Moderna Vaccine

1. ​​ ​General Information
   
2.  ​​ Information for Individuals Receiving Vaccine​
   
3. ​​ ​Vaccine Training​
   
4.  ​ Vaccine Storage and Handling
   
5.  Vaccine Preparation
   
6.  Vaccine Consent​​
   
7.  Vaccine Administration​​
   
8.  Vaccine Documentation​​​
   

General Information​

• COVID-19 Vaccine General Information​
  
• COVID-19 Saskatchewan Immunization Manual
  
• Moderna COVID-19 Vaccine Monograph​
  
• Moderna COVID-19 Vaccine - What You Should Know (Health Canada)​
  
• CV-19 G0099 Moderna Vaccine Immunization Clinic  - SAMPLE​​​ (February 4, 2021)
• This document is intended to guide immunization clinic design and can be edited to suit each clinic (e.g. replace pictures/information  with relevant clinic pictures/information). There are several sections (supply lists, signage, floor plans, phone numbers, etc.) that can be accessed individually at the bottom of the Excel spreadsheet. ​

Information for Individuals Receiving Vaccine

• ​Moderna Inform​ation Sheet
  
• Moderna Vaccine Screening Questions
• Moderna After Care Sheet​​​​
  
• CV-19 H0019 COVID-19 Immunization - Health Care Worker Information Sheet (January 29, 2021)
  

​​Vaccine Training

• ​Training for all COVID-19 Vaccines​​​​​​​

​​Vaccine Storage and Handling​

Receiving and Packing

• ​Procedure for Receiving COVID-19 Vaccine, Diluent and Dry Ice NOC (eHealth) (March 22, 2021)
• Packaging of Vaccines from Original Packaging (eHealth) (March 30, 2021)
• Moderna Label (December, 2020)​​​​​

​Cold Chain/Temperature Monitoring

• COVID-19 Vaccine Storage and Handling​ and Cold Chain Break Procedure​ for Pfizer and Moderna (eHealth)​​​ (January 19, 2021)
  
• CV-19 WS0057 Packing and Temperature Monitoring of Vaccine​​ (April 8, 2021)
• SHA 0118 Packing and Temperature Control Log Form​ (April 8, 2021)​
• COVID-19 Vaccine Cold Chain Break Form​ (eHealth) (December 14, 2020)
• Temperature Log (eHealth) (December 14, 2020)

​​Wastage/Supply Problem​​​

• Completion of COVID-19 Vaccine Wastage Report Form Work Standard (eHealth) (March 16, 2021)
• Product Wastage Report Form (eHealth) (December 18, 2020)
  
• Vaccine Supply Problem Report (eHealth)​ (February 17, 2021)
  

​Transporting

• Transportation of Moderna COVID-19 Vaccine in Frozen or Thawed State (eHealth)​ (February 17, 2021)
  
• Transportation of COVID-19 Vaccine in a Prefilled Syringe in Exceptional Circumstances (eHealth) (March 12, 2021)
  
• CV-19 WS0070 Documentation and Reconciliation Process when Transporting Pfizer BioNTech and Moderna COVID-19 Vials​ (March 24, 2021)​
  
• SHA 0094 Moderna COVID-19 Vaccine Tracking Form​ (March 4, 2021)​

​Vaccine Preparation

• CV-19 G0088 Moderna COVID-19 Vaccine Preparation for Use​ (February 8, 2021)​
  
• Pooling Residual COVID-19 Vaccine to Obtain Full Dose (eHealth) ​ (March 12, 2012)
  
• CV-19 WS0081 Disposing of Empty COVID-19 Vaccine Vials and Packaging​ (April 20, 2021)
  

Vaccine Consent

• ​CV-19 G0093 Guidelines for Obtaining Consent for COVID-19 Immunization (February 16, 2021)
  
• COVID-19 Vaccine Contraindications and Precautions Background Document ​(eHealth) (April 1​, 2021)
  
• ​Refer to General Immunization Training for Vaccine Precautions Algorithms​
• CV-19 G0096 Vaccine During Pregnancy and Breastfeeding ​(January 22, 2021)​
  
• SHA 0096 COVID-19 Vaccine Consent​ - Substitute Decision Maker​ ​ (February 16, 2021)​
• NOTE:  This consent is for those persons 18 years and older who are unable to understand or sign for their own medical services and have a legal substitute decision-maker.​​
• ​SHA 0107 ​Pregnant Women - Benefit/Risk Information (January 18, 2021)
  
• SHA 0108 Breastfeeding Women - Benefit/Risk Information (January 18, 2021)
  
• SHA 0109 Immune Suppressed Individuals - Benefit/Risk Information (January 18, 2021)
  
• SHA 0110 ​Autoimmune Conditions - Benefit/Risk Informatio​n (January 18, 2021)
  
• SHA 0117 Governing Law and Jurisdiction Agreement Form (April 7, 2021)
  
• COVID-19 Vaccine Eligibility and Procedure for Non-Residents (eHealth) (March 17, 2021)
  

Vaccine Administration

​Order Sets

• SHA OS-033 Moderna COVID-19 Vaccine Administration in Continuing Care​ (January 6, 2021)
  
• SHA OS-035 Moderna COVID-19 Vaccine Administration in Acute Care for ADULTS​ (March 11, 2021)
  

​​​​Medical Directives

• CV-19 MD0007 Moderna Vaccine Administration Without Patient Order - Non-SHA Paramedics​​ (March 11, 2021)
• CV-19 MD0008 Moderna Vaccine Administration Without Patient Order - Non-SHA Authorized Organizations (March 11, 2021)​
  

​​Clinical Procedures/Guidance​

• CV-19 CP0002 Clinical Procedure - Moderna COVID-19 Vaccine WITHOUT Patient Specific Order ​​- Includes Medical Directive​​ (April 1, 2021)
• CV-19 CP0004 Clinical Procedure - Moderna COVID-19 Vaccine Administration WITH Patient Order - Includes Practitioner Order Set (April 1, 2021)
• CV-19 WS0064 Minimizing COVID-19 Vaccine Wastage​ (February 3, 2021)
  

​​​Vaccine Documentation

​NOTE:  Panorama documents have been moved to the Training Webpage​.

​Guidance

• CV-19 WS0060 Documentation​ of Vaccines in SHA Health Care Facilities (March 14, 2021)
  
• CV-19 WS0061 LTC - Completion of Immunization History ​Module in Convergence​ (March 3, 2021)
  
• LTC - Completion of History Immunization Module in Convergence - VIDEO (January 14, 2021)
  
• Comp​letion of Notification of Vaccine Administration and Pfizer/Moderna/AstraZeneca​/COVISHIELD Registration Forms  (eHealth)​​​ (March 12, 2021)
  
• Adverse Events - Reporting (February 10, 2021)
  

​​​​​​​​​ Forms

• SHA 0097 Long Term Care Vaccine Administration Form - Use ONLY where Convergence is used (March 14, 2021)
  
• Notification of Vaccine Administration Form (eHealth)​ - place in health record, where applicable (March 12, 2021)​
  
• NOTE:  If entering information into Convergence, DO NOT fax to the Ministry of Health as indicated.
• Fillable form - can complete electronically or print and hand write information.
  
• ​​Line List - Moderna - 18 Years and Older Panorama Registration Form (eHealth) ​ (March 12, 2021)
• ​​NOTE:  This form does not replace documentation of vaccine administration in the patient/resident health record.​​