Age: 47.0
Sex: F
Vaccine: COVID19-2
Symptoms: Medication error
Clinical narrative: Situation: Patient received an additional dose of a [Pfizer] Bivalent Booster in error this morning. She had previously received a [Moderna] Bivalent Booster in October 2022. Background: Upon arrival, patient confirms with me that she is present for a Pfizer Bivalent booster. I asked the screening questions and performed a medication reconcile because she had zero history on local data tracker for any previous immunizations. Patient answers "no" to all questions on the questionnaire and I tell her that since she has no history of anaphylaxis or severe reactions to the first three doses that the 15 minute wait is optional. I administer the Pfizer Bivalent Booster. She walks out the room and I begin my documentation of her answers and vaccination when a hard stop pops up on local data tracker stating that she has completed the series. I take a look to confirm her previous vaccination history and see that she has received a Moderna Bivalent dose in October of last year. I call her back inside from the waiting area and ask her if the vaccine she had received in October of last year was a Bivalent dose and the patient confirms. I then explain to her since she has received a bivalent booster in the past that she had received today's dose in error. She states, "But that was a Moderna. Aren't I supposed to receive another Bivalent booster months later?" I explain to her that the CDC guidelines state that once you receive a bivalent booster that you have completed the series. She states that her wife was to receive another bivalent booster but I repeat that a bivalent booster will complete the vaccination series and that receiving another one will be an error. She then asks about side effects, I instruct her to keep an eye out specifically for shortness of breath and rashing and that if they are to be present to call 911 or go to urgent care.  Assessment: Upon assessment I see that she had received her three previous vaccines from local Pharmacy and the local Convention Center. The patient is fine with no allergic reactions present.  Recommendation: Lately, we have been receiving many patients who are scheduling for boosters for the same reason, believing that since months have passed since their last booster, that they are overdue for another one. They then either schedule Online or over the phone. The team grooms the schedule the day before for all patients, and we did so as well the day before this incident took place, but this patient added herself onto schedule on the day of her appointment. There should be a better system of scheduling patients to prevent error of duplicate doses. There should be a method utilized to prevent patients from booking an appointment if they have already completed the vaccination series, along the lines of a hard stop, whether they book themselves, or from medical staff or over the phone. The medical staff (myself) should and will continue screening properly, comparing CDC cards with local data tracking charting, medication reconcile as needed, and confirming that they've received the vaccinations that they have received, to prevent error.