Updated COVID-19 Vaccine Guidance as of April 18, 2023 

For all individuals 6 months of age and older, the bivalent mRNA COVID-19 vaccines made by Moderna and Pfizer are to be used for all doses administered, including boosters. The original, monovalent mRNA vaccines for COVID-19 are no longer authorized for use in the United States.

Those currently eligible to receive a second bivalent booster include:

• individuals 65 years of age and older, if greater than 4 months since last booster
• Certain immunocompromised individuals 5 years of age and older, if greater than 2 months since last booster

All individuals 6 years and older are recommended to receive a bivalent mRNA vaccine if they have not previously, regardless of whether they completed their primary/monovalent initial series. Unvaccinated individuals may receive a single dose of a bivalent vaccine as their primary series, rather than several doses of the original monovalent mRNA series.

For children less than 5 years of age, multiple doses continue to be required, but vary based on the vaccine being administered:

• Two-dose series of Moderna bivalent
• Three-dose series of Pfizer bivalent

Children who are 5 years of age and older may receive two doses of Moderna bivalent vaccine or a single dose of the Pfizer bivalent vaccine. 

The CDC’s recommendations of use with the non-mRNA vaccines (Novavax, Jannsen) remain unchanged and those vaccines are available to those who cannot or refuse to receive mRNA vaccines for Covid-19.

References:

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-changes-simplify-use-bivalent-mrna-covid-19-vaccines

https://www.cdc.gov/media/releases/2023/s0419-covid-vaccines.html

Pfizer-BioNTech

• Who can get a bivalent booster: Everyone 12 years of age and older who has completed a primary series of a COVID-19 vaccine (except Novavax)
• When to get a booster: At least two months after most recent dose

Moderna

• Who can get a bivalent booster: Everyone 18 years of age and older who has completed a primary series of a COVID-19 vaccine (except Novavax)
• When to get a booster: At least two months after your most recent dose