COVID-19
Care Center

FDA approval on 8/12/21

ACIP (Advisory Committee on Immunization Practices) approval on 8/13/2021

1.  Active treatment for solid tumor and hematologic malignancies
2. Receipt of solid-organ transplant & taking immunosuppressive therapy *see appendix 1
3. Receipt of CAR-T-Cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppressive therapy)
4. Moderate or severe primary immunodeficiency (e.g., DiGeorge Syndrome, Wiskott-Aldrich syndrome)
5. Advanced or untreated HIV
6. Active treatment with:
   1. High dose systemic corticosteroids (>20mg prednisone or equivalent per day) – or >2mg/kg per day)
   2. Alkylating agents (cyclophosphamide)
   3. Antimetabolites (azathioprine, 6-MP, MTX)
   4. Transplant-related immunosuppressive drugs (cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil)
   5. Cancer chemotherapeutic agents classified as severely immunosuppressive
   6. TNF blockers (etanercept, adalimumab, certolizumab pegol, golimumab, infliximab)
   7. Other biologic agents that are immunosuppressive or immunomodulatory (thymoglobulin, alemtuzumab, rituximab)
7. Medical Conditions with Varied Immunodeficiency
   1. Sickle Cell Disease
   2. Chronic dialysis patients; End Stage Renal Disease
   3. Chronic Liver Disease

a. A pre-assessment form will need to be completed by the patient along with the attestation

b. Patient can schedule a booster shot or walk into clinic

c. Schedule patient for a first dose at this time until the CareLink build is completed

Same administration and dosage as initial vaccine administration

a. If they received Pfizer initially, they should receive Pfizer (12 years and up)

b. If they received Moderna initially, they should receive Moderna (18 years and up)

c. If they received Johnson & Johnson initially, they should NOT receive a booster at this time.

A minimum of 4 weeks (28 days)

a. Enter in third dose into VAMS and Carelink as usual, ignore pop-up warning about third dose. This will be updated once EPIC has sent us the update

b. Do NOT schedule a 4th dose

c. CDC card: Document on the front of the card if possible, if that is not possible document on the back of the CDC card with the same information as with other doses: Lot #, manufacturer, location of vaccine, date of vaccination

• Short term daily steroids, or daily therapy <20mg per day
• Steroid inhalers, topic steroids, intra-articular steroid injection
• >1 month since stopping high-dose systemic steroids
• HIV patients without severe immunosuppression (usually based on CD4+ T-cell counts)
• Autoimmune conditions that are stable and not being treated with immunosuppressive or immunomodulatory medications
• Pregnancy
• Diabetes
• Congestive Heart Failure
• Chronic lung disease
• Obesity

• Healthcare Workers
• Long-term care facility
• Elderly

They attest to having one of the above conditions

No, they need to attest to having one of the above immunocompromising condition

Dose amount and administration is the same as for 1st and 2nd doses