At a Glance: Interim COVID-19 Immunization Schedule

EDITOR'S NOTE: Tables 1 and 2 are accurate as of publication by the CDC on July 23, 2022. The COVID-19 vaccination schedules are accurate as of July 21, 2022.

On June 17, 2022, the FDA authorized the Moderna and Pfizer-BioNTech COVID-19 vaccines for use in children 6 months to 5 years of age,¹ and many parents and caregivers across the country breathed a sigh of relief. Endorsement by the Advisory Committee on Immunization Practices (ACIP) and the CDC followed,² and distribution of these vaccines across the United States began immediately.

The authorization of the vaccine for this final group means that COVID-19 immunizations are available for individuals age 6 months and older. This month, Drug Topics® is providing an overview of the latest interim guidance, direct from the CDC, on administering these vaccines.

Key to Table 1

* Complete the primary series with same product. If the vaccine product previously administered cannot be determined or is no longer available, any age-appropriate mRNA COVID-19 vaccine product may be administered at least 28 days after the first dose. Any COVID-19 vaccine product (age appropriate) may be administered for a booster dose. It does not need to be the same product used for the primary series. An mRNA COVID-19 vaccine is preferred.

† Persons with a recent SARS-CoV-2 infection may consider delaying a primary series or booster dose by 3 months from symptom onset or positive test (if infection was asymptomatic).

‡ Some studies in adolescents and adults have shown the small risk of myocarditis associated with mRNA COVID-19 vaccines might be reduced and peak antibody responses and vaccine effectiveness may be increased with an interval longer than 4 weeks. An 8-week interval may be optimal for people who are not moderately or severely immunocompromised and ages 6 months–64 years, especially for males ages 12–39 years.

§ Age-appropriate mRNA COVID-19 vaccines are preferred over the Janssen COVID-19 vaccine for all vaccine doses for all vaccine-eligible people 18 years of age and older. Janssen COVID-19 vaccine should only be used in limited situations. See: www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

¶ mRNA vaccine must be used.

** People ages 18-49 years: Those who received Janssen COVID-19 vaccine as both their primary series dose and booster dose may receive a second booster dose using an mRNA COVID-19 vaccine at least 4 months after the Janssen booster dose.

Key to Table 2

* Complete the primary series with same product. If the vaccine product previously administered cannot be determined or is no longer available, any age-appropriate mRNA COVID-19 vaccine product may be administered at least 28 days after the first dose. Any COVID-19 vaccine product (age appropriate) may be administered for a booster dose. It does not need to be the same product used for the primary series.

† Persons with a recent SARS-CoV-2 infection may consider delaying a primary series or booster dose by 3 months from symptom onset or positive test (if infection was asymptomatic).

‡ Some studies in adolescents and adults have shown the small risk of myocarditis associated with mRNA COVID-19 vaccines might be reduced and peak antibody responses and vaccine effectiveness may be increased with an interval longer than 4 weeks. An 8-week interval may be optimal for people who are not moderately or severely immunocompromised and ages 6 months–64 years, especially for males ages 12–39 years.

References

1. Coronavirus (COVID-19) update: FDA authorizes Moderna and Pfizer-BioNTech COVID-19 vaccines for children down to 6 months of age. News release. FDA. June 17, 2022. Accessed July 19, 2022 https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-moderna-and-pfizer-biontech-covid-19-vaccines-children 

2. CDC recommends COVID-19 vaccines for young children. News release. CDC. June 18, 2022. Accessed July 19, 2022. https://www.cdc.gov/media/releases/2022/s0618-children-vaccine.html 

3. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. CDC. Reviewed June 30, 2022. Accessed July 12, 2022. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html