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COVID-19
VACCINATION
Ten Things to Know to Administer
COVID-19 Vaccines
By David Doolittle
State health officials have begun distributing COVID-19 vaccines all ancillary supplies, including needles, syringes, alcohol prep pads,
across the state, based on guiding principles that prioritize essential surgical masks, face shields, diluent (if applicable), and COVID-
health care workers and vulnerable populations. 19 vaccination record cards for patients. For the Pfizer/BioNTech
There are numerous requirements and steps physicians and health vaccine, you may receive these supplies in a separate shipment.
care facilities must adhere to in order to administer vaccines. • Time Limitations: The vaccines come in multi-dose vials and need
Below are 10 things to know about administering the vaccines that to be completely used within a limited period of time after the vial
have received an EUA from the FDA so far. is removed from the refrigerator or freezer. The Pfizer/BioNTech
• State Registries: In order to administer a vaccine, you must be en- vaccine requires reconstitution with saline. More details on admin-
rolled in Texas' immunization registry, ImmTrac2. Enrollment in istration, dilution (if applicable), and time limitations are available
ImmTrac2 is part of the registration process at EnrollTexasIZ.dshs. in these Pfizer/BioNTech, Moderna, and Janssen/Johnson&John-
texas.gov. son fact sheets.
• Ordering and Inventory: You will be required to submit requests, • Patient Education: Before you give the shot, you have to provide to
accept your allocation, and report inventory for the COVID-19 the patient an approved Emergency Use Authorization (EUA) fact
vaccine via the Texas Vaccine Allocation & Ordering System sheet or vaccine information statement (VIS). The current EUA fact
(VAOS). Be sure to check your email spam folder and accept your sheets for recipients of the Pfizer/BioNtech, Moderna,
allocation within 48 hours. Resources: and Janssen/Johnson&Johnson vaccines are available on the BCMS
o COVID-19 VAOS – How to Access the System (PDF) website. After the first dose, you must give your patient a COVID-
o COVID-19 VAOS – Provider User Training Guide (PDF) 19 vaccination record card, which is included in your vaccine ship-
o More Department of State Health Services (DSHS) Resources ment. For Pfizer/BioNtech and Moderna, the card is to ensure the
and Video Demonstrations first dose and second dose are from the same vaccine manufacturer.
• Records and Reporting: You will need to report patient informa- If the patient’s card is lost, you can look up which first dose the patient
tion for each vaccine administered to ImmTrac2 within 24 hours of received in ImmTrac2. You cannot give a patient doses from different
administration. COVID-19 vaccination records must be preserved vaccine manufacturers.
for at least three years following vaccination, and will need to be • Safety: You must administer a COVID-19 vaccine in accordance
made available to any federal, state, local, or territorial public health with all requirements and recommendations of CDC and
department to the extent authorized by law. You also need to submit CDC’s Advisory Committee on Immunization Practices
a daily report of the doses administered into the Texas Department (ACIP). The ACIP’s recommendations for the Pfizer/BioN
of Emergency Management (TDEM) Therapeutics and Vaccine Tech,Moderna, and Janssen/Johnson&Johnson vaccines, as well as
Reporting Portal and report any unused or wasted doses specifically CDC’s Interim Considerations for Use of mRNA COVID-19 Vac-
into VAOS. cines are available on the BCMS website.
• Payment: You cannot sell or seek payment for COVID-19 vaccine • Adverse Events: You must input any moderate and severe adverse
and any accompanying supplies provided free by the federal gov- events following vaccination to the Vaccine Adverse Event Report-
ernment. Administration fees may be applied; however, you must ing System (VAERS). Note that you should report adverse events
administer the vaccine regardless of whether the recipient can pay only to VAERS, which is co-managed by the CDC and the U.S.
the fees. If you are enrolled in Medicare or plan to enroll to admin- Food and Drug Administration (FDA). You also must promote to
ister the vaccine, you need to keep up to date on coding, billing, recipients V-Safe, a smartphone-based tool that uses text messaging
and payment requirements from CMS. and web surveys to provide personalized health check-ins.
• Temperature Monitoring: You must have a digital data logger to
closely monitor and record the refrigerator and freezer temperatures CDC also has published Interim Considerations: Preparing for the
that store the COVID-19 vaccine. These records must be preserved Potential Management of Anaphylaxis at COVID-19 Vaccination Sites.
for at least three years. Find more information on the requirements
of digital data loggers on the DSHS website. Find more tools, resources, and information on TMA’s COVID-
• Ancillary Supplies: COVID-19 vaccine shipments will come with 19 Resource Center, which is continually updated.
Copyright 2021 Texas Medical Association; used with permission
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