FormWeb • SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312)

Ochsner Health

Ochsner Health System Formulary

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Medications listed are available on OH EPIC Formulary, unless otherwise noted.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.

Ochsner Health

Ochsner Health System Formulary

Formulary Addition Request Questions or Suggestions?

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SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312)

SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312)

Drug Name	Form	Strength	Infusion Center Available	Restricted	Non-formulary	Ambulatory Available	Interchange	REMS
Spikevax PF	SUSPENSION, INTRAMUSCULAR	preservative-free 50 mcg/0.5 mL

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Restriction/Criteria of use:

Indication: prevention of COVID-19 infection
Service line: All providers
Formulary location: Ambulatory
Service location: Clinic
Patient population: Adult and Pediatric
Prior authorization required: no

Last updated: Oct. 23, 2023

Ambulatory: Clinic
Vaccine: OHS Vaccine Formulary

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