Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: Child Received 3rd dose of COVID  Vaccine;  First dose given  11/18/2021; Dose #2 given 12/09/2021; 3rd Dose given 01/16/2022;  See notes below:  Call received approximately 4:30 pm today from parent expressing concern that her son received a third dose of COVID vaccine today.  Initially parent spoke with office.  Verified that the child had indeed received a covid vaccine today as per the consent roster.   The first dose was given by our staff on 11-18-2021 at a event, the 2nd dose was given on 12-09-2021 in our office, when the child was presented with grandma since he had been absent at the clinic earlier that day.  5:30 PM, I called the mother and spoke with her regarding the above incident.  I reassured her that we were sorry for the mistake and that we are currently exploring the incident to determine how this occurred since vaccinator had given all three doses of vaccine.  I provided parent with CDC information regarding additional dose recommendations for children of specific health concerns such as impaired immune systems and though this was not the reason that patient received the 3rd dose, I wanted her to know that there are scientific indications for safe administration of the additional dose.   The consent form printed from the system indicated a consent date of 01/03/2022. Parent stated that she followed the instruction that were provided at the time of patient received dose 1 which was 11-18-2021 and shortly after the first dose did consent for the second dose to be given on December 9th at the School. Patient was absent from school that day and later in the day the grandmother presented at office to have patient receive dose 2.    Parent stated that she assumed that since vaccinator provided the first 2 doses that the system would cancel out the consent that she had completed on clinic that she had signed prior to the December 9th  clinic visit.  Both dose one and two are documented timely into the EMR and consequently into system. System is used ideally in the school settings to facilitate parents and guardians to provide their consent for vaccines to be given at a clinic location without the physical presence of the parent/guardian.  The system does not communicate with our EMR thus an indicator to flag that the individual had received dose 2 at a location other than the intended school location indicated through system did not occur.   I instructed parent on the potential local and antibody responses that she may or may not see with patient, she verbalized understanding. She stated that she had already informed patient's teacher and the school secretary of the incident. I assured her that we do our best to safeguard against future incidents through exploration of the processes currently in place.  Parent stated that she was very appreciative of the vaccination service in the school setting. She expressed that she felt it necessary to bring her concern forward and repeatedly thanked me for calling her back. I told her that I would call her back in the next 1-2 days and that she was welcome to call our office with any questions she may have. Parent did ask if there was a way to ensure that parents are aware of when children are receiving vaccines at school such as a reminder all call. A very cordial discussion of vaccines, covid disease, the stress of parenting and school during a pandemic ensued.