NEWS AND UPDATES

This page last updated: 06/11/2022 10:30

Moderna vaccine quantity on hand: 0

Pfizer vaccine (ages 5 to 11) quantity on hand: 0

Pfizer vaccine (ages 12 to 17) quantity on hand: 0

Paxlovid (nirmatrelvir/ritonavir) quantity on hand: 24

Influenza vaccine quantity on hand: 5

 

>>> We will be temporarily postponing COVID-19 vaccine administrations through early July.  This page will be updated again at that time. <<<

 

 

 

 

 

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY.

 

For all vaccine recipients: please have your vaccine card and consent form ready upon arrival to minimize delay.

 

 

COVID-19 RAPID ANTIGEN TESTS

Which tests do you carry?

At this time, we are carrying the iHealth COVID-19 Rapid Antigen Tests, manufactured by iHealth Labs, Inc.

The iHealth test was granted an emergency use authorization (EUA # 153925) by the FDA on 22 December 2021.

 

How accurate are the iHealth tests compared to others?

There are currently 17 rapid antigen tests for at-home use approved by the FDA.

The iHealth test is comparable to (if not slightly more accurate than) the commonly-known BinaxNow at-home test by Abbott.

Like most at-home systems, each kit contains two tests, which are self-collected from both nares and performed at least 24 hours (but not more than 48 hours) apart.

The package insert and instructions for use are available here.

 

Can I get free COVID-19 tests?

As of January 15th, insurance companies are (technically) required to cover up to eight FDA-approved at-home tests per individual per month without a prescription at no cost to the end user.

The intent of this law was to easily and quickly provide tests to the public when needed for self-testing by incentivizing insurance companies to offer point-of-sale coverage at pharmacies and other providers.

However, given the recent extremely high demand for tests, short supply, and propensity for individuals to stockpile supplies after a shortage, insurance companies have been reluctant to cover most FDA-approved tests. Insurance companies are free to choose which tests are covered; of the seventeen currently authorized tests, we have observed only two or three manufacturers to be covered reliably.

In the event that an individual purchases an FDA-approved test on their own, or from a provider unable to provide point-of-sale billing, or a test that is not included on the insurance company’s point-of-sale formulary but is FDA-approved, the law stipulates that insurance companies must reimburse the individual for the full cost of the test (up to eight per month).

We believe that the current reluctance with insurance companies to cover all FDA-approved tests for point-of-sale dispensing is a strategy to reduce their costs by forcing individuals to manually submit their receipts for reimbursement.

Until more tests are added to insurance formularies, be prepared to purchase your tests out of pocket and submit receipts on your own for reimbursement.

 

COVID-19 Vaccine Information

When can I receive my vaccine?

Vaccine administration is offered weekly, Monday through Thursday, between 10:00 am and 5:00 pm, or until supplies run out.

We are typically able to restock supply within one week of running out; the expected ETA for the next shipment will be shown at the top of this page once the order has been approved by the NYS Department of Health.

No appointment is necessary, though we recommend arriving as early as possible.

Individuals arriving later in the afternoon or evening may be asked to return at a different time or on another day to minimize the risk of discarding unused doses.

Out-of-state residents may be vaccinated by New York providers, however you must still complete the online NYS COVID-19 Vaccination Form for the NYS Department of Health.

 

Regarding heterologous (i.e. “mix-and-match”) dosing:

The FDA discontinued the requirement that booster doses must be from the same manufacturer as the primary series, primarily as a measure to increase vaccination rates among eligible individuals by not limiting providers based on the type of vaccine available at any given time.

Individuals may receive either of the two mRNA vaccines (Pfizer or Moderna) as a booster dose.

An added benefit of heterologous boosting is that immunity appears to be superior and more durable than receiving three doses of the same vaccine. This is particularly important for individuals who have received the Pfizer vaccine, as efficacy wanes considerably with time and age. However, individuals who have received two doses of the Moderna vaccine are probably less likely to benefit from a third dose of the Pfizer vaccine as opposed to a third dose of the Moderna vaccine. We recommend that all eligible individuals receive a third and/or fourth dose of the Moderna vaccine.

Note that heterologous dosing only applies to booster doses at this time. Both primary course doses must still be identical, as well as third-dose revaccinations.

 

Regarding multiple booster doses, when to receive, and spacing between vaccines:

As of 30 March 2022, the CDC and FDA authorized a second round of boosters for adults aged 50 or older who have received their first booster dose at least four months prior.

Up until that announcement, our impression was that a second booster round would be forthcoming in the late summer or fall, in preparation for people returning indoors and coming into closer contact with one another. Any antibodies your body produces (to all antigens, not just COVID) are naturally cleared after three to six months, even though immunologic memory may persist for much longer. Providing additional booster doses is an effective strategy for increasing antibody levels in anticipation of near-term exposure.  Therefore, consideration may be given to wait, and coordinate vaccine administration and the resultant boost in circulating antibody levels with an increase (or anticipated increase) in COVID cases and risk of exposure.

However: given the uncertainty of Federal and State vaccine supply and funding, we would advise all eligible individuals to receive their second booster dose as soon as possible. We would rather administer another round again later in the year than advise waiting and potentially delaying or missing a dose if local infection rates do indeed begin to rise.

 

Now that you will have both mRNA vaccines in stock and available for adults, can I choose which one I get?

No; our Pfizer stock will be quite limited and used preferentially for those under 18.

All primary series vaccinations and booster doses for adults will be Moderna only.

 

Regarding vaccine dose amounts:

For the Moderna vaccine (ages 18 and up):

  • Primary series: two 0.5 mL doses, separated by 28 days.
  • Third-dose revaccination for immunocompromised individuals: one 0.5 mL dose at least one month after completing the primary series.
  • Booster doses: one 0.25 mL dose at least four months after the most recent dose (primary series or first booster).

For the pediatric Pfizer vaccine (ages 5 to 11) :

  • Primary series: two 0.2 mL doses, separated by 21 days.
  • Third-dose revaccination for immunocompromised individuals: one 0.2 mL dose at least one month after completing the primary series.
  • Booster dose: not currently authorized or recommended by the FDA and CDC.

For the adolescent/adult Pfizer vaccine (ages 12 and up):

  • Primary series: two 0.3 mL doses, separated by 21 days.
  • Third-dose revaccination for immunocompromised individuals: one 0.3 mL dose at least one month after completing the primary series.
  • Booster doses: one 0.3 mL dose at least four months after the most recent dose (primary series or first booster).

 

Regarding Moderna vaccine eligibility:

There are three classes of Moderna vaccine eligibility, as outlined below. The dose you receive, and when you can receive it, depends on whether the immunization is a third-dose revaccination or a third-dose booster.

  • Primary series (full dose, 100 μg/0.5 mL): available to any individual aged 18 or older.
  • Third dose revaccination (full dose, 100 μg/0.5 mL) for severely immunocompromised individuals:
    • Given at least 28 days after completion of the second dose; all three doses together constitute the primary series for these individuals.
    • Administered due to a medical condition or receipt of immunosuppressive medications or treatments which may have impaired response to the primary series. These conditions and treatments include but are not limited to:
      • Active treatment for solid tumor and hematologic malignancies,
      • Receipt of solid-organ transplant and taking immunosuppressive therapy,
      • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy),
      • Moderate or severe primary immunodeficiency,
      • Advanced or untreated HIV infection,
      • Active treatment with high-dose corticosteroids (e.g. > 20 mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-associated immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
  • Booster doses (half dose, 50 μg/0.25 mL) for the following individuals:
    • Available to the following recipients:
      • All individuals aged 18 or older.
    • Timing after previous doses…
      • At least four months after the most recent dose for past recipients of Moderna or Pfizer vaccines, OR
      • At least three months after the most recent dose for immunocompromised individuals who have received the Moderna or Pfizer vaccines, OR
      • At least two months after a single dose of the Janssen vaccine.

Regarding Pfizer vaccine eligibility:

Like the Moderna vaccine, there are three classes of Moderna vaccine eligibility. The dose you receive, and when you can receive it, depends on the recipient’s age and whether the immunization is a third-dose revaccination or a third-dose booster.

Adult/adolescent Pfizer vaccine (a.k.a. Comirnaty):

  • Primary series (full dose, 30 μg/0.3 mL): available to any individual aged 12 or older. Two doses separated by 21 days.
  • Third dose revaccination (full dose, 30 μg/0.3 mL) for severely immunocompromised individuals:
    • Given at least 28 days after completion of the primary series.
    • Administered due to a medical condition or receipt of immunosuppressive medications or treatments which may have impaired response to the primary series. These conditions and treatments include but are not limited to:
      • Active treatment for solid tumor and hematologic malignancies,
      • Receipt of solid-organ transplant and taking immunosuppressive therapy,
      • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy),
      • Moderate or severe primary immunodeficiency,
      • Advanced or untreated HIV infection,
      • Active treatment with high-dose corticosteroids (e.g. > 20 mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-associated immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
  • Booster doses (full dose, 30 μg/0.3 mL) for the following individuals:
    • Available to the following recipients:
      • All individuals aged 12 or older.
    • Timing after previous doses…
      • At least four months after completing a Moderna primary course, OR
      • At least four months after completing a Pfizer primary course, OR
      • At least two months after a single dose of the Janssen vaccine.

Pediatric Pfizer vaccine (not Comirnaty):

  • Primary series (full dose, 10 μg/0.2 mL): available to any individual aged 5 to 11. Two doses separated by 21 days.
    If a child turns from 11 to 12 years of age between their first and second doses of the primary series, they may receive either strength.
  • Third dose (full dose, 10 μg/0.2 mL) for severely immunocompromised individuals:
    • Given at least 28 days after completion of the primary series.
    • Administered due to a medical condition or receipt of immunosuppressive medications or treatments which may have impaired response to the primary series. These conditions and treatments include but are not limited to:
      • Active treatment for solid tumor and hematologic malignancies,
      • Receipt of solid-organ transplant and taking immunosuppressive therapy,
      • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy),
      • Moderate or severe primary immunodeficiency,
      • Advanced or untreated HIV infection,
      • Active treatment with high-dose corticosteroids (e.g. > 20 mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-associated immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
  • Booster dose (full dose, 10 μg/0.2 mL) for the following individuals:
    • Not currently recommended or approved by the FDA and CDC.

Consent forms and procedure:

For unvaccinated children aged 5 to 11 seeking their first dose of the pediatric Pfizer vaccine:

  • Verify eligibility:
    • Currently any child, aged 5 to 11 years of age, may receive the pediatric 10 μg Pfizer vaccine with parental consent.
  • Print and complete the COVID-19 Vaccine Consent Form.
  • Complete the online NYS COVID-19 Vaccination Form prior to arriving at the pharmacy.
  • Arrive at the pharmacy between 10:00 am and 5:00 pm, Monday through Thursday, with the completed consent form.
  • The second appointment will be scheduled for 21 days after the date of the first vaccination. Due to the sensitive storage requirements for the Pfizer vaccine, you must return to the original provider to receive the second dose. Please make all efforts to adhere to the 21 day timing interval.

 

For unvaccinated children aged 12 to 17 seeking their first dose of the adult Pfizer vaccine (coming soon):

  • Verify eligibility:
    • Currently any child, aged 12 to 17 years of age, may receive the adult 30 μg Pfizer vaccine with parental consent.
  • Print and complete the COVID-19 Vaccine Consent Form.
  • Complete the online NYS COVID-19 Vaccination Form prior to arriving at the pharmacy.
  • Arrive at the pharmacy between 10:00 am and 5:00 pm, Monday through Thursday, with the completed consent form.
  • The second appointment will be scheduled for 21 days after the date of the first vaccination. Due to the sensitive storage requirements for the Pfizer vaccine, you must return to the original provider to receive the second dose. Please make all efforts to adhere to the 21 day timing interval.

 

For unvaccinated adults seeking their first or second dose (primary course) of the Moderna vaccine:

  • Verify eligibility:
    • Currently any individual 18 or older may receive the Moderna vaccine.
  • Print and complete the COVID-19 Vaccine Consent Form.
  • Complete the online NYS COVID-19 Vaccination Form prior to arriving at the pharmacy.
  • Arrive at the pharmacy between 10:00 am and 5:00 pm, Monday through Thursday, with your completed consent form and driver’s license.
  • Your second appointment will be scheduled for 28 days after the date of your first vaccination.

 

For adults seeking their first, second, or booster dose of the Pfizer or Janssen vaccines:

  • Change your mind and just get the Moderna vaccine.

 

For immunocompromised adults seeking a third dose (0.5 mL) of the Moderna vaccine:

  • Verify eligibility:
    • The individual previously received two doses of the Moderna vaccine, AND
    • More than 28 days has elapsed since receipt of the most recent Moderna dose, AND
    • The individual meets the eligibility criteria for severe immunocompromisation as described above.
  • Locate your vaccine card to bring to the pharmacy.
  • Print and complete the COVID-19 Vaccine Consent Form.
  • Print and complete the Third-Dose Eligibility Attestation Form.
  • Complete the online NYS COVID-19 Vaccination Form prior to arriving at the pharmacy.
  • Arrive at the pharmacy between 10:00 am and 5:00 pm, Monday through Thursday, with your completed consent form, eligibility attestation form, and vaccine card.
  • A fourth dose (0.25 mL booster) is administered at least three months after completing the primary course.

 

For non-immunocompromised adults and adolescents seeking a booster dose:

  • Verify eligibility:
    • The individual previously completed a primary vaccination series for any COVID-19 vaccine, AND
    • Sufficient time has elapsed since receipt of the most recent COVID-19 dose…
      • Janssen: at least two months
      • Pfizer: at least four months
      • Moderna: at least four months, AND
    • The individual is 12 years of age or older.
  • Locate your vaccine card to bring to the pharmacy.
  • Print and complete the COVID-19 Vaccine Consent Form.
  • Complete the online NYS COVID-19 Vaccination Form prior to arriving at the pharmacy.
  • Arrive at the pharmacy between 10:00 am and 5:00 pm, Monday through Thursday, with your completed consent form, eligibility attestation form, and vaccine card.

 

Can I receive a flu shot at the same time as my COVID vaccine?

Yes, flu shots are available for all individuals aged 5 and up.

If you are seeking to have a flu shot administered at the same time as your COVID-19 vaccine, please print and complete the Influenza Vaccine Consent Form ahead of your visit to save time.

We will only be administering standard-dose preservative-free quadrivalent flu vaccines this year. The senior (65+) high-dose and adjuvanted vaccines are 6 to 7 times more expensive than standard-dose vaccines for us to acquire; we decided to maximize the number of individuals we could vaccinate by purchasing only standard-dose vaccines.  (And since we should all continue to be vigilant and proactive in reducing our exposure to communicable diseases by continuing to wear masks and practice social distancing anyway, the marginal benefit of the high-dose and adjuvanted influenza vaccines is perhaps less significant this year.)

Most insurance plans cover flu shots in full; the out-of-pocket cost if not covered or uninsured is $20.00.

 

COVID-19 ORAL ANTIVIRAL THERAPEUTICS

The U.S. Department of Health and Human Services selected Riverside Remedies to provide oral antiviral medications for the treatment of mild-to-moderate COVID-19.

We were informed that the number of providers selected to participate is relatively limited, though we have no other indication at this time as to how many other local providers will also be offered these medications. All providers with antiviral stock are required to report daily inventory to a centralized database, so that prescribers will be able to find local stock quickly.

What medications are available?

Currently, two oral medications have received emergency use authorization by the FDA and CDC to treat mild-to-moderate COVID-19:

  • Paxlovid: a combination drug consisting of:
    • Nirmatrelvir, a novel SARS-CoV-2 protease inhibitor that inhibits viral replication, and
    • Ritonavir, another antiviral not useful against SARS-CoV-2 itself but instead prevents the body from metabolizing the nirmatrelvir too quickly.
  •  Molnupiravir: a single-entity nucleoside analog that prevents SARS-CoV-2 replication by mutagenesis.

We are (finally!) expecting to receive our first shipment of Paxlovid by the first week of May.  The inventory count at the top of this page will be updated periodically to reflect current stock.

Given that Paxlovid is more effective and the preferred agent over molnupiravir, we will likely only maintain inventory of the former for the foreseeable future.

How are the medications used?

Importantly, these medications can only be used for post-exposure treatment – they cannot be used for pre- or post-exposure prophylaxis for the prevention of COVID-19, nor as a substitute for vaccination.

They also cannot be used for severe disease that require hospitalization, in which case a patient would likely be administered a monoclonal antibody infusion (among other things).

These drugs are only intended to aid the patient in recovering at home from a mild-to-moderate infection, and to possibly help preventing a less serious case from progressing to a more serious one that may require hospitalization. They are analogous to Tamiflu in this way – they won’t prevent you from getting sick in the first place, but once confirmed may help you recover a little more quickly and comfortably.

How do I get an oral antiviral medication if I need one?

A prescription is required; any provider prescribing Paxlovid and molnupiravir should know the requirements to initiate therapy.

However, there are a few points that you can consider to ensure that we are able to dispense in a timely manner:

  • A prescription for Paxlovid or molnupiravir must contain an ICD-10 code and date of positive COVID-19 test; make sure your prescriber includes both on the prescription.
  • Therapy should be initiated as soon as possible – within five days of symptom onset, and preferably within 72 hours.
  • Paxlovid has a lengthy list of potential drug interactions, as ritonavir is a potent inhibitor of multiple liver enzyme pathways that metabolize many other common prescription and OTC medications. Proper interaction screening is critically important.
  • If you are not a regular patient of ours, we would strongly recommend that you provide us with a list of any and all medications (prescriptions and OTC medications) that you take, so that we can accurately screen for interactions.