COVID-19 Update for Vanguard Patients

Updated September 12, 2022

Vanguard Medical Group is here to help you stay safe through this ongoing pandemic. Here are some steps you can take to stay safe with your loved one.

COVID-19 Vaccine and Booster is your best protection!  Most of the patients who are hospitalized are unvaccinated. Even though Omicron breakthrough infections are common, getting vaccinated plus a booster makes a breakthrough infection less severe. The CDC has approved a bivalent booster that includes both the Omicron and the original strain. This is a different booster from the one previously offered.

COVID Testing: COVID testing demand has increased rapidly due to the Omicron surge and there are not enough tests available.   Pharmacies and online retailers like Amazon have limited supplies.  Click here to find a local state or county COVID test site near you.    The State of New Jersey offers a mail in saliva test.  Click here to learn about or order your New Jersey free test.

COVID Testing at Vanguard: If you have COVID symptoms and are under age 65 and do not have any health conditions and do not feel that you need to speak to a health provider, then you can just schedule a rapid COVID test.  If you have questions or think you may also need other testing such as flu or strep, or a PCR then you need to first have a telemedicine visit with one of our providers.

People with COVID who are over 65 or are immunocompromised or have chronic health conditions should schedule a telemedicine visit first so we can determine if anti-viral medication or monoclonal antibody treatment would be recommended.  We also need to have a plan to follow up with you if your illness progresses.

See below for Frequently Asked Questions about COVID-19 testing.

COVID Vaccines and Boosters

Here are the current recommendations for COVID vaccines and boosters

If you are NOT Moderately or Severely Immunocompromised:

	Pfizer-BioNTech	Moderna	J&J/Janssen	Novavax
6 months – 4 years old*	Yes (3 dose primary series) No booster	Yes (2 dose primary series) No booster	No	No
5-11 years old†	Yes (2 dose primary series)   Monovalent Pfizer booster 5 months after 2nd dose	Yes (2 dose primary series) No booster	No	No
12-17 years old	Yes (2 dose primary series)   Bivalent Pfizer booster 2 months after 2nd dose	Yes (2 dose primary series) No boosterBivalent Pfizer booster 2 months after 2nd dose	No	Yes (2 dose primary series)Bivalent Pfizer booster 2 months after 2nd dose
18+ years old	Yes (2 dose primary series)   Bivalent mRNA booster 2 months after 2nd dose	Yes (2 dose primary series)Bivalent mRNA booster 2 months after 2nd dose	1 J&J and 1 mRNA vaccine Bivalent mRNA booster 2 months after 2nd dose	Yes (2 dose primary series)Bivalent mRNA booster 2 months after 2nd dose

*Moderna has a vaccine approved for infants 6 months – 5 years old; Pfizer has a vaccine for 6 months – 4years old
†Moderna has a vaccine approved for 6-11 year olds; Pfizer 5-11 years old
**people who received Janssen COVID-19 Vaccine as both their primary series dose and first booster dose may receive a second booster dose at least 2 months after the first booster dose, for a total of 3 doses

If you ARE Moderately or Severely Immunocompromised:

	Pfizer-BioNTech	Moderna	J&J/Janssen	Novavax
6 months – 4 years old*	3 dose primary series No booster	3 dose primary series No booster	No	No
5-11 years old†	3 dose primary series Monovalent Pfizer booster 3 months after 3rd dose	3 dose primary series No booster	No	No
12-17 years old	3 dose primary series Bivalent Pfizer booster at least 2 months after last primary series dose or last booster	3 dose primary series Bivalent Pfizer booster at least 2 months after last primary series dose or last booster	No	2 dose primary series Bivalent Pfizer booster at least 2 months after last primary series dose
18 years and older	3 dose primary series Bivalent mRNA booster at least 2 months after last primary series dose or last booster	3 dose primary series No booster	1 J&J followed by 1 mRNA vaccine 4 weeks after Bivalent mRNA booster at least 2 months after last primary series dose or last booster	2 dose primary series Bivalent mRNA booster at least 2 months after last primary series dose

*Moderna has a vaccine approved for infants 6 months – 5 years old; Pfizer has a vaccine for 6 months – 4years old
†Moderna has a vaccine approved for 6-11 year olds; Pfizer 5-11 year olds.
Source: https://www.cdc.gov/vaccines/covid-19/downloads/COVID-19-vacc-schedule-at-a-glance-508.pdf

COVID vaccines are available at most Vanguard offices at selected days and times.  Please call your office for availability or contact the Patient Access Team at patientaccessteam@vanguardmedgroup.com or 973-559- 0081

You can also find information from the Centers for Disease Control and Prevention and New Jersey Department of Health websites.

Click here for FAQs about COVID-19 and COVID-19 vaccinations.

COVID-19 Testing

When should you get tested?
Ask yourself these questions to see if you should get tested for COVID-19. If you answer “yes”, contact the Patient Access Team at patientaccessteam@vanguardmedgroup.com or 973-559- 0081 to request a COVID-19 test appointment.

• Do you have any of these symptoms of COVID-19?
  Fever, cough, chills, unexplained muscle pain, shortness of breath, sore throat, loss of taste/smell

The CDC offers this interactive self-checker tool, which can help you decide whether or not you need to be tested.

COVID-19 PCR and Rapid Testing

• The PCR test is very sensitive and can detect the virus within your system even before you have any symptoms. This test is sent out to a laboratory for processing.  Due to the Omicron surge, PCR results are taking 3-4 days on average.
• The Rapid test as its name indicates can provide results the same day. It is most accurate when you are having symptoms.  Home rapid tests are fairly accurate if you are having symptoms.  They are less accurate when you are asymptomatic or testing after an exposure.

Your primary care provider will determine which test is right for you based on your potential exposure, medical history, and symptoms. He or she may also recommend testing for flu, strep, or other illnesses when you get your COVID-19 test. Please call your local office to schedule your appointment today!

*COVID-19 tests are billed according to your individual insurance company’s policy. Medicare and major insurance plans are accepted.

Frequently Asked Questions:

Q: Am I eligible to receive the bivalent COVID-19 booster?

A: Anyone over the age of 12 is eligible to receive the bivalent COVID booster 2 months after receiving your last COVID vaccine.  (You must have received at least 2 doses of Moderna or Pfizer or one dose of either if you received a J&J dose)

Q: Which bivalent mRNA booster should I receive, Pfizer or Moderna?

A: The Pfizer bivalent booster is available for those ages 12 and older. The Moderna booster is for those age 18 and older.  It does not make any difference which vaccine you received previously.

Q: I recently had COVID infection.  How long should I wait to receive the bivalent booster?

A: After COVID infection you generally have antibody protection for several months.  The CDC recommends delaying a primary series or booster by about 3 months from symptom onset or positive test.

Q: I was going to get the previous booster.  Should I do that and then get the bivalent booster?

A: No, the previous boosters are no longer being used.  We are switching over to the bivalent booster.

Q: I recently received my very first dose of Pfizer or Moderna.  Should I get the bivalent booster for my second dose?

A: No, you should complete your first two doses of the original Pfizer or Moderna vaccine and then two months later you can receive the bivalent booster.

Q: I’m immunocompromised or on medication that suppresses my immune system and the COVID vaccines may not give me good protection.  What else can I do?

A: There is a preventive monoclonal antibody medicine that you may be eligible for that gives you antibodies to help protect you from a serious COVID infection.   This medicine is called Evusheld and it is given by injection every 6 months.  It is available at our Verona office. If you receive your booster vaccine first, you should wait 2 weeks to receive Evusheld. There is no wait time if you receive EVUSHELD before a COVID-19 booster.

Q: Where can I receive a bivalent COVID booster or other COVID vaccine?

A: COVID vaccines including the bivalent booster are being distributed by the New Jersey Department of Health and will soon be available at most Vanguard offices.

Q: I have some COVID symptoms and I did a home test and it’s positive.  What do I need to do?

A: If you are younger than 65 yrs. old, in generally good health and not immunocompromised, and are not feeling out of breath, you can self-manage at home. (video from CDC on managing at home). The home tests are very accurate when you have symptoms, and you probably don’t need an additional test. Up and down fevers are common in the first 3-5 days and can be managed with Tylenol.  Keep hydrated by drinking plenty of liquids.  Honey or over the counter cough medicine may help reduce the cough.  You should isolate from others to prevent spreading the infection. If you have had no fever for 24 hours and your symptoms are improving, you can come out of isolation after 7 days but should continue to wear a mask for another 3 days. (Day 0 is the first day of your symptoms.)  Our recommendation is a little more conservative than the CDC.  The CDC allows for return to work after 5 days with additional recommendations on masking and follow up testing.  This guidance makes sense for essential workers during a worker shortage, but does have a little more risk for infection spread.

Q: How long do I need to isolate if I have COVID?  I’m hearing different recommendations and am confused about which I should follow.

A: People with COVID are most contagious from 2 days before their symptoms start through 3-4 days after their symptoms start.  By day 8 (Day 0 is the first day of your symptoms) most people with COVID are no longer contagious.  Those who are immunocompromised or had a severe case of COVID may have trouble getting rid of the virus and may be contagious for longer and should speak with their healthcare provider.  People who have been vaccinated, especially those who also received the booster may get rid of the virus more quickly.  The CDC shortened the isolation period to allow essential workers to return to work after 5 days with continued masking for another 5 days.  Employers and local government may have their own requirements which you may be obliged to follow.  Here is our recommendation:

If you have COVID with symptoms, we recommend you isolate for 7 days (the first day of your symptoms is day 0.)  If you have not had a fever (temp of 100.4 or more) in the previous 48 hours and your symptoms are improving, you can end isolation after day 7 but should wear a mask around others for another 3 days (so a 10 day total).  If you are an essential worker, then the CDC guideline may make more sense for you.

Q: I have symptoms of COVID and I want to get tested.  Do I need a telemedicine visit?

A: If you have COVID symptoms and are under age 65 and do not have any health conditions and do not feel that you need to speak to a health provider, then you can just schedule a rapid COVID test.  If you have questions or think you may also need other testing such as flu or strep, or a PCR then you need to first have a telemedicine visit with one of our providers.

People with COVID who are over 65 or are immunocompromised or have chronic health conditions should schedule a telemedicine visit first so we can determine if anti-viral medication or monoclonal antibody treatment would be recommended.  We also need to have a plan to follow up with you if your illness progresses.

Q: I was exposed to someone with COVID and feel ok but would like to get tested.  Can I get tested at Vanguard?

A: Due to the current COVID surge and the large number of sick patients, we are presently only able to test those who have COVID symptoms.  Testing is also available at many state and county sites.