Who is recommended to receive COVID-19 (Coronavirus Disease 2019) vaccines?

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Last updated: November 6, 2025View editorial policy

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COVID-19 Vaccination Recommendations

All individuals aged 6 months and older should receive the 2024-2025 COVID-19 vaccine, regardless of prior vaccination history. 1

Universal Recommendation

The Advisory Committee on Immunization Practices (ACIP) voted 11-0 (with one abstention) to recommend vaccination with 2024-2025 COVID-19 vaccines for all persons aged ≥6 months. 1 This universal recommendation applies to everyone in this age group, with specific dosing schedules based on age, immune status, and vaccination history. 1

Immunocompetent Individuals (Without Moderate or Severe Immunocompromise)

Adults and Adolescents (≥12 years)

  • One dose of 2024-2025 COVID-19 vaccine is needed to be up to date, regardless of prior vaccination history 1
  • Available vaccines include Moderna, Pfizer-BioNTech, or Novavax 1
  • Exception: Unvaccinated individuals choosing Novavax should receive 2 doses, 3-8 weeks apart 1
  • Minimum interval of 8 weeks after the last COVID-19 vaccine dose is recommended 1

Children (5-11 years)

  • One dose of 2024-2025 COVID-19 vaccine (Moderna or Pfizer-BioNTech) is needed 1
  • Same 8-week interval applies after prior vaccination 1

Young Children (6 months-4 years)

  • Require a multidose initial vaccination series when first receiving COVID-19 vaccination 1
  • Unvaccinated children need:
    • Moderna: 2 doses, 4-8 weeks apart 1
    • Pfizer-BioNTech: 3 doses (doses 1-2 spaced 3-8 weeks apart, then dose 3 at ≥8 weeks after dose 2) 1
  • Previously vaccinated children need at least 1 dose of 2024-2025 vaccine, with specific schedules based on prior doses received 1

Moderately or Severely Immunocompromised Individuals

All immunocompromised persons aged ≥6 months should receive at least 1 dose of 2024-2025 COVID-19 vaccine, with additional doses often recommended. 1, 2

Unvaccinated Immunocompromised Individuals

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

Previously Vaccinated Immunocompromised Individuals

  • At least 1 dose of 2024-2025 vaccine is required 2
  • May receive 1 additional age-appropriate dose at least 2 months later, guided by assessment of immune status 2
  • This includes patients with cancer, who face higher risk for severe COVID-19 outcomes 2

Special Populations and Considerations

Cancer Patients

  • Should be considered moderately or severely immunocompromised and follow enhanced vaccination schedules 2
  • Ideally vaccinate at least 2 weeks before initiation or resumption of immunosuppressive therapies 2
  • Coordination with oncology team is essential for optimal timing 2
  • All household members should be up-to-date with COVID-19 vaccines for indirect protection 2

Recent SARS-CoV-2 Infection

  • May consider delaying vaccination by 3 months after symptom onset or positive test, though this is optional 3

Older Adults

  • Vaccination is particularly important given higher susceptibility to severe COVID-19 outcomes 4, 5
  • Studies demonstrate excellent efficacy (79.49%) and protection against severe disease (87.01%) in older adults 4

Rationale for Updated 2024-2025 Vaccines

The 2024-2025 vaccines are updated monovalent formulations specifically developed against current circulating variants (Omicron JN.1-line, including JN.1 and KP.2), providing better protection than previous vaccine series. 3 This addresses the evolution of SARS-CoV-2 and waning vaccine effectiveness noted with prior formulations. 6

Common Pitfalls to Avoid

  • Do not delay vaccination beyond recommended timeframes, as this prolongs suboptimal protection, especially for high-risk individuals 2
  • Do not overlook immunocompromised status (including cancer patients), which warrants additional doses beyond the standard single dose 2
  • Do not assume prior vaccination is sufficient—the 2024-2025 formulation is recommended for everyone regardless of vaccination history 1
  • For young children (6 months-4 years), do not administer only a single dose when a multidose series is required 1
  • Do not mix manufacturers within a series for immunocompromised individuals receiving initial vaccination 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

COVID-19 Vaccination Guidelines for Immunocompromised Individuals

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

COVID-19 Vaccination in Adults Who Received a Pediatric Dose

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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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