Editor’s note: For the latest news on COVID-19, visit http://bit.ly/AAPNewsCOVID19.
The American Medical Association has approved new Current Procedural Terminology codes for vaccinating young children with bivalent COVID vaccines.
The codes went into effect Dec. 8, the day the Food and Drug Administration (FDA) authorized Moderna’s bivalent COVID-19 vaccine as a booster dose for children ages 6 months through 5 years and the Pfizer-BioNTech bivalent COVID vaccine as a third primary series dose for children 6 months through 4 years (see clinical guidance below). The following codes will be used for these vaccines.
Moderna administration and product codes
0164A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, booster dose
91316 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, for intramuscular use
Pfizer-BioNTech administration and product codes
0173A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, third dose
91317 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA- LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris- sucrose formulation, for intramuscular use
The Centers for Disease Control and Prevention (CDC) has provided the following clinical guidance for using the vaccines, which can be found at http://bit.ly/3VKj1Hz.
- Children ages 6 months through 4 years who complete a Moderna primary series (two doses separated by four to eight weeks) can receive one bivalent Moderna booster dose at least two months after completion of their primary series.
- Children 5 years of age who complete a Moderna primary series may receive either a bivalent Moderna booster or a bivalent Pfizer-BioNTech booster at least two months after completion of the primary series.
- Children ages 6 months through 4 years who are being vaccinated with the Pfizer-BioNTech vaccine should receive the Pfizer-BioNTech monovalent vaccine for their first two doses (separated by three to eight weeks) followed by the bivalent Pfizer-BioNTech vaccine as their third primary series dose at least eight weeks after the second monovalent primary series dose. Children in this age group who have received three Pfizer-BioNTech monovalent primary series doses are not eligible for a booster dose.
The AAP has created a dosing guide to help pediatricians navigate the differing doses, vials and time periods.
The bivalent COVID vaccines already are recommended as a booster dose for people ages 5 years and older. They contain the original SARS-CoV-2 strain and an omicron BA.4/5 spike protein.
The FDA announced Friday it will hold a meeting of its Vaccines and Related Biological Products Advisory Committee on Jan. 26 to discuss whether to change the composition of primary doses and the composition and schedule of booster doses.
“We are hopeful this upcoming discussion will provide us with the optimal path forward for COVID-19 vaccines, helping to ensure that the public remains best protected from evolving virus variants,” said Peter Marks, M.D., PhD., director of the FDA’s Center for Biologics Evaluation and Research.
COVID cases have been rising and health officials are concerned they will continue to do so as people head indoors for the winter and gather for holidays. From the week ending Oct. 18 through Dec. 8, the number of children with COVID-19 at hospital admission increased 68%, according to an AAP analysis of data gathered by the U.S. Department of Health and Human Services. New weekly COVID admissions for children under 5 years nearly doubled during that time.
The White House released a plan Thursday for dealing with COVID-19 this winter. It includes expanding access to free testing, making vaccines and treatments readily available, preparing personnel and resources and focusing on the people at highest risk of severe illness.
“The most important thing Americans can do is to go get their updated COVID-19 vaccine right away,” said Ashish Jha, M.D., White House COVID-19 response coordinator. “… The updated COVID-19 vaccine is your best protection against the version of COVID we’re fighting right now.”
- COVID-19 CPT vaccine and immunization codes
- CDC clinical considerations for administering COVID-19 vaccines
- CDC webinar on bivalent COVID 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 COVID vaccines for children ages 6 months through 4 years