The correct answer is:

Regardless of the setting, vaccination of persons who were treated with antibody infusion for active COVID-19 illness should be deferred for at least 90 days after this treatment.

Educational Objective:

Review the special COVID-19 vaccination rules for 2 specific subgroups (asymptomatic people currently in quarantine after a known exposure and people who recently received a passive antibody infusion for active COVID-19 illness) in various settings (community setting and long-term care/homeless/correctional facilities).

Key Point:

In their December 15, 2020 publication, the CDC recommends the following with regards to the Pfizer-BioNTech Covid-19 mRNA vaccine (Editor’s note: CDC recommendations for the just-released Moderna vaccine are presumably forthcoming):

Vaccination in persons who received monoclonal antibodies or convalescent plasma as part of a COVID-19 treatment should be deferred from vaccination for at least 90 days after these treatments to prevent the infused antibodies from interfering with the person’s own vaccine-induced immune response.

Explanation:

The CDC bases this recommendation on (1) a current lack of data on safety or efficacy of COVID-19 vaccination in persons who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment and (2) on the estimated half-life of the antibodies from these therapies and evidence suggesting reinfection is uncommon within 90 days of initial COVID-19 infection.

For persons with a known SARS-CoV-2 exposure but without known COVID-19 infection, the CDC recommends:

Community or Outpatient Setting: Defer vaccination until any quarantine period has ended. The goal is to avoid exposing healthcare personnel (HCP) or other persons to this possibly infectious person during the vaccination visit.

Residents of congregate healthcare settings (e.g., long-term care facilities): Residents and staff in these settings currently under quarantine for a known exposure to SARS-CoV-2 may be vaccinated, as the HCP are already in close contact with residents and this will likely not result in additional exposures.

Residents of other congregate settings (e.g., correctional facilities, homeless shelters). Residents and staff in these settings currently under quarantine for a known exposure to SARS-CoV-2 may be vaccinated in order to avoid delays and missed opportunities for vaccination. Where feasible, precautions should be taken to limit the mixing of individuals with a recent known exposures with other residents or non-essential staff.

In their statement released on December 19, 2020, Moderna did not address any protocol or exclusions related to persons residing in the community or a long-term care homeless/correctional facility.

References:

Centers for Disease Control and Prevention (CDC): Covid-19 Vaccination.  (Updated December 15 2020; Accessed December 18, 2020).

Centers for Disease Control and Prevention (CDC): People with Certain Medical Conditions. (Updated December 1, 2020; Accessed December 18, 2020)

Centers for Disease Control and Prevention (CDC): Pregnancy, Breastfeeding, and Caring for Newborns. (Updated December 18, 2020; Accessed December 18, 2020)

Moderna announces FDA authorization of Moderna COVID-19 Vaccine in US. December 19, 2020.