Alert on the risk of confusing booster and conventional vaccine

Experts are expressing concern that vaccine suppliers may confuse the Omicron booster vial with those used for conventional vaccines.

The concern emerged at a public meeting of advisers from the United States Centers for Disease Control and Prevention last week and was taken up by a panel of health experts on Saturday – the Western States Scientific Safety Review Workgroup – to four states, including California.

“The task force remains concerned about the potential for errors in the administration of different COVID-19 vaccines, given that formulations for different age groups look similar,” the group said in a statement. “It is imperative that clear guidance on vaccination against COVID-19 be disseminated to all vaccine providers.”

Newer vaccines are known as bivalent vaccines. They are designed to protect not only against the original strain of coronavirus, but also against BA.5 and another sub-variant of Omicron called BA.4. The new booster is only allowed to people 12 years and older.

Conventional injections are monovalent vaccines, intended to protect only against the original strain of coronavirus.

The conventional vaccine formula is still used for people who have not yet been vaccinated.

The risk of confusion comes from the color of the cap of the vials. The color of the vial caps of some of the new boosters are identical to those of the old vaccines.

For example, Pfizer’s conventional and updated bivalent injections for people ages 12 and older come in a capped bottle of the same color — gray, according to slides from a presentation the CDC gave to science advisers the following day. last week. Clinicians will need to read the label to distinguish between the conventional vaccine and the updated booster.

Both vials contain the same amount of vaccine – 30 micrograms – but the conventional vaccine was designed only against the original strain of coronavirus, while the updated booster has half reserved for the original strain and the rest against the BA.4/BA.5 Sub-variants of Omicron.

For people aged 12 and over, the conventional Pfizer vaccine and the updated Omicron booster have the same color vial cap – grey.


The updated Pfizer booster label includes the words “Bivalent” and “Original and Omicron BA.4/BA.5”.

Pfizer-BioNTech labels distinguishing between conventional vaccine and new booster

The updated Pfizer booster label reads “Bivalent” and “Original and Omicron BA.4/BA.5”.


For Moderna’s vaccines, a possible source of confusion is that the vial cap is dark blue for both the conventional primary vaccine for children ages 6-11 and the updated booster for adults.

Both vials contain the same dose of vaccine – 50 micrograms. But the children’s version of the primary dose is designed entirely against the original strain of coronavirus. The updated adult booster has half of its volume designed against the original strain and the rest against the BA.4/BA.5 subvariants.

Similarities Between Conventional and Updated Moderna Booster

Moderna’s vaccines, both the conventional vaccine for children ages 6 to 11, and the updated Omicron booster for adults, share the same vial cap color: dark blue.


The label of the updated Omicron booster is labeled “Bivalent” and “Original and Omicron BA.4/BA.5”.

The updated Moderna booster has the phrase

The updated Omicron booster for Moderna bears the phrase “Bivalent” and “Original and Omicron BA.4/BA.5” on the label.


Vaccinators will need to ensure that the right vaccine is given to the right person.

During a Tuesday press briefing, White House COVID-19 response coordinator Dr. Ashish Jha said FDA scientists are working to ensure vaccine suppliers are properly training staff to making sure “people can get the right vaccine”.

“We have seen no evidence of large-scale errors or people getting the wrong vaccine. I’m confident the system continues to work effectively, but I know the FDA continues to monitor this very closely,” Jha said.

CDC Director Dr. Rochelle Walensky said her agency was actively working to distribute photos of the bottle caps and to educate vaccine administrators to “minimize confusion.”

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