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    SARS-CoV-2 Virus (COVID-19) mRNA Vaccine

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    Apr.01.2024
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    SARS-CoV-2 Virus (COVID-19) mRNA Vaccine

    Indications/Dosage

    Labeled

    • prevention of coronavirus disease 2019 (COVID-19)

    General Dosing Information

    • NOTE: The updated 2023/2024 COVID-19 vaccine strain targets the Omicron XBB.1.5 variant.[67339][67786][67907][67908]
    • COVID-19 vaccination is recommended for individuals 6 months and older for the prevention of COVID-19.
    • When possible, patients 6 months to 4 years should receive all doses of COVID-19 vaccine from the same manufacturer.
    • For unvaccinated patients ages 6 months to 4 years, it is recommended that initial vaccination include either 2 doses of updated Moderna COVID-19 vaccine or 3 doses of updated Pfizer-BioNTech COVID-19 vaccine. It is recommended that patients age 6 months to 4 years who received previous mRNA doses receive 1 or 2 homologous doses of updated Moderna or updated Pfizer-BioNTech COVID-19 vaccine, depending on the number of prior doses. Patients in this age group who received all doses in the initial vaccination series should receive 1 dose of a homologous updated mRNA vaccine.
    • It is recommended that all patients 5 years and older receive 1 dose of the updated mRNA COVID-19 vaccine, regardless of previous vaccination history.
    • Individuals 12 years and older who previously received 1 or more doses of Novavax COVID-19 vaccine or Janssen COVID-19 vaccine, including those who also received any mRNA vaccine doses, are recommended to receive 1 dose of any updated COVID-19 vaccine.
    • It is recommended that individuals 65 years and older receive 1 additional dose of updated COVID-19 vaccine.
    • For patients who are moderately or severely immunocompromised receiving an mRNA COVID-19 vaccine, it is recommended that initial vaccination include a 3 dose series of updated Moderna COVID-19 vaccine or updated Pfizer-BioNTech COVID-19 vaccine. For moderately or severely immunocompromised patients who received previous mRNA doses, 1 or 2 doses of updated Moderna or updated Pfizer-BioNTech vaccines are recommended, depending on the number of prior doses.
    • Doses administered up to 4 days before the minimum interval or age are considered valid. Doses given any time after the recommended interval are valid. If a COVID-19 dose is administered prior to the 4-day grace period, the dose should be repeated. Space the repeat dose the recommended minimum interval after the dose given in error.
    • The COVID-19 vaccine may be administered with other vaccines without regard to timing.
      • Health care providers may simultaneously administer COVID-19, influenza, and respiratory syncytial virus (RSV) vaccines to eligible patients.
      • There is no required minimum interval between receiving a dose of any COVID-19 vaccine and an orthopoxvirus vaccine. Due to the documented risk for myocarditis after both the smallpox and mRNA COVID-19 vaccines and unknown risk with smallpox and monkeypox vaccine, patients, in particular adolescents or young adult males, may consider waiting 4 weeks after smallpox and monkeypox vaccination before getting an mRNA COVID-19 vaccine. However, if vaccination with the smallpox and monkeypox vaccine is recommended for prophylaxis during an outbreak, do not delay administration because of recent mRNA COVID-19 vaccination.[66175]
    • The influenza season will coincide with the continued or recurrent circulation of SARS-CoV-2. Influenza vaccination of patients 6 months and older may reduce symptoms that might be confused with those of COVID-19. Additionally, prevention and reduction of influenza severity could decrease hospitalizations and intensive care unit admissions and alleviate stress on the health care system.[63436]

    Off-Label

      † Off-label indication

      For the prevention of coronavirus disease 2019 (COVID-19)

      not previously vaccinated with a COVID-19 vaccine

      Intramuscular dosage (Pfizer-BioNTech COVID-19 vaccine)

      Adults 65 years and older

      0.3 mL (30 mcg) IM for 2 doses. Administer the second dose at least 4 months after the first dose of COVID-19 vaccine.[53026] [66175]

      Adults 18 to 64 years

      0.3 mL (30 mcg) IM.[53026] [67786]

      Children and Adolescents 12 to 17 years

      0.3 mL (30 mcg) IM.[53026] [67786]

      Children 5 to 11 years†

      0.3 mL (10 mcg) IM.[53026] [67907]

      Infants† and Children† 6 months to 4 years

      0.3 mL (3 mcg) IM for 3 doses. Administer dose 1 at week 0, dose 2 at week 3 to 8, and dose 3 at week 11 to 16. Children turning from 4 to 5 years during the vaccination series should complete this series.[53026] [66175] [67907]

      Intramuscular dosage (Moderna COVID-19 vaccine)

      Adults 65 years and older

      0.5 mL (50 mcg) IM for 2 doses. Administer the second dose at least 4 months after the first dose of COVID-19 vaccine.[53026] [66175]

      Adults 18 to 64 years

      0.5 mL (50 mcg) IM.[53026] [67339]

      Children and Adolescents 12 to 17 years

      0.5 mL (50 mcg) IM.[53026] [67339]

      Children 5 to 11 years†

      0.25 mL (25 mcg) IM.[53026] [67908]

      Infants† and Children† 6 months to 4 years

      0.25 mL (25 mcg) IM for 2 doses. Administer dose 1 at week 0 and dose 2 at week 4 to 8. Children turning from 4 to 5 years during the vaccination series should complete this series.[53026] [66175] [67908]

      previously vaccinated with at least 1 dose of any original monovalent or bivalent COVID-19 vaccine

      Intramuscular dosage (Pfizer-BioNTech COVID-19 vaccine)

      Adults 65 years and older

      0.3 mL (30 mcg) IM for 2 doses. First dose at least 8 weeks after the last dose of original COVID-19 vaccine. Second dose at least 4 months after the first dose of updated COVID-19 vaccine.[53026] [66175]

      Adults 18 to 64 years

      0.3 mL (30 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67786]

      Children and Adolescents 12 to 17 years

      0.3 mL (30 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67786]

      Children 5 to 11 years†

      0.3 mL (10 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67907]

      Infants† and Children† 6 months to 4 years who received 1 dose of COVID-19 vaccine

      0.3 mL (3 mcg) IM for 2 doses. Administer the first dose 3 to 8 weeks after receipt of the previous dose of COVID-19 vaccine and dose 2 at least 8 weeks after dose 1. Children turning from 4 to 5 years during the vaccination series should complete this series.[53026] [66175] [67907]

      Infants† and Children† 6 months to 4 years who received 2 to 4 doses of COVID-19 vaccine

      0.3 mL (3 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67907]

      Intramuscular dosage (Moderna COVID-19 vaccine)

      Adults 65 years and older

      0.5 mL (50 mcg) IM for 2 doses. First dose at least 8 weeks after the last dose of original COVID-19 vaccine. Second dose at least 4 months after the first dose of updated COVID-19 vaccine.[53026] [66175]

      Adults 18 to 64 years

      0.5 mL (50 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67339]

      Children and Adolescents 12 to 17 years

      0.5 mL (50 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67339]

      Children 5 to 11 years†

      0.25 mL (25 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67908]

      Infants† and Children† 6 months to 4 years who received 1 dose of COVID-19 vaccine

      0.25 mL (25 mcg) IM 4 to 8 weeks after the last dose of COVID-19 vaccine.[53026] [67908]

      Infants† and Children† 6 months to 4 years who received at least 2 doses of COVID-19 vaccine

      0.25 mL (25 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine.[53026] [67908]

      patients with certain kinds of immunocompromise

      Intramuscular dosage (Pfizer-BioNTech COVID-19 vaccine)

      Adults 65 years and older†

      0.3 mL (30 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series. If unvaccinated, administer 3 doses at week 0, week 3, and at week 7. Administer an additional dose of the updated formulation at least 8 weeks after the last dose of the updated formulation. Further additional doses may be administered at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [66175]

      Adults 18 to 64 years†

      0.3 mL (30 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series. If unvaccinated, administer 3 doses at week 0, week 3, and at week 7. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [66175]

      Children† and Adolescents† 12 to 17 years

      0.3 mL (30 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series. If unvaccinated, administer 3 doses at week 0, week 3, and at week 7. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [66175]

      Children 5 to 11 years†

      0.3 mL (10 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series. If unvaccinated, administer 3 doses at week 0, week 3, and at week 7. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [67907]

      Infants† and Children† 6 months to 4 years

      0.3 mL (3 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series. If unvaccinated, administer 3 doses at week 0, week 3, and at week 11. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [67907]

      Intramuscular dosage (Moderna COVID-19 vaccine)

      Adults 65 years and older†

      0.5 mL (50 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series at least 4 weeks apart. If unvaccinated, administer 3 doses at week 0, week 4, and at week 8. Administer an additional dose of the updated formulation at least 8 weeks after the last dose of the updated formulation. Further additional doses may be administered at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [66175]

      Adults 18 to 64 years†

      0.5 mL (50 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series at least 4 weeks apart. If unvaccinated, administer 3 doses at week 0, week 4, and at week 8. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [66175]

      Children† and Adolescents† 12 to 17 years

      0.5 mL (50 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series at least 4 weeks apart. If unvaccinated, administer 3 doses at week 0, week 4, and at week 8. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [66175]

      Infants† and Children† 6 months to 11 years

      0.25 mL (25 mcg) IM at least 8 weeks after the last dose of COVID-19 vaccine if previously vaccinated with 3 or more doses. If previously vaccinated with 1 or 2 doses of COVID-19 vaccine, administer the necessary doses to complete the 3 dose series at least 4 weeks apart. If unvaccinated, administer 3 doses at week 0, week 4, and at week 8. An additional dose of the updated formulation may be administered at least 8 weeks after the last dose of the updated formulation at the discretion of the health care provider based on the patient's clinical circumstances.[53026] [67908]

      Therapeutic Drug Monitoring

      Maximum Dosage Limits

      • Adults

        0.3 mL/dose (30 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.5 mL/dose (50 mcg) IM for Moderna COVID-19 vaccine.

      • Geriatric

        0.3 mL/dose (30 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.5 mL/dose (50 mcg) IM for Moderna COVID-19 vaccine.

      • Adolescents

        0.3 mL/dose (30 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.5 mL/dose (50 mcg) IM for Moderna COVID-19 vaccine.

      • Children

        12 years: 0.3 mL/dose (30 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.5 mL/dose (50 mcg) IM for Moderna COVID-19 vaccine.

        5 to 11 years: 0.3 mL/dose (10 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.25 mL/dose (25 mcg) IM for Moderna COVID-19 vaccine.

        1 to 4 years: 0.3 mL/dose (3 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.25 mL/dose (25 mcg) IM for Moderna COVID-19 vaccine.

      • Infants

        6 to 11 months: 0.3 mL/dose (3 mcg) IM for Pfizer-BioNTech COVID-19 vaccine; 0.25 mL/dose (25 mcg) IM for Moderna COVID-19 vaccine.

        1 to 5 months: Safety and efficacy have not been established.

      • Neonates

        Safety and efficacy have not been established.

      Patients with Hepatic Impairment Dosing

      Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

      Patients with Renal Impairment Dosing

      Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.

      † Off-label indication
      Revision Date: 04/01/2024, 09:27:21 AM

      References

      53026 - Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) recommended immunization schedules for persons aged 0 through 18 years and adults aged 19 years and older-United States. Accessed April 25, 2023. Available at https://www.cdc.gov/vaccines/schedules/hcp/index.html63436 - Grohskopf LA, Blanton LH, Ferdinands JM, et al. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2023-2024 Influenza Season. MMWR 2023;72(2):1-25.66175 - Center for Disease Control and Prevention. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Updated Jan 18, 2024. Accessed March 1, 2024. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.

      How Supplied

      BNT162B2 Omicron (XBB.1.5) Suspension for injection

      Pfizer-BioNTech COVID-19 2023-2024 Formula 3mcg/0.3mL Vaccine Suspension for Injection (59267-4315) (Pfizer Manufacturing Belgium NV) null

      BNT162B2 Omicron (XBB.1.5) Suspension for injection

      Pfizer-BioNTech COVID-19 2023-2024 Formula 10mcg/0.3mL Vaccine Suspension for Injection (59267-4331) (Pfizer Manufacturing Belgium NV) null

      BNT162B2 Omicron (XBB.1.5) Suspension for injection

      COMIRNATY COVID-19 2023-2024 Formula 30mcg/0.3mL Vaccine Pre-filled Syringe Suspension for Injection (00069-2392) (Pfizer Injectables) nullCOMIRNATY COVID-19 2023-2024 Formula 30mcg/0.3mL Vaccine Pre-filled Syringe Suspension for Injection package photo

      BNT162B2 Omicron (XBB.1.5) Suspension for injection

      COMIRNATY COVID-19 2023-2024 Formula 30mcg/0.3mL Vaccine Pre-filled Syringe Suspension for Injection (00069-2377) (Pfizer Injectables) null

      BNT162B2 Omicron (XBB.1.5) Suspension for injection

      COMIRNATY COVID-19 2023-2024 Formula 30mcg/0.3mL Vaccine Suspension for Injection (00069-2362) (Pfizer Injectables) null

      CX-038839 Omicron (XBB.1.5), Cholesterol, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, SM-102, PEG2000-DMG Suspension for injection

      spikevax COVID-19 mRNA 2023-2024 Formula 50mcg/0.5mL Vaccine Suspension for Injection 12 Years and older (Multiple-Dose Vial) (80777-0102) (Moderna US, Inc) (off market)

      Nucleoside-modified messenger RNA (modmRNA) of SARS-CoV-2 Suspension for injection

      Pfizer-BioNTech COVID-19 3mcg/0.2mL Vaccine Suspension for Injection 6 Months through 4 Years of Age (Maroon Cap/Maroon Border) (59267-0078) (Pfizer Manufacturing Belgium NV) (off market)

      Nucleoside-modified messenger RNA (modmRNA) of SARS-CoV-2 Suspension for injection

      Pfizer-BioNTech COVID-19 10mcg/0.2mL Vaccine Suspension for Injection 5 Years through 11 Years of Age (Orange Cap) (59267-1055) (Pfizer Manufacturing Belgium NV) (off market)

      Nucleoside-modified messenger RNA (modmRNA) of SARS-CoV-2 Suspension for injection

      COMIRNATY COVID-19 30mcg/0.3mL Vaccine Suspension for Injection (Gray Cap/Gray Label Border) (00069-2025) (Pfizer Injectables) null

      Nucleoside-modified messenger RNA (modmRNA) of SARS-CoV-2 Suspension for injection

      COMIRNATY COVID-19 30mcg/0.3mL Vaccine Suspension for Injection (Purple Cap/Purple Label Border) (00069-1000) (Pfizer Injectables) null

      Nucleoside-modified messenger RNA (modmRNA) of SARS-CoV-2 Suspension for injection

      Pfizer-BioNTech COVID-19 30mcg/0.3mL Vaccine Suspension for Injection 12 Years of Age and Older (Gray Cap) (59267-1025) (Pfizer Manufacturing Belgium NV) (off market)

      Nucleoside-modified messenger RNA (modmRNA) of SARS-CoV-2 Suspension for injection

      Pfizer-BioNTech COVID-19 30mcg/0.3mL Vaccine Suspension for Injection 12 Years of Age and Older (Purple Cap) (59267-1000) (Pfizer Manufacturing Belgium NV) (off market)

      SM-102, Cholesterol, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG, Elasomeran, CX-034476 Omicron (BA.4/BA.5) Suspension for injection

      Moderna COVID-19 10mcg/0.2mL Bivalent Booster Vaccine Suspension for Injection 6 Months to 5 Years (Dark Pink Cap/Label with a Yellow Box) (80777-0283) (Moderna US, Inc) null

      SM-102, Cholesterol, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG, Elasomeran, CX-034476 Omicron (BA.4/BA.5) Suspension for injection

      Moderna COVID-19 50mcg/0.5mL Bivalent Booster Vaccine Suspension for Injection (Dark Blue Cap/Gray Border Label) (80777-0282) (Moderna US, Inc) null

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      Moderna COVID-19 25mcg/0.25mL Vaccine Suspension for Injection 6 Months to 11 Years (Dark Blue Cap/Dark Blue Label in Green Carton) (80777-0287) (Moderna US, Inc) null

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      Moderna COVID-19 25mcg/0.25mL Vaccine Suspension for Injection 6 Months to 5 Years (Dark Blue Cap/Teal Border Label) (80777-0279) (Moderna US, Inc) (off market)

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      Moderna COVID-19 50mcg/0.5mL Booster Vaccine Suspension for Injection (Dark Blue Cap/Purple Border Label) (80777-0275) (Moderna US, Inc) (off market)

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      Moderna COVID-19 50mcg/0.5mL Vaccine Suspension for Injection 6 Years to 11 Years (Dark Blue Cap/Magenta Border Label) (80777-0277) (Moderna US, Inc) (off market)

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      spikevax COVID-19 mRNA 50mcg/0.5mL Vaccine Suspension for Injection 12 Years and older (Pre-Filled Syringe) (80777-0102) (Moderna US, Inc) null

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      spikevax COVID-19 mRNA 50mcg/0.5mL Vaccine Suspension for Injection 12 Years and older (Single Dose Vial) (80777-0102) (Moderna US, Inc) null

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      Moderna COVID-19 100mcg/0.5mL Vaccine Suspension for Injection (Red Cap/Light Blue Border Label) (80777-0273) (Moderna US, Inc) (off market)

      Synthetic messenger RNA (mRNA) of SARS-CoV-2, Cholesterol, SM-102, 1,2-DISTEAROYL-SN-GLYCERO-3-PHOSPHOCHOLINE, PEG2000-DMG Suspension for injection

      spikevax COVID-19 mRNA 100mcg/0.5mL Vaccine Suspension for Injection 18 Years and older (80777-0100) (Moderna US, Inc) null

      Tozinameran, BNT162B2 Omicron (BA.4/BA.5) Suspension for injection

      Pfizer-BioNTech COVID-19 3mcg/0.2mL Bivalent Vaccine Suspension for Injection 6 Months through 4 Years of Age (Maroon Cap/Maroon Border) (59267-0609) (Pfizer Manufacturing Belgium NV) null

      Tozinameran, BNT162B2 Omicron (BA.4/BA.5) Suspension for injection

      Pfizer-BioNTech COVID-19 10mcg/0.2mL Bivalent Booster Vaccine Suspension for Injection 5 Years through 11 Years of Age (Orange Cap/Orange Border) (59267-0565) (Pfizer Manufacturing Belgium NV) null

      Tozinameran, BNT162B2 Omicron (BA.4/BA.5) Suspension for injection

      Pfizer-BioNTech COVID-19 30mcg/0.3mL Bivalent Booster Vaccine Suspension for Injection 12 Years of Age and Older (Gray Cap/Gray Border) (59267-0304) (Pfizer Manufacturing Belgium NV) null

      Tozinameran, BNT162B2 Omicron (BA.4/BA.5) Suspension for injection

      Pfizer-BioNTech COVID-19 30mcg/0.3mL Bivalent Booster Vaccine Suspension for Injection 12 Years of Age and Older (Gray Cap/Gray Border) (59267-1404) (Pfizer Manufacturing Belgium NV) null

      Description/Classification

      Description

      NOTE: The 2023/2024 COVID-19 vaccine strain targets the Omicron XBB.1.5 variant.[67339][67786][67907][67908]

      The COVID-19 vaccine is a vaccine that contains messenger RNA (mRNA) encoding the viral spike glycoprotein (S) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is used for active immunization for the prevention of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2. Pfizer-BioNTech COVID-19 and Moderna COVID-19 vaccine use in patients 12 years and older is FDA-approved.[67339][67786] Pfizer-BioNTech COVID-19 and Moderna COVID-19 vaccine use in patients 6 months to 11 years is covered under an Emergency Use Authorization (EUA).[67907][67908] One of the advantages of mRNA vaccines is that they can be rapidly manufactured. The process is cell-free and can be scaled, allowing quick responses to large outbreaks and epidemics, such as the COVID-19 pandemic. Additionally, mRNA vaccines offer a different technology; unlike other vaccines, RNA-based vaccines introduce an mRNA sequence coded for a disease-specific antigen, which elicits a robust innate immune response when presented to the immune system.[66084][66093] In clinical trials, RNA-vaccines and RNA-based therapeutic agents have been found to be safe and well-tolerated. The most commonly reported adverse drug reactions include injection site pain, fever, chills, fatigue, muscle pain, and headache. Serious allergic reactions and anaphylaxis have been reported in patients outside of clinical trials during mass vaccination. In January 2023, the CDC's Vaccine Safety Datalink (VSD), a real-time surveillance system, met the statistical criteria to prompt additional investigation into a potential risk of ischemic stroke in patients 65 years and older in the 21 days after vaccination with the Pfizer-BioNTech COVID-19 bivalent vaccine. No other safety systems have shown a similar risk and multiple subsequent analyses have not validated this risk. The CDC and FDA will continue to evaluate additional data from these and other vaccine safety systems; however, no change in vaccination practice is recommended.[66084][67339][67786][67907][67908][68453]

      Classifications

      • General Anti-infectives Systemic
        • Vaccines
          • Pure Vaccines
            • SARS-CoV-2 (Covid-19) Vaccines
      Revision Date: 04/01/2024, 09:27:21 AM

      References

      66084 - Mulligan MJ, Lyke KE, Kitchin N, et al. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature 2020; 586:589-593.66093 - jackson NA, Kester KE, Casimiro D, et al. The promise of mRNA vaccines: a biotech and industrial perspective. npj Vaccines. 2020; 5:1167339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.68453 - Food and Drug Administration. CDC and FDA identify preliminary COVID-19 vaccine safety signal for persons aged 65 years and older. Retrieved Jan 17, 2023. Available on the World Wide Web at: https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/cdc-and-fda-identify-preliminary-covid-19-vaccine-safety-signal-persons-aged-65-years-and-older?utm_medium=email&utm_source=govdelivery.

      Administration Information

      General Administration Information

      For storage information, see the specific product information within the How Supplied section.

       

      Storage and Handling Prior to Thawing (Pfizer-BioNTech COVID-19 vaccines)

      • Cartons of Pfizer-BioNTech COVID-19 vaccine may arrive in thermal containers with dry ice. Once received, vaccine may be immediately transferred from the thermal container to the refrigerator, stored between 2 to 8 degrees C (35 to 46 degrees F), thawed, and stored for up to 10 weeks. Record the 10-week refrigerated expiration date on the carton at the time of transfer. Cartons of multiple dose vials, single dose vials, and prefilled syringes may take up to 2 hours to thaw.
      • Alternatively, Pfizer-BioNTech COVID-19 vaccine may be stored in an ultra-low temperature freezer at -90 to -60 degrees C (-130 to -76 degrees F) until the expiration date printed on the vials or syringes and cartons. Do NOT store at -25 to -15 degrees C (-13 to 5 degrees F). Once vials or syringes are thawed they should not be refrozen.
      • Cartons of Pfizer-BioNTech COVID-19 vaccine may also arrive at 2 to 8 degrees C (35 to 46 degrees F). Check that the carton has been updated to reflect the 10-week refrigerated expiration date, not to exceed the expiration date printed on the vial or syringe and cartons.
      • Minimize exposure to room light and avoid exposure to direct sunlight and ultraviolet light during storage.
      • Transportation of frozen vials: If local redistribution is needed, vaccine may be transported at -90 to -60 degrees C (-130 to -76 degrees F) or at 2 to 8 degrees C (35 to 46 degrees F).[67786][67907]

       

      Storage and Handling Prior to Thawing (Moderna COVID-19 vaccine)

      • Store vaccine frozen between -50 to -15 degrees C (-58 to 5 degrees F) until ready to use. Keep in the original container to protect from light.
      • Transportation of vials: If transport at -50 to -15 degrees C (-58 to 5 degrees F) is not feasible, available data support transportation of 1 or more thawed vials or syringes for up to 12 hours at 2 to 8 degrees C (35 to 46 degrees F) when shipped using shipping containers which have been qualified to maintain 2 to 8 degrees C (35 to 46 degrees F) and under routine road and air transport conditions with shaking and vibration minimized. Once thawed and transported at 2 to 8 degrees C (35 to 46 degrees F), vials or syringes should not be refrozen and should be stored at 2 to 8 degrees C (35 to 46 degrees F) until use.[67339][67908]

      Route-Specific Administration

      Injectable Administration

      • Administer intramuscularly. Do not administer intravenously, intradermally, or subcutaneously.
      • Due to the potential for errors, separation of the different formulations during storage is recommended. Additionally, ensure proper labeling for individual syringes prior to administration.[67102][67188]
      • Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
      • The Pfizer-BioNTech COVID-19 vaccine (Comirnaty) is a white to off-white suspension while the Pfizer-BioNTech COVID-19 vaccine for use in patients 6 months to 11 years is clear to slightly opalescent; neither should contain particulate matter.[67786][67907] The Moderna COVID-19 vaccine is a white to off-white suspension. It may contain white or translucent product-related particles.[67339][67908]
      • The COVID-19 vaccine may be administered with other vaccines without regard to timing.
        • Health care providers may simultaneously administer COVID-19, influenza, and respiratory syncytial virus (RSV) vaccines to eligible patients.
        • There is no required minimum interval between receiving a dose of any COVID-19 vaccine and an orthopoxvirus vaccine. Due to the documented risk for myocarditis after both the smallpox and mRNA COVID-19 vaccines and unknown risk with smallpox and monkeypox vaccine, patients, in particular adolescents or young adult males, may consider waiting 4 weeks after smallpox and monkeypox vaccination before getting an mRNA COVID-19 vaccine. However, if vaccination with the smallpox and monkeypox vaccine is recommended for prophylaxis during an outbreak, do not delay administration because of recent mRNA COVID-19 vaccination.
      • A 30 minute observation period after vaccination is recommended for the following patient populations:
        • History of a non-severe, immediate (onset less than 4 hours) allergic reaction after administration of a previous dose of a COVID-19 vaccine.
        • History of a diagnosed non-severe allergy to a component of the COVID-19 vaccine.
      • A 15 minute observation period after vaccination is recommended for all other patients.[66175]

      Intramuscular Administration

      Pfizer-BioNTech COVID-19 vaccine

      Thawing (Pfizer-BioNTech COVID-19 vaccines)

      • The Pfizer-BioNTech COVID-19 vaccine plastic prefilled syringes and single dose vials are supplied as a frozen suspension that is preservative-free and must be thawed prior to administration. Single dose glass prefilled syringes should not be frozen; discard if they have been frozen.
        • Thawing under refrigeration [2 to 8 degrees C (35 to 46 degrees F)]: Thaw for up to 2 hours.
        • Thawing at room temperature [up to 25 degrees C (77 degrees F)]: Thaw vials for 30 minutes. Thaw plastic prefilled syringes in the carton for 60 minutes.
      • During storage, minimize exposure to room light and avoid exposure to direct sunlight and ultraviolet light. Do NOT refreeze thawed vials or plastic syringes.
      • Vials or plastic syringes may be thawed and stored in the refrigerator [2 to 8 degrees C (35 to 46 degrees F)] for up to 10 weeks.
      • Thawed vials or plastic syringes thawed in the carton may be stored at room temperature [up to 25 degrees C (77 degrees F)] for up to 12 hours prior to use; if individual prefilled syringes are thawed outside the carton, use within 4 hours.
      • Store glass prefilled syringes under refrigeration [2 to 8 degrees C (35 to 46 degrees F)]; total time at room temperature [8 to 25 degrees C (46 to 77 degrees F)] must not exceed 12 hours.[67786][67907]

       

      Dilution (only for multiple dose vials with yellow caps and yellow vial label borders)

      • Before dilution, gently invert vial 10 times to mix. Do NOT shake.
      • Inspect liquid in the vial prior to dilution. The liquid should be a clear to slightly opalescent with no visible particles. Do not use if it is discolored or contains particulate matter.
      • Dilute the vaccine suspension in its original vial with 1.1 mL of 0.9% Sodium Chloride Injection.
      • Equalize vial pressure before removing the needle from the vial by withdrawing air into the empty diluent syringe.
      • Record the date and time of dilution on the vial label.
      • Before administration, gently invert vial 10 times to mix. Do NOT shake.
      • After dilution, multiple-dose vials contain 3 doses of 0.3 mL each.
      • If the amount of vaccine remaining in the vial cannot provide a full dose of 0.3 mL, discard the vial and content; do not pool excess vaccine from multiple vials.
      • Storage after dilution: Store between 2 and 25 degrees C (35 to 77 degrees F) and use within 12 hours from the time of dilution. Discard any vaccine remaining in vials after 12 hours.

       

      Do NOT dilute (only for single dose vials and prefilled syringes)

      • Before administration, gently invert vial or syringe 10 times to mix. Do NOT shake.
      • After mixing, the vaccine should appear as a white to off-white suspension (Comirnaty) or clear to slightly opalescent (Pfizer-BioNTech COVID-19 vaccine). Do not use if it is discolored or contains particulate matter.[67786][67907]

       

      Intramuscular Injection

      • Prior to vaccine administration, verify the patient's age and the vaccine(s) they have requested; ensure the age-appropriate formulation is used. Involve the parent or caregiver in reading the label to confirm the correct vaccine. Only bring the labeled vaccine syringe(s) for 1 patient into the vaccination area. Document the lot number and date of manufacture prior to vaccine administration with additional documentation after vaccine administration.[67188]
      • After withdrawing the dose from a single or multiple dose vial, administer immediately as an intramuscular injection. For single dose prefilled syringes, administer the dose intramuscularly immediately after removing the tip cap and attaching an appropriate needle. If not able to be administered immediately, use within 4 hours.[67786][67907]

       

      Moderna COVID-19 vaccine

      Thawing

      • The Moderna COVID-19 vaccine contains a frozen suspension that is preservative-free and must be thawed prior to use.
        • Multiple dose vials containing 5 doses:
          • Thawing in the refrigerator: Thaw and store in the refrigerator [2 to 8 degrees C (36 to 46 degrees F)] for 2 hours. Allow vial to remain at room temperature for 15 minutes prior to administration.
          • Thawing at room temperature: Thaw at room temperature [15 to 25 degrees C (59 to 77 degrees F)] for 45 minutes.
        • 0.25 mL and 0.5 mL single dose vial:
          • Thawing in the refrigerator: Thaw and store in the refrigerator [2 to 8 degrees C (36 to 46 degrees F)] for 45 minutes. Allow vial to remain at room temperature for 15 minutes prior to administration.
          • Thawing at room temperature: Thaw at room temperature [15 to 25 degrees C (59 to 77 degrees F)] for 15 minutes.
        • 0.5 mL single dose prefilled syringe:
          • Thawing in the refrigerator: Thaw and store in the refrigerator [2 to 8 degrees C (36 to 46 degrees F)] for 1 hour. Allow syringes to remain at room temperature for 15 minutes prior to administration.
          • Thawing at room temperature: Thaw at room temperature [15 to 25 degrees C (59 to 77 degrees F)] for 45 minutes.
        • Do NOT refreeze thawed vials or syringes.
        • Thawed vials or syringes can be handled in room light conditions; however, minimize exposure to room light during storage.[67339][67908]

       

      Preparation

      • Swirl multiple dose vials and single dose vials gently after thawing and between each withdrawal. Do NOT shake. Do NOT dilute.[67339][67908]
        • Each 0.25 mL single-dose vial contains notably more than 0.25 mL; do not withdraw more than 0.25 mL. Discard vial and excess volume.[69752]
        • Each 2.5 mL multiple-dose vial contains 5 doses of 0.5 mL. If the amount of vaccine remaining in the vial cannot provide a full dose, discard the vial and content; do not pool excess vaccine from multiple vials.
        • Storage before multiple dose vials and single dose vials have been needle-punctured:
          • Storage in refrigerator: Store between 2 and 8 degrees C (36 to 46 degrees F) for up to 30 days.
          • Storage outside refrigerated conditions: Store between 8 and 25 degrees C (46 to 77 degrees F) for a total of 24 hours.
        • Storage after multiple dose vial has been needle-punctured: Discard 12 hours after the first puncture.
      • Swirl single dose prefilled syringes gently after thawing. Do NOT shake. Do NOT dilute.
        • Use a sterile needle of the appropriate size for intramuscular injection.
        • Storage of single dose prefilled syringes:
          • Storage in refrigerator: Store between 2 and 8 degrees C (36 to 46 degrees F) for up to 30 days.
          • Storage outside refrigerated conditions: Store between 8 and 25 degrees C (46 to 77 degrees F) for a total of 24 hours.[67339][67908]

       

      Intramuscular Injection

      • Prior to vaccine administration, verify the patient's age and the vaccine(s) they have requested; ensure the age-appropriate formulation is used. Involve the parent or caregiver in reading the label to confirm the correct vaccine. Only bring the labeled vaccine syringe(s) for 1 patient into the vaccination area. Document the lot number and date of manufacture prior to vaccine administration with additional documentation after vaccine administration.[67188]
      • After withdrawing the dose from the vial, administer immediately as an intramuscular injection. For single dose prefilled syringes, administer the entire dose as an intramuscular injection and discard syringe after use.[67339][67908]

      Clinical Pharmaceutics Information

      From Trissel's 2‚Ñ¢ Clinical Pharmaceutics Database
        Revision Date: 04/01/2024, 09:27:21 AM

        References

        66175 - Center for Disease Control and Prevention. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Updated Jan 18, 2024. Accessed March 1, 2024. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.67102 - Institute for Safe Medication Practices (ISMP). Adult and pediatric COVID-19 vaccine mix-ups are predictable. Acute Care ISMP Medication Safety Alert 2021;26(22):1-4.67188 - Institute for Safe Medication Practices (ISMP). National Alert Network (NAN Alerts) Age-related COVID-19 vaccine mix-ups. Retrieved on Dec 6, 2021.67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.69752 - FDA drug safety communication. Important information about the correct dosage and administration of Moderna COVID-19 vaccine (2023-2024 formula) for individuals 6 months through 11 years of age. November 2, 2023. Accessed from the worldwide web at https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-information-about-correct-dosage-and-administration-moderna-covid-19-vaccine-2023-2024?utm_medium=email&utm_source=govdelivery

        Adverse Reactions

        Mild

        • anorexia
        • arthralgia
        • chills
        • diarrhea
        • dizziness
        • fatigue
        • fever
        • headache
        • injection site reaction
        • malaise
        • myalgia
        • nausea
        • pruritus
        • rash
        • syncope
        • urticaria
        • vomiting

        Moderate

        • erythema
        • lymphadenopathy

        Severe

        • anaphylactoid reactions
        • angioedema
        • appendicitis
        • Bell's palsy
        • myocarditis
        • pericarditis

        Local injection site reaction was the most commonly reported adverse reaction after COVID-19 vaccine administration during clinical trials. In general, the rates and severity of the reactions were slightly higher after the second dose compared to after the first.[66080] [66120] [66904] [67085] [67339] After Pfizer-BioNTech COVID-19 vaccine administration, pain (66.1% to 86.2%), erythema or redness (5% to 18.5%), and swelling (4.9% to 16.4%) at the injection site were reported during clinical trials. About one-third of patients 12 to 55 years (30.9% to 44.7%) who received the vaccine reported pain that either interfered with daily activity or prevented it; the percentage of patients reporting this degree of pain was lower in patients 5 to 11 years (15.2% to 18.1%) and 56 years and older (14.9% to 19.2%). Redness and swelling occurred more frequently in patients 5 to 11 years (14.7% to 18.5% and 10.5% to 16.4%, respectively) compared to patients 12 years and older (5% to 7.2% and 4.9% and 7.8%, respectively). The mean duration of pain at the injection site after dose 2 was 2.3 to 2.5 days (range 1 to 70 days), for redness 2.2 to 3 days (range 1 to 34 days), and for swelling 1.9 to 2.6 days (range 1 to 34 days). After the booster dose, the mean duration of pain at the injection site for patients 5 to 11 years was 2.4 days (range 1 to 35 days), for redness 2.3 days (range 1 to 12 days), and for swelling 2.3 days (range 1 to 9 days). After the booster dose, the mean duration of pain at the injection site for patients 18 to 55 years was 2.6 days (range 1 to 8 days), for redness 2.2 days (range 1 to 15 days), and for swelling 2.2 days (range 1 to 8 days).[66080] [66904] [67085] After Moderna COVID-19 vaccine administration, pain at the injection site was reported in 92% of patients. The highest rates of pain were in patients 18 to 64 years after dose 2, with 89.9% reporting pain and 4.6% reporting that it prevented daily activity and required the use of pain relievers. Erythema or redness (2.4% to 9%) and swelling or hardness (4.5% to 12.7%) were reported in patients 18 years and older. Axillary swelling or tenderness was more common after the second dose in both age groups (18 to 64 years: 16.2% after dose 2, 11.6% after dose 1 and 65 years and older: 8.5% after dose 2, 6.1% after dose 1). Most local reactions lasted 1 to 3 days.[66120] [66199] [67339] Patients who have received dermal fillers may develop swelling at or near the site of filler injection (usually face or lips) after mRNA COVID-19 vaccine administration. It appears to be temporary and can resolve with medical treatment, including corticosteroid therapy. These patients may receive mRNA COVID-19 vaccines without additional precautions; however, they should be advised to contact their health care provider if they develop swelling at or near the site of dermal filler after vaccination.[66175]

        During clinical trials, fatigue (33.6% to 67.8%), headache (22.4% to 64.5%), and malaise (0.1% to 0.5%) occurred after administration of the COVID-19 vaccine. The rates and severity of the reactions were generally higher after the second dose compared to the first dose.[66080] [66120] [66904] [67085] [67339] In patients who received the Pfizer-BioNTech COVID-19 vaccine, fatigue was more frequently reported in patients 12 to 55 years (49.4% to 66.2%) compared to patients 5 to 11 years (33.6% to 39.4%) and patients 56 years and older (33.7% to 51%). Mild fatigue (not interfering with activity) was more frequent in patients 5 to 11 years (21.4% to 22% vs. 11.3% to 17.3% moderate) and patients 56 years and older (20.7% to 21% vs. 8.2% to 12.9% moderate). In contrast, patients 12 to 55 years reported moderate fatigue (causing some interference with activity) more frequently (12 to 15 years: 34.1% to 42.7% vs. 21.1% to 24.7% mild; 16 to 55 years: 21.7% to 35.4% vs. 20.8% to 26.2% mild). Headache was also more common in patients 12 to 55 years (43.5% to 64.5%) compared to patients 5 to 11 years (22.4% to 28%) and patients 56 years and older (25% to 39.4%). The incidence of fatigue and headache after a booster dose of the Pfizer-BioNTech COVID-19 vaccine in patients 5 to 11 years (45.6% and 34%, respectively) and 18 to 55 years (63.7% and 48.4%, respectively) was similar to that seen after the second dose of the primary series. Dizziness and syncope were reported during postmarketing experience.[66080] [66904] [67085] In Moderna COVID-19 vaccine clinical trials, fatigue (70%) was the most frequently reported systemic adverse reaction. The highest incidence of fatigue was reported by patients 18 to 64 years after the second dose, with 67.8% reporting any fatigue, 10.7% reporting fatigue that prevented daily activities, and 1 case requiring an emergency room visit or hospitalization. Headache was reported by approximately twice as many patients after the second dose in both age groups (18 to 64 years: 63% after dose 2, 35.3% after dose 1 and 65 years and older: 46.3% after dose 2, 24.5% after dose 1). The incidence of fatigue and headache after a booster dose of the Moderna COVID-19 vaccine (53.5% to 67.7% and 39.5% to 56.1%, respectively) was similar to that seen after the second dose of the primary series.[66120] [67339]

        Musculoskeletal adverse reactions reported during COVID-19 vaccine clinical trials include muscle pain or myalgia (9.1% to 61.7%) and/or joint pain or arthralgia (3.3% to 45.6%).[66080] [66120] [66904] [67085][67339] New or worsened muscle pain (9.1% to 11.7%) and joint pain (3.3% to 5.2%) were reported less frequently in patients 5 to 11 years compared to patients 16 years and older. In patients 12 to 15 years of age, new or worsened muscle pain was reported in about one-third of patients (32.4%) after the second Pfizer-BioNTech COVID-19 vaccine dose compared to 24.1% after the first dose. A similar number of patients 16 to 55 years (39.3% after dose 2, 22.9% after dose 1) and 56 years or older (28.9% after dose 2, 13.6% after dose 1) reported new or worsened muscle pain. Moderate to severe muscle pain (causing some interference with daily activities or preventing activities) was reported after dose 2 in 18.5% of patients 12 to 15 years, 22.9% of patients 16 to 55 years, and 16.6% of patients 56 years and older. New or worsened joint pain was reported in approximately twice as many patients after the second dose compared to the first dose in patients 12 years and older (12 to 15 years: 15.8% after dose 2, 9.7% after dose 1; 16 to 55 years: 23.8% after dose 2, 11.8% after dose 1; and 56 years and older: 19% after dose 2, 8.7% after dose 1). The incidence of myalgia and arthralgia after a booster dose of the Pfizer-BioNTech COVID-19 vaccine in patients 5 to 11 years (18.3% and 6.7%, respectively) and 18 to 55 years (39.1% and 25.3%, respectively) was similar to that seen after the second dose of the primary series.[66080] [66904] [67085] During Moderna COVID-19 clinical trials, myalgia was more common after the second dose in both age groups (18 to 64 years: 61.7% after dose 2, 23.7% after dose 1 and 65 years and older: 47.2% after dose 2, 19.7% after dose 1). Myalgia that prevented daily activity was reported in significantly more patients after the second dose (18 to 64 years: 10.1% after dose 2, 0.6% after dose 1 and 65 years and older: 5.6% after dose 2, 0.5% after dose 1). Similar to myalgia, arthralgia was more common after the second dose in both age groups (18 to 64 years: 45.6% after dose 2, 16.6% after dose 1 and 65 years and older: 35.1% after dose 2, 16.4% after dose 1). Arthralgia that prevented daily activity was reported in significantly more patients after the second dose (18 to 64 years: 5.9% after dose 2, 0.4% after dose 1 and 65 years and older: 3.4% after dose 2, 0.3% after dose 1). One case of arthralgia requiring an emergency room visit or hospitalization was reported in the vaccine group. The incidence of myalgia and arthralgia after a booster dose of the Moderna COVID-19 vaccine (39.5% to 41.9% and 47.4% to 49.6%, respectively) was similar to that seen after the second dose of the primary series.[66120] [67339]

        During clinical trials, chills (4.6% to 48.7%) and fever (1.3% to 19.6%) occurred after administration of the COVID-19 vaccine. The rates and severity of the reactions were generally higher after the second dose compared to the first dose.[66080] [66120] [66904] [67085] [67339] In patients 5 to 15 years, fever of 101.2 degrees F (38.4 degrees C) or higher was reported in 3 times more patients after the second Pfizer-BioNTech COVID-19 vaccine dose (5 to 11 years: 3.1% after dose 2, 1% after dose 1; 12 to 15 years: 9.9% after dose 2, 3.6% after dose 1). In patients 16 to 55 years, fever of 101.2 degrees F (38.4 degrees C) or higher was reported in 6 times more patients after the second Pfizer-BioNTech COVID-19 vaccine dose (6.9% after dose 2, 1.2% after dose 1). In patients 56 years and older, fever of 101.2 degrees F (38.4 degrees C) or higher was reported in 3.3% of patients after dose 2 compared to 0.1% of patients after dose 1. In patients who received the Pfizer-BioNTech COVID-19 vaccine, chills were more frequently reported in patients 12 to 55 years (16.5% to 41.5%) compared to patients 5 to 11 years (4.6% to 9.8%) and patients 56 years and older (6.5% to 23.4%).[66080] [66904] [67085] After Moderna COVID-19 vaccine administration, fever was reported in more patients 18 to 64 years after dose 2 (17.4%) compared to dose 1 (0.9%). A fever of 102.1 degrees F (38.9 degrees C) or higher was reported by 1.7% of patients after dose 2 compared to less than 0.1% after dose 1. Significantly more patients 65 years and older also reported fever after the second dose (9.9% after dose 2, 0.3% after dose 1). A fever of 102.1 degrees F (38.9 degrees C) or higher was reported by 0.5% of patients after dose 2 compared to less than 0.1% after dose 1. The greatest incidence of chills occurred after dose 2 in patients 18 to 64 years (48.7%).[66120] [67339] The incidence of chills and fever after a booster dose of the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine was similar to that seen after the primary series.[66080] [66120] [67085]

        Adverse gastrointestinal (GI) reactions have been reported during COVID-19 vaccine trials.[66080] [66120] [66904] [67085] [67339] Diarrhea (5.3% to 10.7%), nausea (0.4% to 1.2%), and vomiting (0.5% to 2.8%) were reported during Pfizer-BioNTech COVID-19 vaccine clinical trials. Anorexia (decreased appetite) was reported by 0.1% of patients 5 to 11 years old.[66080] [66904] [67085] During Moderna COVID-19 vaccine clinical trials, nausea and/or vomiting was reported in twice as many patients 18 to 64 years after dose 2 (21.4%) compared to dose 1 (9.4%). A similar difference was seen in patients 65 years and older (11.9% after dose 2; 5.2% after dose 1). One case of intractable nausea and vomiting requiring hospitalization was reported as a serious adverse reaction in the vaccine group.[66120] [67339] The incidence of GI adverse reactions after a booster dose of the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine was similar to that seen after the primary series.[66080] [66120] [67085]

        Rare cases of myocarditis and pericarditis have been reported after mRNA COVID-19 vaccination, particularly in adolescents and young adults. The observed risk is greater for males younger than 40 years of age than for females and older males and the risk is highest in males 12 to 17 years of age (Pfizer-BioNTech COVID-19 vaccine) and in males 18 to 24 years of age (Moderna COVID-19 vaccine). Onset typically has been within 7 days after vaccination, occurring more often after the second dose. The risk of myocarditis may be reduced by extending the interval to 8-weeks between the first and second dose in patients 12 years and older, especially males 12 to 39 years. According to evidence from multiple sources, the risk of myocarditis and pericarditis is higher in males under 40 after Moderna COVID-19 vaccination compared to other authorized or approved COVID-19 vaccines. From May 1 through June 11, 2021, there were 40.6 cases of myocarditis per million second doses of mRNA COVID-19 vaccines administered to males aged 12 to 29 years and 2.4 cases per million second doses administered to males aged 30 years and older; reporting rates among females were 4.2 and 1 cases per million second doses, respectively. Although postmarketing data is limited, available evidence suggests a lower risk after administration of a mRNA booster dose compared to the risk after the second dose in the primary series. No cases of myocarditis were reported in patients aged 5 to 11 years (n = 3,082) in Pfizer-BioNTech COVID-19 trials with at least 7 days of follow-up after dose 2, although the study was not powered to assess the risk for myocarditis. Consider myocarditis and pericarditis in adolescents and young adults with acute chest pain, shortness of breath, or palpitations. Most patients require hospitalization, but have experienced resolution of acute symptoms. Although data from short-term follow-up suggests that most patients have resolution of acute symptoms, information is not yet available about long-term sequelae. It is unclear if patients who develop myocarditis or pericarditis after a first dose of mRNA COVID-19 vaccine are at an increased risk of further adverse cardiac effects after a subsequent dose of vaccine; until additional information is available, a subsequent dose should generally be avoided. If the decision is made to receive a subsequent dose, the episode of myocarditis or pericarditis should be resolved. Considerations for subsequent vaccination include myocarditis or pericarditis was considered unrelated to mRNA COVID-19 vaccination (e.g., due to SARS-CoV-2 or other viruses, diagnosis was made more than 3 weeks after vaccination), personal risk of severe acute COVID-19 (e.g., age, underlying conditions), level of COVID-19 community transmission and personal risk of infection, or timing of any immunomodulatory therapies. Patients with a history of myocarditis or pericarditis prior to COVID-19 vaccination should not receive a mRNA vaccine dose until their episode of myocarditis or pericarditis has completely resolved, which incudes no evidence of ongoing heart inflammation or sequelae. For men 18 years and older who develop myocarditis or pericarditis after a dose of mRNA COVID-19 vaccine and chose to receive a subsequent dose of COVID-19 vaccine, consider administration of the Janssen COVID-19 vaccine instead of a mRNA COVID-19 vaccine, taking into account the risk of thrombosis with thrombocytopenia syndrome. In a retrospective study of 139 patients (mostly white male; median age of 15.8 years), suspected myocarditis was reported in 131 (94.2%) patients receiving the Pfizer-BioNTech vaccine, with the majority of cases occurring after the second dose 128 (91.4%). Five cases (3.6%) were reported after the Moderna COVID-19 vaccine, 1 case (0.7%) occurred after the Janssen COVID-19 vaccine, and the brand was unknown in 2 patients. Median onset of symptoms was 2 days after vaccination and the most common symptom was chest pain (99.3%). Patients were treated with nonsteroidal anti-inflammatory drugs (81.3%), intravenous immunoglobulin (21.6%), glucocorticoids (21.6%), colchicine (7.9%), or no anti-inflammatory therapies (8.6%). Twenty-six patients (18.7%) were in the ICU, but only 2 patients were treated with inotropic/vasoactive support, and none required ECMO or died. The median hospital stay was 2 days (0 to 10 days).[66080] [66120] [66175] [66698] [66770] [66904] [67172]

        Serious allergic reactions or anaphylactoid reactions have been reported in patients outside of clinical trials during mass vaccination. During phase 2/3 Pfizer-BioNTech COVID-19 vaccine clinical trials, a subset of patients in the vaccinated group had hypersensitivity-related adverse reactions, possibly representing allergic reactions (0.63% vs. 0.51%, placebo).[66080] [66175] During mass vaccination with the Pfizer-BioNTech COVID-19 vaccine outside of clinical trials, severe allergic reactions, including anaphylaxis and other hypersensitivity reactions (e.g., rash, pruritus, urticaria, angioedema), have been reported.[66080] During this time, 21 cases of anaphylaxis were identified (a rate of 11.1 anaphylaxis cases per million doses administered). Of those, 17 patients had a documented history of allergies or allergic reaction and 7 patients had a history of anaphylaxis. Median time to symptom onset was 13 minutes (range = 2 to 150 minutes). Twenty patients were available for follow-up and all had recovered or been discharged home. An additional 83 nonanaphylaxis allergic reactions were reported; symptoms included pruritus, rash, itchy and scratchy sensation in the throat, and mild respiratory symptoms. Median time to symptom onset was 12 minutes (range = less than 1 minute to 20 hours). In most patients (85%), symptoms occurred within 30 minutes. For 67% of patients, a past history of allergies or allergic reactions was documented. Rash was reported in patients 5 to 11 years old (0.3%) and in patients after administration of the booster dose (0.3%).[66397] [67085] During Moderna COVID-19 clinical trials, hypersensitivity related adverse reactions were reported in 1.5% of vaccine recipients compared to 1.1% of placebo recipients. Hypersensitivity reactions included injection site rash and injection site urticaria. Rash was also reported in 1.8% of patients after administration of the booster dose.[66120] During mass vaccination with the Moderna vaccine, 10 cases of anaphylaxis were identified (a rate of 2.5 anaphylaxis cases per million doses administered). Of those, 9 patients had a documented history of allergies or allergic reaction and 5 patients had a history of anaphylaxis. Median time to symptom onset was 7.5 minutes (range = 1 to 45 minutes). Eight patients were available for follow-up and all had recovered or been discharged home. An additional 43 nonanaphylaxis allergic reactions were reported; symptoms included pruritus, rash, itchy and scratchy sensation in the throat, sensations of throat closure, and mild respiratory symptoms. Median time to symptom onset was 15 minutes (range = less than 1 minute to 24 hours). In most patients (73%), symptoms occurred within 30 minutes. For 60% of patients, a past history of allergies or allergic reactions was documented.[66398]

        Lymphadenopathy was reported in 0.3% to 0.9% of patients 5 years and older during Pfizer-BioNTech COVID-19 vaccine clinical trials and in 2.5% and 5.2% of patients 5 to 11 years and 18 to 55 years, respectively, after the booster dose. From dose 1 through 30 days after dose 2, lymphadenopathy was reported in more patients in the vaccine group than in the placebo group (5 to 11 years: 13 vs. 1; 12 to 15 years: 7 vs. 1; 16 years and older: 64 vs. 6).[66080] [66904] [67085] During Moderna COVID-19 vaccine clinical trials, lymphadenopathy-related events were reported in 1.7% of patients who received the vaccine compared to 0.8% of patients who received placebo. These events included lymphadenopathy, lymphadenitis, lymph node pain, vaccination-site lymphadenopathy, injection-site lymphadenopathy, and axillary mass.[66120] [67339]

        During Pfizer-BioNTech COVID-19 vaccine clinical trials, appendicitis was reported as a serious adverse reaction in 8 patients receiving vaccine (n = 18,801) vs. 4 receiving placebo (n = 18,785). Bell's palsy (facial paralysis) was reported by 4 patients in the Pfizer-BioNTech COVID-19 vaccine group (n = 18,801) compared to none of the patients in the placebo group. Onset of facial paralysis occurred on day 37 after dose 1 (patient did not receive dose 2) and days 3, 9, and 48 after dose 2. During the blinded portion of Moderna COVID-19 vaccine clinical trials, there were 8 reports of facial paralysis (including Bell's palsy) in the vaccine group compared to 3 patients in the placebo group. In the 28-day follow-up period, there were 2 cases of facial paralysis in the vaccine group (occurring on 8 and 22 days, respectively, after vaccination) compared to 1 in the placebo group (occurring 17 days after vaccination). In the United States, it is estimated that between 25 and 35 in 100,000 people are affected with Bell's palsy. During the blinded portion of Moderna COVID-19 vaccine clinical trials, there were 50 reports of herpes zoster in the vaccine group compared to 23 patients in the placebo group. In the 28-day follow-up period, there were 22 cases of herpes zoster in the vaccine group compared to 15 in the placebo group. Currently available information is insufficient to determine a causal relationship between appendicitis, Bell's palsy, or herpes zoster with the vaccine.[66080] [66120] [66184] [67339]

        Revision Date: 04/01/2024, 09:27:21 AM

        References

        66080 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19) for 12 years and older. Purple cap and purple border. Retrieved November 22, 2022.66120 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19) for 12 years and older. Red cap and light blue border. Retrieved December 8, 2022.66175 - Center for Disease Control and Prevention. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Updated Jan 18, 2024. Accessed March 1, 2024. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.66184 - National Organization for Rare Disorders (NORD). Bell's Palsy. Accessed December 18, 2020. Available on the World Wide Web at https://rarediseases.org/rare-diseases/bells-palsy/.66199 - Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. [published online ahead of print, 2020 Dec 30]. N Engl J Med. Doi: 10.1056/NEJMoa2035389.66397 - Centers for Disease Control and Prevention. Allergic reactions including anaphylaxis after receipt of the first dose of Pfizer-BioNTech COVID-19 vaccine - United States, December 14-23, 2020. MMWR 2021;70:1-6.66398 - Centers for Disease Control and Prevention. Allergic reactions including anaphylaxis after receipt of the first dose of Moderna COVID-19 vaccine - United States, January 10, 2021. MMWR 2021;70(4):125-129.66698 - Centers for Disease Control and Prevention (CDC). Clinical considerations: myocarditis and pericarditis after receipt of mRNA COVID-19 vaccines among adolescents and young adults. Accessed May 28, 2021. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.html?ACSTrackingID=USCDC_425-DM58530&ACSTrackingLabel=Clinical%20Considerations%3A%20Myocarditis%20and%20Pericarditis%20after%20Receipt%20of%20mRNA%20COVID-19%20Vaccines&deliveryName=USCDC_425-DM58530.66770 - Gargano JW, Wallace M, Hadler SC, et al. Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices, June 2021. MMWR Morb Mortal Wkly Rep. ePub: 6 July 2021. DOI: http://dx.doi.org/10.15585/mmwr.mm7027e1.66904 - Comirnaty (COVID-19) injection package insert for 12 years of age and older. Purple cap and purple border. Retrieved July 8, 2022.67085 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19) for 5 to 11 years of age. Orange cap and orange border. Retrieved November 22, 2022.67172 - Truong DT, Dionne A, Muniz JC, McHugh KE, et al. Clinically suspected myocarditis temporally related to COVID-19 vaccination in adolescents and young adults: suspected myocarditis after COVID-19 vaccination. Circulation 2022; 145(5): 345-356.67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.

        Contraindications/Precautions

        Absolute contraindications are italicized.

        • acquired immunodeficiency syndrome (AIDS)
        • agammaglobulinemia
        • anticoagulant therapy
        • breast-feeding
        • chemotherapy
        • coagulopathy
        • corticosteroid therapy
        • dialysis
        • hemophilia
        • human immunodeficiency virus (HIV) infection
        • hypogammaglobulinemia
        • immunosuppression
        • infection
        • laboratory test interference
        • neoplastic disease
        • organ transplant
        • pregnancy
        • radiation therapy
        • renal failure
        • severe combined immunodeficiency (SCID)
        • syncope
        • thrombocytopenia
        • vitamin K deficiency

        The COVID-19 vaccine is contraindicated in patients with a history of a severe allergic reaction to any component of the vaccine or in individuals whohad a severe allergic reaction (e.g. anaphylaxis) after a previous dose of a COVID-19 vaccine. In these patients, do not vaccinate with the same COVID-19 vaccine type. Patients with a contraindication to 1 type of COVID-19 vaccine may receive the alternative COVID-19 vaccine type in the usual vaccination setting; however, consultation with an allergist-immunologist is encouraged to provide expert evaluation of the original allergic reaction, and depending on the outcome of the evaluation, reassess if administration of additional doses of the same vaccine type may be possible. Patients with a history of a diagnosed non-severe allergy to a component of the COVID-19 vaccine or a history of a non-severe, immediate (onset less than 4 hours) allergic reaction after administration of a previous dose of 1 COVID-19 vaccine type have a precaution to vaccination with that COVID-19 vaccine. The alternative COVID-19 vaccine type may be administered in the usual vaccination setting. Vaccination with the same COVID-19 vaccine type may be considered on an individual basis in an appropriate setting and under the supervision of a health care provider experienced in the management of severe allergic reactions. Consider an observation period of 30 minutes after vaccination and referral to an allergist-immunologist in these patients.[66175][67339][67786][67907][67908]

        Immunocompromised patients, including patients with immunosuppression or receiving immunosuppressive therapy, may not have an adequate immune response to the COVID-19 vaccine. Patients at increased risk include, but are not limited to, those who have received a solid organ transplant and are taking immunosuppressive therapy, those who are receiving active treatment with high-dose corticosteroids (i.e., 20 mg or more of prednisone or equivalent per day when administered for 2 weeks or more), transplant related immunosuppressive drugs, and other biologic agents that are immunosuppressive or immunomodulatory, and patients with moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome). Administration of an additional mRNA COVID-19 vaccine dose at least 2 months after the last dose of COVID-19 vaccine has been authorized for individuals who have undergone solid organ transplantation, or are diagnosed with a condition that is considered to have an equivalent level of immunocompromise.[66175] [67339] [67786] [67907] [67908] Immunosuppressed persons may also include patients with severe combined immunodeficiency (SCID), hypogammaglobulinemia, or agammaglobulinemia. Short-term (less than 2 weeks) corticosteroid therapy or intra-articular, bursal, or tendon injections with corticosteroids should not be immunosuppressive.[65107] [66175] Ideally, complete COVID-19 vaccination at least 2 weeks before initiation or resumption of immunosuppressive therapies, but timing of COVID-19 vaccination should take into consideration current or planned immunosuppressive therapies and optimization of both the patient's medical condition and response to vaccine. Serologic testing or cellular immune testing to assess for immunity after COVID-19 vaccination, outside the context of research studies, is not recommended. Re-vaccination after immune competence is regained in patients who received mRNA COVID-19 vaccines during treatment with immunosuppressive drugs is not recommended. For patients receiving antibody therapies not specific to COVID-19 treatment (e.g., intravenous immunoglobulin, RhoGAM), there is no recommended minimum interval between these therapies and administration of mRNA COVID-19 vaccines. Administration of mRNA COVID-19 vaccines either together or at any interval before or after receipt of an antibody-containing product is unlikely to substantially impair the development of a protective antibody response. During clinical trials, no imbalances were noted in the occurrence of symptoms consistent with autoimmune conditions or inflammatory disorders in patients who received the COVID-19 vaccine compared to placebo. Patients with autoimmune conditions may receive the COVID-19 vaccine.[66175]

        Patients with altered immune states due to generalized neoplastic disease or an immune system compromised by radiation therapy or chemotherapy may not have an adequate immune response to the COVID-19 vaccine. Patients at increased risk include, but are not limited to, those receiving active treatment for solid tumor and hematologic malignancies, receipt of chimeric antigen receptor (CAR) T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppresive therapy), and active treatment with alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory. Administration of an additional mRNA COVID-19 vaccine dose at least 2 months after the last dose of COVID-19 vaccine has been authorized for individuals who have undergone solid organ transplantation, or are diagnosed with a condition that is considered to have an equivalent level of immunocompromise.[66175] [67339] [67786] [67907] [67908] Ideally, complete COVID-19 vaccination at least 2 weeks before initiation or resumption of immunosuppressive therapies, but timing of COVID-19 vaccination should take into consideration current or planned immunosuppressive therapies and optimization of both the patient's medical condition and response to vaccine. Serologic testing or cellular immune testing to assess for immunity after COVID-19 vaccination, outside the context of research studies, is not recommended.[66175] Delay vaccination for at least 3 months after hematopoietic cell transplantation (HCT) or engineered cellular therapy (e.g. CAR-T cells) to maximize vaccine efficacy.[66335] Revaccinate patients who received 1 or more doses of COVID-19 vaccine prior to or during HCT or CAR-T-cell therapy for any doses administered before or during treatment starting at least 3 months after transplant or CAR-T-cell therapy. An mRNA COVID-19 vaccine is recommended for revaccination doses. Consider revaccination 6 months after therapy completion for patients who received 1 or more doses of COVID-19 vaccine during treatment with B-cell-depleting therapies (e.g., rituximab, ocrelizumab) that were administered over a limited period (e.g., as part of a treatment regimen for certain malignancies). For patients receiving B-cell-depleting therapies on a continuing basis, COVID-19 vaccines should be administered approximately 4 weeks before the next scheduled therapy.[66175] For patients with hematologic malignancies receiving intensive cytotoxic chemotherapy (e.g., cytarabine/anthracycline-based induction regimens for AML), delay vaccination until absolute neutrophile count (ANC) recovery. For patients with solid tumor malignancies undergoing major surgery, separate date of surgery from vaccination by at least a few days to allow symptoms (e.g. fever) to be correctly attributed to surgery vs. vaccination. For more complex surgeries (e.g. splenectomy or surgery that may lead to an immunosuppressive state) surgeons may recommend a wider window (+/- 2 weeks) from the time of surgery.[66335]

        Postponing vaccination with the COVID-19 vaccine is recommended in patients with a moderate or severe acute illness or infection, with or without fever. Defer COVID-19 vaccination until the illness has improved. Advise individuals with known current SARS-CoV-2 infection to defer any COVID-19 vaccination at least until recovery from the acute illness and criteria to discontinue isolation have been met. Individuals who recently had SARS-CoV-2 infection may consider delaying a COVID-19 vaccine dose by 3 months from symptom onset or positive test. Increased time between infection and vaccination may result in an improved immune response to vaccination. Additionally, a low risk of reinfection has been observed in the weeks to months after infection. Take into account risks of COVID-19 severe disease or characteristics of the predominant SARS-CoV-2 strain when determining whether to delay a COVID-19 vaccination after infection.[66175]

        Although patients with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) could have a diminished response, the COVID-19 vaccine should be offered to patients with chronic, stable HIV. Administration of an additional mRNA COVID-19 dose at least 2 months after last dose of COVID-19 vaccine has been authorized for individuals who have undergone solid organ transplantation, or are diagnosed with a condition that is considered to have an equivalent level of immunocompromise. Patients at increased risk include, but are not limited to, those with advanced or untreated HIV infection (people with HIV and CD4 counts less than 200/mm3, history of AIDS-defining illness without immune reconstitution, or clinical manifestations of symptomatic HIV infection).[66175] [67339] [67786] [67907] [67908]

        The COVID-19 vaccine is administered by intramuscular (IM) injection only. Carefully consider the risks and benefits in patients at increased risk for bleeding after an intramuscular injection, such as thrombocytopenia, bleeding disorders (e.g., hemophilia), coagulopathy, vitamin K deficiency, and those receiving anticoagulant therapy. Caution and appropriate precautions to minimize the risk of bleeding or hematoma formation are advised.[65107] [66175] [67339] [67786] [67907] [67908]

        COVID-19 vaccination is strongly recommended during pregnancy and in recently pregnant individuals (up to 6 weeks postpartum). Vaccination may occur in any trimester and is recommended as soon as possible to maximize maternal and fetal health.[66175] [66179] [66863] A growing body of evidence suggests that benefits of COVID-19 vaccination outweigh any known or potential risk of vaccination during pregnancy. Recent studies have also shown that antibodies produced after COVID-19 vaccination during pregnancy are transferred to the newborn, and COVID-19 vaccination in pregnant patients reduces the risk of COVID-19 hospitalization in infants younger than 6 months.[66175] Data analyzed from 3 vaccine safety-related databases (VAERS, the v-safe active surveillance system, and the v-safe pregnancy registry) did not identify safety concerns for pregnant patients who were vaccinated late in their pregnancy or their infants. Analysis of current data from the V-SAFE pregnancy registry did not find an increased risk of miscarriage among approximately 2,500 pregnant women who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy. Miscarriage rates in this population were 13%, compared to 11% to 16% of pregnancies in the general population. There is no current evidence that COVID-19 vaccines cause fertility problems in woman or men.[66175] [66863] [66864] In a prospective cohort study of 131 mRNA COVID-19 vaccine recipients (84 pregnant, 31 lactating, and 16 non-pregnant), vaccine-induced antibody titers were equivalent in pregnant and lactating women compared to non-pregnant women. All titers were significantly higher than those induced during SARS-CoV-2 infection during pregnancy. Vaccine-generated antibodies were present in all umbilical cord blood samples; neutralizing antibody titers were lower in umbilical cord compared to maternal sera, although statistical significance was not reached. No differences in reactogenicity were noted between the groups.[66558] A pregnancy exposure registry is available that monitors pregnancy outcomes in women exposed to Moderna COVID-19 vaccine during pregnancy. Encourage women vaccinated with Moderna COVID-19 vaccine to enroll in the registry by calling 1-866-663-3762. Additionally, encourage pregnant women to enroll in the CDC's V-SAFE program by going to vsafe.cdc.gov.[67339]

        COVID-19 vaccination is recommended in all eligible women, including those who are breast-feeding.[66179] [66864] There are limited data regarding use of the COVID-19 vaccine during breast-feeding, its effect on milk production, and its excretion in human breast milk. However, the COVID-19 vaccines cannot cause infection in either the lactating patient or the infant.[66175] Recent reports suggest mothers who have received mRNA COVID-19 vaccines have antibodies in their breast milk, which may help protect their babies.[66864] In a prospective cohort study of 131 mRNA COVID-19 vaccine recipients (84 pregnant, 31 lactating, and 16 non-pregnant), vaccine-induced antibody titers were equivalent in pregnant and lactating women compared to non-pregnant women. All titers were significantly higher than those induced during SARS-CoV-2 infection during pregnancy. Vaccine-generated antibodies were present in all breast milk samples. No differences in reactogenicity were noted between the groups.[66558] If a breast-feeding infant experiences an adverse event possibly related to a maternally administered vaccine, health care providers are encouraged to report the adverse event to the FDA.

        Injectable vaccines, including the mRNA COVID-19 vaccines, have been associated with episodes of dizziness, syncope, and fainting, especially in adolescents. Prior to administration, ensure procedures are in place to prevent falls and manage syncopal reactions. Patients should remain seated or lying down during the observation period to decrease the risk for injury. If syncope develops, observe patients until symptoms resolve.[66175] [67339] [67786] [67907] [67908]

        Data suggest immune response to COVID-19 vaccination may be reduced in patients with renal failure receiving dialysis. Counsel dialysis patients about the potential for reduced immune responses and the need to continue following precautions to avoid exposure to the SARS-CoV-2 virus.[69469]

        The use of the COVID-19 vaccine has resulted in laboratory test interference with the Bio-Rad Laboratories BioPlex 2200 Syphilis Total and Rapid Plasma Reagin (RPR) kit. False reactivity may occur for at least 5 months after COVID-19 vaccination. It is unknown if other RPR tests may also be affected. Treponemal testing for syphilis such as Treponema pallidum particle agglutination (TP-PA) and treponemal immunoassays do not appear to be impacted. Retest patients who receive a positive result using the Bio-Rad BioPlex 2200 Syphilis Total and RPR kit for syphilis with another test to confirm results. For patients with a negative treponemal test, but reactive RPR result using the Bio-Rad BioPlex 2200 Syphilis Total and RPR kit, repeat RPR testing is not necessary unless otherwise clinically indicated. For patients previously treated for syphilis, whose treponemal testing will remain persistently positive, and are being evaluated for a possible new syphilis infection, interpret a reactive RPR in the context of the patient's medical history, risk factors, and clinical presentation. If the Bio-Rad BioPlex 2200 Syphilis Total and RPR kit was used and the clinical presentation does not support syphilis reinfection, then confirm reactive results with a RPR test from another manufacturer.[67201]

        Revision Date: 04/01/2024, 09:27:21 AM

        References

        65107 - Kroger A, Bahta L, Hunter P. General Best Practice Guidelines for Immunization. Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP). Accessed April 25, 2024. Available at https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html.66175 - Center for Disease Control and Prevention. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Updated Jan 18, 2024. Accessed March 1, 2024. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.66179 - The American College of Obstetricians and Gynecologists' Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group. COVID-19 vaccination considerations for obstetric-gynecologic care. Public advisory, December 2020. Last updated January 6, 2023. Accessed April 21, 2023. Available at: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-1966335 - National Comprehensive Cancer Network. Cancer and COVID-19 vaccination preliminary recommendations of the NCCN COVID-19 vaccination advisory committee. Updated January 22, 2021. Accessed January 22, 2021. Available at: https://www.nccn.org/covid-19/pdf/COVID-19_Vaccination_Guidance_V1.0.pdf.66558 - Gray KJ, Bordt EA, Atyeo C, et al. COVID-19 vaccine response in pregnant and lactating women: a cohort study. American Journal of Obstetrics and Gynecology (2021), doi: https://doi.org/10.1016/j.ajog.2021.03.023.66863 - Center for Disease Control and Prevention. New CDC data: COVID-19 vaccination safe for pregnant people. Released August 11, 2021. Accessed August 11, 2021. Available at: https://www.cdc.gov/media/releases/2021/s0811-vaccine-safe-pregnant.html.66864 - Center for Disease Control and Prevention. COVID-19 vaccines while pregnant or breastfeeding. Updated Oct 20, 2022. Accessed April 21, 2023. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html.67201 - Food and Drug Administration. FDA Drug Safety Communication: Possible false RPR reactivity with BioPlex 2200 Syphilis total and RPR test kit following a COVID-19 vaccine - letter to clinical laboratory staff and health care providers. Retrieved Dec 20, 2021. Available on the World Wide Web at: https://www.fda.gov/medical-devices/letters-health-care-providers/possible-false-rpr-reactivity-bioplex-2200-syphilis-total-rpr-test-kit-following-covid-19-vaccine?utm_medium=email&utm_source=govdelivery67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.69469 - Rouphael N, Bausch-Jurken M. COVID-19 vaccination among patients receiving maintenance renal replacement therapy: immune response, real-world effectiveness, and implications for the future. JIC. 2023; 228: S49-S54.

        Mechanism of Action

        The Pfizer-BioNTech COVID-19 vaccine contains nucleoside-modified messenger RNA (modRNA) and the Moderna COVID-19 vaccine is made up of a synthetic messenger RNA (mRNA), both encoding the viral spike glycoprotein (S) of SARS-CoV-2. The RNA is encapsulated in lipid nanoparticles, which enables entry into host cells, expression of the S protein, and elicitation of both antibody and cellular immune responses.[67339][67786][67907][67908]

        Revision Date: 04/01/2024, 09:27:21 AM

        References

        67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.

        Pharmacokinetics

        The COVID-19 vaccine is administered intramuscularly. Vaccination does not ensure immunity.[67339][67786][67907][67908]

         

        Affected cytochrome P450 isoenzymes: none

        Route-Specific Pharmacokinetics

        Intramuscular Route

        After Pfizer-BioNTech COVID-19 vaccine administration, SARS-CoV-2 geometric mean titers (GMTs) 50% neutralizing (NT50) were measured in different age groups 30 days after dose 2. SARS-CoV-2 GMTs (NT50) were 1,197.6 (10 mcg/dose) in patients 5 to 11 years and 1,146.5 (30 mcg/dose) in patients 16 to 25 years with a geometric mean ratio (GMR) of 1.04. There was no difference in seroresponse rates in these age groups. SARS-CoV-2 GMTs (NT50) were 1,535.2 (3 mcg/dose) in patients 2 to 4 years and 1,180 (30 mcg/dose) in patients 16 to 25 years with a GMR of 1.3. The difference in seroresponse rates was 1.2%. SARS-CoV-2 GMTs (NT50) were 1,406.5 (3 mcg/dose) in patients 6 to 23 months and 1,180 (30 mcg/dose) in patients 16 to 25 years with a GMR of 1.19. The difference in seroresponse rates was 1.2%.[67907]

         

        After Moderna COVID-19 vaccine administration, SARS-CoV-2 geometric mean titers (GMTs) 50% neutralizing (NT50) were measured in different age groups 28 days after dose 2. SARS-CoV-2 GMTs (NT50) were 1,401.7 in patients 12 to 17 years and 1,299.9 in patients 18 to 25 years with a geometric mean ratio (GMR) of 1.1. There was a 0.2% difference in seroresponse rates in these age groups. SARS-CoV-2 GMTs (NT50) were 1,610.2 in patients 6 to 11 years and 1,299.9 in patients 18 to 25 years with a GMR of 1.2. The difference in seroresponse rates was 0.1%. SARS-CoV-2 GMTs (NT50) were 1,410 in patients 2 to 5 years and 1,390.8 in patients 18 to 25 years with a GMR of 1. The difference in seroresponse rates was -0.4%. SARS-CoV-2 GMTs (NT50) were 1,780.7 in patients 6 to 23 months and 1,390.8 in patients 18 to 25 years with a GMR of 1.3. The difference in seroresponse rates was 0.7%.[67908]

        Revision Date: 04/01/2024, 09:27:21 AM

        References

        67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.

        Pregnancy/Breast-feeding

        pregnancy

        COVID-19 vaccination is strongly recommended during pregnancy and in recently pregnant individuals (up to 6 weeks postpartum). Vaccination may occur in any trimester and is recommended as soon as possible to maximize maternal and fetal health.[66175] [66179] [66863] A growing body of evidence suggests that benefits of COVID-19 vaccination outweigh any known or potential risk of vaccination during pregnancy. Recent studies have also shown that antibodies produced after COVID-19 vaccination during pregnancy are transferred to the newborn, and COVID-19 vaccination in pregnant patients reduces the risk of COVID-19 hospitalization in infants younger than 6 months.[66175] Data analyzed from 3 vaccine safety-related databases (VAERS, the v-safe active surveillance system, and the v-safe pregnancy registry) did not identify safety concerns for pregnant patients who were vaccinated late in their pregnancy or their infants. Analysis of current data from the V-SAFE pregnancy registry did not find an increased risk of miscarriage among approximately 2,500 pregnant women who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy. Miscarriage rates in this population were 13%, compared to 11% to 16% of pregnancies in the general population. There is no current evidence that COVID-19 vaccines cause fertility problems in woman or men.[66175] [66863] [66864] In a prospective cohort study of 131 mRNA COVID-19 vaccine recipients (84 pregnant, 31 lactating, and 16 non-pregnant), vaccine-induced antibody titers were equivalent in pregnant and lactating women compared to non-pregnant women. All titers were significantly higher than those induced during SARS-CoV-2 infection during pregnancy. Vaccine-generated antibodies were present in all umbilical cord blood samples; neutralizing antibody titers were lower in umbilical cord compared to maternal sera, although statistical significance was not reached. No differences in reactogenicity were noted between the groups.[66558] A pregnancy exposure registry is available that monitors pregnancy outcomes in women exposed to Moderna COVID-19 vaccine during pregnancy. Encourage women vaccinated with Moderna COVID-19 vaccine to enroll in the registry by calling 1-866-663-3762. Additionally, encourage pregnant women to enroll in the CDC's V-SAFE program by going to vsafe.cdc.gov.[67339]

        breast-feeding

        COVID-19 vaccination is recommended in all eligible women, including those who are breast-feeding.[66179] [66864] There are limited data regarding use of the COVID-19 vaccine during breast-feeding, its effect on milk production, and its excretion in human breast milk. However, the COVID-19 vaccines cannot cause infection in either the lactating patient or the infant.[66175] Recent reports suggest mothers who have received mRNA COVID-19 vaccines have antibodies in their breast milk, which may help protect their babies.[66864] In a prospective cohort study of 131 mRNA COVID-19 vaccine recipients (84 pregnant, 31 lactating, and 16 non-pregnant), vaccine-induced antibody titers were equivalent in pregnant and lactating women compared to non-pregnant women. All titers were significantly higher than those induced during SARS-CoV-2 infection during pregnancy. Vaccine-generated antibodies were present in all breast milk samples. No differences in reactogenicity were noted between the groups.[66558] If a breast-feeding infant experiences an adverse event possibly related to a maternally administered vaccine, health care providers are encouraged to report the adverse event to the FDA.

        Revision Date: 04/01/2024, 09:27:21 AM

        References

        66175 - Center for Disease Control and Prevention. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Updated Jan 18, 2024. Accessed March 1, 2024. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.66179 - The American College of Obstetricians and Gynecologists' Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group. COVID-19 vaccination considerations for obstetric-gynecologic care. Public advisory, December 2020. Last updated January 6, 2023. Accessed April 21, 2023. Available at: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-1966558 - Gray KJ, Bordt EA, Atyeo C, et al. COVID-19 vaccine response in pregnant and lactating women: a cohort study. American Journal of Obstetrics and Gynecology (2021), doi: https://doi.org/10.1016/j.ajog.2021.03.023.66863 - Center for Disease Control and Prevention. New CDC data: COVID-19 vaccination safe for pregnant people. Released August 11, 2021. Accessed August 11, 2021. Available at: https://www.cdc.gov/media/releases/2021/s0811-vaccine-safe-pregnant.html.66864 - Center for Disease Control and Prevention. COVID-19 vaccines while pregnant or breastfeeding. Updated Oct 20, 2022. Accessed April 21, 2023. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html.67339 - Spikevax (COVID-19) injection package insert. Princeton, NJ: Moderna US, Inc.; 2024 April.67786 - Comirnaty (COVID-19) injection package insert. Mainz Germany. Biontech. New York, NY. Pfizer; 2023 September67907 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine (2023-2024 formula), for 6 months through 11 years of age. Most recent EUA authorized date December 2023.67908 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Moderna COVID-19 vaccine (2023-2024 formula), for individuals 6 months through 11 years of age. Most recent EUA authorized date September 2023.

        Interactions

        Level 3 (Moderate)

        • Abatacept
        • Abemaciclib
        • Abrocitinib
        • Acalabrutinib
        • Adalimumab
        • Ado-Trastuzumab emtansine
        • Afatinib
        • Albuterol; Budesonide
        • Alectinib
        • Alemtuzumab
        • Alpelisib
        • Aminolevulinic Acid
        • Amivantamab
        • Anakinra
        • Anifrolumab
        • Antithymocyte Globulin
        • Arsenic Trioxide
        • Asciminib
        • Asparaginase Erwinia chrysanthemi
        • Avacopan
        • Avapritinib
        • Axicabtagene Ciloleucel
        • Axitinib
        • Azacitidine
        • Azathioprine
        • Belantamab mafodotin
        • Belatacept
        • Belimumab
        • Belinostat
        • Belumosudil
        • Bendamustine
        • Benralizumab
        • Betamethasone
        • Bevacizumab
        • Bexarotene
        • Bimekizumab
        • Binimetinib
        • Bleomycin
        • Blinatumomab
        • Bortezomib
        • Bosutinib
        • Brentuximab vedotin
        • Brexucabtagene Autoleucel
        • Brigatinib
        • Brodalumab
        • Budesonide
        • Budesonide; Formoterol
        • Budesonide; Glycopyrrolate; Formoterol
        • Busulfan
        • Cabazitaxel
        • Cabozantinib
        • Calaspargase pegol
        • Canakinumab
        • Capecitabine
        • Capmatinib
        • Carboplatin
        • Carfilzomib
        • Carmustine, BCNU
        • Ceritinib
        • Certolizumab pegol
        • Cetuximab
        • Chlorambucil
        • Ciltacabtagene Autoleucel
        • Cisplatin
        • Cladribine
        • Clofarabine
        • Cobimetinib
        • Copanlisib
        • Corticosteroids (systemic)
        • Corticotropin, ACTH
        • Cortisone
        • Crizotinib
        • Cyclophosphamide
        • Cyclosporine
        • Cytarabine, ARA-C
        • Dabrafenib
        • Dacarbazine, DTIC
        • Dacomitinib
        • Dactinomycin, Actinomycin D
        • Daratumumab
        • Daratumumab; Hyaluronidase
        • Dasatinib
        • Daunorubicin
        • Daunorubicin Liposomal; Cytarabine Liposomal
        • Decitabine
        • Decitabine; Cedazuridine
        • Deflazacort
        • Denosumab
        • Deucravacitinib
        • Dexamethasone
        • Dinutuximab
        • Docetaxel
        • Dostarlimab
        • Doxorubicin
        • Doxorubicin Liposomal
        • Dupilumab
        • Duvelisib
        • Eculizumab
        • Efgartigimod Alfa
        • Efgartigimod Alfa; Hyaluronidase
        • Elotuzumab
        • Emapalumab
        • Enasidenib
        • Encorafenib
        • Enfortumab vedotin
        • Entrectinib
        • Epirubicin
        • Erdafitinib
        • Eribulin
        • Erlotinib
        • Estramustine
        • Etanercept
        • Etoposide, VP-16
        • Everolimus
        • Fam-Trastuzumab deruxtecan
        • Fedratinib
        • Fingolimod
        • Floxuridine
        • Fludarabine
        • Fluorouracil, 5-FU
        • Fostamatinib
        • Gefitinib
        • Gemcitabine
        • Gemtuzumab Ozogamicin
        • Gilteritinib
        • Glasdegib
        • Golimumab
        • Guselkumab
        • Hydrocortisone
        • Hydroxyurea
        • Ibritumomab Tiuxetan
        • Ibrutinib
        • Idarubicin
        • Idecabtagene Vicleucel
        • Idelalisib
        • Ifosfamide
        • Imatinib
        • Immunosuppressants
        • Inebilizumab
        • Infigratinib
        • Infliximab
        • Inotuzumab Ozogamicin
        • Iobenguane I 131
        • Irinotecan
        • Irinotecan Liposomal
        • Isatuximab
        • Ivosidenib
        • Ixabepilone
        • Ixazomib
        • Ixekizumab
        • Lapatinib
        • Larotrectinib
        • Leflunomide
        • Lenvatinib
        • Lisocabtagene Maraleucel
        • Lomustine, CCNU
        • Loncastuximab Tesirine
        • Lorlatinib
        • Lurbinectedin
        • Lutetium Lu 177 dotatate
        • Margetuximab
        • Mechlorethamine, Nitrogen Mustard
        • Melphalan
        • Melphalan Flufenamide
        • Mepolizumab
        • Mercaptopurine, 6-MP
        • Methotrexate
        • Methoxsalen
        • Methylprednisolone
        • Midostaurin
        • Mirikizumab
        • Mitomycin
        • Mitotane
        • Mitoxantrone
        • Mobocertinib
        • Mogamulizumab
        • Moxetumomab pasudotox
        • Mycophenolate
        • Nanoparticle Albumin-Bound Paclitaxel
        • Nanoparticle Albumin-Bound Sirolimus
        • Natalizumab
        • Naxitamab
        • Necitumumab
        • Nelarabine
        • Neratinib
        • Nilotinib
        • Niraparib
        • Niraparib; Abiraterone
        • Obinutuzumab
        • Ocrelizumab
        • Ofatumumab
        • Olaparib
        • Olaratumab
        • Omacetaxine
        • Omalizumab
        • Osimertinib
        • Oxaliplatin
        • Ozanimod
        • Paclitaxel
        • Palbociclib
        • Panitumumab
        • Panobinostat
        • Pazopanib
        • Pegaspargase
        • Pegcetacoplan
        • Pemetrexed
        • Pemigatinib
        • Pentostatin
        • Pertuzumab
        • Pertuzumab; Trastuzumab; Hyaluronidase
        • Pexidartinib
        • Polatuzumab Vedotin
        • Ponatinib
        • Ponesimod
        • Porfimer
        • Pralatrexate
        • Pralsetinib
        • Prednisolone
        • Prednisone
        • Procarbazine
        • Radium-223 Dichloride
        • Ramucirumab
        • Ravulizumab
        • Regorafenib
        • Reslizumab
        • Ribociclib
        • Ribociclib; Letrozole
        • Rilonacept
        • Ripretinib
        • Ritlecitinib
        • Rituximab
        • Rituximab; Hyaluronidase
        • Romidepsin
        • Rucaparib
        • Ruxolitinib
        • Sacituzumab Govitecan
        • Sarilumab
        • Secukinumab
        • Selinexor
        • Selpercatinib
        • Selumetinib
        • Siltuximab
        • Siponimod
        • Sirolimus
        • Sonidegib
        • Sorafenib
        • Sotorasib
        • Spesolimab
        • Streptozocin
        • Sunitinib
        • Tacrolimus
        • Tafasitamab
        • Tagraxofusp
        • Talazoparib
        • Talimogene Laherparepvec
        • Tazemetostat
        • Tebentafusp
        • Temozolomide
        • Temsirolimus
        • Tepotinib
        • Teriflunomide
        • Tezepelumab
        • Thioguanine, 6-TG
        • Thiotepa
        • Tisagenlecleucel
        • Tisotumab Vedotin
        • Tivozanib
        • Tocilizumab
        • Tofacitinib
        • Topotecan
        • Trabectedin
        • Tralokinumab
        • Trametinib
        • Trastuzumab
        • Trastuzumab; Hyaluronidase
        • Tretinoin, ATRA
        • Triamcinolone
        • Trifluridine; Tipiracil
        • Trilaciclib
        • Tucatinib
        • Ublituximab
        • Umbralisib
        • Upadacitinib
        • Ustekinumab
        • Vamorolone
        • Vandetanib
        • Vedolizumab
        • Vemurafenib
        • Venetoclax
        • Vinblastine
        • Vincristine
        • Vincristine Liposomal
        • Vinorelbine
        • Vismodegib
        • Voclosporin
        • Vorinostat
        • Zanubrutinib
        • Ziv-Aflibercept
        Abatacept: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Abemaciclib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Abrocitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Acalabrutinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Adalimumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ado-Trastuzumab emtansine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Afatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Albuterol; Budesonide: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Alectinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Alemtuzumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Alpelisib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Aminolevulinic Acid: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Amivantamab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Anakinra: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Anifrolumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Antithymocyte Globulin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Arsenic Trioxide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Asciminib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Asparaginase Erwinia chrysanthemi: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Avacopan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Avapritinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Axicabtagene Ciloleucel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Axitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Azacitidine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Azathioprine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Belantamab mafodotin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Belatacept: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Belimumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Belinostat: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Belumosudil: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bendamustine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Benralizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Betamethasone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bevacizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bexarotene: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bimekizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Binimetinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bleomycin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Blinatumomab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bortezomib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Bosutinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Brentuximab vedotin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Brexucabtagene Autoleucel : (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Brigatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Brodalumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Budesonide: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Budesonide; Formoterol: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Budesonide; Glycopyrrolate; Formoterol: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Busulfan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cabazitaxel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cabozantinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Calaspargase pegol: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Canakinumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Capecitabine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Capmatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Carboplatin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Carfilzomib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Carmustine, BCNU: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ceritinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Certolizumab pegol: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cetuximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Chlorambucil: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ciltacabtagene Autoleucel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cisplatin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cladribine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Clofarabine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cobimetinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Copanlisib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Corticosteroids (systemic): (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Corticotropin, ACTH: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cortisone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Crizotinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cyclophosphamide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cyclosporine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Cytarabine, ARA-C: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dabrafenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dacarbazine, DTIC: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dacomitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dactinomycin, Actinomycin D: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Daratumumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Daratumumab; Hyaluronidase: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dasatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Daunorubicin Liposomal; Cytarabine Liposomal: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Daunorubicin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Decitabine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Decitabine; Cedazuridine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Deflazacort: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Denosumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Deucravacitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dexamethasone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dinutuximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Docetaxel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dostarlimab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Doxorubicin Liposomal: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Doxorubicin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Dupilumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Duvelisib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Eculizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Efgartigimod Alfa: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Efgartigimod Alfa; Hyaluronidase: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Elotuzumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Emapalumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Enasidenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Encorafenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Enfortumab vedotin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Entrectinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Epirubicin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Erdafitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Eribulin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Erlotinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Estramustine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Etanercept: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Etoposide, VP-16: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Everolimus: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Fam-Trastuzumab deruxtecan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Fedratinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Fingolimod: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Floxuridine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Fludarabine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Fluorouracil, 5-FU: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Fostamatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Gefitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Gemcitabine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Gemtuzumab Ozogamicin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Gilteritinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Glasdegib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Golimumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Guselkumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Hydrocortisone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Hydroxyurea: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ibritumomab Tiuxetan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ibrutinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Idarubicin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Idecabtagene Vicleucel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Idelalisib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ifosfamide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Imatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Immunosuppressants: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Inebilizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Infigratinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Infliximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Inotuzumab Ozogamicin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Iobenguane I 131: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Irinotecan Liposomal: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Irinotecan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Isatuximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ivosidenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ixabepilone: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ixazomib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ixekizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lapatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Larotrectinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Leflunomide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lenvatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lisocabtagene Maraleucel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lomustine, CCNU: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Loncastuximab Tesirine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lorlatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lurbinectedin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Lutetium Lu 177 dotatate: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Margetuximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mechlorethamine, Nitrogen Mustard: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Melphalan Flufenamide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Melphalan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mepolizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mercaptopurine, 6-MP: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Methotrexate: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Methoxsalen: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Methylprednisolone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Midostaurin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mirikizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mitomycin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mitotane: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mitoxantrone: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mobocertinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mogamulizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Moxetumomab pasudotox: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Mycophenolate: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Nanoparticle Albumin-Bound Paclitaxel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Nanoparticle Albumin-Bound Sirolimus: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Natalizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Naxitamab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Necitumumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Nelarabine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Neratinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Nilotinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Niraparib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Niraparib; Abiraterone: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Obinutuzumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ocrelizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ofatumumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Olaparib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Olaratumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Omacetaxine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Omalizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Osimertinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Oxaliplatin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ozanimod: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Paclitaxel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Palbociclib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Panitumumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Panobinostat: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pazopanib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pegaspargase: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pegcetacoplan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pemetrexed: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pemigatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pentostatin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pertuzumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pertuzumab; Trastuzumab; Hyaluronidase: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pexidartinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Polatuzumab Vedotin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ponatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ponesimod: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Porfimer: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pralatrexate: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Pralsetinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Prednisolone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Prednisone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Procarbazine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Radium-223 Dichloride: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ramucirumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ravulizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Regorafenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Reslizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ribociclib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ribociclib; Letrozole: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Rilonacept: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ripretinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ritlecitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Rituximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Rituximab; Hyaluronidase: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Romidepsin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Rucaparib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ruxolitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sacituzumab Govitecan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sarilumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Secukinumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Selinexor: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Selpercatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Selumetinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Siltuximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Siponimod: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sirolimus: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sonidegib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sorafenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sotorasib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Spesolimab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Streptozocin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Sunitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tacrolimus: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tafasitamab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tagraxofusp: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Talazoparib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Talimogene Laherparepvec: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tazemetostat: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tebentafusp: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Temozolomide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Temsirolimus: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tepotinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Teriflunomide: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tezepelumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Thioguanine, 6-TG: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Thiotepa: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tisagenlecleucel: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tisotumab Vedotin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tivozanib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tocilizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tofacitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Topotecan: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Trabectedin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tralokinumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Trametinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Trastuzumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Trastuzumab; Hyaluronidase: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tretinoin, ATRA: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Triamcinolone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Trifluridine; Tipiracil: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Trilaciclib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Tucatinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ublituximab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Umbralisib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Upadacitinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ustekinumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vamorolone: (Moderate) Patients receiving corticosteroids in greater than physiologic doses may have a diminished response to the SARS-CoV-2 virus vaccine. Counsel patients receiving corticosteroids about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vandetanib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vedolizumab: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vemurafenib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Venetoclax: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vinblastine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vincristine Liposomal: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vincristine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vinorelbine: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vismodegib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Voclosporin: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Vorinostat: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Zanubrutinib: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080] Ziv-Aflibercept: (Moderate) Patients receiving immunosuppressant medications may have a diminished response to the SARS-CoV-2 virus vaccine. When feasible, administer indicated vaccines prior to initiating immunosuppressant medications. Counsel patients receiving immunosuppressant medications about the possibility of a diminished vaccine response and to continue to follow precautions to avoid exposure to SARS-CoV-2 virus after receiving the vaccine. [65107] [66080]
        Revision Date: 04/01/2024, 09:27:21 AM

        References

        65107 - Kroger A, Bahta L, Hunter P. General Best Practice Guidelines for Immunization. Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP). Accessed April 25, 2024. Available at https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html.66080 - Food and Drug Administration (FDA). Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19) for 12 years and older. Purple cap and purple border. Retrieved November 22, 2022.

        Monitoring Parameters

        • laboratory monitoring not necessary

        US Drug Names

        • COMIRNATY COVID-19
        • Moderna COVID-19
        • Moderna COVID-19 Bivalent
        • Pfizer-BioNTech COVID-19
        • Pfizer-BioNTech COVID-19 Bivalent
        • spikevax COVID-19 mRNA
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