Navigate Ongoing COVID-19 Vaccine Changes

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

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

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

Continue to encourage patients to get 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.

Consider 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 reassure patients that any COVID-19 vaccine can be given with other vaccines.

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

Key References

  • https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html (5-30-23)
  • https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-changes-simplify-use-bivalent-mrna-covid-19-vaccines (5-30-23)
  • https://covid.cdc.gov/covid-data-tracker/#vaccine-effectiveness (5-30-23)
  • JAMA Netw Open. 2023 May 1;6(5):e2310650
Hospital Pharmacist’s Letter. June 2023, No. 390606



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