Be Ready to Dispense COVID-19 Spring “Boosters”

Patients will ask if they need another COVID-19 vaccine this spring.

CDC now says that patients age 65 years or older who already had a 2023-2024 COVID-19 vaccine should get an additional dose.

It’s partly because COVID-19 transmission remains substantial year-round and cases tend to go up in the summer...unlike flu or RSV.

And vaccine effectiveness is expected to wane over time.

Continue to ask patients about their COVID-19 vaccine history...or help check immunization get patients up to date.

Be aware that about 60% of patients 65 and up still haven’t received a first 2023-2024 COVID-19 vaccine. Offer to pull in your pharmacist to discuss concerns and share info with these patients.

For example, there are still about 20,000 COVID-19 hospitalizations and 2,000 deaths weekly...and older adults are most at risk. But vaccination may cut the risk of severe illness by about half.

If older patients already got a 2023-2024 COVID-19 vaccine, offer an additional dose...especially to those over 75, in long-term care facilities, or with chronic conditions (heart disease, diabetes, etc).

But check that it’s been at least 4 months after their last COVID-19 vaccine...or 3 months since a COVID-19 infection...prior to dispensing.

Expect your pharmacist to encourage getting the additional dose by the end of patients can also get a COVID-19 vaccine in the fall.

Dispense any brand of an age-appropriate COVID-19 vaccine for the additional dose in older adults. Use standard doses...0.3 mL for Comirnaty (Pfizer-BioNTech)...or 0.5 mL for Spikevax (Moderna) or Novavax.

Be aware, there’s no change to the recommendations for moderately or severely immunocompromised patients 6 months and older. These patients and their provider can consider additional COVID-19 vaccine least 2 months after the prior dose as needed.

Don’t dispense an additional dose to immunocompetent adults under 65...there’s not enough added benefit and it’s not cost-effective. But still check that these patients are current with vaccination.

Point out that recommended COVID-19 vaccines...including the additional dose for older adults...will be covered under Medicare Part B, Medicaid, and most private plans.

If needed, connect patients to resources for no-cost vaccines, such as the local health department or CDC’s Bridge Access Program.

Anticipate that FDA will decide on the strains for the 2024-2025 COVID-19 vaccines in May...and CDC will vote on the fall plan in June.

Check our resource, COVID-19 Vaccines, for updates.

Key References

  • CDC. Use of COVID-19 vaccines in the United States. Interim clinical considerations. Last updated March 1, 2024. (Accessed March 5, 2024).
  • CDC. ACIP Presentation Slides: February 28-29, 2024 Meeting. Last updated February 29, 2024. (Accessed March 5, 2024).
  • Wallace M. Evidence to Recommendations Framework: Additional Dose of 2023-2024 Formula COVID-19 Vaccine in Older Adults. Last updated February 28, 2024. (Accessed March 5, 2024).
  • DeCuir J, Payne AB, Self WH, et al. Interim Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged ≥18 Years - VISION and IVY Networks, September 2023-January 2024. MMWR Morb Mortal Wkly Rep. 2024 Feb 29;73(8):180-188.
Pharmacy Technician's Letter. April 2024, No. 400405

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