Ask the Experts: COVID-19: Scheduling Vaccines

Results (11)

Periodically verify whether you are using the most current available documents by checking Immunize.org’s regularly updated Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools: www.immunize.org/catg.d/p3130.pdf. This resource is updated at least monthly with the dates of the most currently available materials from CDC and FDA.

There is normally a delay between the public announcement of a change in COVID-19 vaccination recommendations and the release of updated CDC guidance documents that incorporate the change. Information is generally updated first on the CDC web page: Use of COVID-19 Vaccines in the United States (www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html).

Last reviewed: March 19, 2024

No. Simply administer the next dose that is currently recommended. To determine what is needed now based upon a person’s vaccination history, age, and immunocompromised status, refer to the CDC COVID-19 Vaccination Infographic (for most people): www.cdc.gov/vaccines/covid-19/downloads/COVID19-vaccination-recommendations-most-people.pdf and the CDC COVID-19 Vaccination Infographic (for immunocompromised people): /www.cdc.gov/vaccines/covid-19/downloads/COVID19-vaccination-recommendations-immunocompromised.pdf.

Last reviewed: March 19, 2024

No. People should not be routinely scheduled to receive a dose earlier than recommended. Schedulers should offer appointments beginning on the date of the recommended interval or later. CDC guidance allows for doses to be given up to 4 days before the recommended interval in order to avoid missed vaccination opportunities when a recipient unexpectedly arrives early and might not return on schedule.

Last reviewed: March 19, 2024

In this specific situation, CDC states that a child age 6 months–4 years who received 1 Moderna and 1 Pfizer-BioNTech COVID-19 vaccine dose for the first 2 doses of COVID-19 vaccine should receive a third dose of the 2023–2024 Formula of either Moderna or Pfizer-BioNTech COVID-19 vaccine at least 8 weeks after the second dose.

For all questions of brand interchangeability, please review CDC’s interim recommendations for COVID-19 vaccine administration errors and deviations: www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us-appendix.html#appendix-b.

Last reviewed: March 19, 2024

A person who is not moderately or severely immunocompromised and has only ever received a single dose of Novavax COVID-19 vaccine may receive a single dose of any licensed or authorized COVID-19 (2023–2024 Formula) vaccine, including Novavax.

Last reviewed: March 19, 2024

Everyone age 6 months and older is recommended to receive at least one dose of updated (2023–2024 Formula) COVID-19 vaccine, regardless of past vaccination history. Any updated (2023–2024 Formula) COVID-19 vaccine received in another country that is listed for emergency use by the World Health Organization (WHO-EUL) or authorized or licensed for use by the FDA counts toward fulfilling this recommendation.

CDC has provided additional details based upon age and immunocompromised status at its website: www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us-appendix.html#appendix-a.

A list of the vaccines that have already received WHO-EUL status is available here: https://extranet.who.int/prequal/vaccines/covid-19-vaccines-who-emergency-use-listing.

Last reviewed: March 19, 2024

This patient, like other adults, is considered up to date after receiving a single dose of updated (2023–2024 Formula) COVID-19 vaccine at least 8 weeks after his most recent COVID-19 vaccination.

Last reviewed: March 19, 2024

An asymptomatic person who is scheduled for COVID-19 vaccination and is exposed to SARS-CoV-2 virus may be vaccinated; however, COVID-19 vaccination after exposure is not recommended as post-exposure prophylaxis, so vaccination should not be expected to prevent illness caused by past exposure. A person who is currently sick with a respiratory virus should defer vaccination until at least the recovery from the acute illness, and consider additional measures to prevent spread, in accordance with current CDC guidance. Healthcare facilities may have specific policies in place to reduce the risk of spread of respiratory viruses to healthcare staff and other patients.

CDC summarizes its current guidance on respiratory viruses (updated March 2024) here: www.cdc.gov/respiratory-viruses/guidance/respiratory-virus-guidance.html.

People who recently had SARS-CoV-2 infection and are due for a COVID-19 vaccine may consider delaying the dose by up to 3 months from symptom onset or positive test (if infection was asymptomatic). According to CDC, increasing the time between infection and vaccination may result in an improved immune response to vaccination. At this time, there is evidence of a low risk of reinfection in the weeks following infection. A recipient’s individual risks for severe disease and current COVID-19 conditions in the community should be taken into account when deciding whether to delay vaccination up to 3 months after infection.

Last reviewed: March 19, 2024

Yes, COVID-19 vaccines and other routine vaccines, including influenza and RSV vaccines, may be coadministered on the same day, given in different syringes and at different anatomical sites. COVID-19 vaccines may also be given at any interval before or after any other vaccination.

Of note, there is no required minimum interval between receiving a dose of any COVID-19 vaccine and an orthopoxvirus vaccine, either Jynneos or ACAM2000 vaccine (e.g., for mpox prevention), regardless of which vaccine is administered first. However, use of Jynneos vaccine should be prioritized over ACAM2000 when co-administering a COVID-19 vaccine and an orthopoxvirus vaccine.

People, particularly adolescent or young adult males, who are recommended to be vaccinated against both mpox and COVID-19 might consider waiting 4 weeks between vaccines. This is because of the observed risk for myocarditis and pericarditis after receipt of ACAM2000 orthopoxvirus vaccine and COVID-19 vaccines, and the hypothetical risk for myocarditis and pericarditis after Jynneos vaccine. However, if a patient’s risk for mpox or severe disease due to COVID-19 is increased, administration of mpox and COVID-19 vaccines should not be delayed.

Additional information is available from CDC: www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#timing-spacing-interchangeability.

Last reviewed: March 19, 2024

Your patient may choose to receive the vaccines at the same visit or separately, without regard to the timing interval. In general, when deciding whether to coadminister other vaccines with COVID-19 vaccine, you should consider whether the patient is behind or at risk of becoming behind on recommended vaccines, their risk of vaccine-preventable disease (e.g., during an outbreak or occupational exposures), and the reactogenicity profile of the vaccines.

When multiple vaccines are administered at a single visit, administer each injection in a different syringe and at a different injection site. For adolescents and adults, the deltoid muscle may be used for more than one injection, though injection sites should be at least one inch apart. It is generally preferable to administer reactogenic vaccines such as Shingrix and COVID-19 vaccine in different arms, if possible. If the patient prefers both injections in the same deltoid, that is also acceptable.

Immunize.org has developed a one-page guide to administering multiple intramuscular vaccinations to an adult at one visit: www.immunize.org/catg.d/p2030.pdf.

Last reviewed: March 19, 2024

The timing of CDC-recommended vaccination is unaffected by the receipt of COVID-19 monoclonal antibodies or convalescent plasma.

Last reviewed: March 19, 2024

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