CDC recommends that all people receive an updated (2023–2024 Formula) COVID-19 vaccine at least 2 months after their most recent previous dose of COVID-19 vaccine, as authorized or approved by FDA. There are three options: Moderna or Pfizer-BioNTech mRNA vaccine (both FDA-authorized beginning at age 6 months and FDA-licensed for age 12 years and older), or Novavax adjuvanted protein subunit vaccine (authorized for age 12 years or older). Most people age 5 years and older should receive a single dose of vaccine.
Certain people need, or have the option to receive, more than one 2023–2024 COVID-19 vaccine dose:
- All previously unvaccinated individuals age 12 years or older receiving Novavax vaccine should receive two doses separated by at least 3 weeks.
- Children younger than age 5 years are recommended to receive at least one updated 2023–2024 Formula mRNA vaccine dose. If not previously vaccinated, or incompletely vaccinated, they should complete a 2-dose (Moderna) or 3-dose (Pfizer-BioNTech) primary series, using the same brand for all doses. CDC recommends that children younger than age 5 years receive the same brand for all doses (also referred to as homologous doses), even after completing the primary series. If it is not feasible to administer the same brand for one of the following reasons, it is acceptable to use a different brand: the brand is unavailable at the clinic at the time of the vaccination visit; the previous brand is unknown; the child would not otherwise receive a recommended vaccine; or, the child cannot continue with the previous brand due to a contraindication.
- Individuals who are moderately or severely immunocompromised and who have not already completed a 3-dose primary series, should complete a 3-dose primary vaccination series with the updated 2023–2024 Formula. Use the same brand for all doses of the primary series, unless the brand is unavailable at the time of the clinic visit, the patient would otherwise choose not to complete the series, or the patient has a contraindication to vaccination with the original product. If the primary series is already complete, then a single dose of any age-appropriate updated (2023–2024 Formula) COVID-19 vaccine should be administered at least 2 months after the most recent dose of COVID-19 vaccine. Additional doses may be given, spaced at least 2 months apart, as determined by these individuals with their clinical teams.
For details, see CDC’s current recommended COVID-19 vaccination schedule for all people age 6 months and older here: www.cdc.gov/vaccines/covid-19/downloads/COVID-19-immunization-schedule-ages-6months-older.pdf.
Last reviewed:
October 26, 2023
For individuals with moderate to severe immunocompromise, CDC states that, beyond the primary series, additional doses of 2023–2024 COVID-19 vaccine may be administered (with a minimum two-month interval) based on the clinical judgment of the individual’s healthcare provider and personal preference and circumstances.
The option to receive these additional doses is offered because vaccine effectiveness declines most rapidly in people with moderate to severe immunocompromise. Such people also have the highest risk of hospitalization with COVID-19 if infected. Although protection against severe disease is more durable than protection against milder illness, individuals in these groups may benefit from shorter intervals between doses.
See CDC’s interim immunization schedule for details: www.cdc.gov/vaccines/covid-19/downloads/COVID-19-immunization-schedule-ages-6months-older.pdf.
Last reviewed:
October 26, 2023
Janssen (Johnson & Johnson) COVID-19 vaccine is no longer available for use in the United States. The last remaining doses expired May 7, 2023. People age 18 years or older who received 1 or 2 Janssen COVID-19 Vaccine doses are recommended to receive one 2023–2024 Formula dose (Moderna, Pfizer-BioNTech, or Novavax).
Last reviewed:
October 26, 2023
Yes. Vaccination should be offered regardless of history of prior SARS-CoV-2 infection.
Viral testing to assess for current SARS-CoV-2 infection or serologic testing to assess for prior infection for the purposes of vaccine decision-making is not recommended. However, as with all vaccines, vaccination should be deferred until after recovery from moderate to severe illness. In addition, to minimize the risk of exposing others to SARS-CoV-2 virus, vaccination of a person diagnosed with COVID-19 generally should be deferred until the person does not pose a risk of infection to others.
Although not required, people who recently had SARS-CoV-2 infection may consider delaying a 2023–2024 COVID-19 vaccine 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. Among vaccine recipients at increased risk of post-vaccination myocarditis (e.g., adolescent and adult males younger than age 40), an increased interval also may reduce the rare risk of myocarditis after vaccination. 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:
October 26, 2023
CDC defines an “additional primary dose” as a subsequent dose of vaccine administered to people who are less likely to develop a protective immune response after initial vaccination because of moderate or severe immunocompromise. All previously unvaccinated people with moderate or severe immunocompromise are recommended to receive an initial 3-dose primary COVID-19 series.
CDC defines a “booster dose” as a subsequent dose of vaccine administered to enhance or restore protection which might have declined over time after primary series vaccination.
Last reviewed:
October 26, 2023
