Provider Alert! Pediatric Updates for Moderna & Pfizer-BioNTech COVID-19 Vaccines

Date: July 12, 2022

Attention: All Providers

Effective Date: June 17, 2022

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with the COVID-19 event. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that on June 17, 2022, the U.S. Food and Drug Administration (FDA) authorized emergency use of the Moderna COVID-19 and the Pfizer-BioNTech COVID-19 vaccine for children down to 6 months of age. The federal Public Readiness and Emergency Preparedness (PREP) Act allows pharmacists to administer COVID-19 vaccines to children three and older.

How this impacts providers: The Health and Human Services Commission (HHSC) allows for pharmacy benefit coverage of the Moderna COVID-19 and the Pfizer-BioNTech COVID-19 vaccine in compliance with the expanded use authorized by the FDA.

Moderna COVID-19 Vaccine:

• The FDA previously authorized the Moderna COVID-19 Vaccine for adults 18 and older.
• The FDA amended the emergency use authorization (EUA) to include children six months through 17 years.
  • For the expanded pediatric age group, the Moderna COVID-19 vaccine is administered as a primary series of two intramuscular doses one month apart. This two-dose schedule is identical to that of older age groups. The vaccine dosage strength varies by age.

Pfizer-BioNTech COVID-19 Vaccine:

• The FDA previously authorized the Pfizer-BioNTech COVID-19 for use in individuals five and older.
• The FDA amended the EUA to include the use of the vaccine in children six months through four years.
  • The Pfizer-BioNTech COVID-19 vaccine is administered as a primary series of three intramuscular doses for the expanded pediatric age group. The initial and second doses are administered three weeks apart, and the third dose is administered at least eight weeks after the second. This three-dose schedule is different than the two-dose schedule for older age groups. The vaccine dosage strength varies by age.

Note: The age group definitions for the Moderna and Pfizer-BioNTech COVID-19 vaccines are not identical.

As of June 17, 2022, the Medicaid and CHIP formularies include the following Moderna COVID-19 and Pfizer-BioNTech COVID-19 vaccines as payable pharmacy benefits:

Next steps for providers: Providers are encouraged to share this communication with their staff.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.