Stay Sharp 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.

Expect your pharmacist to explain that these vaccines are also effective against circulating variants, including EG.5.1 (“Eris”) and BA.2.86 (“Pirola”)...and that bivalent vaccines should no longer be used.

And they’ll reinforce that COVID-19 vaccines are the best tool we have to reduce risk of hospitalization and death from COVID-19.

Be aware, any age-appropriate 2023-2024 COVID-19 vaccine can be used for everyone 6 months and older without contraindication. Both Moderna and Pfizer-BioNTech are authorized down to age 6 months.

Let your team know it’s ONE dose of updated COVID-19 vaccine for patients 5 years and older...regardless of prior vaccination.

Keep in mind that there should be an interval of about 2 months after a bivalent vaccine to give the 2023-2034 vaccine...or about 3 months after a recent COVID-19 infection.

For kids under 5 years and people who are immunocompromised, the number of COVID-19 vaccine doses varies based on immune status and prior vaccination. But at least 1 dose should be the 2023-2024 vaccine.

Stay vigilant for vaccine preparation changes. For example, all Pfizer doses are now 0.3 mL...and only the pediatric formulation will require dilution.

Let patients know that COVID-19 vaccines are no longer government-funded and cost about $120 to $130/dose.

But 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.

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

Use our resource, COVID-19 Vaccines, to learn about differences and similarities between products.

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.
Pharmacy Technician's Letter. October 2023, No. 391001

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