BCHHS Public Health Provider Update: COVID update & Influenza resources

October 5, 2021

State and Local COVID-19 Update

  •          As of 10/4/2021, there have been 26,344 confirmed cases of COVID-19 and 397 COVID-19-related deaths in Buncombe County residents since the start of the pandemic.
  •          While still high, for the 3rd week in a row, Buncombe County has seen a consistent, steady decline in the case rate and percent positivity. The case rate has fallen to 216 cases per 100,000 population in the last 7 days and the percent positivity is now 6.7%.
  •          Per the NCDHHS dashboard, 62% of the total Buncombe County population is partially vaccinated and 59% is fully vaccinated.
    •    On 10/1/2021, NCDHHS updated county vaccination data from the US Departments of Defense and Veterans Affairs, the Indian Health Services, and the Federal Bureau of Prisons to reflect the county of residence for the person vaccinated. NCDHHS recently had discovered that the CDC vaccination report that provided this data was based on county of administration, while all other vaccine data is by county of residence. This correction resulted in vaccination rates changing for most counties, including Buncombe.
  •          The NCDHHS weekly Respiratory Disease Surveillance Report contains a wide variety of data on COVID-19, including post-vaccination surveillance data (starting on page 12).
    •    COVID-19 vaccines remain highly effective at preventing severe illness, hospitalization and death from COVID-19, including from the Delta variant. Even with highly effective vaccines, the number of post-vaccination cases is expected to rise as virus transmission goes up and as more people are vaccinated.
    •    For the week ending September 18, 2021, unvaccinated individuals in NC were more than 4 times more likely to get COVID-19 and more than 16 times more likely to die of COVID-19 when compared to vaccinated individuals.

COVID-19 Vaccination for Pregnant People

  •          Last week, the CDC issued a health advisory recommending urgent action to increase COVID-19 vaccination among people who are pregnant, were recently pregnant, are trying to become pregnant or who might become pregnant in the future.
    •    COVID-19 vaccination rates are low among pregnant persons in the US; a vast majority are unvaccinated. Racial & ethnic disparities exist in vaccination coverage, with vaccination coverage lowest for non-Hispanic Black pregnant persons.
  •          Pregnant and recently pregnant people with COVID-19 are at increased risk for severe illness & death compared to non-pregnant people with COVID-19. Pregnant persons with COVID-19 have an increased risk for adverse pregnancy and neonatal outcomes, including preterm birth and NICU admission, compared to pregnant persons without COVID-19.
  •          Studies continues to provide evidence of both the safety and effectiveness of COVID-19 vaccination in pregnancy. The benefits of vaccination for both pregnant persons and their fetus/infant outweigh known or potential risks.
  •          Recommendations for Healthcare Providers:
    •    Ensure all clinical staff are aware of the recommendation for vaccination of people before and during pregnancy and the serious risks of COVID-19 to pregnant and recently pregnant people and their fetuses/infants.
    •    Increase outreach efforts to encourage, recommend, and offer vaccination to people who are pregnant, recently pregnant (including those who are lactating), who are trying to get pregnant now, or who might become pregnant in the future. A strong recommendation from a healthcare provider is a critical factor in COVID-19 vaccine acceptance and can make a meaningful difference to protect the health of pregnant and recently pregnant people and their fetuses/infants from COVID-19.
    •    For healthcare providers who see patients who are pregnant, recently pregnant (including those who are lactating), who are trying to get pregnant now, or who might become pregnant in the future:
      •   Review patients’ COVID-19 vaccination status at each pre- and post-natal visit and discuss COVID-19 vaccination with those who are unvaccinated.
      •   Reach out to your patients with messages encouraging and recommending the critical need for vaccination.
      •   Remind patients that vaccination is recommended even for those with prior COVID-19 infections. Studies have shown that vaccination provides increased protection in people who have recovered from COVID-19.
      •   Support efforts to ensure people receiving the first dose of an mRNA COVID-19 vaccine (i.e., Pfizer-BioNTech, Moderna) return for their second dose to complete the series as close as possible to the recommended interval.
      •          Consider a booster dose in eligible pregnant persons.
      •   Communicate accurate information about COVID-19 vaccines and confront misinformation with evidence-based messaging from credible sources. For example, there is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.
    • Become a COVID-19 vaccine provider and vaccinate patients during their visit
      • To learn more about enrolling as a COVID-19 vaccine provider in NC, see the information here.

Updates on Buncombe County COVID-19 Vaccine Clinics

  1. Drive-through Pfizer Booster Dose Clinic
    • This week, Buncombe County will continue to provide Pfizer boosters at Biltmore Church-Arden Campus (35 Clayton Rd., Arden) to individuals included in the CDC recommendations.
    • The booster drive-through site will be open Mon-Fri from 10am-4pm this week. (Note the change in closing time due to very low volumes of clients in the late afternoon/early evening hours last week.)
    • No appointment needed.
    • In the event of adverse weather, Buncombe County will use all available communication platforms and partners to notify the community.
    • We ask that individuals bring proof of prior vaccination, preferably their vaccine card.
    • Only Pfizer vaccine will be available at this site.
  2. Walk-in COVID-19 Vaccine Clinic
    • BCHHS offers all 3 types of COVID-19 vaccines and all doses at the HHS building at 40 Coxe Ave. in downtown Asheville.
    • The clinic is open Mon-Fri from 9am-4pm.
    • No appointment needed.

3.       COVID-19 vaccines for the homebound

  •          We are able to provide any recommended dose of any of the 3 types of COVID-19 vaccine to those living in Buncombe County who cannot easily leave their homes to access vaccination.
  •          If you know someone in need of this service, have them or their caregiver call the Buncombe County Ready Team at 828-419-0095.

Updates on Booster Doses for Moderna and J&J Vaccines and COVID-19 Vaccine for 5-11 Year Olds

  •          Upcoming meetings of the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC)
    •    October 14th:  Discussion of an amendment to the Emergency Use Authorization (EUA) of the Moderna COVID-19 vaccine for administration of a booster dose in those 18 years of age and older
    •    October 15th:  Discussion of an amendment to EUA of J&J’s Janssen COVID-19 vaccine for administration of a booster dose in those 18 years of age and older
    •    October 26th:  Review of data on use of Pfizer COVID-19 vaccine in children 5-11 years of age
  •          Following these meetings, the FDA must adopt or reject VRBPAC’s recommendations and update the EUA for the relevant vaccine, if indicated. Then the CDC’s Advisory Committee on Immunization Practices (ACIP) will discuss any changes to the EUAs, review the data and vote on recommendations. And finally, the CDC must adopt or reject ACIP’s recommendations and guidance.

Influenza Season Resources/Continuing Education

  •          “2021–2022 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Practitioners” CDC COCA call for clinicians
    •    Thursday, 10/7 from 2-3pm
    •    CME credit is available for the live and recorded versions of this webinar.
  •          “2021-2022 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines” CDC COCA call for clinicians
    •    CME credit is available for this recorded webinar.
    •    Some key points from the webinar:
      •   Influenza vaccine is recommended for all those 6 months of age and older who do not have contraindications.
      •   Vaccination should be offered ideally by the end of October.
      •   COVID-19 vaccines may be administered without regard to timing of other vaccines, including the flu vaccine.
      •   Children who need 2 doses (those aged 6 months through 8 years who have never been vaccinated, who have not received ≥2 total doses previously, or whose vaccination history is unknown) should receive their first dose as soon as possible after vaccine is available.
      •   Vaccination should continue throughout the season, as long as influenza viruses are circulating, and unexpired vaccine is available.

If you have any concerns or questions about COVID-19 or any other communicable disease, please contact the Buncombe County Communicable Disease staff at 828-250-5109 (available 24/7).