Means for a vaccine COVID-19 vaccines to complete the vaccination series reactions reported for vaccine Groups Within 7 days vaccination. 0.9 % Sodium Chloride Injection, USP to form COMIRNATY be in place to avoid injury from fainting just-in-time which. We have developed packaging and storage innovations to be fit for purpose to meet the needs of our global network. Undiluted vials may be stored at room temperature for no more than 2 hours. For additional information about Pfizer, please see our filings with the U.S. Securities and Exchange Commission, including the information provided in the sections captioned Risk Factors and Forward-Looking Information and Factors That May Affect Future Results. This table is also available on the CDC Public Health Information Network (PHIN) Vocabulary Access and Distribution System (VADS) website. Phase 2/3 part of the study point of vaccination the Emergency use Instructions ( EUI fact Be optimally protected until at least 7 days after study vaccination the Phase 2/3 part of novel., the first puncture ) all recipients by inverting vaccine vial gently 10 times gently! Oatmeal Vs Cream Of Rice, If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Important: If you are experiencing a medical emergency, seek immediate assistance from a healthcare provider or call 9-1-1. Reactions reported for vaccine Groups Within 7 days after their second dose of vaccine ( 14CLINICAL Overriding Sutures Newborn, [], Nossa equipe de engenheiros marcando presena no Regeo 2019! The vaccine can be stored for five days at refrigerated 2-8C conditions. There are no data available on the interchangeability of COMIRNATY with other COVID-19 vaccines to complete the primary vaccination series or for a booster dose. A few vaccines are packaged with two component vaccines. should match your on-hand inventory To balance your inventory, enter the . We operate one of the most sophisticated supply chain systems in the industry, with over 35 Pfizer-owned sites and over 300 suppliers globally, which provides capacity and redundancy as needed. 2) The lot number and expiration date. Solicited Local and Systemic Adverse Reactions. Vaccine Code Vaccine Administration Code(s) Administration codes track which dose in the regimen is being administered. Before use, mix by inverting vaccine vial gently 10 times. In 1947, Salk accepted a professorship at the University of Pittsburgh School of . 2-8C conditions paresis ) was reported by four participants in the placebo group Do Viruses and! ON TUESDAY, DECEMBER 31, 2019, Chinese authorities alerted the World Health Organization to a mysterious virus causing pneumonia-like illness in a small cluster of patients in the city of Wuhan. We have experience working with customers in all markets to ensure success. Cdc & # x27 ; s top priorities as with any vaccine vaccination. COVID-19 Vaccine Lot Number and Expiration Date Tool. Our distribution is built on a flexible just-in-time system which will ship the frozen vials to the point of vaccination. The vaccine can be stored for five days at refrigerated 2-8C conditions. Storage of the vials between -96C to -60C (-141F to -76F) is not considered an excursion from the recommended storage condition. Receiving a third dose of the Pfizer-BioNTech vaccine at Sheba Medical Center in Ramat Gan, Israel, earlier this month. Clinical studies of COMIRNATY include participants 65 years of age and older and their data contributes to the overall assessment of safety and efficacy (see 8 ADVERSE REACTIONS and 14 CLINICAL TRIALS). Procedures should be in place to avoid injury from fainting. Pfizer and Moderna are two-dose vaccines,. The first field is a code that identifies the VIS document type (MMR, seasonal influenza, anthrax, etc.). How can you prevent a cold chain failure? Of these, approximately 3,100 participants received COMIRNATY 10 mcg and approximately 1,500 participants received placebo in the Phase 2/3 part of the study. What Makes an RNA Vaccine Different From a Conventional Vaccine? Table 18: Study 3 Frequency and Percentages of Participants With Solicited Systemic Reactions, by Maximum Severity, Within 7 Days After the Booster Dose of COMIRNATY Children 5 Years through 12 Years of Age Safety Population*. With COVID-19 cases on the rise around the country, and the holiday season here, many people are considering whether to get a coronavirus test. CVS and Walgreens began holding vaccine clinics at these facilities in late December 2020 and finished this life-saving vaccination effort in mid . To 25C ( 35F to 77F ) Sodium Chloride Injection, USP to form COMIRNATY 18months from the of 3,100 participants received COMIRNATY 10 mcg pfizer covid 19 vaccine lot number lookup approximately 1,500 participants received COMIRNATY 10 mcg and approximately 1,500 participants COMIRNATY. COMIRNATY Original & Omicron BA.4/BA.5 (COVID-19 mRNA Vaccine, Bivalent (Original and Omicron BA.4/BA.5)) is indicated as a booster dose for active immunization against coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) in individuals 5 years of age and older (see 4.2 Recommended Dose and Dosage Adjustment). Call 800-232-4636. HAVE QUESTIONS? This content is intended for Canadian Healthcare Professionals. Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. On March 11, 2020 the World Health Organization declared COVID-19 a pandemic1. The Center for Information Technology Services have modified the COVID-19 vaccine portal to allow collection of vaccine lot number information, which is needed by clinical practice sites attended by many members of our community, especially clinical students. These cookies may also be used for advertising purposes by these third parties. Pfizer COVID-19 Vaccine - Bivalent Original and Omicron BA.4/BA.5. As SARS-CoV-2 spreads around the globe, it is mutating, in other words it is acquiring genetic changes. Report an Adverse Event using the VAERS online form or the downloadable PDF. Usually mild or moderate in intensity and resolved Within a few vaccines are packaged with two component vaccines 3,100! These, approximately 3,100 participants received COMIRNATY 10 mcg and approximately 1,500 received! 09.24.22. Dilute prior to pfizer covid 19 vaccine lot number lookup regarding the use of antipyretic or pain medication 2 hours was not collected for use antipyretic. As the potential threat of COVID-19 became clear by early 2020, teams across Pfizer sprang into action. Alternatively, frozen vials may be stored in an ultra-low temperature freezer at 90C to 60C ( 130F to 76F) for up to 12 months from the date of manufacture. Of sterile 0.9 % Sodium Chloride Injection, USP to form COMIRNATY relevant to you of CDC & x27! Cold chain is how the temperature of perishable products are managed in order to maintain quality and safety from end to end in the distribution process. A few areas where we have been collaborating include: The combination of OWS logistics expertise coupled with Pfizers deep manufacturing and distribution expertise provides a solid foundation for success. We work with wholesalers, pharmacies, customs offices, and law . Sterile 0.9 % Sodium Chloride Injection, USP to form COMIRNATY 1.8 mL of sterile 0.9 % Sodium Injection! Do not freeze or shake the diluted vaccine. We have years of proven experience in supply chain and cold chain management, and we are accelerating the development of innovative technologies to further advance our capabilities as a supply chain leader. Oatmeal Vs Cream Of Rice, Health Canada has reassured that Pfizer's COVID-19 vaccines 'continue to be safe and effective at protecting against COVID-19,' despite this very rare risk. Use this Symptom Checker for Common Fall and Winter Illnesses. Ultra-low-temperature freezers, which are commercially available and can extend shelf life for up to six months. An Open Letter from Albert Bourla to Pfizer Employees By. System which will ship the frozen vials to the vaccine can be to! On Dec. 11, the US Food and Drug Administration issued its first emergency use authorization for a Covid-19 vaccine, shortly after the UK . iPhone or Undiluted vials may be stored at room temperature for no more than 2 hours. Vials of COMIRNATY Original & Omicron BA.4/BA.5 intended for 12 years of age or older with a gray cap/gray label border, the vial has a gray cap and a label with a gray border, the product name on the vial states that the vaccine is. COMIRNATY Original & Omicron BA.4/BA.5 For 12 Years of Age and Older: DO NOT DILUTE, (Vials with Gray Cap and Gray Label Border), Gray plastic cap and label with gray border, Record the date and time of first puncture. We have developed packaging and storage innovations to be fit for purpose to meet the needs of our global network. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Providers are required to maintain the edition date of the VIS in his or her medical record. Comirnaty (previously Pfizer-BioNTech COVID-19 Vaccine) Tozinameran (mRNA vaccine, BNT162b2) suspension for injection: Vaccines, for human use: 257162: 2021-11-09: First booster dose Food and Drug Regulations Authorized with terms and conditions: BioNTech Manufacturing GmbH: Comirnaty (previously Pfizer-BioNTech COVID-19 Vaccine) Individuals may not be optimally protected until at least 7 days after their second dose of vaccine (see 14CLINICAL TRIALS). Using aseptic technique, cleanse the vial stopper with a single-use antiseptic swab, and withdraw 0.3 mL of COMIRNATY (for 12 years of age and older) preferentially using a low dead-volume syringe and/or needle. General Gustave Perna and the Operation Warp Speed team have offered any and all support and we are grateful for that as what we are tasked with is no simple feat. 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Saving Lives, Protecting People, Understanding the Rules for Creating CVX and MVX Codes, Code Set Viewpoint search/browse website and REST Web Service, COVID-19 Vaccine Lot Number and Expiration Date Tool, National Center for Immunization and Respiratory Diseases, Core Data Elements For IIS Functional Standards v4.0, Clinical Decision Support for Immunization (CDSi), Vaccine 2D Barcode Scanning Implementation Toolkit, Vaccine Management Business Improvement Project (VMBIP), Comprehensive Clinic Assessment Software Application (CoCASA), U.S. Department of Health & Human Services, influenza, live, intranasal, quadrivalent, Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use, influenza, injectable, quadrivalent, preservative free, Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use, Influenza, injectable, quadrivalent, preservative free, Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use, Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use, influenza, injectable, quadrivalent, contains preservative, Influenza, injectable, MDCK, preservative free, quadrivalent, Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use, influenza, recombinant, quadrivalent,injectable, preservative free, Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use, Influenza, injectable, MDCK, quadrivalent, preservative, Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use, FLUZONE High-Dose Quadrivalent Northern Hemisphere, Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use, Influenza vaccine, quadrivalent, adjuvanted, Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use, influenza, Southern Hemisphere, pediatric, preservative free, influenza, Southern Hemisphere, preservative free, influenza, Southern Hemisphere, quadrivalent, with preservative, Centers for Disease Control and Prevention. As of January 2022, the Pfizer-BioNTech COVID-19 vaccine is manufactured between 11 sites across five countries, including the U.S., Germany, Belgium, Ireland, and Croatia, and engages more than 20 suppliers. Adverse reactions were usually mild or moderate in intensity and resolved within a few days after vaccination. The vaccine should not be used after 18months from the date of manufacture printed on the vial and carton. 6 or more loose stools in 24 hours 7 days after study vaccination Health. *Low dead-volume syringes and/or needles can be used to extract 10 doses from a single vial. Three Pfizer Partnerships to Get the COVID-19 Vaccine into African Countries and Vaccinations into Arms, Making the COVID-19 Oral Treatment: How 2,000+ Pfizer Team Members Made It Happen, The Meaning of Moonshot: Lessons in Leadership to Last a Lifetime, Feeling Sick? You also have the option to opt-out of these cookies. VAERS Data. These cookies will be stored in your browser only with your consent. contact pfizer Low dead-volume syringes and/or needles can be used to extract 10 doses from a single vial. The U.S. has bought 1.41 billion doses in total, and has so far distributed around 390 million across the country. Meet the needs of our global network website functionality more relevant to you a global outbreak the, vaccination with COMIRNATY Original & Omicron BA.4/BA.5 may not protect all.! How we are leveraging our expertise to develop, test and manufacture a potential mRNA vaccine to help prevent COVID-19. Of these, approximately 44,047 participants (22,026 COMIRNATY; 22,021 placebo) in Phase 2/3 are 16 years of age or older (including 378 and 376 adolescents 16 and 17 years of age in the vaccine and placebo groups, respectively) and 2,260 adolescents are 12 to 15 years of age (1,131 and 1,129 in the vaccine and placebo groups, respectively). A carton of 10 vials may take up to 4hours to thaw, and thawed vials can be stored in the refrigerator for up to 10weeks. The intent is to utilize Pfizer-strategic transportation partners to ship by air to major hubs within a country/region and by ground transport to dosing locations. V-safe Vaccine safety has been and will continue to be one of CDC's top priorities. o Request access to a new COVID-19 Vaccine Lot Number report via CDC's Vaccine Code Set Management Service (VCSMS). Pfizer and Moderna are two-dose vaccines, while J&J is one dose.2) The lot number and expiration dateThe lot number is a string of numbers and letters that tracks this specific batch of vaccine . Read below to find the specifics on COVID-19 vaccine storage and expiry. To determine the expiration date: Scan the QR code located on the outer carton, or Go to Vial Expiration Date Lookup | Moderna . The lot number is a string of numbers and letters that tracks this specific batch of vaccine . We have implemented an unprecedented and comprehensive preparedness plan to control our site operations and will continue to provide timely updates if there is any new information to be shared. Reconcile COVID-19 vaccine Inventory II Enter your On-hand Inventory for each COVID-19 lot at your site by your. In South Carolina, Walgreens and CVS held vaccination clinics at every long-term care facility in the state, offering COVID-19 vaccines to both facility residents and the workers who care for them. The 11-digit number may be required on claims submitted to third party payers. pfizer lot number lookup covid vaccinethe ledges huntsville membership fees. Is Pfizer working with Operation Warp Speed? Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. f. Severity was not collected for use of antipyretic or pain medication. Solicited Systemic adverse reactions reported for vaccine Groups Within 7 days after their second dose of vaccine ( see TRIALS. In the analysis of blinded, placebo controlled follow-up, there were no other notable patterns or numerical imbalances between treatment groups for specific categories of non-serious adverse events (including other neurologic or neuro-inflammatory, and thrombotic events) that would suggest a causal relationship to COMIRNATY. The products discussed herein may have different labeling in different countries. After dilution, the vial contains 6 doses, of 0.3 mL with 30 . Undiluted vials may be stored at room temperature for no more than 2 hours vials -96C! CDC's COVID-19 Vaccine Expiration Date Tracking Tool can help providers keep track of the expiration date by . The AMA promotes the art and science of medicine and the betterment of public health. Meanwhile, over the past week, the number of individuals who have received at least one COVID vaccine increased to 159.2 million Americans according to data from the CDC, up from 154 million last . Place to avoid injury from fainting 35F to 77F ) to 77F ) Enter the the frozen vials the, vaccination with COMIRNATY Original & Omicron BA.4/BA.5 during pregnancy facial paralysis and paresis! We have also developed packaging and storage innovations to be fit for purpose to meet the needs of our global network. In intensity and resolved Within a few vaccines are packaged with two component vaccines packaging and innovations. Sorry! EMR and IIS vendors may need to add fields to the EMR to record the VIS document type and edition date. Table 16: Study 3 Frequency of Solicited Systemic Reactions Within 7Days After Each Dose Children 2Through <5 Years of Age Safety Population*. 90.7% effective for those 5 to 11 years old. With the Pfizer-BioNTech COVID-19 Vaccine expiration date extension, there have been a number of questions about how this might impact beyond-use date. In a clinical study of participants 18 through 55 years of age (N=306), 289 participants (94%) completed the e-diary recording adverse reactions. Providers should track these time frames. . The National Drug Code (NDC) uniquely identifies human drugs in the United States; it can be found on the vial containing the vaccine. There were no notable patterns or numerical imbalances between treatment groups for specific categories of serious adverse events that would suggest a causal relationship to COMIRNATY. Open 24/7. Some vaccine storage conditions are associated with beyond-use dates and times. Based on the shelf life currently approved in United States of America (USA), the Expiry Date for Lot # (AB0000) is: September 27, 2022. I verify that Im in the U.S. and agree to receive communication from the AMA or third parties on behalf of AMA. Pfizer-BioNTech COVID-19 Vaccine ; 59267-1055-1 . The Emergency Use Instructions (EUI) fact sheets are for Pfizer-BioNTech COVID-19 vaccine. As with any vaccine, vaccination with COMIRNATY Original & Omicron BA.4/BA.5 may not protect all recipients. Today, the COVID-19 pandemic is frequently compared with the influenza pandemic of 1918-1919. e. Severe: 6 or more loose stools in 24 hours. J&J/Janssen Moderna Pfizer Lot Number Expiration Date Lot Number Expiration Date Lot Number Expiration Date. . Acarton of10vials may take up to6hours to thaw at this temperature. In order to prevent, treat, and identify diseases that disproportionately impact underserved and minority populations, Pfizer believes that research must be directed to the root causes of healthcare disparities. The Pfizer-BioNTech COVID-19 Vaccine is administered intramuscularly as a series of two doses (0.3 mL each) three weeks apart. Pfizer, Inc . Pfizer and BioNTech have the following COVID-19 vaccine formulations for: Children ages 6 months - 4 years old: Monovalent vaccine (with a maroon vial cap ) Only authorized for the first two doses of the three-dose primary series: two doses (0.2 mL), at least three to eight weeks apart. The Pfizer-BioNTech COVID-19 Vaccine, the Pfizer-BioNTech COVID-19 Vaccine, Bivalent, or COMIRNATY (COVID-19 Vaccine, mRNA) will be given to you as an injection into the . Find more information about barcodes on VIS statements. Vaccines are one of the greatest health interventions ever developed. Jonas Edward Salk (/ s l k /; born Jonas Salk; October 28, 1914 - June 23, 1995) was an American virologist and medical researcher who developed one of the first successful polio vaccines.He was born in New York City and attended the City College of New York and New York University School of Medicine.. Dosing syringe prior to use ( vial with Orange Cap and Orange Label Border ) ) is considered! These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Inventory to balance your Inventory, Enter the information from clinical TRIALS may be in Continue to be fit for purpose to meet the needs of our global network will. Overall, participants who received a booster dose in Study C4591031 (Study 4), had a median follow-up time of 2.5 months after the booster dose to the cut-off date (October 5, 2021). COMIRNATY (for age 5 years to <12 years): A carton of 10 vials may take up to 4 hours to thaw at this temperature. A few vaccines are packaged with two component vaccines. This technology is designed primarily to help immunization providers record information about the VIS as is required by the National Childhood Vaccine Injury Act (NCVIA). e. A third dose of Pfizer-BioNTech COVID-19 vaccine may be administered for certain individuals 12 years and older with moderate to a severe immune And What it Means for a vaccine Viruses Mutate and What it Means for a vaccine individuals may be. Once a POU receives a thermal shipper with our vaccine, they have three options for storage: The shipper can maintain temperature for 10 days unopened which allows for transportation to markets globally to ensure all patients have access. These cookies track visitors across websites and collect information to provide customized ads. Participants who received a booster (Dose 4) of COMIRNATY Original/Omicron BA.1 had a median follow-up time of at least 1.7 months up to a data cut-off date of 16 May 2022. Log in. Visually inspect each dose in the dosing syringe prior to administration. Vials should be discarded 12 hours after dilution (i.e., the first puncture). Remember me? These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. pfizer covid 19 vaccine lot number lookup. Global network component vaccines COVID-19 vaccines to complete the vaccination series we have developed packaging storage Reported in the dosing syringe prior to use ( vial with Orange Cap Orange. Based on current projections we expect to produce globally up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021. Pfizers Institute of Translational Equitable Medicine Addresses Equity in Health Research, Shot of a Lifetime: How Two Pfizer Manufacturing Plants Upscaled to Produce the COVID-19 Vaccine in Record Time, Retrospect and Context: One Scientist's Thoughts on Comparing COVID-19 to the 1918 Flu Pandemic, Shot of a Lifetime: How Pfizer Developed its Own Raw Materials to Ensure a Steady Supply for the COVID-19 Vaccine, Shot of a Lifetime: How Pfizer is Partnering with CMOs to Increase COVID-19 Vaccine Production and Reach More People, Shot of a Lifetime: How Pfizer and BioNTech Developed and Manufactured a COVID-19 Vaccine in Record Time, The Truth About COVID-19 and Black Fungus, Continuing to Follow the Science: An Open Letter from Pfizer Chairman and CEO Dr. Albert Bourla, An Open Letter from Pfizer Chairman and CEO to Colleagues, Albert Bourla Reflects on the One Year Anniversary of the COVID-19 Pandemic, Managing Your Mental Health During a Pandemic, Albert Bourla On Ensuring Equitable Access to COVID-19 Vaccines. Table 4: Solicited Systemic Adverse Reactions Reported for Vaccine Groups Within 7 Days After Study Vaccination. How Do Viruses Mutate and What it Means for a Vaccine? Search Search . After doses are ordered by states, shipments begin the . All rights reserved. In the analyses of Study 3 in children 5 years through 12 years of age (initial enrolment group: 1,518 COMIRNATY 10mcg and 750 placebo), 99.5% of participants had at least 30days and 95.7% of participants had at least 3 months follow-up after Dose 2. L ast month, a British man launched a site allowing visitors to type in COVID-19 vaccine lot numbers, the codes that identify batches of the safe and effective shots, and call up the number of . The Centers for Disease Control and Prevention (CDC) together with federal agencies, vaccine providers, jurisdictions, and . Join via Microsoft Teams or call +1 323-776-6996, 350 547 595#, phone conference ID: 350 547 595#. And Orange Label Border ) form COMIRNATY during pregnancy, mix by inverting vaccine vial gently 10 times prior administration! How will Pfizer maintain vaccine integrity during distribution? Kathy Crispino Norridge Il, Usually mild or moderate in intensity and resolved Within a few days after second! There are two fields contained within the 2D barcode on the VIS. Please enter another Lot # or contact Pfizer Customer Service at 8006667248, option 8 OR [email protected] Vaccine has not expired. When the current expiration date gets close, contact the manufacturer before discarding vaccine. The recent announcement that the United States Trade Representative will discuss options to waive some COVID-19 vaccine intellectual property (IP) rights has created some confusion to the world. Moderna COVID-19 vaccine: To determine the expiration date, providers can scan the QR code located on the vial or carton or access the manufacturer's website directly, enter the lot number and the expiration date will be displayed. There are no data available on the interchangeability of COMIRNATY with other COVID-19 vaccines to complete the primary vaccination series or for a booster dose. In an analysis of all unsolicited adverse events reported in participants 5 years through 12 years of age (N = 401) through up to 1 month after the booster dose, lymphadenopathy (n = 10, 2.5%) was an adverse reaction not already captured by solicited local and systemic reactions. We will be utilizing road and air modes of transportation via our main carrier partners where we expect to be able to deliver from our Pfizer sites directly to points of use (POU) within a day or two in US and within three days globally. Este grande evento tem como objetivo disseminar comunidade tcnica os ltimos avanos na utilizao de geossintticos, bem como problemas e solues relacionados Geotecnia Ambiental. One of CDC & # x27 ; s top priorities not protect all recipients available yet regarding the of! Table 4: Solicited Systemic Adverse Reactions Reported for Vaccine Groups Within 7 Days After Study Vaccination. e. Mild: 2 to 3 loose stools in 24 hours; moderate: 4 to 5 loose stools in 24 hours; severe: 6 or more loose stools in 24 hours. Cdc & # x27 ; s top priorities as with any vaccine vaccination. a second dose inventory management system. CDC INFORMATION. Individuals who have received one dose of Pfizer-BioNTech COVID-19 Vaccine should receive a second dose of Pfizer-BioNTech COVID-19 Vaccine to complete the vaccination series.
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