What is the recommended Covid (Coronavirus) vaccine administration schedule?

COVID-19 Vaccination Schedule

All persons aged ≥6 months should receive at least one dose of the 2024-2025 COVID-19 vaccine, with specific schedules varying by age, vaccination history, and immune status. 1

For Immunocompetent Persons Aged ≥5 Years

Previously Vaccinated Individuals

• One dose of 2024-2025 COVID-19 vaccine (Moderna, Pfizer-BioNTech, or Novavax for ages ≥12 years) is recommended 1
• Administer at least 8 weeks after the last COVID-19 vaccine dose 1, 2
• The vaccine manufacturer does not need to match previous vaccinations 2

Unvaccinated Individuals

• Ages 5-11 years: One dose of 2024-2025 Moderna or Pfizer-BioNTech vaccine 1
• Ages ≥12 years:
  • One dose of Moderna or Pfizer-BioNTech (no second dose needed) 1
  • OR two doses of Novavax given 3-8 weeks apart if choosing this platform 1

For Children Aged 6 Months-4 Years

Unvaccinated Children

• Moderna series: 2 doses given 4-8 weeks apart 1
• Pfizer-BioNTech series: 3 doses (doses 1 and 2 given 3-8 weeks apart; dose 3 given ≥8 weeks after dose 2) 1

Previously Vaccinated Children

The schedule depends on which vaccine was previously received and how many doses: 1

• If received 1 Moderna dose previously: Give 1 additional dose 4-8 weeks after dose 1 1
• If received ≥2 Moderna doses previously: Give 1 dose ≥8 weeks after last dose 1
• If received 1 Pfizer dose previously: Give 2 additional doses (3-8 weeks between doses 1-2, then ≥8 weeks between doses 2-3) 1
• If received 2 Pfizer doses previously: Give 1 dose ≥8 weeks after dose 2 1
• If received ≥3 Pfizer doses previously: Give 1 dose ≥8 weeks after last dose 1

For Moderately or Severely Immunocompromised Persons

Unvaccinated Immunocompromised Individuals

• Ages 6 months-11 years: 3-dose series of 2024-2025 mRNA vaccine (all doses from same manufacturer) 1, 3
• Ages ≥12 years: Either 3 doses of 2024-2025 mRNA vaccine (same manufacturer) OR 2 doses of 2024-2025 Novavax 1

Previously Vaccinated Immunocompromised Individuals

• At least 1 dose of 2024-2025 vaccine is required 1, 3
• May receive 1 additional age-appropriate dose at least 2 months after the initial 2024-2025 dose 3
• Timing should be coordinated with oncology or immunology teams, ideally administered ≥2 weeks before starting immunosuppressive therapy 3

Important Clinical Considerations

Vaccine Selection

• The 2024-2025 vaccines are monovalent formulations targeting Omicron JN.1 lineage variants (KP.2 strain for Moderna/Pfizer-BioNTech; JN.1 strain for Novavax) 1
• These updated formulations provide better protection against currently circulating variants than previous vaccine series 3

Timing After Recent COVID-19 Infection

• Vaccination may be delayed by 3 months after symptom onset or positive test, though this is optional 2

Common Pitfalls to Avoid

• Do not count pediatric doses given to adults as valid adult doses—an additional age-appropriate dose should be administered at least 8 weeks later 2
• Do not delay vaccination beyond recommended timeframes, as this prolongs suboptimal protection, particularly for high-risk patients 3
• Do not overlook immunocompromised status (including cancer patients), which warrants additional doses beyond the standard single 2024-2025 dose 3
• Report vaccination errors to VAERS when incorrect doses are administered 2

Household Protection

• All household members of immunocompromised individuals should remain up-to-date with COVID-19 vaccines to provide indirect protection 3