How to Know When (and If) You Need Another COVID Vaccine
What started out as a simple recipe for COVID protection—take an injection, come back in three weeks, and take another one—has turned into a Byzantine maze over the past thirty months. The government has realized how confusing the COVID vaccination schedules have become and is trying to simplify them to make them more understandable and reflect how the options have affected our vaccines. Here is the new information you need to know.
Vaccines “initial series” came to an end
The simple original series of vaccines we received—two doses of Moderna or Pfizer monovalent vaccines three weeks apart—does not exist anymore. Monovalent vaccines (as they call initial doses of vaccines) have been phased out by the FDA as we move into a more streamlined vaccination schedule. In fact, there are no longer Moderna or Pfizer monovalent doses for the initial series or booster dose in the US.
Instead of this initial series, if you are a healthy adult, you will simply receive one dose of Moderna or Pfizer bivalent vaccine. If you never received the original series, you now only need one dose of bivalent to be up to date.
If you only received one of the two doses and were looking for the second, it’s time to stop looking. Instead of a second dose to complete this series, you will simply receive a bivalent dose.
For healthy adults and children 6 years of age and older, one dose is sufficient.
Previous booster recommendations made it difficult to understand what you need and when; to make things easier, you now only need one bivalent shot. In the future, this will likely become an annual flu shot, and one day both vaccines may even be available as a combination shot. At this point, whether you’ve ever been vaccinated or revaccinated, all you need is one dose of bivalent vaccine from Moderna or Pfizer and you’re done. If you already have the starter series plus the bivalent booster, you’re all set.
If you haven’t gotten a bivalent booster yet, you should go and get one to keep up to date. If you received a booster at any time since mid-September 2022, you have received a bivalent certificate, since all Moderna and Pfizer boosters were replaced around this time.
The good news is that if you’re not immunocompromised and you’re at least 6 years old, it really is that simple. No matter what you have received previously, be it zero doses, two doses, or seven doses, you still need to make sure you get one bivalent injection or go for one bivalent injection and you’re done. And that’s great because, as always, there are exceptions, as you’ll read below.
Immunocompromised adults and the elderly 65 years of age and older
The good news is that the boosters you’ve been so desperately waiting for are here . While healthy adults get one dose of the bivalent vaccine, people in this group can get two, and advice on who qualifies remains vague, so you shouldn’t ask a lot for one dose at the pharmacy. Usually you just need to sign an attestation form that meets your requirements. This means that you can just go to the pharmacy, tell the vaccinator that you have a weakened immune system and that you need a booster; if they challenge you at all, just say “please provide me with an appraisal form” and that should be it. You sign it to say you’re immunocompromised and they keep fit.
You can also get extra doses throughout the year like we did before, but the bad news is that you’ll need a script from a doctor and a vaccinator to fill it out. Pharmacists have been largely unwilling to comply with these scenarios over the past few years, but the new guidance makes it clear that they must. It’s too early to talk about it, but let’s hope for the best.
I hope that telehealth services fill this gap for immunocompromised people who do not have a healthcare provider, as Paxlovid has done over the past year.
Children under 6 years of age have a more complex schedule
The recommendations get a little more complicated for younger children. Their vaccines use different doses and schedules than the adult versions, so the CDC offers a set of charts to help your doctor determine what your child’s next shot needs.
We describe recommendations for healthy children below. However, if your child is immunocompromised, it’s best to discuss their situation with their pediatrician to make sure they get the right amount and type of vaccines.
Children from 6 months to 4 years
Les bébés will still need an initial series of doses of the vaccine to kick-start their immunity. It’s complicated, so pay attention and when in doubt, refer to the CDC table .
If your child has never received a COVID vaccine, they will need:
- Two doses of Moderna bivalent vaccine four to eight weeks apart, or
- Three doses of Pfizer bivalent vaccine with an interval of three to eight weeks between the first and second doses and at least eight weeks between the second and third doses.
If your child started but did not complete their initial streak:
- If they received one dose of Moderna monovalent vaccine, they will need one Moderna bivalent dose at least eight weeks after the last vaccine dose.
- If they received one dose of Pfizer monovalent vaccine, they will need two doses of Pfizer bivalent vaccine, the first three to eight weeks after the monovalent vaccine dose, and then a second dose eight weeks after that.
- If they have received two monovalent doses of Pfizer, they will need one bivalent dose of Pfizer at least eight weeks after the last dose of the vaccine.
If your child completed the initial streak and received a bivalent booster:
- Until they need additional doses.
Children 5 years old
If your child has never received a COVID vaccine, they will need:
- Two doses of Moderna bivalent vaccine four to eight weeks apart, or
- One dose of Pfizer bivalent vaccine.
If your child started but did not complete their initial streak:
- If they received one dose of Moderna monovalent vaccine, they will need one dose of Moderna bivalent vaccine at least four weeks after the last vaccine dose.
- If they have received one or two doses of Pfizer monovalent vaccine, they need one dose of Pfizer vaccine at least eight weeks after their last dose of vaccine.
If your child completed the initial streak and received a bivalent booster:
- Until they need additional doses.
Novavax and J&J
If you haven’t heard of Novavax, it’s a late addition to the game, but it’s important nonetheless. Instead of an mRNA vaccine, a traditional protein vaccine is used. There are arguments for better or worse, but if you’re someone who couldn’t get an mRNA vaccine for a good reason or because the word RNA scared you, then this vaccine is for you. However, be aware that if you are Hispanic or Latino , this vaccine may be less effective. Most of Novavax’s research predates the Omicron variant, so while the numbers in the research look great, none of them are new enough for our current options.
If you are 12 years old or older and you can find a place that offers it, Novavax’s two-dose regimen would be considered your “original series”, but getting a bivalent mRNA converter is still recommended. You can get a Novavax booster six months after your original streak.
J&J is still authorized but almost impossible to find and only allowed in “very limited situations”. Even if you qualify, you’ll have a hell of a lot of time to track it down.
If you have J&J, it is recommended to get a bivalent mRNA booster, whether Moderna or Pfizer.
Yes, you still need to get vaccinated
I won’t waste time on whether we are still in a pandemic; seems insulting to the 600 people who died yesterday from COVID . One in ten infections (these aren’t people, they’re infections) result in some form of long-term COVID , and we live in a country with less than perfect healthcare and no real social network for the temporarily or permanently disabled, with no federal reimbursement for COVID treatment or testing. , or guaranteed sick leave, paid or otherwise. Most people will have COVID many times during their lives, as you have probably already experienced. The math is not in your favor. It’s a textbook “fuck and find out” situation.
COVID vaccines are the most tested vaccines in human history, having been put into the hands of 5.5 billion people – that’s a billion, b. In the US alone, 270 million people received the vaccine. Yes, pharmaceutical companies cash in on them, but pharmaceutical companies can be evil and still make medical discoveries that save lives.
Getting a vaccine is now relatively easy, and you can go to almost any pharmacy for it. You can see places nearby in advance. Hot tip: I know of at least five cases where people met their partner while waiting for a vaccine, and speaking only for themselves, they have a better chance than Bumble. If you are afraid of needles or the medical facility, call a friend to come with you. If you don’t get a ride, call your county’s COVID hotline (they still exist, if not, call your county health department). They will deliver the vaccinator to your home or take you to the vaccination site. If you are afraid of exposed medical situations, call an independent pharmacy and ask them to inject you outside.