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COVID-19: Vaccine Booster Eligibility, Oral Antiviral Medication

The U.S. Food and Drug Administration (FDA) Nov. 19 expanded eligibility for both the Moderna and Pfizer-BioNTech COVID-19 vaccine booster doses for all individuals ages 18 and older.

Vaccine booster doses previously were authorized only for certain at-risk populations. The expanded eligibility is based on the FDA’s analysis of immune response data that supported use in the previously authorized populations for boosters. Vaccine booster doses previously were authorized only for certain at-risk populations. The expanded eligibility is based on the FDA’s analysis of immune response data that supported use in the previously authorized populations for boosters. The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices on Nov. 19 unanimously endorsed the boosters for all adults while reiterating its strong endorsement of boosters for older adults.

Pfizer EUA for Oral Antiviral Medication

Pfizer Inc. filed on Nov. 16 for emergency use authorization (EUA) for a COVID-19 oral antiviral medication to treat mild to moderate COVID-19 in patients at increased risk of hospitalization or death. If authorized, PAXLOVID, would be the first oral antiviral for COVID-19 that could be prescribed as a home treatment to high-risk patients at the first sign of infection.

Pfizer seeks the EUA based on positive results from an interim analysis that demonstrated an 89 percent reduction in risk of COVID-19–related hospitalization or death from any cause in patients treated with PAXLOVID compared to placebo within three days of symptom onset, with no deaths in the treatment group.

New ICD-10 Codes for Vaccination Status

Effective April 2022, CDC will implement three new ICD-10 diagnosis codes for reporting COVID-19 vaccination status. The codes include:

  • unvaccinated for COVID-19;
  • partially vaccinated to COVID-19; and
  • other under-immunization status.

Further, effective April 2022, the Centers for Medicare & Medicaid Services (CMS) will implement seven new ICD-10 procedure codes for COVID-19 therapeutics and vaccines. CMS notes that, for hospitalized patients, Medicare pays for the COVID-19 vaccines and their administration separately from the Diagnosis-Related Group rate. As such, Medicare expects that the appropriate CPT codes will be used when a Medicare beneficiary is administered a vaccine while a hospital inpatient.

Visit the America’s Essential Hospitals coronavirus resource page for more information about the pandemic.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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