What are the COVID-19 (Coronavirus Disease 2019) vaccine recommendations for 2025?

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Last updated: September 8, 2025 • View editorial policy

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COVID-19 Vaccine Recommendations for 2025

For 2025, all persons aged ≥6 months should receive the 2024-2025 COVID-19 vaccine formulation targeting the Omicron JN.1 lineage strains to protect against severe COVID-19-associated illness and death. 1, 2

General Vaccination Schedule

For Persons Without Moderate or Severe Immunocompromise:

  • Ages ≥12 years: 1 dose of 2024-2025 COVID-19 vaccine (Moderna, Novavax, or Pfizer-BioNTech)
    • Exception: Unvaccinated persons choosing Novavax should receive 2 doses, 3-8 weeks apart
  • Ages 5-11 years: 1 dose of 2024-2025 COVID-19 vaccine (Moderna or Pfizer-BioNTech)
  • Ages 6 months-4 years: Initial multidose series including at least 1 dose of 2024-2025 COVID-19 vaccine
    • Unvaccinated: 2 doses of Moderna (4-8 weeks apart) or 3 doses of Pfizer-BioNTech (3-8 weeks between doses 1-2, ≥8 weeks between doses 2-3)
    • Previously vaccinated: Varies based on previous vaccination history (see detailed schedule below)

For Persons With Moderate or Severe Immunocompromise:

  • All ages ≥6 months: At least 1 dose of 2024-2025 COVID-19 vaccine
  • Unvaccinated ages 6 months-11 years: 3-dose series of 2024-2025 mRNA COVID-19 vaccine (same manufacturer)
  • Unvaccinated ages ≥12 years: Either 3 doses of 2024-2025 mRNA COVID-19 vaccine (same manufacturer) or 2 doses of 2024-2025 Novavax
  • Previously vaccinated with completed initial series: May receive 1 additional dose of 2024-2025 COVID-19 vaccine at least 2 months after the last recommended dose

Detailed Vaccination Schedules

For Previously Vaccinated Persons (≥5 years without immunocompromise):

  • Wait ≥8 weeks after last COVID-19 vaccine dose
  • Receive 1 dose of 2024-2025 COVID-19 vaccine (Moderna, Pfizer-BioNTech, or Novavax [≥12 years only])

For Children 6 months-4 years (without immunocompromise):

  • Previously received Moderna:
    • 1 prior dose: 1 dose of 2024-2025 Moderna (4-8 weeks after dose 1)
    • ≥2 prior doses: 1 dose of 2024-2025 Moderna (≥8 weeks after last dose)
  • Previously received Pfizer-BioNTech:
    • 1 prior dose: 2 more doses of 2024-2025 Pfizer-BioNTech
    • 2 prior doses: 1 more dose of 2024-2025 Pfizer-BioNTech (≥8 weeks after dose 2)
    • ≥3 prior doses: 1 dose of 2024-2025 Pfizer-BioNTech (≥8 weeks after last dose)

Special Considerations

Timing After COVID-19 Infection:

  • Complete isolation period and ensure acute symptoms have resolved before vaccination
  • Consider delaying vaccination by 3 months from symptom onset or positive test for optimal immune response 2

For Immunocompromised Individuals:

  • Standard timing recommendations apply, but additional doses may be required
  • Specific medication considerations:
    • Corticosteroids: Taper to <10 mg/day prior to vaccination if possible
    • Anti-CD20 medications: Consider vaccination 4 weeks before or 6 months after treatment
    • Transplant recipients: Vaccination generally postponed for 3-6 months after transplantation 2

Vaccine Effectiveness

The 2024-2025 COVID-19 vaccines have demonstrated effectiveness in preventing severe outcomes:

  • 33% effectiveness against COVID-19-associated ED/UC visits among adults ≥18 years
  • 45-46% effectiveness against COVID-19-associated hospitalization among immunocompetent adults ≥65 years
  • 40% effectiveness against COVID-19-associated hospitalization among immunocompromised adults ≥65 years 3

These findings support the current recommendations for all eligible individuals to receive the 2024-2025 COVID-19 vaccine to reduce the risk of severe disease and hospitalization.

Safety Information

  • Common reactions include injection site pain, fatigue, headache, and muscle pain
  • Serious adverse events are rare
  • Healthcare providers should report adverse events to the Vaccine Adverse Event Reporting System (VAERS) 1, 2

Common Pitfalls to Avoid

  • Waiting too long after infection: Natural immunity wanes over time, leaving individuals vulnerable to reinfection 2
  • Getting vaccinated while still symptomatic: May worsen symptoms and complicate assessment of vaccine side effects 2
  • Relying solely on natural immunity: Vaccination after infection provides more durable and broader protection than infection alone 2
  • Inaccurate documentation: Ensure accurate documentation of previous COVID-19 vaccination history to determine the appropriate 2024-2025 vaccination schedule 2
  • Unnecessary delays: Delaying vaccination may leave individuals vulnerable to infection and severe outcomes 2

The 2024-2025 COVID-19 vaccines are specifically designed to target currently circulating SARS-CoV-2 strains and provide important protection against severe COVID-19 outcomes, particularly for those at increased risk for severe illness and death.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Guideline

COVID-19 Vaccination Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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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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