SPECIAL BULLETIN COVID-19 #217: Third Dose of Pfizer-BioN Tech Vaccine for Children Ages 5-11 Certain immunocompromised children will qualify

January 14, 2022

On Jan. 3, 2022, the U.S. Food and Drug Administration amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine to allow for a third dose in the primary series for certain immunocompromised children ages 5 through 11. This includes children who have undergone solid organ transplantation or who have been diagnosed with conditions which are considered to have an equivalent level of immunocompromise. Children ages 5 through 11 who are fully vaccinated and are not immunocompromised do not need a third dose at this time.

As of Jan. 3, 2022, Medicaid and NC Health Choice will cover a third dose of the Pfizer-BioNTech COVID-19 Vaccine primary series for immunocompromised children ages 5 through 11 for all vaccinating providers.

The new vaccine administration code assigned to the third dose of Pfizer’s pediatric COVID-19 vaccine is:

91307

SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to prevent the patient from contracting COVID–19. 10 mcg/0.2 mL

0073A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; third dose

All other aspects of claims billing still apply (see COVID-19 Bulletin #196 for details).

If you have any questions about product-specific information, please contact the Immunization Branch help desk at 877-873-6247 and press option 6.

CONTACT

NCTracks Contact Center: 800-688-6696

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