Important--Guidance Regarding COVID-19 Vaccine Administration Errors

Good Afternoon Immunization Partners,

Recently we have received some phone calls and messages regarding questions on restarting the COVID-19 vaccine series or giving extra doses of COVID-19 vaccine. It is important that whenever you are trying to determine the next step when a vaccine questions arises that you use your available resources.

CDC has developed guidance on preventing and reporting COVID-19 vaccine administration errors. Vaccine Administration errors are preventable events, and the focus of CDC’s guidance is to prevent errors. Whenever you are questioning what to do next pull out the resource COVID-19 Vaccine Administration Errors and Deviations CDC or review the Interim Clinical Consideration for Use of COVID-19 Vaccines Currently Authorized in the United States.

Information regarding the recent question about restarting a COVID-19 vaccination series due to the interval date passing can be found within CDC’s resources. CDC’s guidance on intervals between mRNA doses states that the second dose of Pfizer-BioNTech and Moderna vaccines should be administered as close to the recommended interval as possible, but not earlier than recommended (i.e., for Pfizer-BioNTech it is 3 weeks or for Moderna it is 1 month). If it is not feasible to adhere to the recommended interval and a delay in vaccination is unavoidable, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be administered up to 6 weeks (42 days) after the first dose. However, there is limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window. If the delay is longer than 6 weeks you never need to restart the series due to a delay in the second dose. If a patient does not come back on time for the second dose of an mRNA COVID-19 vaccine you simply administer the second dose to complete the series.

Another great resource to help address COVID-19 vaccine questions is the Immunization Action Coalition Ask the Experts COVID-19. Below is a chart that can be found within the Interim Clinical Consideration for Use of COVID-19 Vaccines Currently Authorized in the United States from the CDC. The full chart has a great deal of valuable information and we highly recommend you review the chart and all the resources that we are sharing in this email.

 

Vaccines	Type	Administration error/deviation	Interim recommendation
mRNA vaccines only (Pfizer-BioNTech and Moderna)	Intervals	Second dose administered fewer than 17 days (Pfizer-BioNTech) or fewer than 24 days (Moderna) after the first dose (i.e., administered earlier than the 4-day grace period)	Do not repeat dose.
		Second dose administered more than 42 days after the first dose	Do not repeat dose. This deviation from CDC guidance does not require VAERS reporting.

 

 Please use these great resources to help with any questions you have regarding vaccine administration and to help prevent vaccine administration errors. If you have any questions regarding vaccine administration, you may always reach out to us at CHECCimms@michigan.gov.

Thank you for all your hard work to protect Michiganders from vaccine-preventable diseases!

-The Immunization Nurse Education Team, Andrea, Heidi, Maria, and Terri

 

Please direct Coronavirus (COVID-19) related inquiries to the DHHS COVID-19 hotline at 1-888-535-6136.  For the most up-to-date information, facts and FAQs, go to www.michigan.gov/Coronavirus.