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The original monovalent COVID-19 vaccine boosters cannot be used for adolescents and adults who are eligible for the new bivalent boosters, according to the Centers for Disease Control and Prevention (CDC).
Vaccinators who mistakenly use the monovalent vaccine must submit a report to the Vaccine Adverse Event Reporting System (VAERS) regardless of whether an adverse event occurred.
On Sept. 1, the CDC signed off on bivalent COVID vaccine boosters designed to better protect against the SARS-CoV-2 omicron variant. The Pfizer-BioNTech bivalent booster can be used for people ages 12 years and older, and the Moderna bivalent booster can be used for people ages 18 years and older. A single bivalent booster can be administered two months after a primary series or booster with any monovalent COVID-19 vaccine. A bivalent vaccine cannot be used for the primary series.
In authorizing the new bivalent boosters, health officials removed authorization for monovalent boosters for people ages 12 years and older. The CDC has laid out steps vaccinators should take in the event of a vaccine administration error:
- Inform the recipient.
- Consult with the state immunization program and/or immunization information system (IIS) on how to enter the dose in the IIS.
- Submit a report to VAERS describing the error, how it occurred and how many people were affected.
- Implement strategies to prevent future errors.
If a monovalent booster is incorrectly used instead of a bivalent booster, the dose does not need to be repeated. If a repeat dose is desired based on clinical judgment or patient preference, it should be given at least two months after the errant dose, according to the CDC.
If a bivalent Pfizer-BioNTech vaccine is incorrectly administered as part of a primary series, do not repeat the dose. If a bivalent Moderna vaccine is incorrectly administered as part of a primary series, repeat the dose immediately because Moderna boosters are lower doses than Moderna primary series vaccines.
- CDC clinical considerations for administering COVID-19 vaccines
- FDA fact sheet on administering COVID-19 vaccines
- AAP COVID vaccination resources
- AAP pediatric COVID-19 vaccine dosing quick reference guide
- AAP/Health and Human Services COVID vaccine toolkit
- Information from HealthyChildren.org on preparing children for a COVID-19 vaccine