Vaccine Administration: Ages 5 and older now eligible
All individuals ages 5 and older are now eligible for vaccination. The Moderna, Pfizer, and Johnson & Johnson vaccines are available for those ages 18 and older. Only the Pfizer vaccine is available to those ages 12 to 17. A pediatric dosage of the Pfizer vaccine is available to those ages 5 to 11.
Find information about vaccinating youth and adolescents here.
Three vaccines are now available to prevent COVID-19 disease in the United States:
- Pfizer-BioNTech COVID-19 Vaccine
- Moderna COVID-19 Vaccine
- Johnson & Johnson’s Janssen COVID-19 Vaccine
The pediatric dose of the Pfizer vaccine is one third the dose available to people 12 and older. It is a 2-dose series, administered at least 3 weeks apart. It will arrive in a 10-dose vial with an orange cap and an orange border on the label and must be diluted before use.
See interim clinical considerations for use of mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna) currently authorized in the US from the CDC for administration, patient counseling, and other details.
Vaccine Clinics This Week
Third dose of Pfizer/Moderna for immunocompromised individuals
On August 12, the U.S. Food and Drug Administration (FDA) amended its emergency use authorizations (EUAs) for Pfizer and Moderna COVID-19 vaccines to allow an additional (third) dose for certain immunocompromised people including those who have:
- Been receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress immune response
Call and recall patients determined to be immunocompromised who received Pfizer or Moderna vaccine and offer an additional (third) dose of COVID-19 vaccine. Offer the same vaccine product (i.e., Pfizer or Moderna) the person originally received.
The primary series for Johnson & Johnson/Janssen (J&J) COVID-19 vaccine remains one dose; however, people who received a J&J dose should get a booster dose two months after.
People who received an additional primary shot (third dose) may also receive a booster dose five months after that shot.
Encouraging Vaccination and Talking with Patients
On July 27, the Centers for Disease Control and Prevention (CDC) issued a health advisory declaring an urgent need to increase the percentage of the population fully vaccinated against COVID-19. Promote the COVID-19 vaccines and vaccinate everyone 12 years or older, including those who are pregnant, lactating or who may become pregnant.
For information about the role of healthcare providers in encouraging vaccination and tips on how to have conversations with patients, the following resources may be helpful to you:
- How Health Care Providers Can Promote COVID-19 Vaccination
- Fostering COVID-19 Vaccine Confidence in Russian- and Ukrainian-Speaking Communities
- Vaccine Confidence Discussion Guide
- Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Health Information Environment
Vaccine timing and completion
- Restarting the series: Currently, there is no recommendation to restart either the Pfizer or Moderna vaccine series due to time between the first and second doses. While we know the second dose is most effective given 21 or 28 days after the first dose, there is no need to restart the series if the second dose is given later than that. If a patient comes in overdue for their second dose, you only need to administer the second dose to complete the series.
- Updated standing orders: The Centers for Disease Control and Prevention (CDC) will be revising standing orders for the Johnson & Johnson vaccine to include additional screening for Guillain-Barré syndrome recommended during their July 8, 2021, update to the Emergency Use Authorization Fact Sheets.
This follows the previous revisions informing people of the increased risk of thrombosis with thrombocytopenia syndrome (TTS). Following a thorough safety review weighing the benefits and risks, the Advisory Committee on Immunization Practices (ACIP) voted to recommend the ongoing use of Johnson & Johnson vaccine under a revised emergency use authorization (EUA). ACIP recommended the Food and Drug Administration (FDA) include a warning statement and Johnson & Johnson include an information sheet at vaccination informing people about the increased risk of thrombosis with thrombocytopenia syndrome (TTS).
Discard any Johnson & Johnson EUA Fact Sheets you have on hand and use the new fact sheets.
If a patient is concerned about the increased risk associated with J&J vaccine, offer Moderna or Pfizer vaccine.
Following the issuance of an emergency order from the Washington State Office of the Insurance Commissioner, healthcare providers can now bill insurance for vaccine consults with patients, even if the patient does not get vaccinated at that visit.
Patients should not pay out-of-pocket costs to get COVID-19 vaccine. Enrolled providers must give the vaccine regardless of a patient’s ability to pay. Providers may bill a patient’s health plan or program. Providers may not bill the patient for the balance. For details, see CDC’s information on filing claims for reimbursement.
Pfizer and Johnson & Johnson Vaccine Storage Updates
The FDA updated its Pfizer-BioNTech COVID-19 vaccine storage guidelines. The vaccine may be kept at standard frozen temperatures, including:
- Storing undiluted Pfizer vaccine vials at -25°C to -15°C for up to 2 weeks.
- Transport undiluted Pfizer vaccine vials at -25°C to -15°C.
- Continue to thaw and store Pfizer vaccine in the refrigerator (2°C to 8°C) for up to 5 days.
View the updated fact sheet.
The pediatric formulation can be stored for 6 months in an ultra-low temperature freezer (-90 deg C to -60 deg C) and 10 weeks in the refrigerator (2 deg C to 8 deg C).
The FDA has extended the shelf life of Johnson & Johnson (Janssen) (J&J) COVID-19 vaccine from 4½ months to 6 months when the vaccine has been refrigerated at temperatures of 36° to 46° Fahrenheit (2° to 8° Celsius). Visit the J&J lot expiry checker to determine the updated expiration of your vaccine.
The FDA has also extended the shelf life of Pfizer-BioNTech COVID-19 vaccine an additional 3 months on vials dated after July 2021 as long as authorized storage conditions (-90°C to -60°C or ‑130°F to -76°F) have been maintained. Frozen vials stored at -25°C to -15°C and refrigerated vials (2°C to 8°C) are not eligible for extension. Visit CDC’s Pfizer-BioNTech COVID-19 vaccine page for additional information.
Enrollment is Still Open
Provider enrollment for COVID-19 vaccine is still open. If you would like to give COVID-19 vaccine, enroll through Washington State Department of Health (DOH) now.
Helpful Resources for Offices Administering Vaccine
· Pre-vaccination checklist for COVID-19 vaccines:
. V-Safe Infographic:
Additional Information for Providers
Centers for Disease Control and Prevention’s (CDC’s) COVID-19 Vaccine Training Module offers a general overview of immunization best practices for healthcare providers.
The DOH COVID-19 vaccine provider toolkit has many helpful resources.