8/28/2020 Health Advisory: Influenza and COVID-19 Updates for Providers

| August 28, 2020

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Background

On Aug. 21, CDC released recommendations for immunization practices of seasonal influenza during the 2020-2021 season. Given the concurrent COVID-19 pandemic, widespread use of Influenza vaccine is more important than ever. Changes to the components of the 2020-2021 influenza vaccine:

  • Egg-based H1N1 vaccine component updated to an A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus.
  • Cell- or recombinant-based H1N1 vaccine component updated to an A/Hawaii/70/2019 (H1N1)pdm09-like virus.
  • Egg-based H3N2 vaccine component updated to an A/Hong Kong/2671/2019 (H3N2)-like virus.
  • Cell- or recombinant-based H3N2 vaccine component updated to an A/Hong Kong/45/2019 (H3N2)-like virus.
  • B/Victoria lineage vaccine component updated to a B/Washington/02/2019 (B/Victoria lineage)-like virus.
  • High-dose vaccine and adjuvanted vaccine will be available in quadrivalent formulations (HD-IIV4 and aIIV4) this year. High-dose vaccine will not be available in trivalent formulation.

It is best to vaccinate as soon as the vaccine is available, prior to influenza activity in the community. Give influenza vaccine throughout the season. Never miss an opportunity to vaccinate.

Groups recommended for vaccination

CDC recommends influenza vaccine for all people 6 months or older. Encourage people at higher risk for complications to get vaccinated:

  • Children under age 5 (especially those under age 2).
  • People age 50 and older.
  • Pregnant people.
  • People with diabetes, asthma, heart disease, morbid obesity or other chronic health conditions.
  • People with immunosuppression.
  • Children on long-term aspirin therapy.
  • American Indians/Alaska Natives.
  • People with extreme obesity (BMI> 40).
  • Caregivers and household contacts of those at higher risk for complications.

Guidance for specific populations

People who have experienced severe respiratory symptoms after exposure to egg may receive any licensed, recommended, age-appropriate influenza vaccine. If given a vaccine other than a culture- or recombinant-based vaccine, they should be supervised by a healthcare provider who is able to recognize and manage severe allergic reactions. Guidance for other specific populations can be found here.

Vaccinating people with COVID-19

  • To avoid exposing healthcare personnel to COVID-19, defer vaccinating people with suspected or confirmed COVID-19—regardless of whether they have symptoms—until they meet criteria to discontinue isolation.
  • If vaccination is deferred, remind patients to return for vaccination once recovered from COVID-19.

Vaccination timing

  • Prioritize administering vaccine by the end of October. Continue to offer vaccination as long as influenza viruses are circulating locally, and unexpired vaccine is available.
  • Vaccinating too early in the season (i.,e., July or August) may lead to suboptimal immunity later in the season, particularly among older adults.
  • Delaying vaccination might result in greater immunity later in the season—but might also result in missed opportunities to vaccinate and difficulties vaccinating a population within a more constrained period should you choose to wait until influenza rates are higher.

Public health surveillance

Seasonal influenza surveillance begins in October and ends in April. It is important to stay up to date on local influenza activity. We post periodic influenza surveillance updates on our website throughout the season.

Additional resources

COVID-19 test guidance

Washington State Department of Health guidance has not changed for who should be tested for COVID-19. Test people who have COVID-19 symptoms or who were a close contact of a confirmed case. Close contacts of confirmed cases also need to quarantine for 14 days after last exposure even if they test negative for COVID-19, because it is possible for people who test negative to still be incubating the virus and become contagious later.

COVID-19 test processing

Labs report varying amounts of time to process COVID-19 tests. To support faster turnaround, we encourage providers to use in-state labs. See current COVID-19 test processing times for in-state private labs below.

Lab Time to process specimen and report results Tests processed daily
Quest 24-48 hours 750-1000
LabCorp 48 hours-4 days 130,000 nationally
Northwest Pathology 24-48 hours 8,000
FidaLab Monday-Thursday: 24 hours, Friday-Saturday: 72 hours 700-1,000
Kaiser 48 hours 800

 

Reporting Positive COVID-19 Cases

Providers must fax positive lab results with demographic information to 509-249-6628.

Patient communication

Providers are urged to reinforce masking and social distancing recommendations with patients. DOH survey of Yakima County residents who have utilized community testing locations show that 76% trust their doctor to inform them about COVID19 recommendations.

Providers should review documents below with patients and provide a copy to take home at the time of evaluation. Providers should notify patients that if their test results come back positive, they will be called by the Department of Health for an interview and depending on their work and other activities while infectious, they may also be called by the Health District. Providers should emphasize that patients must stay in quarantine/isolation pending test results and remind patients that a negative test result does not mean they don’t have COVID-19 and should continue to isolate if they have symptoms.

Providers should immediately notify patients of positive results and direct them to the patient education below. Positive cases should also be advised to notify close contacts and provide them with education below for “exposed to a confirmed”.

For symptoms—What to do if you have symptoms of COVID-19 and have not been around a person diagnosed with COVID-19.

For exposed—What to do if you may have been exposed to a person with COVID-19.

For confirmed or suspected—What to do if you have confirmed or suspected COVID-19.

Additional resources