BCHHS Public Health Provider COVID Update: BCHHS vaccine clinic move, NCDHHS guidance on sequencing, CDC guidance on post-COVID conditions

June 21, 2021

Local and state COVID-19 update

  • As of today, there have been 18,043 confirmed cases of COVID-19 and 324 COVID-19 related deaths in Buncombe County residents since the start of the pandemic.
  • Both Buncombe County and NC continue to see reductions in the numbers of new COVID-19 cases and percent positivity, along with other COVID metrics.
    • The percent of tests that are positive in Buncombe County residents is down to 1.3%. NC’s percent positivity is 1.9%.
    • There have been 11 cases per 100,000 population in the last 7 days in Buncombe County. A majority of cases are occurring in those 25-50 years of age.
  • Per the NCDHHS dashboard, 52% of the population of Buncombe County has been vaccinated with at least 1 dose of COVID-19 vaccine and 49% is fully vaccinated. More details on the demographics of those vaccinated can be found on the dashboard.

 

BCHHS COVID-19 Vaccine Clinic move

  • Monday, 6/21, is the last day for Buncombe County’s COVID-19 vaccine clinic at AB Tech.
  • On Wednesday, 6/23, the county’s COVID-19 vaccine clinic will reopen at the BCHHS building at 40 Coxe Ave. in downtown Asheville. The clinic will be open Mon-Fri from 9a-4p to walk-ins. We continue to vaccinate those 12 years of age and older.

 

Become a COVID-19 vaccine provider!

 

Update on reports of myocarditis following mRNA COVID-19 vaccination

  • There have been no updates to the CDC’s clinical considerations about myocarditis and pericarditis in adolescents & young adults after receipt of mRNA COVID-19 vaccines since they became available in late May.
    • COVID-19 vaccination continues to be recommended for those 12 years of age and older given the greater risk of other serious complications related to COVID-19.
    • Report all cases of myocarditis and pericarditis following COVID-19 vaccination to VAERS.
  • The FDA’s Vaccines and Related Biological Products Advisory Committee meeting on 6/10 included a review of preliminary data.
  • The CDC’s Advisory Committee on Immunization Practices (ACIP) will be reviewing updated data at their 6/23-6/25 meeting to further evaluate myocarditis following mRNA COVID-19 vaccination and assess benefit-risk balance.

 

Updated CDC COVID-19 vaccine guidance

  • CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States was updated 6/1/2021.
    • Updates included:
      • Information on cases of myocarditis and pericarditis occurring after mRNA COVID-19 vaccination, particularly in adolescents and young adults.
      • Information on the efficacy of the Pfizer-BioNTech COVID-19 vaccine in adolescents ages 12–15 years in patient counseling.
      • Updated data on local and systemic symptoms following vaccination with an mRNA COVID-19 vaccines in patient counseling section.
      • Clarification in contraindications and precautions and Appendix B of guidance for people with a history of an immediate allergic reaction to a vaccine or injectable therapy that contains a component also contained in a COVID-19 vaccine.
      • Updated list of ingredients in COVID-19 vaccines (i.e., lack of metals) in Appendix C.
  • CDC’s Pre-vaccination Checklist for COVID-19 vaccines was updated 5/27/2021.

 

Updated NCDHHS guidance on genomic sequencing of SARS-CoV-2 specimens

  • Multiple SARS-CoV-2 variants continue to circulate worldwide and in the US.
    • The CDC has designated the Delta variant, which was first detected in India, as the newest variant of concern. It is the most contagious variant yet and can cause more severe illness. It currently is responsible for ~10% of all new COVID-19 infections in the US. COVID-19 vaccines have been shown to be highly effective against this variant.
  • Please see the updated guidance from NCDHHS (attached) about requesting SARS-CoV-2 genomic sequencing and reporting vaccine breakthrough cases.
  • Clinicians may submit samples for sequencing for cases meeting one or more of the criteria below. Cases meeting criteria marked with ** below may be submitted without prior approval, all other cases require prior approval by the Communicable Disease Branch Epidemiologist On-Call at 919-733-3419.
    • **Persons who have a positive diagnostic test at least 14 days after completing vaccination with an FDA authorized vaccine (meaning after two doses for Pfizer and Modern vaccines or one dose of Janssen vaccine) and with no previous positive test in the preceding 45 days.
    • **Persons with suspected re-infection, if:
      • Both the initial and subsequent positive sample are available for submission, OR
      • The positive test was collected at least 90 days after their initial positive and the person had new onset of COVID-19 symptoms requiring hospitalization
    • Persons with severe immune compromise with prolonged infection
    • Persons with international travel within 14 days before symptom onset/positive test
    • **Pediatric deaths
    • **Cases of multisystem inflammatory syndrome in children (MIS-C)
    • Cases of multisystem inflammatory syndrome in adults (MIS-A)
    • Outbreak or cluster
  • For details on how to request sequencing, please see the attachment. For additional questions, contact those named in the attachment or the BCHHS Communicable Disease staff at 828-250-5109.

CDC Interim Guidance on Evaluating and Caring for Patients with Post-COVID Conditions

  • CDC’s new interim guidance on evaluating and caring for patients with post-COVID conditions provides new information to assist healthcare professionals with evaluating, managing, and caring for patients who may experience long-term effects after a COVID-19 infection.
  • Here is a link to a webinar that was held 6/17/2021 on “Evaluating and Caring for Patients with Post-COVID Conditions” – slide set and recording are available, as is CME credit.