CDC’s Long Term Care (LTC) Pharmacy Partnership Program provides three COVID-19 vaccination clinics for LTC facilities enrolled in the program. As many LTC facilities are closing in on their third clinic, questions have arisen whether residents and staff will be able to receive a first dose of the vaccine at the third and final clinic. AHCA/NCAL has been actively working with CDC, CVS, and Walgreens on this issue. VHCA-VCAL has also had numerous discussion with VDH on this topic.

CDC policy is to optimize vaccine access for residents and staff, which means delivering the first dose of either vaccine at the third clinic. This FAQ outlines what to expect at third clinics. However, the pharmacies will defer to state/jurisdictional guidance. In Virginia, VDH is allowing first doses at third clinics. VDH has been in recent communication with their CVS and Walgreens contacts in Virginia to reiterate this.

If residents and staff receive the first dose of the vaccine at the third clinic, it is important to determine how they will access the second dose. For assistance in securing the second dose on behalf of staff or residents, providers should: 

• Contact their state public health department for more information on vaccine availability.  

• Call on the retail pharmacies involved in the CDC’s Federal Retail Pharmacy Program. Retail pharmacies participating in the program vary by state and territory, visit the CDC website to find out which pharmacies are participating. At present, only CVS is participating in Virginia. 

Because Virginia has opted to use the Pfizer-BioNTech vaccine through the Pharmacy Partnership, it will be more challenging to access a second dose due to the unique cold chain storage requirements. VDH is aware of this situation and is working on guidance for facilities.

AHCA/NCAL advises, if all potential options for administering the second dose have been exhausted, clinical leadership may consider the following:

• Counseling residents to finish the vaccine series using the Moderna vaccine. The Advisory Committee on Immunization Practices recommends:  
  • “In exceptional situations in which the first-dose vaccine product cannot be determined or is no longer available, any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the mRNA COVID-19 vaccination series.”

• Delay timing of the second dose administration up to six weeks (42) days. CDC guidance dictates that in situations where it is not feasible to adhere to the recommended interval (21 days for Pfizer and 28 days for Moderna, the second dose can be administered to 6 weeks (42 days) after the first.