Provider Alert! Pfizer COVID-19 Vaccine Coverage Update

Date: November 15, 2021

Attention: All Pediatric and Family Medicine Providers

Effective Date: October 29, 2021

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to 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: New information for November 9, 2021: the FDA issued a new emergency use authorization (EUA) for the use of the Pfizer-BioNTech COVID-19 Vaccine on October 29, 2021, for children aged 5-11 years old.
Guidance from May 12, 2021: Texas Children’s Health Plan (TCHP) would like to make network providers aware of new guidance approved by the Food and Drug Administration and The Center for Disease Control’s Advisory Committee on Immunization Practices. Effective, May 12, the Pfizer-BioNTech COVID-19 vaccine is authorized for adolescents age 12 years old and older.

How this impacts providers: The Texas Department of State Health Services Information for COVID-19 Vaccination Providers:  https://www.dshs.state.tx.us/coronavirus/immunize/vaccination-providers.aspx

In an effort to increase the accessibility to the COVID-19 vaccination in underserved areas of Texas, the Texas Division of Emergency Management (TDEM) and the Texas Military Department (TMD) launched the State Mobile Vaccination Team Call Center. Businesses or civic organizations can call 844-90-TEXAS and select option 3 to schedule a visit with a state mobile vaccine team to vaccinate employees, visitors, or members. Homebound Texans are also encouraged to call the hotline and select option 1 to request a state mobile vaccination team to visit their home.

Administration: COVID-19 and other vaccines may now be administered without regard to timing.  This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days.

Next steps for providers: The Pfizer-BioNTech COVID-19 Vaccine for children aged 5-11 years old is a different product, tris-sucrose formulation, and requires different storage, dosage, and dilution, from the vaccines currently available for adolescents and adults.

On November 1, 2021, HHSC added coverage for the pediatric Pfizer-BioNTech COVID-19 Vaccine. HHSC will add the NDCs for each vaccine to the formulary for Medicaid and CHIP as a reimbursable pharmacy benefit for members ages 5-11.

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.