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We appreciate you!

The NMDOH thanks you for joining us to support the state of New Mexico’s COVID-19 vaccination efforts!

Patients consistently rank healthcare providers as their most trusted source of vaccine information. Your strong recommendation to get a COVID-19 vaccine is critical for vaccine acceptance.
Being able to provide vaccines in your office will also help us to reach more people. There are many resources available to help you effectively vaccinate your patients.
Information and guidance about COVID-19 vaccine products are constantly evolving as we learn more, so please continue to review updated CDC materials. Additionally, please see Health Alert Networks (HANs) sent by the state for important updates.

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Take Care NM Campaign

The Take Care NM Campaign encourages New Mexicans to get their COVID-19 vaccine as part of their preventive care visit, well-child check-ups, mental health appointments, and prescriptions

This Toolkit for Providers includes:

How to manage and administer the COVID-19 vaccine
How to talk to your patients about the COVID-19 vaccine
How to talk with parents about the COVID-19 vaccine for their children
How to best utilize the Take Care New Mexico provider marketing toolkit for your practice

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Toolkit Components

Part 1: Becoming a COVID-19 Vaccine Provider

Part 2: Getting your practice ready to manage COVID-19 Vaccine

Part 3 : Administering COVID-19 Vaccine in your Practice

Part 4 : COVID-19 Vaccine Reporting

Part 5 : Ordering COVID-19 Vaccine for your Office

Part 6 : If you want to order Pfizer for your Office

Part 7 : Messaging about the COVID-19 Vaccine

Part 8 : COVID-19 Vaccine Outreach

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Part 1: Becoming a COVID-19 Vaccine Provider

How to Enroll as a COVID-19 Vaccine Provider

COVID-19 Training Modules

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How to Enroll as a

COVID-19 Vaccine Provider

How to Enroll as a COVID-19 Vaccination Provider | CDC

https://cv.nmhealth.org/providers/vaccines/vaccine-provider-portal/

Step by Step Provider Enrollment Document:

Link to Document #1: Provider Enrollment Step-By-Step

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LINK to TRAINING MODULES: https://www2.cdc.gov/vaccines/ed/COVID-19/

LINK to: Compilation of All COVID-19 Provider Trainings

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Part 2: Getting Your Practice Ready

to Manage COVID-19 Vaccine

Staff Roles for Vaccine Management

Vaccine Management Plans

Billing Compliance

Standing Orders

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Staff Roles for Vaccine Management

You will need to identify staff to fulfill two main roles:

Temperature Monitoring:
Storage Unit Temperatures

Upload temperatures weekly for all storage units used for COVID-19 vaccine.

b. Temperature Monitoring and Excursions

Ensure site compliance with all storage and handling requirements, including monitoring of storage unit temperatures. All temperature excursions must be reported immediately and a COVID-19 Troubleshooting Record (TSR) initiated.

COVID-19 Inventory Reconciliation

Perform inventory reconciliation weekly.

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Vaccine Management Plans

Every staff member who works with vaccines is responsible for proper storage and handling of vaccines and must familiarize themself with their site’s Routine and Emergency Vaccine Management Plans.

Every site must have two written vaccine management plans:

Routine Vaccine Management Plan

Link to Document #2: Routine Vaccine Management Plan

Emergency Vaccine Management Plan (see section 7 of Vaccine Storage and Handling Toolkit-March 2021 (cdc.gov))

Keep your plans by the storage units!

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Billing Compliance

If you participate in the CDC COVID-19 Vaccination Program, you MUST:

Administer the vaccine with no out-of-pocket cost to your patients for the vaccine or administration of the vaccine
Vaccinate everyone, including the uninsured, regardless of coverage or network status

If you participate in the CDC COVID-19 Vaccination Program, you MAY NOT:

Balance bill for COVID-19 vaccinations
Charge your patients for an office visit or other fee if COVID-19 vaccination is the only medical service given
Require additional medical or other services during the visit as a condition for getting a COVID-19 vaccination

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Standing Orders: Vaccine Administration

These are Standing Orders that you can use for Vaccine Administration:

DOH COVID-19 vaccine protocol/standing order template (add your organization’s letterhead):

Link to Document #3. Standing Order Template

CDC Standing Orders for COVID-19 Vaccine:
Pfizer: https://www.cdc.gov/vaccines/COVID-19/info-by-product/pfizer/downloads/standing-orders.pdf
Moderna: https://www.cdc.gov/vaccines/COVID-19/info-by-product/moderna/downloads/standing-orders.pdf
Janssen: https://www.cdc.gov/vaccines/COVID-19/info-by-product/janssen/downloads/Janssen-Standing-Orders.pdf

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Standing Orders:

Vaccine Reactions and Anaphylaxis (Rare)

Although Anaphylaxis from the vaccines is extremely rare, staff must be prepared. DOH POD sites must have epinephrine available, and medical practices should have emergency supply kits containing epinephrine. If you do not, please use this opportunity to acquire emergency supplies and develop an emergency plan that does not solely include calling 911.

These are Standing Orders that you can use for Anaphylaxis Management:

Medical Management of Vaccine Reactions in Adults in a Community Setting (immunize.org)

DOH Emergency Response protocol/standing order template (add your organization’s letterhead):

Link to Document #4: DOH Emergency Response Protocol Template

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Part 3: Administering COVID-19 Vaccine in Your Practice

Vaccine Workflow Considerations

Informed Consent

Parental Consent for Children

Co-administration of the Vaccine

“Wastage” Policy

Liability

Who Should/Can Be Vaccinated?

Other Vaccination Provider Tips

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Vaccine Workflow:

with 15 min Observation Period

Think through options for providing vaccine:

Have separate nurse clinic appointments for vaccine
Use current vaccine work flow for COVID-19 vaccine
Give COVID-19 vaccine at the beginning of the visit so that the 15 minutes of observation is during the provider visit
“Mass Vax” model: Pick a day where you will vaccinate a large # of patients

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Informed Consent

Before administering COVID-19 vaccine, organization must provide an approved Emergency Use Authorization (EUA) fact sheet to each vaccine recipient, the adult parent or caregiver accompanying the recipient, or other legal representative.

The EUA’s are updated with new information and approvals. Check the CDC website periodically to ensure you have the most current version.

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EUA Forms:

(These can be printed out or reviewed by patient digitally)

Pfizer:

Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) (fda.gov)

Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers (fda.gov)

Moderna:

Moderna COVID-19 Vaccine EUA Fact Sheet for Health Care Providers (fda.gov)

Moderna COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers (fda.gov)

Janssen (J&J):

Janssen COVID-19 Vaccine - EUA Fact Sheet for Healthcare Providers Administering Vaccine (janssenlabels.com)

Janssen COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers 04232021 (fda.gov)

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Informed Consent for Children (under 18)

Practices can utilize their own consent forms for vaccination of minors
DOH allows vaccinations without a parent or legal guardian present with signed consent forms
If you choose to use the DOH parental consent form, the link is here:

COVID-19 Vaccine Resources | NMDOH - Coronavirus Updates (nmhealth.org)

LINK TO DOWNLOAD CONSENT FORM:

NMDOH-Parental-Consent-Form-for-COVID-19-Administration-051321-ENGLISH.pdf (nmhealth.org)�

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Co-administration with Other Vaccines

COVID-19 vaccines and other vaccines may now be administered without regard to timing.
This includes simultaneous administration of COVID-19 vaccines and other vaccines on the same day, as well as co-administration within 14 days.

Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC

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“Wastage Policy”: Try not to waste, but always vaccinate an eligible person

The more Americans who get vaccinated, the fewer COVID-19 cases, hospitalizations, outbreaks, and deaths that will occur.
As access to COVID-19 vaccine increases, it is important for providers to not miss any opportunity to vaccinate every eligible person who presents at vaccine clinics.
We recognize that as we continue to create more opportunities to vaccinate more people, it may increase the likelihood of leaving unused doses in a vial.

While we want to continue to follow best practices to use every dose possible, we do not want that to be at the expense of missing an opportunity to vaccinate every eligible person when they are ready to get vaccinated. Link to Document #5: CDC Wastage Guidelines

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Liability

Your office cannot be sued over a vaccine side effect
All claims go to the National Vaccine Injury Compensation Program
For more information, go to:
National Vaccine Injury Compensation Program | Official web site of the U.S. Health Resources & Services Administration (hrsa.gov)
Compensation Programs for Potential COVID-19 Vaccine Injuries (congress.gov)

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Who Should/Can Be Vaccinated?

Initially vaccine providers were encouraged to vaccinate more than just their population of patients due to limited resources
Now providers can choose to vaccinate only their patients due to the fact that the vaccine has become more readily available
Anyone over 12 years old is eligible to be vaccinated

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Other Vaccination Provider Tips

Reduce amount of paperwork or steps required to make an appointment. Look for ways you can streamline the intake process once in office (this also prevents exposure longer than necessary). Consider having patients complete paperwork ahead of time. This can also help people commit to getting vaccinated. Share messages like “Pre-fill in the paperwork at this link to make sign-in faster.”
Schedule the second vaccine appointment during the first appointment if using a two-dose vaccine.
Provide follow-up reminders via text or email that are close to the appointment date.
Consider barriers your patients may face. Ask people how they plan on getting to the appointment. Consider pointing to other accessibility resources, such as vaccinations for homebound patients, locations with expanded office hours, or offer walk-in appointments if possible. Your local health department may be able to point you to some of these resources.

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Part 4: COVID-19 Vaccine Reporting Requirements

Vaccine Administration Reporting (NMSIIS)

Inventory Reporting (VaccineFinder)

Temperature Excursions

Adverse Events Reporting (VAERS)

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NMSIIS Reporting

Within 24 hours of administering a dose of COVID-19 vaccine:

Report in NMSIIS (New Mexico Statewide Immunization Information System)
Data can be reported to NMSIIS via Data Exchange, manual entry, or the NM Registration App
NMSIIS Help Desk 833-882-6454

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Vaccine Finder Reporting:

Inventory Reporting

COVID-19 Providers are required to report inventory DAILY in VaccineFinder

Each provider has to log into the Vaccine Provider website: https://covid.locating.health/login
Need to enter daily report on aggregate doses on hand for each COVID-19 Vaccine

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Temperature Excursions

Any temperature reading outside the manufacturer’s recommended range is considered a temperature excursion and requires IMMEDIATE action by site staff.

Any staff who hears an alarm or becomes aware of a temperature excursion must IMMEDIATELY initiate the COVID-19 Troubleshooting process, following the steps on page one of the COVID-19 Vaccine Troubleshooting Record (TSR) – this form is accessible on NMSIIS Reports.
Quarantine and label exposed vaccines "DO NOT USE" (do not discard these vaccines) and begin the process of contacting manufacturers for viability determination.

Pfizer: 800-438-1985 or www.PfizerMedInfo.com

Moderna: https://tools.modernamedinfo.com/excursion

Janssen: https://www.janssenmd.com/janssen-covid19-vaccine/interactive-content/stability-information

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Adverse Event Reporting: VAERS

All adverse events or reactions must be reported in the Vaccine Adverse Events Reporting System (VAERS): https://vaers.hhs.gov/

Healthcare providers are required to report to VAERS the following adverse events after COVID-19 vaccination [under Emergency Use Authorization (EUA)], and other adverse events if later revised by CDC:

Vaccine administration errors, whether or not associated with an adverse event (AE)
Serious AEs regardless of causality. Serious AEs per FDA are defined as:

Death;
A life-threatening AE;
Inpatient hospitalization or prolongation of existing hospitalization;
A persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions;
A congenital anomaly/birth defect;
An important medical event that based on appropriate medical judgement may jeopardize the individual and may require medical or surgical intervention to prevent one of the outcomes listed above.

Cases of Multisystem Inflammatory Syndrome
Cases of COVID-19 that result in hospitalization or death

Healthcare providers are encouraged to report to VAERS any additional clinically significant AEs following vaccination, even if they are not sure if vaccination caused the event.

Also report any additional select AEs and/or any revised safety reporting requirements per FDA’s conditions of authorized use of vaccine(s) throughout the duration of any COVID-19 vaccine being authorized under an Emergency Use Authorization (EUA).

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Part 5:

Ordering COVID-19 Vaccine

for Your Office

How To Obtain Moderna and J&J Vaccine

Statewide Registration System

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How To Obtain Moderna and J & J:

Once you get set up in NMSIIS as a provider, you can order Moderna and J&J vaccine through NMSIIS
Both vaccines will then be shipped directly to your office

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Statewide Registration System:

If you would like to get set up with the state-wide online registration system, you will need to be a NMSIIS provider first.
Using the statewide app can help you with filling your vaccine event schedule, sending reminders to patients, and tracking and scheduling second doses.

For access to the statewide registration system, please use the following link for support: https://cv.nmhealth.org/providers/vaccines/vaccine-provider-portal/

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Part 6:

If You Want to Use Pfizer

How to Obtain Pfizer Vaccine

Co-administration of Pfizer with Pediatric Vaccines

Current Hub Providers

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Ordering Pfizer

Providers can order Pfizer through NMSIIS in amounts of 1170 doses or 450 doses. Pfizer can be stored until expiration in an ultra low freezer or for 31 days in the refrigerator.

For providers who want a smaller number of Pfizer doses, they can obtain vaccine through “redistribution” from a provider who has ultra low storage capacity.

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Preparing for the Pfizer Vaccine:

It is critical that healthcare professionals and personnel are familiar with the specific guidance for vaccine storage, handling, preparation, and administration that are unique for the Pfizer COVID-19 vaccine.

Special Note to Pediatric Providers:

COVID-19 vaccine can be co-administered with other childhood and adolescent vaccines.

Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC

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How To Obtain Pfizer Vaccine

at a “Redistribution” Hub Site

To pick up vaccine, you need to be a COVID-19 Vaccine Provider

Pick up Procedures Link:

Link to Document #6: Pfizer Provider Transfer Process

Link to Document #7: COVID-19 Vaccine Transfers: What will you need to get vaccine from a hub?

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List of Current Pfizer Hub Providers:

ULT Hub Site Locations

NE Public Health Office, Santa Fe County-Dawn Aldridge, 505-476-2622

Christus St. Vincent, Santa Fe County-Christine Atwell, 505-913-5522

Arthritis New Mexico, Bernalillo County-Art Snyder, 575-532-5934

Rio Grande Family Medicine, Bernalillo County-David Hsi, 505-224-7400 ext.238

SW Public Health Office, Dona Ana County-Valerie Duenas-575-528-5024

Gerald Champion Regional Medical, Otero County-Kerry Bolin 575-443-7847

Holy Cross Hospital, Taos County-Tamara Brown, 575-737-3377

Clinica La Esperanza, Bernalillo County-Fabian Ortega, 505-489-4421

Guadalupe County Hospital, Guadalupe County-Mandelyn Cordova, 575-472-3417 ext.120

Midtown Public Health Office, Bernalillo County-Erica Flores, 505-383-0154

Roswell Public Health Office, Chaves County-Debra Belyeu-Haeny, 575-624-6050 ext.6151

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Part 7: Vaccine Messaging

How to talk to your patients

about the COVID-19 Vaccine

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You are a trusted messenger!

Patients consistently rank healthcare providers as their most trusted source of vaccine information. Your strong recommendation to get a COVID-19 vaccine is critical for vaccine acceptance.

Make it clear to your patients that you recommend COVID-19 vaccination for them.
Tell your patients how important COVID-19 vaccines are to protecting their health, as well as the health of their family and friends.
COVID-19 vaccines are new, and it’s understandable that your patients may have questions. Your answers can help them make an informed decision about getting vaccinated.
Make it clear that you understand they may have questions, and you want to answer them, so they feel confident in choosing to get vaccinated.

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How to talk to your patients

Start from a place of empathy and understanding
Assume patients will want to be vaccinated but may not know where to get a vaccine or how to make an appointment
Give your strong recommendation for the vaccine
Listen and respond to patient questions
Wrap up the conversation with at least one action such as:

Scheduling a vaccination appointment with your facility, another vaccination provider, or pharmacy,
Reading the additional information you provide to them about COVID-19 vaccination, or
Learning how they can find a COVID-19 vaccine and what to expect at their vaccination appointment.

Continue to remind them about importance at future visits

References:

CDC How to talk to your patients about COVID-19 vaccination

Answering Patients’ Questions about COVID-19 Vaccine and Vaccination

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Motivational Interviewing

Common persuasive styles (commanding, advising, lecturing or shaming) can often backfire.
Motivational interviewing skills can help communicate persuasively.
Check out this helpful interactive article from the NY times
“Your Friend Doesn’t Want the Vaccine. What Do You Say?”

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Key Messages for Your Patients

COVID-19 vaccines are safe and effective.
Everyone aged 12 years and older is now eligible to get a COVID-19 vaccination.
Besides our office, there are several places to find a COVID-19 vaccine.
You may have side effects after vaccination, but these are normal.
It typically takes 2 weeks after vaccination for the body to build protection (immunity) against the virus that causes COVID-19. You are not fully vaccinated until 2 weeks after the 2nd dose of a two-dose vaccine or 2 weeks after a one-dose vaccine.
People who have been fully vaccinated can start to do some things that they had stopped doing because of the pandemic.

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New Mexico Specific Messaging

This is messaging specific to New Mexico based upon local surveys

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Messaging about Common Concerns

Clarify misperception about side effects: death, blood clots, etc.; this will also affect parents’ decisions about their kids
Communicate that those who are vaccinated benefit from avoiding serious symptoms and death
Communicate that when more people get vaccinated, they don’t have to wear a mask when seeing family, eating out, or attending events

Reference: Possible Side Effects After Getting a COVID-19 Vaccine

Handout on Side Effects: What to Expect after Getting a COVID-19 Vaccine

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Address Common Concerns

Vaccine Concerns	Possible Response
I am worried about Blood Clots	1 in 1 million vaccinated people with blood clots versus 1 in 600 chance of dying from COVID-19
I am worried about Blood Clots
I am worried about dying from the vaccine	Vaccine prevents death and hospitalization from COVID-19; 94% effective at preventing symptomatic COVID-19;
I am worried that I can get COVID-19 from the vaccine	Vaccines are safe and effective and you cannot get COVID-19 from the vaccine.
I am worried about the vaccine causing infertility	No evidence that any vaccines cause fertility problems; You can also safely get vaccine if breastfeeding or pregnant.; Great Video from Alabama by OBGYN on safety of Vaccine for women
I am worried about nausea, fatigue, mild fever, and having a sore arm	Exercise arm, drink fluids, take tylenol/ibuprofen for mild fever Link: What to expect after getting COVID Vaccine

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Presbyterian Messages on Common Concerns

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NM DOH Messaging

Survey data from DOH identified concerns about ID, insurance and cost
Posters address these concerns in multiple languages

Link to New Mexico Specific Education: Resource Page

https://cv.nmhealth.org/COVID-19-vaccine/resources/

Link to COVID Vax Flyers

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Educational Materials for Patients

Benefits of Getting the COVID-19 Vaccine

COVID-19 vaccination will help keep you from getting COVID-19.
COVID-19 vaccination is a safe way to help build protection.
COVID-19 vaccination is an important tool to help us get back to the moments we miss.

What you can do when fully vaccinated

You can resume indoor and outdoor activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal or territorial laws, rules and regulations including local business and workplace guidance.
If you travel in the United States, you do not need to get tested before or after travel or self-quarantine after travel.
If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms.

HHS: COVID-19 Public Education Campaign Resources

HHS: Talking Points for Health Care Leaders to Encourage Vaccine Confidence

Vaccine Communication Toolkit for Medical Centers, Clinics, Pharmacies, and Clinicians

Pediatric Healthcare Professionals COVID-19 Vaccination Toolkit

Key Things to Know about COVID-19 Vaccines

Frequently Asked Questions about Vaccination

Vaccine Recipient Education

Sample letter to patients to encourage COVID-19 vaccination

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Part 8:

COVID-19 Vaccine Outreach

Vaccination Outreach Tips

Partnering with Communities

On-Site Vaccination Requests

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Vaccination Outreach Tips

Offer a point of contact with any vaccine-related materials you share so patients can follow up with questions. Consider sharing printed materials with a phone number in case patients don’t have Internet access.
Talk to patients about your own vaccine experience. Share your reasons for getting vaccinated, concerns you had, and the information that made you feel confident about getting vaccinated. Be honest about side effects you experienced. Talk about getting your family members vaccinated. Encourage your staff to do the same, if they are comfortable sharing.
Make the invitation personal. Instead of a “Dear Patient” mass email, personalize your correspondence--“Dear Darren.” Sign the outreach email personally from the primary healthcare provider. Find a sample letter from health care providers to their patients on CDC’s website.
Offer virtual “office hours” for patients who want to ask questions. This could be someone on call at a specific time or setting up a time to interact with patients and families via web conference call or on a livestream to share key messages about vaccination.
Make vaccination the social norm. Highlight how many people are getting vaccinated where applicable to encourage vaccination (e.g., 87% of my patients over 50 have gotten their COVID-19 vaccine. Get yours today!)

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Community Partnerships

Partnering with community-based organizations can help to:

Build vaccine demand
Encourage and support vaccination sign-up
Improve access to vaccination opportunities offered by your office
Organize a vaccine event at your office

Reference: Guide for Community Partners for more information on how to partner with local organizations

National Guard / DOH Mobile Team Event

in partnership with the Mexcian Consulate

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On-Site Vaccination Request: getvaxnm.com

If you want to host a weekend, evening or weekday clinic and you don’t have enough staff, sign up for an on-site vaccination event at getvaxnm.com, and the DOH can send a team to support you!

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org