Pfizer Booster Authorized for Use

The Centers for Disease Control and Prevention (CDC) made recommendations on Sept. 24^th authorizing the Pfizer COVID-19 vaccine booster for certain eligible populations. Their final recommendation includes eligible populations as well as workers in COVID-19 high risk group and work settings, overruling the CDC’s Advisory Committee on Immunization Practices (ACIP), which excluded workers in their recommendations. Eligible groups may receive the booster at least six months following completion of their primary Pfizer vaccine series and may receive it at any point after that time.

Eligible groups include the following:

People 65 years and older and residents in long term care settings should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least six months after their Pfizer-BioNTech primary series;
People aged 50-64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least six months after their Pfizer-BioNTech primary series;
People aged 18-49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least six months after their Pfizer-BioNTech primary series, based on their individual benefits and risks; and
People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least six months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

The CDC states that occupations at increased risk for COVID-19 exposure and transmission include frontline essential workers and health care workers as previously detailed by the CDC.* This includes:

First responders (health care workers, firefighters, police, congregate care staff)
Education staff (teachers, support staff, daycare workers)
Food and agriculture workers
Manufacturing workers
Corrections workers
U.S. Postal Service workers
Public transit workers
Grocery store workers

*List could be updated in the future

On Sept. 29^th, the State issued updated vaccination guidance authorizing immediate use of the Pfizer booster. Eligibility includes those age 65+ and those residing in long term care settings, which the State guidance defines as nursing homes, assisted living facilities, residential care communities, group homes, and senior housing. The State also issued an updated Vaccination Screening Checklist last week. Members should carefully review this document, as it includes updated consultation and timing considerations for individuals who have received monoclonal antibody therapies, convalescent plasma, or have various medical conditions, allergic reactions, or other conditions. The Department of Health has also issued an updated Screening and Consent Form for primary and booster vaccinations.

On Sept. 28^th, DOH issued Dear Administrator Letters (DALs) to both nursing homes and adult care facilities (ACFs) to ensure that clinical and pharmacy partnerships or capabilities are in place to facilitate both primary and booster doses for residents and staff. More on the DALs is available here.

At this time, the Pfizer booster may only be administered to individuals who have received the Pfizer primary two-dose vaccine regimen. Individuals who have received the Johnson & Johnson or Moderna vaccine must wait for Food and Drug Administration (FDA) and CDC approval and recommendation of those particular boosters. Reporting indicates that approvals may only be a few weeks away. The CDC’s position on the issue of interchangeability of COVID-19 vaccine brands is outlined here. Members who are organizing vaccine clinics should take caution to identify primary vaccine series for residents and staff when considering additional doses for booster doses for those recommended above.

While many members may already have partnerships established with their long term care pharmacies for COVID-19 vaccination (primary and boosters), Western New York members should note that Wegmans Pharmacy has communicated their interest and availability for on-site Pfizer COVID-19 vaccine booster clinics in Erie, Niagara, and Chautauqua counties at independent, assisted, and skilled nursing facilities. Their team can bill vaccinations electronically while on-site to Medicare Parts B and D (no copay), the federal plan for uninsured patients (no copay), or they can bill the facility directly. In addition, they can bill all commercial insurance plans for employee booster vaccinations. Wegmans does not charge the facility any staffing or clinic fees. Wegmans is one of the largest providers of employer and senior living flu clinics in Western New York, and references are available. Members can contact Jon Paeplow from Wegmans for more details at Jonathan.Paeplow@wegmans.com or 716-254-1083. Other retail pharmacy contacts are listed below in the CDC’s resource for retail pharmacy partners.

The CDC will be holding a Clinician Outreach and Communication Activity (COCA) Call on Tues., Sept. 28^th from 2 to 3 p.m. entitled What Clinicians Need to Know About the Latest CDC Recommendations for Pfizer-BioNTech COVID-19 Booster Vaccination. Clinicians will learn about the vaccine booster recommendations, safety of booster doses, and clinical guidance for using the Pfizer-BioNTech COVID-19 booster vaccine. A recording will be made available. To learn more and register, click here.

Additional resource documents from the CDC to assist with access to COVID-19 vaccine primary series and boosters are available below:

The Centers for Medicare and Medicaid Services (CMS) will cover the cost of boosters for eligible consumers. CMS will continue to cover COVID-19 immunizations, including boosters, for eligible consumers, with no cost sharing, according to a press release issued last week. Those with Medicare pay nothing for the vaccine or its administration, and there is no applicable copayment, coinsurance, or deductible. Nearly all Medicaid and Children's Health Insurance Program (CHIP) beneficiaries will also not have any cost sharing obligations. CMS will also reimburse all Medicare providers for administration of the booster vaccine.

In addition, the State issued guidance in the NYS Medicaid Update providing for Medicaid reimbursement for administration of the Pfizer booster.

Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342