What are the current COVID-19 (Coronavirus Disease 2019) vaccine guidelines?

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Last updated: May 4, 2025View editorial policy

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From the Guidelines

The current COVID-19 vaccine guideline recommends that everyone 6 months and older should stay up to date with COVID-19 vaccines, with most people now needing one updated 2024-2025 vaccine dose, as stated in the most recent study 1. The updated vaccines are Pfizer-BioNTech, Moderna, or Novavax, designed to protect against recent variants. For most adults and children, a single dose is sufficient regardless of previous vaccination history. However, people who are moderately or severely immunocompromised may need additional doses based on their doctor's recommendation. For initial vaccination in those who have never received a COVID vaccine, multiple doses may be required depending on age and vaccine brand. The vaccines work by training your immune system to recognize and fight the virus that causes COVID-19, specifically targeting current circulating variants. Some key points to consider include:

  • The COVID-19 vaccine can be given at the same time as other vaccines, including the seasonal flu vaccine, making it convenient to get protected against multiple respiratory illnesses simultaneously.
  • Side effects are typically mild and may include pain at the injection site, fatigue, headache, and muscle pain lasting 1-2 days.
  • The recommendation for COVID-19 vaccination is based on the latest guidance from the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC), as outlined in the study 1.
  • It's essential to consult with a healthcare provider to determine the best vaccination schedule for individual needs, especially for those with underlying medical conditions or compromised immune systems.

From the Research

COVID-19 Vaccine Guidelines

The current COVID-19 vaccine guidelines are based on recommendations from the Advisory Committee on Immunization Practices (ACIP) and the Food and Drug Administration (FDA) 2, 3.

  • Three COVID-19 vaccines are currently approved or authorized for primary vaccination in the United States:
    • Pfizer-BioNTech/Comirnaty
    • Moderna COVID-19 vaccine
    • Janssen (Johnson & Johnson) COVID-19 vaccine
  • An additional primary dose is recommended for certain immunocompromised recipients of an initial mRNA COVID-19 vaccination series 2.
  • A booster dose is recommended for certain recipients aged ≥18 years who are at increased risk for serious complications of COVID-19 or exposure to SARS-CoV-2 2, 4, 5.

Booster Dose Recommendations

  • Adults who received a primary Janssen vaccine dose should preferentially receive a heterologous mRNA vaccine booster dose ≥2 months later, or a homologous Janssen vaccine booster dose if mRNA vaccine is contraindicated or unavailable 4.
  • All adults who have received mRNA vaccines for their COVID-19 primary series vaccination should receive an mRNA booster dose when eligible 4, 5.
  • The effectiveness of a primary COVID-19 vaccine series plus a booster dose is higher than a primary series alone for preventing COVID-19 hospitalization due to the Omicron variant 5.

Vaccine Effectiveness

  • Vaccine effectiveness against Omicron variant COVID-19-associated hospitalization is higher for a boosted regimen than a primary series alone for both mRNA vaccines used in the US 5.
  • The vaccine effectiveness of primary series and booster doses against Omicron variant COVID-19-associated hospitalization in the United States is significant, with a primary series plus one booster of any vaccine product dose having a vaccine effectiveness of 77% (95% CI: 71-82%) 5.

Improving Vaccine Completion

  • Infographics can be a useful tool to aid and bolster the deployment of COVID-19 vaccines, and can improve completion of a two-dose COVID-19 vaccine regimen by explaining what the vaccine is and why returning for the second dose is beneficial 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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