At a Glance: Interim COVID-19 Immunization Schedule

Drug Topics Journal, Drug Topics August 2022, Volume 166, Issue 8

The latest guidance for when to administer the COVID-19 vaccine to patients aged 6 months and older.

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