Don’t Let Your Guard Down for COVID-19 Vaccine Errors

Changes from CDC and FDA will aim to streamline COVID-19 vaccine schedules and products.

All mRNA COVID-19 vaccines (Moderna, Pfizer-BioNTech) you dispense should now be BIvalent...since the MONOvalent versions are no longer authorized. And the Janssen (Johnson & Johnson) COVID-19 vaccine is no longer available.

Double-check fridges and freezers for these products...and follow policies for proper disposal. Also remove shelf tags or other items labeled “mRNA monovalent”, “Janssen”, or “J&J”...to limit confusion.

Continue to ask about immunizations when documenting med histories, to help clinicians determine how many bivalent mRNA COVID-19 vaccines should be administered...and when.

For now, patients 6 years and older need ONE dose of a bivalent COVID-19 vaccine to be current with vaccination.

Plus a SECOND bivalent dose is now an option for patients age 65 and up if it’s been at least 4 months since their prior bivalent dose.

And some patients who are immunocompromised (organ transplant, etc) or kids under age 6 may need THREE or more doses. Follow CDC’s Interim COVID-19 Immunization Schedule.

Don’t let fewer COVID-19 vaccine options lead you to let your guard down for errors.

Verify that all labels for Moderna or Pfizer-BioNTech COVID-19 vials say “bivalent” before prepping or administering vaccine.

Continue to dilute the maroon- or orange-capped vials of bivalent Pfizer-BioNTech vaccine...but don’t dilute the gray-capped vials or either Moderna bivalent vaccine.

Stay tuned for changes. Experts will meet in June to discuss possible updates to COVID-19 vaccines based on circulating variants.

See our resource, COVID-19 Vaccines, for dosing, storage, etc.

And look into our PTU Elite: Immunizations program for training on administration.

Key References

  • https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html (5-31-23)
  • https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-changes-simplify-use-bivalent-mrna-covid-19-vaccines (5-31-23)
  • https://covid.cdc.gov/covid-data-tracker/#vaccine-effectiveness (5-31-23)
  • JAMA Netw Open. 2023 May 1;6(5):e2310650
Hospital Pharmacy Technician’s Letter. June 2023, No. 390606



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