mpox)– Updates and Q&A Fridays 9am-10:30am One-time registration | Slides & recordings
Sincerely,
COVID-19 Vaccine Provider Outreach Team
Los Angeles County Department of Public Health
Steps to Enroll in the COVID-19 Vaccination Program
Please make sure to review the program requirements prior to enrolling in the program. Currently program enrollment is open to providers who routinely vaccinate their patients. Providers who do not provide routine vaccinations should contact the COVID Call Center regarding eligibility. To enroll, all providers must have an active license to practice in California.
Follow the steps below:
Step 1: Review Program Requirements
Please review the requirements prior to beginning the enrollment process to determine if your organization or site meets the requirements to enroll.
- Enrollment Kit (walks you through the enrollment process and requirements)
- Provider Enrollment Worksheet (gather required information before logging in to myCAvax)
- Storage Guidelines (CDC Storage & Handling Toolkit)
- myCAvax Training
- COVID-19 Vaccine Systems at a Glance Guide
Step 2: Enroll in CAIR
Enrollment in myCAvax and the State Immunization Information System (IIS) or California Immunization Registry (CAIR) is a condition of participation in the state’s COVID-19 vaccine programs. In addition, Vaccination Partners administering COVID-19 vaccine will be required to document COVID-19 vaccines directly into CAIR and MyTurn, or use an EHR interface with CAIR.
If you need to enroll in CAIR, visit: http://cairweb.org/enroll-now/.
- For additional assistance, contact the CAIR Help Desk
- By phone: 1-800-578-7889
- By Email: CAIRHelpDesk@cdph.ca.gov
- Some Vaccination Partners may already be enrolled in CAIR; organizations that are uncertain of their enrollment status should contact their Local CAIR Representative or the CAIR Help Desk, both of which are noted on the CAIR enrollment webpage.
- Provider sites that are interested in submitting immunization data to CAIR from their EHR systems should first review the CAIR2 DX Support page for details regarding the process.
- CAIR Frequently Asked Questions
Step 3: Enroll in MyCAvax
Before enrolling in myCAvax, complete the Provider Enrollment Worksheet. Upon completion of the form, your organization will receive an invitation code. This code can be shared with multiple locations within the organization. Once submitted through myCAvax, your organization and corresponding sites registered will receive an email confirming request to enroll. If you do not receive an email, contact the COVID Call Center at covidcallcenter@cdph.ca.gov or call (833) 502-1245 Monday through Friday from 9 AM to 5 PM. Further instructions can be accessed at the links directly below:
- Enrollment Kit (for prospective and enrolling providers)
- Enrollment page on EZIZ for new pediatric providers
- Enrolling Provider Organizations (walks you through Section A)
- Enrolling Provider Locations (walks you through Section B)
- Enrolling Community Health Centers (HRSA)
- Welcome Kit (post-approval)
Additional Program Requirements
Vaccine Finder
All providers are required to report their vaccine inventory in the CDC’s Vaccine Finder platform. Review the forms below to help you create an account and begin the process of reporting your vaccine inventory.
MyTurn
- My Turn allows providers the opportunity to have an all-in-one-application from clinic management, dose accountability and reporting, scheduling and walk-in registration for vaccine clinics. Reference materials are available on the EZIZ MyTurn Website.
Quick Reference Guidance for Healthcare Professionals
The California COVID-19 Vaccination Program Provider Operations Manual (POM) provides basic information on the proper storage, preparation, and administration of all vaccines. It includes everything you need to know about ordering vaccines, receiving and storing vaccine shipments, routine tasks and reporting, managing vaccine inventory, and patient visits.
General Information:
- Clinical Considerations webpage
- COVID-19 Vaccine Product Information
Vaccine Manufacturers
- Vaccine product guide (EZIZ)
- Pfizer: vaccine webpage EUA
- Moderna: vaccine webpage for providers EUA
- Novavax: vaccine
webpage for providers
EUA
- 12+ years of age and older EUA
Vaccine Information:
- COVID-19 Vaccine Training: General Overview of Immunization Best Practices for Healthcare Providers
- Storage, handling, preparation, administration, and documentation for:
- Pfizer Vaccine: Storage and Handling | Vaccine Administration
- Moderna Vaccine: Storage and Handling | Vaccine Administration
- Novavax Vaccine: Storage and Handling | Vaccine Administration
FAQs and Answering patients’ questions about COVID-19 vaccine:
- Engaging in Effective Vaccine Conversations webpage
- Common Questions People May Ask Healthcare Professionals 2 page handout
- Patient FAQs: CDC; LAC DPH - English Spanish
California Department of Public Health (CDPH)
- California COVID-19 Vaccination Program
- CDPH - Required Trainings & Resources
- CDPH-Providers of Pediatric Services: How to Enroll in the California COVID-19 Vaccination Program View slides Watch recorded webinar
- Coadministration of Vaccines - CDC Guidance
- California State Public Health Officer Order
California Medical Association (CMA)
Los Angeles County Department of Public Health (LAC DPH)
- DPH Vaccine Call Center 833-540-0473 open daily 8am to 8:30pm. Answers questions and helps callers find a vaccination site, make an appointment, arrange transportation or in-home vaccination.
- Patient COVID Vaccine Schedule (including information on booster doses and schedules for people who are immunocompromised) English | Spanish and are available in multiple languages at ph.lacounty.gov/howtogetvaccinated
- How to get vaccinated webpage for the public to search for a vaccine by zip code, and get information on in-home vaccination, vaccine schedules by age and immune status, vaccine side effects, vaccine records, and more. English | Spanish
- VaccinateLACounty.com (Spanish - vacunatelosangeles.com) Vaccination resources for the public
CDC Routine Vaccine Schedules
- Child and Adolescent Schedule
- Recommended vaccination schedule for ages 18 years or younger
- Adult Schedule
- Recommended vaccination schedule for ages 19 years or older
Receiving & Transporting Vaccine
Identify a designated vaccine storage site and appropriate temperature monitoring unit.
Create protocol to monitor storage unit temperatures twice a day and create a log to document AM and PM temperatures.
- Storage Requirements at a Glance
- COVID-19 Vaccine Management Plan
- COVID–19 Vaccine Temperature Log
- CDPH Vaccine Management Resources
- CDC’s Vaccine Storage & Handling Toolkit (COVID-19 Addendum)
Steps for Receiving Vaccine
- Verify number of doses/vials received.
- Make sure vaccine was transported at the appropriate temperature.
- Store vaccine in designated storage unit.
- Complete sign – off sheet
- Transport Temperature Log
Other key resources/information:
Vaccine Preparation
Planning Guidance
- Pfizer job aid (Under Revision)| Vaccine Preparation Infographic (Under Revision)
- Moderna job aid (Under Revision)
- Novavax job aid
- RTI VanishPoint videos for 1mL low deadspace safety syringe and 3mL syringe
Expiration Dates and COVID-19 vaccines
The expiration date should be checked prior to preparing or administering vaccine. Expired vaccine or diluent should NEVER be used. As additional stability data become available, the expiration dates for some products may change. Follow the instructions below to determine the expiration date.
- Moderna COVID-19 vaccine: To determine the expiration date, providers can scan the QR code located on the vial or carton or access the manufacturer’s website directly, enter the lot number and the expiration date will be displayed. CDC’s https://www.cdc.gov/vaccines/covid-19/downloads/expiration-tracker.pdf can help providers keep track of the expiration date by lot number.
- Pfizer COVID-19 vaccine: This vaccine product has an expiration date located on the vaccine vial. CDC will be updating VTrckS effective immediately to replace the placeholder date in VTrckS with the actual expiration date.
- Novavax COVID-19 vaccine: The expiration date is NOT printed on the vaccine vial or carton. To determine the expiration date:
COVID-19 Vaccine Schedule and Recommendations for bivalent boosters
- Covid-19 Vaccine Timing (includes schedule for bivalent booster) (Under Revision)
- COVID-19 Vaccine Interim Immunization schedule for persons 6 months of age and older
Develop standing orders/standardized procedures for vaccine administration.
- Moderna Standing Order 6mos-5 years (Under Revision)
- Moderna Standing Order 6-11 (Under Revision)
- Moderna Standing Order 12+ (Under Revision)
- Pfizer 6mos-4 years Standing Order (Under Revision)
- Pfizer 5-11 Standing Order (Under Revision)
- Pfizer 12+ Standing Order (Under Revision)
- Novavax Standing Order
Develop or use internal procedures to obtain assent or consent
Every recipient must receive an EUA fact sheet of the vaccine being administered (Fact sheets are available in 20 languages at these links: Pfizer, Moderna, and Novavax). Persons 18 and older receiving any of the three vaccines must assent to vaccination. Youth ages 6 months through 17 receiving Pfizer, Moderna, or Novavax (≥ 12 years) vaccine must have consent from their parent or guardian.
Plan for adverse reactions
- Preparing for Anaphylaxis Preparing for the Potential Management of Anaphylaxis at COVID-19 Vaccination Sites. From CDC
- Medical Management of Vaccine Reactions in Adults in a Community Setting From IAC
- Recognizing and Responding to Anaphylaxis
Ensure emergency cart supplies are sufficient for treating adverse reactions. (i.e. Benadryl, Epinephrine)
Familiarize staff with the Vaccine Adverse Event Reporting System (VAERS) reporting system and reportable events.
Review best practices for immunizations with staff and train staff in advance or use just in time training.
Skills Checklist for Vaccine Administration
Ensure staff are appropriately trained to identify age – appropriate anatomical sites for intramuscular (IM) injections.
Ensure staff is using proper hand hygiene - e.g. wash hands for 20 seconds before administering vaccines, change gloves between patients, and anytime they become soiled. (See CDC hand hygiene recommendations)
Begin engaging and provide COVID-19 vaccine resources for staff and residents
- Frequently Asked Questions LAC DPH
- Talking to Patients About COVID – 19 Vaccines CDC
- Encourage patients to register for the CDC’s V-Safe (see below)
Develop system to generate reminders to administer second dose at the designated interval.
Create a process to reconcile vaccination with your facility’s MAR.
Vaccine Administration
Who can give the vaccine?
- See list of qualified persons covered to administer COVID-19 vaccines under the PREP Act Declaration and its amendments
- Licensees Authorized to Administer Vaccines in California
Verify contraindications and precautions to vaccination.
- Pre-Vaccination Screening Form (for Pfizer-BioNTech, Moderna and Novavax COVID-19 Vaccines)
Ensure staff administering vaccine are following the Seven (7) Rights of vaccine administration:
- Right patient
- Right time
- Right medication
- Right dose
- Right route and technique
- Right site
- Right documentation
Document vaccine administered in your EHR, CAIR, or MyTurn.
Reporting Adverse Reactions and Vaccine Errors
- Report all administration errors per facility protocol and take corrective action immediately. Report all vaccine errors to VAERS and the Vaccine Error Reporting Program (VERP)
- Report any adverse reactions to VAERS and document per your facility's protocol.
- Report any needlestick injuries per facility protocol and refer for medical treatment and evaluation if needed.
- Encourage patients to enroll in v-safe, which provides personalized health check–ins for side effects in patients who’ve been vaccinated. The program is available in English, Korean, Simplified Chinese, Spanish and Vietnamese. Key Messages for V-Safe.
Update your vaccine inventory in Vaccine Finder.
Resources for Vaccinating Children Under 5
- Pediatric Provider Kids Sprint Toolkit
- Recommending COVID-19 Vaccination: Clinical Talking Points for Providers of Pediatric Services
- Preparing for Under 5 Vaccination
- Planning for Under 5 Vaccinations Webinar Recording and Slides
- Intramuscular (IM) Injections for Children (video)
- Comfort Measures Video
- Comforting Restraint
- Babies: PDF | Video
- Giving All the Doses Under 12 Months | 12 Months and Older (PDF)
- Infants 11 months of age and younger (PDF)
- Children 1 through 2 years of age (PDF)
- Children 3 through 6 years of age (PDF)
Post-Vaccination
Provide Patient with Documentation of Vaccination
- DPH 'Vaccine side effects' webpage English | Spanish with summary handouts in multiple languages
- DPH Stickers "I Got my COVID-19 Vaccine" English | Spanish | Traditional Chinese | Simplified Chinese | Korean | Armenian | Tagalog | Arabic | Russian | Japanese
English | Español
Monitor vaccine recipients for the recommended duration after vaccination for adverse reactions
- See Observation periods following vaccination in this Guidance from CDC
Reconcile vaccination records with your facility’s MAR and begin 2nd dose and/or booster planning
Billing and Reimbursement
Providers cannot charge any out-of-pocket cost for COVID-19 vaccine. The vaccine must be made available at no cost to all individuals to ensure equitable access. Denying anyone vaccination or reducing appointments based on the person’s insurance status, charging for an office visit or other fee (if COVID-19 vaccination is the sole medical service provided), requiring additional medical services to receive COVID-19 vaccination, or seeking any additional reimbursement, including through balance billing from the vaccine recipient, is prohibited.
The loss of the HRSA COVID-19 Uninsured Program funding may prove a challenge to serving your neediest community members. Public Health is working hard to advocate with the federal and state government on your behalf. In the meantime, here are some considerations and resources to assist providers:
- Providers may be able to bill Medicare, Medi-Cal or private insurance to obtain reimbursement for administering vaccines, and through other available mechanisms for the uninsured, where appropriate
- California’s Department of Health Care Services will accept claims for individuals enrolled in the COVID-19 Uninsured Group Program. Individuals must apply for the COVID-19 Uninsured Group Program through a Medi-Cal Qualified Provider in the following programs: Presumptive Eligibility for Pregnant Women, Breast and Cervical Cancer Treatment Program, Hospital Presumptive Eligibility, and Child Health and Disability Prevention. Providers must submit applications via the COVID-19 Uninsured Group Application Portal.
- Providers may refer any patient to a walk-in community vaccination site – they can visit the How to Get a Vaccine webpage or call the DPH Call Center at 833-540-0473 which is open 7 days a week from 8:00am-8:30pm for appointment or referral assistance
- Providers may wish to hold onto records for possible future claim submission should the HRSA Uninsured Program receive funding and begin accepting claims, or another source of funding is established.
- Billing and reimbursement webinar (4-29-22) from the California Department of Public Health and California Medical Association Slides and recording.