What to know about the 2023-2024 COVID-19 vaccines

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Updated March 5, 2024 – On February 28, 2024, the Centers for Disease Control and Prevention recommended people ages 65+ receive an additional dose of the 2023-2024 COVID-19 vaccine at least four months after receiving their first dose of the 2023-2024 COVID-19 vaccine.

Q: Who should get the 2023-2024 COVID-19 vaccine?

A: The Centers for Disease Control and Prevention (CDC) recommends everyone ages 6 months and older should receive the 2023–2024 COVID-19 vaccine, regardless of previous COVID-19 infection.

A: People should get the 2023–2024 vaccine as soon as possible, as long as it’s been at least eight weeks after receiving the most recent dose of any COVID-19 vaccine. People who have recently recovered from a COVID-19 infection can wait 90 days before getting the updated vaccine.

Respiratory virus season begins in October, and it will take about 2 weeks for the updated vaccine to provide maximum protection after someone receives it.

As of February 28, 2024, people age 65+ are recommended to receive a booster dose of the 2023-2024 COVID-19 vaccine at least four months after receiving their first dose.

Q: Is the 2023-2024 COVID-19 vaccine better than previous versions?

A: Yes. The 2023–2024 vaccines are monovalent vaccines designed based on the XBB.1.5 Omicron subvariant. The XBB variant and its many subvariants account for a great majority of the COVID-19 strains currently circulating, and because those strains are so similar, the updated vaccines (made by Moderna, Pfizer and Novavax) should provide better protection against severe COVID-19 complications and hospitalization caused by the Omicron strains circulating now.

The previous, bivalent mRNA boosters made by Pfizer and Moderna and released in September 2022 were designed based on two strains—the original COVID-19 strain that emerged at the start of the pandemic, plus Omicron BA.4/5. Most people’s immunity from that vaccination has waned, and those strains are no longer circulating; the bivalent vaccine is no longer available.

Q: Does it matter if I’ve never been vaccinated against COVID-19, or if I’ve not completed a primary series or received any boosters?

A: For most people ages 6 months and older, a single dose of the 2023–2024 COVID-19 vaccine is recommended, regardless of previous vaccination history. The exceptions are some children under age 5 and people age 12+ receiving the 2023-2024 Novavax vaccine who have never been vaccinated.

  • Children ages 6 months through 4 years who have never received a COVID-19 vaccination should receive a full primary series with either mRNA vaccine (Moderna or Pfizer).
    • Moderna: two doses, with dose 2 received at least four weeks after dose 1.
    • Pfizer: three doses, with dose 2 received at least three weeks after dose 1, and dose 3 received at least eight weeks after that.
  • Children ages 6 months through 4 years who have started but not yet completed their primary series should complete the primary series with a 2023–2024 mRNA vaccine, using the same brand they’ve already received.
  • Children ages 5 to 11 should get a single dose of either brand of 2023–2024 mRNA vaccine, regardless of vaccination history.
  • People ages 12 and older have the option of getting either one dose of an mRNA vaccine (Pfizer or Moderna) regardless of vaccination history, OR they can get the 2023-2024 non-MRNA COVID-19 vaccine from Novavax (one dose if they’ve previously been vaccinated against COVID-19; two doses, three weeks apart, if they’ve never received a COVID-19 vaccine).

Q: What are the recommendations for immunocompromised people?

A: The recommended number and intervals of doses of the 2023–2024 COVID-19 vaccine for people who are moderately or severely immunocompromised are based on COVID-19 vaccination history and the vaccine manufacturer.

Immunocompromised people of any age who have:

  • not received any previous COVID-19 vaccines should receive three doses of either brand of 2023–2024 mRNA vaccine.
    • Moderna: Dose 2 should be received four weeks after dose 1; and dose 3 received at least four weeks after dose 2.
    • Pfizer: Dose 2 should be received three weeks after dose 1; and dose 3 received at least eight weeks after dose 2.
  • started but have not completed a primary series should complete the primary series with a 2023–2024 mRNA vaccine, using the same brand they’ve already received; then receive an additional dose of the same brand at least four weeks (Moderna) or at least eight weeks (Pfizer) later.
  • completed a primary series should receive one dose of either brand of 2023–2024 mRNA vaccine.

Immunocompromised people ages 12 and older have the option of receiving the 2023-2024 (non-mRNA) Novavax COVID-19 vaccine. Dosing recommendations can be found here.

Additional doses beyond these recommendations may be administered at the discretion of the health care provider, based on the individual’s personal health situation. Immunocompromised people or those at higher risk, such as older adults, should discuss additional doses with their health care provider.

Q: Is there a non-mRNA vaccine available from Novavax?

A: The original non-mRNA Novavax COVID-19 vaccine is no longer authorized. In its place, a non-MRNA 2023-2024 COVID-19 vaccine made by Novavax is authorized for people ages 12 and older. It was developed based on Omicron subvariant XBB.1.5.

Q: Can I get the 2023-2024 COVID-19 vaccine at the same time as the flu and RSV vaccines?

A: Yes, it is safe and effective for eligible people to receive any combination of COVID-19, flu and respiratory syncytial virus (RSV) vaccines at the same time. It is also safe and effective for eligible infants and toddlers to receive nirsevimab—monoclonal antibody treatment to protect against RSV—at the same time as they receive COVID-19 and flu vaccines.

Q: Will I have to pay for the 2023-2024 COVID-19 vaccine?

A: No. Previous rounds of COVID-19 vaccines and boosters were purchased by the federal government and distributed at no cost to states and the public. This time, health care providers and pharmacies are purchasing the 2023–2024 vaccines on the commercial market directly from the manufacturers, as they do for other vaccines, and providing them at no cost to the public under most insurance plans (including Medicare and Oregon Health Plan). You may need to use an approved, in-network pharmacy or health care facility. Check with your insurance provider if you have questions.

For uninsured or underinsured adults, the CDC has launched the Bridge Access Program, which provides COVID-19 vaccines at no cost to patients through providers, pharmacies (uninsured only), local health centers, tribal or territorial health departments through December 2024.

Uninsured children can receive the updated COVID-19 vaccine at no cost under the existing federal Vaccines for Children program. Additionally, eligible children and adults in Oregon can receive vaccines at no cost through OHA’s Vaccine Access Program.

A comprehensive guide to insurance coverage for COVID-19, RSV and flu vaccines can be found here.