COVID-19 Vaccination Partner Program
Physicians, Medical Clinics and Pharmacist Vaccination Partners
The Manitoba government has been working with its network of physician and pharmacist partners to deliver COVID-19 vaccines. This includes the College of Physicians and Surgeons of Manitoba, College of Family Physicians, College of Pharmacists, Doctors Manitoba and Pharmacists Manitoba.
Program Outline and Requirements
Pharmacists, clinics and physicians who are interested in providing COVID-19 vaccines can register with Manitoba Health. Once applications are received, they will be reviewed by Public Health, who will be looking for:
- completeness of applications (public health officials will follow up with providers whose forms are incomplete and encourage them to resubmit); and
- confirmation the provider has an active client identification number with Manitoba Health for ordering publicly funded vaccines.
- If the provider does have an active client number, public health officials will connect with them by email to confirm that their application is approved and to provide additional information.
Program Requirements
Medical clinics and pharmacies participating in the Manitoba COVID-19 Immunization Program are required to abide by the following program requirements:
Eligibility Criteria:
1. Immunize patients/clients (including those who are not a patient of your clinic/pharmacy) as per Manitoba's COVID-19 vaccine eligibility criteria. Eligibility criteria is guided by the National Advisory Committee on Immunization (NACI).
2. Review client immunization records via eChart or the Provincial Health Information Management System (PHIMS) to view COVID-19 immunization history and vaccine product to determine minimum intervals.
Doses Administered:
3. All COVID-19 vaccine doses must be reported within two (2) business days of administration to the client/patient via:
- The Claims Processing System (CPS) for fee-for-service (FFS) physicians and, non-FFS physicians/nurse practitioners via shadow billing; or,
- PHIMS for pharmacists and other providers (as determined by Manitoba Health).
- New PHIMS users are required to review and complete the appropriate application forms/resources contained in the registration package that will be shared following approval and notification from Manitoba Health to participate in the COVID-19 Immunization Program.
- Fee-for-service (FFS) physicians who use a third party billing company should advise them that they may have to submit claims more frequently to meet the two (2) business day requirement.
NOTE: for information on remuneration, contact your professional association.
4. All patient/client immunization records must include (at minimum) the client/patient personal health identification number (PHIN), the location of administration, provider, date of administration, vaccine product, lot number, reason for immunization and any additional regulatory requirements.
5. Record and submit doses administered to persons without a PHIN via the appropriate inputting information available here: Client with no PHIN.
Reporting - Inventory & Wastage:
6. Report inventory levels and wastage via:
- Online secure web link (information to be shared following registration) every Thursday, at a minimum, for FFS physicians and non-FFS physicians/nurse practitioners.
- Medical Clinic Weekly Vaccine Inventory Guideline (pdf); or,
- PHIMS for pharmacists (and other providers, as determined by Manitoba Health). It is recommended to conduct Physical Counts in PHIMS after every clinic and/or vial used and to report wastage in PHIMS after each clinic day, or once a week at a minimum. Refer to the PHIMS process to report wastage at: https://phimsmb.ca/files/documenting-vaccine-wastage.pdf (NOTE: The document indicates to enter from a "client file", but this is not necessary)
Information Technology (IT):
7. Ensure information technology (IT) systems are in place to support reporting doses administered, inventory and wastage.
- Information on PHIMS IT requirements are available at: phimsmb.ca/getting-access/readiness/.
Cold Chain Storage and Monitoring:
8. Designate a refrigerator to store COVID-19 and/or other vaccines (NO BAR FRIDGES) that is monitored with an appropriate temperature monitoring device such as a continuous temperature monitor or minimum/maximum thermometer. Household mercury-styled thermometers are not acceptable.
- For specific guidance on the storage and handling requirements for the COVID-19 vaccines refer to: COVID-19 Vaccines Storage and Handling Quick Reference
9. Record refrigerator temperatures twice daily and report cold chain excursions as per the provincial Cold Chain Protocol for Vaccines and Biologics.
Vaccine Safety:
10. Review the clinic/pharmacy anaphylaxis management protocol/plan. Current provincial guidance is as per the Canadian Immunization Guide Anaphylaxis and other Acute Reactions following Vaccination: Canadian Immunization Guide - Canada.ca and NACI recommendations; NACI Recommendations - Post Vaccination Observation Period.
- All patients/clients must be observed for a minimum of 15 minutes after receiving the vaccine.
- Individuals can be immunized if they have allergies not related to the vaccine, such as allergies to foods, insect stings or seasonal/environmental allergies. They should talk to their immunizer or health care provider about their allergies before vaccination.
- People who have a suspected or known allergy to a component of the vaccine (e.g., tromethamine, PEG in COVID-19 mRNA vaccines), or have experienced an allergic reaction after receipt of a COVID-19 vaccine should be referred to an allergist for further assessment.
Please refer to the guidance document from the Canadian Society of Allergy and Clinical Immunology for more information: 2021-04-10 UPDATE - COVID-19 Vaccine Testing & Administration Guidance (csaci.ca)
11. Ensure anaphylaxis medication (e.g., epinephrine/Epi-Pen) and anaphylaxis management equipment is on site at all times.
12. Report adverse events following immunization (AEFI), as per www.gov.mb.ca/health/publichealth/cdc/div/aefi.html#rrp. In accordance with Section 59 of The Public Health Act, health care providers are to report a reportable AEFI within seven days of becoming aware of the AEFI. Furthermore, health care providers should report a serious AEFI within one business day, which can be by telephone, followed by the complete written report within 72 hours.
Competency:
13. Ensure immunizers are competent to deliver COVID-19 vaccines. An immunization provider is a health care professional who is registered or licensed to provide health care under an Act of the Legislature and who is authorized under that act to administer vaccines to a patient/client.
- There may be manufacturer developed educational webinars available; check with your respective regulatory college, or the Public Health Agency of Canada for information.
- Manitoba Health provides COVID-19 Vaccine Administration-Immunization Theory Training for health care professionals hired as immunizers.
Public Health Guidelines:
14. Review national guidance for vaccine delivery in the presence of COVID-19. To access provincial infection, prevention and control and other applicable guidelines for health care providers, go to: sharedhealthmb.ca/covid19/providers/.
15. Access provincial COVID-19 vaccine resources including:
- product monographs, quick reference guides, NACI guidelines, etc. at: manitoba.ca/covid19/health-care-providers..html.
- Consent forms as well as vaccine factsheets for patients/clients can be found at: manitoba.ca/covid19/public-resources.html.
NOTE: the above program requirements are subject to change as per the evolving provincial and national COVID-19 vaccine landscape. Continued participation implicitly assumes that participating medical clinics and pharmacies are amenable to the evolving program requirements.
Questions and Answers
Community Pharmacies and Medical Clinics
Yes, provided they are authorized/certified and competent to administer vaccines. An immunizer is a health care provider who is registered or licensed to provide health care under legislation and who is authorized under that legislation to administer vaccines to a client/patient. If you have questions, contact your regulatory body.
All COVID-19 vaccine doses must be reported within two (2) business days of administration to the client/patient via:
- The Claims Processing System (CPS) for fee-for-service (FFS) physicians and, non-FFS physicians/nurse practitioners via shadow billing; or,
- PHIMS for pharmacists and other providers (as determined by Manitoba Health
Fee-for-service (FFS) physicians: All doses of COVID-19 vaccine that are administered are to be reported to the Claims Processing Unit using the correct tariff code (COVID-19 Vaccine and Flu Vaccine Comparison Chart with Tariff Codes). Those doses would be included as part of the regular payment processes.
Pharmacies: Payment is completed automatically each quarter based on the number of doses of COVID-19 that have been entered into PHIMS. Data must be entered correctly in order to receive payment.
The types of refrigerators that can be used are outlined in Manitoba's Cold Chain Protocol.
Health care providers are to refer to Manitoba's Cold Chain Protocol for the recommended cold chain monitoring devices.
Manitoba Health monitors the vaccine products and immunizations that have been distributed, received, administered and wasted. Audits are conducted on a regular basis.
If a participant cannot accommodate the delivery of onsite COVID-19 vaccinations (i.e., at their medical clinic, community pharmacy or workplace), they are authorized to set-up an offsite immunization clinic (e.g., at a local community centre or building), provided all program requirements and eligibility criteria are adhered to.
It is the discretion of the immunizer on how to proceed. Following the eligibility criteria as closely as possible is critical as the criteria specifies the populations at increased risk of experiencing serious illness requiring hospitalization and/or increased risk of being exposed to COVID-19.
As booster doses of COVID-19 vaccine are being recommended, it is important to be able to determine the time since last COVID-19 dose and follow the recommended or minimum intervals identified. If doses are too close together, a dose given may be considered invalid and re-immunization may be required. That invalid dose also may not appear on their electronic immunization record.
Questions and Answers Specific to Community Pharmacies
All COVID-19 vaccines must be recorded in PHIMS. If the client/patient does not exist in PHIMS (e.g., client/patient does not have a personal health identification number (PHIN)), the community pharmacy can record the immunization using the appropriate inputting form (Inputting-form-pharmacies.pdf (manitoba.ca)) located at Province of Manitoba | Pharmacies. The form is to be submitted twice weekly on Mondays and Fridays (if even only one entry on the form) to have the immunization(s) centrally recorded into PHIMS.
As a registered PHIMS user you have access to resources and tools in PHIMS.
A PHIMS user can enter vaccine administration on behalf of the immunization provider. If the immunization provider is not yet entered into PHIMS, "Other, Provider" can be selected for the provider. See question 31 with questions related to regulatory requirements for entering a drug administration record.
Yes. Specifically, community pharmacies who have applied for and have been accepted to administer COVID-19 vaccines will be required to document all COVID-19 doses administered directly into PHIMS. For clients/patients not found in PHIMS, please complete the appropriate inputting form available at (Clients not found in PHIMS) All other vaccines administered are to be submitted through DPIN where they will be uploaded into PHIMS through an existing interface.
From the provincial immunization program perspective, the administration of COVID-19 vaccines into DPIN does not need to occur. It is a requirement that they be documented in PHIMS. If COVID-19 vaccines are entered into DPIN for clinic/facility-specific reasons, they should be entered as DU. The inclusion of the PS code is not required for the COVID-19 vaccine. (NOTE: if the PS code is unintentionally entered, it will not be pulled into PHIMS to avoid duplicate entries). All other administered vaccines should continue to be recorded in DPIN per routine practices and protocols.
Regulatory questions associated with recording vaccines that have been administered to clients/patients for the purposes of complying with drug administration record requirements should be directed to the College of Pharmacists of Manitoba.
