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Snafu delays second shot of vaccine

Providers, state working to ensure patients are notified of changes

The State Department of Health over the weekend discovered a problem that had been building since early January that will require delaying second dose appointments for up to two weeks for as many as 60,000 people and rescheduling first dose appointments for up to 55,000 people.

The problem, which applies only to the Moderna vaccine, occurred because an unknown number of still-unidentified providers inadvertently used doses intended for second shots as first shots, due to a “perfect storm” of vaccine shortages, demand for shots, uncertainty in deliveries from the federal government, provider misunderstandings and imperfect communication from the department, faccording to department spokespeople.

It will take three weeks to work through the fix that the department has created in cooperation with the new bipartisan vaccine task force — a fix that should guarantee that no first-dose recipient gets their second dose more than the maximum 42 days later, as set by the Centers for Disease Control and Prevention, officials said.

The state is working with providers to ensure that everyone who has an appointment that needs to be rescheduled is notified, officials said.

Everyone will continue to get their second shot from the provider that administered their first, officials said.

If providers don’t reach out to reschedule, people should assume their previously made appointments are valid, according to Barry Ciccocioppo, spokesman for the state Department of Health.

Between 30,000 and 60,000 people may need to reschedule their second doses, according to acting Health Secretary Alison Beam.

Between 30,000 and 55,000 first doses slated for delivery this week may need to be used for second doses, Beam said.

There is no medicinal difference between first and second doses, Beam said.

The problem happened because of confusion created by shipments of first doses and second doses as requested by providers, ordered by the department, then sent directly to providers by the manufacturer — in separate packages, but without labels to distinguish packages intended for second doses from the those intended for first doses, Ciccocioppo said.

Providers have been besieged with people clamoring for shots, and the department has been telling providers not to hold back vaccine for second doses, because the state is taking care to place its federal orders for those second doses so they’ll arrive in time for providers to administer them, Ciccocioppo said.

But some providers seem to have misinterpreted that guidance, he said. The department meant that providers shouldn’t hold back vials they’d ordered as first doses to be used as second doses, he said.

They still need to use doses they order for second shots as second shots, he said.

“We should have been more clear,” he said. From now on, the department will be, he added.

The department realized it had a problem this weekend when providers placed orders for a total of 200,000 second shots but there were only 143,000 vials for second shots available from the federal government, according to Ciccocioppo.

The state is receiving 183,000 first doses this week.

Providers using the Pfizer vaccine are not part of the problem, and neither are the federal partnership with CVS and Walgreens to vaccinate long-term care facilities, the new direct federal allocation program with Rite Aid and Topco and the separate federal allocation for Philadelphia County, officials said.

The department plans to prioritize the second shot requirements, then allocate the rest of available vaccines for first shots over the next three weeks, according to Ciccocioppo.

Providers will make adjustments by postponing second-shot appointments, if necessary, for one or two weeks, which will still allow all second shots to be given within the maximum 42 days of recipients’ first shots, according to Beam.

The hope is that the disruption of first-shot appointments will be minimized with the help of second-dose postponements, uncommitted vaccines that some providers may have in stock and the gradually rising federal allocation, she said.

Using second doses for first shots not only creates a shortfall equal to the number of those second doses, but also creates additional demand for second doses, due to the new first-dose recipients whose second shots will come due in several weeks, Ciccocioppo acknowledged.

It doesn’t double the need “instantly,” however, he said.

The department will be checking into which providers may have improperly used second doses for first shots, but first wanted to work out the solution to the problem, Ciccocioppo said.

‘It’s not a question of whose fault it is,” Ciccocioppo said. “But how can we fix this as quickly as possible.”

The mechanisms are in place so the problem won’t recur, Beam said.

Mirror Staff Writer William Kibler is at 814-949-7038.

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