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Technically Speaking
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January 2021
Technically Speaking
A Monthly Column by Deborah Wexler, MD
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.
Subscribe to VEC's Vaccine Update for Healthcare Professionals to stay up to date on vaccine-related issues, including reviews of recently published journal articles, media recaps, and announcements about new resources and webinars. To subscribe, visit the Vaccine Update Newsletter Sign-up Form
The archive of past Technically Speaking columns is also available through links on the right side of this web page.
TECHNICALLY SPEAKING
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:

  • Pfizer-BioNTech – 21 days
  • Moderna – 28 days

On January 6, CDC revised its Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States to emphasize the necessity of vaccinating according to the recommended schedule. The information regarding dosing intervals is summarized below:

  • 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.

Visit CDC's Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States for full details.

Related Links

The archive of past Technically Speaking columns is also available through links on the right side of this web page.
 
This page was updated on January 22, 2021.
This page was reviewed on January 22, 2021.
2021 ISSUES >> view all issues
JUNE 2021
Saying Goodbye – and Leaving You with My "Top Ten" List of Places to Bookmark on Immunize.org
MAY 2021
Be sure you know the anatomical landmarks for administering intramuscular injections in the arm
MARCH 2021
IAC's newly updated "COVID-19 Vaccines" web page makes it easy to find important resources from CDC and others
FEBRUARY 2021
2021 Recommended U.S. Immunization Schedules for Children/Teens and for Adults Just Released – Laminated versions available for pre-order from IAC
JANUARY 2021
Don't Make the Mistake of Scheduling Dose #2 of COVID-19 Vaccine Too Early
2020 ISSUES >> view all issues
DECEMBER 2020
FDA issues EUA for Pfizer-BioNTech mRNA vaccine; CDC approves its use and provides clinical guidance
NOVEMBER 2020
Prevent Shoulder Injuries Caused by Missing the Deltoid Muscle When Injecting Vaccines!
OCTOBER 2020
ACIP Updates Recommendations on the Use of MenACWY and MenB Vaccines
SEPTEMBER 2020
Is It 0.25 mL or 0.5 mL? What Is the Correct Dose of Injectable Flu Vaccine for Children Younger Than 3?
JULY 2020
Choosing Proper Needle Length for Vaccination of Children and Adults: What Should You Consider?
JUNE 2020
Preventing Preventable Vaccine Administration Errors in Your Medical Setting
MAY 2020
IAC Launches New MenB Vaccination Honor Roll Recognizing Colleges and Universities That Require or Recommend the Vaccine to Protect Their Students
APRIL 2020
Our Society Deserves Vaccination: Two New Educational Pieces from IAC Explain the Science Supporting Vaccines and the Value of the Vaccine Injury Compensation Program
MARCH 2020
Now Available to Order! IAC's Laminated Versions of CDC's 2020 Immunization Schedules
FEBRUARY 2020
Sign up for IZ Express—the Best Way to Stay Current with Weekly U.S. Immunization News, Information, and Resources
JANUARY 2020
CDC Releases 2020 Version of Its Vaccine Storage and Handling Toolkit
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