Become a Pro at Dispensing mRNA COVID-19 Vaccines

You'll face questions about how to dispense the Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines...as vaccination efforts expand.

Individuals should get either vaccine series when eligible.

Can different vaccines be used for each dose? Only in RARE cases.

When taking med histories, document which COVID-19 vaccine patients received...to help ensure they get the same product if a second dose is given during their admission.

Is there "wiggle room" on timing of the second dose? A bit.

Pfizer-BioNTech's second dose is recommended 21 days after the first dose...Moderna's is recommended 28 days after the first dose.

But keep in mind that, if needed, it's okay to give the second dose up to 4 days early...and to schedule second doses up to 42 days after the first.

Are there tips to properly prepare doses and avoid errors? Yes.

Be aware that Pfizer-BioNTech's vaccine must be diluted and is 0.3 mL/dose...Moderna's should NOT be diluted and is 0.5 mL/dose.

Store the vaccines apart from COVID-19 monoclonal antibodies. Mix-ups are occurring between casirivimab and the Moderna vaccine. They both come in 5 mL vials with red caps.

Use any extra full doses you can draw up...but don't "pool" excess vaccine from multiple vials.

Dispense syringes with the same needle you used to draw up the dose. This will account for the small amount of vaccine that could be lost in the needle's dead space...and avoid possibly underdosing.

Be aware that these vaccine doses DON'T have to be prepped in a sterile area. Follow directions in package labeling.

Assign syringes and vials a beyond-use date of 6 hours after diluting Pfizer-BioNTech vaccine...or puncturing a Moderna vial.

See our COVID-19 Vaccines chart and tech tutorial, The Basics of Immunization and Vaccines, for more details on prep, storage, etc.

And since federal guidance authorizes qualified techs to give COVID-19 vaccines, consider talking to your manager about our Pharmacy Technicians University's PTU Elite: Immunizations training program. It'll help you meet requirements to give vaccines...and be confident and prepared.

Key References

  • www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html (2-3-21)
  • www.fda.gov/news-events/press-announcements/fda-statement-following-authorized-dosing-schedules-covid-19-vaccines (2-3-21)
  • www.immunize.org/askexperts/experts_cov.asp (2-3-21)
  • https://ismp.org/resources/learning-errors-new-covid-19-vaccines (2-3-21)
  • www.cdc.gov/coronavirus/2019-ncov/vaccines/safety.html (2-3-21)
Hospital Pharmacy Technician's Letter. February 2021, No. 370210



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