What is the current evidence on COVID-19 (Coronavirus Disease 2019) vaccine recommendations according to age groups and populations at risk?

From the Guidelines

COVID-19 vaccine recommendations vary by age group and risk status, with most health authorities recommending vaccination for nearly all individuals aged 6 months and older, as supported by the most recent evidence from 2024 1.

Key Recommendations

• For primary vaccination, most adults should receive either mRNA vaccines (Pfizer-BioNTech or Moderna) or protein-based vaccines (Novavax), typically in a two-dose series.
• Children 6 months to 17 years should receive age-appropriate formulations, with dosing intervals adjusted for their age group, as outlined in the recommendations from the Advisory Committee on Immunization Practices (ACIP) 1.
• For updated protection, annual booster doses are recommended for everyone 6 months and older, with the most recent formulations targeting circulating variants.
• High-risk populations, including older adults (65+), immunocompromised individuals, those with chronic medical conditions, pregnant women, and healthcare workers, should prioritize staying current with vaccinations, with some immunocompromised individuals requiring additional doses, as noted in the evidence from 2024 1.

Age-Specific Guidance

• Persons aged 5–11 years without moderate to severe immunocompromise need 1 dose of 2024–2025 COVID-19 vaccine (Moderna or Pfizer-BioNTech) to be up to date 1.
• Persons aged ≥12 years without moderate to severe immunocompromise need 1 dose of 2024–2025 COVID-19 vaccine (Moderna, Novavax, or Pfizer-BioNTech) to be up to date, with specific guidance for those who have not previously received any COVID-19 vaccines 1.

Booster Doses

• Annual booster doses are recommended for everyone 6 months and older, with the most recent formulations targeting circulating variants, to maintain protection against evolving variants, as supported by the evidence from 2024 1.
• The recommendations reflect evidence that COVID-19 vaccines significantly reduce the risk of severe disease, hospitalization, and death across all age groups, with benefits far outweighing potential risks, as noted in the studies from 2022 and 2024 1.

populations at risk

• High-risk populations should prioritize staying current with vaccinations, with some immunocompromised individuals requiring additional doses, as noted in the evidence from 2024 1.

From the Research

COVID-19 Vaccine Recommendations by Age Group

• The COVID-19 vaccine has been shown to be effective in preventing COVID-19 in persons 16 years of age or older, with an efficacy of 95% 2.
• The vaccine has also been found to be safe and effective in adolescents aged 12-15 years, with a favorable safety profile and an efficacy of 100% 3.
• However, the effectiveness of the vaccine in older adults has been found to decline over time, with a decline in vaccine effectiveness against both severe acute respiratory syndrome coronavirus 2 infection and severe COVID-19 4.
• As a result, a booster dose of the COVID-19 vaccine has been recommended for older adults, particularly those 65 years and older 4.

Populations at Risk

• Older adults, particularly those 60 years and older, are considered a high-risk population for COVID-19 and are prioritized for vaccination 5.
• The vaccine has been found to be effective in preventing severe COVID-19 in older adults, with a significant reduction in the risk of severe disease and death 2.
• However, the coverage of COVID-19 vaccination programs for older adults is uneven across countries, with large differences in vaccination rates and coverage by region 5.
• Children under the age of 12 are not currently recommended to receive the COVID-19 vaccine, although this may change as more data becomes available 6.

Vaccine Effectiveness and Safety

• The COVID-19 vaccine has been found to be highly effective in preventing COVID-19, with an efficacy of 95% or higher in most studies 2, 3.
• The vaccine has also been found to be safe, with a favorable safety profile and few serious adverse events reported 2, 3.
• However, there have been reports of rare side effects, such as heart inflammation and blood clots, associated with the vaccine 6.
• Long-term monitoring is essential to determine the efficacy and safety of the vaccine over time 6.