On January 3rd, 2023, parent called into Public Health and left a voicemail that her son, patient, had received an invalid vaccine per his record.  Via text communication, the parent wrote that his "first booster didn't get updated. It said Not Valid but he received it June 28th 2022. Can you check this for him. PHN investigated. Client did receive vaccine 6/28/22 from PH clinic. The family was walk-in and an add on to scheduled appts. Record shows that 5-11 Orange top Pfizer was administered by volunteer, MD. Lot FL8o94 and MD wrote the words orange top on the administration form. This was a third/booster dose. Primary series was received 6/3/21 and 6/ 24/21. This 6/28/22 dose would be the incorrect product for the client's age of 14 years. Patient had recently received his bivalent booster from another organization on 1/3/23. PHN contacted COVID vaccine program at Department of Health. PHN notified supervisors of issue and working on an recommended outcome. RN from Department of Health replied and gave the following recommendation: The 5-11 dose that was given as a monovalent booster would just be considered a vaccination error. If a VAERS was not completed you should complete one: Vaccine Adverse Event Reporting System (VAERS) With regard to dose #4(bivalent booster), this child would be considered current and no need to re-vaccinate.   Refer to: Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC ? Pfizer-BioNTech COVID-19 Vaccine o People ages 12 years and older: A 2-dose primary series and 1 bivalent mRNA booster dose (Moderna or Pfizer-BioNTech) is recommended. The primary series doses are separated by 3?8 weeks and the bivalent mRNA booster dose is administered at least 2 months after completion of the primary series (for people who have not received any booster doses), or at least 2 months after the last monovalent booster dose. PHN sent this communication to parent.  Hello, First, I am so happy you reached out. Thank you for the information you shared in our text messages. I have attached your son?s vaccine record.   It appears he had an initial series of two Pfizer doses that were the appropriate dose for his age.   The 3rd dose, a booster, looks to have been given at one of our clinics and appears to have been a dose of vaccine that was intended for a younger age. This means it was slightly less in both dose amount and dose strength. It most likely provided a boost in immunity but may not have had the same effectiveness as the product for those 12 and older. On behalf of our agency, I apologize for this. There are no known adverse effects from your son receiving this product. I confirmed with the Department of Health.  Your son recently received his bivalent booster, 1/3/23.  In checking with CDC and Department of Health,  1) The 5-11 dose that was given as a monovalent booster would just be considered a vaccination error. We will report it as such in VAERS - Report an Adverse Event.  2) If desired, you can report it as the parent too 3) With regard to dose #4(bivalent booster), this child would be considered current and no need to re-vaccinate.   Recommendations for your son?s age group have been updated. Your son has a valid primary dose and his bivalent booster and is fully up to date. If he had/has  any special immune compromising conditions, we would look at other guidance to determine if any other doses might be recommended but at this time, with the information you provided, he should be considered fully vaccinated.  Here are the guidance we now follow currently: Pfizer-BioNTech COVID-19 Vaccine a. People ages 12 years and older: A 2-dose primary series and 1 bivalent mRNA booster dose (Moderna or Pfizer-BioNTech) is recommended. The primary series doses are separated by 3?8 weeks and the bivalent mRNA booster dose is administered at least 2 months after completion of the primary series (for people who have not received any booster doses), or at least 2 months after the last monovalent booster dose. Again, I apologize for this error and will follow-up to assure it is reported. Please let me know any questions or concerns upon your review,   Last: no reports of any untoward effects from 6/28/22 administration, nor reports of any illness from SARS COVID-19.  VAERS filed. Note made on client chart. RN PHN 1/4/23