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Idaho clinics rush to train staff for COVID booster rollout

by REBECCA BOONE Associated Press
| October 23, 2021 1:00 AM

BOISE (AP) — With expanded access to coronavirus boosters approved and vaccinations for younger kids on the horizon, family physicians are fielding phone calls from people eager to get the shots. But this round of vaccinations is more complicated than the last — with mix-and-match possibilities between different vaccine brands, different dosage sizes and varying rules about exactly who qualifies for which booster.

It all means that many health care providers will spend a few days training staff before they can start putting shots in arms, said Dr. David Peterman, the CEO of Primary Health Group in southwestern Idaho.

"Let's step back a minute and understand that every vaccine comes with very specific instructions in how it's packaged, how to take it out, how to dilute it if needed, what syringes to use, how to store it and more," Peterman said Friday. "So with the COVID vaccines — Moderna, Johnson & Johnson and Pfizer — each have their own rules. And in our case, where we give thousands of vaccines, we want to make sure that we won't make an error."

Everyone who got J&J's single-shot vaccine can get a second dose at least two months after their original vaccination, according to the FDA rules. Those who were originally vaccinated with Pfizer can get a booster if they are 65 or older and their last dose was at least six months ago. Those aged 18 and older who live in long-term care settings, have underlying medical conditions or who live or work in high-risk settings can also get a booster. Both the J&J and Pfizer boosters are the same dose as the original shots.

Moderna recipients can also get a booster six months after their last shot if they are 65 or older or if they are at high risk of COVID-19 because of job, health or living conditions. But Moderna's booster dose is half the size as the one used for the original shots.

And people can mix-and-match the brands they use for their boosters if needed — someone who got the J&J vaccine could choose a Pfizer or Moderna booster, for instance.

Each Moderna vial holds 15 doses if they are used for a first or second shot. That means the same vial holds 30 booster doses, said Peterman — but rules designed to reduce the risk of contamination means each vial can only be punctured 20 times. That means "wastage," where extra vaccine is thrown away, will likely increase, he said.

The different size doses also require different syringe and needle sizes to increase measuring accuracy, Peterman said — and while the federal government provided syringes for the full-size original doses, so far it isn't providing or recommending what syringes to use with the Moderna boosters.

Peterman hopes to have all of his staffers trained so Primary Health clinics can start giving boosters on Tuesday, Peterman said. In the meantime, he's been frustrated by the wave of news articles and statements from public health officials telling people they can get the boosters starting this weekend. One such announcement came from the Idaho Department of Health and Welfare on Friday afternoon.

"Booster doses are available now at pharmacies, clinics, and healthcare providers statewide," the IDHW announcement read.

Peterman's glad the boosters have been approved, but he said the rollout leaves a lot to be desired.

"No one stopped to say, 'Wait, we need to make sure primary providers have all the information so they can train to safely give the boosters,'" Peterman said.