Moderna Clarification on Bivalent Vaccine for Children Under Age 6 

The latest Moderna Emergency Use Authorization (EUA) changes and the new recommendations for the Moderna bivalent vaccine has resulted in two presentations of Moderna bivalent COVID-19 vaccine for children under six years old. Determining which presentation and dosage to use is based on the child’s vaccination history. 

• The dark blue cap vaccine presentation should be administered if the child six months through five years has never been vaccinated with any COVID-19 vaccine, has been previously vaccinated with one vaccine dose of a monovalent vaccine, or has previously been vaccinated with one dose of bivalent vaccine. 
• The pink cap vaccine vial presentation should be administered if the child six months through five years has been previously vaccinated with two doses of a monovalent vaccine. 

Note: The dark blue cap is the same product that has been in use. When orders are placed, DHS selects ancillary kits for the vaccine being ordered. On the ordering survey, the separation into age groups represents the intended use so DHS can determine if a pediatric or an adult ancillary kit is processed with the order. 

For more information, please view these resources: 

• Moderna COVID-19 Vaccine Bivalent Vaccine Vial Infographic 
• CDC: Administration of Moderna COVID-19 Vaccines 
• CDC: Use of COVID-19 Vaccines in the United States Interim Clinical Considerations 

Vaccine Hub Orders to End at Noon on May 16 

The four COVID-19 vaccine distribution hubs will close by the end of May. Vaccinators can continue to place COVID-19 vaccine hub orders until noon on Tuesday, May 16. After this time, COVID-19 vaccines will only be available via direct ship order or from the Wisconsin COVID-19 Vaccine Exchange. Beginning May 23, all vaccine will be direct ship. 

Vaccinators will continue to place orders for federally purchased vaccine by completing the COVID-19 Vaccine Ordering Survey. This is the same process that is used now to order COVID-19 vaccines and this process will continue to be used until commercialization.   

The final delivery date for vaccine hub orders will be: 

• Regions 1 and 4 Hubs (Mayo, Eau Claire) – Tuesday, May 23
• Regions 2, 3 and 6 Hubs (Prevea, Green Bay) – Wednesday, May 24
• Reg 5 Hub (SSM, Madison) – Tuesday, May 23
• Reg 7 Hub (MCW, Wauwatosa) – Tuesday, May 23 

After these dates, regional managers will no longer be available and all communications regarding orders should be done via email to DHSCOVIDVaccinator@wi.gov. Without regional managers, vaccinators will need to pay extra attention when placing vaccine orders as it will be unlikely that changes to orders can be made once they are placed.  

Vaccinators are encouraged to use the Wisconsin COVID-19 Vaccine Exchange to both list extra doses they do not need and to check first for doses they do need as smaller quantities may be available through this avenue. Like the vaccine ordering survey, the vaccine exchange will continue to be available until commercialization. 

DHS is receiving many reports of vaccinators that are refusing to accept delivery of ancillary kits. As a reminder, ancillary kits that accompany vaccine orders must be accepted by vaccinators. If kits continue to be refused, vaccinators can lose their ordering privileges per McKesson. 

Vaccinators that have excess ancillary kits can: 

• Use them to administer other vaccines 
• Seek out donation within the U.S.
• Shred/destroy excess vaccine cards 

Memorial Day Holiday Ordering and Delivery 

No orders will be delivered from Saturday, May 27 through Memorial Day on Monday, May 29, 2023. Only Pfizer will be delivered on Tuesday, May 30. 

Pfizer Vaccines 

• Orders placed by 8:00 a.m. CST on Thursday, May 25 will be delivered Tuesday, May 30. 
• If you would like to hold delivery for Friday, May 26, contact Pfizer by Tuesday, May 23, 8:00 p.m. CST at cvgovernment@pfizer.com. 
• If you would like to hold delivery for Tuesday, May 30, contact Pfizer by Wednesday, May 24, 8:00 p.m. CST at cvgovernment@pfizer.com. 

 Moderna and Novavax Vaccines  

• McKesson Specialty will not be processing orders over the holiday weekend or on Tuesday, May 30.
• If you have not already spoken with McKesson Specialty Customer Service and want to request a hold for your orders, please email COVIDVaccineSupport@McKesson.com or call 1-833-343-2703 by 11:00 a.m. CST on Wednesday, May 24. 

New and Updated Resources   

Updated Clinical Resources from CDC 

• The Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States have been updated to reflect changes that allow people who are moderately or severely immunocompromised to receive additional COVID-19 bivalent vaccine doses to help restore protection that may wane over time. 

Updated Communication and Education Resources from CDC 

• MMWR: Correlations and Timeliness of COVID-19 Surveillance Data Sources and Indicators ― United States, October 1, 2020–March 22, 2023 
• MMWR: COVID-19 Surveillance After Expiration of the Public Health Emergency Declaration ― United States, May 11, 2023 
• MMWR: Effectiveness of Monovalent mRNA COVID-19 Vaccination in Preventing COVID-19–Associated Invasive Mechanical Ventilation and Death Among Immunocompetent Adults During the Omicron Variant Period — IVY Network, 19 U.S. States, February 1, 2022–January 31, 2023 

DHS May 9 Vaccinator Webinar: Recording and Links Shared 

• Recording: https://vimeo.com/showcase/8511959 
• Medicare.gov Coronavirus disease 2019 (COVID-19) vaccine: https://www.medicare.gov/coverage/coronavirus-disease-2019-covid-19-vaccine 
• KFF Medicaid and the Inflation Reduction Act of 2022: https://www.kff.org/policy-watch/medicaid-and-the-inflation-reduction-act-of-2022/​ 
• Vaccines for Children Program vs. CDC COVID-19 Vaccination Program: https://www.cdc.gov/vaccines/covid-19/vfc-vs-covid19-vax-programs.html​ 
• HHS Bridge Access Program For COVID-19 Vaccines and Treatments: https://www.hhs.gov/about/news/2023/04/18/fact-sheet-hhs-announces-hhs-bridge-access-program-covid-19-vaccines-treatments-maintain-access-covid-19-care-uninsured.html#:~:text=Specifically%2C%20the%20Program%20will%20provide,at%20no%20cost%20for%20uninsured
• CDC Interim Clinical Considerations: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html​
• DHS COVID-19: Vaccinator Enrollment: https://www.dhs.wisconsin.gov/covid-19/vaccinator-enrollment.htm
• CDC COVID-19 vaccination guidance for people who are not moderately or severely immunocompromised: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#not-immunocompromised​
• Wisconsin COVID-19 Vaccine Exchange: https://app.smartsheet.com/b/publish?EQBCT=102895be169146c4b69c1a9115346878
• Moderna COVID-19 Vaccine: Storage and Handling Summary (cdc.gov): https://www.cdc.gov/vaccines/covid-19/info-by-product/moderna/storage.html​
• Administration of Moderna COVID-19 Vaccines | CDC: https://www.cdc.gov/vaccines/covid-19/info-by-product/moderna/administration.html​ 

In Case You Missed It 

V-Safe System Enrollments Ending Soon 

The Centers for Disease Control and Prevention (CDC) will bring new enrollment in their V-safe After Vaccination Health Checker (v-safe) to a close soon. CDC has noted that at this point in the program, very little new data are being reported.  

V-safe was developed specifically for COVID-19 vaccines and has been an essential component of pandemic vaccine safety monitoring systems that have successfully and comprehensively characterized the safety of the COVID-19 vaccines used in the United States.  

Please note the following important details for v-safe users:  

• After May 19, those who had enrolled and participated in v-safe for COVID-19 vaccines will be unable to add new COVID-19 vaccine doses to their account.     
• Health check-ins (and follow-up calls, if needed) for any doses added before May 19 will continue until June 30.   
• V-safe participants will continue to have access to their account to review previous entries and to complete remaining health check-ins until June 30.