COVID-19 Immunization Program in Saskatchewan Pharmacies - Wednesday April 7th, 2021
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COVID-19
Immunization Program
in Saskatchewan
Pharmacies
Wednesday April 7th, 2021
Moderator:
Dawn Martin, CEO
PAS
Welcome Everyone • PAS Members & Non-Member Attendees • Pharmacists • Technicians • Pharmacy Students • Technician Students • Pharmacy Assistants • Local and regional pharmacy managers • Pharmacy administrators • Over 630 pharmacy team members registered for this complimentary webinar lead by PAS
Housekeeping
• Attendees are in listen-only mode
• Audio
• If you are having audio issues, check your volume
button, or close out and re-enter the session
• Use the Q&A to ask questions that will be
addressed at the end of the presentation
• Recording
• This session is being recorded
• All registrants will automatically be sent the recording
within the next 24 hours
Overview of the Presentation
• PAS will address as many details of the COVID-19 Immunization
Program (CIP) in community pharmacies as possible
• Some details are still pending or being developed
• In addition to myself, representatives that are on hand to present
and/or answer questions include:
• PAS - Myla Bulych, Director of Professional Practice
• SCPP- Jeana Wendel, Registrar & Lori Postnikoff, Deputy Registrar
• DPEBB - Arlene Kuntz, Director Professional Practice
• SHA -Patrick Robertson Executive Director, Provincial Programs –
Pharmacy Services
• NIHB/Indigenous Services Canada -Katherine Windl, Covid-19 Vaccine
Surge Planning Task Team Regional NIHB COVID co-ordination Lead
• Questions will be addressed by all panelists at the end of the
presentation
Presenter:
Myla Bulych, Director of
Professional Practice
PASFocus on “First Doses”
• Similar to the larger provincial roll out, the COVID-19 Immunization
Program (CIP) in Saskatchewan community pharmacies is currently
geared toward and focusing on the first shot of COVID-19 vaccine
doses only.
• More details will be provided in the future for the provincial
“second dose strategy”.
• This session will be an overview of the “draft” policy of the CIP
• The final policy will be provided to pharmacies shortly
• Updates will appear in bulletins
• DPEBB website CIP Drug Plan
NOTE: Pharmacies are not permitted to provide second
administrations of vaccine to patients until directed to do so.CIP Eligible Pharmacies
• For your pharmacy to be eligible to administer COVID-19
immunizations:
• Register your pharmacy and be compliant with all of the
requirements as per the Ministry of Health
• You may register at any time, if you have not already done so
• As of April 7, 2021:
• 388 of the 418 pharmacies in Saskatchewan have
registered to participate in the CIP (93%)Who Can Administer Publicly- Funded
COVID-19 Immunization in the CIP?
• Licensed pharmacist (with AMC)
• Pharmacist extended intern (with AMSC)
• Pharmacy student intern (completed at least 2 years of
education at U of S with AMSC)
• Licensed pharmacy technician (with AMTC)
• Formerly licensed pharmacists may inject (only) contact SCPP
for more details
……according to the Regulatory Bylaws of the Saskatchewan
College of Pharmacy Professionals (SCPP)General Distribution Details
for COVID-19 Vaccine Products
• Primarily through McKesson in the early weeks
• other wholesalers possibly coming on board later
• Phased approach for distribution
• starting with pilot pharmacies
• Delays in the shipping of vaccines from the manufacturers
possible. In this case pharmacies:
• will be notified as soon as possible of any delays
• may be required to adjust appointments on short notice
• Distribution will vary
• not all pharmacies will receive vaccine on a weekly basis,
particularly early in the roll-outVaccine Product (as of April 7 th, 2021)
• AstraZeneca COVID-19 Vaccine®
• 5ml multidose vials (DIN 02510847) and 4ml multidose
vials (DIN 02511444 )
• COVID-19 Vaccine Moderna®
• multidose vials (DIN 02510014)
• Covishield Vaccine®
• multidose vials (DIN 02512947)
• Pfizer-BioNTECH® COVID-19 Vaccine®
• multidose vials (DIN 02509210)
More products may become available as they are
approved by Health CanadaVaccine Product Con’t (as of April 7 th, 2021)
• Each pharmacy will only receive one* vaccine product based
on:
• available vaccine supply
• what vaccine has already been provided in their area, etc.
• to support patient safety/reduce the risk for errors in mixing and
administration
*While every effort will be made to provide only one vaccine
product to pharmacies, there may be a need to provide
additional products based on available supply.Vaccine Product Con’t (as of April 7th, 2021)
• Vaccine amounts shipped will be pre-determined and may
vary based on:
• pharmacy capacity
• usual HR, holidays, new hires, staff sickness, etc.
• vaccine supply
• local outbreaks and need
• Amount of vaccine generally will be provided in packages
approved by Health Canada
• solutions are being considered on how to spilt packages to reduce
wastage
• mRNA vaccine products will be shipped in the thawing stateEligible Patients for CIP • An eligible patient under the CIP is a resident of Saskatchewan with a valid Saskatchewan Health Services card that meets the current provincial age sequencing requirements of the available COVID-19 vaccine. NOTE: Out-of-province patients or patients without a valid Saskatchewan Health Services card must be referred to public health. They are not eligible to receive COVID-19 vaccine from community pharmacies.
Age Eligibility for Each Vaccine Product
(as of April 7th, 2021)
• Based on vaccine type
• Age subject to change based on evidence
• AstraZeneca COVID-19 Vaccine® - Saskatchewan residents with a valid
Health Services card, fifty-five (55) years of age and older.
• COVID-19 Vaccine Moderna® – Saskatchewan residents with a valid
Health Services card, eighteen (18) years of age and older
• Covishield Vaccine®- Saskatchewan residents with a valid Health
Services card, fifty-five (55) years of age and older.
• Pfizer-BioNTECH® COVID-19 Vaccine® - Saskatchewan residents with a
valid Health Services card, sixteen (16) years of age and older.Injection Supplies • Pharmacies will be provided with injection supplies from the federal allocation to the province • Further details are pending, but will be provided shortly • Wallet Cards and Immunization Stickers • Will be shipped to pharmacies with their vaccine supply • More details on this later in the presentation
Start Date of the CIP
• Pilot phase
• anticipated to start the week of April 19, 2021
• limited number of pharmacies
• week one: ~10,000 doses of Moderna vaccine being distributed (100
doses per pilot site)
• week two: ~10,000 doses of Pfizer vaccine (150 doses per pilot site)
• vaccination supplies will also be part of this distribution
• pilot pharmacies will be notified no later than one week prior to
distribution
• it is anticipated that this type of direct notification process will continue
throughout the COVID-19 Immunization ProgramStart Date of the CIP Con’t
• Larger provincial roll out:
• dependent on a number of factors, including vaccine availability, and
other considerations
• likely to begin in May with a substantive vaccine supply expected
over June to August
• provincial supply will be split strategically among all vaccination
partners, including the SHA and pharmaciesGoal of Pilot Phase
• Work through logistics of wholesalers sending vaccine and
ancillary supplies to community pharmacies
• Provide an opportunity for pharmacies to work through the
process before a larger roll out occurs:
• receiving supply
• booking appointments
• administration
• documentation
• Evaluate the success of the initial Moderna and Pfizer pilots
and make modifications to the processes as required
• Expand a coordinated roll out in May 2021 to include more
pharmacies and communitiesHow are Pilot Sites Being Chosen? • A multitude of factors were considered in the chosen pilot sites including but not limited to: • Responses to the PAS survey and capacity • Regional outbreaks • Vaccine supply available • Vaccine already given in the area
How are Pilot Sites Being Notified? • Your pharmacy will be contacted directly via phone approximately one week in advance, by the Ministry of Health to discuss/confirm: • Your pharmacy’s ability to participate • Vaccine supply allocation • Policy and process requirements • Communications to public and patients • Etc.
Patient Bookings
• Must follow age sequence
• An eligible patient under the CIP is a resident of Saskatchewan
with a valid Saskatchewan Health Services card that meets the
current provincial age sequencing requirements of the available
COVID-19 vaccine
• Patient’s receiving COVID-19 immunizations can not be limited
to “pharmacy patients” only
• For pilot or larger roll-out
• We understand the challenges of this and the inquires you will
get, especially in the early days of the pilot announcementsLimiting/Avoiding Wastage
• Step-Wise Approach
• MoH is developing an algorithm for offering doses to patients to
prevent wastage when vaccine is still available at the end of the day
in an opened vial
• Pooling Residual COVID-19 Vaccine to Obtain a Full Dose
• The temporary practice of pooling residual COVID-19 vaccine from up to three
vials to obtain a full dose has been approved
• Purpose -to protect as many individuals as possible from COVID-19 while
initial vaccine supply is limited.
• Determined the risk of contamination is relatively low compared to losing
doses of the vaccines to prevent morbidity and mortality from COVID-19.
• A work standard can be found on the COVID-19 Immunization Manual at
COVID-Vaccine-WS-Pooling-residual-vaccine-to-obtain-full-dose.pdf
(ehealthsask.ca)
• The need to pool vaccine doses will be re-evaluated as more ample COVID-19
vaccine supply is received.Covid-19 Immunization Fee (CIF)
• DPEBB pays 100% of the CIF for eligible* patients (*valid Saskatchewan
health card)
• Provincial/Federal government cover publicly funded COVID-19 vaccine and its
distribution
• $20.00 per injection of eligible COVID-19 immunization
• as per # of injections required for product
• as per eligible age for vaccine product
• NEW for COVID-19 vaccine only, single claim to be submitted including:
• DIN of product
• CIF submitted as the acquisition/unit drug cost
• Adjudicate benefit service as a one (1) day supply
• On the date of the immunization service
• CIF includes all activities/expenses related to provision of the service
• patient assessment, administration of the COVID-19 vaccine, monitoring the
patient, drugs and supplies used to manage adverse events following
immunization and required record-keepingCovid-19 Immunization Fee (CIF)
No incentives shall be provided by the Proprietor or an agent
on behalf of the Proprietor to any other person in relation to
the provision of publicly funded COVID-19 vaccine
immunization.
“Incentives” means any money, gifts, donations to a charity,
rebates, refunds, customer loyalty programs, points,
coupons, discounts, goods and/or rewards which can be
redeemed for a gift or other benefit.CIP Outside of the Pharmacy
Alternate Locations
• Examples: a vacant storefront in a shopping centre, an open space outside
of the pharmacy within a shopping centre, or a vacant building in another
location, etc.
• Sites will only be considered if they are NOT in use for other purposes
• Alternate Locations Registration Form
Congregate Living Settings
• Buildings which house residents who may have mobility, accessibility
and/or cognitive challenges, that are for profit, not for profit public or
privately owned
• May or may not be licensed by the Government of Saskatchewan.
• Do not include LTC facilities
• Examples: assisted living/seniors’ independent housing and group homes
• Contact public health prior to administering in these locationsCIP Outside of the Pharmacy Home Visits • The intent of off-site home visits by community pharmacists is to provide enhanced accessibility to those patients at high-risk of COVID-19 complications and who may have mobility issues or cognitive deficits. Personal Care Homes • to date all COVID-19 immunizations have been provided via public health
Documentation and Reporting
• SCPP and SIM requirements
• https://formulary.drugplan.ehealthsask.ca/COVIDImmunizationProgr
am
• Adjudication
• Ensure the COVID-19 vaccine product record is submitted to the
Pharmaceutical Information Program (PIP)
• COVID-19 immunizations will be captured during the
adjudication process, and sent automatically to Panorama
• Must be submitted the day of administration
• Important for inventory control
• COVID-19 exposure screening questionsDocumentation and Reporting Con’t
• Consent form
• medSask and CPDPP are developing a consent and documentation
form for COVID-19 immunizations
• Form NOT mandatory, but it is compliant with:
• SCPP legislation requirements
• DPEBB program policy
• Copyright material; if form is integrated with local software, it must
maintain medsask/CPDPP logos
NOTE: During the current COVID-19 pandemic, pharmacists
are permitted to obtain informed verbal consent from the
patient or their agent, it must be documentedDocumentation and Reporting Con’t
• Contact tracing
• Develop a process to document attendees on a daily basis.
• Must be available, upon request by public health, whether the vaccine
is administered at the pharmacy or in an alternate location separate
from the pharmacy.
• Cold-Chain
• Report all cold chain break incidents for publicly funded COVID-19
vaccine immediately upon discovery as per requirements set out in the
COVID-19 Immunization Manual.
• https://www.ehealthsask.ca/services/Manuals/Pages/COVID-19.aspx
• Wastage
• Report all COVID-19 vaccine wastage for publicly funded COVID-19
vaccine as per requirements set out in the COVID-19 Immunization
Manual.
• https://www.ehealthsask.ca/services/Manuals/Pages/COVID-19.aspxDocumentation and Reporting Con’t
• AEFIs
• Report immediately to local public health (NOT the Ministry of Health)
Adverse Events Following Immunization (AEFIs) for publicly funded COVID-19
vaccine as per requirements set out in the Chapter 11 of the Saskatchewan
Immunization Manual.
• https://www.canada.ca/content/dam/phac-
aspc/documents/services/immunization/aefi-form-july23-2020-eng.pdf
• *NEW* AESIs
• Adverse Events of Special Interest (AESI) following immunization with any
COVID-19 vaccine using the national Adverse Event Following Immunization
(AEFI) reporting form
• COVID-19 vaccine AESIs to be reported immediately to local public health
as AEFIs:
1. Thrombotic events including:
a. Pulmonary embolism
b. Venous thromboembolism (VT) e.g., deep vein thrombosis (DVT), phlebitis,
thrombophlebitis
c. Stroke (if it is possible to confirm if the stroke was embolic or hemorrhagic, please
specify)
d. Limb ischemia
e. Abdominal thrombosis (such as adrenal vein thrombosis, portal/mesenteric vein
thrombosis)
f. Cerebral venous thrombosis
2. Hemorrhagic disease or bleeding disorders (including, for example, abnormal uterine
bleeding warranting urgent care)
3. Thrombocytopenia
4. Other coagulation or blood disorders:
a. Disseminated intravascular coagulation (DIC)
b. Hemolytic uremic syndrome (HUS)
c. Complement disordersDocumentation and Reporting Con’t
• *NEW* Health Care Worker Status
• Tracking HCW status will be required
• Details pending
• *NEW * Vaccine Distribution Tracking System
• Record vaccine product received from wholesaler and
administered on a daily basis into the provincial Vaccine
Distribution Tracking System (VDTS)
• Further details pending, will be found at
https://formulary.drugplan.ehealthsask.ca/COVIDImmunizationP
rogram
Additional documentation and reporting
MAY be required in the future.
Please check the final policy document for up-to-date
information and requirements.Documentation and Reporting Con’t
• Fact Sheets
• The Ministry of Health COVID-19 vaccine specific Fact Sheet and After
Care Sheet are to be made available to each individual to whom a
COVID-19 vaccine is administered.
https://www.ehealthsask.ca/services/Manuals/Pages/COVID-19.aspx
• Wallet Cards and Immunization Stickers
• The Ministry of Health wallet card, as a record of immunization, is to
be made available to each individual to whom a COVID-19 vaccine is
administered.
• Stickers and wallet cards will be automatically provided to pharmacies
via wholesalers when vaccine is shipped, no need to order
Store all documents for future use in a secure manner for a
period of seven (7) years from the date of provision of the
service.Communications Strategy
• Meetings between PAS, MOH and SHA on approaches for
pilot phase and larger provincial role out
• Weighed risks and benefits of types of messaging
• Used lessons learned from other provinces
• PAS provided front line pharmacist perspective on workload issues
answering questions and inquiries
• Will not be able to totally mitigate misunderstandings by
public and resources needed to answer their questions
• General approach
• “Soft” approach messaging for pilot phase
• Larger roll out communications being developed
• PAS support
• Local and pharmacy messagingLocal and Pharmacy Specific
Communications Strategy
• Resource your pharmacy appropriately, especially in early days
of announcements
• Consider including info on phone message, eg:
• If you are, or ARE NOT a pilot site
• If you have appointments left, or do not
• Dedicated line for COVID-19 immunization bookings
• Pharmacy social media
• Community social media
• Posters, bag stuffersPublic Education on COVID-19
Immunization
• PAS has been working with other health care agencies (SCPP,
SMA, CPSS, SRNA etc.) on a public education campaign to
promote COVID-19 immunizations to the Saskatchewan
public
• Part two of this social media campaign will roll out the week of April
19th, 2021
• The provincial government along with PAS, CPDPP and other
health care agencies are working on a campaign and
education specific to health care workers to achieve an
immunization rate of over 85%.
• Website coming next week
• Several other provincial and federal agencies are in the
process of developing public COVID-19 immunization
awareness and educational campaigns that PAS will alert you
to over time.Presenter:
Jeana Wendel, Registrar
SCPPTraining and Education:
▪ Information can be found on SCPPs website using the link below with respect to what training
is required for the different classes of immunizers.
https://www.saskpharm.ca/site/profprac/training?nav=sidebar
Extended Interns, Pharmacy Student Interns, Pharmacy Technicians and Formerly Licensed
Pharmacist Immunizers:
▪ Training requirements as per the above link
▪ SCPP will be releasing FAQs to support questions as well as support scope of practice
questions
▪ There are aspects of immunization that can only be completed by a licensed pharmacist
Rapid Testing Access:
• Awaiting Ministerial approval for emergency bylaws (April 9 or 16)
• Will enable Pharmacists to perform COVID-19 testing as well as provide COVID-19 results
• Contracts will be required between pharmacy and SHA
• Training will be required as per SHA
• Reporting requirements (results entered into a specific portal)
• There will be follow up expectations as per public health
• More to followPresenter:
Katherine Windl
Covid-19 Vaccine Surge Planning Task Team
Regional NIHB COVID co-ordination Lead
NIHB, Indigenous Services CanadaGeneral Vaccine Overview April 7, 2021
Vaccines Administered in First
Nations communities
As of Mar 31, 2021 at 4:00 pm
Communities in Doses
COVID Zone Administered
Far North Central 788
Far North West 1,847
Far North East 2,667
North West 2,031
North Central* 1,639
North East 700
Central East 2,428
South East* 2,705
Total 14,805
*Due to community confidentiality with only one community per zone, First Nations
communities data in Saskatoon region is combined with North Central, and Regina,
South West and South Central are combined with South East.Supporting the COVID-19 Mass Vaccination • All 82 First Nations communities in Sk have received and administered their first vaccine allocations. • The majority of communities have estimated vaccine uptake at 75% or greater, which aligns with the provincial uptake estimates • Communities have used a variety of methods for sharing information with members about vaccine clinics and promoting vaccine uptake (community web pages, social media newsletters, posters, flyers, phone trees, sharing information by word-of-mouth)
ISC Support • Traditional Immunizers • Non-Traditional • Need for additional Immunizers is in areas north of Saskatoon
SHA online and telephone booking system for COVID-
19 vaccine appointments in urban centres
• SHA’s online booking system, available 24/7 can be found at:
http://www.saskatchewan.ca/covid19-vaccine
• Vaccine Call Centre, operates 8 AM to 11 PM, seven days per week:
1-833-SASK-VAX (1-833-727-5829).
• As of April 7, eligible groups provincially include:
• Citizens 58 years and older
• In the Northern SK Administrative District: Individuals 50 to 57 years of age
• Remaining phase one health care workers
• Individuals with underlying health conditions who are clinically extremely
vulnerable through an eligibility letter (majority of these individuals have
already been identified by their health care team)Contact us
ISC SASK COVID-19 VACCINE INBOX
Katy Windl
Saskatchewan Regional Pharmacist,
• Community-specific information on Katherine.windl@canada.ca
services, doses or timelines
• Vaccine safety and administration
questions NIHB Regional Office
• Funding or support questions 1-866-885-3933
• Sharing vaccine-related stories or
communications products ISC Casual Immunizers apply here:
• Returning surveys or other ISC https://emploisfp-psjobs.cfp-psc.gc.ca/psrs-
requests for information srfp/applicant/page1800?toggleLanguage=en&post
er=1557403
sac.saskcovid-19vaccine-
vaccincovid-19.isc@canada.caQuestions? • PAS - Dawn Martin, CEO & Myla Bulych, Director of Professional Practice • SCPP - Jeana Wendel, Registrar & Lori Postnikoff, Deputy Registrar • DPEBB - Arlene Kuntz, Director Professional Practice • SHA - Patrick Robertson Executive Director, Provincial Programs – Pharmacy Services • NIHB/Indigenous Services Canada -Katherine Windl, Covid-19 Vaccine Surge Planning Task Team Regional NIHB COVID co-ordination Lead
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