What are the current Coronavirus (COVID-19) vaccine recommendations?

From the Guidelines

The current COVID-19 vaccine recommendation is for everyone 6 months and older to receive an updated 2024-2025 COVID-19 vaccine, regardless of previous vaccination history, with the specific vaccination schedule depending on age, previous vaccination history, and immunocompromised status, as outlined in the Advisory Committee on Immunization Practices (ACIP) recommendations 1.

Key Recommendations

• For children 6 months through 4 years who are not moderately or severely immunocompromised, the recommended vaccination schedule varies based on previous COVID-19 vaccination history, with unvaccinated children receiving 2-3 doses of Moderna or Pfizer-BioNTech vaccine, and those with previous vaccination receiving 1-2 additional doses 1.
• For persons aged 5 years and older who are not moderately or severely immunocompromised, a single dose of the 2024-2025 COVID-19 vaccine is recommended, with the option to receive Moderna, Pfizer-BioNTech, or Novavax vaccine 1.
• For persons who are moderately or severely immunocompromised, at least 1 dose of the 2024-2025 COVID-19 vaccine is recommended, with additional doses potentially recommended depending on vaccination history and age 1.

Vaccine Options

• The vaccines available in the US include Pfizer-BioNTech, Moderna, and Novavax, with the specific vaccine and schedule determined by age, previous vaccination history, and immunocompromised status.

Administration and Side Effects

• COVID-19 vaccines can be administered at the same time as other vaccines, including the seasonal flu vaccine.
• Side effects are typically mild and include soreness at the injection site, fatigue, headache, and muscle pain, usually resolving within 1-2 days.

Timing and Immunocompromised Status

• Timing of vaccination is important, with consideration given to waiting 3 months from symptom onset for those who have recently had COVID-19.
• Immunocompromised status plays a significant role in determining the vaccination schedule, with moderately or severely immunocompromised individuals potentially requiring additional doses.

From the Research

COVID-19 Vaccine Recommendations

The current COVID-19 vaccine recommendations are as follows:

• Three COVID-19 vaccines are currently approved or authorized by the Food and Drug Administration (FDA) and recommended for primary vaccination by the Advisory Committee on Immunization Practices (ACIP) in the United States: the 2-dose mRNA-based Pfizer-BioNTech/Comirnaty and Moderna COVID-19 vaccines and the single-dose adenovirus vector-based Janssen (Johnson & Johnson) COVID-19 vaccine 2.
• An additional primary dose is recommended for certain immunocompromised recipients of an initial mRNA COVID-19 vaccination series 2, 3.
• 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, as well as in recipients aged ≥18 years of Janssen COVID-19 vaccine 2.
• The Advisory Committee on Immunization Practices (ACIP) recommends that all persons aged ≥5 years receive 1 booster dose of a COVID-19 vaccine after completion of their primary series 4.
• A second mRNA booster dose is authorized for adults aged ≥50 years and persons aged ≥12 years with moderate to severe immunocompromise 4.

Vaccine Effectiveness

• COVID-19 mRNA vaccines provide protection against infection with SARS-CoV-2 and are highly effective against COVID-19-associated hospitalization among eligible persons who receive 2 doses 5.
• Vaccine effectiveness declines after several months among all persons, but a third dose of mRNA vaccine can provide improved protection against COVID-19-associated hospitalization 5.
• Among adults without immunocompromising conditions, vaccine effectiveness against COVID-19 hospitalization was higher among those who received a booster dose (97%) compared with that among 2-dose recipients (82%) 5.
• Among adults with immunocompromising conditions, vaccine effectiveness was higher among those who received a third dose to complete a primary series (88%) compared with 2-dose recipients (69%) 5.

Safety Monitoring

• The Centers for Disease Control and Prevention (CDC) has developed v-safe, a voluntary, smartphone-based safety surveillance system, to provide information on adverse reactions after COVID-19 vaccination 3, 4.
• Initial findings indicate no unexpected patterns of adverse reactions after an additional dose of COVID-19 vaccine, with most adverse reactions being mild or moderate 3.
• The CDC will continue to monitor vaccine safety, including the safety of additional doses of COVID-19 vaccine, and provide data to guide vaccine recommendations and protect public health 3, 4.