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Supporting health and social care providers in Devon

Preparing for booster doses of COVID-19 vaccinations in care homes FAQs – September 2021

1. Who will receive a booster vaccine?

JCVI advises that for the 2021 COVID-19 booster vaccine programme individuals who received vaccination in Phase 1 of the COVID-19 vaccination programme (priority groups 1 to 9) should be offered a third dose COVID-19 booster vaccine. This includes:

  1. residents in a care home for older adults and their carers
  2. all those 80 years of age and over and frontline health and social care workers
  3. all those 75 years of age and over
  4. all those 70 years of age and over and clinically extremely vulnerable individuals (footnote 1)
  5. all those 65 years of age and over
  6. all individuals aged 16 years (footnote 2) to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality (footnote 3)
  7. all those 60 years of age and over
  8. all those 55 years of age and over
  9. all those 50 years of age and over

Further details about the booster vaccination: COVID-19 vaccination.

JCVI advise that the booster vaccine dose is offered no earlier than six months after completion of the primary vaccine course (1st and 2nd dose) and should be deployed in the same order as during Phase 1 with operational flexibility to maximise delivery and prioritise those most vulnerable.

Footnotes:

1. See description of clinically extremely vulnerable individuals. This advice on vaccination does not include all pregnant women or those under the age of 16 years (see above).

2. The Pfizer-BioNTech vaccine is authorised in those aged 16 years and over. The AstraZeneca vaccine is only authorised for use in those aged 18 years and over.

3. This also includes those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill.

2. Which Vaccine will Care Home residents and staff receive?

Most residents and staff will receive a further dose of the Pfizer vaccine irrespective of the vaccine that was previously received although in some circumstances individuals may be offered a half dose of Moderna.

Where the above vaccines cannot be offered due to allergies, AstraZeneca booster vaccinations may be considered for those who received AstraZeneca in their primary course.

3. How long after the second dose can care home staff, and residents have the booster?

The booster vaccination will be administered no earlier than 6 months after the second dose vaccination.

4. How long after a positive COVID-19 test can staff and residents have the booster?

The booster vaccination can be administered four weeks after a positive COVID-19 test result.

5. Is it mandatory for care home staff to have their booster vaccine?

Not at present but we anticipate it may be deemed mandatory in future.

6. What if a resident or staff member reacted to their last injection?

If a resident or member of staff had a severe anaphylactic reaction to a previous COVID-19 vaccination, or are allergic to any of its ingredients, they should not have the booster. Other reactions are usually mild and self-limiting and do not stop them being vaccinated again- and they may not react even if they did last time.

The risks of COVID-19 infection tend to far outweigh risks associated with the vaccine. We advise them to take some paracetamol at the time of their injection to reduce the risk of side effects.

7. What if someone is allergic to the ingredients of the Pfizer jab?

Please discuss options with your GP before receiving the booster vaccination.

8. How and when will care home residents receive their booster vaccinations?

The programme of booster doses will in care home will begin imminently with vaccinations taking place approximately six months after the initial doses, although there may be some flexibility around this to allow Primary Care Networks to plan their schedule of care home visits.

You can expect to be contacted by your Primary Care Network about a week before the vaccine is due. Please wait to be contacted.

The scheduling of visits will be determined by several factors. Delivery schedules for vaccine are determined nationally and Primary Care Networks do not generally receive much notice of the delivery. The outbreak status of the home may also affect the scheduling of the visit.

In most of the county GP Practices will be visiting homes to deliver vaccinations to residents and staff, however in some parts of North Devon North Devon Health Care Trust will provide the vaccination visits and in some parts of Plymouth University Hospitals Plymouth will do the same

East, Mid and South Devon Homes

For residents who are unwell or not present on the day due to hospital admission the Primary Care Network Vaccinating Team will arrange for follow up visit.

Primary Care Networks will vaccinate staff present on the day that the resident vaccinations take place.

Those staff not present on the day will be asked to book a booster vaccination slot at the Greendale Vaccination Centre, English Riviera Centre Vaccination centre or a local Community Pharmacy or Pop up clinic

Frontline health and social care workers (HSCW) should be able to book a COVID-19 booster vaccination through the national Booking Service by self-declaring as frontline HSCW when booking their appointment – Book or manage your coronavirus (COVID-19) vaccination – NHS or by ringing 119.

North and West Devon Homes

For residents who are unwell or not present on the day due to hospital admission the Vaccinating Team, Vaccination Centre Outreach or Primary Care Networks will arrange for follow up visit

Where a Primary Care Network has opted out the North Devon Hospital Trust and Plymouth University Hospitals will vaccinate staff as well as residents when they arrange to visit

Those staff not present on the day will be asked to book a booster vaccination slot at the Barnstaple Vaccination Centre, Home Park Vaccination Centre or a local Community Pharmacy if there is an offer or a pop-up clinic.

Frontline HSCW should be able to book a COVID-19 Booster vaccination through the national Booking Service by self-declaring as frontline HSCW when booking their appointment – Book or manage your coronavirus (COVID-19) vaccination – NHS or by ringing 119.

Please note:

If a member of staff tries to book an appointment less than six months from their second vaccination date they will not be able to self-declare as a frontline HSCW and will be unable to book a booster appointment. Please ensure that they try again once six months since their second dose has passed.

9. What do I need to do to prepare for the visiting team appointment at the Care Home?

  • Create adequate space to enable the vaccination to take place – An area of diluting and mixing; a room for vaccinating and an area for observation
  • Prepare a log of those who require vaccination
  • Make sure best interest and capacity have been concluded ahead of your vaccination visit
  • Engage staff and residents early
  • Ensure the visiting team are aware of any COVID-19 cases ahead of any visit.

If you have already prepared consent using the whole forms please don’t repeat the exercise but going forward please do use the updated forms.

10. What happens if a resident does not have capacity to consent?

  • The vaccinator needs to be satisfied that the person has capacity to consent to the vaccine (but will need information from the care home about this).
  • If a person has capacity, they may wish to involve relatives
  • If there is a health and welfare Lasting Power of Attorney (LPA) or court appointed deputy (CAD), the person must lack capacity & you must see a copy of the LPA. They are the best interest decision maker and must be consulted and agree for the vaccine to go ahead. A local best interest decision cannot over-ride this.
  • Where a person does not have capacity to consent & with no LPA/CAD, a relative cannot consent on their behalf but should be consulted – a best interest decision is needed.
  • The vaccinator, who is the decision maker, needs to be satisfied that it is in the person’s best interest to have the vaccine (based on the information provided to them on the day).
  • If in doubt stop, do not give the vaccine and do further investigations with those who can speak for the person, e.g. family, paid carers. Consider holding a best interest meeting.
  • People should not be disadvantaged because they lack capacity to consent.
  • Consent forms can be found here – COVID-19 vaccination programme.

11. Will the flu vaccinations be offered at the same time?

Primary Care Networks will endeavour to co-administer the COVID-19 booster and Flu vaccinations where possible however neither programme should postpone delivery to enable co-administration and that may result in two visits to a home.

12. Are Health and social care workers aged 16 – 17 ¾ years able to receive Pfizer booster vaccinations?

As outlined in the Green Book and protocol for the administration of Pfizer vaccine health and social care workers aged 16 -17 should receive the two dose primary course of the Pfizer vaccine. Frontline health and social care workers aged 16 and over who have direct contact with patients, clients or service users are eligible to receive a third dose booster vaccination as HSCW

13. What if a resident or staff member can’t remember the date of their previous COVID-19vaccinations?

Please contact your registered GP practice or download the NHS app which will contain the dates of your vaccinations.

14. What happened if there is an outbreak of COVID-19 when the booster dose of vaccine is due?

The following guidance should be followed in the event of an outbreak: Care Home Vaccination Team Guidance in the event of COVID-19 cases or outbreaks.

A risk assessment will be required to determine whether vaccination of residents can take place. Your Primary Care Network contact will risk assess the situation with the care home and work to support vaccinating residents and staff who are not affected by the outbreak.

15. What information will be required for the booster dose vaccination visit?

The Primary Care Network will aim to arrange the visit in the same way as the first and second dose were delivered. Each Primary Care Network will have its own approach to planning the visit. Please ensure that you respond to any request for information to support the smooth running of the vaccination day.

This information will include details of those who need to be vaccinated along with consent and the information required for checks the Primary Care Network need to carry out before they can visit.

If any care homes staff attend a mass vaccination site for their booster vaccination having booked via the national booking system, they will be asked further screening questions. All Health and Social care staff will need to bring ID as described below.

Check-in and ID requirements for frontline HSCW arriving for their appointment at a Community Pharmacy or Vaccination Centre site

  • frontline HSCW should verbally declare at check-in at the vaccination site that:
  • they are a frontline HSCW, as identified by the Green Book and the Social Care Worker Standard Operating Procedure and outlined in the eligibility overview Table 1 (see question 1 above)
  • the type of role/work they do and
  • the name of their employer.

They are asked to provide as proof of employment as a HSCW one of the following:

  • a workplace photo ID
  • a recent letter from their employer (last 3 months) [1] or
  • recent payslip which shows their employer (last 3 months).

The recipient should be informed that their employment as HSCW will be recorded in the point of care (PoC) system together with their vaccination.

[1] The employer letter is locally implemented. Local authorities have been asked to produce a letter template for personal assistant.

16. What happens if we have residents that have not yet been vaccinated?

There may be circumstances whereby there are:

  • new residents not yet vaccinated
  • residents that have previously declined the vaccination
  • residents were not well enough to have the vaccination
  • new residents who came to the home after second doses were completed.

This should be discussed with the Primary Care Network prior to the visits. Outside of this, requests for vaccinations for these residents can be picked up as part of any regular link or discussions with your local practice. If these links are not in place you can contact the named Clinical lead for your care home.

17. What happens if there are new staff who have not yet been vaccinated?

Frontline health and social care staff should be encouraged to take up the booster vaccine as soon as they are eligible this can be done by self-declaring as a frontline HSCW at the National Booking Service – Book or manage your coronavirus (COVID-19) vaccination – NHS or by ringing 119.

Please note:

They will not be able to book their vaccination via this route until six months since their second dose appointment has passed.

18. What else would ensure a smooth vaccination visit?

  • Consent: Each vaccination dose requires a new consent process.
  • Engage: Staff and Residents are informed of the planned visit.
  • Preparation: Ensure space is available and staff are prepared for the visit.
  • Resident Clinical Information: INR scores, allergy reactions or symptoms attributed to the first vaccination, changes in medication, medical history or capacity.
  • Flexibility: PCNs will make every effort to work with the home but they may be visiting several homes on the same day. This could mean a home may not get their preferred visit time.
  • Vaccination Day: Be prepared for a busy day for both staff and residents with staff on-site to support the vaccination team. If possible, it would be helpful for residents to brought to one area and prepared for vaccination, (arms easily accessible).

19. How do I record booster vaccinations for staff and residents?

The capacity tracker will allow you to record both resident and staff COVID-19 booster and flu vaccinations from September. Please do update the system so we can understand progress and gaps.

20. Who should I contact if I have any queries about the booster vaccinations?

Please email CCG if you have any questions not covered in this FAQ document.

21. Useful Links


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