COVID-19 bivalent booster vaccines – important update

The recent availability of the Moderna Spikevax Bivalent Booster Vaccine has seen a rise in the number of vaccine-related calls and incident reports to PDL. With the availability of the Pfizer Comirnaty Bivalent Booster Vaccine imminent, the PDL Professional Officers would like to remind pharmacists of the need to review all vaccination procedures before offering a new vaccine and ensure steps are in place to minimise the risk of errors.

PDL recommendations to prevent vaccination errors

• Verbally confirm the expected vaccine with the patient, parent or carer using an open question prior to each vaccination. For example, “As part of my checking process, please confirm which vaccine you expect to receive today?”.
• If the patient requests Moderna or Pfizer, discuss the different vaccine types available and confirm which specific vaccine they were anticipating.
• Review your booking system to ensure that, where possible, the booking system clearly states which vaccine type the patient is selecting.
• Don’t make assumptions. If your pharmacy only stocks one type of Moderna vaccine, it is still important to confirm which type the patient is expecting. Incidents have been reported where the original Moderna vaccine was administered as it was the only one in stock, but the patient had expected the bivalent formulation.
• ALWAYS check the AIR before vaccinating every individual. Pay close attention to how many COVID-19 vaccinations the patient has had and how long since the last dose.
• Ensure the selected vaccine is appropriate for the patient’s age and be mindful that this can be dependent on whether the patient is having a primary or booster dose.
• Ask about any previous COVID-19 infections, and confirm the time that has elapsed since, as this may change the recommended booster vaccination date.
• Display the ‘COVID-19 Vaccines in Australia’ poster in the vaccine area for vaccinating pharmacists to refer to. Pharmacists should be alert to practice changes and update resources, such as this poster.
• Keep up to date with the ‘ATAGI clinical guidance for COVID-19 vaccine providers’ and review the guidelines regularly.
• Have a system to clearly identify the thaw expiry date and always check the date before preparing doses. Use a calendar reminder to quarantine vaccines that have passed the expiry date.

COVID-19 bivalent booster notes

In addition, it’s important to note the following:

• The recommended interval between doses is the same as all other COVID-19 vaccines – at least 3 months should have elapsed since the last dose or previous COVID-19 infection.
• As with all vaccines, ensure your state or territory legislation allows for vaccination by pharmacists for this vaccine. ATAGI approval does not mean automatic allowance in every jurisdiction.
• Training modules for Moderna Spikevax Bivalent Booster and Pfizer Comirnaty Bivalent Booster are now available in the COVID-19 Vaccination Training Portal. Pharmacists are reminded to be alert to training updates and complete the relevant COVID-19 vaccination module for any COVID-19 vaccination offered in your pharmacy.

Important NSW note

The ‘NSW Vaccination Standards’ released on 11 November 2022 now lists the broader heading of SARS-COV-2 (COVID-19) vaccines rather than listing the individual vaccine brands.

PDL is aware there was some confusion regarding the previous versions of the Standards as they did not specifically reference the bivalent vaccine. NSW Health has advised the profession that the previous version of the Standards included the bivalent vaccine by default within the reference to the Spikevax (Moderna) vaccine.

For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7.