COVID-19 Immunization Guide for B.C. Pharmacies: AstraZeneca

AstraZeneca Vaccine in Pharmacies

Updated: Nov. 2, 2021 10:52 a.m. PDT

This guidance is co-developed with the British Columbia Ministry of Health

Please check this web page frequently, as information is constantly evolving and changing.

Table of Contents

• Training and Education
• AstraZeneca COVID-19/COVISHIELD vaccine product information
  • U.S.-labelled AstraZeneca COVID-19 Vaccine
  • COVAX-labelled AstraZeneca COVID-19 Vaccine
  • Vaccine storage
• Vaccine Expiry Date
• Distribution of Vaccine and Supplies
• Reporting Cold Chain Incidents
• Scheduling of Appointments
• Vaccine Eligibility Screening and Verification of Eligibility
  • Clinically Extremely Vulnerable (CEV) Patient Population
  • Third dose for individuals who are immunocompromised
  • Booster doses
• COVID-19 vaccinations outside B.C. and Canada
• Informed consent
• Post-immunization monitoring and aftercare
• PharmaNet Data Entry and PINs
• Inventory Management
• Reporting Adverse Events Following Immunization (AEFI)
• Reporting of sub-dose vials and other non-cold chain incidents and issues
• Registering for CareConnect and Provincial Immunization Registry (PIR)
• Resolving incorrect COVID-19 vaccine records
• More Resources

• To provide COVID-19 vaccines, B.C. pharmacists must be certified as per the College of Pharmacists of BC’s drug administration requirements.
• Pharmacists are encouraged to complete BCCDC COVID-19 immunization webinars, which provides a foundation of knowledge for the delivery of safe and effective COVID-19 vaccines. 
  • New course (October 22, 2021): BCCDC COVID-19 Immunization for Children 5-11 years of age course
• BCCDC has created a Healthcare Provider Q&A which includes general and evolving information about COVID-19 vaccines in B.C. It can be found on the COVID-19 vaccination toolkit for health professionals webpage.

Community Pharmacy Standards of Practice

• Pharmacists providing immunizations must follow the College’s Standards, Limits and Condition for Drug Administration by Injection and Intranasal Route.
• Pharmacists must follow the Community Pharmacy Standards of Practice.
  • Patient counselling
    • If a drug-related problem is identified during pharmacist/patient consultation, the pharmacist must take appropriate action to resolve the problem.
    • At a minimum, the pharmacist must confirm that the right patient is getting the right drug /strength and must also provide a direct opportunity for the patient to ask questions.
  • Reviewing PharmaNet*
    • A pharmacist must review the patient’s personal health information stored on the PharmaNet database before dispensing a drug and take appropriate action if necessary with respect to, but not limited to, appropriateness of drug therapy, drug interactions, allergies, adverse drug reactions, and therapeutic duplication.
  • Performing a final check
    • A pharmacist must review the prescription label to ensure it is consistent with the prescription and/or hardcopy.
    • Always check the expiry date of the product before providing the vaccine. Rotate vaccines according to expiry date (place those with the longest expiry date at the back)

* If COVID-19 vaccine dose is not on PharmaNet, check CareConnect

Product Information

For COVID-19 vaccine product details, refer to BC Immunization Manual Part-4 Biological Products, which includes information on doses and schedule, administration procedures, storage and handling, dilution requirements, contra-indications, precautions, special considerations, and adverse events.

U.S.-labelled AstraZeneca COVID-19 Vaccine

See Health Canada notice regarding U.S.-labelled vaccine supplies of AstraZeneca COVID-19 Vaccines.

COVAX-labelled AstraZeneca COVID-19 Vaccine

The brand name of the vaccine on the COVAX labels (which is a global supply) is COVID-19 Vaccine AstraZeneca. For COVAX-labelled AstraZeneca vaccines, the QR code links to non-Canadian information (WHO label), which is different from the Health Canada Approved Product Monograph. Therefore, the QR code should be disregarded. Healthcare professionals should refer to the Canadian AstraZeneca Product Monograph for information approved by Health Canada. For more information, refer to the Health Product Risk Communication for the COVAX supply.

Vaccine Storage

Pharmacies are to adhere to the College of Pharmacists of BC’s Professional Practice Policy – 68: Cold Chain Management of Biologicals. Cold chain management principles and procedures are outlined in BC Immunization Manual Appendix E—Management of Biologicals. BCCDC guidelines outline how to deal with refrigerator temperature excursions, equipment malfunctions and power failures.

Storage requirements for AstraZeneca/COVISHIELD vials

• AstraZeneca vaccine must not be frozen.
• Unopened vials have a shelf life of 6 months when stored in a refrigerator at 2°C to 8°C.
• Keep vials in a 2°C to 8°C environment, i.e., refrigerate until ready for immediate use.
• Vials should be kept upright in their original (SKU) box.
• Vials should be kept away from direct sunlight to prevent prolonged light exposure.
• Opened (after first puncture) vials at room temperature must not exceed a use period of 6 hours.
• Opened vials can be re-refrigerated at 2°C to 8°C for up to 48 hours, but total cumulative storage time once punctured must not exceed 48 hours. Example: if a vial is punctured and kept at room temperature (up to +30°C) for 4 hours it could be returned to the refrigerator for a total of 42 hours and at room temperature for 2.

See BCCDC SOP for COVID-19 AstraZeneca/COVISHIELD Vaccine Shipping, Storage, and Use Guidelines.

Storage requirements for AstraZeneca/COVISHIELD pre-drawn vaccines

In exceptional circumstances, it is acceptable to pre-draw vaccine:

• The vaccine is stable for up to 6 hours at room temperature after the vial is first punctured. If a dose is pre-drawn from a vial just removed from refrigeration, then vaccine would have to be administered within 6 hours.
• If the vial has been at room temperature prior to the vaccine being loaded into a syringe, that time must be subtracted from the total 6 hours for the syringe.
• Pre-drawn syringes should be carefully labelled to ensure that they are not used outside of their window of stability.
• Pre-drawn syringes unused at the end of a day may not be returned to the refrigerator for use the next day and must be wasted. To avoid wastage, care should be taken to pre-draw a reasonable number of doses.

See BCCDC SOP for COVID-19 AstraZeneca/COVISHIELD Vaccine Redistribution Guidelines

U.S. labelled AstraZeneca COVID-19 Vaccine: As per Health Canada notice (March 31, 2021), AstraZeneca is providing US-labelled vaccine supplies with English-only vial and carton labels in order to expedite the distribution of AstraZeneca COVID-19 Vaccine in Canada. Two key points:

1. The expiration date is not printed on the US vial and carton labels. Pharmacists must verify the expiration date prior to vaccination. The expiration date for the corresponding batch/lots can be found in the “Product affected” section of this document, by going to www.AZCOVID-19.com, or by scanning the QR code on the US English-only carton label

2. There is no DIN on the packaging, it is the U.S. NDC Code.

• PharmaCare has activated the AstraZeneca COVID-19 Vaccine PIN (66127320) which applies to both 8-dose and 10-dose vials. Please see publicly funded vaccines and COVID-19 vaccine PINs for submission to PharmaNet below

Expiry Date Interpretation

As per BCCDC, the expiry date on vaccines should be interpreted as follows:

• When specified as month/year, product expires on the last day of the month and may continue to be administered until the end of the month (e.g., expiry of January 2021 means January 31, 2021, and may be used until 11:59 pm in the local time zone)
• When specified as a day/month/year, product expires at the end of the day of expiry i.e., may be administered up until the last minute of the labelled expiry day, within the time zone of use (e.g., product expiring on April 2, 2021, may be used until 11:59 pm on April 2, in the time zone).

What to do with Expired Product

• Remove expired vaccines from the refrigerator. 
• Ensure expired stock is clearly labelled/marked not to be used.
• Do a thorough inventory of the numbers of expired doses (including partial vials)
• Record inventory wasted in PharmaNet. See Inventory Management section.
• Dispose of the vaccines using your regular biomedical waste disposal procedures for vaccines.

COVID-19 vaccines (AstraZeneca and COVISHIELD) are shipped to the major wholesaler distribution centres in B.C., which will directly ship a pre-determined allocation of doses to each selected pharmacy site. Vaccine supplies and personal protective equipment (PPE) will also be provided along with the vaccines and are available at no cost through the Provincial Health Services Authority (PHSA) supply chain.

The following vaccine and supplies will be delivered directly to your pharmacy:

*Supplies list may change depending on vaccine.

If a temperature excursion occurs while COVID-19 vaccines are in your pharmacy:

1. Quarantine affected vaccines under refrigeration (or required storage) and label as “Do Not Use.”
2. Cold chain consultation process initiated.
   • Report incident to local public health for determination of vaccine* (see footnote for FHA pharmacies only).
   • Cold chain incident form completed. For instructions and form, see the Vaccine Management webpage.

For “No” the present directive is to treat unusable COVID vaccine as biological waste and dispose of it accordingly on site, not to send it back to the CDC.

3. The incident must be resolved, and a report submitted to IBCOC_Operations@phsa.ca with the following information:

• Date of incident
• Location of incident
• Situation surrounding incident:
  • Excursion temperature(s) and duration
  • Lot number, expiry
  • Detailed description of event
  • Number of affected doses
  • Impact on clinic (e.g., closed early, cancelled, clients redirected to alternate side)
• Recommendations

See BCCDC SOP for COVID-19 Vaccine Cold Chain Incident Reporting Process

*For Pharmacies in Fraser Health Authority Only:

• Refer to Cold Chain Incident (CCI) Break for Refrigerated Vaccine storage at 2°C to 8°C and Process Maps for Cold Chain Incident – fridge.  These SOPs have been developed for FH Vaccine Clinics and can be applied by community pharmacies.
• Almost all communication is done via email. Calling is only necessary if a timely response is not received.
• Unusable vaccine does NOT need to be returned to BCCDC. Dispose vaccine in biomedical waste bins.
• CCI contact for FHA: Caitlin McEwen (Logistics Manager) at caitlin.mcewen@fraserhealth.ca

• Pharmacies are responsible for booking immunization appointments (online and telephone). Consider options for walk-ins.
• Updated June 4, 2021: For Dose 2 appointments, pharmacies are to contact patients who received Dose 1 at their pharmacy to schedule Dose 2.  Do not book appointments for Dose 1. Currently, AstraZeneca/COVISHIELD vaccines are reserved for Dose 2 only.
• Pharmacies will be informed of the number of doses they will receive. This will help with scheduling appointments according to available supply.
• If your pharmacy does not have an online booking system, but is interested in one, the BCPhA offers an online booking platform. More information can be found here. 

Review BCCDC’s COVID-19 Vaccine Screening Checklist.

• See Contraindications and Precautions in BCCDC’s Healthcare Provider Q&A.  A new guidance document for  “Valid contraindications and deferrals to COVID-19 vaccination” has been developed and is available on the COVID-19 vaccination toolkit for health professionals.
• COVID-19 mRNA vaccine should not be given to an individual if they have a:
  • History of anaphylactic reaction to a previous dose of an mRNA COVID-19 vaccine or to any component of the vaccine. These individuals should be offered an adenovirus vector COVID-19 vaccine and observed for a least 30 minutes after immunization.
     
• AstraZeneca/COVISHIELD vaccine is indicated in individuals 18 years of age and older for dose 2.
• These vaccines are no longer being offered as a first dose, unless there is a contraindication to the mRNA vaccines, or as advised by the Medical Health Officer or an allergist. Informed consent should include the risk and symptoms of Thrombosis with Thrombocytopenia Syndrome (TTS) versus the individual’s risk of serious illness from COVID-19, as well as the need to seek immediate medical care should symptoms develop.
  • The contraindication and recommendation for AstraZeneca/COVISHIELD first dose should be documented or communicated by the prescriber rather than self-reported by the patient.
  • Individuals who are not contraindicated to the AstraZeneca/COVISHIELD vaccine but have a strong preference for this vaccine may be referred e.g., by public health, to pharmacies to initiate and complete a vaccination series. Pharmacists must obtain and document informed consent and provide the appropriate aftercare for this product.
• The minimum age for vaccine receipt is based on year of birth (e.g., the vaccine may be offered to individuals who will be turning 18 years of age within the current calendar year), per BC Government recommendations.
• Pharmacies must review patient identification (ID) and ensure ID matches the patient profile in PharmaNet.
  • See CPBC’s professional practice policy – 54 when identifying patients, and verify age through government issued ID (e.g., driver’s license, passport, BC Services card etc.).
  • As per Community Pharmacy Standards, Limits and Conditions for Drug Administration, pharmacists must assess the appropriateness of the vaccine for the patient, including reviewing the patient’s PharmaNet profile and resolve any issues identified, if required, in advance of providing the vaccination.
• Confirm patients have received their first dose.
  • Check PharmaNet to confirm that first dose was provided.
  • If the pharmacy has access to CareConnect, check Provincial Immunization Registry to determine if patient has received a first dose at a public health clinic
  • Verbal confirmations should only be used as a secondary source of verification, as patient interviews are not 100% reliable
• Review BCCDC’s COVID-19 Vaccine Screening Checklist.
  • COVID-19 vaccines should not be given to an individual if they have a:
    • History of anaphylactic reaction to a previous dose of the vaccine or to any component of the vaccine. These individuals should be offered an mRNA COVID-19 vaccine and observed for a least 30 minutes after immunization.
    • History of thrombosis with thrombocytopenia following a previous dose of an adenovirus vector COVID-19 vaccine. These individuals should be offered an mRNA vaccine.
    • History of capillary leak syndrome.
• (NEW!) Non-residents of B.C/ Non-Canadians are able to be vaccinated at a community pharmacy:
  • Anyone living, working or studying in B.C. during the pandemic can receive the COVID-19 vaccine, even if they are not a Canadian citizen or permanent resident (with ID showing they meet the age/current eligibility requirement).
  • Pharmacies will be reimbursed for this service. As with any other patient, a PHN is to be generated for the patient if they do not currently have one. No one that is eligible (as per current criteria) is to be turned away for an appointment they have booked. Name and date of birth of patient is required. 
• BCCDC has created a Healthcare Provider Q&A document which includes general and evolving information about COVID-19 vaccines currently used in B.C. It can be found on the COVID-19 vaccination toolkit for health professionals webpage.

Clinically Extremely Vulnerable (CEV) Patient Population

• Updated: June 21, 2021. Some pharmacies may be geographically selected to  provide dose 2 AstraZeneca/COVISHIELD vaccines to special patient populations including those who are clinically extremely vulnerable. These individuals have received dose 1 by public health.
• For information and guidance on COVID-19 vaccines for people who are clinically extremely vulnerable, see guidance documents on the COVID-19 vaccination toolkit for health professionals page.

Third doses for individuals who are immunocompromised

Updated September 14, 2021: Following the provincial announcement that third doses are recommended for some people who are immunocompromised, BCCDC has updated Part 4 – Biological Product page for AstraZeneca COVID-19 vaccine.

For individuals 12 years and older who are severely immunocompromised, a 3-dose primary series is recommended. Moderna COVID-19 vaccine is preferentially recommended for the 3rd dose, which should be provided at least 28 days after the 2nd dose. If Moderna is unavailable, Pfizer vaccine can be given. For a full list of eligible patients for a 3rd dose, see Part 4 – Biological Products for COVID-19 vaccines or “Who is eligible for a 3rd dose” in Vaccine Registration and Eligibility.

Patients who are eligible for 3rd doses will receive an invitation by text, email or phone call through the Get Vaccinated system about how and when to book a third dose. People who are not eligible and who did not receive an invitation through the Get Vaccinated system will not be able to get a third dose.

A physician/nurse practitioner can complete the Attestation Letter to confirm patient’s eligibility for a third dose.

Booster Doses

Updated November 01, 2021: As per updated Part 4 – Biological Product Page for AstraZeneca Vaccine, a booster dose with a COVID mRNA vaccine is recommended at least 6 months after a primary COVID-19 vaccine series has been completed for the following groups:

• The minimum interval between completion of the primary series and the booster dose is 8 weeks. This interval may be applied for a minority of individuals for practical reasons, with consideration of the individual benefits and risks, but is not to be used as a routine interval.
• The minimum age for the booster dose is based on year of birth (i.e., the vaccine may be offered to individuals who will be turning 18 years of age within the current calendar year), per Provincial Health Officer recommendations.

Third dose vs a booster dose

As per BCCDC, a third dose is not the same as a booster. Third doses are recommended for people who are severely immunocompromised. They do not develop the same immune response to the first two doses of the vaccine, therefore a third dose is needed to get a similar level of protection, as others in the population. For these people, receiving a third dose to complete the initial vaccine series can help individuals create antibodies to protect them from COVID-19.

A booster dose is an additional vaccine that may be recommended later if the protection from the initial two-dose vaccine series begins to decrease over time. A booster gets immunity back up to a desirable level of protection for an extended period of time.

• For COVID-19 vaccines received in another province, patients can submit proof of an official vaccination record which will be entered into the Provincial Immunization Registry. For more information, see Vaccine Registration and Eligibility.
• To support health care providers with approaches for individuals who have received COVID-19 vaccination outside of Canada review World Health Organization (WHO) Emergency Use Authorization (EUA) Qualified COVID-19 Vaccines.
  • Individuals who have received a complete series with a vaccine that is WHO EUA qualified are considered fully vaccinated and no further doses are required. However, one additional dose of a COVID-19 mRNA vaccine may be provided for individuals upon request if they have been vaccinated with a WHO-approved vaccine series that is not authorized in Canada. The minimum interval between the preceding dose and the additional dose is 4 weeks.
  • Individuals who have received a series with a vaccine that is not WHO EUA qualified should be offered a full COVID-19 vaccine series using a vaccine available in BC. There is no minimum interval required when restarting the series following receipt of a non-WHO approved vaccine.
  • Individuals who have received a first dose of a COVID-19 vaccine overseas that is also available in BC should receive the same vaccine for their second dose if readily available, and if they meet the current BC eligibility criteria for 2nd dose (i.e., at least 4 weeks following first dose). If the vaccine they received for their first dose is not available in BC, but the same type of vaccine is available, this should be offered. A 6 to 8 week interval between doses is recommended. A minimum interval of 4 weeks is acceptable, if required.

• Before administering any vaccine, pharmacists must obtain informed consent as per CPBC’s Standards, Limits and Conditions for Drug Administration.
• See BCPhA example COVID-19 Consent for Immunization, which incorporates BCCDC’s screening checklist.
• The BC Immunization Manual Appendix A – Informed Consent provides guidance on how to document informed consent.
• A link or copy of the HealthLink BC File for COVID-19 vaccines should be provided to each patient as part of the consent process.
• For AstraZeneca/COVISHIELD, informed consent should include the risk of Thrombosis with Thrombocytopenia Syndrome (TTS) versus the individual’s risk of serious illness from COVID-19, and that they can choose to receive an mRNA vaccine as a second dose.

Download: AstraZeneca COVID-19 Vaccine Consent Form

• Patients are to remain in a designated area for 15-minute observation period following COVID-19 vaccine receipt.
• Provide the patient a record of immunization, as per PharmaCare policy manual section 8.10. At a minimum the record should include the patient name, dose number, date of administration, product given, lot number and pharmacy information. See example vaccine record card.
• Encourage patients to sign up to Health GateWay to access their digital immunization record. PharmaNet data is fed into the Provincial Immunization Registry which is subsequently uploaded to Health Gateway where patients can access the health records themselves.
• Provide patients the COVID-19 Vaccine After care sheet, which includes information about rare cases of blood clots and/or bleeding following the AstraZeneca COVID-19 Vaccine/COVISHIELD and a list of symptoms for when to seek immediate medical attention.

PharmaNet fan-out messages: COVID-19 reporting

As per PharmaCare Newsletter (May 4, 2021), a number of pharmacies have received PharmaNet fan-out messages because they are reporting COVID-19 vaccines incorrectly. Correct reporting of COVID-19 vaccine administration and inventory received, transferred, wasted, and returned, is critical for tracking by the Public Immunization Registry (PIR) and for delivery of second doses.

For details on fan-outs and how to correct your entries, see PharmaNet Fan-outs for COVID-19 Vaccine Entry Errors.

Review the following section on PharmaNet data entry formats to ensure information is entered correctly.

PharmaNet Data Entry:

Recently, a connection was made between PharmaNet and the Provincial Immunization Registry (PIR) to ensure that all immunizations recorded in PharmaNet are reflected in a patient’s provincial immunization record. The PIR record is subsequently uploaded to the Health Gateway where patients can access their health records themselves.

Due to the strict reporting requirements of COVID-19 Immunizations, pharmacists must follow these rules:

1. Provide immunizations as per the immunization priority criteria. 
2. Record immunizations administered in PharmaNet by 11:59 p.m. on the day that they are given to the patient.
3. Follow all PharmaNet vaccine administration claim entry requirements for COVID-19 immunizations (see below)
4. Follow COVID-19 vaccine inventory receipt and daily wastage PharmaNet entry requirements (see below).
5. Verify patient identification and update demographics in PharmaNet if necessary. Note: address must be updated through the specific address update transaction feature

PharmaNet claim entry:

1. Use the product identification number (PIN) as assigned by PharmaCare.
2. The administering pharmacist should be the prescriber.
3. Follow the protocol for entry of the “Directions for Use” (Sig) field (see below).
4. Quantity is the amount administered to the patient, in millilitres(e.g., 0.5 mL for AstraZeneca/COVISHIELD) 
5. Days supply for first doses should be the anticipated interval to next dose (i.e. 28 days for AstraZeneca/COVISHIELD). Days supply for second doses should be entered as 1 day.

Data to be entered in the Directions for Use field:
Some aspects of immunizations are not recorded in PharmaNet as separate data elements.  The Provincial Immunization Registry (PIR) requires these additional elements to ensure appropriate reporting and clinical follow-up.  To account for this, the pharmacy must follow new data entry requirements in the “Directions for Use”, or “Sig” field sent to PharmaNet.

 
Entry of this information in this format will allow PharmaNet to accurately extract these additional data elements and submit on behalf of providers to the PIR.  Only certain “allowable values” are permitted to be entered for each data element. PharmaNet will verify the information prior to sending to the PIR.  

This information should be recorded in the “Directions for Use” field in the above order separated by an underscore “_”.  DO NOT enter any other characters.

Example entries for “Directions for Use” for COVID-19 vaccines:
For COVISHIELD with lot number 4120Z003, example entries in the “Directions for Use” field are:
 

There is no need to add “LOT” or “Arm” or any other information like expiry or IM. 

Please do NOT enter the following example formats, otherwise it will not lead to a complete record in the Provincial Immunization Registry:
 

For vaccine PINS, see Publicly Funded Vaccines.

Ensure the PIN for the COVID-19 vaccine is entered correctly. If the wrong PIN has been submitted, the pharmacy MUST reverse the claim and BACKDATE under the correct PIN (if not, it will appear incorrectly as dose 2 in the Provincial Immunization Registry).

COVID-19 immunizations will be reimbursed via the usual process for vaccinations.  

At the time of submission, PharmaNet will indicate that the immunization is NOT a benefit. This is expected; reimbursement is done by a secondary process, which identifies the number of immunizations administered by a pharmacy, irrespective of adjudication results. You do not need to reverse and resubmit the claim.

Accurate daily inventory accounting is critical. Both receipt of inventory and daily wastage of doses must be recorded for central reporting and management of inventory. To achieve this efficiently in PharmaNet, pharmacies must follow the procedures below. 

1. Receiving inventory

• Submit under the O-Med, a claim to PharmaNet under the PIN for the product received:
  • Quantity = total volume in mL received 
  • Directions for Use = Received_LOT
  • Note the underscore “_”
• This must be done on as soon as you receive/ on the same day you receive the vaccine.

2. Recording wastage

• Submit to PharmaNet using O-Med PHN, under the vaccine PIN for the product wasted:
  • Quantity = total volume in mL wasted
  • Directions for Use, depending on reason for wastage, please enter the following:
    • Wastage_CCI: Handling Error_Lot [for cold chain incidents]
    • Wastage_Damage to Product_Lot
    • Wastage_Expired Product_Lot

  • Note the underscore “_”

• This must be done on the same day the product is wasted.

• If you receive damaged or missing vials from the distributor, as per COVID-19 Vaccine Post-Arrival Documentation and Administration Protocols, email IBCOC_Operations@phsa.ca the following information:

  • Damage to vials? If yes, describe how many and to what extent.

  • Missing vials? If yes, how many?

3. Transferring product between pharmacies *NEW*

• Transfer of vaccines can be done between selected B.C. pharmacies participating in the COVID-19 campaign.
• Pharmacists must adhere to the cold chain requirements as per College PPP-68 Cold chain management.
• Review BCCDC AZ/CS Redistribution Guidelines which provides information to support the redistribution of vaccine.
• Ensure appropriate insulated packaging when transporting vaccines as per BCCDC Immunization Manual Chapter 2: Immunization Appendix E – Management of Biologics.

PharmaNet data entry: For transferring product between stores, use the 3-character PEC (e.g. A01) of the store you are transferring to, or the PEC of the store you are transferring from. 

• Pharmacy transferring out the product:
  • Submit to PharmaNet using O-Med PHN, under the vaccine PIN for product transferred:
    • Quantity = total volume in mL being transferred.

    • Directions for Use = Transfer_Lot_(to)PEC  

    • Example: PEC of pharmacy you are transferring to is ZBA. Sig field for transfer to: Transfer_4120Z003_ZBA

  • Must be done on the same day product is being transferred.
• Pharmacy receiving the transferred product:
  • Submit to PharmaNet using O-Med PHN, under the vaccine PIN for product transferred:
    • Quantity = total volume in mL being transferred.

    • Directions for Use = Received_Lot_(from)PEC

    • Example: PEC of pharmacy you are receiving product from is A01. Sig field for transfer from: Received_4120Z003_A01

  • This must be done on the same day product is received.

4. Returning product to BCCDC for redistribution

The following criteria must be met for vaccine(s) to be considered eligible for return to BCCDC vaccine distribution centre:

• The temperature was maintained between +2°C and +8°C for these products throughout their storage at site.
• Products were stored in a safe and secure location with no public access.
• The refrigerator temperature was logged at the start and end of each business day.
• Only full, unpunctured vials are being returned.

• Complete BCCDC COVID-19 Vaccine Redistribution form and fax to BCCDC at (604) 707-2581. 

• PharmaNet data entry: Submit to PharmaNet using O’Med PHN, under the vaccine PIN for product returned:
  • Quantity = total volume in mL being returned
  • Directions for use = Return_LOT_BCCDC
    • Note the underscore “_”
    • This must be done on the same day vaccine is returned to BCCDC.

Examples:

• Effective March 31, 2021, a $5.90 supplement will be temporarily added to PharmaCare’s vaccination administration fee for COVID-19 vaccines in pharmacies.
• PharmaCare’s fee for publicly funded vaccines is $12.10. The supplement applies to COVID-19 immunizations only. With the supplement added to the vaccine administration fee, pharmacies will receive $18.00 for every COVID-19 vaccine they administer

• According to BCCDC, an adverse event following immunization (AEFI) is defined as an untoward event temporarily associated with immunization that may or may not have been caused by the vaccine or immunization process.
• The AEFI with COVID-19 Vaccine Case Report Form is an abbreviated version of the standard AEFI case report form and is available in the COVID-19 Vaccination Toolkit for Health Professionals. It is intended for use by community vaccine providers (i.e., non-public health professionals) and the reporting of AEFIs associated with COVID-19 vaccination.
• For criteria on reporting AEFIs, and to help healthcare providers interpret AEFIs and their implications for subsequent immunization, see BC Immunization Manual Part 5 – Vaccine Associated Adverse Events.
• Other AEFI resources:
  • BCCDC Reporting AEFI Questions & Answers.
  • How to report an AEFI (includes AEFI case report form, AEFI user guide, and where to send an AEFI report).
  • AEFI Reporting Procedure 
• Pharmacist are encouraged to record relevant Adverse Drug Reactions (ADEs) in PharmaNet in addition to the AEFI form.

Consultation on vaccine usability is required when the expected number of doses withdrawn from an AstraZeneca vial is less than labeled. For these instances, and other concerns such as sediment, discoloration, etc., contact local public health for a consultation.

If after hours/unable to contact local public health and your need for information is urgent, contact the Provincial Health Duty Officer at 1 (250) 686-6061.

• To access the Provincial Immunization Registry (PIR), pharmacists need access to CareConnect. It’s anticipated that all pharmacists will need to access the PIR to administer Dose 2.
• Getting CareConnect access:
  • Independent pharmacies, email Private.Careconnect@phsa.ca
  • Corporate and small groups: contact head office.

• Complete the following survey form through this link -   Enrol in CareConnect.  Once completed, the CareConnect team send the instructions for the next steps.
  • IMPORTANT NOTE: You may have received information on CareConnect enrolment through the College of Pharmacists of BC email in mid-March.  The above link is the same link shared by the College. 

There have been some reports of COVID-19 vaccinations not showing up on patients' vaccination records. If a patient reports that their pharmacy COVID-19 immunization is not recorded on their vaccination records, please provide the following instructions.

1. Instruct patients to call 1-833-838-2323 to get help and make it clear that they received their vaccine in a pharmacy, OR
2. if patient believes their immunization record is wrong, update it at immunizationrecord.gov.bc.ca. Note: the update takes 4 to 7 days to process.

For health professionals

• BCPhA Dose 2 Guidance for Pharmacies
• Vaccine Errors - BCCDC COVID-19 Guidance Document on the Management of Inadvertent Vaccine Errors. This resource can be found on the COVID-19 Vaccination Toolkit for Health Professionals webpage - NEW
• Landmarking Reminder for Deltoid IM Injections
• Vaccine-induced Immune Thrombotic Thrombocytopenia Guidance for British Columbia
• Ministry of Health Webinar (Apr. 27, 2021)
• BCCDC COVID-19 Immunize BC Operations Centre: Standard Operating Procedures
• BCCDC COVID-19 vaccination toolkit for health professionals
• BCCDC Resources for Indigenous Communities NEW!
• Ministry of Health PharmaNet Cheat Sheet for COVID-19 Vaccines
• AztraZeneca Global site for access to resources, current product monograph and patient information

• BCCDC Infection, Prevention and Control Guidance for Community Immunization Clinics 
• BCCDC resources for Culturally safe care 
• BCCDC Immunization Communication Tool (vaccine hesitancy) and Immunization Communication Tool for COVID-19
• BCCDC Continuity, Prioritization and Safe Delivery of Immunization Services during COVID-19 Response. Updated October 27, 2020
• National Advisory Committee on Immunization
• NACI Rapid Response: Recommended use of AstraZeneca COVID-19 vaccine in younger adults
• NACI Recommendations on the use of COVID-19 vaccines
• NACI: Guidance on the prioritization of key populations for COVID-19 immunization
• NACI Planning guidance for immunization clinics for COVID-19 vaccines
• Health Canada: Webinars on COVID-19 vaccines
• Health Canada COVID-19: Guidance documents for Health Professionals
• PHAC COVID-19 Vaccination Tool Kit for Health Care Providers

For Patients

• COVID-19 Vaccination – Second dose vaccine choice for people who received AstraZeneca/COVISHIELD. This resource can be found on the Vaccine registration and eligibility webpage - NEW
• BCCDC COVID-19 vaccination at a glance
• Health Gateway Health Gateway - NEW
• HealthLink BC COVID-19 Vaccines
• BC COVID-19 Immunization Plan
• BCCDC Getting a Vaccine (Registering for the vaccine, what to expect, after getting the vaccine).
• BCCDC Vaccine Considerations (includes information for people with health conditions that make them clinically extremely vulnerable).
• First Nations Health Authority (FNHA) COVID-19 Vaccine Resources
• ImmunizeBC COVID-19 Vaccine Frequently Asked Questions
• Health Canada COVID-19 How vaccines are developed (video)
• Health Canada: What you need to know about COVID-19 vaccines for Canada
• Health Canada: Vaccine development and approval in Canada
• World Health Organization’s (WHO) Science in 5 COVID-19 Series (video and audio series) – available weekly on WHO’s YouTube, Instagram, Facebook, Twitter and LinkedIn channels and on all major podcast platforms.

Resource Centre

• Online Booking Platform
• Health Topics
• COVID-19 (Coronavirus) Resources