About the COVID-19 Vaccines

The CDC recommends everyone 6 months and older should get an updated 2023-2024 COVID-19 vaccine.

February 28, 2024 - The Centers for Disease Control and Prevention (CDC) recommend adults ages 65 years and older receive an additional updated 2023-2024 COVID-19 vaccine dose. The recommendation acknowledges the increased risk of severe disease from COVID-19 in older adults, along with the currently available data on vaccine effectiveness.

People who are up to date have lower risk of severe illness, hospitalization, and death from COVID-19 than people who are unvaccinated or who have not completed the doses recommended for them by CDC.

The Washington State Department of Health is currently updating webpages and documents to align with the most recent CDC guidance.

Pfizer-BioNTech COVID-19 Vaccine Information

Vaccine Summary

The Pfizer-BioNTech COVID-19 vaccine for those 6 months through 4 years is a three-dose series, the first 2 doses given 21 days apart and the third dose given at least 8 weeks after the second dose.

The Pfizer-BioNTech COVID-19 vaccine for those 5 years through 64 years old vaccine is one updated 2023-2024 dose.

  • Children 6 months – 4 years old who have initiated a Pfizer three-dose series should complete the series with 1 or 2 doses of an updated 2023-2024 Pfizer COVID-19 vaccine (timing and number of doses to administer depends on the previous number of Pfizer COVID-19 vaccine(s) received).
  • Children 6 months - 4 years old who previously completed a Pfizer three-dose series should receive an updated 2023-2024 Pfizer COVID-19 vaccine.
  • Individuals 5 and older that have received one or more previous doses of any COVID-19 vaccine should receive at least one dose of updated 2023-2024 COVID-19 vaccine (Pfizer or Moderna).
  • Adults 65 years old and older should receive 2 doses of updated Pfizer 2023-2024 COVID-19 vaccine at least 4 months apart.

The clinical trials revealed no major unanticipated adverse events.

Resources

Dry Ice Safety

Moderna COVID-19 Vaccine Information

Vaccine Summary

The Moderna COVID-19 vaccine for those 6 months-4 years is a two-dose series, given one month apart. 

The Moderna COVID-19 vaccine for those 5 years through 64 years old is one updated 2023-2024 dose.

  • Children 6 months – 4 years old who have initiated a Moderna two-dose series should complete the series with 1 dose of the updated 2023-2024 Moderna COVID-19 vaccine.
  • Children 6 months to 4 years who previously completed a Moderna two-dose series should receive an updated 2023-2024 Moderna COVID-19 vaccine.
  • Individuals 5 and older that have received one or more previous doses of any COVID-19 vaccine should receive at least one dose of updated 2023-2024 COVID-19 vaccine (Pfizer or Moderna).
  • Individuals 6 months and older who are moderately or severely immunocompromised should complete a 3-dose series and may receive additional doses of updated 2023-2024 COVID-19 vaccine at least 2 months after their last 2023-2024 dose.
  • Adults 65 years old and older should receive 2 doses of updated Moderna 2023-2024 COVID-19 vaccine at least 4 months apart. 

No serious safety concerns were found.

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Novavax COVID-19 Vaccine, Adjuvanted Information

Vaccine Summary

Novavax COVID-19 vaccine, Adjuvanted 2023-2024 formula contains the SARS-CoV-2 spike protein and Matrix-M adjuvant. An adjuvant increases a vaccine’s ability to stimulate the body’s immune system to fight off disease (to improve vaccine effectiveness).

The Novavax COVID-19 vaccine, Adjuvanted for those 12-64 years old and previously vaccinated is 1 dose of updated 2023-2024 formula.

Novavax COVID-19 vaccine, Adjuvanted 2023-2024 formula contains the SARS-CoV-2 spike protein and Matrix-M adjuvant. An adjuvant increases a vaccine’s ability to stimulate the body’s immune system to fight off disease (to improve vaccine effectiveness).

  • Individuals 12 years old and older previously vaccinated with any COVID-19 vaccine: one dose of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula), administered at least 2 months after receipt of the last dose of a COVID-19 vaccine.
  • Individuals 12 years old and older not previously vaccinated with any COVID-19 vaccine: two doses of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula), administered three weeks apart.
  • Immunocompromised individuals 12 years old and older: an additional dose of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula) may be administered at least 2 months following the last dose of a COVID-19 vaccine (2023-2024 Formula).  Additional doses of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula) may be administered at the discretion of the healthcare provider, taking into consideration the individual’s clinical circumstances. The timing of the additional doses may be based on the individual’s clinical circumstances. 
  • Adults 65 years old and older should receive 2 doses of updated Novavax 2023-2024 COVID-19 vaccine at least 4 months apart.

No serious safety concerns were found.

Resources

Frequently Asked Questions

Does the COVID-19 vaccine work against variant strains?

COVID-19 vaccines are working well to prevent severe illness, hospitalization, and death, even against variants. However, public health experts are seeing reduced protection against mild and moderate COVID-19 illness, especially among-high risk populations.

The updated 2023-2024 COVID-19 vaccines were created to help boost immunity and provide better protection from the omicron variant. It’s important to get all recommended doses available for best protection. Receiving an updated 2023-2024 COVID-19 vaccine can restore protection and provide enhanced protection against the variants currently responsible for most infections and hospitalizations in the United States

Vaccination is the best protection against COVID-19 illness.

Should I administer extra vaccine doses to my patients?

People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 vaccine dose have the option to receive one or more additional an updated 2023-2024 doses at least 2 months after their last 2023-2024 dose. Please visit the CDC's Clinical Guidance for COVID-19 Vaccination page for the latest vaccine recommendations for people who are moderately to severely immunocompromised.

Please do not administer any doses of vaccine beyond the doses recommended by CDC, even if your patient requests it. Also, please do not administer any doses of vaccine to someone outside of the recommended age range for that vaccine.

Is the vaccine effective in all age groups?

Yes, the clinical trials showed similar results in different age groups, including those over 65 years of age.

What types of symptoms are normal after receiving the vaccine?

Like other routine vaccines, the most common side effects are a sore arm, fatigue, headache, and muscle pain. These symptoms are a sign that the vaccine is prompting an immune response. For most people, these side effects occurred within two days of getting the vaccine and lasted about a day. People who were 55 years or older were less likely to report having side effects than younger people.

Are there any restrictions on who can receive the vaccine?

Generally, the COVID-19 vaccines should not be given to anyone who is under the authorized age or has a history of severe allergic reactions to an ingredient or previous dose of the COVID-19 vaccines.

Pfizer-BioNTech

The Pfizer COVID-19 vaccine should not be given to anyone:

  • Under 6 months of age
  • Outside of the appropriate age dose
  • With a history of severe or immediate allergic reactions to an ingredient of the Pfizer-BioNTech vaccine, such as polyethylene glycol or polysorbate
  • Who had a severe or immediate allergic reaction to their first dose of an mRNA COVID-19 vaccine (Pfizer or Moderna)

Moderna

The Moderna COVID-19 vaccine should not be given to anyone:

  • Under 6 months of age
  • Outside of the appropriate age dose
  • With a history of severe or immediate allergic reactions to an ingredient of the Moderna vaccine, such as polyethylene glycol or polysorbate
  • Who had a severe or immediate allergic reaction to their first dose of an mRNA COVID-19 vaccine (Pfizer or Moderna)

Novavax

The Novavax vaccine currently should not be given:

  • To anyone under the age of 12 years old until further research can support its use in that age category. 
  • Outside the appropriate age dose.
  • To anyone with a history of myocarditis or pericarditis.

 See the Advisory Committee on Immunization Practices’ (ACIP) interim clinical considerations for COVID-19 vaccines for more information.

Should I administer the vaccine to patients with a history of allergies?

The COVID-19 vaccines should not be given to people with a known history of severe allergic reaction, such as anaphylaxis, to any ingredient or a previous dose of the COVID-19 vaccines.

People who have had a severe allergic reaction to other vaccines or injectable therapies may still be able to receive this vaccine. However, providers should do a risk assessment and counsel them about the potential risks. If the patient decides to get the vaccine, providers should observe them for 30 minutes to monitor for any immediate reactions. People who report having mild or childhood allergic reactions to medications or vaccines may still get the vaccine.

How quickly is someone protected from COVID-19 after receiving the vaccine?

It will take about two weeks after someone receives a COVID-19 vaccine dose to have maximum protection. Protection may wane over time, so it’s important to stay up to date with all doses recommended to you.

What is the recommended dosage and schedule?

Pfizer-BioNTech (Comirnaty)

  • 6 months through 4 years: three 0.3 mL (3mcg) 2023-2024 doses, the first 2 doses given at least 21 days apart. The third dose is given at least 8 weeks after the second dose.
  • 5 through 11 years old: one 0.3 mL (10mcg) 2023-2024 dose.
  • 12 through 64 years old: one 0.3 mL (30mcg) 2023-2024 dose.
  • 65 years old and older: two 0.3 mL (30mcg) 2023-2024 doses. The second dose is given at least 4 months after the first.

The CDC recommends everyone 6 months and older get at least one dose of updated 2023-2024 COVID-19 vaccine. People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 vaccine dose have the option to receive one or more additional updated 2023-2024 doses at least 2 months after their last dose.

People 65 years old and older should receive an additional dose of updated 2023-2024 COVID-19 vaccine at least 4 months after their first 2023-2024 dose.

Please visit the CDC's Clinical Guidance for COVID-19 Vaccination page for the latest vaccine recommendations for people who are moderately to severely immunocompromised.

Moderna

  • 6 months-11 years old: one 0.25mL (25mcg) 2023-2024 dose
  • 12 through 64 years old: one 0.5 mL (50mcg) 2023-2024 dose
  • 65 years old and older: two 0.5 mL (50mcg) 2023-2024 doses. The second dose is given 4 months after the first.

The CDC recommends everyone 6 months and older get at least one dose of updated 2023-2024 COVID-19 vaccine.

People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 vaccine dose have the option to receive 1 or more additional updated 2023-2024 doses at least 2 months after their last dose. People 65 years old and older should receive an additional dose of updated 2023-2024 COVID-19 vaccine at least 4 months after their first 2023-2024 dose. Please visit the CDC's Clinical Guidance for COVID-19 Vaccination page for the latest vaccine recommendations for people who are moderately to severely immunocompromised.

Novavax

  • 12 years and older and unvaccinated: two 0.5mL (5 mcg rS and 50 mcg of Matric-M adjuvant) 2023-2024 doses given 21 days apart.
  • 65 years and older and unvaccinated: three 0.5mL (5 mcg rS and 50 mcg of Matric-M adjuvant) 2023-2024 doses; the second given 21 days after the first, the third given at least four months after the second.
  • 12 years and older and previously vaccinated: one 0.5mL (5 mcg rS and 50 mcg of Matric-M adjuvant) 2023-2024 dose.
  • 65 years and older and previously vaccinated: two 0.5mL (5 mcg rS and 50 mcg of Matric-M adjuvant) 2023-2024 doses at least 4 months apart.

The CDC recommends everyone 6 months and older get at least one dose of updated 2023-2024 COVID-19 vaccine. People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 vaccine dose have the option to receive 1 or more additional updated 2023-2024 doses at least 2 months after their last dose. People 65 years old and older should receive an additional dose of updated 2023-2024 COVID-19 vaccine at least 4 months after their first 2023-2024 dose.

Protection may wane over time, so it’s important to get any recommended doses on time.

How much of the vaccine is in each pre-filled syringe/vial?

Pfizer-BioNTech 12 years + adolescent/adult 2023-2024 formula (pink label with DO NOT FREEZE): Each pre-filled syringe contains 1 dose (0.3mL) of the vaccine.

Pfizer-BioNTech 12 years + adolescent/adult 2023-2024 formula (gray cap): Each single dose vial contains 1 dose (0.3 mL) of the vaccine.

Pfizer-BioNTech 5-11 pediatric 2023-2024 formula (blue cap): Each single dose vial contains 1 dose (0.3 mL) of the vaccine.

Pfizer-BioNTech 6 months-4 years pediatric/infant 2023-2024 formula (yellow cap): Once diluted, each vial contains 3 doses (0.3 mL) of the vaccine.

Moderna 12 years+ adult/adolescent 2023-2024 formula (dark blue cap): Each single dose vial contains 1 dose (0.5mL) of the vaccine.

Moderna 6 months-11 years pediatric 2023-2024 formula (dark blue cap with green label): Each single dose vial contains 1 dose (0.25mL) of the vaccine.

Novavax, adjuvanted 12 years+ adolescent/adult 2023-2024 formula (royal blue cap): Each vial of vaccine contains 5 doses of 0.5mL each.

Please review the Vaccine Product Characteristics Chart for more information.

Can I use any extra doses in the vaccine vials?

You may find that some vials contain extra doses. You can use every full dose you can get from the Pfizer-BioNTech and Moderna vaccine vials. However, you should be sure to:

  • Maintain the dilution concentration of the Pfizer-BioNTech vaccine. See the Pfizer-BioNTech diluent poster (PDF) for more information.
  • Discard any amount of vaccine remaining in the vial that is less than a full dose. Do not pool liquid from multiple vials to create a dose.

If you administer extra doses, you will need to reconcile your inventory in the Washington State Immunization Information System (WAIIS). We recommend you do this every Tuesday for accurate reporting. If you use an electronic health record (EHR) to input data into the WAIIS, you may need to reconcile more often. Instructions are available in the extra dose reconciliation guide (PDF).

My patient/client is moderately or severely immunocompromised. What is the COVID-19 vaccination recommendation for them?

People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 vaccine dose have the option to receive 1 or more additional updated 2023-2024 doses at least 2 months after their last 2023-2024 dose. Please visit the CDC's Clinical Guidance for COVID-19 Vaccination page for the latest vaccine recommendations for people who are moderately to severely immunocompromised.

As medical providers it is imperative to understand the vaccine recommendation for this high-risk population. Please encourage your immunocompromised patients or clients to get vaccinated and ensure they receive all doses recommended to them.