From the Guidelines
The recommended COVID-19 vaccination strategy is to receive a single dose of the updated COVID-19 vaccine, such as Moderna or Pfizer-BioNTech, annually, regardless of previous vaccination history, as recommended by the Advisory Committee on Immunization Practices (ACIP) in 2024 1. This strategy is based on the latest evidence from the ACIP, which recommends a single dose of the updated vaccine for persons aged ≥5 years who are not moderately or severely immunocompromised, with an interval of ≥8 weeks after the last dose 1. The COVID-19 vaccines have been shown to be highly effective at preventing severe illness, hospitalization, and death from COVID-19, with side effects generally being mild and resolving within a few days 1. Key points to consider when implementing this vaccination strategy include:
- Unvaccinated individuals should receive a single dose of Moderna or Pfizer-BioNTech, or two doses of Novavax (for those aged ≥12 years) 1
- Previously vaccinated individuals should receive a single dose of Moderna, Pfizer-BioNTech, or Novavax, with an interval of ≥8 weeks after the last dose 1
- Children aged 6 months to 4 years who have never been vaccinated should receive multiple doses of the vaccine according to their healthcare provider's guidance 1
- People who are moderately or severely immunocompromised may need additional doses based on their individual circumstances 1
From the Research
Covid-19 Vaccination Strategy
The recommended Covid-19 vaccination strategy involves staying up to date with the recommended Covid-19 vaccines, including initiation of Covid-19 vaccination immediately when eligible 2.
Vaccine Effectiveness
- The effectiveness of monovalent mRNA Covid-19 vaccines against emergency department or urgent care encounters was evaluated, showing 29% effectiveness for 2 monovalent Moderna doses and 43% effectiveness for 3 monovalent Pfizer-BioNTech doses 2.
- The effectiveness of ≥1 bivalent dose was 80% among children aged 6 months-5 years 2.
- Other studies have shown that mRNA Covid-19 vaccines are effective in preventing SARS-CoV-2 infection, with real-world vaccine effectiveness of 86.1% for BNT162b2 and 93.3% for mRNA-1273 3.
- The ARCT-154 self-amplifying mRNA Covid-19 vaccine has also shown efficacy against Covid-19, with 56.6% effectiveness against any Covid-19 and 95.3% effectiveness against severe Covid-19 4.
Booster Vaccines
- Heterologous booster vaccines, such as protein-based NVX-CoV2373, have been shown to elicit more potent ancestral strain and omicron-specific antibody responses compared to homologous and heterologous inactivated and viral vector boosts 5.
- A study evaluating the immunogenicity following two doses of the BBIBP-CorV vaccine and a third booster dose with a viral vector and mRNA Covid-19 vaccines found that all booster vaccines could induce the total IFN-ɣ T-cell response 6.
Vaccination Recommendations
- All children should stay up to date with recommended Covid-19 vaccines, including initiation of Covid-19 vaccination immediately when they are eligible 2.
- Vaccine-mediated protection in inactivated and viral vector recipients may be optimized with the use of a heterologous protein-based booster such as NVX-CoV2373 5.