COVID-19 Immunization Guide For B.C. Pharmacies: Moderna

Updated on September 16, 2021 (Originally posted on June 28, 2021)

Moderna Vaccine in Pharmacies

Updated: Sept. 16, 2021 at 12:02 p.m. PDT

This guidance is developed with the British Columbia Ministry of Health

Current State

Vaccine: COVID-19 mRNA Vaccine - Moderna

On Aug. 27, 2021, Health Canada approved Moderna COVID-19 vaccine for individuals 12 years of age and older. See Summary of NACI statement: Recommendation on the use of mRNA COVID-19 vaccines in adolescents 12 to 17 years of age.

Priority group: Moderna is indicated in adults 12 years of age and older. Pharmacies can provide a complete series of the vaccine (dose 1 and/or dose 2).

Age is based on year of birth (i.e., the vaccine may be offered to individuals who will be turning 12 years of age within the current calendar year), per Provincial Health Officer recommendations.

BCCDC has created a Healthcare Provider Q&A document which includes general and evolving information about COVID-19 vaccines in B.C. It can be found on the COVID-19 vaccination toolkit for health professionals webpage.

Important Reminders

  • Record immunizations in PharmaNet on the day that they are given.
  • Ensure the PIN for the COVID-19 vaccine is entered correctly.
  • PharmaNet data is extracted by the Provincial Immunization Registry (PIR) every day at 9 p.m. If you need to make a change to a claim, please do this before the next 9 p.m extract. Only change a claim outside of this time frame if the wrong PIN was used, and back-date to the service date (or else a second record will be made in the Public Immunization Registry)
  • Verify patient ID. Update patient demographics in PharmaNet if needed.
  • Check PharmaNet and CareConnect for prior dose before administering a vaccine, including any AEFIs (adverse events following immunizations) on CareConnect. Patient interviews are not 100% reliable. See Registering with CareConnect.

Training and Education

  • To provide COVID-19 vaccines, B.C. pharmacists must be certified as per the College of Pharmacists of BC’s drug administration requirements.
  • Pharmacists are encouraged to complete BCCDC COVID-19 immunization webinars, which provides a foundation of knowledge for the delivery of safe and effective COVID-19 vaccines. 
  • The BCCDC has developed further resources for health professionals on COVID-19 vaccines.

Community Pharmacy Standards of Practice

  • Pharmacists providing immunizations must follow the College’s Standards, Limits and Condition for Drug Administration by Injection and Intranasal Route.
  • Pharmacists must follow the Community Pharmacy Standards of Practice.
    • Patient counselling
      • If a drug-related problem is identified during pharmacist/patient consultation, the pharmacist must take appropriate action to resolve the problem.
      • At a minimum, the pharmacist must confirm that the right patient is getting the right drug /strength and must also provide a direct opportunity for the patient to ask questions.
    • Reviewing PharmaNet*
      • A pharmacist must review the patient’s personal health information stored on the PharmaNet database before dispensing a drug and take appropriate action if necessary with respect to, but not limited to, appropriateness of drug therapy, drug interactions, allergies, adverse drug reactions, and therapeutic duplication.
    • Performing a final check
      • A pharmacist must review the prescription label to ensure it is consistent with the prescription and/or hardcopy.
      • Always check the expiry date of the product before providing the vaccine. Rotate vaccines according to expiry date (place those with the longest expiry date at the back)

* If COVID-19 vaccine dose is not on PharmaNet, check CareConnect

Moderna Vaccine Product (COVID-19 mRNA Vaccine)

For COVID-19 vaccine product details, refer to BC Immunization Manual Part-4 Biological Products Moderna (COVID-19 mRNA Vaccine mRNA-1273), which includes information on doses and schedule, administration procedures, storage and handling, contra-indications, precautions, special considerations, and adverse events.

Moderna vaccine is available in 10-dose and 14-dose vials. In order to expedite the distribution of the vaccine in Canada, U.S.-labelled vaccine supplies with English-only vial and carton labels are provided.  Healthcare professionals should be aware that there are no changes to the product. The indication, dosage, route of administration, strength, formulation, and non-medicinal ingredients in the US-labelled product are the same as the current Health Canada-authorized COVID-19 vaccine.

The U.S. labelled product yields at least 14 doses and contains a different carton and vial label. Continue to reference the Canadian Product Monograph for all product information for use in Canada. Note: to consistently extract 14 doses, a minimum ratio of 7 low-dead-volume syringes to 7 non-low-dead volume syringes is recommended. See section Extracting Doses.

The Moderna Call Centre is available from 9am to 5pm EST, Monday through Friday, and can be reached at 1-866-MODERNA (1-866-663-3762).

Doses and schedule:

  • 2 doses given as 0.5 mL IM, 28 days apart*.
    • *This is the schedule authorized by Health Canada. However, the current interval between doses in B.C. is based on vaccine supply and operational recommendations as outlined on the government of B.C. website.
    • As of Aug. 9, 2021, permitted dosing interval for all COVID-19 vaccines is 28 days. This means pharmacies can offer dose 2 to patients at 4 weeks after dose 1. The preferred interval between dose 1 and 2 is still six to eight weeks, with the exception of those living or working in outbreak communities and individuals who meet approved criteria for an expedited dose 2.
    • *The minimum interval between doses is 21 days. For optimal responses, immunizers should observe the recommended intervals as much as possible, however, doses given earlier than recommended may still be considered valid and need not be repeated if minimum intervals are observed.
    • The vaccine series should be completed with the same COVID-19 vaccine product. If it is not possible to determine what product was used for the first dose, or if the same product is unavailable, the second dose may be given with an available mRNA product.
    • NACI recommends that mRNA vaccine (Pfizer BioNTech or Moderna) can be offered as a second dose to individuals who received a first dose of the AstraZeneca/COVISHIELD vaccine, unless contraindicated.

Third doses for individuals who are immunocompromised

Updated September 14, 2021: Following the provincial announcement that third doses are recommended for some people who are immunocompromised, BCCDC has updated Part 4 – Biological Product page for Pfizer Vaccine.

For individuals 12 years and older who are severely immunocompromised, a 3-dose primary series is recommended. Moderna COVID-19 vaccine is preferentially recommended for the 3rd dose, which should be provided at least 28 days after the 2nd dose. If Moderna is unavailable, Pfizer vaccine can be given.

Severely immunosuppressed includes individuals who:

  • Have had a solid organ transplant (heart, lung, liver, kidney, pancreas or islet cells, bowel or combination organ transplant).
  • Since January 2021, have been treated for and/or are receiving active treatment (chemotherapy, targeted therapies, immunotherapy) for malignant hematological disorders (e.g., leukemia, lymphoma, or myeloma).
  • Since January 2020, have received treatment with any anti-CD20 agents (i.e., rituximab, ocrelizumab, ofatumumab, obinutuzumab, ibritumomab or tositumomab).
  • Since January 2020, have been treated on B-cell depleting agents (i.e., epratuzumab, MEDI-551, belimumab, BR3-Fc, AMG-623, atacicept, anti-BR3, alemtuzumab).
  • Have combined immune deficiencies affecting T-cells, immune dysregulation or type 1 interferon defects.
  • Since September 2019, have had bone marrow or stem cell transplant or are still taking immunosuppressant medications related to transplant.

Information on how to obtain third doses for people who are immunocompromised has been added to BCCDC’s Vaccine Considerations and Registration and Eligibility pages.

Vaccine Storage and Handling

For more information on storage and handling and temperature monitoring refer to Appendix E: Management of Biologicals and Guidance for Receiving and Handling the Moderna COVID-19 mRNA Vaccine.

Extracting doses

If 14-dose vials are used, to consistently extract 14 doses, providers will need two things:

  1. A minimum ratio of 7 low-dead volume (LDV)/space syringes and 7 non-low-dead volume syringes
  2. Good technique that employs vial pressure optimization and vial septum rotation to reduce the chance of loss due to leakage.

Details are presented in the infographic  that was prepared by USP. USP has other resources online that can be accessed here, including videos.

Recapping of the needle

  • Recapping of the needle following preparation of the vaccine may be required for various reasons such as transport and storage.
  • When choosing to recap the needle following preparation of the vaccine, follow the Passive Needle Recapping Technique.
  • Recapping should NOT be done following vaccine administration.
  • As biological product administration requires a safety-engineered needle, it is important to engage safety mechanism on the needle immediately following administration of the biological product. Immediately discard needle and attached syringe in hard sided, labeled sharps container.
  • Any needle stick injuries should be reported as per Health Authority/Employer protocol.

 

Vaccine Expiry

The expiry date is not printed on the Moderna US-labelled product. The expiry date for the corresponding lots can be found the “Product affected” section of the Health Canada alert. The expiration date information is also found at www.modernacovid19global.com/ca or by scanning the QR code printed on the carton next to the lot number, or on the vial label next to the storage information, which links to the US website.  A link is present at the top of the US website to direct Canadian users to the Canadian website (www.modernacovid19global.com/ca).

Expiry date interpretation

As per BCCDC, the expiry date on vaccines should be interpreted as follows:

  • When specified as month/year, product expires on the last day of the month and may continue to be administered until the end of the month (e.g., expiry of January 2021 means January 31, 2021, and may be used until 11:59 pm in the local time zone)
  • When specified as a day/month/year, product expires at the end of the day of expiry i.e., may be administered up until the last minute of the labelled expiry day, within the time zone of use (e.g., product expiring on April 2, 2021, may be used until 11:59 pm on April 2, in the time zone).

What to do with expired product

  • Remove expired vaccines from the refrigerator and
  • clearly label/mark not to be used.
  • Do a thorough inventory of the numbers of expired doses (including partial vials)
  • Record inventory wasted in PharmaNet. See PharmaNet data entry requirements in Inventory Management section. Dispose of the vaccines using your regular biomedical waste disposal procedures for vaccines.

Ordering and Distribution of Vaccine & Supplies

  • Moderna vaccine is transported/distributed to your pharmacy from Health Authority at thawed state (2°C to 8°C) as per BCCDC Moderna Redistribution Guidelines.
  • Northern Health will directly deliver Moderna vaccine to pharmacy sites on a weekly basis every Tuesday afternoon (with the exception of Fort Nelson – vaccines are delivered weekly on Thursdays)
  • Pharmacies must submit weekly orders by Wednesday end of day, for delivery the following week.
  • Moderna vaccine is transported/distributed to your pharmacy from Health Authority at thawed state (2°C to 8°C) as per BCCDC redistribution guidelines.
    • Record date/time product thawed (check labels and transportation documentation)
    • Vaccine can be transported at refrigerated temperatures for up to 12 hours.
    • Time used to transport counts as part of the 30 day-limit.
  • Vaccine supplies e.g., safety needles and syringes will be provided along with the vaccines and are available at no cost through the Provincial Health Services Authority (PHSA) supply chain.

Reporting Cold Chain Incidents

If a temperature excursion occurs while vaccine is in your pharmacy:

  1. Quarantine affected vaccine and label as “Do Not Use”.
  2. Receiving site notifies IBCOC_Operations@phsa.ca as soon as possible. Call 1-250-686-6061, if after hours and assistance is required to initiate a cold chain consultation.
  3. Cold chain consultation process initiated.
    • Report incident to local public health for determination of vaccine use. If after hours/unable to contact local public health and your need for information is urgent, contact the Provincial Health Duty Officer at 1 (250) 686-6061.
    • Cold chain incident form completed. For instructions and form, see the Vaccine Management webpage.

Picture2.png

4. Within 24 hours, the incident must be resolved, and a report submitted to IBCOC_Operations@phsa.ca with the following information:

  • Date of incident
  • Location of incident
  • Situation surrounding incident:
    • Excursion temperature(s) and duration
    • Lot number, expiry
    • Detailed description of event
    • Number of affected doses
    • Impact on clinic (e.g., closed early, cancelled, clients redirected to alternate side)
  • Recommendations

5. Upon receipt of this report, the Immunize BC Operations Centre will be responsible to report the incident to the National Operations Centre (NOC).

See BCCDC SOP for COVID-19 Vaccine Cold Chain Incident Reporting Process

Scheduling Appointments

  • Pharmacies are responsible for booking immunization appointments (online and telephone). Consider options for walk-ins.
  • If your pharmacy does not have an online booking system, but is interested in one, the BCPhA offers an online booking platform. More information can be found here.

Vaccine Eligibility Screening and Verification

1. Moderna vaccine is indicated in individuals 18 years of age and older.

2. The minimum age for vaccine receipt is based on year of birth (i.e., the vaccine may be offered to individuals who will be turning 12 years of age within the current calendar year), per Provincial Health Officer recommendations.

3. Pharmacies must review patient identification (ID) and ensure ID matches the patient profile in PharmaNet.

4. Check PharmaNet and Careconnect to confirm history of a COVID-19 vaccine and any related AEFIs.

  • Verbal confirmations should only be used as a secondary source of verification, as patient interviews are not 100% reliable.

5. Review BCCDC’s COVID-19 Vaccine Screening Checklist.

  • See Contraindications and Precautions in BCCDC’s Healthcare Provider Q&A.
  • COVID-19 mRNA vaccine should not be given to an individual if they have a:
    • History of anaphylactic reaction to a previous dose of an mRNA COVID-19 vaccine or to any component of the vaccine. These individuals should be offered an adenovirus vector COVID-19 vaccine and observed for a least 30 minutes after immunization.
  • The 2nd dose of COVID-19 mRNA vaccine should be deferred in those who experienced a physician-diagnosed myocarditis or pericarditis event following the first dose with no other cause identified, until further information about the risk of recurrence is available. Deferral is not required for those with a prior history of myocarditis or pericarditis that is unrelated to COVID-19 mRNA vaccines and are no longer being followed by a medical professional for heart issues. 

6. Non-residents of B.C/ Non-Canadians are able to be vaccinated at a community pharmacy:

  • Anyone living, working or studying in B.C. during the pandemic can receive the COVID-19 vaccine, even if they are not a Canadian citizen or permanent resident (with ID showing they meet the age/current eligibility requirement).
  • Pharmacies will be reimbursed for this service. As with any other patient, a PHN is to be generated for the patient if they do not currently have one. Name and date of birth of patient is required.

7. BCCDC has created a Healthcare Provider Q&A document which includes general and evolving information about COVID-19 vaccines currently used in B.C. It can be found on the COVID-19 vaccination toolkit for health professionals webpage.

COVID-19 vaccinations outside B.C. and Canada

  • For COVID-19 vaccines received in another province, patients can submit proof of an official vaccination record which will be entered into the Provincial Immunization Registry. For more information, see Vaccine Registration and Eligibility.
  • To support health care providers with approaches for individuals who have received COVID-19 vaccination outside of Canada review World Health Organization (WHO) Emergency Use Authorization (EUA) Qualified COVID-19 Vaccines.
    • Individuals who have received a complete series with a vaccine that is WHO EUA qualified are considered fully vaccinated and no further doses are required. However, one additional dose of a COVID-19 mRNA vaccine may be provided for individuals upon request if they have been vaccinated with a WHO-approved vaccine series that is not authorized in Canada. The minimum interval between the preceding dose and the additional dose is 4 weeks.
    • Individuals who have received a series with a vaccine that is not WHO EUA qualified should be offered a full COVID-19 vaccine series using a vaccine available in BC. There is no minimum interval required when restarting the series following receipt of a non-WHO approved vaccine.
    • Individuals who have received a first dose of a COVID-19 vaccine overseas that is also available in BC should receive the same vaccine for their second dose if readily available, and if they meet the current BC eligibility criteria for 2nd dose (i.e., at least 4 weeks following first dose). If the vaccine they received for their first dose is not available in BC, but the same type of vaccine is available, this should be offered. A 6 to 8 week interval between doses is recommended. A minimum interval of 4 weeks is acceptable, if required.

Informed Consent

Post-immunization Monitoring and Aftercare

  • Patients are to remain in a designated area for 15-minute observation period following COVID-19 vaccine receipt.
  • Provide the patient a record of immunization, as per PharmaCare policy manual section 8.10. At a minimum the record should include the patient name, dose number, date of administration, product given, lot number and pharmacy information. See example vaccine record card. 
  • Encourage patients to sign up to Health GateWay to access their digital immunization record. PharmaNet data is fed into the Provincial Immunization Registry which is subsequently uploaded to Health Gateway where patients can access the health records themselves.
  • Provide patients the COVID-19 Vaccine After care sheet, which includes information what possible side effects and what to expect over the next few days after the vaccine.

PharmaNet Data Entry

PharmaNet Cheat Sheet COVID-19 Vaccines - printable PDF (Updated April 20, 2021)

PharmaNet fan-out messages: COVID-19 reporting

As per PharmaCare Newsletter (May 4, 2021), a number of pharmacies have received PharmaNet fan-out messages because they are reporting COVID-19 vaccines incorrectly. Correct reporting of COVID-19 vaccine administration and inventory received, transferred, wasted, and returned, is critical for tracking by the Public Immunization Registry (PIR) and for delivery of second doses.

For details on fan-outs and how to correct your entries, see PharmaNet Fan-outs for COVID-19 Vaccine Entry Errors.

Review the following section on PharmaNet data entry formats to ensure information is entered correctly.

 

PharmaNet Data Entry:

Recently, a connection was made between PharmaNet and the Provincial Immunization Registry (PIR) to ensure that all immunizations recorded in PharmaNet are reflected in a patient’s provincial immunization record. The PIR record is subsequently uploaded to the Health Gateway where patients can access their health records themselves.

Due to the strict reporting requirements of COVID-19 Immunizations, pharmacists must follow these rules:

  1. Provide immunizations as per the immunization priority criteria. 
  2. Record immunizations administered in PharmaNet by 11:59 p.m. on the day that they are given to the patient.
  3. Follow all PharmaNet vaccine administration claim entry requirements for COVID-19 immunizations (see below)
  4. Follow COVID-19 vaccine inventory receipt and daily wastage PharmaNet entry requirements (see section Inventory Management).
  5. Verify patient identification and update demographics in PharmaNet if necessary. Note: address must be updated through the specific address update transaction feature

PharmaNet claim entry:

  1. Use the product identification number (PIN) as assigned by PharmaCare. See Vaccine PINS.
  2. The administering pharmacist should be the prescriber.
  3. Follow the protocol for entry of the “Directions for Use” (Sig) field (see below).
  4. Quantity is the amount administered to the patient, in millilitres (e.g., 0.5 mL for Moderna vaccine).
  5. Days supply for first doses is 21 days*. Days supply for second doses is 1 day.

* Note that the provincial permitted interval between dose 1 and 2 is 28 days. The preferred interval between dose 1 and 2 is still six to eight weeks, with the exception of those living or working in outbreak communities and individuals who meet approved criteria for an expedited dose 2. Health Canada product monograph authorizes 28 days between doses. The minimum interval is 21 days.

Data to be entered in the Directions for Use field 
Some aspects of immunizations are not recorded in PharmaNet as separate data elements.  The Provincial Immunization Registry (PIR) requires these additional elements to ensure appropriate reporting and clinical follow-up.  To account for this, the pharmacy must follow new data entry requirements in the “Directions for Use”, or “Sig” field sent to PharmaNet.

 
Entry of this information in this format will allow PharmaNet to accurately extract these additional data elements and submit on behalf of providers to the PIR.  Only certain “allowable values” are permitted to be entered for each data element. PharmaNet will verify the information prior to sending to the PIR.  

Data element Order in text Allowable value Description
Lot 1st Lot number as provided on vial The Lot number allows Ministry to determine: 
  • the expiry of the product used, 
  • trace inventory across the province,
  • monitor for trends in adverse effects following immunization (AEFI),
  • contact patients in event of a Lot-specific issue.
Lot 2nd Left Arm/site where the vaccine was injected. 
Right

This information should be recorded in the “Directions for Use” field in the above order separated by an underscore “_”.  DO NOT enter any other characters.


Example entries for “Directions for Use” for COVID-19 vaccines:

If there is a dash/hyphen in the Lot number, include it in your PharmaNet entry, e.g. ABC123-12_LEFT”. For Moderna vaccine LOT ABC123-12, example entries in the “Directions for Use” field are:
 

Lot Site Directions for Use
ABC123-12 Left ABC123-12_LEFT
ABC123-12 Right ABC123-12_RIGHT

There is no need to add “LOT” or “Arm” or any other information like expiry or IM. 

Please do NOT enter the following example formats, otherwise it will not lead to a complete record in the Provincial Immunization Registry:
 

X WRONG 0.5ML INTRAMUSCULAR INJECTION - LOT#4120Z003 (RIGHT)
X WRONG LOT:4120Z003.1ST 0.5 INTRA MUSCULAR LEFT ARM
X WRONG LOT 4120Z003. 0.5 ML(S) INTRA MUSCULAR 
X WRONG 4120Z003_RIGHT (PIN#66127322)
X WRONG INJECT AS DIRECTED

 

Vaccine PINs

Moderna vaccine PIN is 66127304

Ensure the PIN for the COVID-19 vaccine is entered correctly. If the wrong PIN has been submitted, the pharmacy MUST reverse the claim and BACKDATE under the correct PIN (if not, it will appear incorrectly as dose 2 in the Provincial Immunization Registry).

Claim Adjudication Results

COVID-19 immunizations will be reimbursed via the usual process for vaccinations.  

At the time of submission, PharmaNet will indicate that the immunization is NOT a benefit. This is expected; reimbursement is done by a secondary process, which identifies the number of immunizations administered by a pharmacy, irrespective of adjudication results. You do not need to reverse and resubmit the claim.

Inventory Management

Accurate daily inventory accounting is critical. Both receipt of inventory and daily wastage of doses must be recorded for central reporting and management of inventory. To achieve this efficiently in PharmaNet, pharmacies must follow the procedures below. 

1. Receiving inventory

  • Submit under the O-Med, a claim to PharmaNet under the PIN for the product received:
    • Quantity = total volume in mL received 
    • Quantity should be multiple of the vaccine dose (i.e., multiple of 0.5 mL). E.g., for one 14-dose vial received, quantity = 7 mL.
    • Directions for Use = Received_LOT
    • Note the underscore “_
  • This must be done on as soon as you receive/ on the same day you receive the vaccine.

2. Recording wastage

  • Submit to PharmaNet using O-Med PHN, under the vaccine PIN for the product wasted:
    • Quantity = total volume in mL wasted
      • Quantity should be multiple of the vaccine dose (i.e., multiple of 0.5 mL). E.g., for 3 doses wasted, quantity = 1.5 mL.
    • Directions for Use, depending on reason for wastage, please enter the following:
      • Wastage_CCI: Handling Error_Lot [for cold chain incidents]
      • Wastage_Damage to Product_Lot
      • Wastage_Expired Product_Lot
    • Note the underscore “_

  • This must be done on the same day the product is wasted.

3. Transferring product between pharmacies 

PharmaNet data entry: For transferring product between stores, use the 3-character PEC (e.g. A01) of the store you are transferring to, or the PEC of the store you are transferring from. 

  • Pharmacy transferring out the product:
    • Submit to PharmaNet using O-Med PHN, under the vaccine PIN for product transferred:
      • Quantity = total volume in mL being transferred.
      • Directions for Use = Transfer_Lot_(to)PEC  

      • Example: PEC of pharmacy you are transferring to is ZBA. Sig field for transfer to: Transfer_4120Z003_ZBA

    • Must be done on the same day product is being transferred.
  • Pharmacy receiving the transferred product:
    • Submit to PharmaNet using O-Med PHN, under the vaccine PIN for product transferred:
      • Quantity = total volume in mL being transferred.
      • Directions for Use = Received_Lot_(from)PEC

      • Example: PEC of pharmacy you are receiving product from is A01. Sig field for transfer from: Received_4120Z003_A01

    • This must be done on the same day product is received.

4. Returning product to NHA for redistribution

In exceptional cases, NHA will assess case-by-case whether product can be returned for use in public health clinics.  The following criteria must be met for vaccine(s) to be considered eligible for return:

  • The temperature was maintained between +2°C and +8°C for these products throughout their storage at site.
  • Products were stored in a safe and secure location with no public access.
  • The refrigerator temperature was logged at the start and end of each business day.
  • Only full, unpunctured vials are being returned.

PharmaNet data entry: Submit to PharmaNet using O’Med PHN, under the vaccine PIN for product returned.

  • Quantity = total volume returned in mLs
  • Directions for use = Return_LOT_BCCDC
  • Note the underscore “_”
  • This must be done on the same day vaccine is returned.

Examples:

Sig field

Example

Immunization Dispense

Lot_SITE

4120Z003_LEFT

Received Inventory

Received_Lot

Received_4120Z003

Wastage of Inventory (choose one)

Wastage_CCI: Handling Error_Lot 

(for cold chain incident)

Wastage_CCI: Handling Error_4120Z003

Wastage_Damage to Product_Lot

Wastage_Damage to Product_4120Z003

Wastage_Expired Product_Lot

Wastage_Expired Product_4120Z003

Stock transfer (use PEC of store you are transferring from or to)

Received_Lot_(from)PEC code

Received_4120Z003_A01

Transfer_Lot_(to)PEC code

Transfer_4120Z003_ZBA

Return

Return_Lot_BCCDC

Return_4120Z003_BCCDC

Reimbursement

  • Effective March 31, 2021, a $5.90 supplement will be temporarily added to PharmaCare’s vaccination administration fee for COVID-19 vaccines in pharmacies.
  • PharmaCare’s fee for publicly funded vaccines is $12.10. The supplement applies to COVID-19 immunizations only. With the supplement added to the vaccine administration fee, pharmacies will receive $18.00 for every COVID-19 vaccine they administer

Reporting Adverse Events Following Immunizations (AEFI)

  • According to BCCDC, an adverse event following immunization (AEFI) is defined as an untoward event temporarily associated with immunization that may or may not have been caused by the vaccine or immunization process.
  • The AEFI with COVID-19 Vaccine Case Report Form is an abbreviated version of the standard AEFI case report form and is available in the COVID-19 Vaccination Toolkit for Health Professionals. It is intended for use by community vaccine providers (i.e., non-public health professionals) and the reporting of AEFIs associated with COVID-19 vaccination.
  • For criteria on reporting AEFIs, and to help healthcare providers interpret AEFIs and their implications for subsequent immunization, see BC Immunization Manual Part 5 – Vaccine Associated Adverse Events.
  • Other AEFI resources:
  • Pharmacist are encouraged to record relevant Adverse Drug Reactions (ADEs) in PharmaNet in addition to the AEFI form.
  • Check CareConnect for history of AEFIs associated with previous immunization.

Delayed local reactions including pain, redness, swelling, and occasionally pruritus, were observed in the Moderna clinical trials in about 1% of vaccine recipients, with onset on or after day 8 following vaccination. These delayed reactions were more likely to occur following the first dose than the second dose, and are thought to represent dermal hypersensitivity, typically resolving after 4-5 days. Vaccine recipients who have experienced these delayed local reactions have safely received the second dose. These events are not reportable unless they meet the reporting criteria outlined in the BC Immunization Manual, Part 5: Adverse Events Following Immunization.  See “What are the expected local adverse events following the administration of COVID-19 mRNA vaccination” in BCCDC’s Healthcare Provider Q&A.

Reporting of sub-dose vials

See COVID-19 Sub-Numbered Dose Vial Reporting procedures if a Moderna vial yields less than labelled doses (13-15). A Sub Dose Survey Form must be completed and reported to IBCOC (IBCOC_Operations@phsa.ca) if 12 or fewer doses are extracted from a vial.

Note: A common error in completing the form relates to the columns E and F (# of vials used on day of report and # of vials from which expected number of doses are retrieved). The # of vials used on the day of the report is needed to establish a correct denominator and the # of vials which yielded the expected amount allows us to calculate a numerator. If your teams can do their best to provide these numbers it would be much appreciated.

Reporting receipt of damaged vials or missing vials

B.C. is required to report to the National Operations Centre (NOC) on the acceptability of all vaccines and other materials received in-province via a federal contract with the supplier. See Post-Arrival Documentation % Administration Protocols if you have received damaged or missing vials for how to report. Reports should be sent to IBCOC (IBCOC_Operations@phsa.ca).

Registering for CareConnect and Provincial Immunization Registry (PIR)

  • To access the Provincial Immunization Registry (PIR), pharmacists need access to CareConnect. It’s anticipated that all pharmacists will need to access the PIR to administer Dose 2.
  • Getting CareConnect access:
  • Complete the following survey form through this link -   Enrol in CareConnect.  Once completed, the CareConnect team send the instructions for the next steps.
    • IMPORTANT NOTE: You may have received information on CareConnect enrolment through the College of Pharmacists of BC email in mid-March.  The above link is the same link shared by the College. 

Resources