AFL 21-20 From the California Department of Public Health
June 9, 2021
TO: General Acute Care Hospitals (GACHs)
Acute Psychiatric Hospitals (APHs)
SUBJECT: Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Eligible Individuals Prior to Discharge
All Facilities Letter (AFL) Summary
This AFL recommends GACHs and APHs offer COVID-19 vaccinations to eligible individuals prior to discharge. The California Department of Public Health (CDPH) recognizes that not all GACHs and APHs currently have the ability to take these steps. This AFL provides technical assistance on options and resources to assist GACHs and APHs vaccinate their patients.
CDPH recommends that GACHs and APHs offer COVID-19 vaccine to eligible individuals prior to discharge from hospital admission, 24-hour observation, or emergency department, including those at highest risk of morbidity and mortality from COVID-19 such as:
- Patient age 65 years or older
- Patient being discharged to congregate care or residential settings, including: post-acute medical facilities, skilled nursing facilities, residential care facilities for the elderly, correctional facilities, behavioral health facilities, and homeless shelters
- Psychiatric patient being discharged
The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices has no product preference among the COVID-19 vaccines, and CDPH recommends that providers offer any available COVID-19 vaccine at hospital discharge. Vaccination should not be delayed to offer a specific product. A single-dose vaccine could be preferable, if available, for patients whose second dose will occur following discharge from the hospital. However, if a two-dose vaccine is administered, hospitals are recommended to provide the first dose in a two-dose series and direct patients to MyTurn website where the site will guide them through searching for a second dose after they select that they have already received a first dose.
Additionally, for hospitals not in the state vaccination network administered by Third-Party Administrator (TPA) Blue Shield, hospitals will need to take these steps:
- Hospitals enrolled in myCAvax (e.g. GACHs that were vaccinating prior to the creation of the TPA network), may need to set up a closed clinic in MyTurn to administer vaccine to patients. Visit the Quick Sheet for Types of Clinics in My Turn (PDF) and reference instructions for “Walk-In Only” clinics. These hospitals will still need to report vaccinations to CAIR2 and will likely need a CAIR2 interface or will need to input vaccinations manually.
- Hospitals not in myCAVax (e.g., APHs, GACHs that have not administered COVID-19 vaccinations to date) need to enroll in myCAVax. Visit Steps to Participation For Providers Who Are New to the COVID-19 Vaccination Program and Network to learn how to enroll.
- All hospitals not in the TPA network, would request doses from the local health jurisdictions.
Hospitals in the TPA network will need to take these steps:
- Place a vaccine order request within the myCAvax system.
- Hospitals in the TPA network may need to set up a closed clinic in MyTurn to administer vaccine to patients. Visit the Quick Sheet for Types of Clinics in My Turn (PDF) and reference instructions for “Walk-In Only” clinics.
If you have any questions about this AFL, please contact the Healthcare-Associated Infections Program at HAIProgram@cdph.ca.gov or email@example.com.
Original Signed by Cassie Dunham
Acting Deputy Director
- Provider Bulletin
- CDC Guidance for Vaccinating Older Adults and People with Disabilities for Vaccination Sites
- MyTurn website
- Quick Sheet for Types of Clinics in My Turn (PDF)
- Steps to Participation For Providers Who Are New to the COVID-19 Vaccination Program and Network
- Increasing Access to Vaccination Opportunities: COVID-19 Vaccination upon Discharge from Hospitals, Emergency Departments, and Urgent Care Facilities