Wrong COVID vaccine dose given to over 100 kids at Virginia pharmacy, officials say

More than 100 children were given the wrong COVID-19 vaccine dose at a Virginia pharmacy, health officials said.

Between Wednesday, Nov. 3, and Thursday, Nov. 4, an estimated 112 children ages 5-11 were incorrectly administered a COVID-19 vaccine dose intended for people ages 12 and older at Ted Pharmacy in Aldie, Virginia, the Virginia Department of Health told McClatchy News in a statement on Nov. 11.

The department said this “resulted in these children receiving a lower dose than recommended.”

“Our understanding is that Ted Pharmacy attempted to give the correct 10 microgram dosage to those under 12 by administering 0.1 ml of the adult formulation,” David Goodfriend, director of the Loudoun County Health Department, told local outlet WUSA. “Due to the very small volume used, and concerns raised by some parents as to whether 0.1 ml was actually administered, it is possible some children were underdosed.”

The state health department did not provide more information on what led to the children receiving a lower dose than recommended, and Ted Pharmacy hasn’t responded to a request for comment or provided further information.

The Pfizer-BioNTech COVID-19 vaccine available to children ages 5-11 is a lower dose than what’s available to older children and adults, and the American Academy of Pediatrics said the vaccines available to younger children also have different dilution requirements.

The CDC said the vaccine formulations are “not interchangeable.” Children ages 5-11 should only be given a vaccine from a vial with an orange cap. Vials with purple caps are intended for people ages 12 and older.

The Loudoun County Health Department sent a letter to the parents of impacted children on Nov. 10 notifying them of the incident. It recommended that they review guidance from the Centers for Disease Control and Prevention and contact their health care provider to “discuss options to complete the COVID-19 vaccine series,” which includes two primary doses of the Pfizer vaccine administered at least 21 days apart.

The county health department said CDC guidance indicates that, in general, if 10 micrograms of the Pfizer vaccine intended for people ages 12 and older were given to a child ages 5-11, the dose should not be repeated.

“However, since the dose cannot be assured in this smaller volume, based on clinical judgment (e.g., child received two doses of incorrect formulation), a repeat dose of Pfizer-BioNTech COVID-19 Vaccine 5-11 years formulation (orange cap) may be administered at an interval of 21 days after the dose given in error,” the CDC said, according to the county health department.

The department said the next step for parents should be talking to their child’s primary care doctor or pediatrician to decide whether to restart the vaccine series at least 21 days after the incorrect dose was administered or to “proceed with the child receiving their second dose as scheduled.”

“All future doses to your child should be of the 5 to 11 Pfizer-BioNTech COVID-19 vaccine formulation,” it said.

The state health department said authorities on Nov. 5 ordered Ted Pharmacy to stop administering COVID-19 vaccines and collected all COVID-19 vaccines from the location.

“VDH has not received any other reports of pharmacies or providers administering COVID-19 vaccines formulated for 12 years and older to children 5-11 years old,” the department said. “VDH contacted other pharmacy partners with additional communication that outlined vaccine administration guidance.”

The Pfizer COVID-19 vaccine is safe and effective for people ages 5 and older, the CDC said. The U.S. Food and Drug Administration authorized it for emergency use in children ages 5-11 on Oct. 29. The Moderna and Johnson & Johnson COVID-19 vaccines remain available only to people ages 18 and older.

“Vaccinating children will help protect them from getting COVID-19 and therefore reducing their risk of severe disease, hospitalizations, or developing long-term COVID-19 complications,” the agency said. “Getting your children vaccinated can help protect them against COVID-19, as well as reduce disruptions to in-person learning and activities by helping curb community transmission.”

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