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Younger Age Groups Now Eligible For Bivalent COVID-19 Booster Vaccines

Date: 11/09/22

On October 12, 2022, the U.S. Food and Drug Administration (FDA) amended the Emergency Use Authorizations (EUAs) for the bivalent Pfizer-BioNTech and Moderna COVID-19 vaccines for use as a single booster dose in younger age groups at no cost. The Centers for Disease Control (CDC) recommends that all children, including children who have already had COVID-19, should get vaccinated.

For the Pfizer-BioNTech booster:

  • Children 5 years old and older are authorized for the bivalent Pfizer-BioNTech COVID-19 booster vaccine, at least two months following completion of the primary vaccination series or the most recent monovalent booster vaccine.
  • A new formulation is used for the bivalent COVID-19 booster vaccine that is specific to the younger age group.
  • Texas Health and Human Services (HHSC) added the following National Drug Codes (NDCs) to the Medicaid and CHIP formulary as a payable pharmacy benefit for children 5 through 11 years of age, effective October 12, 2022:

Drug Name

Dose

NDC

PFIZER COVID BIVAL (5-11YR)EUA

0.2 mL

59267-0565-02

PFIZER COVID BIVAL (5-11YR)EUA

0.2 mL

59267-0565-01

For the Moderna booster:

  • Children 6 years old and older are authorized for the bivalent Moderna COVID-19 booster vaccine, after at least two months following completion of the primary vaccination series or the most recent monovalent booster vaccine.  
  • No new formulation for the bivalent COVID-19 booster vaccine, but there is a difference in dosage for children 6 through 11 years old.
  • HHSC previously added the following NDCs to the Medicaid and CHIP formulary on August 31, 2022, as a payable pharmacy benefit.  Under the amended EUA from the FDA, these NDCs are now authorized for use in children 6 through 11 years of age.
    • As a reminder, the same NDCs for the bivalent Moderna COVID-19 booster dose can be used for individuals 12 years of age and older, but the dose is 0.5 mL.

Drug Name

Dose

NDC

MODERNA COVID BIVAL (6Y UP) EUA

0.25 mL

80777-0282-05

MODERNA COVID BIVAL (6Y UP) EUA

0.25 mL

80777-0282-99

Pharmacy providers should submit bivalent Pfizer-BioNTech and Moderna COVID-19 booster dose claims using the Submission Clarification Code (SCC) value of “10” (“Meets Plan Limitations”).  

To learn more, please review: