COVID-19 Vaccine
 

Questions and Answers


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Community Pharmacies and Medical Clinics


  • There is no minimum volume or quota to meet.
  • Operate clinics in best interests of client/patient health and service.
  • Encourage special or extended hour clinics.
  • Encourage administering allocated inventory as soon as possible.
  • Follow Manitoba’s eligibility criteria for who can be immunized.
  • Account for all doses before ordering.

Click here for detailed information on the program requirements.   

The Vaccine Implementation Task Force will be monitoring the vaccines that have been distributed, received, administered and wasted, and how long quickly they were administered to eligible persons. Performance of these key indicators will affect future allocations and decision-making.

 


At this time, the Vaccine Implementation Task Force is planning to distribute non-mRNA vaccines to community pharmacies, medical clinics and workplaces. Non-mRNA COVID-19 vaccines adhere to routine storage and handling requirements required of other publicly-funded vaccines, including the seasonal influenza vaccine. However, as transport and storage guidelines are updated for the mRNA vaccines (and Pfizer-BioNTech in particular), this direction may change. If that happens, participants will be notified.


Yes, each participant will be responsible for scheduling its own appointments via whichever method (e.g., online, telephone, etc.) deemed appropriate (including second doses for 2 dose vaccine schedules) as best suits their practice and client/patient needs. Manitoba’s centralized booking system is only for booking appointments at a Super-Site or Pop-up Clinic.


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.


Manitoba will identify who is eligible for vaccine based on priority populations and will expand that eligibility when deemed appropriate. This information will be located on the COVID-19 website and will be announced through media when those changes are made.

Participants are to only immunize persons who meet the current provincial eligibility criteria. Each clinic/facility/workplace will need to determine how best to approach screening interested clients/patients to confirm eligibility. Options may include screening clients/patients when they book an appointment or reviewing their client/patient listing and contacting (via telephone, text message, etc.) those that meet provincial eligibility criteria.


Medical staff that are registered (or registering) to participate in the Manitoba COVID-19 Immunization Program are eligible to receive the COVID-19 vaccine. In order to prevent wastage, staff are requested to use the end of day remaining doses of open vials that would otherwise need to be discarded.

 


Billing for medical clinics/physicians will follow current billing processes.

Billing for community pharmacies will be processed based on the immunizations that are entered into PHIMS based on the PHIMS data entry procedures and will follow the current quarterly payment schedule. Errors in PHIMS entry could affect billing.

Workplaces are solely responsible for ensuring sufficient qualified immunizers (employed or under contract) are available onsite and that licensed medical professional(s) are overseeing the safety and efficiency of the Program.


The types of refrigerators that can be used are outlined in Manitoba’s Cold Chain Protocol. This includes using a commercial or domestic vaccine fridge while considering the modifications that should be considered in those fridges to ensure temperature stability. Bar fridge units are NOT permitted.


Health care providers are to refer to Manitoba’s Cold Chain Protocol for the recommended cold chain monitoring devices. Note: fluid-filled bio-safe liquid thermometers, bi-metal stem thermometers and household mercury thermometers are NOT recommended for the temperature monitoring of refrigerators containing vaccines and biologics.


The Education Program for Immunization Competencies (EPIC) third edition is not mandatory but should be considered as it has information that is specific to COVID-19 immunizations, information on vaccine hesitancy, and could be a great opportunity to refresh some skills.

EPIC is being provided at no cost to COVID-19 immunizers who are new to immunizing or are returning to immunizing and need resources for training. One seat provides a user with access to the following three learning programs: (1) the full EPIC, with users being able to select from any or all of the 14 modules depending on jurisdictional/user needs (a completion certificate to be provided per module); (2) the existing vaccine hesitancy module; (3) the new COVID-19 vaccine hesitancy - moving to acceptance module. To access for free, please have your supervisor email vaccines@gov.mb.ca.


No, provided immunizers are immunizing within their regular contracted roles (e.g., community pharmacy, medical clinic or workplace occupational health), then they are not required to complete the online modules through RRC, or any other certification courses.


As anticipated, the initial demand for vaccines exceeded the available supply.  The following framework is generally used to guide how much vaccine is shipped to participants:

  • COVID-19 case numbers and epidemiology in a community;
  • the proportion of eligible Manitobans served by the medical clinic, community pharmacy or workplace;
  • the provider’s capacity to administer the vaccine; and
  • if people have access to the vaccine at other locations, such as Super-sites, Pop-up Clinics and focused immunization teams (FITs).

For the first allocation of AstraZeneca/COVISHIELD, the first shipment (18,000 doses) was received and allocated to community pharmacies and medical clinics was short-dated product with an expiry date of April 2, 2021. These exigent, external factors affected decisions around the first allocation.

Community pharmacies that had not yet been provisioned access to the Public Health Information Management System (PHIMS) on the date AstraZeneca/COVISHIELD was approved could not be included in the initial allocation.

The Vaccine Implementation Task Force will continue to review and adjust its allocation model as more AstraZeneca/COVISHIELD supply arrives to Manitoba.


Manitoba will be supplying needles and syringes to participants eligible to receive an allocation of the COVID-19 vaccine as part of the COVID-19 Immunization Program and as long as supplies are available. The supplies will be sent to participants in advance of the arrival of the COVID-19 vaccine. The process for obtaining supplies may be reviewed and modified as the campaign progresses.


No. Any PPE issues identified by community pharmacies, medical clinics or workplaces can be reported to Shared Health. These issues will be reviewed to look for a solution.


Participation in the COVID-19 Immunization Program is contingent on interested participants completing/submitting the online registration eForm and agreeing to follow the program requirements.


Questions about the registration process can be directed to COVID@gov.mb.ca. This email is monitored Monday to Friday during regular business hours; your email will be responded to in the priority in which it was received, as quickly as possible.

For community pharmacies, once you are registered and have been approved, you will be assigned a Digital Health Facilitator who you can contact directly about PHIMS training or information sharing agreement (ISA) questions.


The Vaccine Implementation Task Force will be monitoring the vaccines that have been distributed, received, administered and wasted. Any discrepancies or issues will be reviewed in connection with the associated community pharmacy, medical clinic or workplace to review the issue(s) and look for ways to correct any discrepancies. Compliance and performance of a given clinic/facility/workplace will be considered in future allocations of vaccines to that clinic/facility/workplace.



A public facing map is available online at https://www.gov.mb.ca/covid19/vaccine/finder.html. However, many of these sites indicated on the map may no longer be taking appointments as indicated on the map; the public is encouraged to contact the location/facility directly to determine vaccine supply and opportunity to be immunized.


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.



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, located at https://manitoba.ca/covid19/vaccine/partners/index.html. 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.


A member of the PHIMS Team will be connecting with your pharmacy to assist you with access to PHIMS.  They will provide resources and tools to help you use PHIMS.  You can contact them if you have additional questions.


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. 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 into PHIMS. For clients/patients not found in PHIMS, please complete the appropriate inputting form available at: https://www.gov.mb.ca/covid19/vaccine/eligibility-criteria.html. All other vaccination administration records will be added to PHIMS via the existing DPIN interface.


Following approval of the COVID-19 Vaccine Registration Form, the contact indicated on the registration form will be notified regarding next steps to start the process of setting up access to PHIMS.


There is an annual PHIMS user fee that is currently being waived.


Instructor-led training is NOT being provided. Rather, there is a variety of resources available at: https://phimsmb.ca/resources/non-public-health/pharmacy/ for self-directed training. The resource material includes Quick Reference Cards (QRCs), guides, and videos. Webinars have also been scheduled to demonstrate what PHIMS looks like and answer questions about the application.


The PHIMS resource material is located here: https://phimsmb.ca/resources/non-public-health/pharmacy/. In addition to documents and videos, webinars have been scheduled for demonstrating what PHIMS looks like and answering questions about the application.


There is no formal training, but the resource material is available anytime. It is recommended that the resource material is read and viewed prior to logging into the PHIMS application. Demonstration webinars have been scheduled to demonstrate what PHIMS looks like and answer questions about PHIMS.


From the provincial program perspective, there is no need to also enter them into DPIN as long as all COVID-19 vaccines have been 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 per routine practices and protocols.


It is up to the discretion of the pharmacist. If the pharmacist wants to ensure his/her own software has the record of the immunization, he/she can enter it as needed.


Existing operations at community pharmacies do not currently allow or require pharmacists to do the following tasks:

  • record reason for immunization upon administering the vaccine to eligible persons; or,
  • provincially report inventory and wastage.

In addition, PHIMS provides pharmacists with an efficient mechanism for confirming client immunization history prior to immunization.


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.



There have been reports that some providers have been able to get extra doses from the AstraZeneca/Covishield vaccine vials. In order for your “inventory on hand” to be accurate in PHIMS,  please complete a manual, or “Physical Count”, of your inventory after each day and/or after each vial and update your PHIMS inventory accordingly. Otherwise, if the PHIMS inventory reaches zero, PHIMS will not present the extra doses and you will not be able to document the extra doses administered into a client’s file.

If the inventory in PHIMS goes to “0” before you have recorded all of the doses given to clients, you will need to contact the Service Desk ( Servicedesk@sharedhealthmb.ca 204-940-8500 or 1-866-999-9698) to have the inventory adjusted accordingly.



Questions and Answers Specific to Workplaces


Initial supply of COVID-19 vaccine that is being allocated is expected to be lower than the demand. In an effort to maximize efficiency, only large workplaces are eligible to participate. Smaller workplaces should encourage their employees to get vaccinated at a Super-site or Pop-up Clinic when they are eligible.


No. Workplaces are to only immunize persons who meet the current provincial eligibility criteria. Manitoba will identify who is eligible for vaccine based on priority populations and will expand that eligibility when deemed appropriate. Therefore, not every employee will be eligible at the same time. Information on eligibility criteria is located on the COVID-19 website and will be announced through media changes are made.

Each workplace will need to determine how best to approach screening interested clients/patients to confirm eligibility.


Yes. Your workplace can apply but will need to arrange for a qualified health care provider to come onsite to administer the vaccines prior to registering (i.e. pharmacist, physician, nurse or nurse practitioner). It is important that arranging your health care provider(s) to immunize does not impact immunization capacity elsewhere and is explained during registration.