Follow-up for Positive COVID-19 Cases and their Close Contacts
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Follow-up for Positive COVID-19
Cases and their Close Contacts
Tools for LBOHs
March 16, 2021
Hillary Johnson, MHS, Infectious Disease Epidemiologist
Scott Troppy, MPH, PMP, CIC, Surveillance Epidemiologist
Alexandra DeJesus, MPH, CIC, Infectious Disease Epidemiologist
Bureau of Infectious Disease and Laboratory Sciences
MA Department of Public Health
Tuesday Webinars for COVID-19 Case
Investigation and Follow-up
• Discussing New Guidelines, MAVEN Updates, Changes in
Tuesdays @ 11am
Protocols, New Tools, Case Investigation FAQs, Follow-up
Procedures.
MDPH Epi Program: 617-983-6800
MDPH MAVEN Help Desk: isishelp@mass.gov
MDPH ISIS Help Desk: 617-983-6801
MDPH ISIS Fax: 617-983-6813
COVID-19 Vaccine Rollout email COVID-19-Vaccine-Plan-MA@mass.gov
MDPH Food Protection Program: 617-983-6712
CTC Help Desk: 857-305-2828
* CTC Local Health Help ctclocalhealthhelp@covid19.pih.org
CTC Local Health Liaison List
Higher Ed Contact List
MAVEN Office Hours w/Hillary, Scott, & Alex:
Fridays 11:00-12:00
• Open Q&A. Not a formal presentation. 2
MAVEN Help has Guidance Documents and • Send us your questions or ask us live.
Previous Webinars: • No requirement to attend. Pop in, pop out.
http://www.maventrainingsite.com/maven-help/toc.html • You’ll need to register via Scott’s email.
Topics Today • MAVEN COVID Immediate workflow – review and clear out old cases • MAVEN Reporting Server Issues • MAVEN Release Notes Review • Variants of Concern • MIIS – MAVEN Integration • Antigen Review • Updated Guidance for Vaccinated Individuals • Quarantine 3 • Travel Order
Updates for today, Tuesday, 3/16/2021
LBOH Immediate Workflow – COVID-19 event only –
please check your workflow TODAY and clear out the
workflow
MAVEN Reporting Server Issues
MAVEN D Release Review
Released on Friday, March 12th
4
Immediate Notification workflow (COVID-19 Only)
UPDATE: COVID-19 Immediate Notification Workflow -
1,501 events in this workflow this morning
This will allow proper notification of all new COVID-19 events for
your jurisdiction. (Confirmed and Probable Cases)
Please review all events/cases in this workflow and complete your
Step 1- LBOH Notification to “Yes” to clear out this workflow.
If you are retaining ownership then complete Step 2 (Investigation
Started) & Step 3 (LBOH Investigator (name, lboh, phone number)
When you are done then complete Step 4 (Case Report Form
Complete 5
You can complete Step 5 if you want – if not then leave blank
MAVEN Reporting Server Issues
Sent: Monday, March 15, 2021 3:00 PM
To: All MAVEN Users
Subject: MAVEN Reports/Reporting Server Update - MONDAY, 3/15 at 2:59 p.m. - PLEASE READ!
Good afternoon – we continue to receive reports of some users unable to access reports. As
earlier emails have stated, IT is aware of this issue and is working to resolve it. This issue is
not affecting all reports nor is it affecting your ability to access events in MAVEN. If you
experience an issue with running a report, log out of MAVEN, and try again.
We ask that you please do not email the Help Desk regarding this issue as it is widespread
and we will update all users once it has been resolved for all reports.
Thanks for your patience.
6
MAVEN Release Notes
March 12, 2021
Release 6.1.3.2_D
Bureau of Infectious Disease and Laboratory Sciences
MA Department of Public Health
7
COVID -19
• Add new variables to SARS to capture ENX utilization [MAEDSS-12995]
• Update COVID-19 Case Investigation Wizard with ENX questions
[MAEDSS-13007]
• Update LBOH COVID-19 Set COVID Assistance to Yes (Probable and
Confirmed) workflows to remove cases once COVID Assistance is
marked to "Yes or No“ [MAEDSS-13000]
• SARS Contacts should update to Probable or Confirmed with new
labs [MAEDSS-12950]
8
COVID-19 Variant of Concern
Added variable to capture if specimens were sequenced
and a new variant was identified (Variant of Concern) in
SARS events [MAEDSS-13037]
Added question to the Clinical Question Package and COVID Wizard
Not editable by local users
If question is answered as Yes users will need to review lab data to
see which variant has been sequenced
Information will be updated on an ongoing basis in the question
package
Added to the LBOH Confirmed and Probable Report
9
COVID-19 Variant of Concern – Lab tab
10COVID Confirmed and Probable Report
- VOC field added to your report
11COVID-19
Update the four case attributes that bring lab information
into Clinical QKPG of EPI/IMM model for COVID-19 events
[MAEDSS-12956]
12LBOH MAVEN Reports
Disable Excel as an output option for LBOH reports
[MAEDSS-12987]
This will assist with system performance and reduce the
number of error messages some MAVEN users have been
reporting
We recommend using the CVS (Comma Separated Values)
format for reports
13EPI – Foodborne/Waterborne
Listeriosis and Clostridioides difficile
LIST - CDIFF coinfection link is displaying as LACCCCCGSSSSYL
Cross Product Notifier [MAEDSS-13014]
Updated the Cross Product Notifier Description in the
notifications section
14MAVEN – MIIS Immunization
Integration for COVID Events
• Massachusetts Immunization Information System (MIIS) Integration into
MAVEN [MAEDSS-12966, 12965, 12964, 12963, 12962, 12961, 12960, 12959, 12958, 12957]
• MIIS will be queried for COVID contacts and confirmed/probable cases in
MAVEN from 12/15/2020 – present, and prospectively
• Two MIIS queries each for contacts and confirmed/probable cases,
separated by 14 days
• If a contact later becomes a case, MIIS will be queried again
• MIIS query dates can be found in the MAVEN Administrative Question Package
• If a match is found through the MIIS query, MIIS data will automatically
populate the MAVEN Vaccine Question Package 15MAVEN – MIIS Immunization
Integration for COVID Events
• MIIS Information Questions are in the
Administrative Question Package
• Checks Confirmed Cases and Contacts
• Two weeks later we check MIIS again
• MIIS query may successfully find the
person but may not mean the vaccine
information is in the MIIS system
• These date fields show the 1st and 2nd
query has occurred
• These are not editable
16Vaccine QP#4 – Patient/Parent Recall
17Tuesday Webinars for COVID-19 Case
Investigation and Follow-up
• Discussing New Guidelines, MAVEN Updates, Changes in
Tuesdays @ 11am
Protocols, New Tools, Case Investigation FAQs, Follow-up
Procedures.
MDPH Epi Program: 617-983-6800
MDPH MAVEN Help Desk: isishelp@mass.gov
MDPH ISIS Help Desk: 617-983-6801
MDPH ISIS Fax: 617-983-6813
COVID-19 Vaccine Rollout email COVID-19-Vaccine-Plan-MA@mass.gov
MDPH Food Protection Program: 617-983-6712
CTC Help Desk: 857-305-2828
* CTC Local Health Help ctclocalhealthhelp@covid19.pih.org
CTC Local Health Liaison List
Higher Ed Contact List
MAVEN Office Hours w/Hillary, Scott, & Alex:
Fridays 11:00-12:00
• Open Q&A. Not a formal presentation. 18
MAVEN Help has Guidance Documents and • Send us your questions or ask us live.
Previous Webinars: • No requirement to attend. Pop in, pop out.
http://www.maventrainingsite.com/maven-help/toc.html • You’ll need to register via Scott’s email.Summary of Key Guidance & Tools
• Isolation & Quarantine Guidance Documents
• 03/08/21 Updated Quarantine Guidance: https://www.mass.gov/guidance/information-and-guidance-for-persons-in-quarantine-due-to-covid-19 Updated
• Guidance now states recently recovered (in first 90 days) and fully vaccinated people do not need to quarantine.
• Quarantine Guidance Translations available here: https://www.mass.gov/guidance/information-and-guidance-for-persons-in-quarantine-
due-to-covid-19#download-in-additional-languages
• 8/9/2020: Isolation Guidance Document http://www.maventrainingsite.com/maven-help/pdf/COVID19-Isolation-information-and-guidance_ver2.0_August9.pdf
• Date: March 8, 2021 – Occupational Exposure & Return to Work Guidance Updated
• https://www.mass.gov/doc/return-to-work-guidance/download
• Now includes language about recently recovered and fully vaccinated people.
• Pediatric Clinical Testing Advisory Helpful to get
• 11/25/2020 Advises Pediatricians to Test for COVID-19 in all patients with symptoms compatible with COVID, regardless of age Docs to test Kids
• https://www.mass.gov/doc/pediatric-and-adolescent-covid-19-testing-guidance/download
• Date: 10/21/2020 COVID‐19 Testing Scenarios FAQ Lab Results Questions
• Describes different lab test results and what to do
• Outlines discordant results and what they mean
• http://www.maventrainingsite.com/maven-help/pdf/COVID-19%20Testing%20Scenarios%20FAQ_Ver%201.0_October2020.pdf
• 10/27/2020 Updated COVID-19 Case Classification Manual
• Serology positive labs are now classified as “suspect” cases.
• http://www.maventrainingsite.com/maven-help/pdf/case-classification-manual/COVID19__10272020_FINAL.pdf 19Summary of Key Guidance & Tools
• Date: 8/22/2020: - COVID-19 PCR and Antibody Testing Public Health Response
Recommendations
• Table describes different Public Health Actions based upon different testing
results.
• Big take home: PCR & Antigen positive patients should be treated like cases.
• Serology + cases no longer require public health follow-up.
• http://www.maventrainingsite.com/maven-help/pdf/COVID-
19%20PCR%20and%20Antibody%20Testing%20Public%20Health%20Response%20Recommendations%20for%20LBOH%20Ver
4.0_Aug22.pdf
• Date 8/10/2020: Follow-up for Positive Antigen Test Results
• http://www.maventrainingsite.com/maven-help/pdf/Antigen%20Results%20Follow-
up%20Guidance_ver1.0_August_10.pdf.
We discussed this
follow-up Table
• Reminder that while Antigen Tests = Probable, we still treat like a case and isolate
Today.
accordingly & do contact tracing.
• A PCR obtained at the same time (w/i 2 calendar days) will trump the antigen test
result. 20Summary of Key Guidance & Tools
• Date: March 2021 Update - Gov. Baker issued COVID-19 Order No. 45 which issues a mandatory 10 day
quarantine period for travelers to MA (including MA residents who traveled outside of MA and are
returning).
• If travelers (including returning MA residents) don’t fit into one of the Exemption Categories, must quarantine.
• IF you were a COVID case in the last 3 months, you don’t have to test/quarantine. After 3 months you do.
• IF you are fully vaccinated, you do not have to test/quarantine.
More Updated
• There is a form to fill out online. https://www.mass.gov/forms/massachusetts-travel-form FAQs. Check
• A negative PCR (or Abbot BinaxNOW) test within 72 hours of travel can excuse you from quarantine. them out!
• https://www.mass.gov/info-details/covid-19-travel-order
• Updated FAQs: https://www.mass.gov/info-details/covid-19-travel-order#potential-other-traveler-scenarios-
• Date: 02/11/2021– – Updated CDC Guidance on Duration of Isolation & Precautions for Adults with
COVID-19
• 10 Day Isolation Period now has more data supporting it. CDC Guidance on Duration
• Ignore most additional PCR tests up to 3 months after initial illness onset. of Isolation
• No need to quarantine up to 3 months after initial illness onset.
• https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
MA State testing
• Date: 8/7/2020: Updated MA Testing Guidance
• https://www.mass.gov/doc/covid-19-testing-guidance/download guidance – anticipate 21
• Update says to get a PCR with ANY Antigen test an update soon.
• Also says no need to test again in 90 days after initial diagnosis.New MAVEN Help DOCUMENTS!!!!
http://www.maventrainingsite.com/maven-help/toc.html
NEW Daycare/School/Sports
Resources Folder!
LBOH Daycare Cluster Follow-
up Guidance Document
School Nurse Webinar
School Isolation & Quarantine
Calculation Tools
Generic Program Isolation &
Quarantine Calculation Tools
22
Sports FAQs & Hockey
Exposure Template LetterNew MAVEN Help DOCUMENTS!!!!
http://www.maventrainingsite.com/maven-help/toc.html
LBOH Daycare Cluster Follow-
up Guidance Document
Childcare/Daycare Close Contacts Letter
Template Letters: New
Folder! Gen Notification Letter
In Home Daycare Letter
K-12 School Template 23
School Close Contacts Letter
Letters: New Folder!
School Gen Notification LetterUpdates – A quick recap for March 16, 2021
Last Tuesday Webinar – March 9, 2021
Always Remember you can
see all previous webinar
recordings and slides in
MAVEN Help.
24
MAVEN Help: http://www.maventrainingsite.com/maven-help/toc.htmlAntigen Tests: Follow this table
• Q. How do we know when an antigen
should be confirmed with a PCR?
• A. Consult this guidance table for how to
follow up on Antigen Positive individuals
who also obtain a PCR test.
• If the PCR is collected at the same time or
within 2 days of the Antigen Test, the PCR
result trumps the antigen result.
http://www.maventrainingsite.com/maven-
help/pdf/Antigen%20Results%20Follow-
up%20Guidance_ver1.0_August_10.pdf 25TABLE 1: Public Health Follow-up for when Both Antigen & PCR Specimens are Collected ** Health agent should contact isishelp@mass.gov or the Division of Epidemiology at 617-983-6800 with MAVEN ID# for cases requiring changes in surveillance case 26 classification status. Be sure to update notes in your MAVEN cases accordingly.
Antigen+ & PCR-
• Any negative PCR collected within 2 days before or after will trump the Antigen
result.
- Day 4 - Day 3 - Day 2 - Day 1 Day 0 Day 1 Day 2 Day 3 Day 4
Antigen +
PCR - PCR - PCR - PCR - PCR -
This case is presumed negative. Revoke Case.**
** Health agent should contact isishelp@mass.gov or the Division of Epidemiology at
617-983-6800 with MAVEN ID# for cases requiring changes in surveillance case 27
classification status. Be sure to update notes in your MAVEN cases accordingly.Antigen+ & PCR-
• Any negative PCR collected > 3 days before or after Positive Antigen does not change
follow-up.
- Day 4 - Day 3 - Day 2 - Day 1 Day 0 Day 1 Day 2 Day 3 Day 4
Antigen +
PCR- PCR- PCR- PCR-
Negative PCRs collected so far from the antigen test do not give us enough
information to trump the +Antigen. Treat as a case and follow up.
28Antigen+ & PCR+
• A positive PCR will update the case from Probable to Confirmed.
- Day 4 - Day 3 - Day 2 - Day 1 Day 0 Day 1 Day 2 Day 3 Day 4
Antigen +
PCR+ PCR+ PCR+ PCR+ PCR+ PCR+ PCR+ PCR+ PCR+
Positive PCRs collected at any point will make the case CONFIRMED. But
going from Probable to Confirmed doesn’t change follow-up.
Treat as a case and follow up.
29Antigen Testing Quick Info
• Antigen & PCR testing Summary of Discussion
• The August 7th MDPH Testing Guidance has not yet been officially updated, although
updates have been recommended several times (still recommends antigen tests get
confirmed with a PCR).
• Not all antigen testing platforms are equal, although we feel better about BinaxNOW
Rapid test results.
• We are still utilizing our Antigen Follow-up Table, which states a PCR result w/i 2 days
of the antigen result shall trump the antigen result.
• If you receive a negative test and COVID-19 is still suspected in a patient, the
recommendation is to test again (PCR).
30Antigen Testing Quick Info
• Antigen & PCR testing Summary of Discussion
• For symptomatic students in DESE & EEC settings, a negative PCR test is still the
required test for returning to school/daycare for sick children who go home and/or
call in sick.
• EEC Guidance Playbook pg 17 states PCR test is required.
• For k-12 DESE guidance, the wording is a little less direct, as the their Protocols Document
doesn’t specify a type of test, however,
• More recently, the updated DESE BinaxNOW guidance & FAQs
https://www.doe.mass.edu/covid19/BinaxNOW/ does state that sick kids can’t come back to
school without a PCR or waiting the 10 days (even if they had a negative binax at school).
• Pediatric and Adolescent Testing Guidance states that providers should be testing even lightly
symptomatic kids with PCR testing.
• The DESE Protocol doc DOES reference the MDPH state testing guidance frequently. The Aug 7th
MDPH testing Guidance STILL states that all antigen results should be confirmed with a PCR.
31Summary of Key Guidance & Tools
Updated Key Documents/Pages
• 03/08/21 Updated Quarantine Guidance:
• Guidance now states recently recovered and recently fully vaccinated people do not need to
quarantine in first 90 days.
• Quarantine Guidance Translations available here:
• 8/9/2020: Isolation Guidance Document http://www.maventrainingsite.com/maven-
help/pdf/COVID19-Isolation-information-and-guidance_ver2.0_August9.pdf
• 3/8/21 – Occupational Exposure & Return to Work Guidance
• Now includes language about recently recovered and recently fully vaccinated people.
• COVID-19 Vaccine Frequently Asked Questions
• Updated FAQs on vaccinated people for travel, quarantine, and post-vaccination
recommendations.
• Travel Order
• 3/8/21 - Updated Travel Order to include fully vaccinated status as an exemption. 32
• Antigen Results (only BinaxNOW) are now accepted for Travel Order – 3-15-21 PM updateCDC Updated Pages
• CDC has updated their “mRNA Vaccines” page to now:
• “Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in
the United States”
• Great resource for all your vaccine questions. Now includes info on all three vaccines!
• Immunization Action Coalition (IAC)’s Ask the Experts page has been
updated for the J&J COVID-19 vaccine.
• https://www.immunize.org/askexperts/experts_cov.asp
• CDC has moved their guidance on vaccinated individuals to a NEW page:
• Interim Public Health Recommendations for Fully Vaccinated People
• Talks about what precautions are still needed for fully vaccinated people, etc.
33Your Questions – What is MA doing now?
• Has MA finally adopted new guidance for fully vaccinated individuals
who are identified as contacts that is in alignment with CDC?
• Yes! There have been more updates since last Tuesday!
• Has MA updated the Travel Order to account for fully vaccinated
individuals?
• Yes! There have been more updates since last Tuesday!
34MA Quarantine Guidance for Fully
Vaccinated Individuals
Information and Guidance for Persons in Quarantine due to COVID-19
Updated March 8, 2021 (Quarantine Page has been updated.)
Updated
• Please note that individuals who had COVID-19 in the last 90 days (from day of
symptom onset or day of first positive test if asymptomatic), AND individuals who
have received either two doses of the Moderna or Pfizer COVID-19 vaccines or a
single dose of the Janssen COVID-19 vaccine, at least 14 days ago, are not required
to quarantine following an exposure.
35Additional Quarantine Guidance Update
• Antigen Tests utilized to exit out of Strict Quarantine early (after 7 days of
strict quarantine) must now be Abbot BinaxNOW antigen tests.
• Only the Abbot BinaxNOW antigen test is an acceptable antigen test for reduced
strict quarantine.
Updated
36
This has been updated on the MDPH Quarantine Guidance Page and in the Return to Work Guidance.MA Travel Order Update
Fully Vaccinated Individuals may now meet one of the exemptions to the
Travel Order and do not need to Test or Quarantine upon arrival in MA.
• Persons Who Have Been Completely Vaccinated for COVID-19: Individuals who have
received two doses of either the Moderna or Pfizer COVID-19 vaccines OR who have received
a single dose of the Janssen vaccine, more than 14 days ago and who do not have symptoms, Updated
do not need to obtain a negative test prior to traveling to, or quarantine upon arrival to,
Massachusetts.
• COVID-19 vaccinated individuals arriving in Massachusetts must have documentation of their
vaccination(s), including the date(s) of administration, available if asked.
• This exception does not include COVID-19-recovered individuals who have symptoms of
COVID-19, who must follow all testing and quarantine guidance outlined in the travel rules
• https://www.mass.gov/info-details/covid-19-travel-order
37As of 3/15 PM, Travel Order
MA Travel Order Update Website IS NOW UPDATED to also
allow BinaxNOW antigen results.
Travel Order Website has been updated to accept BinaxNOW antigen tests. It states
any other antigen test result must be confirmed by PCR. (Text is a little buried under
“Testing as an Alternative to Quarantine” Header). There is also a new #7FAQ.
• Information about approved molecular tests can be found in the Department of Public
Updated
Health Guidance. A negative result from an antigen test, other than the Abbott BinaxNOW,
must be confirmed by a negative result from an FDA EUA-approved molecular (PCR) SARS-
CoV2 test, on a sample obtained 72 hours or less prior to arrival in Massachusetts. If a
negative result is obtained from the Abbott BinxNOW antigen test, no PCR confirmation is
required. Serology tests will not be accepted.
• FAQ #7. I had an antigen test which was negative, do I need to be tested again?
• A. Yes, a negative antigen test from any antigen test other than the Abbott BinaxNOW, must
be confirmed by a negative result from an FDA EUA-approved molecular (PCR) SARS-
CoV2 test on a sample obtained 72 hours or less prior to arrival in Massachusetts.
38Vaccine: The Big Questions
• Do vaccinated individuals have to quarantine if identified as a close contact of
a confirmed case?
• A. No. If > 2 weeks past completing the vaccine series, fully vaccinated individuals
do not need to quarantine at this time. (they should monitor themselves for Updated
symptoms). UPDATED
• If a vaccinated individual tests positive, are they considered a case?
• A. Yes. The vaccine will not cause a COVID test to be positive. These people are cases
and should isolate and contact tracing should occur.
• Do vaccinated individuals have to comply with the travel order?
• A. They still need to comply; however, they may qualify for an exemption. If > 2
weeks past completing the vaccine series, fully vaccinated individuals do not need to 39
quarantine for 10 days or seek testing at this time. UPDATED
UpdatedCOVID-Recovered: The Big Questions
• Do COVID-recovered individuals have to quarantine if identified as a close contact of a
confirmed case?
• A. A previously recovered individual identified as a contact would not need to
quarantine in their first 90 days after diagnosis (symptom onset or date of test no
symptoms). If > 90 days since their positive test, a new exposure would require
quarantine at that time.
• If a COVID-recovered individual tests positive again, are they considered a case?
• A. There is no recommendation to test in the 90 days after initial diagnosis, as we know patients
can remain PCR+ for quite some time. If a case tests positive again in the first 90 days, they do not
need to isolate again. However, they should isolate again and contacts should quarantine if the case
tests positive again > 90 days from original diagnosis.
• Do COVID-recovered individuals have to comply with the travel order?
• A. Yes. They still need to comply; however, they may qualify for an exemption. Individuals
who are COVID-19-recovered, meaning individuals who tested positive more than 10 days but less
than 90 days ago and who do not have symptoms, do not need to obtain a negative test prior to 40
traveling to or quarantine upon arrival to Massachusetts.FAQs on Mass.Gov have been updated! What should I do if I experience symptoms after receiving a COVID-19 vaccine? (Updated 3/5/21) • Some people have side effects after being vaccinated (such as tiredness, headache, and pain at the injection site), which are normal signs that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days. • If you develop respiratory symptoms like runny nose, cough, or loss of sense of smell or taste, these are not side effects of the vaccine and you should consider getting tested for COVID-19 or talk to your healthcare provider. • It is possible to get COVID-19 even after you get the vaccine. Stay home if you are sick and avoid close contact with others. 41
Fully vaccinated people with COVID-19 symptoms:
Don’t Ignore.
In general, sick people that present with COVID-like symptoms should be
considered for testing regardless of their vaccination status at this time.
• Although the risk that fully vaccinated people could become infected with
COVID-19 is low, any fully vaccinated person who experiences symptoms
consistent with COVID-19 should isolate themselves from others, be clinically
evaluated for COVID-19, and tested for SARS-CoV-2 if indicated. The
symptomatic fully vaccinated person should inform their healthcare provider of
their vaccination status at the time of presentation to care.
• https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-
guidance.html#anchor_1615135598178
42Fully vaccinated people with no COVID-like
symptoms following an exposure
Fully vaccinated people with no COVID-like symptoms do not need to
quarantine or be tested following an exposure to someone with suspected or
confirmed COVID-19, as their risk of infection is low.
• Fully vaccinated people who do not quarantine should still monitor for
symptoms of COVID-19 for 14 days following an exposure.
• If they experience symptoms, they should isolate themselves from others, be
clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated, and
inform their health care provider of their vaccination status at the time of
presentation to care.
43
• https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-
guidance.html#anchor_1615135598178CDC Updated Pages
• CDC has updated their “mRNA Vaccines” page to now:
• “Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in
the United States”
• Great resource for all your vaccine questions. Now includes info on all three vaccines!
• Immunization Action Coalition (IAC)’s Ask the Experts page has been
updated for the J&J COVID-19 vaccine.
• https://www.immunize.org/askexperts/experts_cov.asp
• CDC has moved their guidance on vaccinated individuals to a NEW page:
• Interim Public Health Recommendations for Fully Vaccinated People
• Talks about what precautions are still needed for fully vaccinated people, etc.
44Summary Table
45Travel
46Travel Order: Which Test?
Q. What test is required to comply with the travel order?
• A. Negative PCR test or Negative Abbott BinaxNOW
• If the antigen test is NOT Abbott BinaxNOW, you need a follow-up PCR test to confirm
the negative.
• If a negative result is obtained from the Abbott BinxNOW antigen test, no PCR
confirmation is required. Serology tests will not be accepted.
UPDATED!!!
Travel Order Acceptable Tests
Negative PCR Test
or 47
Negative BinaxNOW Antigen TestTravel Order: Vaccinated Travelers
Q. If a traveler has been vaccinated, are they still subject to the Travel Order?
• A. YES, but they likely meet an exemption to testing or quarantine:
• Persons Who Have Been Completely Vaccinated for COVID-19: Individuals who
have received two doses of either the Moderna or Pfizer COVID-19 vaccines OR
who have received a single dose of the Janssen vaccine, more than 14 days ago
and who do not have symptoms, do not need to obtain a negative test prior to
traveling to, or quarantine upon arrival to, Massachusetts.
48What About International Travel?
Q. Are there different requirements for international travel?
CDC Requirement:
• Effective January 26, CDC requires all air passengers (2 and over) entering the United States (including U.S. citizens and Legal
Permanent Residents) to present a negative COVID-19 test, taken within three calendar days of departure or proof of recovery
from the virus within the last 90 days.
• You cannot board without proof of recent recovery or a new negative test.
CDC Recommendation as a Best Practice:
• Get tested with a viral test 3-5 days after travel AND stay home and self-quarantine for a full 7 days after travel. Even if you
test negative, stay home and self-quarantine for the full 7 days.
MA Travel Order:
• All International travelers arriving in Massachusetts must complete the Massachusetts Travel Form and must quarantine for
10 days unless they can provide proof of a negative test result that meets the criteria stated above or they are covered by one of
the other, limited exceptions.
• The additional guidance from CDC to quarantine and retest upon arrival is only a recommendation, not a requirement at this
time.
• MA Travel Order has not been updated to distinguish international travel and additional quarantine requirements at this time,
although international travelers must obtain a PCR (if collected in another country), not antigen test. 49Travel Order: COVID-Recovered Persons Q. If I have recently recovered from COVID-19, do I have to test again to comply with the travel order? A. Persons Who Tested Positive within 90 Days of Arrival to Massachusetts and Successfully Completed Isolation now meet one of the Travel Order Exemptions and do not have to re-test or quarantine at this time. • COVID-19-recovered (meaning individuals who tested positive more than 10 days but less than 90 days ago and who do not have symptoms) do not need to obtain a negative PCR test prior to traveling to, or quarantine upon arrival to, Massachusetts. • COVID-19 recovered individuals arriving in Massachusetts must have documentation of the positive PCR test result, including the date it was taken, available if asked. This exception does not include COVID-19-recovered individuals who have symptoms of COVID-19, who must follow all testing and quarantine guidance outlined in the travel 50 rules.
Travel Order: Children Under 10 TRAVEL ORDER & Children 10 & Under: Children 10 and under may currently utilize their parents as proxy for testing out of quarantine: Children 10 years and younger should mimic the quarantine requirement and testing options completed by the household adult they accompanied for travel. If the accompanying adult chooses to quarantine, the child must also quarantine. If the accompanying adult chooses to obtain a test, the child and adult must quarantine until the adult’s negative test result is received. However, if their parents are recently recovered cases (and the child was not previously diagnosed) or if the parents are vaccinated, the travel order does not directly address this scenario. What should a young child do if not previously a case themselves but their parent is exempt due to being recently recovered/vaccinated from COVID? • A. Take the travel order guidance literally (that the child can mimic their parent), and the child can claim an exemption from the travel order as well at this time. 51
Travel Quarantine – How to Count it Out
• Q. For the travel order and the 10 day quarantine, is the day that
individuals return to MA considered day 0 or day 1 when counting out the
10 full days?
• A. Consider the last date they were in the high risk state/country as Day 0,
and count from there.
• So if I left yesterday and arrived today (so traveled overnight), my Day 0 is yesterday
and I start counting from there.
• If I left this morning and arrived tonight, then my day 0 (last exposure) is today.
52When Can You Test for Travel Order?
All visitors entering Massachusetts, including returning residents, who do not
meet an exemption, are required to:
A negative test prior to arrival in MA
• Complete the Massachusetts Travel Form prior to arrival, unless you are visiting shows that you are likely not a
from a lower-risk state designated by the Department of Public Health. positive case upon arrival.
• Quarantine for 10 days or produce a negative COVID-19 test result that has been Earlier testing may not be reflective
administered up to 72-hours prior to your arrival in Massachusetts. of additional exposure “in transit,”
and travelers should keep this in
mind when observing self for
If your COVID-19 test result has not been received prior to arrival, visitors, and residents must
symptoms in the following days.
quarantine until they receive a negative test result. Quarantine (max 10 days)
Day Day Day Day Day Day Day Day Day Day Day Day Day Day Day Day
-4 -3 -2 -1 0 1 2 3 4 5 6 7 8 9 10 11
53
Can Obtain PCR or BinaxNOW Antigen
Test Too Arrival In MA Test Any Time No Symptoms?
Early Exit Quarantine.54
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