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Don’t Make the Mistake of Scheduling Dose #2 of COVID-19 Vaccine Too Early
January 2021
Technically Speaking
A Monthly Column by Deborah Wexler, MD
IAC Executive Director Dr. Deborah Wexler writes Technically Speaking, a column featured in each issue of Vaccine Update for Healthcare Professionals, the monthly e-newsletter from the Vaccine Education Center (VEC) at the Children’s Hospital of Philadelphia. Technically Speaking columns cover practical topics in immunization delivery such as vaccine administration techniques, storage and handling, contraindications and precautions, and scheduling.
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Don’t Make the Mistake of Scheduling Dose #2 of COVID-19 Vaccine Too Early
Published January 2021
There have been numerous reports of mRNA COVID-19 vaccine recipients being asked to return earlier than the recommended interval to receive their second dose. Frequently this has been caused by a misunderstanding about the intent of allowing a 4-day grace period when determining the interval between dose #1 and dose #2.
When the clinical considerations for COVID-19 vaccines were first published by CDC, they included the concept that a “grace period” of 4 days was allowable if the minimum interval between doses was inadvertently shortened. A similar grace period has been in place for other vaccines for many years. However, the grace period was intended to be used only when a vaccine was determined retroactively to have been given at less than the recommended minimum interval. In that case, a dose given within 4 days of the recommended interval would not have to be repeated. The grace period was not intended to be used when scheduling future vaccination visits.
For COVID-19 vaccines currently available in the U.S., the recommended interval which should be used for scheduling between dose #1 and dose #2 is:
Routine Scheduling. Do not schedule people to receive dose #2 earlier than the recommended intervals (i.e., 21 days for Pfizer-BioNTech or 28 days for Moderna).
Inadvertent Early Doses. If dose #2 is inadvertently administered as much as 4 days too early (“grace period”), it may be considered valid, but this 4-day period should not be utilized for routine scheduling.
No Maximum Interval. There is no maximum interval between dose #1 and dose #2 for either vaccine. If dose #2 is administered beyond 21 (Pfizer-BioNTech) or 28 days (Moderna), there is no need to restart the series.
