COVID-19 Vaccination Recommendations
All persons aged ≥6 months should receive one dose of 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
Primary Vaccination Recommendations by Age Group
Adults (≥18 years)
- One dose of 2024-2025 COVID-19 vaccine (options include Moderna, Pfizer-BioNTech, or Novavax)
- For unvaccinated adults:
- Either 2 doses of mRNA vaccine (Moderna or Pfizer-BioNTech) or 2 doses of Novavax
Adolescents (12-17 years)
- One dose of 2024-2025 COVID-19 vaccine
- For unvaccinated adolescents:
- 2-dose primary series of Moderna, Pfizer-BioNTech, or Novavax
Children (5-11 years)
- One dose of 2024-2025 COVID-19 vaccine (Pfizer-BioNTech)
- For unvaccinated children:
- 2-dose primary series of Moderna or Pfizer-BioNTech
Young Children (6 months-4 years)
- For unvaccinated children:
- Either 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) 1
Special Population Recommendations
Immunocompromised Individuals
- At least one dose of 2024-2025 COVID-19 vaccine
- Unvaccinated immunocompromised persons should receive:
- Either 3 doses of 2024-2025 mRNA COVID-19 vaccine or
- 2 doses of 2024-2025 Novavax COVID-19 vaccine 1
- Those who have completed an initial series and received at least 1 dose of 2024-2025 COVID-19 vaccine may receive 1 additional age-appropriate dose at least 2 months after the last recommended dose 2
- Further additional doses may be administered based on clinical judgment, with at least 2 months between doses 2
Recent COVID-19 Infection
- Persons who recently had SARS-CoV-2 infection may consider delaying vaccination by 3 months from symptom onset or positive test result 2
- Complete isolation period and ensure acute symptoms have resolved before vaccination 1
Vaccine Effectiveness and Safety
Effectiveness
- 2024-2025 COVID-19 vaccines have demonstrated:
- 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 1
Safety Profile
- Common reactions include injection site pain, fatigue, headache, and muscle pain 1
- Serious adverse events are rare 1
- Studies of previous booster doses showed:
- Systemic reactions were less frequent following booster doses compared to primary series dose 2 3
- Among v-safe registrants who received homologous COVID-19 mRNA boosters, systemic reactions were reported less frequently after the booster (58.4% for Pfizer-BioNTech and 64.4% for Moderna) than after dose 2 (66.7% and 78.4%, respectively) 3
Important Considerations and Pitfalls
Key Pitfalls to Avoid
Overlooking vaccination for high-risk individuals: Cancer patients and immunocompromised individuals are particularly vulnerable to severe COVID-19 illness and should be prioritized for vaccination 1
Waiting too long after infection: Natural immunity wanes over time, and vaccination after infection provides more durable and broader protection than infection alone 1
Assuming one-size-fits-all approach: Immunocompromised individuals require different dosing schedules compared to the general population 2, 1
Neglecting reporting of adverse events: Healthcare providers should report adverse events to VAERS, particularly for vaccines under Emergency Use Authorization 2
Reporting Adverse Events
- Report adverse events to the Vaccine Adverse Event Reporting System (VAERS) at https://vaers.hhs.gov or 1-800-822-7967 2
- For COVID-19 vaccines under Emergency Use Authorization, reporting certain adverse events is required 2
Conclusion
COVID-19 vaccination remains a critical tool for preventing severe disease, hospitalization, and death. The 2024-2025 vaccine formulations target current circulating variants and provide important protection, especially for vulnerable populations. Healthcare providers should ensure patients stay up to date with recommended vaccines according to age and risk factors.