Navigate Ongoing COVID-19 Vaccine Changes

You’ll need to stay on top of changing COVID-19 vaccine that monovalent mRNA products are no longer authorized.

Only about 17% of people in the US have had a bivalent dose.

Acknowledge that overall vaccine efficacy wanes over time and most patients have had COVID-19...making data challenging to interpret.

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But explain that adults who’ve had a bivalent vaccine continue to have a lower risk of urgent care visits and hospitalizations than those who haven’t...even with circulating variants.

Educate that vaccines continue to be monitored as new variants surface...and experts meet in June to discuss the fall plan.

Continue to ask patients if they’ve had any COVID-19 vaccines...and point out that vaccine schedules are simpler now.

For now, recommend ONE dose of a bivalent COVID-19 vaccine to patients age 6 years and up who haven’t had a bivalent dose...regardless of prior vaccination.

Offer an optional SECOND bivalent dose for patients age 65 and up if it’s been at least 4 months since their prior bivalent dose.

Follow CDC’s Interim COVID-19 Immunization Schedule, especially for patients who are immunocompromised or kids under 6 years. The number of bivalent doses varies based on age, immune status, and prior vaccines.

For instance, give 2 doses of Moderna to kids under 6 years...or 3 doses of Pfizer-BioNTech to kids under 5 years...if they’re unvaccinated and not immunocompromised.

For patients who are moderately or severely immunocompromised (taking certain biologics, organ transplant, etc), use shared decision-making to consider additional bivalent doses at least 2 months after the prior dose as needed.

Continue to give any COVID-19 vaccine with other vaccines.

Advise that combo flu and COVID-19 vaccines are in the works...but won’t likely be ready this year.

Expect COVID-19 vaccine costs to shift to payers possibly later this year...and billing and co-pays to be similar to flu vaccines.

See our resource, COVID-19 Vaccines, for dosing, storage, etc.

Key References

  • (5-23-23)
  • (5-23-23)
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  • JAMA Netw Open. 2023 May 1;6(5):e2310650
Pharmacist's Letter. June 2023, No. 390606

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