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Friday Five (November 26, 2021)

This edition of the Friday Five features updates on administering COVID-19 vaccines to children, rapid antigen testing for COVID-19, new Tacrolimus Formulation for renal patients, and more.

Administering COVID-19 and Influenza Vaccines to Patients Five Years of Age and Older

On November 17, 2021, Manitoba Health and Seniors Care announced that pharmacists who have certification of authorization to administer drugs and vaccines by injection can now administer COVID-19 and Influenza vaccines to those five (5) years of age and older effective immediately.

Please note that the expansion to administer vaccines from the age of five (5) years and older is only for COVID-19 vaccines and Influenza vaccines that are part of Manitoba’s Seasonal Influenza Immunization Program.

This change is also applicable to University of Manitoba College of Pharmacy students on rotations (for influenza vaccines only), and to certified pharmacy interns completing internship hours (for COVID-19 vaccines by interns who have been certified and approved by the College through this application, and for influenza vaccines).

The age for pharmacist administration of vaccines remains at seven (7) years of age and older for all other vaccines at this time.

Minimum Time Intervals Between COVID-19 Primary Series and Booster Doses

According to the Manitoba COVID-19 Vaccine: Clinical Practice Guidelines for Immunizers and Health Care Providers, third/booster doses are recommended to be given at least six (6) months after the last COVID-19 vaccine dose (regardless of which products were used for previous doses), unless otherwise explicitly stated.

Doses given earlier than the minimum required interval, including doses given for the primary series, are considered invalid when recorded in PHIMS, which may result in ineligibility to obtain fully vaccinated status. Pharmacists administering COVID-19 vaccines must diligently screen individuals and independently checking PHIMS for the most accurate information on the vaccination status of individuals.

Rapid Antigen Testing for COVID-19

As of November 23, 2021, a new Ministerial Order under The Regulated Health Professions Act (rapid testing) authorizes pharmacists to perform/administer rapid antigen tests and rapid molecular (non-PCR) COVID-19 tests for Manitobans for any reason, with the authorization for pharmacist test interpretation/communication of diagnosis. This new order replaces the previous one that only permitted rapid testing for travel purposes.

Pharmacies electing to offer this service will be responsible for acquiring rapid testing supplies, training staff and advertising the service at their site. The COVID-19 rapid antigen tests may be self-administered by the individual seeking the test or administered by the pharmacist and conducted within the pharmacy facility, with pharmacist test interpretation/diagnosis and documentation provided. Pharmacists offering this service must comply with the minimum applicable documentation requirements outlined in section 106 of the Pharmaceutical Regulation, the Test Interpretation Practice Direction, and the Records and Information Practice Direction.

Members of the public exhibiting signs or symptoms of COVID-19, or having tested positive using a rapid test, must be directed to a provincial testing site immediately. This will ensure that any diagnostic results are integrated with the health system, tracked and reported, and that positive test results immediately trigger Public Health interventions including expedited contact tracing.

Tacrolimus Formulation Change for New WRHA Adult Renal Transplant Patients

The Winnipeg Regional Health Authority (WRHA) has recently changed the policy on which tacrolimus formulation is prescribed for new kidney transplant patients. There is high potential for dispensing errors given the multiple formulations of tacrolimus available. As well, there is high potential for harm if the wrong formulation is dispensed.

Envarsus PA is a new, once-daily formulation of tacrolimus. It was added as a Part 3 EDS benefit by Manitoba Pharmacare in October 2020 (Bulletin 109). There are now four tacrolimus products marketed in Canada (Prograf, Sandoz-tacrolimus, Advagraf, and Envarsus PA). None of the formulations are considered interchangeable with each other in Manitoba.

Starting October 27, adult patients receiving a new, kidney transplant will be started on prolonged-release tacrolimus (Envarsus PA) as first-line therapy for immunosuppression. This change in formulation will not affect patients who are already stable on their current formulation of tacrolimus.

Health Canada has reported graft rejection and other adverse reactions when patients were inadvertently switched to a different formulation and did not receive adequate follow-up with levels and dosage adjustments if required. Tacrolimus and the Risk of Graft Rejection due to Medication Errors: Inadvertent Switching between Different Oral Formulations – Recalls and safety alerts (healthycanadians.gc.ca)

Pharmacists should be diligent in confirming the correct formulation prior to dispensing tacrolimus to avoid severe potential medication incidents.

Contacting the College Using the Staff Directory

The COVID-19 pandemic has caused a widespread transformation in how we communicate and work together. The transition to remote work, combined with additional Covid-19 related and daily life pressures and demands has led to many adaptations and frustrations, including the increased reliance on digital communications.  The College has improved the staff directory for registrants with a Staff Contacts for College Registrants listing to help registrants find the best suited staff member to address specific categories of questions.  If your question falls outside of the categories in the directory, please contact the College by email at info@cphm.ca.

 If your question or situation is an urgent matter related to direct patient care, please call 204-233-1411 and press 220 to speak with reception. 

Please note all voice mail messages are automatically transferred to email for review. 

For all other non-urgent matters, email remains the best method for contacting the College. It is always our intention to respond as promptly as possible.  Please be mindful that the College receives a large volume of enquiries through voicemail and email.   Staff strives to respond within 1-3 business days.

CPhM Website Updates

Starting Monday, November 29, 2021, website users will notice some updates to cphm.ca, such as enhanced content, improved navigation, and more advanced search capability. Some things to watch out for include:

  • Updated menu to help visitors find what they need, including secondary menu headings and improved content for
    • pharmacy and pharmacist registration
    • pharmacy technician listing
    • owning and operating a pharmacy
    • maintaining a pharmacist licence
    • continuing competency
    • quality assurance
    • expanded scope of practice
  • New content including shared learning using local case studies (Practice and Education menu) to help pharmacy professionals improve pharmacy practice
  • A prominent button at the top of the menu to help visitors find the pharmacy, pharmacist, and pharmacy technician registers
  • Improved website search

There will be a website outage from 9:30 a.m. —12:00 p.m. on November 29, 2021, while the updates are implemented.

We welcome your feedback. Please email Rachel Carlson (rcarlson@cphm.ca) with your comments and suggestions.

CPhM Office Schedule During the Holiday Season

The College of Pharmacists of Manitoba will observe the following holiday schedule:

  • Closed at 12:00 noon Friday, December 24 through Tuesday, December 28, 2021
  • Open 8:30 a.m. to 4:30 p.m. Wednesday, December 29 – Thursday, December 30, 2021
  • Closed at 12:00 noon Friday, December 31 through Monday, January 3, 2021
  • Regular office hours resume on Tuesday, January 4, 2022, 8:30 a.m. to 4:30 p.m.

Please be reminded that the CPhM office remains closed to visitors and continues to operate as a virtual office due to the COVID-19 pandemic. All services continue, however, adjustments in service delivery and delays may occur.

Documents may be left in the black deposit box to the left of the main entrance. Email is the most efficient means by which to contact staff.

Thank you for your kind attention and cooperation.