On January 21, 2021, the Centers for Disease Control and Prevention updated their resource page for mRNA CoVID-19 vaccines. The updates are the interim recommendations from the Advisory Committee on Immunization Practices (ACIP) for the use of Pfizer-BioNTech and Moderna COVID-19 vaccines.
A Summary of the recent changes includes:
- Updated recommendations on intervals between the first and second dose
- Updated recommendations on interchangeability of vaccine products
- Updated language on vaccination of persons with a history of SARS-CoV-2 infection
- New vaccination recommendations in persons with a history of dermal fillers
- Additional resources on vaccine excipients (Appendix B)
An updated summary to the administration on intervals between the first and second dose includes:
- CDC continues to recommend that people get their second dose of COVID-19 vaccine as close to the recommended interval as possible (3 weeks for Pfizer-BioNTech, and one month for Moderna).
- CDC’s updated guidance was revised to allow for second dose administration up to 6 weeks (42 days) after the first if it is not feasible to adhere to the recommended interval. CDC is not advocating for people to delay getting their second dose, but the data from clinical trials support this range.
The CDC continues to recommend that the mRNA COVID-19 vaccines are not interchanged with each other or with other COVID-19 vaccine products, since the safety and efficacy of a mixed-product series has not been evaluated. In an exceptional situation when the first-dose vaccine product cannot be determined, any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the mRNA COVID-19 vaccination series.
The complete CDC updated resource page for mRNA COVID-19 vaccines can be accessed at: Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines | CDC.
Issue
The federal government has contracted with pharmacies to administer the mRNA COVID-19 vaccines in most nursing homes in the U.S. The pharmacists that are on-site for the administration of the vaccines should be knowledgeable and prepared to answer any questions that may arise regarding the vaccine. As leaders in nursing facilities, it is also our role to be knowledgeable in the administration of the mRNA COVID-19 to ensure the safety of the residents and staff.
Discussion
- Review policies and procedures related to the administration of the mRNA COVID-19 vaccines. Ensure that the most recent updates are included in your policies and revise if needed.
- Train all appropriate staff on your policies and procedures for administration of the mRNA COVID-19 vaccines. Document that these trainings occurred and file in each employee’s education file.
- Audit to ensure that all residents and staff were offered the vaccines, that either a verbal or written consent was obtained prior to the administration of the mRNA COVID-19 vaccine, and that spacing of administration complies with product guidelines.
