Requested actions
- Be aware of local and national reports of myocarditis and pericarditis among people who received COVID-19 mRNA vaccine within the last 2 weeks.
- Promptly report cases to the U.S. Vaccine Adverse Events Reporting System (VAERS) at https://vaers.hhs.gov/reportevent.html.
- Vaccinate everyone 12 years or older against COVID-19.
- Build trust in COVID-19 vaccines.
- Review all patients’ vaccination records and help them get up to date with vaccines. You can administer COVID-19 vaccine simultaneous with, or within any number of days of, other vaccines.
Myocarditis and pericarditis following COVID-19 vaccination
On May 17, the Centers for Disease Control and Prevention (CDC) Vaccine Safety Technical Subgroup reported a few cases of myocarditis and pericarditis among people who received COVID-19 mRNA vaccine. No similar reporting pattern is observed after receiving Janssen (Johnson & Johnson) COVID-19 vaccine. Cases are predominantly male adolescents and young adults. Disease onset occurs more often following dose 2 than dose 1, and typically within several days after vaccination. Most cases appear to be mild, and follow-up is ongoing. It is not currently clear if there is a causal association with COVID-19 vaccination. CDC continues to recommend COVID-19 vaccination for people 12 years or older.
CDC is monitoring myocarditis and pericarditis in multiple safety systems, including VAERS and the Vaccine Safety Datalink (VSD). To date, a safety signal has not been identified in VAERS or VSD.
CDC posted Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults, as well as related resources for the public. To support ongoing monitoring for this potential adverse event, evaluate patients with chest pain for myocarditis or pericarditis and inquire about recent COVID-19 vaccination. Promptly report any such cases to VAERS and to the Health Department. Clinical features of myocarditis and pericarditis include:
- Chest pain or pressure.
- Shortness of breath.
- Palpitations.
- Electrocardiogram (EKG) changes.
- Elevated cardiac biomarkers.
Elicit a detailed history, including vaccination status and potential exposures to COVID-19. Test patients for COVID-19 infection with a molecular (PCR) test. Initial evaluation should include ECG, troponin level, and inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate. It is important to consider other potential causes.
Additional information
- Follow-up of patients with myocarditis, consult recommendations from American Heart Association and the American College of Cardiology.
- Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults, CDC.
- COVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines, World Health Organization (WHO) May 26, 2021 press release.
- Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination, CDC.
- Selected Adverse Events Reported after COVID-19 Vaccination, CDC.
New vaccination incentives
On June 3, Gov. Jay Inslee announced COVID-19 vaccination incentives. The state will draw winners from the Washington State Immunization Information System (WA IIS). Accurate and prompt vaccination records are crucial to properly incentivize vaccine recipients.
- Enter all COVID-19 vaccination records into WA IIS as quickly as possible.
- Make sure patient information is accurate and up to date.
- Make sure you enter all submitted patient information. Many people are having trouble getting MyIR Mobile to recognize them because the provider did not enter their phone number or other crucial information.
Be prepared, patients may contact you to verify their vaccination status. If they do so, you may:
- Send them to MyIR Mobile if they can read English and have internet access and skills.
- Send them to the Washington State Department of Health (DOH) call center at (800) 525-0127 if they prefer a different language or don’t have internet access or skills. Operators can help callers access and verify their vaccination records in WA IIS and can help in many languages or connect with an interpreter.
- Supply them with a WA IIS or electronic health record (EHR) printout if the above options don’t work for them.
Additional information
- COVID-19 vaccine locator—DOH.
- COVID-19 vaccine for providers
- COVID-19 vaccine and enrollment information for providers—DOH.
- COVID-19 vaccine provider toolkit and resources—DOH.
- COVID-19 vaccination for providers—CDC.
- Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis—CDC.
- Pfizer-BioNTech COVID-19 vaccine information for providers—CDC.
- Moderna COVID-19 vaccine information for providers—CDC.
- ACIP’s interim considerations for preparing for management of potential anaphylaxis at COVID-19 vaccination sites—CDC.
- Providers authorized to administer and order vaccines—DOH.
- COVID-19 vaccine training module on best practices for providers—CDC.
- J&J/Janssen Health Alert, CDC.
- Vaccine-induced immune thrombotic thrombocytopenia frequently asked questions, American Society of Hematology (ASH).
- Diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia webinar, ASH and CDC.
- April 15, 2021 COCA Call: Johnson & Johnson/Janssen COVID-19 vaccine and cerebral venous sinus thrombosis with thrombocytopenia update for clinicians on early detection and treatment, CDC.
Recent MMWR publications
- COVID-19 Vaccine Breakthrough Infections Reported to CDC—United States, January 1-April 30, 2021.
- Patterns in COVID-19 Vaccination Coverage, by Social Vulnerability and Urbanicity—United States, December 14, 2020-May 1, 2021.
COVID-19 testing
Abbott Laboratories extended all BinaxNOW tests’ shelf life to 12 months. See Abbott’s BinaxNOW COVID-19 Ag Card Product Expiry Update for new expiration dates by lot number.
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. The table below shows COVID-19 test processing times for in-state private labs.
| LAB | TIME TO PROCESS TEST | TESTS PROCESSED DAILY |
|---|---|---|
| FidaLab | 24-48 hours | 600 |
| Kaiser | 24 hours | 600-700 |
| LabCorp | 48 hours | Unknown |
| Northwest Pathology | 24-48 hours | 20,000 |
| Quest | 24-48 hours | 600 |
| UW Virology | 18-24 hours | 3,000-6,000 |
| Atlas Genomic | 9 hours | 10,000 |
Patient education
Share the following materials with patients.
- What to do if you have COVID-19.
- What to do if you may have been exposed to COVID-19.
- What to do if you have COVID-19 symptoms and have not been tested or exposed.