DOH Issues Updated Vaccination Guidance

On July 1, 2022, the Department of Health (DOH) issued updated general COVID-19 vaccination guidance for providers that includes several updates, most of which relate to infants and children being eligible for the vaccine.

Also of interest, the Centers for Disease Control and Prevention (CDC) recently updated its COVID-19 Immunization Schedule, which provides a handy chart with all immunization schedules for all age populations, vaccination timing per brand, as well as specifics for immunocompromised individuals. The resource document also has a chart with vaccine product specifications, including packaging details, age indications, diluent, and dosage requirements.

The summary of updates includes the following:

Update as of June 18, 2022: Everyone aged six months and older in the U.S. should receive a COVID-19 primary series vaccination for the prevention of COVID-19. This New York State COVID-19 vaccination program provider guidance includes all age ranges accordingly.
On June 23, 2022, the CDC authorized the Moderna COVID-19 vaccine for use as a two-dose primary series in individuals aged 6 to 11 years and 12 to 17 years.
Currently, children aged 6 to 11 years and 12 to 17 years who receive a Moderna primary series separated by four to eight weeks are not authorized to receive a booster dose. Children aged 5 to 11 years and 12 to 17 years who receive a Pfizer primary series separated by three to eight weeks should receive one booster dose at least five months after the completion of the primary series.
Additionally, on June 23, 2022, the CDC updated the COVID-19 vaccine schedule for those eligible to receive a COVID-19 vaccine, by age, immunocompetency status, and vaccine product. A summarized immunization schedule for individuals 6 months of age and older can be found here.
There are special considerations for the immunocompetent population for an extended interval of up to eight weeks between dose one and two of the Pfizer or Moderna vaccine. An eight-week interval between the first and second doses of an mRNA COVID-19 vaccine primary series may be optimal for some people aged 6 months to 64 years, especially for males aged 12 to 39 years, as it might reduce the small risk of myocarditis/pericarditis associated with mRNA COVID-19 vaccines and might result in a better immune response. A shorter interval (three weeks for Pfizer-BioNTech, four weeks for Moderna) between the first and second doses remains the recommended interval for people who are moderately and severely immunocompromised; adults aged 65 years and older; and in situations where there is increased concern about COVID-19 community levels or an individual’s higher risk of severe disease.
In general, the same mRNA vaccine product should be utilized for all doses in the primary series. The CDC’s interim clinical considerations note that children aged 6 months to 4 years who inadvertently receive different mRNA products for the first two doses of an mRNA COVID-19 vaccine series should follow a three-dose schedule. A third dose of either mRNA vaccine should be administered at least eight weeks after the second dose to complete the three-dose primary series. This is considered a vaccination administration error and should be reported to the Vaccine Adverse Event Reporting System (VAERS).
Individuals should receive the recommended age-appropriate vaccine dosage based on their age on the day of vaccination. According to the CDC, if a child moves from a younger group to an older age group during the primary series or between primary series and receipt of a booster dose, they should receive the vaccine product and dosage for their older age group for all subsequent doses. However, Food and Drug Administration (FDA) authorization allows for different dosing for certain age transitions; more information regarding transitions from a younger to older group can be found here for the Pfizer-BioNTech COVID-19 vaccine and here for the Moderna COVID-19 vaccine.
New York State Wastage Guidance has been updated to reflect updated guidance.
Storage and Handling Guidance has been updated to reflect updated guidance inclusive of all age ranges.

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