COVID-19 Vaccination Recommendations
The Advisory Committee on Immunization Practices (ACIP) recommends that all individuals aged 6 months and older receive the 2024-2025 COVID-19 vaccine, regardless of prior vaccination history. 1, 2
General Recommendations by Age Group
Adults and Adolescents (≥12 years)
- Individuals without moderate or severe immunocompromise need one dose of 2024-2025 COVID-19 vaccine (Moderna, Pfizer-BioNTech, or Novavax) to be up to date 1
- Previously unvaccinated individuals who choose Novavax should receive two doses of the 2024-2025 Novavax vaccine 1
- Minimum interval of 8 weeks is recommended between the last COVID-19 vaccine dose and the 2024-2025 vaccination 1, 2
Children (5-11 years)
- Children without moderate or severe immunocompromise need one dose of 2024-2025 COVID-19 vaccine (Moderna or Pfizer-BioNTech) to be up to date 1
- Minimum interval of 8 weeks is recommended between the last COVID-19 vaccine dose and the 2024-2025 vaccination 1
Young Children (6 months-4 years)
- Initial multidose vaccination series is recommended when first receiving COVID-19 vaccination 1
- Need more than one COVID-19 vaccine dose, including at least one dose of the 2024-2025 COVID-19 vaccine, to be up to date 1
- Unvaccinated children: 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 Populations
Individuals with Moderate or Severe Immunocompromise
- Should receive at least one dose of 2024-2025 COVID-19 vaccine 1, 2
- Unvaccinated individuals aged 6 months-11 years: recommended to receive an initial 3-dose vaccination series of a 2024-2025 mRNA COVID-19 vaccine (same manufacturer) 1
- Unvaccinated individuals aged ≥12 years: complete an initial series with either 3 doses of a 2024-2025 mRNA COVID-19 vaccine (same manufacturer) or 2 doses of 2024-2025 Novavax COVID-19 vaccine 1
Vaccine Effectiveness and Safety
- COVID-19 vaccines have demonstrated high effectiveness against severe disease, hospitalization, and death across all variants of concern 3, 4
- mRNA vaccines (Moderna and Pfizer-BioNTech) have shown effectiveness of >86% against COVID-19-associated hospitalization within the first 24 weeks after vaccination 5
- Moderna vaccine has shown slightly higher effectiveness after both first dose (74%) and second dose (93%) compared to other vaccines 6
- Serious adverse events are rare with COVID-19 vaccines, with most vaccines showing little to no difference in serious adverse events compared to placebo 4
Economic Considerations
- COVID-19 vaccines are most cost-effective in adults aged ≥65 years, who experience the highest rates of severe COVID-19 1
- The incremental cost-effectiveness ratio (ICER) for adults ≥65 years is $23,308 per quality-adjusted life year (QALY) 1
- ICERs are higher for younger age groups but become more favorable when considering higher vaccine impact, higher risk for COVID-19-associated hospitalization, and higher quality of life impact for symptomatic illness 1
Important Considerations and Caveats
- The 2024-2025 COVID-19 vaccines are updated monovalent vaccines targeting current virus variants (Omicron JN.1-line, including JN.1 and KP.2) 1, 2
- The choice of vaccine manufacturer does not need to match prior vaccinations 2
- For individuals who have recently had a SARS-CoV-2 infection, a delay in vaccination of 3 months after symptom onset or positive test may be considered 2
- Antibody levels tend to decline over time, highlighting the importance of staying up to date with recommended vaccinations 5, 7
- While a potential signal for ischemic stroke was identified in adults aged ≥50 years, cumulative data has not provided clear evidence of a safety problem, and benefits of COVID-19 vaccines in preventing severe disease outweigh theoretical risks 1