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CDC OKs additional COVID vaccine doses for immunocompromised children

May 2, 2023

The Centers for Disease Control and Prevention (CDC) has updated its mRNA COVID-19 vaccination schedule to include additional vaccine doses for people who are moderately or severely immunocompromised.

Changes include the following:

  • Three bivalent mRNA doses are recommended at the time of initial vaccination for people ages 6 months and older.
  • One or two bivalent mRNA vaccine doses are recommended for people ages 6 months and older who previously received only monovalent doses, depending on age and vaccine product.
  • People who previously received a bivalent mRNA vaccine dose(s) have the option to receive one or more additional bivalent mRNA doses.

To view all updates, see the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States.

The Food and Drug Administration (FDA) also revised its emergency use authorization (EUA) fact sheets for Pfizer-BioNTech COVID-19 bivalent vaccine and the Moderna COVID-19 bivalent vaccine to reflect the changes (see resources below).

The changes come after health officials recently approved a plan to simplify COVID-19 vaccination while acknowledging complexities remain for vaccinating young children. Those changes include using only bivalent versions of mRNA COVID-19 vaccines, with most children and adults now needing just one bivalent dose regardless of their vaccination history.

The previous changes, approved in mid-April by the CDC and FDA, are aimed at reducing the number of different mRNA COVID-19 vaccine vials from 11 to five and eliminating look-alikes that cause confusion. Officials hope the new guidance will reduce errors and improve uptake.

Less than 17% of people have received a bivalent vaccine, including just under 8% of adolescents ages 12-17 years, less than 5% of children ages 5-11 years and 0.6% of both 2- to 4-year-olds and those younger than 2 years, according to CDC data.

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