CDC’s first full FluView report of the 2022-2023 flu season shows that while flu activity is relatively low overall, there are early increases happening in most of the country. Flu activity is highest and increasing the most in the southeast and south-central parts of the United States. This increased activity could signal an early start to flu season. CDC recommends that everyone 6 months and older get vaccinated each year, ideally by the end of October, but vaccination should continue as long as flu viruses may circulate. For people who live in a community where flu activity has already begun, there’s still time to be vaccinated. Most of the time flu activity peaks between December and February, although significant activity can last as late as May.

This week’s FluView report shows that the percentage of respiratory specimens testing positive for flu nationally has reach 3.3%. The percent positive ranges from about 10% in HHS Region 4 (the southeast of the country) to 0.2% in the northwestern part of the country. In Region 6 (the south-central part of the country) 5% of specimens tested positive for flu, followed by Region 9 (the south-west of the country and Hawaii and Guam) at 4%.

The report also shows data from the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) which tracks the percentage of people visiting outpatient health care providers or emergency departments for respiratory illness. Respiratory illness, also referred to as influenza-like illness (ILI), is defined as fever or couth or sore throat. ILI is already slightly above the national baseline of 2.5%. National and regional baselines indicate a statistically significant increase above the average percent of patient visits for ILI during weeks of low flu activity in previous seasons. This is a high level of ILI for this time of year and the first time that ILI has been above baseline at this time of year since the 2009 H1N1 flu pandemic.

It’s important to note that ILINet monitors symptoms of respiratory disease, not laboratory-confirmed flu, and will therefore capture respiratory illness visits due to infection with pathogens that can present with similar symptoms, including flu, the virus that causes COVID-19, and RSV. Other respiratory viruses are circulating at elevated levels in the United States at this time; therefore, it is important to evaluate data from ILINet and other symptom-based data in the context of other sources of surveillance data to obtain a complete and accurate picture of flu and other respiratory virus activity.

While the timing and severity of the upcoming flu season cannot be predicted, the United States has experienced little flu for the past two seasons. Reduced population immunity, particularly among young children who may never have had flu exposure or been vaccinated, could bring about a robust return of flu. CDC is particularly concerned about drops in flu vaccine coverage in the past two years among higher risk groups, including children and pregnant people. ILI visits at this time are highest among children 0-4 years, followed by people 5-24 years. Often flu activity first increases in children and then spreads to older age groups.

This week, CDC also reported three new pediatric deaths for the prior (2021-2022) flu season, bringing the season total to 43 pediatric deaths. This report further underscores the importance of vaccination among children. During most years, about 80% of pediatric flu deaths happen in children who have not been fully vaccinated.

More than 105 million doses of flu vaccine have been distributed in the United States at this time. You can find a flu vaccine by visiting vaccines.gov and entering your zip code.

To learn more, please visit https://www.cdc.gov/flu/spotlights/2022-2023/early-flu-activity.htm

Boyd Nursing and Rehabilitation is excited to share resident Judith Minix’s Success Story!

Ms. Minix came to Boyd Nursing for rehabilitation following a brief hospital stay that left her weak and in a debilitated state, which inhibited her from returning home. Ms. Minix was optimistic to begin her rehabilitation journey, sharing compassion and delivering words of encouragement to other residents along the way. Over the course of her three week stay, Judith received physical and occupational therapy services to work on strengthening and endurance training, balance and mobility training, self care training, and instruction on strategies and interventions to achieve her prior level of independent function to return home. Ms Minix was successful in her rehab and returned home, reporting that she is happy to have had the opportunity to come to Boyd Nursing for rehab, and that she would like to be able to come back to volunteer, as she has always enjoyed doing for others. Congratulations to Judith and her Care Team on their success!

What’s New for 2022-2023

A few things are different for the 2022-2023 influenza (flu) season, including:

• The composition of flu vaccines has been updated.
• For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine.
• The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season.
• The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older.
• Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose.

To learn more, please visit https://www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm.

Viral tests look for a current infection with SARS-CoV-2, the virus that causes COVID-19, by testing specimens from your nose or mouth. There are two main types of viral tests: nucleic acid amplification tests (NAATs) and antigen tests. In certain circumstances, one test type may be recommended over the other. All tests should be performed following FDA’s requirements.

• NAATs, such as PCR-based tests, are most often performed in a laboratory. They are typically the most reliable tests for people with or without symptoms. These tests detect viral genetic material, which may stay in your body for up to 90 days after you test positive. Therefore, you should not use a NAAT if you have tested positive in the last 90 days.
• Antigen tests* are rapid tests which produce results in 15-30 minutes. They are less reliable than NAATs, especially for people who do not have symptoms. A single, negative antigen test result does not rule out infection.  To best detect infection, a negative antigen test should be repeated at least 48 hours apart (known as serial testing). Sometimes a follow-up NAAT may be recommended to confirm an antigen test result.

*Self-tests, or at-home tests, are usually antigen tests that can be taken anywhere without having to go to a specific testing site. Follow FDA and manufacturer’s instructions, including for the number of times you may need to test. Multiple negative test results increase the confidence that you are not infected with the virus that causes COVID-19.

• You can order free self-test kits at COVIDtests.gov or purchase tests online, in pharmacies, and retail stores.
• You can also visit FDA’s website to see a list of authorized tests.
• As noted in the labeling for authorized over-the-counter antigen tests: Negative results should be treated as presumptive (meaning that they are preliminary results). Negative results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions. Please see FDA guidance on the use of at-home COVID-19 antigen tests.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html#types-of-tests

Everyone 6 Months and Older Should Get a COVID-19 Vaccine

COVID-19 vaccination has many benefits and is an important tool to help protect you from severe illness, hospitalization, and death.

Even if you or your child have had COVID-19, you should still get yourself or your child vaccinated.

• Getting a COVID-19 vaccine after having COVID-19 provides added protection against the virus that causes COVID-19.
• People who already had COVID-19 and do not get vaccinated after their recovery are more likely to get COVID-19 again than those who get vaccinated after their recovery.
• If you were given monoclonal antibodies or convalescent plasma while sick with COVID-19 you do not need to wait to get vaccinated.

Before the Vaccination

If you do not regularly take over-the-counter medications, you should not take them before you get a COVID-19 vaccination.

It is not known how over-the-counter (OTC) medicines, such as ibuprofen, aspirin, or acetaminophen, might affect how well the vaccine works. You may be able to take these types of medications to reduce fever or pain after you get your vaccine to relieve any pain or discomfort resulting from possible side effects.

Get a COVID-19 vaccine with your routine medical procedures and screenings

You can combine most procedures, screenings, and vaccinations at the same appointment when you get your COVID-19 vaccination. Talk to your healthcare provider if you have questions.

Children, teens, and adults may get a COVID-19 vaccine and other vaccines, including a flu vaccine, at the same time.

Preparing children and teens for vaccination

If you are getting your child or teen vaccinated learn how you can support them and talk to them about what to expect. The experience of getting a COVID-19 vaccine will be very similar to that of getting routine vaccines.

Requesting accommodations at COVID-19 vaccination sites

• When making an appointment or arriving for vaccination, you can let staff and/or volunteers know you or your child might need some accommodations.
• People with disabilities can use the COVID-19 Vaccine Disability Information and Access Line (DIAL) to get help with COVID-19 vaccinations.

If you have allergies related to vaccines

Talk to your doctor if you:

• have had a severe allergic reaction to a previous dose to learn if you should get a different type of COVID-19 vaccine,
• are allergic to polyethylene glycol (PEG) and you should not get Pfizer-BioNTech or Moderna COVID-19 vaccine,
• are allergic to polysorbate and you should not get Novavax or J&J/Janssen COVID-19 vaccine
• if you are allergic to other types of vaccines or injectable medications for other diseases.

• If you had an immediate allergic reaction (a reaction that started within 4 hours of getting vaccinated) to a COVID-19 vaccine, but the reaction was not considered severe by a medical professional, you can receive another dose of the same vaccine under certain conditions. Your doctor may refer you to an allergy and immunology specialist for more care or advice.
• If you have had an immediate allergic reaction—even if it was not severe—to a vaccine or injectable therapy for another disease, you should discuss this with your doctor to determine which COVID-19 vaccine is best for you.

If you have allergies not related to vaccines

You should get vaccinated if you have allergies that are not related to vaccines or injectable medications such as food, pet, venom, environmental, or latex allergies. People with a history of allergies to medications taken by mouth or a family history of severe allergic reactions can also get vaccinated.

At the Vaccination Site

• You should receive a paper or electronic version of a fact sheet that tells you more about the COVID-19 vaccine you or your child received. Each approved and authorized COVID-19 vaccine has its own fact sheet that contains information to help you understand the risks and benefits of that vaccine.
• There is no charge for your COVID-19 vaccine. Your COVID-19 vaccine is free. COVID-19 vaccines are paid for with taxpayer dollars and are given free of charge to all people living in the United States, regardless of health insurance or immigration status. If anyone asks you to pay for a COVID-19 vaccine, it’s a scam.

After Getting a COVID-19 Vaccine

• Stay on site to be monitored for at least 15 minutes.
• Make sure your vaccination provider updates your vaccination card (or gives you one if this is your first dose).
• Stay up to date with the recommended COVID-19 vaccines and boosters.
• You may experience side effects after getting a COVID-19 vaccine.
• Adverse effects (serious safety problems) and severe allergic reactions are rare.
• To report any side effects, you can sign up for v-safe. V-safe is a smartphone-based tool that provides quick and confidential health check-ins via text messages and web surveys so you can quickly and easily share with CDC how you or your dependent feel after getting a COVID-19 vaccine.

Watch Video: Use v-safe to tell CDC how you’re feeling after COVID-19 vaccination [00:00:34]

Your CDC COVID-19 Vaccination Card

Keep your CDC COVID-19 vaccination card for proof of vaccination. Consider taking a picture of your card after each of your COVID-19 vaccination appointments as a backup copy.

• Bring your card to your appointment whenever you get a primary series dose or booster so that your provider can fill in information about your shot.
• If your vaccine card is full, your vaccine provider can give you another card.
• If you did not receive a CDC COVID-19 vaccination card at your first appointment, contact the vaccination provider site where you got your first shot to find out how you can get a vaccination card. You can also contact your state health department to get a copy of your vaccination record.
• Some vaccination providers and health departments may offer you access to a QR code or digital copy of your COVID-19 vaccination card in addition to giving you a physical CDC COVID-19 vaccination card. Contact your vaccination provider or local health department to learn if a digital copy of your card is available to you.
• If you were vaccinated abroad there are ways you can update your U.S. vaccination record.
• To report suspicious activity involving fake CDC COVID-19 vaccination cards, please visit Fraud Alert: COVID-19 Scams or call 1-800-HHS-TIPS.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect.html.

What You Need To Know

• In addition to following the recommended COVID-19 vaccination schedule, tixagevimab/cilgavimab (Evusheld), a combination of two monoclonal antibodies, should be administered to people who are moderately or severely immunocompromised every 6 months for pre-exposure prophylaxis to supplement vaccine protection. Per the product EUA, Evusheld can be given at least 2 weeks after COVID-19 vaccine. People may initiate Evusheld at any time after this interval, including between doses in the primary series and between any primary and booster doses.
• This medication can provide protection for those not expected to mount an adequate immune response following vaccination, including those who are immunocompromised due to a medical condition or immunosuppressive medication, or for those individuals for whom COVID-19 vaccination is not recommended due to a history of severe adverse reaction to COVID-19 vaccination.
• Evusheld is administered by intramuscular injection by a healthcare provider at an office or healthcare facility.
• Current locations of EVUSHELD distribution can be found here.

The current treatment guidelines [5.4 MB, 456 pages] on the use of Evusheld as pre-exposure prophylaxis:

• Tixagevimab 300 mg plus cilgavimab 300 mg (Evusheld) administered as two 3-mL intramuscular (IM) injections for adults and adolescents (aged ≥12 years and weighing ≥40 kg) who do not have SARS-CoV-2 infection, who have not been recently exposed to an individual with SARS-CoV-2 infection AND who:
  • Are moderately to severely immunocompromised or
  • Are not able to be fully vaccinated with any available COVID-19 vaccines due to history of severe adverse reactions
• Tixagevimab plus cilgavimab should be repeated every 6 months.
• Individuals who received tixagevimab 150 mg plus cilgavimab 150 mg should be given a second dose as soon as possible.
  • If the initial dose was administered ≤3 months prior, the second dose should be tixagevimab 150 mg plus cilgavimab 150 mg.
  • If the initial dose was administered >3 months prior, the second dose should be tixagevimab 300 mg plus cilgavimab 300 mg.
• Individuals should be clinically monitored after injections and observed for at least 1 hour.
• Evusheld is contraindicated in individuals with previous severe hypersensitivity reactions, including anaphylaxis, to Evusheld.
• There is not currently sufficient evidence to recommend either for or against the use of SARS-CoV-2 serologic testing to assess for immunity or guide clinical decisions about using Evusheld for pre-exposure prophylaxis. For more information, see NIH’s COVID-19 Treatment Guidelines.

Evusheld and timing with COVID-19 vaccination

• Evusheld may be given at least 2 weeks after any COVID-19 vaccine.
• After this interval, Evusheld may be initiated at any time between primary series and booster doses.
• COVID-19 vaccines may be administered at any time after Evusheld administration.
• Use of monoclonal antibodies is not a substitute for COVID-19 vaccination.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/pre-exposure-prophylaxis.html.

• Updated guidance reflects new recommendations for isolation and precautions for people with COVID-19.
• Removed Assessment for Duration of Isolation and Key Findings From Transmission Literature sections so page provides most current information.

Key Points

• People who are infected but asymptomatic or people with mild COVID-19 should isolate through at least day 5 (day 0 is the day symptoms appeared or the date the specimen was collected for the positive test for people who are asymptomatic). They should wear a mask through day 10. A test-based strategy may be used to remove a mask sooner.
• People with moderate or severe COVID-19 should isolate through at least day 10. Those with severe COVID-19 may remain infectious beyond 10 days and may need to extend isolation for up to 20 days.
• People who are moderately or severely immunocompromised should isolate through at least day 20. Use of serial testing and consultation with an infectious disease specialist is recommended in these patients prior to ending isolation.

Recommendation for Ending Isolation

For people who are mildly ill with SARS-COV-2 infection and not moderately or severely immunocompromised:

• Isolation can be discontinued at least 5 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter) if fever has resolved for at least 24 hours (without taking fever-reducing medications) and other symptoms are improving.
• Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​.
• A high-quality mask should be worn around others at home and in public through day 10. A test-based strategy may be used to remove a mask sooner.
• If symptoms recur or worsen, the isolation period should restart at day 0.
• People who cannot wear a mask, including children < 2 years of age and people of any age with certain disabilities, should isolate for 10 days.
• In certain high-risk congregate settings that have high risk of secondary transmission, CDC recommends a 10-day isolation period for residents.

For people who test positive, are asymptomatic (never develop symptoms) and not moderately or severely immunocompromised:

• Isolation can be discontinued at least 5 days after the first positive viral test (day 0 is the date the specimen was collected for the positive test, and day 1 is the next full day thereafter).
• A high-quality mask should be worn around others at home and in public through day 10. A test-based strategy may be used to remove a mask sooner.
• If a person develops symptoms within 10 days of testing positive, their 5-day isolation period should start over (day 0 changes to the first day of symptoms).
• People who cannot wear a mask, including children < 2 years of age and people of any age with certain disabilities, should isolate for 10 days.
• In certain high-risk congregate settings that have high risk of secondary transmission, CDC recommends a 10-day isolation period for residents.

For people who are moderately ill and not moderately or severely immunocompromised:

• Isolation and precautions can be discontinued 10 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter).

For people who are severely ill and not moderately or severely immunocompromised:

• Isolation should continue for at least 10 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter).
• Some people with severe illness (e.g., requiring hospitalization, intensive care, or ventilation support) may remain infectious beyond 10 days. This may warrant extending the duration of isolation and precautions for up to 20 days after symptom onset (with day 0 being the day symptoms appeared) and after resolution of fever for at least 24 hours (without the taking fever-reducing medications) and improvement of other symptoms.
• Serial testing prior to ending isolation can be considered in consultation with infectious disease experts.

For people who are moderately or severely immunocompromised (regardless of COVID-19 symptoms or severity):

• Moderately or severely immunocompromised patients may remain infectious beyond 20 days. For these people, CDC recommends an isolation period of at least 20 days, and ending isolation in conjunction with serial testing and consultation with an infectious disease specialist to determine the appropriate duration of isolation and precautions.
• The criteria for serial testing to end isolation are:
  • Results are negative from at least two consecutive respiratory specimens collected ≥ 24 hours apart (total of two negative specimens) tested using an antigen test or nucleic acid amplification test.
  • Also, if a moderately or severely immunocompromised patient with COVID-19 was symptomatic, there should be resolution of fever for at least 24 hours (without the taking fever-reducing medication) and improvement of other symptoms. Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​.
  • Re-testing for SARS-CoV-2 infection is suggested if symptoms worsen or return after ending isolation and precautions.
• If a patient has persistently positive nucleic acid amplification tests beyond 30 days, additional testing could include molecular studies (e.g., genomic sequencing) or viral culture, in consultation with an infectious disease specialist.
• For the purposes of this guidance, moderate to severely immunocompromising conditions include, but might not be limited to, those defined in the interim clinical considerations for people with moderate to severe immunocompromise due to a medical condition or receipt of immunosuppressive medications or treatments.
  • Other factors, such as end-stage renal disease, likely pose a lower degree of immunocompromise, and there might not be a need to follow the recommendations for those with moderate to severe immunocompromise.
  • Ultimately, the degree of immunocompromise for the patient is determined by the treating provider, and preventive actions should be tailored to each patient and situation.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html.

Boyd Nursing and Rehabilitation is pleased to share our newest success story of Ms. Helen Davis!

Ms. Davis came to Boyd Nursing for rehab in August following a recent hospital stay leaving her with mobility and self-care deficits.  Over the past month, Helen has cooperatively and diligently completed an individualized rehab program of strength and balance training, gait training, and self-care training to regain her functional independence to return home. We are pleased to announce that Helen has completed her rehabilitation stay and fulfilled her goal of returning home! She was welcomed home by her canine friend, Precious. Helen says “Therapy did me well. My hip no longer hurts and I am getting around good. I look forward to taking walks with my dog again but I will miss walking around the courtyard at Boyd looking at the flowers and watching the turtles.” Ms. Davis, we here at Boyd Nursing are happy to have been part of your successful recovery and glad to see you reunited with your dog Precious. We wish you the very best!  

Effective September 1^st, 2022, CDC Director Rochelle P. Walensky, M.D., M.P.H., endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendations for use of updated COVID-19 boosters from Pfizer-BioNTech for people ages 12 years and older and from Moderna for people ages 18 years and older.

Updated COVID-19 boosters add Omicron BA.4 and BA.5 spike protein components to the current vaccine composition, helping to restore protection that has waned since previous vaccination by targeting variants that are more transmissible and immune-evading.

In the coming weeks, CDC also expects to recommend updated COVID-19 boosters for other pediatric groups, per the discussion and evaluation of the data by ACIP on Sept. 1, 2022. When data are available and FDA authorizes these other types of COVID-19 boosters, CDC will quickly move to help make them available in the United States.

The Food and Drug Administration’s (FDA) authorization of updated COVID-19 boosters, and CDC’s recommendation for use, are critical next steps forward in our country’s vaccination program—a program that has helped provide increased protection against COVID-19 disease and death.

The following is attributable to Dr. Walensky:

“The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant. They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants. This recommendation followed a comprehensive scientific evaluation and robust scientific discussion. If you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.”

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

To learn more, please visit https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html

General Information

Manufacturer: Novavax, Inc.

Number of Shots: 2 doses in the primary series, given 3–8 weeks apart.

People who are moderately or severely immunocompromised should also receive 2 doses, given 3 weeks apart (a 3rd primary dose is not currently authorized).

Booster Shot:  Novavax COVID-19 vaccine is not authorized for use as a booster dose.

Type of Vaccine: Protein subunit

How Given: Shot in the muscle of the upper arm

Does NOT Contain: Eggs, preservatives, latex, metals
See full list of ingredients

Name: NVX-CoV2373

Safety Data Summary

• COVID-19 vaccines have undergone—and continue to undergo—the most intensive safety monitoring in U.S. history. Side effects that happen within 7 days of getting vaccinated are common but are mostly mild and only last a few days. Some people have reactions that affect their ability to do daily activities.
• Side effects throughout the body (such as fever, chills, tiredness, and headache) are more common after the second dose of the vaccine.
• Severe allergic reactions to vaccines are rare but can happen. Cases of myocarditis and pericarditis have been reported in people who received Novavax COVID-19 vaccine.

Learn more about vaccine safety monitoring after a vaccine is authorized or approved for use.

How Well the Vaccine Works

• Vaccines reduce the risk of COVID-19, including the risk of severe illness and death among people who are fully vaccinated.
• COVID-19 vaccines are effective. Clinical trials demonstrate that Novavax COVID-19 reduces the risk of COVID-19, including the risk of severe illness and death. However, studies from other COVID-19 vaccines have shown that protection declines over time especially with the Omicron variant.
• All FDA-approved or authorized COVID-19 vaccines provide substantial protection against COVID-19 hospitalization and death.
• CDC will continue to provide updates as we learn more.

Learn about Novavax’s clinical trial information for people 18 years and older.

Novavax COVID-19 Vaccine Ingredients

COVID-19 vaccine ingredients are considered safe for most people. Nearly all of the ingredients in COVID-19 vaccines are ingredients found in many foods—fats, sugar, and salts. The Novavax COVID-19 vaccine also includes harmless pieces (proteins) of the virus that causes COVID-19; they are pieces of what is often called the spike protein.  After vaccination, the body creates an immune response to these protein pieces. This response helps protect you from getting sick with COVID-19 in the future. After the body produces an immune response, it discards all the vaccine ingredients, just as it would discard any substance that cells no longer need. This process is a part of normal body functioning.

All COVID-19 vaccines are manufactured with as few ingredients as possible and with very small amounts of each ingredient. Each ingredient in the vaccine serves a specific purpose as seen in the table below.

Type of Ingredient	Ingredient	Purpose
Protein	SARS-CoV-2 recombinant spike protein	Causes an immune response that helps protect the body from getting sick with COVID-19 in the future.
Lipids (fats)	Cholesterol Phosphatidylcholine	Work together to help the recombinant spike protein enter cells
Adjuvant	Fraction-A and Fraction-C of Quillaja saponaria Molina extract.	Facilitates activation of the cells of the innate immune system.
Salts, sugar, and acid	Disodium hydrogen phosphate heptahydrate Disodium hydrogen phosphate dihydrate Polysorbate-80 Potassium chloride (common food salt) Potassium dihydrogen phosphate (common food salt) Sodium chloride (basic table salt) Sodium dihydrogen phosphate monohydrate Sodium hydroxide or hydrochloric acid Water	Work together to help keep the vaccine molecules stable while the vaccine is manufactured, shipped, and stored until it is ready to be given to a vaccine recipient.

The vaccine may also contain very small amounts of ingredients from the manufacturing stage, which can be found in the EUA Fact Sheet.

Ingredients That Are NOT Used in COVID-19 Vaccines

The above table lists ALL ingredients in the Novavax COVID-19 vaccine. There are NO ingredients in this vaccine beyond what is listed in the table. The Novavax COVID-19 vaccine has:

• No preservatives such as thimerosal or mercury or any other preservatives.
• No antibiotics such as sulfonamide or any other antibiotics.
• No medicines or therapeutics such as ivermectin or any other medications.
• No tissues such as aborted fetal cells, gelatin, or any materials from any animal.
• No food proteins such as eggs or egg products, gluten, peanuts, tree nuts, nut products, or any nut byproducts (COVID-19 vaccines are not manufactured in facilities that produce food products).
• No metals such as iron, nickel, cobalt, titanium, rare earth alloys, or any manufactured products like microelectronics, electrodes, carbon nanotubes or other nanostructures, or nanowire semiconductors.
• No latex. The vial stoppers used to hold the vaccine also do not contain latex.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/novavax.html.