{"id":1316,"date":"2022-07-22T18:39:03","date_gmt":"2022-07-22T18:39:03","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/clinicians\/?page_id=1316"},"modified":"2022-07-22T18:39:03","modified_gmt":"2022-07-22T18:39:03","slug":"covid-19-update-for-virginia-35","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/clinicians\/covid-19-update-for-virginia-35\/","title":{"rendered":"COVID-19 UPDATE FOR VIRGINIA"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-1137 size-full\" src=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/134\/2022\/04\/Letterhead-Greene_2022-1.png\" alt=\"\" width=\"1700\" height=\"452\" \/><\/p>\n<p style=\"text-align: center\"><strong>COVID-19 Update for Virginia<\/strong><\/p>\n<p style=\"text-align: center\"><span style=\"font-weight: 400\">July 22, 2022<\/span><\/p>\n<p><span style=\"font-weight: 400\">Dear Colleague:<\/span><\/p>\n<p><span style=\"font-weight: 400\">I am writing to provide you brief updates on COVID-19, monkeypox, and parechovirus.<\/span><\/p>\n<p><b>EVUSHELD Dosing Schedule Change<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">On June 29, the U.S. Food and Drug Administration (FDA) revised the <\/span><a href=\"https:\/\/www.fda.gov\/media\/154701\/download\"><span style=\"font-weight: 400\">EVUSHELD<\/span><\/a><span style=\"font-weight: 400\"> Emergency Use Authorization (EUA) to recommend repeat dosing (300 mg tixagevimab\/300 mg cilgavimab) every 6 months for patients needing ongoing pre-exposure prophylaxis against COVID-19.<\/span><\/li>\n<\/ul>\n<p><b>Paxlovid &#8211; Pharmacist Prescriptive Authority<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">On July 6, FDA revised the EUA for <\/span><a href=\"https:\/\/www.fda.gov\/media\/155050\/download\"><span style=\"font-weight: 400\">Paxlovid<\/span><\/a><span style=\"font-weight: 400\"> (nirmatrelvir and ritonavir) to authorize state-licensed pharmacists to prescribe Paxlovid to eligible patients, with certain limitations to ensure appropriate patient assessment and prescribing of Paxlovid.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Pharmacists are only able to prescribe Paxlovid if the following conditions are met:<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Health records less than 12 months old are available to assess renal and hepatic function AND a comprehensive medication list (including over-the-counter and prescription medications) is available to assess drug-drug interactions.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">If a drug-drug interaction must be resolved with modification of another medication or the patient is not eligible for Paxlovid per the EUA, the patient must be referred to their primary care or other healthcare provider.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><b>CDC Recommends Novavax COVID-19 Vaccine for Individuals Aged 18 Years and Older<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">On July 13, the FDA granted an EUA for the Novavax vaccine in adults, 18 years and older.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">After a meeting of the Advisory Committee on Immunization Practices (ACIP) to discuss the vaccines, on July 19, the Centers for Disease Control and Prevent<\/span><span style=\"font-weight: 400\">ion (CDC) <\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2022\/s0719-covid-novavax-vaccine.html\"><span style=\"font-weight: 400\">recommended<\/span><\/a> <span style=\"font-weight: 400\">that the vaccine be used as a two-dose primary series.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Additional guidance is available in CDC\u2019s <\/span><a href=\"https:\/\/www.cdc.gov\/vaccines\/covid-19\/clinical-considerations\/covid-19-vaccines-us.html\"><span style=\"font-weight: 400\">Interim Clinical Considerations<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Novavax is not yet available for ordering but is anticipated to begin in August. Virginia&#8217;s complete allocation is 20,800 doses with no additional doses expected at this time. Vaccines will be made available for pharmacies, healthcare provider offices and health departments to order; however, due to the limited supply not all locations may carry the vaccines.\u00a0<\/span><\/li>\n<\/ul>\n<p><b>Monkeypox Updates\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">In the current outbreak in non-endemic countries, monkeypox virus is <\/span><a href=\"https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/transmission.html\"><span style=\"font-weight: 400\">spreading mostly through close, intimate contact<\/span><\/a><span style=\"font-weight: 400\"> with someone who has monkeypox. To date, many cases have been reported in gay, bisexual and other men who have sex with men. As explained in this recent publication, <\/span><a href=\"https:\/\/www.acpjournals.org\/doi\/10.7326\/M22-1748\"><span style=\"font-weight: 400\">Monkeypox: Avoiding the Mistakes of Past Infectious Disease Epidemics<\/span><\/a><span style=\"font-weight: 400\">, the epidemiology of an emerging condition may change over time, and it is important to avoid stigmatizing a particular population.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Testing for monkeypox is now available at multiple commercial laboratories <\/span><span style=\"font-weight: 400\">(<\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2022\/s0706-monkeypox-labcorp.html\"><span style=\"font-weight: 400\">Labcorp<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2022\/s0711-monkeypox-quest.html\"><span style=\"font-weight: 400\">Quest Diagnostic<\/span><span style=\"font-weight: 400\">s<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2022\/s0714-aegis-monkeypox-testing.html\"><span style=\"font-weight: 400\">Aegis Sciences<\/span><\/a><span style=\"font-weight: 400\">, and <\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2022\/s0718-sonic-monkeypox-testing.html\"><span style=\"font-weight: 400\">Sonic Healthcare<\/span><\/a><span style=\"font-weight: 400\">). Testing at <\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2022\/s0711-monkeypox-mayo.html\"><span style=\"font-weight: 400\">Mayo Clinic Laboratories<\/span><\/a><span style=\"font-weight: 400\"> is expected<\/span> <span style=\"font-weight: 400\">to become available soon. VDH encourages providers to utilize commercial laboratories for testing.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Public health testing at the Division of Consolidated Laboratory Services (DCLS) continues to be available; providers should consult their <\/span><a href=\"https:\/\/www.vdh.virginia.gov\/health-department-locator\/\"><span style=\"font-weight: 400\">local health department (LHD)<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">VDH urges providers to report all suspected cases immediately to their <\/span><a href=\"https:\/\/www.vdh.virginia.gov\/health-department-locator\/\"><span style=\"font-weight: 400\">LHD<\/span><\/a><span style=\"font-weight: 400\">,<\/span><span style=\"font-weight: 400\"> even if testing is conducted through a commercial laboratory.\u00a0\u00a0\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Vaccine for postexposure prophylaxis (PEP) is available for known close contacts of individuals with monkeypox.\u00a0\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">As more vaccine becomes available from the federal government, LHDs will soon expand vaccine availability to people with certain exposure risk factors, with priority given to areas with confirmed cases.\u00a0 Please check the VDH website regularly for the most current information.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">For the most current information and resources, including information about treatment, please visit VDH\u2019s <\/span><a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/monkeypox-information-for-healthcare-professionals\/\"><span style=\"font-weight: 400\">Monkeypox Information for Healthcare Professionals<\/span><\/a><span style=\"font-weight: 400\"> and <\/span><a href=\"https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/clinicians\/index.html\"><span style=\"font-weight: 400\">CDC\u2019s Information For Healthcare Professionals<\/span><\/a><span style=\"font-weight: 400\"> websites.<\/span><\/li>\n<\/ul>\n<p><b>CDC Health Alert Network: Recent Reports of Human Parechovirus (PeV) in the U.S.\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">On July 12, CDC released a<\/span> <a href=\"https:\/\/emergency.cdc.gov\/han\/2022\/han00469.asp\"><span style=\"font-weight: 400\">health advisory<\/span><\/a><span style=\"font-weight: 400\"> to alert clinicians and public health staff that PeV is circulating in the U.S.\u00a0 Since May 2022, CDC has received reports from multiple states that the virus is infecting neonates and children.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">No cases have been reported in Virginia at this time.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Parechoviruses<\/span> <a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/67\/wr\/mm6718a2.htm\"><span style=\"font-weight: 400\">can cause a variety of illnesses, ranging from asymptomatic infection to severe illness and death<\/span><\/a><span style=\"font-weight: 400\">. Neonates and infants are at the highest risk of severe disease.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Clinicians are encouraged to include PeV in the differential diagnoses of infants presenting with fever, sepsis-like syndrome, or neurologic illness (seizures, meningitis) without another known cause.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Testing for PeV is available at commercial clinical laboratories, and hospitals may use multiplex meningitis and encephalitis panels for CSF testing that include PeV.\u00a0 DCLS does not currently test for PeV but can facilitate specimen shipment to CDC.\u00a0 Providers should consult with their <\/span><a href=\"https:\/\/www.vdh.virginia.gov\/health-department-locator\/\"><span style=\"font-weight: 400\">LHD<\/span><\/a> <span style=\"font-weight: 400\">for assistance if considering CDC testing.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Thank you again for your continued partnership.\u00a0 <\/span><span style=\"font-weight: 400\">Please visit the<\/span> <a href=\"https:\/\/www.vdh.virginia.gov\/\"><span style=\"font-weight: 400\">Virginia Department of Health website<\/span><\/a> <span style=\"font-weight: 400\">for current clinical and public health guidance on<\/span> <a href=\"https:\/\/www.vdh.virginia.gov\/coronavirus\/get-the-latest-guidance\/health-professionals\/\"><span style=\"font-weight: 400\">COVID-19,<\/span><\/a> <a href=\"https:\/\/www.vdh.virginia.gov\/surveillance-and-investigation\/monkeypox\/monkeypox-information-for-healthcare-professionals\/\"><span style=\"font-weight: 400\">Monkeypox<\/span><\/a><span style=\"font-weight: 400\">, and other information. <\/span><b>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400\">Sincerely,<\/span><\/p>\n<p><span style=\"font-weight: 400\">Colin M. Greene, MD, MPH<\/span><br \/>\n<span style=\"font-weight: 400\">State Health Commissioner \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>COVID-19 Update for Virginia July 22, 2022 Dear Colleague: I am writing to provide you brief updates on COVID-19, monkeypox, and parechovirus. EVUSHELD Dosing Schedule Change On June 29, the U.S. Food and Drug Administration (FDA) revised the EVUSHELD Emergency Use Authorization (EUA) to recommend repeat dosing (300 mg tixagevimab\/300 mg cilgavimab) every 6 months [&hellip;]<\/p>\n","protected":false},"author":428,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-1316","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>COVID-19 UPDATE FOR VIRGINIA - Clinicians<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/clinicians\/covid-19-update-for-virginia-35\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"COVID-19 UPDATE FOR VIRGINIA - Clinicians\" \/>\n<meta property=\"og:description\" content=\"COVID-19 Update for Virginia July 22, 2022 Dear Colleague: I am writing to provide you brief updates on COVID-19, monkeypox, and parechovirus. 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