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Dept. Of Health: dose mixup may cause delays

Because of lack of clear communications and instructions, and unlabeled shipments, some people received their first dose of COVID-19 vaccine earlier than expected and others may have to wait up to two extra weeks for the second dose.

But no one got a “wrong” dose.

The Pennsylvania Department of Health announced a mix-up that caused 200,000 doses of the Moderna vaccine to be given as first doses instead of second doses over the past month.

No one who received vaccine received the wrong amount or the wrong medicine. There is no chemical difference between the doses.

That the doses are the chemically the same added to the lack of clarity. Providers couldn’t look at vials in their shipments to determine which arms to put them in.

Those patients who received the “wrong” dose simply moved ahead earlier than the department expected. And, those doses were not immediately available for those in need of second doses.

Department of Health Press Secretary Barry Ciccocioppo addressed the problem, first announced by the department on Wednesday, at a press briefing on Thursday.

He said vaccine providers have to submit separate requests for ‘first-dose’ vaccine and ‘second-dose’ vaccine. Those providers then receive two shipments – one of first-dose and one of second-dose.

The confusion arose because the shipments are not labeled and information about how shipments would be made was unclear.

Compounding that lack of clarity, the department has been urging providers to put as many first doses in arms as possible – not holding back – for a month, Ciccocioppo said.

“We’re not trying to place the blame on anybody,” he said. “There’s no difference in the medicine. The box is the same. We’ve been saying, ‘don’t hold back first doses.’ We have those things come together. There’s no distinction between boxes and they’re hearing ‘get it out.'”

For those providers who were tracking carefully, the shipments of second doses should have matched up well with the number of second doses requested… but that was not made clear.

“Second doses were given as first doses,” Ciccocioppo said. “That’s the problem we have to correct.”

Asked why the problem was specific to the Moderna vaccine and did not seem to be impacting those distributing Pfizer vaccine, Ciccocioppo said he did not know.

“What we’re doing now is fixing that problem,” he said. “The fix that we have in place is going to take about three weeks.”

The department stands firm in its guarantee. “Everybody who got their first dose will get their second dose,” Ciccocioppo said. “We are making sure that the providers do have enough second dose vaccines.”

Patients will receive their second dose at the same place they got their first dose and they will get it within the Centers for Disease Control and Prevention’s (CDC) window of 42 days, he said.

That might cause the department to have to shift first doses – “pull some of our first-dose allocation to make sure,” Ciccocioppo said. “Right now, there is not enough vaccine for everybody that is eligible. We’ve got about 4 million people (who are eligible in Phase 1A) chasing 180,000 doses” – the state’s allocation this week.

Locally, the situation will change little in the short term.

“At this point we are focused on assuring that second doses are given appropriately,” Warren General Hospital Chief Nursing Officer Joe Akif said. “We currently are covered for the next two weeks. Our hope is that the remaining two weeks are covered timely.”

With the department willing to push second doses out to 42 days, the hospital has a buffer of two additional weeks.

The hospital doesn’t have many people still waiting for second doses.

“Because we were completing second doses, there are not a huge amount of second doses outstanding,” Akif said. “We are not overly concerned at this time for delivery of second doses.”

Gaughn’s Drug Store hadn’t needed to order any second doses until last week. All of its clinics so far have delivered only first doses.

“At this point, we are unable to predict how this will affect our vaccine supply over the course of the next few weeks,” Gaughn’s Drug Store Vaccine Coordinator Justin Scholl said. “However, the information that has been communicated by the Department of Health suggests that those who have received their first dose of Moderna COVID-19 vaccine up to this point in any of our clinics may have to have the administration of the second dose pushed back in order to allow the supply chain to be replenished.”

“If you have an appointment scheduled for a second dose in the coming weeks, we are keeping the previously scheduled appointments for the second doses,” he said. “We will make decisions as to whether or not we need to reschedule these appointments based on the allocation of vaccine that we receive in the coming weeks. If we need to reschedule your appointment due to this shortage, we will reach out to you directly via phone or the email that you have provided.”

“The state has further indicated that this will also have a substantial limitation on the number of first doses available statewide for the next several weeks,” Scholl said. “We will continue to request doses from the state for first doses, as we have been for the past month, and will continue to work through our list to the best of our ability to administer first doses.”

COUNTY UPDATE

There were two new cases and one new COVID-related death announced in the department’s latest information.

There have been 96 deaths of county residents attributed to the disease. The latest one, and the first since Jan. 30, on the department’s graph shows a date of death of Feb. 13.

The department reported that there have been a total of 2,114 cases of COVID-19 in the county. Of those, 1,731 are confirmed and 383 are probables.

The number of COVID-positive patients at Warren General Hospital was down to one according to Thursday’s report. That patient was not on a ventilator nor in intensive care.

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