Age 5 years and received Pfizer-BioNTech primary series: 1 bivalent Pfizer-BioNTech booster dose. This reduction in body weight was not seen in the offspring of rats that had exposures that were 5 times higher than the clinical exposures at the authorized human dose.3. endstream endobj startxref For information on using ritonavir-boosted nirmatrelvir in pediatric patients, see Special Considerations in Children, Therapeutic Management of Nonhospitalized Children With COVID-19, and Therapeutic Management of Hospitalized Children With COVID-19. Not only will this help to produce a more robust antibody response, but by the time youre ready to be boosted, there might be a newer version of the vaccine available that will specifically work against Omicron. Among the 2,085 patients who were randomized within 5 days of symptom onset (mITT1 analysis), COVID-19-related hospitalizations and all-cause deaths occurred in 8 of 1,039 patients (0.77%) in the ritonavir-boosted nirmatrelvir arm and in 66 of 1,046 patients (6.3%) in the placebo arm (89% relative risk reduction; 5.6% estimated absolute reduction; 95% CI, 7.2% to 4.0%; P < 0.001). For more information, see considerations for COVID-19 revaccination. The mean age was 46 years, 51% of the patients were men, and 72% were White. Studies of infants who were exposed to ritonavir through breast milk suggest that the amount of ritonavir that transfers through breast milk is negligible and not considered clinically significant.32 The decision to feed breast milk while taking ritonavir-boosted nirmatrelvir should take into consideration the benefits of breastfeeding, the need for the medication, any underlying risks of infant exposure to the drug, and the potential adverse outcomes of COVID-19. booster dose should be an mRNA COVID- 19 vaccine (i.e., Pfizer - BioNTech or Moderna). In the following exceptional situations, a different COVID-19 vaccine may be administered to complete a primary series at a minimum interval of 28 days from the last COVID-19 vaccine dose: The bivalent mRNA vaccines (i.e., Moderna and Pfizer-BioNTech) arenotcurrently authorized to be used for the primary series with the following exception: children ages 6 months4 years who received 2 primary series doses of a monovalent Pfizer-BioNTech vaccine should receive a bivalent Pfizer-BioNTech vaccine for their third primary series dose. Am I considered fully vaccinated if I was vaccinated in another country? The effects also could lead to the development of new conditions, such as diabetes or a heart or nervous . Laboratory testing is not recommended for the purpose of vaccine decision-making. Quarantine. If possible, those quarantining should also stay away from the people they live with, particularly those who are . Ages 6 months 4 years and completed Pfizer-BioNTech primary series: No booster dose is recommended at this time. No. Among these patients, dysgeusia and diarrhea occurred more frequently in ritonavir-boosted nirmatrelvir recipients than in placebo recipients (6% vs. 0.3% and 3% vs. 2%, respectively). Arbel R, Wolff Sagy Y, Hoshen M, et al. The most common adverse effects of ritonavir-boosted nirmatrelvir are dysgeusia, diarrhea, hypertension, and myalgia. Tables with guidance on managing specific drug-drug interactions: Nirmatrelvir must be administered with ritonavir to achieve sufficient therapeutic plasma concentrations. The optimal timing will depend on your individual circumstances, including how severe your illness was, how long its been since your symptoms resolved and what your risk for re-exposure is. Nirmatrelvir, an orally active MPRO inhibitor, is a potent inhibitor of SARS-CoV-2 variants of concern. The Centers for Disease Control and Prevention (CDC) is saying that before getting your Covid-19 vaccine or vaccine booster you should consider waiting for three months after you first. Determining the time course of CYP3A inhibition by potent reversible and irreversible CYP3A inhibitors using a limited sampling strategy. test, though this isnt a C.D.C. For booster vaccination, Moderna and Pfizer-BioNTech are recommended. Those who are considering receipt of the Janssen COVID-19 Vaccine should see Appendix A: Guidance for use of Janssen COVID-19 Vaccine. Nirmatrelvir is an oral protease inhibitor that is active against MPRO, a viral protease that plays an essential role in viral replication by cleaving the 2 viral polyproteins.1 It has demonstrated antiviral activity against all coronaviruses that are known to infect humans.2 Nirmatrelvir is packaged with ritonavir (as Paxlovid), a strong cytochrome P450 (CYP) 3A4 inhibitor and pharmacokinetic boosting agent that has been used to boost HIV protease inhibitors. What is the recommended bivalent booster vaccine (i.e. After revaccination with the primary series, the patient should receive 1 bivalent mRNA booster dose. This CDC guidance is meant to supplementnot replaceany federal, state, local, territorial, or tribal health and safety laws, rules, and regulations. Ritonavir-boosted nirmatrelvir is not recommended for patients with known or suspected severe hepatic impairment (i.e., Child-Pugh Class C), and it should be used with caution in patients with pre-existing liver diseases, liver enzyme abnormalities, or hepatitis. For more information, see Coadministration of COVID-19 vaccines with other vaccines. Antibodies are an indicator of the bodys efforts to fight off the SARS-CoV-2 virus. It is also known as long COVID. Viral and symptom rebound in untreated COVID-19 infection. How do I verify if a person is moderately or severely immunocompromised? Able to Mask Isolation Guidance; Yes Stay home and isolate for at least the first 5 days; you are probably most infectious during these 5 days And most people who get vaccinated develop a strong and predictable antibody response. Stader F, Khoo S, Stoeckle M, et al. The treatment course of ritonavir-boosted nirmatrelvir for COVID-19 is 5 days. They help us to know which pages are the most and least popular and see how visitors move around the site. %PDF-1.6 % Available at: Hiremath S, McGuinty M, Argyropoulos C, et al. If a person moves from a younger age group to an older age group during the primary series or between the primary series and receipt of the booster dose, they should receive the vaccine dosage for the older age group for all subsequent doses with the following exception: The Food and Drug Administration (FDA) authorization requires that children who receive the Pfizer-BioNTech COVID-19 Vaccine and transition from age 4 years to 5 years during the primary series must complete the series they start. Ritonavir-boosted nirmatrelvir may be used in patients who are hospitalized for a diagnosis other than COVID-19, provided they have mild to moderate COVID-19, are at high risk of progressing to severe disease, and are within 5 days of symptom onset. New COVID-19 booster shots specially formulated to fight multiple omicron variants are available now for children and adults ages 12 and over. Novavax COVID-19 vaccine for booster vaccination and Janssen COVID-19 Vaccine for primary series and booster vaccination should only be used in limited situations. CDC COVID-19 Vaccination Interim Clinical Considerations FAQs for the Interim Clinical Considerations for COVID-19 Vaccination On This Page Vaccination Schedule and Use Vaccine Dosage and Formulation Booster Doses People who are Moderately or Severely Immunocompromised Vaccination and SARS-CoV-2 Laboratory Testing HHS Secretary Xavier Becerra said on Tuesday that public health officials are particularly focused on making sure people ages 50 and older get boosted this month. For more information, see timing, spacing, age transitions, and interchangeability of COVID-19 vaccines. Takashita E, Kinoshita N, Yamayoshi S, et al. Ritonavir-boosted nirmatrelvir has significant drug-drug interactions, primarily due to the ritonavir component of the combination. Can they get a bivalent booster dose? Can people with prior or current SARS-CoV-2 infection receive a COVID-19 vaccine? Antibody testing is not currently recommended to assess the need for vaccination in an unvaccinated person or to assess immunity to SARS-CoV-2 following COVID-19 vaccination or after SARS-CoV-2 infection. Patients who undergo HCT or CAR-T-cell therapy should be revaccinated for the monovalent primary series andbivalentmRNA booster dose received before or during treatment. Federal health officials continue to recommend that everyone get vaccinated and boosted, regardless of whether they've had Covid-19 in the past. 1941 0 obj <>stream If they have not yet received a booster shot, do they still need to get one? People who previously received orthopoxvirus vaccination (either JYNNEOS or ACAM2000), particularly adolescent or young adult males, might consider waiting 4 weeks before receiving a COVID-19 vaccine (i.e., Moderna, Novavax, or Pfizer-BioNTech) because of the observed risk for myocarditis and pericarditis after receipt of ACAM2000 orthopoxvirus vaccine and COVID-19 vaccines (i.e., Moderna, Novavax, or Pfizer-BioNTech) and the unknown risk for myocarditis and pericarditis after JYNNEOS administration. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. However, there are additional considerations for Moderna, Novavax, and Pfizer-BioNTech COVID-19 vaccines if administering an orthopoxvirus (monkeypox) vaccine. The CDC cleared a fourth dose of the old vaccines in March for this age group. An oral SARS-CoV-2 MPRO inhibitor clinical candidate for the treatment of COVID-19. Post-COVID-19 condition refers to the longer-term effects some people experience after their COVID-19 infection. Adults (18 and older) can decide which booster to get, though Pfizer and Moderna boosters are preferred in most situations, per the CDC. Ranganath N, OHoro JC, Challener DW, et al. A booster shot reminds the body to bump up its defenses even faster than the first or second shot in a matter of days. Ritonavir-boosted nirmatrelvir has significant drug-drug interactions, primarily due to the ritonavir component of the combination. Janssen COVID-19 Vaccine is not authorized for use as a second booster. It is considered a vaccine administration error; you are required to report COVID-19 vaccine administration errors to the Vaccine Adverse Event Reporting System (VAERS). People who were initially immunized with . Anderson AS, Caubel P, Rusnak JM, Investigators E-HT. People who received two doses and caught Covid had more than 50% protection against infection. If your risk of reinfection is low for example if you work remotely, are generally healthy and can adhere to public health guidelines for masking and social distancing it might make sense to wait until your natural immunity is waning, which could occur up to three months after an infection, before getting boosted, he said. The primary and booster dosages are the same; the bivalent dose can be counted as a primary series dose. Ali Ellebedy, an immunologist at the Washington University School of Medicine in St. Louis, said that it might make sense to wait until youve fully recovered or can get a negative P.C.R. Soares H, Baniecki ML, Cardin R, et al. Prescribing nirmatrelvir/ritonavir for COVID-19 in advanced CKD. And the guidance on when to schedule a booster appointment after recovering from Covid-19 is less than clear. If a dose is administered earlier than the grace period, see Appendix D for guidance on corrective actions. The mechanisms of action for both nirmatrelvir and ritonavir and the results of animal studies of ritonavir-boosted nirmatrelvir suggest that this regimen can be used safely in pregnant individuals. If a bivalent Moderna vaccine is administered for a primary dose: Repeat the dose immediately (no minimum interval) with a monovalent Moderna vaccine because administration of the bivalent Moderna vaccine will result in a lower-than-authorized primary series dosage. If you are age 18 or older, and got the Janssen COVID-19 vaccine, you can get either of the mRNA vaccine bivalent boosters at least two months after your shot. In general, people whove been infected with the coronavirus tend to have lower levels of antibodies than those whove been vaccinated, said Aubree Gordon, an epidemiologist at the University of Michigan. There is no hard and fast rule for when to schedule a booster shot after having Covid-19. Vaccines provide a tailored set of instructions for the immune system to use in the absence of any distractions, such as an active infection, said Paul Thomas, an immunologist at St. Jude Childrens Research Hospital in Memphis. While nearly 22 million adults 50 and older have received a second booster dose, most people 5 and . What should be done if the incorrect vaccine formulation is administered based on a patients age? Anyone can read what you share. Fewer ritonavir-boosted nirmatrelvir recipients discontinued the study drug due to an adverse event than placebo recipients (2% vs. 4%). People who have stayed asymptomatic since the current COVID-19 exposure. "COVID-19 vaccination decreases the risk of severe disease, hospitalization, and death from COVID-19. The bivalent booster dose is administered at least 2 months after completion of the primary series. People who don't meet the above criteria should still quarantine, the CDC says. hb```, cbM When you get infected with the coronavirus, your immune system mounts a series of responses that bulk up the bodys defenses against future infections. For additional information on the vaccination schedule, see: Yes. Remdesivir, molnupiravir and nirmatrelvir remain active against SARS-CoV-2 Omicron and other variants of concern. Adults 18 and older who got Moderna can get boosted . Jha said everyone else age 12 or older should get a booster shot as soon as they can, particularly the elderly, people with serious medical conditions and those with weak immune systems. Heres what we know. However, it may also increase concentrations of certain concomitant medications, thereby increasing the potential for serious and sometimes life-threatening drug toxicities. Children ages 6 months4 years who completed the Moderna primary series are recommended to receive 1 bivalent Moderna booster dose. Those who have been within 6 feet of someone with COVID for a cumulative total of at least 15 minutes over a 24-hour period should quarantine for five days if unvaccinated or more than six. All Rights Reserved. The trial demonstrated that starting ritonavir-boosted nirmatrelvir within 5 days of symptom onset in these patients reduced the risk of hospitalization or death through Day 28 by 89% compared to placebo.3,4 This efficacy is comparable to remdesivir (87% relative reduction)5 and greater than the efficacy reported for molnupiravir (31% relative reduction).6 However, these agents have not been directly compared in clinical trials. When a child who received a mixed primary dose series turns age 5 years, the child may receive 1 bivalent booster dose with either Moderna or Pfizer-BioNTech vaccine. Age 5 years and completed Moderna primary series: 1 bivalent mRNA booster dose (Moderna or Pfizer-BioNTech). Katzenmaier S, Markert C, Riedel KD, et al. Read CNBC's latest global health coverage: Got a confidential news tip? No, children ages 6 months4 years who have completed the 3-dose Pfizer-BioNTech primary series with monovalent vaccine cannot get a dose of bivalent Pfizer-BioNTech vaccine. The Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for ritonavir-boosted nirmatrelvir on December 22, 2021, for the treatment of COVID-19.3. Sign up for free newsletters and get more CNBC delivered to your inbox. Studies have shown that waiting a few months after an infection to get boosted can result in a stronger immune response from the shot, according to the CDC. Studies also suggest that the antibodies produced after vaccination tend to remain at protective levels for longer. The EPIC-HR study was a multinational randomized trial that compared the use of ritonavir-boosted nirmatrelvir PO twice daily for 5 days to placebo in nonhospitalized patients aged 18 years with mild to moderate COVID-19 who were at high risk of clinical progression. 1913 0 obj <> endobj Boosting with ritonavir, which is a strong CYP3A inhibitor and a P-glycoprotein inhibitor, is required to increase the exposure of nirmatrelvir to a concentration that is effective against SARS-CoV-2. Booster doses may be heterologous. If your patient received the primary series and 1 or 2 (or more) monovalent booster doses before or during treatment:Revaccinate the patient with the primary series. 2022. The CDC now recommends Pfizer boosters after 5 months, down from 6. The vaccine is derived from the original strain of the coronavirus, and that doesnt really exist anymore, Dr. Ellebedy said. Evaluating the interaction risk of COVID-19 therapies. If a patient accidently received a monovalent mRNA vaccine for the booster dose, the dose generally does not need to be repeated. 2022. Previously, the CDC's recommendations relied primarily on the number of COVID-19 cases in a community to determine the need for mask-wearing. The dosage is the same as the first booster dose Now, however, the agency's guidelines are based on three measures: new COVID-related . My patient who is moderately or severely immunocompromised underwent HCT or CAR-T cell therapy after receiving the primary series and 2 monovalent mRNA booster doses. My patient is moderately or severely immunocompromised and previously received EVUSHELD. If a bivalent Pfizer-BioNTech vaccine is administered in error for a primary series dose: Do not repeat the dose. Millions of people who have recently developed Covid-19 may have some new questions about their immunity. To date, the recurrence of COVID-19 symptoms following the use of ritonavir-boosted nirmatrelvir has not been associated with progression to severe COVID-19. People who were fully vaccinated within three months of the exposure. For more information see: ATAGI guidance on myocarditis and pericarditis after mRNA COVID-19 vaccines. My patient previously received a monovalent mRNA booster dose(s). What is the guidance for vaccinating preterm infants? Vaccinators and clinic administrators should not deny COVID-19 vaccination to a person because of a lack of documentation. Those who experienced SARS-CoV-2 infection before starting or completing their primary COVID-19 vaccine series may receive their next dose eight weeks after symptoms started or after testing. Jayk Bernal A, Gomes da Silva MM, Musungaie DB, et al. There is no revaccination formonovalentmRNA booster dose(s) received before or during treatment. No. The COVID-19 Treatment Guidelines Panel (the Panel) is committed to updating this document to ensure that health care providers, patients, and policy experts have the most recent information regarding the optimal management of COVID-19 (see the Panel Roster for a list of Panel members). Nirmatrelvir-ritonavir and viral load rebound in COVID-19. 2022. Is EVUSHELD (tixagevimab/cilgavimab) recommended for people who are moderately or severely immunocompromised for pre-exposure prophylaxis? If my patient received a SARS-CoV-2 antibody product (anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma) can they be vaccinated? Anaphylaxis and other hypersensitivity reactions have also been reported. These cookies may also be used for advertising purposes by these third parties. Nirmatrelvir use and severe COVID-19 outcomes during the Omicron surge. Both nirmatrelvir and ritonavir are substrates of CYP3A. The EPIC-SR trial, which included both of these populations, found that ritonavir-boosted nirmatrelvir did not reduce the duration of symptoms and did not have a statistically significant effect on the risk of hospitalization or death compared to placebo, although the event rates were low.7 Some observational studies evaluated the effect of ritonavir-boosted nirmatrelvir in vaccinated individuals who were at high risk of progression to severe COVID-19, but because of the limitations of observational studies, these data are not definitive.8-10 For information on treatment considerations for vaccinated individuals, see Therapeutic Management of Nonhospitalized Adults With COVID-19. We want to hear from you. Patients who were randomized within 3 days of symptom onset (n = 1,379) were included in the modified intention-to-treat (mITT) analysis. Hair and plasma data show that lopinavir, ritonavir, and efavirenz all transfer from mother to infant in utero, but only efavirenz transfers via breastfeeding. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Phone the call centre if you need help booking an appointment. If you have a high risk of reinfection or serious illness whether because of your age, medical conditions, a weakened immune system or because you live or work in a setting that increases your likelihood of exposure then you may want to boost your immunity with an extra vaccine dose sooner rather than later, Dr. Ellebedy added. The child should receive 1 bivalent Pfizer-BioNTech booster dose when they turn age 5 years, and it has been at least 2 months since completing their primary series. Teens 12 to 17 may get the Pfizer booster. People walk by a Covid-19 testing site at Times Square on May 12, 2022 in New York City. See the latest guidance from CDC for Minimizing the Impact of COVID-19 on Individual Persons, Communities, and Healthcare Systems. Patients should complete the 5-day treatment course of ritonavir-boosted nirmatrelvir, because there are concerns that a shorter treatment course may be less effective or lead to resistance. For more information on the recommended vaccination, see COVID-19 vaccination schedule for people who are not moderately or severely immunocompromised. Federal health officials continue to recommend that everyone get vaccinated and boosted, regardless of whether theyve had Covid-19 in the past. Booster doses for children ages 6 months4 years who completed the Pfizer-BioNTech primary series are not currently authorized. You shouldadministerthe second dose as close as possible to the recommended interval after the first dose. Secure .gov websites use HTTPSA lock (LockA locked padlock) or https:// means youve safely connected to the .gov website. People who previously received SARS-CoV-2 antibody products (anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma) as part of COVID-19 treatment, post-exposure prophylaxis, or pre-exposure prophylaxis can be vaccinated at any time; COVID-19 vaccination does not need to be delayed following receipt of monoclonal antibodies or convalescent plasma. For information about COVID-19 vaccine storage, preparation, and administration, visit the COVID-19 Vaccine FAQs for Healthcare Professionals. Viral rebound and the recurrence of COVID-19 symptoms can also occur in the absence of treatment with ritonavir-boosted nirmatrelvir.19,20, The EPIC-HR trial demonstrated a clinical benefit of ritonavir-boosted nirmatrelvir in patients who were not vaccinated and who were at high risk of progressing to severe COVID-19. What is the difference in the booster dose recommendation for children ages 6 months4 years who completed the Moderna vs Pfizer-BioNTech primary series? Before prescribing ritonavir-boosted nirmatrelvir, clinicians should carefully review the patients concomitant medications, including over-the-counter medications, herbal supplements, and recreational drugs, to evaluate potential drug-drug interactions. The Moderna COVID-19 Vaccine, Bivalent is authorized for use as single booster dose in children 6 months through 5 years of age at least two months after completion of a primary series with the . Can a monovalent mRNA vaccine (i.e., Moderna or Pfizer-BioNTech) be used for the booster dose? Looking for U.S. government information and services. Infants of mothers who were vaccinated and/or had COVID-19 or SARS-CoV-2 infection before or during pregnancy should be vaccinated according to the recommended schedule. %%EOF For primary series vaccination, Moderna, Pfizer-BioNTech, and Novavax COVID-19 vaccines are recommended. Can pregnant or breastfeeding people be vaccinated? Resulting in a lower-than-authorized dose: Repeat the dose immediately (no minimum interval) with the age-appropriate dose and formulation. People who previously received 1 or more monovalent booster doses, are recommended to receive 1bivalent booster dose; it should be administered at least 2 months after the last monovalent booster dose. Owen DR, Allerton CMN, Anderson AS, et al. The CDC estimates about 200 million Americans 12 and older are eligible for the updated shot. And theres so much Omicron around right now that if you havent gotten it already, then this is a chance to avoid getting it., https://www.nytimes.com/2022/02/03/well/live/booster-after-covid.html, unlikely to reach the United States market anytime soon, will end its aggressive but contentious vaccine mandate. - Eligible people ages 12-17 years can only receive Pfizer -BioNTech COVID-19 Vaccine. Rai DK, Yurgelonis I, McMonagle P, et al. This applies to primary series and booster doses of vaccine. (Meaning, if you had a mild infection, its been at least five days since your symptoms started, your symptoms are improving and youve been fever-free for at least 24 hours without the help of medications.). Anyone who was infected can experience post-COVID conditions. So no, the vaccine can't make you test . The CDC is also recommending that children between the ages of 5 and 11 that are moderately or severely immunocompromised should get a third dose of the COVID vaccine 28 days after their second . In accordance with general best practices, preterm infants (infants born before 37 weeks gestation), regardless of birth weight, should receive COVID-19 vaccination at their chronological age and according to the same schedule and guidance as for full-term infants and children. Which COVID-19 vaccines are recommended for people with a history of Guillain-Barre syndrome (GBS)? For people with a history of GBS, as for the general population, mRNA (i.e., Moderna or Pfizer-BioNTech) and Novavax COVID-19 vaccines are recommended for the primary series, and an age-appropriate mRNA vaccine is recommended for the booster dose. When ritonavir is used for 5 days, its induction properties are less likely to be clinically relevant than when the drug is used chronically (e.g., in people who take HIV protease inhibitors).30. See, The person would otherwise not complete the primary series. Yes. COVID-19 supplemental clinical guidance #4: nirmatrelvir/ritonavir (Paxlovid) use in patients with advanced chronic kidney disease and patients on dialysis with COVID-19. What is the difference in the booster dose recommendation for children age 5 years who completed the Moderna vs Pfizer-BioNTech primary series? The country is responding to a new virus known as Coronavirus Disease 19 or COVID-19. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Anyone who has received a primary COVID vaccine is eligible two months from. Heres what to know. A COVID booster shot is an additional dose or doses of a vaccine given after the protection provided by the original shot (s) has begun to decrease over time. COVID-19 has resulted in our hospitals and health care system being strained by the number of critically ill people. The risk-benefit assessment for using ritonavir-boosted nirmatrelvir in these patients may include factors such as medical comorbidities, body mass index, vaccination status, and the number and severity of the risk factors for severe disease. Antibody tests for SARS-CoV-2 look for the presence of antibodies made in response to a previous infection or vaccination. Available at: (CTC) BCTC, COVID Therapy Review and Advisory Working Group (CTRAWG). 1928 0 obj <>/Filter/FlateDecode/ID[<3F544AE364F8124FBF39416F3C549081><9CEB8DA5CD9B424CA4573F7CD23B80B2>]/Index[1913 29]/Info 1912 0 R/Length 88/Prev 899777/Root 1914 0 R/Size 1942/Type/XRef/W[1 3 1]>>stream Which COVID-19 vaccines are recommended for people with a history of Bells palsy? requirement to end isolation and may not occur until a few weeks (or even months) later. Ages 6 months 4 years and completed the Moderna primary series: 1 bivalent Moderna booster dose. A person starts but is unable to complete a primary series with the same COVID-19 vaccine due to a contraindication. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. The patient is recommended to receive 1 bivalent mRNA booster dose at least 2 months after repeating the primary series. People who recently had SARS-CoV-2 infection may consider delaying their primary series or booster COVID-19 vaccine dose by 3 months from symptom onset or positive test (if infection was asymptomatic). Everyone ages 6 months and older, including people who are moderately or severely immunocompromised, are recommended to receive COVID-19 vaccination according to the current schedule. Booster shots are available five months after two doses of the Pfizer or Modern vaccine, or two months after a single dose of Johnson & Johnson vaccine.
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