About the COVID-19 Vaccines

September 12, 2023 - Following FDA regulatory action, the CDC has recommended updated 2023-2024 mRNA COVID-19 vaccines for everyone 6 months and older that target the omicron subvariant XBB.1.5. Bivalent COVID-19 vaccines are no longer authorized or available in the United States. The new COVID-19 vaccine recommendations are as follows:

  • Children 6 months – 4 years old who are unvaccinated are recommended to receive 2 doses of updated 2023-2024 Moderna COVID-19 vaccine or 3 doses of updated 2023-2024 Pfizer COVID-19 vaccine.
  • Children 6 months – 4 years old who were previously vaccinated are recommended to receive 1 or 2 doses of an updated 2023-2024 Moderna or Pfizer COVID-19 vaccine (timing and number of doses to administer depends on the previous COVID-19 vaccine[s] received).
  • Anyone 5 years old and older regardless of previous vaccination is recommended to receive 1 dose of an updated 2023-2024 Moderna or Pfizer COVID-19 vaccine at least 2 months since the last dose of any COVID-19 vaccine.

The Washington State Department of Health is currently reviewing and updating our webpages and supporting resources to reflect these new recommendations.

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 and older 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 at least 2 months after their last dose.
  • 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) at least 2 months after their last dose.
  • 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 dose.

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 and older 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 at least 2 months after their last dose.
    • 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) at least 2 months after their last dose.
    • 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 dose.

    No serious safety concerns were found.

    Resources

    Novavax COVID-19 Vaccine, Adjuvanted

    Vaccine Summary

    The Novavax COVID-19 vaccine, Adjuvant for those 12 years old and older is a two-dose primary series. The second dose is given at least three weeks after the first dose. It 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).

    An updated 2023-2024 mRNA vaccine dose is recommended for everyone, given at least 2 months after any COVID-19 vaccine. Novavax COVID-19 boosters are available for adults if they have completed primary series vaccination but have not previously received a COVID-19 booster—and if they cannot or will not receive an updated mRNA dose.

    No serious safety concerns were found.

    Resources

    Vaccine Requirements

    Is the COVID-19 vaccine required?

    It will be your choice whether to get the vaccine for COVID-19, but some employers, colleges, and universities may require it.

    Can I opt out of the COVID-19 vaccine requirement?

    It varies by employer. Talk with your employer or human resources office about their vaccine opt out or accommodation policies.

    How do I prove that I got vaccinated?

    Talk with your employer or human resources office about what they require for proof of vaccination. If you lost your card, you may get proof of vaccination for free through MyIRMobile if you received vaccination from a participating provider. For language assistance or additional help getting your records, please call 833-VAX-HELP (833-829-4357) or email waiisrecords@doh.wa.gov.

    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 Moderna and Pfizer 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 mRNA vaccine dose have the option to receive one or more additional an updated 2023-2024 mRNA doses at least 2 months after their last bivalent 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) bivalent 2023-2024 doses, the first 2 doses given at least 21 days apart. The third dose given at least 8 weeks after the second dose.
    • 5 through 11 years old: one 0.3 mL (10mcg) 2023-2024 dose.
    • 12 years and older: one 0.3 mL (30mcg) 2023-2024 dose.

    An updated 2023-2024 mRNA vaccine dose is recommended for everyone, given at least 2 months after last dose recieved.

    People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 mRNA vaccine dose have the option to receive one or more additional updated 2023-2024 mRNA doses at least 2 months after their last 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 and older: one 0.5 mL (50mcg) 2023-2024 dose

    An updated 2023-2024 mRNA vaccine dose is recommended for everyone, given at least 2 months after last dose received. 

    People 6 months and older who are moderately to severely immunocompromised who previously received an updated 2023-2024 mRNA vaccine dose have the option to receive 1 or more additional updated 2023-2024 mRNA doses at least 2 months after their last 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: two 0.5mL doses given 21 days apart.
    • An updated 2023-2024 mRNA vaccine dose is recommended for everyone, given at least 2 months after last dose received.     Novavax COVID-19 boosters are available for adults if they have completed primary series vaccination but have not previously received a COVID-19 booster—and if they cannot or will not receive an updated mRNA 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 vial?

    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 COVID-19 vaccine, adjuvanted 12 years+ adolescent/adult primary series and adult monovalent booster formula (royal blue cap): Each vial of vaccine contains 10 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 2023-2024mRNA vaccine dose have the option to receive 1 or more additional updated 2023-2024 mRNA doses at least 2 months after their last 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.