COVID-19 Vaccine Provider Weekly Updates

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COVID-19 Vaccine Provider Weekly Updates

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Minnesota Department of Health

September 22, 2022


Moderna bivalent booster available in MIIC

The Moderna bivalent booster, authorized for people age 18 and older, is now available for ordering again in MIIC. If you have already placed orders that have not been fulfilled, please re-order at this time. The section below explains how this presentation is expected to be available for use in people age 6 years and older following emergency use authorization (EUA) and CDC recommendation.

Bivalent boosters for 5-11-year-olds

The Food and Drug Administration (FDA) is expected to authorize bivalent booster doses for children 5-11 years old in early October. The Advisory Committee on Immunization Practices (ACIP) is not expected to meet.

The Pfizer bivalent booster for 5-11-year-olds (orange cap) will be available for pre-order in MIIC. Vaccine is expected to ship when the EUA is published. Like the Pfizer bivalent vaccine for 12 years and older (gray cap), the bivalent vaccine for 5-11-year-olds (orange cap) label and vials look very similar to the original, monovalent vaccine. Make sure the products are separated to prevent administration errors.

It is anticipated that the current Moderna bivalent vaccine presentation already in use for 18 years and older will be authorized for use in people age 6-17 years old. The dose for 6-11-year-olds will be 0.25 mL, and 0.5 mL for those 12 years and older. The Moderna bivalent booster vaccine is already available for ordering in MIIC but should only be used in those 18 years and older until the EUA is updated.

Pre-ordering event in MIIC

  • The pre-order event for Pfizer bivalent vaccine boosters for 5-11-year-olds will open in MIIC on Friday, Sept. 23. It will remain open until Friday, Sept. 30 at 4:30 p.m.
  • Moderna bivalent vaccine boosters are now available for ordering in MIIC. After the EUA is updated to authorize the use of the vaccine in the 6–17-year-olds, providers will have the option to order this vaccine presentation in MIIC with pediatric ancillary kits that contain more syringes for the smaller dose for 6-11-year-olds.
  • Delivery is expected after the EUA is published. Depending on when the EUA is complete, vaccines may be delivered as early as the first week of October. We will share updates on confirmed delivery dates.
  • We encourage sites to plan for a pause in 5–11-year-old monovalent booster vaccinations after the EUA is issued until sites can operationalize the bivalent boosters for the 5-11 age group.

Considerations for pre-orders

  • The bivalent vaccine is for boosters only after a complete primary series of the monovalent vaccine.
  • Do not over-order during this pre-order opportunity. There will be more opportunities to order vaccine.
  • Consider ordering a small amount to have on hand for the first two weeks after the recommendation, then assess your practice's demand and order more. Order fewer doses if you will not begin vaccinating until the second week.
  • Pre-orders cannot be modified once we have submitted them to CDC.
  • You must be enrolled in the COVID-19 vaccine program to order COVID-19 vaccine. For details on how to enroll, refer to COVID-19 Vaccine Provider Registration.
  • Pfizer 5–11-year-old bivalent booster vaccine (orange cap) storage and handling:
    • Ultra-cold freezer storage until expiration date.
    • No regular freezer storage.
    • Refrigeration storage up to 10 weeks before puncturing vial.
    • 100 dose minimum order, 10 multi-dose vials of 10 doses.
    • Still comes with diluent and ancillary kits.
  • Moderna bivalent booster vaccine storage and handling:
    • No ultra-cold freezer storage.
    • Regular freezer storage until expiry.
    • Refrigeration storage up to 30 days without puncturing.
    • 10 MDVs of 10 doses - 100 dose minimum request.
    • Adolescents ages 12-17 years: same volume and dosage as for adults age 18+.
    • Children ages 6-11: receive half the volume and dosage as for adults age 18+ but can be drawn from the same vial.
    • This presentation is currently available for ordering with adult ancillary kits only, sites will be able to order this vaccine with pediatric ancillary kits following EUA.
    • This vaccine should not be given to anyone under the age of 18 years until after EUA and CDC recommendation. Please stay tuned for when this is announced.

Please contact with questions.

Invalidated shots in MIIC

There are several reasons besides inappropriate age or interval that a dose may be “NOT VALID” on a client’s MIIC record. Doses administered from vaccine lots associated with storage and handling issues, recalled vaccine, or expired lots can lead to sub-optimal immune responses and require the person to be revaccinated. As with other “NOT VALID” doses in a person’s immunization history, the MIIC forecaster will not count these doses towards the recommended vaccination schedule which may also impact doses received after the not valid vaccine. The picture below depicts an invalid dose of COVID-19 vaccine in MIIC and the recommended schedule for a client. Please contact the MIIC helpdesk with questions:

An invalid dose of COVID-19 vaccine in MIIC and the recommended schedule for a client

COVID-19 revaccination for invalid doses

Providers that encounter a situation where a patient’s MIIC record indicates that a COVID-19 dose is “NOT VALID” should assess whether the person has completed their COVID-19 primary series. If a person does not have a completed primary series or if their primary series was invalidated due to a “NOT VALID” dose, the client usually needs an additional monovalent vaccine dose for their vaccine record to show a valid primary series. Having a valid primary series that uses the original vaccine products produces foundational immunity that cannot be gained from the bivalent product and provides a broader range of immune response.

Before administering any COVID-19 vaccine, it is important to assess every client’s immunization history in MIIC.

Does the client have a valid primary series?

  • No: Finish their primary series by administering a monovalent COVID-19 vaccine.
  • Yes: Has it been at least two months since the most recent dose?
    • Yes: Administer a bivalent or age-appropriate* booster if they haven't received it.
    • No: Wait to give the bivalent until at least 2 months after primary series completion.

*People 5-11 years of age are indicated to receive a monovalent booster at this time.

If you have questions regarding a person’s COVID-19 immunization history or revaccination, please email

Share Your Story: Why I Got the COVID-19 Vaccine

There are a lot of reasons to get a COVID-19 vaccine, and we want to hear from Minnesotans what some of those reasons are.

We’re asking people to share why they got themselves or their children vaccinated for COVID-19 to help encourage others to do the same. Maybe you recently got your updated bivalent booster to be better protected before seeing vulnerable family members for holidays in a couple of months. Maybe you wanted to make sure your children were protected for a new school year. Whatever your reason for getting vaccinated, we want to hear from you.

You can record a short video to submit to MDH and we will help share some of the reasons people are rolling up their sleeves.

Visit Share Your Story: Why I Got the COVID-19 Vaccine for more information and instructions for submitting a story.

Find previous bulletins at COVID-19 Vaccine Provider Updates.