Moderna Half Dose Boosters – What We Know So Far

AIM Members –

Please see a quick summary from our Data Project Manager Kristy Westfall on what we know so far regarding the implementation and tracking of Moderna half-dose boosters:

Moderna Booster COVID-19 Vaccine Implementation: What We Know So Far

• • Moderna booster doses are 50 mcg (half of the primary series dose amount). 
    • Individuals who are immunocompromised and are seeking an additional (3rd) dose should receive the full 100 mcg dose
  • There is no separate product for boosters vs. primary series or additional doses for immunocompromised individuals. Booster doses can be drawn from the same vials as full doses at one-half the primary-series administration volume. 
  • One vial of Moderna vaccine contains 14 full doses (100 mcg); a vial can only be punctured up to 20 times.
    • One vial can be used for a mixture of full and half doses or only half doses; a full vial used only for booster doses will have vaccine remaining but must be discarded after the 20th puncture is made.
  • Waste of Moderna vaccine for any reason, including not using all doses due to the puncture limit, should not be reported past 14 doses administered (including half-doses). 
    • Do NOT count volume left in vial as waste. Only count waste if 14 full or half-doses have not been administered from one vial. 
    • If a vial is used only for booster doses, one vial has the potential to administer 28 half doses. Providers may only administer 20 boosters doses (equivalent to 10 full doses)  from the vial, leaving 8 half doses (4 full doses) remaining in the vial that need to be discarded. 
    • If the vial was entered into the inventory in the IIS as 28 doses for reporting purposes, only 4 of the 8 remaining doses would be reported as waste to the CDC, the other 4 would need to be removed from inventory using the “Other” wastage category as per the guidance on accounting for doses drawn out of a vial that did not make a full dose.
      • 4 removed from inventory in the IIS as “Wasted” – “Drawn Up, Not Used” or “Expired multi-dose vial” or other similar reason codes in the IIS/Vtrcks – These WILL be reported to CDC
      • 4 removed from inventory in the IIS as “Wasted” – “Other” (if you are unsure which wastage reason in the IIS reports the waste as “other” when reporting through ExIS, reach out to your vendor or IIS team for more information).
        • The “Other” reason code, when reported to CDC in Vtrcks, will not count as waste. These doses do not need to be reported if waste is reported manually in Vtrcks and not through the ExIS interface.
• View Vermont’s  Moderna Booster Dose Reporting Resource.

CDC IIS Information Brief – October 22, 2021

Wastage and Inventory Reporting Guidance for Moderna Booster (new!)

Moderna COVID-19 vaccine is available and in your inventory in two presentations: the Moderna 10-dose vials and Moderna 14-dose vials. These vials can be used to provide the half-dose booster of Moderna as authorized by FDA and ACIP. Reporting inventory and wastage will not be affected by the use of half-dose booster. To facilitate tracking, IIS should continue to manage inventory and wastage using whole doses.

Inventory reporting: IIS should continue to track inventory in whole doses and report only unopened vials of vaccine. Do not count opened/punctured product.

Wastage reporting: Wastage should be reported only as whole doses. Each dose administered, whether it is a half dose or a full dose, counts against the total possible wastage of 10 doses (for 10-dose vial) or 14 doses (for 14-dose vial). Once 10 or 14 administrations occur in any combination of dose sizes, no wastage should be reported. For a Moderna-14 vial: wastage should only be reported up to 14 doses; do not report wastage over 14 doses even though you can administer up to 20 booster doses from one vial.

Example: In a given day, a clinic administered 1 primary dose and 5 booster doses (half doses) from a Moderna 14-dose vial. The clinic should report as follows:

• 6 people vaccinated (1 primary dose and 5 booster doses)
• 8 doses wasted (14 doses available in the vial minus 6 administered doses)