Updated August 17th, 2021

3^rd COVID-19 dose for patients who are immunocompromised, including kidney transplant recipients,  patients receiving IS meds for GN or cancer, etc. At this point, presence of DM, HTN, CKD, or dialysis does not qualify patients for 3^rd doses.

If you have a patient who meets criteria for 3^rd dose, then:

• Write one of the following nursing text orders, depending on which vaccine the patient will receive:

1. • “Administer 0.3mL Pfizer COVID-19 vaccine (3^rd dose) once”
   • “Administer 0.5mL Moderna COVID-19 vaccine (3^rd dose) once”

• Refer the patient to the appropriate vaccine clinic location (Durham Medical Center Atrium for Pfizer; Greenville HCC or Raleigh 3 CBOC for Moderna).  Per Dr. Embree,  we do not have Moderna at the VA hospital. The closest location is Raleigh 3 and would recommend having an MSA schedule into “RL3-COVID-VACCINE” or calling the Raleigh 3 clinic ahead of time to schedule, if possible.  They accept walk-ups but don’t have enough demand to give vaccine every day and Moderna comes in 10-dose vials so we try not to waste 9 doses, if possible.  Carrie Thomas, PharmD, or Chaneece Williams, RN are good POCs for the Raleigh 3 vaccine clinic if there are any questions.  Alternatively, the patient could get the Moderna dose in the community and just provide proof of vaccination to EOH.