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After Pfizer BioNTech COVID vaccine was released for usage, it was identified that after the appropriate dilution is completed, there may at times be a 6th dose available for use. The Food and Drug Administration has updated their guidance to allow for the 6th dose to be utilized when available. More information can be found via this link: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine
Given the public health emergency, it is acceptable to use every fully obtainable sixth dose from each vial as long as the correct dilution concentration is maintained in the vial. Since these are preservative free vials, any further remaining liquid that does not constitute a full dose should not be pooled from multiple vials to create one. More information about vaccine preparation and dilution can be found via this link: https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/downloads/diluent-poster.pdf.
Key IIS/Technical guidance: For providers that are administering extra doses, the additional doses will result in increased decrementing of doses. As a result, providers are required to reconcile their inventory directly in the WAIIS. Instructions on how to complete this process are detailed in this PDF: Extra Dose Reconciliation. In addition, please refer to the FAQ below for the answers to the most common questions.
FAQ
Q: Why is my physical inventory in the negatives?
A: Whenever an extra dose is administered, it will result in additional decrementing of doses. For instance, 3 vials of Pfizer vaccine should allow for 15 doses. If an organization was able to instead administer 18 doses from 3 vials, the physical inventory will be reported as -3 in the WAIIS. However, this can be corrected in the IIS.
Q: Can I adjust this in my EHR or through VaccineFinder?
A: No. You can only reconcile the difference in WAIIS. Currently, users within your organization are inputting “Received Inventory” into the WAIIS. These same personnel can adjust inventory as well. If they do not have access, please contact us.
Q: How do I reconcile my inventory to account for extra doses?
A: We provided step-by-step instructions and they are detailed here: Extra Dose Reconciliation.
Q: Is there a system to track the extra doses we administer?
A: We recommend that your organization internally tracks and accounts for extra doses to ensure the inventory numbers are accurate in the WAIIS.
Q: How often should I be reconciling my extra doses?
A: Please reconcile your doses on every Tuesday. We pull this data for reporting purposes. If you are directly inputting data into the WAIIS and not using an EHR to do so, you may have to reconcile more often. Once the inventory in the WAIIS hits zero, the user will not be able to fully input additional vaccination records into the WAIIS until the inventory is reconciled.
Q: Who can I contact if I have more questions?
A: Please email COVID.Vaccine@doh.wa.gov
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