Be Ready for Updated mRNA COVID-19 Vaccines

It’ll be all hands on deck for 2023-2024 COVID-19 that most patients will need one.

Both mRNA vaccines (Moderna, Pfizer-BioNTech) are now monovalent...covering the Omicron XBB.1.5 SARS-CoV-2 variant.

Explain that data show these vaccines are also effective against circulating variants, including EG.5.1 (“Eris”) and BA.2.86 (“Pirola”).

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Clarify that bivalent vaccines should no longer be used.

Reinforce that COVID-19 vaccines are still the best tool we have to reduce risk of hospitalization and death from COVID-19.

Recommend any age-appropriate 2023-2024 COVID-19 vaccine for everyone 6 months and older without contraindication. Both Moderna and Pfizer-BioNTech are authorized down to age 6 months.

Give ONE dose of updated COVID-19 vaccine to patients 5 years and older...regardless of prior vaccination.

Advise waiting about 2 months after a bivalent vaccine to give the 2023-2024 vaccine...or about 3 months after a recent COVID-19 infection.

Follow CDC’s Interim Clinical Considerations, especially for patients who are immunocompromised or kids under 5 years.

For instance, give 2 doses of Moderna or 3 doses of Pfizer-BioNTech to healthy, unvaccinated kids age 6 months to 4 years...with at least one dose being the 2023-2024 vaccine.

And ensure patients who are moderately or severely immunocompromised (taking certain biologics, etc) get at least 3 doses of COVID-19 vaccine, with at least one dose of the 2023-2024 vaccine.

Keep in mind, COVID-19 vaccines are no longer government-funded and cost about $120 to $130/dose.

Expect most payers to cover them at no cost for patients. If needed, help connect patients to resources for no-cost vaccines, such as local health departments or CDC’s Bridge Access Program for adults.

Continue to give other immunizations (flu, RSV, pneumococcal, etc) at the same visit, if needed.

Stay tuned. FDA is evaluating an updated Novavax COVID-19 vaccine.

Experts will continue to monitor variants and vaccine efficacy to update COVID-19 vaccines and recommendations...since the timing of COVID-19 season is still evolving.

Use our resource, COVID-19 Vaccines, to compare options.

Key References

  • CDC. Use of COVID-19 Vaccines in the United States. September 15, 2023. (Accessed September 18, 2023).
  • FDA. FDA Takes Action on Updated mRNA COVID-19 Vaccines to Better Protect Against Currently Circulating Variants. September 11, 2023. (Accessed September 13, 2023).
  • Wallace M. Evidence to Recommendations Framework: 2023-2024 (monovalent, XBB containing) COVID-19 vaccine. September 12, 2023. (Accessed September 13, 2023).
  • Medication pricing by Elsevier, accessed September 2023.
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