Help Patients Get Up to Date With Bivalent COVID-19 Boosters

Please see the FDA announcement authorizing Moderna and Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose in Younger Age Groups.

 

You’ll hear lots of questions about updated COVID-19 boosters.

All boosters of Pfizer-BioNTech for patients age 12 and up and Moderna for 18 and up are now bivalent...with 2 mRNA components.

They’ll still cover the original SARS-CoV-2 virus...but also Omicron BA.4/BA.5, the variants currently circulating.

Offer a bivalent COVID-19 booster to all patients age 12 and up if they’ve completed the primary series...and it’s been at least 2 months since their last COVID-19 vaccine dose.

Keep in mind that the number of original monovalent boosters a patient’s had doesn’t affect whether to get an updated bivalent booster.

But UNvaccinated patients still need a PRIMARY series with the original vaccines first...before a bivalent booster.

For now, dispense just ONE bivalent booster...additional boosters aren’t recommended, even for immunocompromised patients.

Use whichever age-appropriate bivalent booster you have in stock.

Draw up 0.3 mL (30 mcg) for Pfizer-BioNTech or 0.5 mL (50 mcg) for Moderna bivalent boosters. Stay alert for errors. 

Encourage eligible patients at higher risk of severe COVID-19 (age over 65, immunocompromised, etc) to get an updated booster promptly.

And help catch patients up when dispensing flu or other routine immunizations (Tdap, etc)...these can be given at the same visit. If you vaccinate, give injections in different limbs...or at least 1 inch apart.

But it’s okay if a lower-risk patient prefers to wait 3 months after COVID-19 infection to get boosted...to try to stretch out immunity.

Refer questions about efficacy or safety of the updated COVID-19 boosters to your pharmacist.

Human data for COVID-19 vaccines with Omicron BA.1...and animal data with BA.4/BA.5...show a better immune response against Omicron versus another original monovalent booster.

And side effects are expected to be similar.

Point out that COVID-19 vaccines are no cost to patients until at least Jan 2023...including admin fees, if not covered by payers.

Use our resource, COVID-19 Vaccines , for specifics on storage, dosing, and more.


Key References

  • https://www.cdc.gov/vaccines/acip/meetings/slides-2022-09-01-02.html (9-22-22)
  • https://www.cdc.gov/vaccines/covid-19/downloads/summary-interim-clinical-considerations.pdf (9-22-22)
  • https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-moderna-pfizer-biontech-bivalent-covid-19-vaccines-use (9-22-22)
Pharmacy Technician's Letter. October 2022, No. 381001



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